Existing law requires all health care providers and laboratories to report cases of human immunodeficiency virus (HIV) infection to the local health officer and requires the local health officer to report unduplicated HIV cases to the State Department of Public Health. Existing law requires public health records related to HIV or acquired immunodeficiency syndrome (AIDS), containing personally identifying information, that were developed or acquired by a state or local public health agency, or an agent of that agency, to be confidential and not disclosed, except as otherwise provided by law for public health purposes or pursuant to a written authorization by the person who is the subject of the record or by their guardian or conservator. Existing law authorizes certain state or local public health officials to disclose those records to other local, state, or federal public health agencies or to medical researchers when the confidential information is necessary to carry out specified duties of the agency or researcher, including in the investigation, control, or surveillance of disease.

This bill would additionally authorize a health care provider of a patient with an HIV infection that has already been reported to a local health officer as described above to disclose identifying information about the patient to a local health jurisdiction or the department if the disclosure is necessary to complete or supplement an HIV case report or for the local health jurisdiction or the department to carry out its duties in the investigation, control, or surveillance of disease, or the coordination of, linkage to, or reengagement in care for a person, as specified. The bill would make conforming changes to related provisions.

Existing law requires all health care providers and laboratories to report cases of human immunodeficiency virus (HIV) infection to the local health officer and requires the local health officer to report unduplicated HIV cases to the State Department of Public Health. Existing law requires public health records related to HIV or acquired immunodeficiency syndrome (AIDS), containing personally identifying information, that were developed or acquired by a state or local public health agency, or an agent of that agency, to be confidential and not disclosed, except as otherwise provided by law for public health purposes or pursuant to a written authorization by the person who is the subject of the record or by their guardian or conservator. Existing law authorizes certain state or local public health officials to disclose those records to other local, state, or federal public health agencies or to medical researchers when the confidential information is necessary to carry out specified duties of the agency or researcher, including in the investigation, control, or surveillance of disease.

This bill would additionally authorize a health care provider of a patient with an HIV infection that has already been reported to a local health officer as described above to disclose identifying information about the patient to a local health jurisdiction or the department if the disclosure is necessary to complete or supplement an HIV case report or for the local health jurisdiction or the department to carry out its duties in the investigation, control, or surveillance of disease, or the coordination of, linkage to, or reengagement in care for a person, as specified. The bill would make conforming changes to related provisions.

Existing law requires all health care providers and laboratories to report cases of human immunodeficiency virus (HIV) infection to the local health officer and requires the local health officer to report unduplicated HIV cases to the State Department of Public Health. Existing law requires public health records related to HIV or acquired immunodeficiency syndrome (AIDS), containing personally identifying information, that were developed or acquired by a state or local public health agency, or an agent of that agency, to be confidential and not disclosed, except as otherwise provided by law for public health purposes or pursuant to a written authorization by the person who is the subject of the record or by their guardian or conservator. Existing law authorizes certain state or local public health officials to disclose those records to other local, state, or federal public health agencies or to medical researchers when the confidential information is necessary to carry out specified duties of the agency or researcher, including in the investigation, control, or surveillance of disease.

This bill would additionally authorize a health care provider of a patient with an HIV infection that has already been reported to a local health officer as described above to communicate with a local health officer or the department to provide additional information required by law or public health guidelines in order to complete or supplement an HIV case report or if the disclosure is necessary disclose identifying information about the patient to a local health jurisdiction or the department if the disclosure is necessary to complete or supplement an HIV case report or for the local health jurisdiction or the department to carry out its duties in the investigation, control, or surveillance of disease, or the coordination of, linkage to, or reengagement in care for a person, as specified. The bill would make conforming changes to related provisions.

Existing law requires all health care providers and laboratories to report cases of human immunodeficiency virus (HIV) infection to the local health officer and requires the local health officer to report unduplicated HIV cases to the State Department of Public Health. Existing law requires public health records related to HIV or acquired immunodeficiency syndrome (AIDS), containing personally identifying information, that were developed or acquired by a state or local public health agency, or an agent of that agency, to be confidential and not disclosed, except as otherwise provided by law for public health purposes or pursuant to a written authorization by the person who is the subject of the record or by their guardian or conservator. Existing law authorizes certain state or local public health officials to disclose those records to other local, state, or federal public health agencies or to medical researchers when the confidential information is necessary to carry out specified duties of the agency or researcher, including in the investigation, control, or surveillance of disease.

This bill would additionally authorize a health care provider of a patient with an HIV infection that has already been reported to a local health officer as described above to communicate with a local health officer or the department to provide additional information required by law or public health guidelines in order to complete or supplement an HIV case report. The bill would prohibit a provider from disclosing personally identifying confidential information about a patient to a local health jurisdiction or the department unless the disclosure is necessary for the jurisdiction or the department to carry out specified duties. report or if the disclosure is necessary for the local health jurisdiction or the department to carry out its duties in the investigation, control, or surveillance of disease, or the coordination of, linkage to, or reengagement in care for a person, as specified. The bill would make conforming changes to related provisions.

Existing law requires all health care providers and laboratories to report cases of human immunodeficiency virus (HIV) infection to the local health officer and requires the local health officer to report unduplicated HIV cases to the State Department of Public Health. Existing law requires public health records related to HIV or acquired immunodeficiency syndrome (AIDS), containing personally identifying information, that were developed or acquired by a state or local public health agency, or an agent of that agency, to be confidential and not disclosed, except as otherwise provided by law for public health purposes or pursuant to a written authorization by the person who is the subject of the record or by their guardian or conservator. Existing law authorizes certain state or local public health officials to disclose those records to other local, state, or federal public health agencies or to medical researchers when the confidential information is necessary to carry out specified duties of the agency or researcher, including in the investigation, control, or surveillance of disease.

This bill would additionally authorize a health care provider of a patient with an HIV infection that has already been reported to a local health officer as described above to communicate with a local health officer or the department to provide additional information required by law or public health guidelines in order to complete or supplement an HIV case report. The bill would prohibit a provider from disclosing personally identifying confidential information about a patient to a local health jurisdiction or the department unless the disclosure is necessary for the jurisdiction or the department to carry out specified duties. The bill would make conforming changes to related provisions.

Existing law requires all health care providers and laboratories to report cases of human immunodeficiency virus (HIV) infection to the local health officer and requires the local health officer to report unduplicated HIV cases to the State Department of Public Health. Existing law requires public health records related to HIV or acquired immunodeficiency syndrome (AIDS), containing personally identifying information, that were developed or acquired by a state or local public health agency, or an agent of that agency, to be confidential and not disclosed, except as otherwise provided by law for public health purposes or pursuant to a written authorization by the person who is the subject of the record or by their guardian or conservator. Existing law authorizes certain state or local public health officials to disclose those records to other local, state, or federal public health agencies or to medical researchers when the confidential information is necessary to carry out specified duties of the agency or researcher, including in the investigation, control, or surveillance of disease.

This bill would additionally authorize a health care provider of a patient with an HIV infection that has already been reported to a local health officer as described above to communicate with a local health officer or the department to provide additional information required by law or public health guidelines in order to complete or supplement an HIV case report. The bill would prohibit a provider from disclosing personally identifying confidential information about a patient to a local health jurisdiction or the department unless the disclosure is necessary for the jurisdiction or the department to carry out specified duties.

Existing law requires all health care providers and laboratories to report cases of human immunodeficiency virus (HIV) infection to the local health officer and requires the local health officer to report unduplicated HIV cases to the State Department of Public Health. Existing law requires public health records related to HIV or acquired immunodeficiency syndrome (AIDS), containing personally identifying information, that were developed or acquired by a state or local public health agency, or an agent of that agency, to be confidential and not disclosed, except as otherwise provided by law for public health purposes or pursuant to a written authorization by the person who is the subject of the record or by their guardian or conservator. Existing law authorizes certain state or local public health officials to disclose those records to other local, state, or federal public health agencies or to medical researchers when the confidential information is necessary to carry out specified duties of the agency or researcher, including in the investigation, control, or surveillance of disease.

This bill would additionally authorize a health care provider of a patient with an HIV infection that has already been reported to a local health officer as described above to communicate with a local health officer or the department for specified purposes, including to obtain public health recommendations on care and treatment or to refer the patient to services provided by the department. to provide additional information required by law or public health guidelines in order to complete or supplement an HIV case report. The bill would prohibit a provider from disclosing personally identifying confidential information about a patient to a local health jurisdiction or the department unless the disclosure is necessary for the jurisdiction or the department to carry out specified duties.

Existing law requires all health care providers and laboratories to report cases of human immunodeficiency virus (HIV) infection to the local health officer and requires the local health officer to report unduplicated HIV cases to the State Department of Public Health. Existing law requires public health records related to HIV or acquired immunodeficiency syndrome (AIDS), containing personally identifying information, that were developed or acquired by a state or local public health agency, or an agent of that agency, to be confidential and not disclosed, except as otherwise provided by law for public health purposes or pursuant to a written authorization by the person who is the subject of the record or by their guardian or conservator. Existing law authorizes certain state or local public health officials to disclose those records to other local, state, or federal public health agencies or to medical researchers when the confidential information is necessary to carry out specified duties of the agency or researcher, including in the investigation, control, or surveillance of disease.

This bill would additionally authorize a health care provider of a patient with an HIV infection that has already been reported to a local health officer as described above to communicate with a local health officer or the department for specified purposes, including to obtain public health recommendations on care and treatment or to refer the patient to services provided by the department. The bill would prohibit a provider from disclosing personally identifying confidential information about a patient to a local health jurisdiction or the department unless the disclosure is necessary for the jurisdiction or the department to carry out specified duties.

 UNFINISHED BUSINESS  

Bill No: SB 504

Author: Laird (D), et al.

Amended: 9/2/25 in Assembly

Vote: 21

SENATE HEALTH COMMITTEE: 10-0, 3/26/25

AYES: Menjivar, Valladares, Durazo, Gonzalez, Limón, Padilla, Richardson, Rubio, Weber Pierson, Wiener

NO VOTE RECORDED: Grove

SENATE JUDICIARY COMMITTEE: 13-0, 4/22/25

AYES: Umberg, Niello, Allen, Arreguín, Ashby, Caballero, Durazo, Laird, Stern, Valladares, Wahab, Weber Pierson, Wiener

SENATE APPROPRIATIONS COMMITTEE: Senate Rule 28.8

SENATE FLOOR: 36-0, 5/8/25 (Consent)

AYES: Allen, Alvarado-Gil, Archuleta, Arreguín, Ashby, Becker, Blakespear, Cabaldon, Caballero, Cervantes, Choi, Cortese, Dahle, Durazo, Gonzalez, Grayson, Grove, Jones, Laird, Limón, McGuire, McNerney, Menjivar, Niello, Ochoa Bogh, Padilla, Pérez, Richardson, Seyarto, Smallwood-Cuevas, Stern, Strickland, Umberg, Wahab, Weber Pierson, Wiener

NO VOTE RECORDED: Hurtado, Reyes, Rubio, Valladares

ASSEMBLY FLOOR: 79-0, 9/8/25 - See last page for vote

SUBJECT: Communicable diseases: HIV reporting

SOURCE: Author

DIGEST:

This bill permits a health care provider of a patient diagnosed with an Human Immunodeficiency Virus (HIV) infection to disclose personally identifying confidential information to a local health department or the California Department of Public Health (CDPH) to provide additional information required in order to complete or supplement an HIV case report.

