BILL NUMBER: SB 680 CHAPTERED
BILL TEXT
CHAPTER 898
FILED WITH SECRETARY OF STATE OCTOBER 14, 2001
APPROVED BY GOVERNOR OCTOBER 14, 2001
PASSED THE SENATE SEPTEMBER 14, 2001
PASSED THE ASSEMBLY SEPTEMBER 12, 2001
AMENDED IN ASSEMBLY SEPTEMBER 10, 2001
AMENDED IN ASSEMBLY JULY 17, 2001
AMENDED IN ASSEMBLY JULY 2, 2001
AMENDED IN SENATE JUNE 4, 2001
AMENDED IN SENATE MAY 8, 2001
AMENDED IN SENATE APRIL 16, 2001
INTRODUCED BY Senator Figueroa
FEBRUARY 23, 2001
An act to amend Sections 128735, 128736, 128737, 128740, 128745,
128750, 128755, and 128765 of, to add Sections 128747 and 128748 to,
and to repeal Section 128815 of, the Health and Safety Code, relating
to health data.
LEGISLATIVE COUNSEL'S DIGEST
SB 680, Figueroa. Health facility data.
Existing law, the Health Data and Advisory Council Consolidation
Act, operative until June 30, 2004, requires every organization that
operates, conducts, or maintains a health facility to make and file
with the Office of Statewide Health Planning and Development,
specified reports containing various financial and patient data.
This bill would additionally impose the above requirements on
every organization that owns a health facility.
This bill would revise the type of data required to be filed with
the office.
Existing law also requires that the office publish certain patient
outcome reports for specified periods.
This bill would revise the data that the office shall publish and
would revise the periods to which the reports shall apply.
Existing law requires the office to maintain a file of all reports
filed under the Health Data and Advisory Council Consolidation Act.
This bill would require the office also to post all reports on its
Web site, and would specify that the reports include a discussion of
findings, conclusions, and trends concerning the overall quality of
medical outcomes for procedures and conditions studied by the
reports.
The bill would delete the provision limiting the duration of the
operation of the Health Data and Advisory Council Consolidation Act.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. The Legislature finds and declares the following:
(a) Public disclosure of the outcomes of surgical and other
hospital procedures facilitates public and market accountability,
reduces mortality rates, and generally promotes improvement in the
quality of medical outcomes. Providing this information to
purchasers, consumers, hospitals, and providers will enable all
market players to act based on more complete information on quality
of care.
(b) Improved collection and dissemination of medical outcomes data
by hospital and, for surgical procedures or conditions, by surgeon,
will provide hospitals and providers information needed to conduct
quality improvement efforts, will improve decisionmaking by
purchasers of health care and consumers, will better inform decisions
about resource allocation and regulation, and will result in cost
savings.
(c) It is, therefore, the intent of the Legislature to facilitate
the continuing provision of quality health services throughout the
state by providing current, accurate data and information to
purchasers, health care service plans, health and disability
insurers, consumers, hospitals, and physicians on quality of health
care services.
SEC. 2. Section 128735 of the Health and Safety Code is amended to
read:
128735. Every organization that operates, conducts, owns, or
maintains a health facility, and the officers thereof, shall make and
file with the office, at the times as the office shall require, all
of the following reports on forms specified by the office that shall
be in accord where applicable with the systems of accounting and
uniform reporting required by this part, except the reports required
pursuant to subdivision (g) shall be limited to hospitals:
(a) A balance sheet detailing the assets, liabilities, and net
worth of the health facility at the end of its fiscal year.
(b) A statement of income, expenses, and operating surplus or
deficit for the annual fiscal period, and a statement of ancillary
utilization and patient census.
(c) A statement detailing patient revenue by payer, including, but
not limited to, Medicare, Medi-Cal, and other payers, and revenue
center except that hospitals authorized to report as a group pursuant
to subdivision (d) of Section 128760 are not required to report
revenue by revenue center.
(d) A statement of cash-flows, including, but not limited to,
ongoing and new capital expenditures and depreciation.
