BILL ANALYSIS                                                                                                                                                                                                    

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          SB 270 (Alquist)
          As Amended August 2, 2010
          2/3 vote.  Urgency 

           SENATE VOTE  :33-0  
           HEALTH              19-0        APPROPRIATIONS      17-0        
          |Ayes:|Monning, Fletcher,        |Ayes:|Fuentes, Conway,          |
          |     |Ammiano, Carter, Conway,  |     |Bradford,                 |
          |     |De La Torre, De Leon,     |     |Huffman, Coto, Davis, De  |
          |     |Eng, Gaines, Hayashi,     |     |Leon, Gatto, Hall,        |
          |     |Hernandez, Jones, Bonnie  |     |Harkey, Miller, Nielsen,  |
          |     |Lowenthal, Nava,          |     |Norby, Skinner, Solorio,  |
          |     |V. Manuel Perez, Salas,   |     |Torlakson, Torrico        |
          |     |Smyth, Audra Strickland,  |     |                          |
          |     |Silva                     |     |                          |
          |     |                          |     |                          |
           SUMMARY  :  Clarifies existing law related to delays in reporting  
          unauthorized access to, and use or disclosure of, a patient's  
          medical information to the California Department of Public  
          Health (DPH), makes other specified clarifications, and extends  
          sunset for California Office of Health Insurance Portability and  
          Accountability Act of 2001 (HIPAA) Implementation (CalOHI).   
          Specifically,  this bill  :   

          1)Authorizes a clinic, health facility, home health agency, or  
            hospice to delay reporting unlawful or unauthorized access,  
            use, or disclosure of a patient's medical information to DPH  
            if a law enforcement agency or official provides the entity  
            with a written or oral statement that compliance with the  
            reporting requirement would likely impede the law enforcement  
            agency's  investigation  , rather than  activities  , that relates  
            to the unlawful or unauthorized access to, and use or  
            disclosure of, a patient's medical information.  

          2)Authorizes a law enforcement agency or official to request an  
            extension of the 60-day delay based upon a written declaration  
            that there exists a bona fide, ongoing, significant criminal  
            investigation of serious wrongdoing, that notification of  


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            patients will undermine the law enforcement agency's  
             investigation  , rather than  activities  .

          3)Clarifies for purposes of this bill, that internal paper  
            records, electronic mail, or facsimile transmissions  
            inadvertently misdirected within the same facility or health  
            care, as specified, shall not constitute unauthorized access  
            to, or use or disclosure of a patient's medical information. 

          4)Clarifies, for enforcement purposes, that it shall be presumed  
            that the facility did not notify the affected patient if the  
            notification was not documented and authorizes this  
            presumption to be rebutted by a licensee only if it  
            demonstrates, by a preponderance of evidence, that the  
            notification was made. 

          5)Extends the sunset date CalOHI from July 1, 2010, to January  
            1, 2013.  

          6)Contains an urgency clause to make the provisions of this bill  
            effective immediately upon enactment.  

           FISCAL EFFECT :  According to the Assembly Appropriations  
          Committee, annualized costs of $4 million (65% General Fund) to  
          extend the sunset of CalOHI until January 1, 2013. The CalOHI  
          funding is included in the 2010-11 Budget proposed by the  
          Governor and approved by the legislative budget committees.

           COMMENTS  :  According to the author, this bill clarifies that  
          disclosure of medical privacy breaches can be suspended for law  
          enforcement investigations, rather than any law enforcement  
          activity, which significantly narrows the limit on disclosure of  
          medical privacy breaches.  Additionally, this bill extends the  
          sunset of the state agency responsible for overseeing the  
          federal health information technology infrastructure grants,  
          including the federal health information exchange grant, and  
          serves as the primary resource for state entities on health  
          information privacy and the implementation of HIPAA regulations.  
           The sunset date for CalOHI is currently set for July 1, 2010,  
          which is why the author requests an urgency clause.  

           Analysis Prepared by  :    Martin Radosevich / HEALTH / (916)  


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