BILL NUMBER: AB 278	AMENDED
	BILL TEXT

	AMENDED IN SENATE  JUNE 21, 2010
	AMENDED IN SENATE  JUNE 3, 2010

INTRODUCED BY   Assembly Member Monning

                        FEBRUARY 12, 2009

    An act to add Section 100336 to the Health and Safety
Code, and to amend Sections 14012 and 14013 of the Unemployment
Insurance Code, relating to public health.   An act to
add and repeal Division 109.6 (commencing with Section 130275) to the
Health and Safety Code, relating to health information. 


	LEGISLATIVE COUNSEL'S DIGEST


   AB 278, as amended, Monning.  California Workforce
Investment Board: Public Health.   Health information
exchange: demonstration projects.  
   Existing law establishes the Office of Health Information
Integrity within the California Health and Human Services Agency to
ensure the enforcement of state law mandating confidentiality of
medical information and to impose administrative fines for the
unauthorized use of medical information. Existing law authorizes the
California Health and Human Services Agency, or one of the
departments under its jurisdiction, to apply for federal funds made
available through the federal American Recovery and Reinvestment Act
of 2009 (ARRA) for health information technology and exchange. 

   This bill would authorize the office to establish and administer
demonstration projects to evaluate potential solutions to facilitate
health information exchange that promote quality of care, respect the
privacy and security of personal health information, and enhance the
trust of the stakeholders. This bill would authorize
California-based health care entities, as defined, to submit an
application with the office to be approved as demonstration project
participants, as defined. The bill would authorize the office to
approve annually up to 4 projects as demonstration projects. The bill
would require any costs associated with the support, assistance, and
evaluation of approved demonstration projects to be funded
exclusively by the above-described federal funds or other non-General
Fund sources.  
   This bill would provide that it shall become inoperative on the
date the Director of the Office of Health Information Integrity
executes a declaration stating that grant period for the
above-described federal funds has ended, and as of that date would be
repealed.  
   Existing law establishes the California Workforce Investment Board
responsible for assisting the Governor in the development,
oversight, and continuous improvement of California's workforce
investment system. Existing law specifies the composition of the
board to include, among others, representatives of business and of
labor organizations.  
   This bill would require the board to additionally include
representatives of philanthropic organizations that are actively
engaged in providing learning, mentoring, and work opportunities to
recruit, educate, and train individuals for, and retain individuals
in, careers in health care and related industries.  

   This bill would revise the responsibilities of the board to
include developing an application to the federal Health Resources and
Services Administration of the Department of Health and Human
Services for a federal health care workforce development planning
grant.  
   The bill would also require the State Department of Public Health
to apply to the federal Centers for Disease Control and Prevention
for a grant to promote positive health behaviors and outcomes for
populations in medically underserved communities through the use of
community health workers, as specified in the federal Patient
Protection and Affordable Care Act of 2010. 
   Vote: majority. Appropriation: no. Fiscal committee: yes.
State-mandated local program: no.


THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:

   SECTION 1.    Division 109.6 (commencing with Section
130275) is added to the   Health and Safety Code  
, to read:  

      DIVISION 109.6.  Health Information Exchange Privacy and
Security Demonstration Projects