Assembly Amendments

of 9/2/25 make nonsubstantive, clarifying changes.

ANALYSIS:

Existing law:

1. Requires CDPH to establish a list of diseases and conditions to be reported by local health officers (LHOs) to CDPH. Requires CDPH to specify the timeliness requirements related to the reporting of each disease and condition, and the mechanisms required for, and the content to be included in, reports made. [Health and Safety Code (HSC) §120130]
2. Requires health care providers and laboratories to report cases of HIV infection to the LHO using patient names on a form developed by CDPH. Requires CDPH and local health department (LHD) employees and contractors to sign confidentiality agreements, which include information related to the penalties for a breach of confidentiality and the procedures for reporting a breach of confidentiality, prior to accessing confidential HIV-related public health records. [HSC §121022]
3. Prohibits public health records relating to HIV/AIDS containing personally identifying information from being disclosed, except for public health purposes or pursuant to a written authorization by the person who is the subject of the record or by the person’s guardian or conservator. Permits CDPH or a LHD, or their agent, to disclose personally identifying information in public health records to other local, state, or federal public health agencies or to corroborating medical researchers, when the confidential information is necessary to carry out the duties of the agency or researcher in the investigation, control, or surveillance of disease, as determined by CDPH or a LHD. [HSC §121025 (a) and (b)]
4. Permits disclosures authorized in 3) above to only include information necessary for the purpose of that disclosure and to be made only upon the agreement that the information will be kept confidential as described in 3) above. Makes unauthorized further disclosure subject to specified penalties. [HSC §121025 (c)]
5. Permits CDPH or LHD staff to further disclose the information to a health care provider who provides care to the HIV-positive person who is the subject of the record for the purpose of assisting in compliance with 2) above. [HSC §121025 (c)(1)]

This bill:

1. Permits a health care provider of a patient diagnosed with an HIV infection, that has already been reported to a LHD, to disclose identifying information about the patient to a LHD or CDPH if the disclosure is necessary to complete or supplement the HIV case report, as determined by the health care provider, the LHD, or CDPH.
2. Permits a health care provider to disclose identifying information about a patient with a diagnosed HIV infection to a LHD or CDPH if the disclosure is necessary for the LHD or CDPH to carry out its duties in the investigation, control, or surveillance of disease, or the coordination of, linkage to, or reengagement in care for a person, as determined by the health care provider, the LHD, or CDPH.
3. Makes technical, clarifying changes to existing law.

Comments

According to the author of this bill:

This bill allows health care providers to share personally identifying information about previously reported HIV infections with local health departments and CDPH when necessary for specified public health purposes. While existing law permits local and state public health officials to share confidential data regarding HIV infections for disease surveillance and surveillance or care coordination, this authorization does not extend to health care providers. This limitation can create barriers to connecting patients with treatment and ensuring continuity of care. This bill enhances coordination between health care providers and public health officials while maintaining strict confidentiality protections.”

Background

According to CDPH, the prevalence of diagnosed HIV infection was 355.6 per 100,000 population in 2022, compared to 343.1 per 100,000 in 2018 – an increase of 3.7%. Of the 142,772 people living with diagnosed HIV infection in 2022, 73.7% were in HIV care and 64.7% achieved viral suppression. Among all racial/ethnic groups, African Americans are the most disproportionately affected by HIV. While Latinx and white individuals make up the largest percentage of persons living with diagnosed HIV, the rate of HIV among African Americans is substantially higher (1,012.3 per 100,000 population, versus 319.5 per 100,000 among whites and 364.8 per 100,000 among Latinx). The rate of new HIV diagnoses among African Americans is 4.4 times higher than whites among men and 5.7 times higher among women. Latinx are also disproportionately affected by HIV with rates of new HIV diagnoses 2.7 times higher than white among men and 1.6 times higher among women.

According to CDPH’s Office of AIDS, in California and the rest of the U.S., HIV infections and AIDS diagnoses are reported through a combination of passive and active surveillance. Passive surveillance is conducted through state required reporting of HIV and AIDS cases by health care providers and reporting of HIV-positive test results from laboratories to local health departments. Active surveillance is accomplished through routine visits to hospitals, physician offices, laboratories, counseling and testing clinics, and outpatient clinics to ensure accuracy of reported data. In California and other states, HIV/AIDS surveillance has historically relied heavily upon active case surveillance, through on-site chart reviews and case report completion by local surveillance staff at the health care provider’s office. To improve timeliness and completeness of reporting and ensure prompt identification and response to emerging problems in the field, the Office of AIDS supports a decentralized reporting system where HIV/AIDS case reports are identified through passive and active surveillance efforts coordinated by California’s 61 local health departments. HIV/AIDS surveillance case data and laboratory reports, reported to local health departments by health care providers and laboratories, is then sent to the HIV/AIDS Surveillance Section via the Lab Data Entry Tool or on the Adult Case Report Form. The Surveillance Section surveillance coordinators review the forms for accuracy and input the information into the Enhanced HIV/AIDS Reporting System, and in turn, submit electronic HIV/AIDS case reports, without personal identifiers, to the federal Centers for Disease Control and Prevention.

Prior/Related Legislation

SB 1333 (Eggman and Roth, Chapter 472, Statutes of 2024) revised the law to permit CDPH and LHDs to disclose personally identifying information in public health records for the coordination of, linkage to, or reengagement in care, as determined by CDPH or the LHD.

FISCAL EFFECT: Appropriation: No Fiscal Com.: Yes Local: No

According to the Assembly Appropriations Committee, there are no state costs.

SUPPORT: (Verified 9/8/25)

AIDS Healthcare Foundation

Beyond AIDS Foundation

California Academy of Preventive Medicine

California Legislative LBGTQ Caucus

California Medical Association

Essential Access Health

Infectious Disease Association of California

OPPOSITION: (Verified 9/8/25)

None received

ARGUMENTS IN SUPPORT: The California Legislative LGBTQ Caucus writes that currently, providers are not explicitly authorized to communicate with public health officials regarding these cases to obtain care recommendations or connect patients with essential services. This limitation creates barriers to care coordination and public health duties. Consistent with the Legislature’s intent to enhance limited data sharing practices to improve the treatment and health outcomes for people living with HIV, it is imperative that we authorize health care providers to disclose personally identifying information regarding previously reported HIV infections when communicating with state or local health officials. AIDS Healthcare Foundation writes that achieving and maintaining a reduced viral load demands continual engagement between the patient and a medical team in order to ensure ongoing monitoring, proper maintenance of medications and swift response to emerging challenges. This bill closes the gap that exists between an HIV care provider and public health official to allow necessary communication about the care needs of a person with HIV. California Academy of Preventative Medicine writes that reporting of cases to public health is legal, but subsequent discussion of patients for coordination of care has had the potential risk of civil and criminal penalties. HIV treatment is only effective if it is continuous. Patients sometimes move or discontinue care, and one of the services provided by public health is assistance to patients to re-engage in care, sometimes with a new provider. Public health staff can also provide education and counseling for patients with HIV infections, and can confidentially refer exposed partners to testing and preventive treatment (PrEP and/or use of condoms), which is done without identifying the name of the patient. However, public health staff may need referrals from care providers in order to know that such services are needed by particular patients.

Ayes: Addis, Aguiar-Curry, Ahrens, Alanis, Alvarez, Arambula, Ávila Farías, Bains, Bauer-Kahan, Bennett, Berman, Boerner, Bonta, Bryan, Calderon, Caloza, Carrillo, Castillo, Chen, Connolly, Davies, DeMaio, Dixon, Elhawary, Ellis, Flora, Fong, Gabriel, Gallagher, Garcia, Gipson, Jeff Gonzalez, Mark González, Hadwick, Haney, Harabedian, Hart, Hoover, Irwin, Jackson, Johnson, Kalra, Krell, Lackey, Lee, Lowenthal, Macedo, McKinnor, Muratsuchi, Ortega, Pacheco, Papan, Patel, Patterson, Pellerin, Petrie-Norris, Quirk-Silva, Ramos, Ransom, Celeste Rodriguez, Michelle Rodriguez, Rogers, Blanca Rubio, Sanchez, Schiavo, Schultz, Sharp-Collins, Solache, Soria, Stefani, Ta, Tangipa, Valencia, Wallis, Ward, Wicks, Wilson, Zbur, Rivas

No Vote Recorded: Nguyen

Prepared by: Melanie Moreno / HEALTH / (916) 651-4111

9/8/25 19:36:09

**** END ****

SENATE THIRD READING

STR Bill Id:SB 504

Author:(Laird)

As Amended Ver:September 2, 2025

Majority vote

SUMMARY

Authorizes, notwithstanding the Confidentiality of Medical Information Act (CMIA), a health care provider of a patient with a human immunodeficiency virus (HIV) infection that has already been reported to a local health officer (LHO) to communicate with an LHO or the Department of Public Health (DPH) to provide identifying information in order to complete or supplement an HIV case report or carry out the LHO or DPH's duties in the investigation, control or surveillance of disease, or the coordination, linkage to and reengagement in case for a person, as determined by the health care provider, the local health jurisdiction, or DPH.

Major Provisions

COMMENTS

Prevalence of HIV in California. According to the DPH Office of Aids report titled "HIV/AIDS Epidemiology and Health Disparities in California 2022," from 2018 through 2022, both the annual number and rate of new HIV diagnoses remained relatively the same in California. The number of new diagnoses increased by 0.4% from 4,863 in 2018 to 4,882 in 2022, while the rate of new diagnoses per 100,000 population declined by 0.8%, from 12.3 to 12.2 during the same time period. Although new HIV diagnoses have declined overall, disparities persist among racial/ethnic groups, gender, age, and transmission categories. Among all racial/ethnic groups, Black/African Americans are the most disproportionately affected by HIV. In 2022, Black/African Americans made up approximately 6% of California's population, yet they accounted for 16% of California's HIV epidemic. Rates among newly diagnosed Black/African American men are 4.4 times higher than white men, and among Black/African American women, 5.7 times higher than white women. Viral suppression among Black/African Americans is typically lower than other race/ethnicities regardless of gender, age, or transmission category. Latinx individuals make up the largest racial/ethnic group among new HIV diagnoses, accounting for 57% of all new HIV diagnoses in 2022; however, they also make up the largest racial/ethnic group in California at almost 40%. Disparities among Latinx individuals include higher rates of HIV diagnoses and lower viral suppression, especially among transgender women, and people with injection drug use history. Rates among newly diagnosed Latinx men are 2.7 times higher than white men, and among Latinx women 1.6 times higher than white women. In addition, among MMSC (male-to-male sexual contact), disparities between Latinx individuals and white individuals have increased from 2018 to 2022. In 2018, the rate of new diagnoses among Latinx MMSC was 2.2 times that of white MMSC; in 2022 it was 3.3 times that of white individuals. In addition, Latinx individuals had a higher proportion of late HIV diagnoses compared to Black/African Americans and white individuals.

The Confidentiality of Medical Information Act (CMIA). The CMIA establishes protections for the use of medical information and prohibits providers of health care, health care service plans, or contractors, from sharing medical information without the patient's written authorization, subject to certain exceptions.

