BILL ANALYSIS                                                                                                                                                                                                    Ó



                                                                            



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                                 UNFINISHED BUSINESS


          Bill No:  SB 249
          Author:   Leno (D)
          Amended:  9/3/13
          Vote:     21

           
           SENATE HEALTH COMMITTEE  :  9-0, 4/24/13
          AYES:  Hernandez, Anderson, Beall, De León, DeSaulnier, Monning,  
            Nielsen, Pavley, Wolk

           SENATE JUDICIARY COMMITTEE  :  7-0, 4/30/13
          AYES:  Evans, Walters, Anderson, Corbett, Jackson, Leno, Monning

           SENATE APPROPRIATIONS COMMITTEE  :  7-0, 5/23/13
          AYES:  De León, Walters, Gaines, Hill, Lara, Padilla, Steinberg

           SENATE FLOOR  :  39-0, 5/28/13
          AYES: Anderson, Beall, Berryhill, Block, Calderon, Cannella,  
            Corbett, Correa, De León, DeSaulnier, Emmerson, Evans, Fuller,  
            Gaines, Galgiani, Hancock, Hernandez, Hill, Hueso, Huff,  
            Jackson, Knight, Lara, Leno, Lieu, Liu, Monning, Nielsen,  
            Padilla, Pavley, Price, Roth, Steinberg, Torres, Walters,  
            Wolk, Wright, Wyland, Yee
          NO VOTE RECORDED: Vacancy

           ASSEMBLY FLOOR  :  77-0, 9/9/13 - See last page for vote


           SUBJECT  :    Public health:  health records:  confidentiality

           SOURCE  :     AIDS Legal Referral Panel
                      Conference of California Bar Associations
                      L.A. Gay & Lesbian Center
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                      San Francisco AIDS Foundation


           DIGEST  :    This bill authorizes the sharing of health records  
          involving the diagnosis, care, and treatment of human  
          immunodeficiency virus (HIV) or acquired immunodeficiency  
          syndrome (AIDS) related to a beneficiary enrolled in federal  
          Ryan White Act (RWA) funded programs who may be eligible for  
          health care under the federal Patient Protection and Affordable  
          Care Act (ACA) between the Department of Public Health (DPH) and  
          qualified entities, as specified.

           Assembly Amendments  clarify that both the local health officer  
          (LHO) and DPH are authorized to access reports of HIV infection  
          that are electronically submitted by laboratories, instead of  
          requiring laboratories, upon request by DPH, to report cases of  
          HIV infection by name directly, and make other, technical  
          changes.

           ANALYSIS  :    

          Existing law:

          1. Requires DPH to administer a program to provide information,  
             establish testing sites, and award contracts for AIDS early  
             intervention projects for the provision of appropriate  
             medical treatment to prevent or delay the progression of  
             disease that results from HIV infection, to coordinate  
             related services, and to provide information and education to  
             prevent the spread of the infection to others. 

          2. Establishes, under the federal Health Insurance Portability  
             and Accountability Act of 1996 (HIPAA), requirements relating  
             to the provision of health insurance, and the protection of  
             privacy of individually identifiable health information.

          3. Prohibits, under the state Confidentiality of Medical  
             Information Act, providers of health care, health care  
             service plans, or contractors, as defined, from sharing  
             medical information without the patient's written  
             authorization, subject to certain exceptions, including  
             disclosure to a probate court investigator, as specified. 

          4. Requires health care providers and laboratories to report  

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             cases of HIV infection to the LHO using patient names, as  
             specified.  Requires LHOs to report unduplicated HIV cases by  
             name to DPH.

          5. Requires health records relating to HIV or AIDS containing  
             personally identifying information, that were developed or  
             acquired by state or local public health agencies or an agent  
             of such an agency, to be confidential and not be disclosed,  
             except as provided by law for public health purposes or in  
             accordance with a written authorization by the person who is  
             the subject of the record or by his/her guardian or  
             conservator.

          6. Permits disclosures for the purpose of facilitating  
             appropriate HIV/AIDS medical care and treatment, including:

             A.    The state public health agency HIV surveillance staff,  
                AIDS Drug Assistance Program (ADAP) staff, and care  
                services staff may further disclose the information to  
                local public health agency staff, who may further disclose  
                the information to the HIV-positive person who is the  
                subject of the record, or the health care provider who  
                provides his/her HIV care, for the purpose of proactively  
                offering and coordinating care and treatment services to  
                him/her.

