BILL ANALYSIS                                                                                                                                                                                                    




                   Senate Appropriations Committee Fiscal Summary
                           Senator Christine Kehoe, Chair

                                           270 (Alquist)
          
          Hearing Date:  5/28/2009        Amended: 5/5/2009
          Consultant: Katie Johnson       Policy Vote: Health 9-0
          _________________________________________________________________ 
          ____
          BILL SUMMARY:  SB 270 would create a health information  
          technology advisory panel to advise the Governor and the  
          Legislature on health information technology in California.
          _________________________________________________________________ 
          ____
                            Fiscal Impact (in thousands)

           Major Provisions         2009-10      2010-11       2011-12     Fund  
          Advisory panel staff                 $50        $100    
          $100General
          _________________________________________________________________ 
          ____

          STAFF COMMENTS:  SUSPENSE FILE. AS PROPOSED TO BE AMENDED.

          This bill would create a health information technology advisory  
          panel that would consist of 22 members, as specified, to make  
          recommendations to maximize the state's eligibility and award of  
          funds made available by the American Recovery and Reinvestment  
          Act of 2009 (ARRA). The ARRA would provide for a $36 billion  
          over several years, mostly for Medi-Cal and Medicare provider  
          incentives to adopt electronic medical record systems, with $2  
          billion set aside for competitive grant funding, subject to  
          further guidance from the Centers for Medicare and Medicaid  
          Services (CMS). To be eligible for provider payments, a provider  
          must demonstrate a "meaningful use" of health information  
          technology.

          It is estimated that this advisory panel would need between 1 to  
          3 staff to facilitate its duties annually, which would include  
          making recommendations to maximize the state's eligibility for  
          ARRA awards, to ensure that safety net providers have access to  
          ARRA funds, to the Governor and the Legislature on a mechanism  
          for designating a nonstate entity that would execute tasks  
          related to accessing federal funds and whether such an entity is  
          necessary, for working with higher education to integrate health  
          information technology into its curriculum and clinical  










          education, to appropriate federal entities for standards and  
          certification, on qualifications for centers in the state that  
          may provide technical assistance and best practices on health  
          information technology, to ensure providers have access to ARRA  
          incentive payments, and to ensure that providers understand the  
          meaning of "meaningful use" as defined in federal law.

          This bill would require that the panel meet at least monthly for  
          the first year, and then as deemed necessary by the chair of the  
          panel. This bill would require the panel to make a  
          recommendation in 2014 whether there would be a need for the  
          advisory panel to exist beyond 2016. This bill would provide  
          that although members would serve without compensation, they  
          would be reimbursed for travel expenses and that consumer  
          representatives could receive a per diem compensation if they  
          would otherwise be unable to attend for economic reasons.

          Page 2
          SB 270 (Alquist)

          There are currently several public and private initiatives  
          underway in California to respond to the health information  
          technology provisions of the ARRA, including an April 2009 CHHS  
          time-limited collaborative to aid in determining whether the  
          state should play the lead role in providing technical services  
          related to health information technology or if that role would  
          be better suited for a state designated entity (SDE), as  
          provided for in the ARRA. This collaborative is funded primarily  
          with foundation moneys and is expected to complete its task and  
          issue a final report in August of 2009. Also, in April 2009, the  
          Governor appointed a deputy secretary of health information  
          technology in the CHHS. It is unknown whether or not current  
          initiatives could fulfill the role of the advisory board set  
          forth in this bill.

          As proposed to be amended, this bill would require that advisory  
          panel meetings would take place via teleconference and would,  
          therefore, not reimburse members for travel expenses. This bill  
          would require, that to the extent possible, the advisory panel  
          would be supported with existing state resources and that it  
          would utilize the expertise of the CHHS's Deputy Secretary for  
          Health Information Technology (HIT). With this addition, it is  
          likely that the panel would require the support of 1 - 2  
          additional staff at a cost of approximately $100,000, assuming  
          that the Deputy Secretary for HIT would count toward one of the  
          staff persons. This bill would also provide that federal and  










          special funds may be used to support this advisory panel and  
          would sunset the panel on January 1, 2014.