Thank you, Chairman Filner, Chairman Michaud, Ranking Member Miller, and members of the Subcommittee, for including HR 6114 in today’s hearing.  I introduced the Simplifying and Updating National Standards to Encourage Testing of the Human Immunodeficiency Virus Act of 2008, also known as the SUNSET Act, with my friend and colleague Charlie Dent, to correct an anachronism in our veterans’ health care laws.

Congress does not often step in and tell the Veterans Administration how to diagnose and treat patients in the system.  I think we can all agree that this is wise.  However, in 1988, Congress passed a law that requires the Veterans Administration to obtain a patient’s written consent before being tested for HIV, the virus that causes AIDS.

While that might have been a best practice in 1988, it is now outdated and must be repealed. 

According to the VA’s Public Health Strategic Working Group, 55% of HIV positive veterans had already suffered significant damage to their immune system AIDS by the time they’re diagnosed as HIV positive.  Those veterans had been to the VA to get medical care an average of 6 times prior to diagnosis. 

That same panel says that quote “the bottom line here is that we are likely dealing with a situation where there are thousands of HIV-infected veterans who are unaware” that they are HIV positive.  That is unacceptable to me, and should be to anyone else who cares about public’s health, and the wellbeing of our veterans.

The face of a person with HIV / AIDS has also changed since 1988.  Today, 53% of VA patients have a risk factor indicating a higher prevalence of HIV, but only 35% of that higher-risk population is tested.  The barriers in current law make testing a disturbingly rare occurrence. 

In 2006, the Centers for Disease Control released guidelines that recommend that HIV testing become a normal part of medical care when appropriate.  After reviewing all the clinical data, CDC strongly believes that separate written consent for HIV screening should no longer be required.  In the Administration’s budget request this year, the VA identified this issue as a problem that needs to be fixed quickly. 

Concerns have been raised that the CDC’s new guidelines don’t go far enough to promote HIV-prevention counseling.  That debate is reasonable, and I understand that the VA is open to discussing that issue with veterans and other stakeholders.  That is why I drafted my bill to be agnostic as to how the VA should proceed after the current regulations are repealed.  The VA has pledged to follow the CDC’s guidelines and to protect patients’ privacy by ensuring their right to an informed, verbal, consent before screening – as they do with any test for a serious condition. 

Perhaps the current guidelines will be in place for the foreseeable future, but as the profile of HIV changes, the VA should be as free as any other medical provider to update their screening standards without future Congressional intervention.

I am grateful for the VFW and AMVETS’s strong support for the SUNSET Act.  I would also like to offer letters of support from AIDS Action, the AIDS Institute and OraSure for the record.  Finally, I would like to thank the Committee’s staff for their help.

The SUNSET Act strikes an outdated law that puts veterans at risk, and it encourages medical professionals to create appropriate HIV screening standards after consultation with veterans, prevention groups, and other stakeholders .  I believe that it should be reported out of this Committee and passed without delay.

Thank you.