(e) A statement reporting the information required in subdivisions
(a), (b), (c), and (d) for each separately licensed health facility
operated, conducted, or maintained by the reporting organization,
except those hospitals authorized to report as a group pursuant to
subdivision (d) of Section 128760.
(f) Data reporting requirements established by the office shall be
consistent with national standards, as applicable.
(g) A Hospital Discharge Abstract Data Record that includes all of
the following:
(1) Date of birth.
(2) Sex.
(3) Race.
(4) ZIP Code.
(5) Principal language spoken.
(6) Patient social security number, if it is contained in the
patient's medical record.
(7) Prehospital care and resuscitation, if any, including all of
the following:
(A) "Do not resuscitate" (DNR) order at admission.
(B) "Do not resuscitate" (DNR) order after admission.
(8) Admission date.
(9) Source of admission.
(10) Type of admission.
(11) Discharge date.
(12) Principal diagnosis and whether the condition was present at
admission.
(13) Other diagnoses and whether the conditions were present at
admission.
(14) External cause of injury.
(15) Principal procedure and date.
(16) Other procedures and dates.
(17) Total charges.
(18) Disposition of patient.
(19) Expected source of payment.
(20) Elements added pursuant to Section 128738.
(h) It is the expressed intent of the Legislature that the patient'
s rights of confidentiality shall not be violated in any manner.
Patient social security numbers and any other data elements that the
office believes could be used to determine the identity of an
individual patient shall be exempt from the disclosure requirements
of the California Public Records Act (Chapter 3.5 (commencing with
Section 6250) of Division 7 of Title 1 of the Government Code).
(i) No person reporting data pursuant to this section shall be
liable for damages in any action based on the use or misuse of
patient-identifiable data that has been mailed or otherwise
transmitted to the office pursuant to the requirements of subdivision
(g).
(j) A hospital shall use coding from the International
Classification of Diseases in reporting diagnoses and procedures.
SEC. 3. Section 128736 of the Health and Safety Code is amended to
read:
128736. (a) Each hospital shall file an Emergency Care Data
Record for each patient encounter in a hospital emergency department.
The Emergency Care Data Record shall include all of the following:
(1) Date of birth.
(2) Sex.
(3) Race.
(4) Ethnicity.
(5) Principal language spoken.
(6) ZIP Code.
(7) Patient social security number, if it is contained in the
patient's medical record.
(8) Service date.
(9) Principal diagnosis.
(10) Other diagnoses.
(11) Principal external cause of injury.
(12) Other external cause of injury.
(13) Principal procedure.
(14) Other procedures.
(15) Disposition of patient.
(16) Expected source of payment.
(17) Elements added pursuant to Section 128738.
(b) It is the expressed intent of the Legislature that the patient'
s rights of confidentiality shall not be violated in any manner.
Patient social security numbers and any other data elements that the
office believes could be used to determine the identity of an
individual patient shall be exempt from the disclosure requirements
of the California Public Records Act (Chapter 3.5 (commencing with
Section 6250) of Division 7 of Title 1 of the Government Code).
(c) No person reporting data pursuant to this section shall be
liable for damages in any action based on the use or misuse of
patient-identifiable data that has been mailed or otherwise
transmitted to the office pursuant to the requirements of subdivision
(a).
(d) Data reporting requirements established by the office shall be
consistent with national standards as applicable.
(e) This section shall become operative on January 1, 2002.
SEC. 4. Section 128737 of the Health and Safety Code is amended to
read:
128737. (a) Each hospital and freestanding ambulatory surgery
clinic shall file an Ambulatory Surgery Data Record for each patient
encounter during which at least one ambulatory surgery procedure is
performed. The Ambulatory Surgery Data Record shall include all of
the following:
(1) Date of birth.
(2) Sex.
(3) Race.
(4) Ethnicity.
(5) Principal language spoken.
(6) ZIP Code.
(7) Patient social security number, if it is contained in the
patient's medical record.
(8) Service date.
(9) Principal diagnosis.
(10) Other diagnoses.
(11) Principal procedure.
(12) Other procedures.
(13) Principal external cause of injury, if known.
