This Month In State Policy

Expedited Partner Therapy

Kansas lawmakers have an opportunity to make expedited partner therapy (EPT) explicitly allowable. SB404, introduced by the state’s Committee on Public Health and Welfare, parallels the bill in Oklahoma’s state legislature that NCSD highlighted last month. The dual pieces of legislation would authorize providers to prescribe STI treatment to partners of patients diagnosed with an STI without examination and include liability protections for the prescriber.

A similar bill was also introduced this month in the Kansas House of Representatives and passed the Committee on Health and Human Services after it was amended to strike a clause allowing adolescents between 16 and 18 years of age to consent to EPT without parental approval; the amendment also defined EPT to specifically include chlamydia, gonorrhea, and trichomoniasis.

If both bills are signed into law within their respective legislatures, the dwindling number of states with legal barriers to EPT permissibility would be cut in half—from four to two.

Syphilis Response

In direct response to policy recommendations from the state’s STI and HBV Legislative Advisory Group, Senator Marko Liias (D – WA) introduced SB5983. The bill aims to curb alarming rates of syphilis in Washington, which have “increased by 49 percent” between 2019 and 2021, as cited in the proposed law. SB5983 would allow medical assistants to administer intramuscular injection treatment for syphilis in patients with known or suspected cases, so long as a licensed health care practitioner supervises via telehealth technology. According to the legislative advisory group’s report, “allowing MAs to give intramuscular injections during telehealth visits fills a gap in care, particularly for pregnant patients with syphilis.”

While Washington already permits EPT, the bill also adds liability protection language for providers with the goal of boosting provider engagement and comfort level. The bill has already passed the state’s Senate and is being sent to the House.

The report from the advisory group included several recommendations beyond the two written into SB5983, including modernizing surveillance systems, expanding jail-based sexual health services, and enhancing prenatal care, to name a few. The recommendations were originally provided to the Washington legislature back in 2022 and were the catalyst for secured funding to support a new STI clinic in Snohomish County, a suburb of Seattle that has not had direct access to a STI clinic in 14 years.

NCSD will be sharing more about the advisory group and its recommendations process in an upcoming This Month in State Policy post.

PrEP at Pharmacies

California Governor Gavin Newsom (D) signed SB339 into law on February 6, which will expand access to pre-exposure prophylaxis (PrEP) medication for HIV prevention at pharmacies. While California state law already permits pharmacists to prescribe PrEP, current rules state a pharmacist may only furnish limited supplies. The new legislation would allow pharmacists to dispense PrEP routinely for a patient if certain conditions are met. The law also requires reimbursement from both Medi-Cal (California’s state Medicaid program) and private insurance plans. In short, SB339 is being considered the equivalent to “offering PrEP without a prescription.”

Meanwhile in New Jersey, Assemblymember Don Guardian (R – Atlantic City) introduced legislation that would enable pharmacists to prescribe and dispense both PrEP and nPEP. A3089 would eliminate prior authorizations to the extent that each modality of PrEP available on the U.S. market is fully covered for eligible patients. Currently, PrEP can be taken as an oral pill daily or as an injectable medication every eight weeks.

While the bill would use a statewide standing order to expand pharmacist authority, it does not include any legal requirements for pharmacist reimbursement—a common constraint that has thwarted rapid uptake of pharmacist-initiated PrEP in other jurisdictions.

HIV Criminalization

Pennsylvania may become one of the first states in the U.S. to officially recognize “HIV is not a Crime Awareness Day” on Feb. 28, a day observed since 2022 by HIV community advocates across the country. State Representative Ben Waxman (D – Philadelphia) introduced HR310, which would acknowledge that many Pennsylvanians have been charged with crimes over the last few decades for conduct that would have been less severely punished were they not living with HIV. When an individual receives enhanced sentencing for a crime due to their HIV status, it is often considered HIV criminalization.

According to the Center for Disease Control and Prevention (CDC), many state laws about HIV exposure are outdated since they became enacted when knowledge of HIV transmission and prevention was less robust. Such laws also inadvertently discourage testing and treatment due to associated stigma. Scientific breakthroughs like “undetectable equals untransmittable” have transformed how HIV is understood and means that current HIV criminalization statues do not usually reflect medically up-to-date information.

LGBTQ+ Policy

Utah’s state legislature passed HB257 after conferencing the bill through several amendments, marking it “the first piece of anti-LGBTQ+ legislation” passed in 2024, according to the Human Rights Campaign. The bill would prohibit adults from using a bathroom in a government-owned facility that does not correspond to the sex designated on their birth certificate. While it also includes restrictions on locker rooms and restroom access for adolescents, legislators adopted a version of the bill that clarifies students cannot be charged with criminal penalties. Adults, however, could be charged with trespassing for violating the new rules, although they can argue against any claims by verifying they have undergone gender-affirming medical procedures or by providing their birth certificate if their certificate has been legally corrected to match their gender identity, a practice that varies by state. Governor Spencer Cox (R) signed the legislation into law on January 30.