What does this bill do? Existing law authorizes DPH and LHOs to disclose personally identifying information regarding patients diagnosed with HIV to other local, state, or federal public health agencies or to medical researchers when necessary for disease investigation, control, or surveillance or coordination of, linkage to, or reengagement in care for a person. Currently, this authorization does not explicitly extend to health care providers. The author contends that this leads to several challenges with regards to HIV care coordination and disease control, including:

1. Public health records can be incomplete. If a laboratory provides the initial HIV case report, health care providers cannot reach out to public health officials to supplement those records with other information such as comorbidities, social history, name, sex, and gender changes.
2. Providers are limited in their ability to place referrals for patients to state-provided clinical or preventative services. This is especially limiting for providers unfamiliar with state-provided services or HIV care.
3. If a patient moves to another jurisdiction, the provider cannot initiate disclosure of personally identifying information to health officials to ensure continuous care.
4. If a provider must close or suspend their practice, they cannot initiate disclosure of personally identifying information to health officials to ensure continuous care.

A 2015 study titled, "The Contribution of Missed Clinic Visits to Disparities in HIV Viral Load Outcomes" found that missed clinic visits contributed to observed differences in viral load outcomes among Black persons and persons with injection drug use history and achieving an improved understanding of differential visit attendance is imperative to reducing disparities in HIV.

This bill authorizes, notwithstanding the CMIA, a health care provider of a patient with an HIV infection that has already been reported to an LHO as described above to communicate with an LHO or DPH to provide additional information in order to complete or supplement an HIV case report. This bill also authorizes, notwithstanding the CMIA, a health care provider to disclose identifying information about a patient to a LHJ or DPH if the disclosure is necessary for the LHJ or DPH to carry out its duties in the investigation, control, or surveillance of disease, or the coordination of, linkage to, or reengagement in care for a person, as determined by the health care provider, the LHJ or DPH.

According to the Author

This bill allows health care providers to share personally identifying information about previously reported HIV infections with LHDs and DPH, but only when necessary for specified public health purposes. The author continues that while existing law permits local and state public health officials to share confidential data regarding HIV infections for disease surveillance or care coordination, this authorization does not extend to health care providers. The author contends that this limitation can create barriers to connecting patients with treatment and ensuring continuity of care. The author concludes that this bill enhances coordination between health care providers and public health officials while maintaining strict confidentiality protections.

Arguments in Support

The California Legislative LGBTQ Caucus (the Caucus) supports this bill and states that currently, health care providers are required to report HIV infections to LHOs, who then report cases to DPH. However, providers are not explicitly authorized to communicate with public health officials regarding these cases to obtain care recommendations or connect patients with essential services. The Caucus continues that this limitation creates barriers to care coordination and public health duties. The Caucus concludes that consistent with the Legislature's intent to enhance limited data sharing practices to improve the treatment and health outcomes for people living with HIV, it is imperative that the legislature authorize health care providers to disclose personally identifying information regarding previously reported HIV infections when communicating with state or local health officials, only for disease investigation, control, or surveillance or coordination of, linkage to, or reengagement in care.

Arguments in Opposition

None.

FISCAL COMMENTS

According to the Assembly Committee on Appropriations, no state costs.

VOTES

SENATE FLOOR: 36-0-4

YES: Allen, Alvarado-Gil, Archuleta, Arreguín, Ashby, Becker, Blakespear, Cabaldon, Caballero, Cervantes, Choi, Cortese, Dahle, Durazo, Gonzalez, Grayson, Grove, Jones, Laird, Limón, McGuire, McNerney, Menjivar, Niello, Ochoa Bogh, Padilla, Pérez, Richardson, Seyarto, Smallwood-Cuevas, Stern, Strickland, Umberg, Wahab, Weber Pierson, Wiener

ABS, ABST OR NV: Hurtado, Reyes, Rubio, Valladares

ASM HEALTH: 15-0-1

YES: Bonta, Chen, Aguiar-Curry, Caloza, Carrillo, Flora, Mark González, Krell, Patel, Patterson, Celeste Rodriguez, Sanchez, Schiavo, Sharp-Collins, Elhawary

ABS, ABST OR NV: Addis

ASM PRIVACY AND CONSUMER PROTECTION: 15-0-0

YES: Bauer-Kahan, Dixon, Bryan, DeMaio, Irwin, Lowenthal, Macedo, McKinnor, Ortega, Patterson, Pellerin, Petrie-Norris, Ward, Wicks, Wilson

ASM APPROPRIATIONS: 15-0-0

YES: Wicks, Arambula, Calderon, Caloza, Dixon, Elhawary, Fong, Mark González, Hart, Pacheco, Pellerin, Jeff Gonzalez, Solache, Ta, Tangipa

UPDATED

VERSION: September 2, 2025

CONSULTANT: Eliza Brooks / HEALTH / (916) 319-2097 FN: 0001439

SENATE THIRD READING

STR Bill Id:SB 504

Author:(Laird)

As Amended Ver:June 26, 2025

Majority vote

SUMMARY

Authorizes a health care provider of a patient with a human immunodeficiency virus (HIV) infection that has already been reported to a local health officer (LHO) to communicate with an LHO or the Department of Public Health (DPH) to provide personally identifying confidential information in order to complete or supplement an HIV case report or carry out the LHO or DPH's duties in the investigation, control or surveillance of disease, or the coordination, linkage to and reengagement in case for a person, as determined by the health care provider, the local health jurisdiction, or DPH.

Major Provisions

COMMENTS

Prevalence of HIV in California. According to the DPH Office of Aids report titled "HIV/AIDS Epidemiology and Health Disparities in California 2022," from 2018 through 2022, both the annual number and rate of new HIV diagnoses remained relatively the same in California. The number of new diagnoses increased by 0.4% from 4,863 in 2018 to 4,882 in 2022, while the rate of new diagnoses per 100,000 population declined by 0.8%, from 12.3 to 12.2 during the same time period. Although new HIV diagnoses have declined overall, disparities persist among racial/ethnic groups, gender, age, and transmission categories. Among all racial/ethnic groups, Black/African Americans are the most disproportionately affected by HIV. In 2022, Black/African Americans made up approximately 6% of California's population, yet they accounted for 16% of California's HIV epidemic. Rates among newly diagnosed Black/African American men are 4.4 times higher than white men, and among Black/African American women, 5.7 times higher than white women. Viral suppression among Black/African Americans is typically lower than other race/ethnicities regardless of gender, age, or transmission category. Latinx individuals make up the largest racial/ethnic group among new HIV diagnoses, accounting for 57% of all new HIV diagnoses in 2022; however, they also make up the largest racial/ethnic group in California at almost 40%. Disparities among Latinx individuals include higher rates of HIV diagnoses and lower viral suppression, especially among transgender women, and people with injection drug use history. Rates among newly diagnosed Latinx men are 2.7 times higher than white men, and among Latinx women 1.6 times higher than white women. In addition, among MMSC (male-to-male sexual contact), disparities between Latinx individuals and white individuals have increased from 2018 to 2022. In 2018, the rate of new diagnoses among Latinx MMSC was 2.2 times that of white MMSC; in 2022 it was 3.3 times that of white individuals. In addition, Latinx individuals had a higher proportion of late HIV diagnoses compared to Black/African Americans and white individuals.

What does this bill do? Existing law authorizes DPH and LHOs to disclose personally identifying information regarding patients diagnosed with HIV to other local, state, or federal public health agencies or to medical researchers when necessary for disease investigation, control, or surveillance or coordination of, linkage to, or reengagement in care for a person. Currently, this authorization does not explicitly extend to health care providers. The author contends that this leads to several challenges with regards to HIV care coordination and disease control, including:

1. Public health records can be incomplete. If a laboratory provides the initial HIV case report, health care providers cannot reach out to public health officials to supplement those records with other information such as comorbidities, social history, name, sex, and gender changes.
2. Providers are limited in their ability to place referrals for patients to state-provided clinical or preventative services. This is especially limiting for providers unfamiliar with state-provided services or HIV care.
3. If a patient moves to another jurisdiction, the provider cannot initiate disclosure of personally identifying information to health officials to ensure continuous care.
4. If a provider must close or suspend their practice, they cannot initiate disclosure of personally identifying information to health officials to ensure continuous care.

A 2015 study titled, "The Contribution of Missed Clinic Visits to Disparities in HIV Viral Load Outcomes" found that missed clinic visits contributed to observed differences in viral load outcomes among Black persons and persons with injection drug use history and achieving an improved understanding of differential visit attendance is imperative to reducing disparities in HIV.

This bill authorizes, notwithstanding existing penalties and prohibitions on disclosure of HIV test results, a health care provider of a patient with an HIV infection that has already been reported to an LHO as described above to communicate with an LHO or DPH to provide additional personally identifying confidential information required by law or public health guidelines in order to complete or supplement an HIV case report. This bill also authorizes a health care provider to disclose personally identifying confidential information about a patient to a local health jurisdiction (LHJ) or DPH if the disclosure is necessary for the LHJ or DPH to carry out its duties in the investigation, control, or surveillance of disease, or the coordination of, linkage to, or reengagement in care for a person, as determined by the health care provider, the LHJ or DPH.

Please see the Assembly Committee on Health analysis for additional background.

According to the Author

This bill allows health care providers to share personally identifying information about previously reported HIV infections with LHDs and DPH, but only when necessary for specified public health purposes. The author continues that while existing law permits local and state public health officials to share confidential data regarding HIV infections for disease surveillance or care coordination, this authorization does not extend to health care providers. The author contends that this limitation can create barriers to connecting patients with treatment and ensuring continuity of care. The author concludes that this bill enhances coordination between health care providers and public health officials while maintaining strict confidentiality protections.

Arguments in Support

The California Legislative LGBTQ Caucus (the Caucus) supports this bill and states that currently, health care providers are required to report HIV infections to LHOs, who then report cases to DPH. However, providers are not explicitly authorized to communicate with public health officials regarding these cases to obtain care recommendations or connect patients with essential services. The Caucus continues that this limitation creates barriers to care coordination and public health duties. The Caucus concludes that consistent with the Legislature's intent to enhance limited data sharing practices to improve the treatment and health outcomes for people living with HIV, it is imperative that the legislature authorize health care providers to disclose personally identifying information regarding previously reported HIV infections when communicating with state or local health officials, only for disease investigation, control, or surveillance or coordination of, linkage to, or reengagement in care.

Arguments in Opposition

None.

FISCAL COMMENTS

According to the Assembly Committee on Appropriations, no state costs.