(14) Other external cause of injury, if known.
(15) Disposition of patient.
(16) Expected source of payment.
(17) Elements added pursuant to Section 128738.
(b) It is the expressed intent of the Legislature that the patient'
s rights of confidentiality shall not be violated in any manner.
Patient social security numbers and any other data elements that the
office believes could be used to determine the identity of an
individual patient shall be exempt from the disclosure requirements
of the California Public Records Act (Chapter 3.5 (commencing with
Section 6250) of Division 7 of Title 1 of the Government Code).
(c) No person reporting data pursuant to this section shall be
liable for damages in any action based on the use or misuse of
patient-identifiable data that has been mailed or otherwise
transmitted to the office pursuant to the requirements of subdivision
(a).
(d) Data reporting requirements established by the office shall be
consistent with national standards as applicable.
(e) This section shall become operative on January 1, 2002.
SEC. 5. Section 128740 of the Health and Safety Code is amended to
read:
128740. (a) Commencing with the first calendar quarter of 1992,
the following summary financial and utilization data shall be
reported to the office by each hospital within 45 days of the end of
every calendar quarter. Adjusted reports reflecting changes as a
result of audited financial statements may be filed within four
months of the close of the hospital's fiscal or calendar year. The
quarterly summary financial and utilization data shall conform to the
uniform description of accounts as contained in the Accounting and
Reporting Manual for California Hospitals and shall include all of
the following:
(1) Number of licensed beds.
(2) Average number of available beds.
(3) Average number of staffed beds.
(4) Number of discharges.
(5) Number of inpatient days.
(6) Number of outpatient visits.
(7) Total operating expenses.
(8) Total inpatient gross revenues by payer, including Medicare,
Medi-Cal, county indigent programs, other third parties, and other
payers.
(9) Total outpatient gross revenues by payer, including Medicare,
Medi-Cal, county indigent programs, other third parties, and other
payers.
(10) Deductions from revenue in total and by component, including
the following: Medicare contractual adjustments, Medi-Cal
contractual adjustments, and county indigent program contractual
adjustments, other contractual adjustments, bad debts, charity care,
restricted donations and subsidies for indigents, support for
clinical teaching, teaching allowances, and other deductions.
(11) Total capital expenditures.
(12) Total net fixed assets.
(13) Total number of inpatient days, outpatient visits, and
discharges by payer, including Medicare, Medi-Cal, county indigent
programs, other third parties, self-pay, charity, and other payers.
(14) Total net patient revenues by payer including Medicare,
Medi-Cal, county indigent programs, other third parties, and other
payers.
(15) Other operating revenue.
(16) Nonoperating revenue net of nonoperating expenses.
(b) Hospitals reporting pursuant to subdivision (d) of Section
128760 may provide the items in paragraphs (7), (8), (9), (10), (14),
(15), and (16) of subdivision (a) on a group basis, as described in
subdivision (d) of Section 128760.
(c) The office shall make available at cost, to any person, a hard
copy of any hospital report made pursuant to this section and in
addition to hard copies, shall make available at cost, a computer
tape of all reports made pursuant to this section within 105 days of
the end of every calendar quarter.
(d) The office, with the advice of the commission, shall adopt by
regulation guidelines for the identification, assessment, and
reporting of charity care services. In establishing the guidelines,
the office shall consider the principles and practices recommended by
professional health care industry accounting associations for
differentiating between charity services and bad debts. The office
shall further conduct the onsite validations of health facility
accounting and reporting procedures and records as are necessary to
assure that reported data are consistent with regulatory guidelines.
This section shall become operative January 1, 1992.
SEC. 6. Section 128745 of the Health and Safety Code is amended to
read:
128745. (a) Commencing July 1993, and annually thereafter, the
office shall publish risk-adjusted outcome reports in accordance with
the following schedule:
Procedures and
Publication Period Conditions
Date Covered Covered
July 1993 1988-90 3
July 1994 1989-91 6
July 1995 1990-92 9
Reports for subsequent years shall include conditions and
procedures and cover periods as appropriate.