             B.    ADAP staff and DPH care services staff may further  
                disclose the information directly to the HIV-positive  
                person who is the subject of the record or the health care  
                provider who provides his or her HIV care, for the purpose  
                of proactively offering and coordinating care and  
                treatment services to him/her.

          7. Prohibits the use of public health records related to persons  
             with HIV/AIDS to determine the insurability of any person.   
             Prohibits the use of the results of an HIV test for  
             determination of insurability, except for life and disability  
             insurance under certain conditions. 

          8. Establishes the ACA, which imposes various requirements, some  
             of which take effect on January 1, 2014, on states, carriers,  
             employers, and individuals regarding health care coverage.   
             Requires every individual to be covered under minimum  
             essential coverage, as specified, and requires every health  

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             insurance issuer offering coverage in the individual or small  
             group markets to ensure coverage includes specified essential  
             health benefits.

          9. Establishes Covered California to facilitate the purchase of  
             qualified health plans by qualified individuals and small  
             employers by January 1, 2014.

          This bill:

          1. Authorizes DPH and qualified entities, as defined, to share  
             with each other health records involving the diagnosis, care,  
             and treatment of HIV or AIDS related to a beneficiary  
             enrolled in RWA funded programs who may be eligible for  
             services under the ACA.

          2. Authorizes qualified entities who are covered entities HIPAA,  
             as specified, to share records only for the purpose of  
             enrolling the beneficiary in Medi-Cal, the Bridge Programs,  
             Medicaid expansion programs, and any insurance plan certified  
             Covered California, or any other program under the ACA, as  
             specified, and for the purpose of continuing access to these  
             programs and plans without disruption.

          3. Requires the information provided by DPH to be limited only  
             to the information necessary for the provisions in #1) and  
             #2) above, and excludes HIV or AIDS surveillance data.   
             Prohibits the further disclosure by any qualified entity,  
             except to any of the following, as necessary:

             A.    The person who is the subject of the record or to his  
                or her guardian or conservator;

             B.    The provider of health care for the person with HIV or  
                AIDS to whom the information pertains; or 

             C.    The Office of AIDS (OA) within DPH.

          4. Defines qualified entity to mean the following:

             A.    Department of Health Care Services;

             B.    Covered California;


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             C.    Medi-Cal managed care plans;

             D.    Health plans participating in the Bridge Program;

             E.    Health plans offered through California; or

             F.    County health departments delivering HIV or AIDS health  
                care services.

          5. Prohibits the disclosure, discovery, or compelling the  
             production of the shared information in any civil, criminal,  
             administrative, or other proceeding.

          6. Provides that #1) through #5) above are to be implemented  
             only to the extent permitted pursuant to federal law and all  
             employees and contractors of a qualified entity who have  
             access to confidential HIV-related medical records under this  
             bill are subject to, and all information that is shared is to  
             be protected under HIPAA, the Confidentiality of Medical  
             Information Act, and the Insurance Information and Privacy  
             Protection Act. 

          7. Authorizes the LHO and DPH to access reports of HIV infection  
             that are electronically submitted by laboratories, as  
             specified. 

          8. Extends privacy protections that currently apply to HIV blood  
             tests to all types of HIV tests.

          9. Makes other technical, clarifying, and conforming changes.

           Background
           
          According to a September 2012 Kaiser Family Foundation report  
          about expanded coverage for people with HIV/AIDS, under the ACA  
          there are multiple public and private sources of insurance  
          coverage and care for people with HIV in the United States.   
          Medicaid (Medi-Cal in California), the nation's principal  
          safety-net health insurance program for low-income Americans, is  
          estimated to cover the largest share of people with HIV.  Fewer  
          are covered by Medicare (the federal health insurance program  
          for people age 65 and older and adults with permanent  
          disabilities), or have private insurance.  A significant share  
          is uninsured, relying primarily on the RWA, the nation's single  

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          largest federal grant program designed specifically for people  
          with HIV who are uninsured or underinsured, and operating as the  
          "payer of last resort."

          The RWA funds health care and support services for people who  
          have HIV/AIDS and who have no health insurance or are  
          underinsured.  According to a 2009 Office of Inspector General  
          report to California, it is the largest source of federal  
          funding specifically for people with HIV/AIDS, and provides  
          assistance to more than 500,000 individuals each year.  The RWA  
          includes a number of programs to meet the needs of different  
          communities and populations affected by HIV/AIDS.