VOTES

SENATE FLOOR: 36-0-4

YES: Allen, Alvarado-Gil, Archuleta, Arreguín, Ashby, Becker, Blakespear, Cabaldon, Caballero, Cervantes, Choi, Cortese, Dahle, Durazo, Gonzalez, Grayson, Grove, Jones, Laird, Limón, McGuire, McNerney, Menjivar, Niello, Ochoa Bogh, Padilla, Pérez, Richardson, Seyarto, Smallwood-Cuevas, Stern, Strickland, Umberg, Wahab, Weber Pierson, Wiener

ABS, ABST OR NV: Hurtado, Reyes, Rubio, Valladares

ASM HEALTH: 15-0-1

YES: Bonta, Chen, Aguiar-Curry, Caloza, Carrillo, Flora, Mark González, Krell, Patel, Patterson, Celeste Rodriguez, Sanchez, Schiavo, Sharp-Collins, Elhawary

ABS, ABST OR NV: Addis

ASM PRIVACY AND CONSUMER PROTECTION: 15-0-0

YES: Bauer-Kahan, Dixon, Bryan, DeMaio, Irwin, Lowenthal, Macedo, McKinnor, Ortega, Patterson, Pellerin, Petrie-Norris, Ward, Wicks, Wilson

ASM APPROPRIATIONS: 15-0-0

YES: Wicks, Arambula, Calderon, Caloza, Dixon, Elhawary, Fong, Mark González, Hart, Pacheco, Pellerin, Jeff Gonzalez, Solache, Ta, Tangipa

UPDATED

VERSION: June 26, 2025

CONSULTANT: Eliza Brooks / HEALTH / (916) 319-2097 FN: 0001279

Date of Hearing: August 20, 2025

ASSEMBLY COMMITTEE ON APPROPRIATIONS

Buffy Wicks, Chair

SBPCA Bill Id:SB 504

Author:(Laird) – As Amended Ver:June 26, 2025

Urgency: No State Mandated Local Program: No Reimbursable: No

SUMMARY:

This bill authorizes a health care provider to disclose confidential and identifying information to public health officials (1) to complete or supplement an HIV case report, or (2) if the disclosure is needed for disease investigation, control, or surveillance, or to provide care for a person.

Specifically, this bill:

1. Authorizes, notwithstanding existing penalties and prohibitions on disclosure of HIV test results, a health care provider of a patient diagnosed with an HIV infection that has already been reported to disclose personally identifying confidential information to a local health officer (LHO) or the California Department of Public Health (CDPH) provide additional information required by law or public health guidelines to complete or supplement a confidential HIV case report.
2. Allows a health care provider to disclose personally identifying confidential information about a patient to a local health jurisdiction (LHJ) or CDPH if the disclosure is necessary for the LHJ or CDPH to carry out its duties in the investigation, control, or surveillance of disease, or the coordination of, linkage to, or reengagement in care for a person, as determined by the health care provider, LHJ or CDPH.
3. Makes other technical and conforming changes.

FISCAL EFFECT:

No state costs.

COMMENTS:

1. Purpose. According to the author:

Senate Bill 504 allows health care providers to share personally identifying information about previously reported HIV infections with local health departments and California Department of Public Health, but only when necessary for specified public health purposes.

While existing law permits local and state public health officials to share confidential data regarding HIV infections for disease surveillance and surveillance or care coordination, this authorization does not extend to health care providers. This limitation can create barriers to connecting patients with treatment and ensuring continuity of care. Senate Bill 504 enhances coordination between health care providers and public health officials while maintaining strict confidentiality protections.

1. Background. Federal and state medical privacy and confidentiality laws, including HIV-specific laws, provide protection against undesired disclosure of a person’s HIV status. Existing law authorizes CDPH and LHOs to disclose personally identifying information regarding patients diagnosed with HIV to other local, state, or federal public health agencies or to medical researchers when necessary for disease investigation, control, or surveillance or coordination of, linkage to, or reengagement in care for a person. However, this authorization does not explicitly extend to health care providers, which the author contends leads to several challenges with regards to HIV care coordination and disease control, including:
   1. Incomplete public health records: If a laboratory provides the initial HIV case report, health care providers are not authorized to provide public health officials with other information such as comorbidities to supplement the initial case report
   2. Health care providers are limited in their ability to place referrals for patients to state-provided clinical or preventative services, especially HIV care.
   3. If a patient moves to another jurisdiction, or a health care provider closes or suspends their practice, the provider may not initiate disclosure of personally identifying information to health officials to ensure continuous care.
2. Related Legislation. SB 278 (Cabaldon) authorizes the disclosure of a Medi-Cal managed care (MCMC) beneficiary’s HIV test result that includes identifying information to their MCMC plan, without the beneficiary’s authorization, for the purpose of administering quality improvement programs.

Analysis Prepared by: Allegra Kim / APPR. / (916) 319-2081

Date of Hearing: July 16, 2025

Fiscal: Yes

ASSEMBLY COMMITTEE ON PRIVACY AND CONSUMER PROTECTION

Rebecca Bauer-Kahan, Chair

SBPCA Bill Id:SB 504

Author:(Laird) – As Amended Ver:June 26, 2025

SENATE VOTE: 36-0

SUBJECT: Communicable diseases: HIV reporting

SYNOPSIS

Existing law provides strong confidentiality provisions for the protection of human immunodeficiency virus (HIV) test information and the identity of the test subject, including prohibitions on sharing that information and civil penalties for the negligent release of that information. There are limited exceptions to the prohibition on sharing this data. These exceptions serve various public health purposes, such as requiring health care providers and laboratories to report all cases of HIV infection to the local health officer (LHO) and the California Department of Public Health (CDPH), as provided.

This bill authorizes a health care provider of a patient with an HIV infection, to communicate with a LHO or CDPH to provide additional information required by law or public health guidelines in order to complete or supplement an HIV case report, if the patient’s HIV infection has already been reported under current law.

This bill enjoys the support of the California Legislative LGBTQ Caucus, the California Medical Association, and the AIDS Healthcare Foundation, among others. There is no registered opposition.

This bill was previously heard by the Health Committee, where it passed on a 15-0-1 vote.

THIS BILL:

1. Authorizes a health care provider of a patient diagnosed with an HIV infection that has already been reported to disclose personally identifying confidential information to an LHO or CDPH to provide additional information required by law or public health guidelines in order to complete or supplement the confidential HIV case report.
2. Prohibits a health care provider from disclosing personally identifying confidential information about a patient to a local health jurisdiction (LHJ) or CDPH unless the disclosure is necessary for the LHJ or CDPH to carry out its duties in the investigation, control, or surveillance of disease, or the coordination of, linkage to, or reengagement in care for a person, as determined by the health care provider, LHJ or CDPH.
3. Makes other technical and conforming changes.

EXISTING LAW:

1. Establishes under federal law, the Health Insurance Portability and Accountability Act of 1996 (HIPAA), which sets standards for the privacy of individually identifiable health information and security standards for the protection of electronic protected health information, including, through regulations, that a HIPAA-covered entity may not condition the provision of treatment, payment, enrollment in a health plan, or eligibility for benefits on the provision of an authorization, except under specified circumstances. Provides that if HIPAA’s provisions conflict with state law, the provision that is most protective of patient privacy prevails. (42 U.S.C. § 1320d, et seq.; 45 Code Fed. Regs. Part 164.)
2. Establishes the Confidentiality of Medical Information Act, which establishes protections for the use of medical information. (Civ. Code § 56 et seq.)
   1. Prohibits providers of health care, health care service plans, or contractors, as defined, from sharing medical information without the patient’s written authorization, subject to certain exceptions. (Civ. Code § 56.10.)
3. Requires health care providers and laboratories to report cases of HIV infection to the (LHOs using patient names on a form developed by CDPH to ensure knowledge of current trends in the HIV epidemic and to ensure that California remains competitive for federal HIV and AIDS funding.
   1. Requires CDPH and local health department (LHD) employees and their contractors to sign confidentiality agreements annually.
   2. Requires any potential or actual breach of confidentiality of HIV-related public health records to be investigated by the LHO, in coordination with CDPH, when appropriate. The LHO is required to immediately report any evidence of an actual breach of confidentiality of HIV-related public health records at a city or county level to CDPH and the appropriate law enforcement agency. (Health & Saf. Code § 121022.)
4. Prohibits public health records relating to HIV/AIDS containing personally identifying information that were developed or acquired by CDPH or an LHD, or their agent, from being disclosed, except for public health purposes or pursuant to a written authorization by the person who is the subject of the record or by that person’s guardian or conservator. (Health & Saf. Code §121025(a).)
   1. Authorizes CDPH or an LHD, or their agent, to disclose personally identifying information in public health records to other local, state, or federal public health agencies or to corroborating medical researchers, when the confidential information is necessary to carry out the duties of the agency or researcher in the investigation, control, or surveillance of disease, as determined by CDPH or an LHD. (Id. at (b).)
   2. Authorizes CDPH and LHDs to disclose personally identifying information in public health records for the coordination of, linkage to, or reengagement in care, as determined by CDPH or a LHD. (Ibid.)
   3. Any disclosures made are to include only the information necessary for the purpose of the disclosure and only upon agreement that the information will be kept confidential. (Id. at (c).)
   4. Authorizes the disclosure of personally identifying information in public health records related to HIV/AIDS by specified state and local public health staff to the HIV-positive person or health care provider for the purpose of proactively offering and coordinating care and treatment services to the HIV-positive person. (Id. at (c)(2).)
5. Prohibits the disclosure of the results of an HIV test to any third party in a manner that provides identifying characteristics of the subject of the test, except to the physician who ordered the test or the subject’s health care providers for the purposes of diagnosis, care, or treatment of the patient. Excludes state-regulated health care service plans from being considered health care providers. (Health & Saf. Code § 120980 and §120985.)
6. Provides various protections for the confidentiality of the results of HIV tests and the identity of the person who took the test, including a prohibition on compelled disclosure of identifying information regarding HIV tests in civil, criminal, administrative, or legislative proceedings, and establishes civil penalties for negligently disclosing the result of such a test in a manner that identifies or provides identifying characteristics of the person to whom the test results apply. (Health & Saf. Code § 120975 & 120980.)

COMMENTS:

1) Author’s statement. According to the author:

Senate Bill 504 allows health care providers to share personally identifying information about previously reported HIV infections with local health departments and California Department of Public Health, but only when necessary for specified public health purposes.

While existing law permits local and state public health officials to share confidential data regarding HIV infections for disease surveillance and surveillance or care coordination, this authorization does not extend to health care providers. This limitation can create barriers to connecting patients with treatment and ensuring continuity of care. Senate Bill 504 enhances coordination between health care providers and public health officials while maintaining strict confidentiality protections.

2) Background. Due to the historical stigma and discrimination associated with HIV/AIDS, California law restricts the sharing and disclosure of HIV-related data and includes specific penalties for unauthorized disclosures. These HIV-specific restrictions were put in place to protect people living with HIV from undesired disclosure of their HIV status.

General federal and state medical privacy and confidentiality laws, as well as HIV-specific laws, offer protection against undesired disclosure of a person’s HIV status. However, these protections can sometimes lead to the inability to share data within the healthcare community, posing difficulties for health care and public health entities looking to identify, prevent, and treat HIV.

According to the author, existing law authorizes CDPH and local health officials to disclose personally identifying information regarding patients diagnosed with HIV to other local, state, or federal public health agencies or to medical researchers when necessary for disease investigation, control, or surveillance or for coordinating, linking, or reengaging in care for a person.

Currently, this authorization does not extend to health care providers, meaning they cannot initiate disclosure to public health officials. This leads to several challenges with regard to HIV care coordination and disease control, including:

1. Public health records can be incomplete. If a laboratory provides the initial report, health care providers cannot reach out to public health officials to supplement those records with other information such as comorbidities, social history, or name, sex, and gender changes.
2. Providers are limited in their ability to place referrals for patients to state-provided clinical or preventative services. This is especially limiting for providers unfamiliar with state-provided services or HIV care.
3. If a patient moves to another jurisdiction, the provider cannot initiate disclosure of personally identifying information to health officials to ensure continuous care.
4. If a provider must close or suspend their practice, they cannot initiate disclosure of personally identifying information to health officials to ensure continuous care.