(b) The procedures and conditions required to be reported under
this chapter shall be divided among medical, surgical and obstetric
conditions or procedures and shall be selected by the office, based
on the recommendations of the commission and the advice of the
technical advisory committee set forth in subdivision (j) of Section
128725. The office shall publish the risk-adjusted outcome reports
for surgical procedures by individual hospital and individual surgeon
unless the office in consultation with the technical advisory
committee and medical specialists in the relevant area of practice
determines that it is not appropriate to report by individual
surgeon. The office, in consultation with the technical advisory
committee and medical specialists in the relevant area of practice,
may decide to report nonsurgical procedures and conditions by
individual physician when it is appropriate. The selections shall be
in accordance with all of the following criteria:
(1) The patient discharge abstract contains sufficient data to
undertake a valid risk adjustment. The risk adjustment report shall
ensure that public hospitals and other hospitals serving primarily
low-income patients are not unfairly discriminated against.
(2) The relative importance of the procedure and condition in
terms of the cost of cases and the number of cases and the
seriousness of the health consequences of the procedure or condition.
(3) Ability to measure outcome and the likelihood that care
influences outcome.
(4) Reliability of the diagnostic and procedure data.
(c) (1) In addition to any other established and pending reports,
on or before July 1, 2002, the office shall publish a risk-adjusted
outcome report for coronary artery bypass graft surgery by hospital
for all hospitals opting to participate in the report. This report
shall be updated on or before July 1, 2003.
(2) In addition to any other established and pending reports,
commencing July 1, 2004, and every year thereafter, the office shall
publish risk-adjusted outcome reports for coronary artery bypass
graft surgery for all coronary artery bypass graft surgeries
performed in the state. In each year, the reports shall compare
risk-adjusted outcomes by hospital, and in every other year, by
hospital and cardiac surgeon. Upon the recommendation of the
technical advisory committee based on statistical and technical
considerations, information on individual hospitals and surgeons may
be excluded from the reports.
(3) Unless otherwise recommended by the clinical panel established
by Section 128748, the office shall collect the same data used for
the most recent risk-adjusted model developed for the California
Coronary Artery Bypass Graft Mortality Reporting Program. Upon
recommendation of the clinical panel, the office may add any clinical
data elements included in the Society of Thoracic Surgeons' data
base. Prior to any additions from the Society of Thoracic Surgeons'
data base, the following factors shall be considered:
(A) Utilization of sampling to the maximum extent possible.
(B) Exchange of data elements as opposed to addition of data
elements.
(4) Upon recommendation of the clinical panel, the office may add,
delete or revise clinical data elements, but shall add no more than
a net of six elements not included in the Society of Thoracic
Surgeons' data base, to the data set over any five-year period.
Prior to any additions or deletions, all of the following factors
shall be considered:
(A) Utilization of sampling to the maximum extent possible.
(B) Feasibility of collecting data elements.
(C) Costs and benefits of collection and submission of data.
(D) Exchange of data elements as opposed to addition of data
elements.
(5) The office shall collect the minimum data necessary for
purposes of testing or validating a risk-adjusted model for the
coronary artery bypass graft report.
(d) The annual reports shall compare the risk-adjusted outcomes
experienced by all patients treated for the selected conditions and
procedures in each California hospital during the period covered by
each report, to the outcomes expected. Outcomes shall be reported in
the five following groupings for each hospital:
(1) "Much higher than average outcomes," for hospitals with
risk-adjusted outcomes much higher than the norm.
(2) "Higher than average outcomes," for hospitals with
risk-adjusted outcomes higher than the norm.
(3) "Average outcomes," for hospitals with average risk-adjusted
outcomes.
(4) "Lower than average outcomes," for hospitals with
risk-adjusted outcomes lower than the norm.
(5) "Much lower than average outcomes," for hospitals with
risk-adjusted outcomes much lower than the norm.
(e) For coronary artery bypass graft surgery reports and any other
outcome reports for which auditing is appropriate, the office shall
conduct periodic auditing of data at hospitals.
