TTS-xit: What Does It Mean for COVID, Production Hold Protocols?

CHATSWORTH, Calif.—The exit last week of major adult testing provider Talent Testing Service (TTS) from the centralized Performer Availability Screening Services (PASS) system maintained by the Free Speech Coalition (FSC) left many industry performers and producers wondering where that left them in terms of having any sort of industry-wide standards in place both for COVID-19 testing protocols and, in a broader scope, those for implementing production holds and performing contact tracing in the event a performer tests positive for any infection included in a screening panel.

In a conference call with adult media last weekend, TTS CEO Sixto Pacheco expressed confidence that his outfit is optimally equipped on both fronts to provide talent the highest level of protection possible. "Our industry, the laboratory industry, is based on what we call standard operating procedures. We have a procedure for everything. If it ain't written, it hasn't been done," Pacheco said. "That's what we are based on."

In regard to COVID-19 testing, which TTS began offering in early May both as a standalone test and as part of its Gold Standard Panel, Pacheco asserted, "I am giving you the best-in-class testing for a pandemic disease that is out there right now to protect the talent." 

The point of contention that appears to have been the "final straw" triggering TTS' schism from PASS, however, lies in the testing firm's insistence upon making COVID-19 screening inseparable from the standard panel required to clear a performer for work.

Under the revised PASS guidelines for production issued by FSC June 12, it is recommended that all talent and personnel on a set be tested for COVID-19 prior to each shoot; if they do so at a PASS-certified facility, the date of their last negative COVID-19 test will be displayed separately from the usual clearance-to-work indication (green check/red X/expiration date) in the PASS portal. 

"PASS clearance is purposely separate from COVID clearance, because the latter is so unpredictable," FSC executive director Michelle L. LeBlanc told AVN. "While a positive COVID test at a PASS certified lab would automatically mark you as unavailable for work, someone who tested elsewhere would still need to present a recent negative COVID test to shoot."

If somebody chooses to test for COVID-19 outside of the PASS network, their status pertaining to the disease simply will not be displayed in the PASS portal, effectively placing the responsibility of verifying their negative status upon the producer overseeing a shoot.

"While we ideally want everyone testing inside of PASS, we always advise to avoid using paper tests or screenshots," LeBlanc cautioned. "Many labs, including the Los Angeles free testing, allow you to log-in to verify results, and allow you to share those results with others."

Pacheco takes issue with this approach on several counts, perhaps most significantly because "when you separate the COVID test in itself from the panel, first of all you have an issue with HIPAA, because now you're looking at a particular test and you know what test it is."

HIPAA, or the Health Insurance Portability and Accountability Act, is a statute enacted by the U.S. Congress in 1996 that instituted regulations safeguarding the privacy of certain personal health information, among other provisions. It is because of HIPAA requirements that PASS has traditionally used the "available/not available" model for indicating a performer's clearance to work, as opposed to disclosing their actual test results for the specific infections on the standard panel.

LeBlanc refuted Pacheco's contention that the PASS method for handling COVID-19 information presents any HIPAA compliance conflicts, maintaining that "the HHS's [i.e. the U.S. Department of Health and Human Services] Office of Civil Rights has issued emergency guidelines regarding COVID that allow greater flexibility for the sharing of information. We don't believe this flexibility is needed for our current system, but certainly the federal government expects that exceptions may need to be made."

This February bulletin provided by LeBlanc outlines the guidelines in question, which state among other allowances that "Health care providers may share patient information with anyone as necessary to prevent or lessen a serious and imminent threat to the health and safety of a person or the public—consistent with applicable law (such as state statutes, regulations, or case law) and the provider's standards of ethical conduct."

Regardless, Pacheco argues that leaving it up to non-medical professionals (read: producers or other production personnel) to verify test results poses risks he cannot idly abide.

"So you're going to tell me now that a non-qualified medical personnel can take a report and is going to read it and is going to say, 'Hmm, this is actually a PCR result,' or could be an antibody, who knows?" he contested. "And they're going to say, 'Yeah, I know what kind of test this is. And I'm gonna go ahead and say yeah, he's COVID cleared.' So we're opening this up to the public. What are we thinking here? ... For me, in order for me to sleep at night, things need to make sense. And certain things to me do not make sense. And I'm sorry."

Meanwhile, the question remains as to what steps would be taken should a performer test positive at TTS for any of the STIs on its Gold Standard Panel, in terms of containment and tracing within the talent pool.

To that end, Pacheco contended, "We have our own procedures where we contact the talent and our doctors do their thing and things of that nature, I mean that's just second nature. ... There's a way of disseminating information throughout the community and in the media—that's not a problem. That's something that's easily done, so I'm not worried about those things."

LeBlanc casts doubt on TTS' ability to handle such a situation adequately, stressing, "PASS is a centralized system that uses multiple labs, and has strong connections with the adult industry, and a well-established and transparent process for calling and lifting holds. A production hold isn't a simple matter of alerting the media and ordering retests—it's a complicated, multipronged coordination between all stakeholders in the industry which is incredibly time intensive, and fraught with risk to the performer pool.

"TTS has no authority to call or lift a production hold, and it's not clear how or if they would work with studios or performers who test outside their network," she continued. "They've already refused to work with FSC, which doesn't bode well for unified communication in a time of crisis. We would do our best to coordinate in any situation, but have serious concerns about the lack of communication we've seen with TTS. They seem to view us as a competitor, rather than a partner."

She concluded, "Unlike TTS, PASS doesn't have any financial stake in the testing system. PASS was designed to avoid conflicts of interest like profit or market share. Our sole goal is to protect the health, well-being and privacy of performers."

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