3) What this bill would do. This bill permits a health care provider treating a patient with an HIV infection that has already been reported to an LHO as described above to communicate with an LHO or CDPH to provide additional information required by law or public health guidelines in order to complete or supplement an HIV case report.

This bill additionally prohibits a provider from disclosing any personally identifying confidential information about a patient to an LHJ or CDPH unless the disclosure is necessary for the LHJ or CDPH to carry out its duties in the investigation, control, or surveillance of disease, or the coordination of, linkage to, or reengagement in care for a person, as determined by the health care provider, the LHJ or CDPH.

ARGUMENTS IN SUPPORT: The California Medical Association writes in support:

Currently, health care providers are required to report HIV infections to local health officers, who then report cases to the California Department of Public Health (CDPH). However, providers are not explicitly authorized to communicate with public health officials regarding these cases to obtain care recommendations or connect patients with essential services. This limitation creates barriers to care coordination and public health duties.

SB 504 allows health care providers to communicate with local health officials and CDPH regarding previously reported cases for public health purposes, including disease control and care coordination. This collaboration would enhance HIV treatment and reinforce California’s public health infrastructure to better protect people living and diagnosed with HIV.

The California Legislative LGBTQ Caucus also writes in support:

Currently, health care providers are required to report HIV infections to local health officers, who then report cases to the California Department of Public Health (CDPH). However, providers are not explicitly authorized to communicate with public health officials regarding these cases to obtain care recommendations or connect patients with essential services. This limitation creates barriers to care coordination and public health duties.

Consistent with the Legislature’s intent to enhance limited data sharing practices to improve the treatment and health outcomes for people living with HIV, it is imperative that we authorize health care providers to disclose personally identifying information regarding previously reported HIV infections when communicating with state or local health officials, only for disease investigation, control, or surveillance or coordination of, linkage to, or reengagement in care.

SB 504 allows health care providers to communicate with local health officials and CDPH regarding previously reported cases for public health purposes, including disease control and care coordination.

REGISTERED SUPPORT / OPPOSITION:

Support

Aids Healthcare Foundation
Beyond Aids Foundation
California Legislative LGBTQ Caucus
California Medical Association (CMA)
Essential Access Health

Opposition

None on file.

Analysis Prepared by: Julie Salley / P. & C.P. / (916) 319-2200

Date of Hearing: June 24, 2025

ASSEMBLY COMMITTEE ON HEALTH

Mia Bonta, Chair

SBPCA Bill Id:SB 504

Author:(Laird) – As Amended Ver:April 24, 2025

SENATE VOTE: 36-0

SUBJECT: Communicable diseases: HIV reporting.

SUMMARY: Authorizes a health care provider of a patient with a human immunodeficiency virus (HIV) infection that has already been reported to a local health officer (LHO) to communicate with an LHO or the Department of Public Health (DPH) to provide additional information required by law or public health guidelines in order to complete or supplement an HIV case report. Specifically, this bill:

1. Authorizes a health care provider of a patient diagnosed with an HIV infection that has already been reported to disclose personally identifying confidential information to an LHO or DPH to provide additional information required by law or public health guidelines in order to complete or supplement the confidential HIV case report.
2. Prohibits a health care provider from disclosing personally identifying confidential information about a patient to a local health jurisdiction (LHJ) or DPH unless the disclosure is necessary for the LHJ or DPH to carry out its duties in the investigation, control, or surveillance of disease, or the coordination of, linkage to, or reengagement in care for a person, as determined by the health care provider, LHJ or DPH.
3. Makes other technical and conforming changes.

EXISTING LAW:

1. Requires DPH to establish a list of diseases and conditions to be reported by LHOs to DPH, including HIV. Requires DPH to specify the timeliness requirements related to the reporting of each disease and condition, and the mechanisms required for, and the content to be included in, reports made. [Health and Safety Code (HSC) § 120130]
2. Requires health care providers and laboratories to report cases of HIV infection to the LHO using patient names on a form developed by DPH. Requires DPH and local health department (LHD) employees and contractors to sign confidentiality agreements, which include information related to the penalties for a breach of confidentiality and the procedures for reporting a breach of confidentiality, prior to accessing confidential HIV-related public health records. [HSC § 121022]
3. Prohibits public health records relating to HIV/AIDS containing personally identifying information from being disclosed, except for public health purposes or pursuant to a written authorization by the person who is the subject of the record or by the person’s guardian or conservator. Permits DPH or an LHD, or their agent, to disclose personally identifying information in public health records to other local, state, or federal public health agencies or to corroborating medical researchers, when the confidential information is necessary to carry out the duties of the agency or researcher in the investigation, control, or surveillance of disease, as determined by DPH or an LHD. [HSC § 121025 (a) and (b)]
4. Permits disclosures authorized in 3) above to only include information necessary for the purpose of that disclosure and to be made only upon the agreement that the information will be kept confidential. Makes any unauthorized further disclosure subject to specified penalties. [HSC § 121025 (c)]
5. Permits DPH or LHD staff to further disclose the information to a health care provider who provides care to the HIV-positive person who is the subject of the record for the purpose of assisting in compliance with 2) above. [HSC § 121025 (c)(1)]
6. Requires blood banks and plasma centers to test all human whole blood and blood components received to detect the presence of viral hepatitis and HIV. Authorizes an LHO disclose to a blood bank or plasma center, on a confidential basis, whether blood or blood components previously transfused may have been donated by a person infected with HIV, in order to implement the blood bank’s or plasma center’s program to notify a recipient of blood or blood components that might have transmitted HIV. Prohibits the blood bank or plasma center from disclosing information that would identify a donor and requires the blood bank or plasma center destroy information communicated to it after reviewing its records as necessary. [HSC § 1603.1]
7. Requires the blood bank or plasma center to report the presence of viral hepatitis to the LHO within 72 hours, as specified. Requires a physician, hospital, or other health care provider to report all AIDS cases, HIV infections, and viral hepatitis infections, including transfusion-associated cases or infections, to the LHO with the information required, and within the timeframes established by the DPH, pursuant to regulations, as specified. [HSC § 1603.1]
8. Prohibits civil liability or criminal sanction from being imposed for disclosure of test results to an LHO if the disclosure is necessary to locate and notify a blood or blood components donor of a reactive result if reasonable efforts by the blood bank or plasma center to locate the donor have failed. Upon completion of the LHO efforts to locate and notify a blood or blood components donor of a reactive result, all records obtained from the blood bank or plasma center pursuant to this subdivision, or maintained pursuant to this subdivision, including, but not limited to, any individual identifying information or test results, shall be expunged by the LHO. [HSC § 1603.3]
9. Makes any person who willfully, maliciously, or negligently discloses the results of an HIV test to a third party in a manner that identifies or provides identifying characteristics of the person to whom the test results apply, except pursuant to a written authorization, except as provided in existing law 2), 6), 7) or 8) above or any other statute that expressly provides an exemption to this section subject to specified penalties. [HSC § 120980]

FISCAL EFFECT: According to the Senate Appropriations Committee, pursuant to Senate Rule 28.8, negligible state costs.

COMMENTS:

1. PURPOSE OF THIS BILL. According to the author, this bill allows health care providers to share personally identifying information about previously reported HIV infections with LHDs and DPH, but only when necessary for specified public health purposes. The author continues that while existing law permits local and state public health officials to share confidential data regarding HIV infections for disease surveillance or care coordination, this authorization does not extend to health care providers. The author contends that this limitation can create barriers to connecting patients with treatment and ensuring continuity of care. The author concludes that this bill enhances coordination between health care providers and public health officials while maintaining strict confidentiality protections.
2. BACKGROUND.
   1. Prevalence of HIV in California. According to the DPH Office of Aids report titled “HIV/AIDS Epidemiology and Health Disparities in California 2022,” from 2018 through 2022, both the annual number and rate of new HIV diagnoses remained relatively the same in California. The number of new diagnoses increased by 0.4% from 4,863 in 2018 to 4,882 in 2022, while the rate of new diagnoses per 100,000 population declined by 0.8%, from 12.3 to 12.2 during the same time period. Although new HIV diagnoses have declined overall, disparities persist among racial/ethnic groups, gender, age, and transmission categories. Among all racial/ethnic groups, Black/African Americans are the most disproportionately affected by HIV. In 2022, Black/African Americans made up approximately 6% of California’s population, yet they accounted for 16% of California’s HIV epidemic. Rates among newly diagnosed Black/African American men are 4.4 times higher than white men, and among Black/African American women, 5.7 times higher than white women. Viral suppression among Black/African Americans is typically lower than other race/ethnicities regardless of gender, age, or transmission category. Latinx individuals make up the largest racial/ethnic group among new HIV diagnoses, accounting for 57% of all new HIV diagnoses in 2022; however, they also make up the largest racial/ethnic group in California at almost 40%. Disparities among Latinx individuals include higher rates of HIV diagnoses and lower viral suppression, especially among transgender women, and people with injection drug use history. Rates among newly diagnosed Latinx men are 2.7 times higher than white men, and among Latinx women 1.6 times higher than white women. In addition, among MMSC (male-to-male sexual contact), disparities between Latinx individuals and white individuals have increased from 2018 to 2022. In 2018, the rate of new diagnoses among Latinx MMSC was 2.2 times that of white MMSC; in 2022 it was 3.3 times that of white individuals. In addition, Latinx individuals had a higher proportion of late HIV diagnoses compared to Black/African Americans and white individuals.
   2. What does this bill do? Existing law authorizes DPH and LHOs to disclose personally identifying information regarding patients diagnosed with HIV to other local, state, or federal public health agencies or to medical researchers when necessary for disease investigation, control, or surveillance or coordination of, linkage to, or reengagement in care for a person. Currently, this authorization does not explicitly extend to health care providers. The author contends that this leads to several challenges with regards to HIV care coordination and disease control, including:
      1. Public health records can be incomplete. If a laboratory provides the initial HIV case report, health care providers cannot reach out to public health officials to supplement those records with other information such as comorbidities, social history, name, sex, and gender changes.
      2. Providers are limited in their ability to place referrals for patients to state-provided clinical or preventative services. This is especially limiting for providers unfamiliar with state-provided services or HIV care.
      3. If a patient moves to another jurisdiction, the provider cannot initiate disclosure of personally identifying information to health officials to ensure continuous care.
      4. If a provider must close or suspend their practice, they cannot initiate disclosure of personally identifying information to health officials to ensure continuous care.

A 2015 study titled, “The Contribution of Missed Clinic Visits to Disparities in HIV Viral Load Outcomes” found that missed clinic visits contributed to observed differences in viral load outcomes among Black persons and persons with injection drug use history and achieving an improved understanding of differential visit attendance is imperative to reducing disparities in HIV.

This bill permits a health care provider of a patient with an HIV infection that has already been reported to an LHO as described above to communicate with an LHO or DPH to provide additional information required by law or public health guidelines in order to complete or supplement an HIV case report. This bill additionally prohibits a provider from disclosing personally identifying confidential information about a patient to a LHJ or DPH unless the disclosure is necessary for the LHJ or DPH to carry out its duties in the investigation, control, or surveillance of disease, or the coordination of, linkage to, or reengagement in care for a person, as determined by the health care provider, the LHJ or DPH.