(f) The office shall publish in the annual reports required under
this section the risk-adjusted mortality rate for each hospital and
for those reports that include physician reporting, for each
physician.
(g) The office shall either include in the annual reports required
under this section, or make separately available at cost to any
person requesting it, risk-adjusted outcomes data assessing the
statistical significance of hospital or physician data at each of the
following three levels: 99 percent confidence level (0.01 p-value),
95 percent confidence level (0.05 p-value), and 90 percent
confidence level (.10 p-value). The office shall include any other
analysis or comparisons of the data in the annual reports required
under this section that the office deems appropriate to further the
purposes of this chapter.
SEC. 7. Section 128747 is added to the Health and Safety Code, to
read:
128747. Commencing July 1, 2002, and biennially thereafter, the
office shall evaluate the impact of the office's published
risk-adjusted outcome reports required by Sections 128745 and 128746
on mortality rates in California and on any other measure of quality
the office deems appropriate. The office shall also coordinate with
other state agencies in promoting prevention and educational
initiatives on those reported procedures and conditions.
SEC. 8. Section 128748 is added to the Health and Safety Code, to
read:
128748. (a) This section shall apply to any risk-adjusted outcome
report that includes reporting of data by an individual physician.
(b) (1) The office shall obtain data necessary to complete a
risk-adjusted outcome report from hospitals. If necessary data for
an outcome report is available only from the office of a physician
and not the hospital where the patient received treatment, then the
hospital shall make a reasonable effort to obtain the data from the
physician's office and provide the data to the office. In the event
that the office finds any errors, omissions, discrepancies, or other
problems with submitted data, the office shall contact either the
hospital or physician's office that maintains the data to resolve the
problems.
(2) The office shall collect the minimum data necessary for
purposes of testing or validating a risk-adjusted model. Except for
data collected for purposes of testing or validating a risk-adjusted
model, the office shall not collect data for an outcome report nor
issue an outcome report until the clinical panel established pursuant
to this section has approved the risk-adjusted model.
(c) For each risk-adjusted outcome report on a medical, surgical,
or obstetric condition or procedure that includes reporting of data
by an individual physician, the office director shall appoint a
clinical panel, which shall have nine members. Three members shall
be appointed from a list of three or more names submitted by the
physician specialty society that most represents physicians
performing the medical, surgical, and obstetric procedure for which
data is collected. Three members shall be appointed from a list of
three or more names submitted by the California Medical Association.
Three members shall be appointed from lists of names submitted by
consumer organizations. At least one-half of the appointees from the
lists submitted by the physician specialty society and the
California Medical Association, and at least one appointee from the
lists submitted by consumer organizations, shall be experts in
collecting and reporting outcome measurements for physicians or
hospitals. The panel may include physicians from another state. The
panel shall review and approve the development of the
risk-adjustment model to be used in preparation of the outcome
report.
(d) For the clinical panel authorized by subdivision (c) for
coronary artery bypass graft surgery, three members shall be
appointed from a list of three or more names submitted by the
California Chapter of the American College of Cardiology. Three
members shall be appointed from list of three or more names submitted
by the California Medical Association. Three members shall be
appointed from lists of names submitted by consumer organizations.
At least one-half of the appointees from the lists submitted by the
California Chapter of the American College of Cardiology, and the
California Medical Association, and at least one appointee from the
lists submitted by consumer organizations, shall be experts in
collecting and reporting outcome measurements for physicians and
surgeons or hospitals. The panel may include physicians from another
state. The panel shall review and approve the development of the
risk-adjustment model to be used in preparation of the outcome
report.
(e) Any report that includes reporting by an individual physician
shall include, at a minimum, the risk-adjusted outcome data for each
physician. The office may also include in the report, after
consultation with the clinical panel, any explanatory material,
comparisons, groupings, and other information to facilitate consumer
comprehension of the data.
(f) Members of a clinical panel shall serve without compensation,
but shall be reimbursed for any actual and necessary expenses
incurred in connection with their duties as members of the clinical
panel.