   130275.  The Legislature finds and declares all of the following:
   (a) There is a need to enhance California's ability to obtain and
use federal funding, as awarded in the State Cooperative Grant
Agreement for health information exchange, for the establishment of
statewide health information exchange infrastructure in California.
The California Health and Human Services Agency is authorized by the
Legislature, under Section 130255, to use those federal funds to
achieve that purpose.
   (b) Health information exchange has the potential to significantly
improve the quality of treatment and care, reduce unnecessary health
care costs, and increase administrative efficiencies within the
health care system. The application of health information exchange
technology to manage health information will also have a significant
impact on consumers, health care facilities, and licensed health care
providers.
   (c) Current laws may not adequately protect privacy, or may impose
obstacles to the exchange of vital health information, as required
by the State Cooperative Grant Agreement for health information
exchange and other federal health information funding programs.
   (d) It is the intent of the Legislature to authorize the Office of
Health Information Integrity within the California Health and Human
Services Agency to establish and administer demonstration projects
funded by federal grants and other sources. It is the intent of the
Legislature that the demonstration projects do all of the following:
   (1) Identify barriers to implementing health information
exchanges.
   (2) Test potential security and privacy policies for the safe and
secure exchange of health information.
   (3) Identify and address differences between state and federal
laws regarding privacy of health information.
   130276.  For purposes of this division, the following definitions
apply:
   (a) "California-based health care entity" means a health care
entity based primarily in California.
   (b) "Demonstration project" means a project approved and
administered by the office in accordance with this division and the
State Cooperative Grant Agreement for health information exchange or
any other similar grant or grants.
   (c) "Demonstration project participant" means a California-based
health care entity that is approved by the office to participate in a
demonstration project.
   (d) "Director" means the Director of the Office of Health
Information Integrity.
   (e) "Health information exchange service participant" means a
California-based health care entity that has voluntarily agreed to
use the health information exchange services developed in accordance
with this division.
   (f) "Meaningful use" means the term as defined in the federal
Health Information Technology for Economic and Clinical Health Act
(HITECH Act) (Public Law 111-5) and the regulations promulgated
thereunder.
   (g) "Office" means the Office of Health Information Integrity.
   (h) "State Cooperative Grant Agreement" means the grant agreement
between the federal government and the state in which the federal
government awarded the state with grant money pursuant to the HITECH
Act in February 2010.
   130277.  The director may adopt regulations to ensure all approved
health information exchange service participants and demonstration
project participants follow rules, and work within parameters, that
are consistent for the exchange of information.
   130278.  Before adopting regulations pursuant to Section 130277,
the office shall adopt the following standards:
   (a) At least 45 days prior to adoption, the office shall post a
proposed regulation on its Internet Web site. Public comment shall be
accepted by the office for at least 30 days after the proposed
regulation is posted. If a member of the public requests a public
hearing during the 30-day review period, the hearing shall be held
prior to adoption of the regulation. The process described in this
subdivision shall apply to the adoption of new regulations and to
changes to existing regulations.
   (b) Adoption of, and changes to, regulations adopted pursuant to
this division shall not be subject to the rulemaking requirements of
Section 11343.4 and Article 5 (commencing with Section 11346) and
Article 6 (commencing with Section 11349) of Chapter 3.5 of Part 1 of
Division 3 of Title 2 of the Government Code.
   (c) The director shall file any regulation adopted pursuant to
Section 130277 with the Office of Administrative Law for filing with
the Secretary of State and publication in the California Code of
Regulations. Any regulation filed with the Office of Administrative
Law pursuant to this subdivision shall include a citation to this
section and any other applicable state or federal laws as providing
authority for the adoption of the regulation.
   (1) Any regulation adopted pursuant to Section 130277 shall become
effective on the date it is filed with the Secretary of State unless
the director prescribes a later date in the regulation or in a
written instrument filed with the regulation.
   (2) Any regulation adopted pursuant to Section 130277 shall expire
the date that this division is repealed.
   130279.  (a) The California Health and Human Services Agency,
through the office, may establish and administer demonstration
projects to evaluate potential solutions to facilitate health
information exchange that promote quality of care, respect the
privacy and security of personal health information, and enhance the
trust of the stakeholders.
   (b) California-based health care entities may submit an
application with the office to be approved as demonstration project
participants. Upon receiving an application, the office shall do both
of the following:
   (1) Assist applicants in soliciting federal funds for the
demonstration projects.
   (2) Work with applicants to define the scope of the demonstration
project.
   (c) The director may approve demonstration projects to test for,
but not limited to, any of the following areas:
   (1) Patient consent and informing policies and practices.
   (2) New technologies and applications that enable the transmission
of protected health information, while increasing privacy
protections by ensuring only required health data is transmitted for
purposes and uses consistent with state and federal law.
   (3) Implementation issues encountered by small solo health care
providers as a result of higher privacy and security requirements.
   (d) The selection of demonstration projects shall be based on, but
not limited to, the following criteria:
   (1) Areas critical to building consumer trust and confidence in
the health information exchange system.
   (2) Projects that help support the exchange of information
critical to meeting the federal meaningful use provisions.
   (3) Areas recommended by the California health information
exchange consumer and industry stakeholder advisory process.
   (e) The office shall engage with health care stakeholders to
evaluate issues identified by the demonstration projects, comment
upon proposed regulations, and discuss solutions for health
information exchange.
   (f) The office may annually approve up to four projects, as
demonstration projects.
   (g) The office shall work collaboratively with approved
demonstration project participants to identify a set of common data
elements that will be used to collect, analyze, and measure
performance.
   (h) The office shall receive reports from the demonstration
project participants on the outcome of the demonstration projects no
later then 60 business days after the end of the demonstration
project.
   130280.  (a) The office shall review the results of a
demonstration project and report those results to the Legislature no
later than six months after the end of a demonstration project.
   (b) The demonstration projects carried out utilizing federal grant
funds may be subject to federal auditing provisions.
   130281.  Any costs associated with the support, assistance, and
evaluation of approved demonstration projects shall be funded
exclusively by federal funds or other non-General Fund sources.
   130282.  This division shall become inoperative on the date the
director executes a declaration stating that grant period for the
State Cooperative Grant Agreement for health information exchange has
ended, and as of that date is repealed.  All matter omitted in
this version of the bill appears in the bill as amended in the
Senate, June 3, 2010. (JR11)