1. SUPPORT. The California Legislative LGBTQ Caucus (the Caucus) supports this bill and states that currently, health care providers are required to report HIV infections to LHOs, who then report cases to DPH. However, providers are not explicitly authorized to communicate with public health officials regarding these cases to obtain care recommendations or connect patients with essential services. The Caucus continues that this limitation creates barriers to care coordination and public health duties. The Caucus concludes that consistent with the Legislature’s intent to enhance limited data sharing practices to improve the treatment and health outcomes for people living with HIV, it is imperative that the legislature authorize health care providers to disclose personally identifying information regarding previously reported HIV infections when communicating with state or local health officials, only for disease investigation, control, or surveillance or coordination of, linkage to, or reengagement in care.
2. RELATED LEGISLATION. SB 278 (Cabaldon) allows for HIV test results to be shared with the Department of Health Care Services or an individual’s Medi-Cal managed care plan without the written authorization of the individual tested for the purpose of proactively offering and coordinating care and treatment services or to administer quality improvement programs designed to improve HIV care for Medi-Cal enrollees. SB 278 passed the Assembly Health Committee on June 17, 2025 with a vote of 15-0.
3. PREVIOUS LEGISLATION. SB 1333 (Eggman and Roth), Chapter 472, Statutes of 2024 permits DPH and LHDs to disclose personally identifying information in public health records for the coordination of, linkage to, or reengagement in care, as determined by DPH or the LHD.
4. DOUBLE REFERRAL. This bill is double referred, upon passage of this committee, it will be referred to the Assembly Committee on Privacy and Consumer Protection.
5. PROPOSED AMENDMENTS. Concerns have been raised regarding ambiguity as it relates to the authorization for a provider to disclose personally identifying confidential information to an LHJ or DPH. To clarify the author’s intent, the Committee may wish to amend this bill to clarify that there are two separate authorizations for a provider to disclose personally identifying information to an LHO or DPH: 1) to complete or supplement the HIV case report and 2) if the disclosure is necessary for the LHJ or DPH to carry out its duties in the investigation, control, or surveillance of disease, or the coordination of, linkage to, or reengagement in care for a person, as determined by the health care provider, the local health jurisdiction, or the department. The Committee may also wish to clarify that the disclosure is authorized notwithstanding existing law 9) above and make technical and conforming changes.

REGISTERED SUPPORT / OPPOSITION:

Support

Aids Healthcare Foundation
California Academy of Preventive Medicine
California Legislative LGBTQ Caucus
California Medical Association
Essential Access Health
Infectious Disease Association of California

Opposition

None on file

Analysis Prepared by: Eliza Brooks / HEALTH / (916) 319-2097

 CONSENT  

Bill No: SB 504

Author: Laird (D), et al.

Amended: 4/24/25

Vote: 21

SENATE HEALTH COMMITTEE: 10-0, 3/26/25

AYES: Menjivar, Valladares, Durazo, Gonzalez, Limón, Padilla, Richardson, Rubio, Weber Pierson, Wiener

NO VOTE RECORDED: Grove

SENATE JUDICIARY COMMITTEE: 13-0, 4/22/25

AYES: Umberg, Niello, Allen, Arreguín, Ashby, Caballero, Durazo, Laird, Stern, Valladares, Wahab, Weber Pierson, Wiener

SENATE APPROPRIATIONS COMMITTEE: Senate Rule 28.8

SUBJECT: Communicable diseases: HIV reporting

SOURCE: Author

DIGEST:

This bill permits a health care provider of a patient diagnosed with an Human Immunodeficiency Virus (HIV) infection to disclose personally identifying confidential information to a local health department or the California Department of Public Health (CDPH) to provide additional information required in order to complete or supplement an HIV case report.

ANALYSIS:

Existing law:

1. Requires the CDPH to establish a list of diseases and conditions to be reported by local health officers (LHOs) to CDPH. Requires CDPH to specify the timeliness requirements related to the reporting of each disease and condition, and the mechanisms required for, and the content to be included in, reports made. [Health and Safety Code (HSC) §120130]
2. Requires health care providers and laboratories to report cases of HIV infection to the LHO using patient names on a form developed by CDPH. Requires CDPH and local health department (LHD) employees and contractors to sign confidentiality agreements, which include information related to the penalties for a breach of confidentiality and the procedures for reporting a breach of confidentiality, prior to accessing confidential HIV-related public health records. [HSC §121022]
3. Prohibits public health records relating to HIV/AIDS containing personally identifying information from being disclosed, except for public health purposes or pursuant to a written authorization by the person who is the subject of the record or by the person’s guardian or conservator. Permits CDPH or a LHD, or their agent, to disclose personally identifying information in public health records to other local, state, or federal public health agencies or to corroborating medical researchers, when the confidential information is necessary to carry out the duties of the agency or researcher in the investigation, control, or surveillance of disease, as determined by CDPH or a LHD. [HSC §121025 (a) and (b)]
4. Permits disclosures authorized in 3) above to only include information necessary for the purpose of that disclosure and to be made only upon the agreement that the information will be kept confidential as described in 3) above. Makes unauthorized further disclosure subject to specified penalties. [HSC §121025 (c)]
5. Permits CDPH or LHD staff to further disclose the information to a health care provider who provides care to the HIV-positive person who is the subject of the record for the purpose of assisting in compliance with 2) above. [HSC §121025 (c)(1)]

This bill

1. Permits a health care provider of a patient diagnosed with an HIV infection to disclose personally identifying confidential information to a LHD or CDPH to provide additional information required in order to complete or supplement an HIV case report.
2. Prohibits a provider from disclosing personally identifying confidential information about a patient to a LHD or CDPH, unless the disclosure is necessary for the LHD or CDPH to carry out its duties in the investigation, control, or surveillance of disease, or the coordination of, linkage to, or reengagement in care for a person, as determined by the LHD or CDPH.
3. Makes technical, clarifying changes to existing law.

Comments

Author’s statement. According to the author, “this bill this bill allows health care providers to share personally identifying information about previously reported HIV infections with local health departments and CDPH when necessary for specified public health purposes. While existing law permits local and state public health officials to share confidential data regarding HIV infections for disease surveillance and surveillance or care coordination, this authorization does not extend to health care providers. This limitation can create barriers to connecting patients with treatment and ensuring continuity of care. This bill enhances coordination between health care providers and public health officials while maintaining strict confidentiality protections.”

Background. According to CDPH, the prevalence of diagnosed HIV infection was 355.6 per 100,000 population in 2022, compared to 343.1 per 100,000 in 2018 – an increase of 3.7%. Of the 142,772 people living with diagnosed HIV infection in 2022, 73.7% were in HIV care and 64.7% achieved viral suppression. Among all racial/ethnic groups, African Americans are the most disproportionately affected by HIV. While Latinx and white individuals make up the largest percentage of persons living with diagnosed HIV, the rate of HIV among African Americans is substantially higher (1,012.3 per 100,000 population, versus 319.5 per 100,000 among whites and 364.8 per 100,000 among Latinx). The rate of new HIV diagnoses among African Americans is 4.4 times higher than whites among men and 5.7 times higher among women. Latinx are also disproportionately affected by HIV with rates of new HIV diagnoses 2.7 times higher than white among men and 1.6 times higher among women.

According to CDPH’s Office of AIDS, in California and the rest of the U.S., HIV infections and AIDS diagnoses are reported through a combination of passive and active surveillance. Passive surveillance is conducted through state required reporting of HIV and AIDS cases by health care providers and reporting of HIV-positive test results from laboratories to local health departments. Active surveillance is accomplished through routine visits to hospitals, physician offices, laboratories, counseling and testing clinics, and outpatient clinics to ensure accuracy of reported data. In California and other states, HIV/AIDS surveillance has historically relied heavily upon active case surveillance, through on-site chart reviews and case report completion by local surveillance staff at the health care provider’s office. To improve timeliness and completeness of reporting and ensure prompt identification and response to emerging problems in the field, the Office of AIDS supports a decentralized reporting system where HIV/AIDS case reports are identified through passive and active surveillance efforts coordinated by California’s 61 local health departments. HIV/AIDS surveillance case data and laboratory reports, reported to local health departments by health care providers and laboratories, is then sent to the HIV/AIDS Surveillance Section via the Lab Data Entry Tool or on the Adult Case Report Form. The Surveillance Section surveillance coordinators review the forms for accuracy and input the information into the Enhanced HIV/AIDS Reporting System, and in turn, submit electronic HIV/AIDS case reports, without personal identifiers, to the federal Centers for Disease Control and Prevention.

Prior/Related Legislation

SB 1333 (Eggman and Roth, Chapter 472, Statutes of 2024) revised the law to permit CDPH and LHDs to disclose personally identifying information in public health records for the coordination of, linkage to, or reengagement in care, as determined by CDPH or the LHD.

FISCAL EFFECT: Appropriation: No Fiscal Com.: Yes Local: No

SUPPORT: (Verified 5/5/25)

AIDS Healthcare Foundation

Beyond AIDS Foundation

California Academy of Preventive Medicine

California Legislative LBGTQ Caucus

Essential Access Health

Infectious Disease Association of California

OPPOSITION: (Verified 5/5/25)

None received

ARGUMENTS IN SUPPORT: The California Legislative LGBTQ Caucus writes that currently, providers are not explicitly authorized to communicate with public health officials regarding these cases to obtain care recommendations or connect patients with essential services. This limitation creates barriers to care coordination and public health duties. Consistent with the Legislature’s intent to enhance limited data sharing practices to improve the treatment and health outcomes for people living with HIV, it is imperative that we authorize health care providers to disclose personally identifying information regarding previously reported HIV infections when communicating with state or local health officials. AIDS Healthcare Foundation writes that achieving and maintaining a reduced viral load demands continual engagement between the patient and a medical team in order to ensure ongoing monitoring, proper maintenance of medications and swift response to emerging challenges. This bill closes the gap that exists between an HIV care provider and public health official to allow necessary communication about the care needs of a person with HIV. California Academy of Preventative Medicine writes that reporting of cases to public health is legal, but subsequent discussion of patients for coordination of care has had the potential risk of civil and criminal penalties. HIV treatment is only effective if it is continuous. Patients sometimes move or discontinue care, and one of the services provided by public health is assistance to patients to re-engage in care, sometimes with a new provider. Public health staff can also provide education and counseling for patients with HIV infections, and can confidentially refer exposed partners to testing and preventive treatment (PrEP and/or use of condoms), which is done without identifying the name of the patient. However, public health staff may need referrals from care providers in order to know that such services are needed by particular patients.

Prepared by: Melanie Moreno / HEALTH / (916) 651-4111

5/7/25 16:05:27

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SENATE JUDICIARY COMMITTEE

Senator Thomas Umberg, Chair

2025-2026 Regular Session

Bill No: SB 504 (Author:Laird)

Version: April 10, 2025

Hearing Date: April 22, 2025

Fiscal: Yes

Urgency: No

Consultant: AM

SUBJECT

Communicable diseases: HIV reporting

DIGEST

This bill authorizes a health care provider of a patient with a human immunodeficiency virus (HIV) infection that has already been reported to a local health officer, as provided under existing law, to communicate with a local health officer (LHO) or the California Department of Public Health (CDPH) to provide additional information required by law or public health guidelines in order to complete or supplement an HIV case report.