SEC. 9. Section 128750 of the Health and Safety Code is amended to
read:
128750. (a) Prior to the public release of the annual outcome
reports, the office shall furnish a preliminary report to each
hospital that is included in the report. The office shall allow the
hospital and chief of staff 60 days to review the outcome scores and
compare the scores to other California hospitals. A hospital or its
chief of staff that believes that the risk-adjusted outcomes do not
accurately reflect the quality of care provided by the hospital may
submit a statement to the office, within the 60 days, explaining why
the outcomes do not accurately reflect the quality of care provided
by the hospital. The statement shall be included in an appendix to
the public report, and a notation that the hospital or its chief of
staff has submitted a statement shall be displayed wherever the
report presents outcome scores for the hospital.
(b) (1) Prior to the public release of any outcome report that
includes data by a physician, the office shall furnish a preliminary
report to each physician that is included in the report. The office
shall allow the physician 30 days from the date the office sends the
report to the physician to review the outcome scores and compare the
scores to other California physicians. A physician who believes that
the risk-adjusted outcome does not accurately reflect the quality of
care provided by the physician may submit a statement to the office
within the 30 days, explaining why the outcomes do not accurately
reflect the quality of care provided by the physician.
(2) The office shall promptly review the physician's statement and
shall respond to the physician with one of the following
conclusions:
(A) The physician's statement reveals a flaw in the accuracy of
the reported data relating to the physician that materially
diminishes the validity of the report. If this finding is made, the
data for that physician shall not be included in the report until the
flaw in the physician's data is corrected.
(B) The physician's statement reveals a flaw in the
risk-adjustment model that materially diminishes the value of the
report for all physicians. If this finding is made, the report using
that risk-adjustment model shall not be issued until the flaw is
corrected.
(C) The physician's statement does not reveal a flaw in either the
accuracy of the reported data relating to the physician or the
risk-adjustment model in which case the report shall be used, unless
the physician chooses to use the procedure set forth in paragraph
(3).
(3) If a physician is not satisfied with the conclusion reached by
the office, the physician shall notify the office of that fact.
Upon receipt of the notice, the office shall forward the physician's
statement to the appropriate clinical panel appointed pursuant to
Section 128748. The office shall forward the physician's statement
with any information identifying the physician or the physician's
hospital redacted, or shall adopt other means to ensure the physician'
s identity is not revealed to the panel. The clinical panel shall
promptly review the physician statement and the conclusion of the
office and shall respond by either upholding the conclusion or
reaching one of the other conclusions set forth in this subdivision.
The panel decision shall be the final determination regarding the
physician's statement. The process set forth in this subdivision
shall be completed within 60 days from the date the office sends the
report to each physician included in the report. If a decision by
either the office or the clinical panel cannot be reached within the
60-day period, then the outcome report may be issued but shall not
include data for the physician submitting the statement.
(c) The office shall, in addition to public reports, provide
hospitals and the chiefs of staff of the medical staffs with a report
containing additional detailed information derived from data
summarized in the public outcome reports as an aid to internal
quality assurance.
(d)
If, pursuant to the recommendations of the office, based on the
advice of the commission, in response to the recommendations of the
technical advisory committee made pursuant to subdivision (d) of this
section, the Legislature subsequently amends Section 128735 to
authorize the collection of additional discharge data elements, then
the outcome reports for conditions and procedures for which
sufficient data is not available from the current abstract record
will be produced following the collection and analysis of the
additional data elements.
(e) The recommendations of the technical advisory committee for
the addition of data elements to the discharge abstract should take
into consideration the technical feasibility of developing reliable
risk-adjustment factors for additional procedures and conditions as
determined by the technical advisory committee with the advice of the
research community, physicians and surgeons, hospitals, consumer or
patient advocacy groups, and medical records personnel.
(f) The technical advisory committee at a minimum shall identify a
limited set of core clinical data elements to be collected for all
of the added procedures and conditions and unique clinical variables
necessary for risk adjustment of specific conditions and procedures
selected for the outcomes report program. In addition, the committee
should give careful consideration to the costs associated with the
additional data collection and the value of the specific information
to be collected.