          In California, DPH/OA administers RWA Part B program funds given  
          to states and territories for HIV care, treatment and adherence  
          support services.  According to DPH, under that program,  
          approximately 30,000 HIV Care Program/Minority AIDS Initiative;  
          40,500 AIDS Drug Assistance Program; and 900 Health Insurance  
          Premium Payment Program/Pre-Existing Condition Insurance Plan  
          clients were served in fiscal year 2011-12. In 2012, DPH/OA  
          received over $163.4 million RWA Part B funds.

           Prior legislation
           
          AB 714 (Atkins, 2011-12) would have required notices of health  
          care eligibility be sent to individuals who are enrolled in, or  
          who cease to be enrolled in, publicly funded state health care  
          programs.  AB 714 was held on the Senate Appropriations  
          Committee suspense file.

           FISCAL EFFECT  :    Appropriation:  No   Fiscal Com.:  Yes    
          Local:  No


          According to the Senate Appropriations Committee:


             Likely administrative costs in the hundreds of thousands to  
             develop agreements with other state agencies and health plans  
             by DPH (special fund).


             Unknown potential information technology costs by DPH  
             (federal funds).  DPH indicates that it may need to make  

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             changes to its information technology systems to share  
             information with other entities.  At this time, DPH does not  
             know whether such changes are necessary or what they would  
             cost.


             Potential increase in Medi-Cal costs in the low millions  
             (federal funds). 

             Unknown potential savings to programs administered by DPH  
             because this bill helps ensure that other sources of health  
             care coverage pay for services (federal funds).

          SUPPORT  :   (Verified  5/23/13) (Unable to reverify at time of  
          writing)

          AIDS Legal Referral Panel (co-source)
          Conference of California Bar Associations (co-source)
          L.A. Gay & Lesbian Center (co-source)
          San Francisco AIDS Foundation (co-source)
          AIDS Project Los Angeles
          American Federation of State, County, and Municipal Employees,  
          AFL-CIO
          California Communities United Institute
          California Primary Care Association 
          Disability Rights California 
          National Association of Social Workers
          Project Inform
          Transgender Law Center


           ARGUMENTS IN SUPPORT  :    The Conference of California Bar  
          Associations, AIDS Legal Referral Panel and the L.A. Gay &  
          Lesbian Center write that the prohibition on any sharing of HIV  
          information, except in extremely limited circumstances is not  
          only duplicative of the protections provided under other law,  
          but it is also an impediment to individuals enrolled in the-  
          funded services, who RWA must transition to new health coverage  
          systems under recent changes to the health care laws.  The  
          California Primary Care Association states that existing law  
          impedes the RWA patients' access to care and providers' efforts  
          to coordinate care.  The Community Clinic Association of Los  
          Angeles County writes that HIV-confidentiality law is inadequate  
          as it was drafted at a time when the only method for determining  

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          HIV status was a blood test, and that this bill extends the  
          protections that now apply to blood tests to all types of HIV  
          tests, including those which may be developed in the future.

           ASSEMBLY FLOOR  :  77-0, 9/9/13
          AYES: Achadjian, Alejo, Allen, Ammiano, Atkins, Bigelow, Bloom,  
            Bocanegra, Bonilla, Bonta, Bradford, Brown, Buchanan, Ian  
            Calderon, Campos, Chau, Chávez, Chesbro, Conway, Cooley,  
            Dahle, Daly, Dickinson, Donnelly, Fong, Fox, Frazier, Beth  
            Gaines, Garcia, Gatto, Gomez, Gonzalez, Gordon, Gorell, Gray,  
            Grove, Hagman, Hall, Harkey, Roger Hernández, Holden, Jones,  
            Jones-Sawyer, Levine, Linder, Logue, Lowenthal, Maienschein,  
            Mansoor, Medina, Melendez, Mitchell, Morrell, Mullin,  
            Muratsuchi, Nazarian, Nestande, Olsen, Pan, Patterson, Perea,  
            V. Manuel Pérez, Quirk, Quirk-Silva, Rendon, Salas, Skinner,  
            Stone, Ting, Wagner, Waldron, Weber, Wieckowski, Wilk,  
            Williams, Yamada, John A. Pérez
          NO VOTE RECORDED: Eggman, Vacancy, Vacancy


          JL:d   9/9/13   Senate Floor Analyses 

                           SUPPORT/OPPOSITION:  SEE ABOVE

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