EXECUTIVE SUMMARY

Existing law provides strong confidentiality provisions for the protection of HIV test information and the identity of the test subject, including prohibitions on sharing that information and civil penalties for the negligent release of that information. There are limited exceptions to the prohibition on sharing this data. These exceptions serve various public health purposes, such as requiring health care providers and laboratories to report all cases of HIV infection to the LHO and CDPH, as provided. This bill seeks to authorize a health care provider to share confidential HIV test information of a patient diagnosed with an HIV infection that has already been reported to the LHO or CDPH to provide additional information required by law or public health guidelines in order to complete or supplement the HIV case report required under existing law. The bill specifies that a health care provider may only disclose this information if it is necessary for the jurisdiction or CDPH to carry out its duties in the investigation, control, or surveillance of disease, or the coordination of, linkage to, or reengagement in care for a person. The bill is author-sponsored and supported by the AIDS Healthcare Foundation, Beyond Aids Foundation, the California Academy of Preventive Medicine, the California Legislative LGBTQ Caucus, and the Infectious Disease Association of California. No timely opposition was received by the Committee. The bill passed the Senate Health Committee on a vote of 10 to 0.

PROPOSED CHANGES TO THE LAW

Existing federal law:

1. Establishes the Health Insurance Portability and Accountability Act (HIPAA), which provides privacy protections for patients’ protected health information and generally prohibits a covered entity, as defined (health plan, health care provider, and health care clearing house), from using or disclosing protected health information except as specified or as authorized by the patient in writing. (45 C.F.R. §§ 164.500 et. seq.)
2. Provides that if HIPAA’s provisions conflict with a provision of state law, the provision that is the most protective of patient privacy prevails. (45 C.F.R. §§ 164.500 et. seq.)

Existing state law:

1. Establishes the Confidentiality of Medical Information Act, which establishes protections for the use of medical information. (Civ. Code §§ 56 et. seq.)
   1. Prohibits providers of health care, health care service plans, or contractors, as defined, from sharing medical information without the patient’s written authorization, subject to certain exceptions. (Civ. Code § 56.10.)
2. Establishes the Medi-Cal program, which is administered by the Department of Health Care Services (DHCS), and under which qualified low-income individuals receive health care services. (Welf. & Inst. Code §§ 14000 et. seq.)
3. Requires health care providers and laboratories to report cases of HIV infection to the (LHOs using patient names on a form developed by CDPH o ensure knowledge of current trends in the HIV epidemic and to ensure that California remains competitive for federal HIV and AIDS funding.
   1. Requires CDPH and local health department (LHD) employees and their contractors to sign confidentiality agreements annually.
   2. Requires any potential or actual breach of confidentiality of HIV-related public health records to be investigated by the LHO, in coordination with CDPH, when appropriate. The LHO is required to immediately report any evidence of an actual breach of confidentiality of HIV-related public health records at a city or county level to CDPH and the appropriate law enforcement agency. (Health & Saf. Code § 121022.)
4. Prohibits public health records relating to HIV/AIDS containing personally identifying information that were developed or acquired by CDPH or an LHD, or their agent, from being disclosed, except for public health purposes or pursuant to a written authorization by the person who is the subject of the record or by that person’s guardian or conservator. (Health & Saf. Code §121025(a).)
   1. Authorizes CDPH or an LHD, or their agent, to disclose personally identifying information in public health records to other local, state, or federal public health agencies or to corroborating medical researchers, when the confidential information is necessary to carry out the duties of the agency or researcher in the investigation, control, or surveillance of disease, as determined by CDPH or an LHD. (Id. at (b).)
   2. Authorizes CDPH and LHDs to disclose personally identifying information in public health records for the coordination of, linkage to, or reengagement in care, as determined by CDPH or a LHD. (Ibid.)
   3. Any disclosures made are to include only the information necessary for the purpose of the disclosure and only upon agreement that the information will be kept confidential. (Id. at (c).)
5. Authorizes the disclosure of personally identifying information in public health records related to HIV/AIDS by specified state and local public health staff to the HIV-positive person or health care provider for the purpose of proactively offering and coordinating care and treatment services to the HIV-positive person. (Id. at (c)(2).)
6. Prohibits the disclosure of the results of an HIV test to any third party in a manner that provides identifying characteristics of the subject of the test, except to the physician who ordered the test or the subject’s health care providers for the purposes of diagnosis, care, or treatment of the patient. Excludes state-regulated health care service plans from being considered health care providers. (Health & Saf. Code § 120980 and §120985.)
7. Provides various protections for the confidentiality of the results of HIV tests and the identity of the person who took the test, including a prohibition on compelled disclosure of identifying information regarding HIV tests in civil, criminal, administrative, or legislative proceedings, and establishes civil penalties for negligently disclosing the result of such a test in a manner that identifies or provides identifying characteristics of the person to whom the test results apply. (Health & Saf. Code § 120975 & 120980.)

This bill:

1. Authorizes a health care provider to share confidential HIV test information of a patient diagnosed with an HIV infection that has already been reported to the LHO or CDPH to provide additional information required by law or public health guidelines in order to complete or supplement the HIV case report required described in Section 121022 of the Health and Safety Code.
2. Prohibits health care providers from disclosing personally identifying information unless necessary for the local health jurisdiction or CDPH to carry out its duties in the investigation, control, or surveillance of disease, or the coordination of, linkage to, or reengagement in care for a person.

COMMENTS

1. Stated need for the bill

The author writes:

Senate Bill 504 allows health care providers to share personally identifying information about previously reported HIV infections with local health departments and California Department of Public Health, but only when necessary for specified public health purposes.

While existing law permits local and state public health officials to share confidential data regarding HIV infections for disease surveillance and surveillance or care coordination, this authorization does not extend to health care providers. This limitation can create barriers to connecting patients with treatment and ensuring continuity of care. Senate Bill 504 enhances coordination between health care providers and public health officials while maintaining strict confidentiality protections.

1. HIV monitoring and confidentiality

The Senate Health Committee analysis provides useful background on how HIV infections are reported and monitored:

According to CDPH’s Office of AIDS, in California and the rest of the U.S., HIV infections and AIDS diagnoses are reported through a combination of passive and active surveillance. Passive surveillance is conducted through state required reporting of HIV and AIDS cases by health care providers and reporting of HIV-positive test results from laboratories to local health departments. Active surveillance is accomplished through routine visits to hospitals, physician offices, laboratories, counseling and testing clinics, and outpatient clinics to ensure accuracy of reported data. In California and other states, HIV/AIDS surveillance has historically relied heavily upon active case surveillance, through on-site chart reviews and case report completion by local surveillance staff at the health care provider’s office. To improve timeliness and completeness of reporting and ensure prompt identification and response to emerging problems in the field, the Office of AIDS supports a decentralized reporting system where HIV/AIDS case reports are identified through passive and active surveillance efforts coordinated by California’s 61 local health departments. HIV/AIDS surveillance case data and laboratory reports, reported to local health departments by health care providers and laboratories, is then sent to the HIV/AIDS Surveillance Section via the Lab Data Entry Tool or on the Adult Case Report Form. The Surveillance Section surveillance coordinators review the forms for accuracy and input the information into the Enhanced HIV/AIDS Reporting System (eHARS), and in turn, submit electronic HIV/AIDS case reports, without personal identifiers, to the federal Centers for Disease Control and Prevention (CDC).^[1]

This bill seeks to authorize a health care provider to share confidential HIV test information of a patient diagnosed with an HIV infection that has already been reported to the LHO or CDPH for the purpose of providing additional information required by law or public health guidelines in order to complete or supplement the HIV case report required under existing law. The author argues that this authorization is necessary for the following reasons:

• • • • Public health records can be incomplete. For example, if a laboratory provides the initial report, health care providers cannot reach out to public health officials to supplement those records with other information.
      • Providers are limited in their ability to place referrals for patients to state-provided clinical or preventative services, especially for providers unfamiliar with state-provided services or HIV care.
      • Providers cannot communicate with health officials regarding specific patients to ensure continuous care if a patient moves to another jurisdiction.
      • Providers who close or suspend their practice cannot communicate with health officials regarding specific patients to ensure continuous care.

Existing law provides strong confidentiality protections for HIV test information and the identity of the test subject. This includes prohibitions on sharing that information and civil penalties for the negligent release of that information. This bill preserves existing confidentiality protections by prohibiting health care providers from disclosing personally identifying information unless necessary for the local health jurisdiction or for CDPH to carry out its duties in the investigation, control, or surveillance of disease, or the coordination of, linkage to, or reengagement in care for a person.

1. Amendments

The author has agreed to make amendments to ensure consistency of terms used throughout the statute. The author has also agreed to amend paragraph (1) of subdivision (c) of Section 120962 of the Health and Safety Code and paragraph (2) of subdivision (c) of Section 15912.1 of the Welfare and Institutions Code to update cross references to subdivisions in Section 121025 of the Health and Safety Code that this bill changes. The specific amendments are as follows:^[2]

Amendment 1

Paragraph (2) of subdivision (c) of Section 121025 of the Health and Safety Code is amended to read as follows:

(2) A health care provider shall not disclose personally identifying confidential information about a patient to a local health jurisdiction or the department unless the disclosure is necessary for the local health jurisdiction or the department to carry out its duties in the investigation, control, or surveillance of disease, or the coordination of, linkage to, or reengagement in care for a person, as determined by the health care provider, the local health jurisdiction, or the department.

Amendment 2

Paragraph (1) of subdivision (c) of Section 120962 of the Health and Safety Code is amended to read:

(c) (1) Information provided by the department pursuant to this section shall constitute confidential public health records as defined in Section 121035, and shall remain subject to the confidentiality protections and restrictions on further disclosure by the recipient under subdivisions (d) (e) and (e) (f) of Section 121025.

Amendment 3

Paragraph (2) of subdivision (c) of Section 15912.1 of the Welfare and Institutions Code is amended to read:

(2) Information shared pursuant to this section is subject to the confidentiality protections of subdivisions (d) (e) and (e) (f) of Section 121025 of the Health and Safety Code.

1. Statements in support

The California Academy of Preventive Medicine writes in support stating:

Some of us practice in public health departments, while others are in the private sector and treat patients with communicable diseases including HIV/AIDS, so we see both sides of this issue. Reporting of cases to public health is legal, but subsequent discussion of patients for coordination of care has had the potential risk of civil and criminal penalties. HIV treatment is only effective if it is continuous. Patients sometimes move or discontinue care, and one of the services provided by public health is assistance to patients to re-engage in care, sometimes with a new provider. Public health staff can also provide education and counseling for patients with HIV infections, and can confidentially refer exposed partners to testing and preventive treatment (PrEP and/or use of condoms), which is done without identifying the name of the patient. However, public health staff may need referrals from care providers in order to know that such services are needed by particular patients.

The new language of this bill sounds like it is adding to current restrictions to communication, but if read carefully it provides an opening for providers to consult with public health. Primary care providers are required by law to offer screening for HIV and will occasionally encounter an unsuspected infection. Many primary care providers who have not treated HIV before will want to refer the patient to an infectious disease specialist, but there may be a long wait time for such an appointment. If they consult the local public health department, they can be provided with guidelines on ordering baseline tests and beginning treatment themselves. Early onset of treatment helps to prevent new infections and results in better treatment outcomes.