(g) The technical advisory committee shall also engage in a
continuing process of data development and refinement applicable to
both current and prospective outcome studies.
SEC. 10. Section 128755 of the Health and Safety Code is amended
to read:
128755. (a) (1) Hospitals shall file the reports required by
subdivisions (a), (b), (c), and (d) of Section 128735 with the office
within four months after the close of the hospital's fiscal year
except as provided in paragraph (2).
(2) If a licensee relinquishes the facility license or puts the
facility license in suspense, the last day of active licensure shall
be deemed a fiscal year end.
(3) The office shall make the reports filed pursuant to this
subdivision available no later than three months after they were
filed.
(b) (1) Skilled nursing facilities, intermediate care facilities,
intermediate care facilities/developmentally disabled, and congregate
living facilities, including nursing facilities certified by the
state department to participate in the Medi-Cal program, shall file
the reports required by subdivisions (a), (b), (c), and (d) of
Section 128735 with the office within four months after the close of
the facility's fiscal year, except as provided in paragraph (2).
(2) (A) If a licensee relinquishes the facility license or puts
the facility licensure in suspense, the last day of active licensure
shall be deemed a fiscal year end.
(B) If a fiscal year end is created because the facility license
is relinquished or put in suspense, the facility shall file the
reports required by subdivisions (a), (b), (c), and (d) of Section
128735 within two months after the last day of active licensure.
(3) The office shall make the reports filed pursuant to paragraph
(1) available not later than three months after they are filed.
(4) (A) Effective for fiscal years ending on or after December 31,
1991, the reports required by subdivisions (a), (b), (c), and (d) of
Section 128735 shall be filed with the office by electronic media,
as determined by the office.
(B) Congregate living health facilities are exempt from the
electronic media reporting requirements of subparagraph (A).
(c) A hospital shall file the reports required by subdivision (g)
of Section 128735 as follows:
(1) For patient discharges on or after January 1, 1999, through
December 31, 1999, the reports shall be filed semiannually by each
hospital or its designee not later than six months after the end of
each semiannual period, and shall be available from the office no
later than six months after the date that the report was filed.
(2) For patient discharges on or after January 1, 2000, through
December 31, 2000, the reports shall be filed semiannually by each
hospital or its designee not later than three months after the end of
each semiannual period. The reports shall be filed by electronic
tape, diskette, or similar medium as approved by the office. The
office shall approve or reject each report within 15 days of
receiving it. If a report does not meet the standards established by
the office, it shall not be approved as filed and shall be rejected.
The report shall be considered not filed as of the date the
facility is notified that the report is rejected. A report shall be
available from the office no later than 15 days after the date that
the report is approved.
(3) For patient discharges on or after January 1, 2001, the
reports shall be filed by each hospital or its designee for report
periods and at times determined by the office. The reports shall be
filed by online transmission in formats consistent with national
standards for the exchange of electronic information. The office
shall approve or reject each report within 15 days of receiving it.
If a report does not meet the standards established by the office, it
shall not be approved as filed and shall be rejected. The report
shall be considered not filed as of the date the facility is notified
that the report is rejected. A report shall be available from the
office no later than 15 days after the date that the report is
approved.
(d) The reports required by subdivision (a) of Section 128736
shall be filed by each hospital for report periods and at times
determined by the office. The reports shall be filed by online
transmission in formats consistent with national standards for the
exchange of electronic information. The office shall approve or
reject each report within 15 days of receiving it. If a report does
not meet the standards established by the office, it shall not be
approved as filed and shall be rejected. The report shall be
considered not filed as of the date the facility is notified that the
report is rejected. A report shall be available from the office no
later than 15 days after the report is approved.
(e) The reports required by subdivision (a) of Section 128737
shall be filed by each hospital or freestanding ambulatory surgery
clinic for report periods and at times determined by the office. The
reports shall be filed by online transmission in formats consistent
with national standards for the exchange of electronic information.
The office shall approve or reject each report within 15 days of
receiving it. If a report does not meet the standards established by
the office, it shall not be approved as filed and shall be rejected.
The report shall be considered not filed as of the date the
facility is notified that the report is rejected. A report shall be
available from the office no later than 15 days after the report is
approved.
(f) Facilities shall not be required to maintain a full-time
electronic connection to the office for the purposes of online
transmission of reports as specified in subdivisions (c), (d), and
(e). The office may grant exemptions to the online transmission of
data requirements for limited periods to facilities. An exemption
may be granted only to a facility that submits a written request and
documents or demonstrates a specific need for an exemption.
Exemptions shall be granted for no more than one year at a time, and
for no more than a total of five consecutive years.
(g) The reports referred to in paragraph (2) of subdivision (a) of
Section 128730 shall be filed with the office on the dates required
by applicable law and shall be available from the office no later
than six months after the date that the report was filed.
(h) The office shall post on its Web site and make available to
any person a copy of any report referred to in subdivision (a), (b),
(c), (d), or (g) of Section 128735, subdivision (a) of Section
128736, subdivision (a) of Section 128737, Section 128740, and, in
addition, shall make available in electronic formats reports referred
to in subdivision (a), (b), (c), (d), or (g) of Section 128735,
subdivision (a) of Section 128736, subdivision (a) of Section 128737,
Section 128740, and subdivisions (a) and (c) of Section 128745,
unless the office determines that an individual patient's rights of
confidentiality would be violated. The office shall make the reports
available at cost.
SEC. 11. Section 128765 of the Health and Safety Code is amended
to read:
128765. (a) The office, with the advice of the commission, shall
maintain a file of all the reports filed under this chapter at its
Sacramento office. The office shall also post all reports on its Web
site. Subject to any rules the office, with the advice of the
commission, may prescribe, these reports shall be produced and made
available for inspection upon the demand of any person, with the
exception of hospital discharge abstract data that shall be available
for public inspection unless the office determines that an
individual patient's rights of confidentiality would be violated.
(b) The reports filed under this chapter shall include an
executive summary, written in plain English to the maximum extent
practicable, that shall include, but not be limited to, a discussion
of findings, conclusions, and trends concerning the overall quality
of medical outcomes, including a comparison to reports from prior
years, for the procedure or condition studied by the report. The
office shall disseminate the reports as widely as practical to
interested parties, including, but not limited to, hospitals,
providers, the media, purchasers of health care, consumer or patient
advocacy groups, and individual consumers.
(c) Copies certified by the office as being true and correct,
copies of reports properly filed with the office pursuant to this
chapter, together with summaries, compilations, or supplementary
reports prepared by the office, shall be introduced as evidence,
where relevant, at any hearing, investigation, or other proceeding
held, made, or taken by any state, county, or local governmental
agency, board, or commission that participates as a purchaser of
health facility services pursuant to the provisions of a publicly
financed state or federal health care program. Each of these state,
county, or local governmental agencies, boards, and commissions shall
weigh and consider the reports made available to it pursuant to the
provisions of this subdivision in its formulation and implementation
of policies, regulations, or procedures regarding reimbursement
methods and rates in the administration of these publicly financed
programs.
(d) The office, with the advice of the commission, shall compile
and publish summaries of the data for the purpose of public
disclosure. The commission shall approve the policies and procedures
relative to the manner of data disclosure to the public. The
office, with the advice of the commission, may initiate and conduct
studies as it determines will advance the purposes of this chapter.
(e) In order to assure that accurate and timely data are available
to the public in useful formats, the office shall establish a public
liaison function. The public liaison shall provide technical
assistance to the general public on the uses and applications of
individual and aggregate health facility data and shall provide the
director and the commission with an annual report on changes that can
be made to improve the public's access to data.
(f) In addition to its public liaison function, the office shall
continue the publication of aggregate industry and individual health
facility cost and operational data published by the California Health
Facilities Commission as described in subdivision (b) of Section
441.95, as that section existed on December 31, 1985. This
publication shall be submitted to the Legislature not later than
March 1 of each year commencing with calendar year 1986 and in
addition shall be offered for sale as a public document.
SEC. 12. Section 128815 of the Health and Safety Code is repealed.