One important advantage of this bill is that far from costing the state money, it may save considerable expense by helping to maintain medical treatment for patients and thus avoiding expensive hospitalizations. Another potential saving of funds will result from prevention of new infections by getting public health involved in preventive services.

SUPPORT

AIDS Healthcare Foundation

Beyond Aids Foundation

California Academy of Preventive Medicine

California Legislative LGBTQ Caucus

Infectious Disease Association of California

OPPOSITION

None received

RELATED LEGISLATION

Pending Legislation: SB 278 (Cabaldon, 2025) authorizes the sharing of HIV test information for the purpose of administering quality improvement programs designed to improve HIV care for Medi-Cal beneficiaries, including value-based payment programs and healthy behavior incentive programs, as provided. SB 278 is currently pending in the Senate Appropriations Committee.

Prior Legislation:

SB 1333 (Eggman, Ch. 472, Stats. 2024) revised and recast existing law to permit the CDPH and LHOs to disclose personally identifying information in public health records for the coordination of, linkage to, or reengagement in care, as provided.

SB 78 (Committee on Budget and Fiscal Review, Ch. 38, Stats. 2019) required, among other things, DHCS to develop value-based payment programs for specified conditions.

PRIOR VOTES:

Senate Health Committee (Ayes 10, Noes 0)

**************

1. Sen. Health Comm. analysis of SB 504 (2025-26 reg. sess.) as introduced Feb. 19, 2026 at pp. 3-4. ↑

2. The amendments may also include technical, nonsubstantive changes recommended by the Office of Legislative Counsel. ↑

SENATE COMMITTEE ON HEALTH

Senator Caroline Menjivar, Chair

BILL NO: SB 504

SUBJECT: Communicable diseases: HIV reporting

SUMMARY:

Permits a health care provider of a patient diagnosed with an HIV infection to communicate with a local health department or the California Department of Public Health about that patient for public health purposes, as specified.

Existing law:

1. Requires the California Department of Public Health (CDPH) to establish a list of diseases and conditions to be reported by local health officers (LHOs) to CDPH. Requires CDPH to specify the timeliness requirements related to the reporting of each disease and condition, and the mechanisms required for, and the content to be included in, reports made.

[HSC §120130]

1. Requires health care providers and laboratories to report cases of HIV infection to the LHO using patient names on a form developed by CDPH. Requires CDPH and local health department (LHD) employees and contractors to sign confidentiality agreements, which include information related to the penalties for a breach of confidentiality and the procedures for reporting a breach of confidentiality, prior to accessing confidential HIV-related public health records. [HSC §121022]
2. Prohibits public health records relating to HIV/AIDS containing personally identifying information from being disclosed, except for public health purposes or pursuant to a written authorization by the person who is the subject of the record or by the person’s guardian or conservator. Permits CDPH or a LHD, or their agent, to disclose personally identifying information in public health records to other local, state, or federal public health agencies or to corroborating medical researchers, when the confidential information is necessary to carry out the duties of the agency or researcher in the investigation, control, or surveillance of disease, as determined by CDPH or a LHD. [HSC §121025 (a) and (b)]
3. Permits disclosures authorized in 3) above to only include information necessary for the purpose of that disclosure and to be made only upon the agreement that the information will be kept confidential as described in 3) above. Makes unauthorized further disclosure subject to specified penalties. [HSC §121025 (c)]
4. Permits CDPH or LHD staff to further disclose the information to a health care provider who provides care to the HIV-positive person who is the subject of the record for the purpose of assisting in compliance with 2) above. [HSC §121025 (c)(1)]

This bill:

1. Permits a health care provider of a patient diagnosed with an HIV infection that has already been reported to a LHD to communicate with a LHD about that patient for public health purposes, including any of the following:
   1. To provide additional information required by law or public health guidelines in order to complete or supplement the HIV case report;
   2. To obtain public health recommendations on care and treatment;
   3. To refer the patient to clinical or preventive services provided by CDPH, including, but not limited to, HIV education and counseling, voluntary partner services, or assistance with the HIV care continuum in order to help achieve a better clinical outcome or the prevention of new HIV infections;
   4. To request information or assistance with a referral for specialty care or other clinical services, treatment of mental health or substance misuse, housing assistance, social services, nutrition assistance, or other coordination of care and treatment;
   5. To request assistance with reengagement or relinkage to care; or
   6. To inform a LHD or CDPH of the provider’s inability to continue to provide care for a patient due to a closure or suspension of the provider’s practice.
2. Prohibits a provider from disclosing personally identifying confidential information about a patient to a LHD or CDPH, unless the disclosure is necessary for the LHD or CDPH to carry out its duties in the investigation, control, or surveillance of disease, or the coordination of, linkage to, or reengagement in care for a person, as determined by the LHD or CDPH.

FISCAL EFFECT:

This bill has not been analyzed by a fiscal committee.

COMMENTS:

1. Author’s statement. According to the author, this bill allows health care providers to share personally identifying information about previously reported HIV infections with local health departments and CDPH, but only when necessary for specified public health purposes. While existing law permits local and state public health officials to share confidential data regarding HIV infections for disease surveillance and surveillance or care coordination, this authorization does not extend to health care providers. This limitation can create barriers to connecting patients with treatment and ensuring continuity of care. This bill enhances coordination between health care providers and public health officials while maintaining strict confidentiality protections.
2. Background. According to CDPH, the prevalence of diagnosed HIV infection was 355.6 per 100,000 population in 2022, compared to 343.1 per 100,000 in 2018 – an increase of 3.7%. Of the 142,772 people living with diagnosed HIV infection in 2022, 73.7% were in HIV care and 64.7% achieved viral suppression. Among all racial/ethnic groups, African Americans are the most disproportionately affected by HIV. While Latinx and white individuals make up the largest percentage of persons living with diagnosed HIV, the rate of HIV among African Americans is substantially higher (1,012.3 per 100,000 population, versus 319.5 per 100,000 among whites and 364.8 per 100,000 among Latinx). The rate of new HIV diagnoses among African Americans is 4.4 times higher than whites among men and 5.7 times higher among women. Latinx are also disproportionately affected by HIV with rates of new HIV diagnoses 2.7 times higher than white among men and 1.6 times higher among women.

According to CDPH’s Office of AIDS, in California and the rest of the U.S., HIV infections and AIDS diagnoses are reported through a combination of passive and active surveillance. Passive surveillance is conducted through state required reporting of HIV and AIDS cases by health care providers and reporting of HIV-positive test results from laboratories to local health departments. Active surveillance is accomplished through routine visits to hospitals, physician offices, laboratories, counseling and testing clinics, and outpatient clinics to ensure accuracy of reported data. In California and other states, HIV/AIDS surveillance has historically relied heavily upon active case surveillance, through on-site chart reviews and case report completion by local surveillance staff at the health care provider’s office. To improve timeliness and completeness of reporting and ensure prompt identification and response to emerging problems in the field, the Office of AIDS supports a decentralized reporting system where HIV/AIDS case reports are identified through passive and active surveillance efforts coordinated by California’s 61 local health departments. HIV/AIDS surveillance case data and laboratory reports, reported to local health departments by health care providers and laboratories, is then sent to the HIV/AIDS Surveillance Section via the Lab Data Entry Tool or on the Adult Case Report Form. The Surveillance Section surveillance coordinators review the forms for accuracy and input the information into the Enhanced HIV/AIDS Reporting System (eHARS), and in turn, submit electronic HIV/AIDS case reports, without personal identifiers, to the federal Centers for Disease Control and Prevention (CDC).

1. Double referral. This bill has been double referred. Should it pass out of this Committee, it will be referred to the Senate Judiciary Committee.
2. Related legislation. SB 278 (Cabaldon) allows for HIV test results to be shared with the Department of Health Care Services or an individual’s Medi-Cal managed care plan without the written authorization the individual tested for the purpose of proactively offering and coordinating care and treatment services or to administer quality improvement programs designed to improve HIV care for Medi-Cal enrollees. SB 278 is set to be heard in this Committee on March 26, 2025.
3. Prior legislation. SB 1333 (Eggman and Roth, Chapter 472, Statutes of 2024) revised the law to permit CDPH and LHDs to disclose personally identifying information in public health records for the coordination of, linkage to, or reengagement in care, as determined by CDPH or the LHD.
4. Support. The California Legislative LGBTQ Caucus writes that currently, providers are not explicitly authorized to communicate with public health officials regarding these cases to obtain care recommendations or connect patients with essential services. This limitation creates barriers to care coordination and public health duties. Consistent with the Legislature’s intent to enhance limited data sharing practices to improve the treatment and health outcomes for people living with HIV, it is imperative that we authorize health care providers to disclose personally identifying information regarding previously reported HIV infections when communicating with state or local health officials. AIDS Healthcare Foundation writes that achieving and maintaining a reduced viral load demands continual engagement between the patient and a medical team in order to ensure ongoing monitoring, proper maintenance of medications and swift response to emerging challenges. This bill closes the gap that exists between an HIV care provider and public health official to allow necessary communication about the care needs of a person with HIV. California Academy of Preventative Medicine writes that reporting of cases to public health is legal, but subsequent discussion of patients for coordination of care has had the potential risk of civil and criminal penalties. HIV treatment is only effective if it is continuous. Patients sometimes move or discontinue care, and one of the services provided by public health is assistance to patients to re-engage in care, sometimes with a new provider. Public health staff can also provide education and counseling for patients with HIV infections, and can confidentially refer exposed partners to testing and preventive treatment (PrEP and/or use of condoms), which is done without identifying the name of the patient. However, public health staff may need referrals from care providers in order to know that such services are needed by particular patients.
5. Amendments. The author is proposing amendments to simplify the sharing of information proposed under this bill as follows:

HSC §121025 (c) (1) A health care provider of a patient diagnosed with an HIV infection that has already been reported pursuant to Section 121022 may disclose personally identifying confidential information to communicate with a local health officer or the department to about that patient for public health purposes, including any of the following:

(A) To provide additional information required by law or public health guidelines in order to complete or supplement the HIV case report described in Section 121022.

(B) To obtain public health recommendations on care and treatment.

(C) To refer the patient to clinical or preventive services provided by the department, including, but not limited to, HIV education and counseling, voluntary partner services, or assistance with the HIV care continuum in order to help achieve a better clinical outcome or the prevention of new HIV infections.

(D) To request information or assistance with a referral for specialty care or other clinical services, treatment of mental health or substance misuse, housing assistance, social services, nutrition assistance, or other coordination of care and treatment.

(E) To request assistance with reengagement or relinkage to care.

(F) To inform a local health jurisdiction or the department of the provider’s inability to continue to provide care for a patient due to a closure or suspension of the provider’s practice.

(2) A provider shall not disclose personally identifying confidential information about a patient to a local health jurisdiction or the department unless the disclosure is necessary for the jurisdiction or the department to carry out its duties in the investigation, control, or surveillance of disease, or the coordination of, linkage to, or reengagement in care for a person, as determined by the health care provider, the jurisdiction, or the department.

SUPPORT AND OPPOSITION:

Support: AIDS Healthcare Foundation

Beyond AIDS Foundation

California Academy of Preventive Medicine

California Legislative LBGTQ Caucus

Infectious Disease Association of California

Oppose: None received.

-- END --