BILL ANALYSIS Ó
AB 2119
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Date of Hearing: April 12, 2016
ASSEMBLY COMMITTEE ON HEALTH
Jim Wood, Chair
AB 2119
(Chu) - As Introduced February 17, 2016
SUBJECT: Medical information: disclosure: medical examiners
and forensic pathologists.
SUMMARY: Authorizes a medical examiner or forensic pathologist
to request medical information from a provider of health care,
health care service plan, or contractor for the purpose of
identifying a deceased person, locating the next of kin, or when
investigating deaths that may involve public health concerns.
Authorizes health care providers to disclose medical information
to a medical examiner, forensic pathologist, or county coroner
without a court order. Specifies that a medical examiner or
forensic pathologist must not disclose medical information
obtained pursuant to this bill to a third party without a court
order.
EXISTING STATE LAW:
1)Prohibits a provider of health care, health care service plan,
or contractor from disclosing medical information regarding a
patient of the provider of health care or an enrollee or
subscriber of a health care service plan without first
obtaining authorization.
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2)Allows a provider of health care, health care service plan, or
contractor to disclose medical information if the disclosure
is compelled by any of the following:
a) By a court, pursuant to a court order;
b) By a board, commission, or administrative agency for
purposes of adjudication pursuant to its lawful authority;
c) By a party to a proceeding before a court or
administrative agency, pursuant to a subpoena;
d) By a board, commission, or administrative agency
pursuant to an investigative subpoena;
e) By an arbitrator or arbitration panel, when arbitration
is lawfully requested by either party, pursuant to a
subpoena;
f) By a search warrant issued to a governmental law
enforcement agency;
g) By the patient or the patient's representative;
h) By a coroner, when requested in the course of an
investigation by the coroner's office for the purpose of
identifying the deceased person or locating next of kin, or
investigating deaths that may involve public health
concerns, organ or tissue donation, child abuse, elder
abuse, suicides, poisonings, accidents, sudden infant
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deaths, suspicious deaths, unknown deaths, criminal deaths,
or upon notification of, or investigation of, imminent
deaths that may involve organ or tissue donation; or,
i) When otherwise specifically required by law.
3)Requires a physician, physician assistant, funeral director,
or other person to immediately notify the coroner when he or
she has knowledge of a death that occurred, or has charge of a
body in which death occurred under numerous circumstances,
including where suicide is suspected.
EXISTING FEDERAL LAW enacts the Health Insurance Portability
and Accountability Act of 1996 (HIPAA), was enacted on August
21, 1996, which requires the Secretary of Health and Human
Services to publicize standards for the electronic exchange,
privacy and security of health information. HIPAA Privacy
regulations require health care providers and organizations,
as well as their business associates, to develop and follow
procedures that ensure the confidentiality and security of
protected health information (PHI) when it is transferred,
received, handled, or shared. This applies to all forms of
PHI, including paper, oral, and electronic, etc. Only the
minimum health information necessary to conduct business is to
be used or shared.
FISCAL EFFECT: None.
COMMENTS:
1)PURPOSE OF THIS BILL. According to the author, medical
diagnoses and mental health issues affect one another and are
more complex than once realized. The author asserts lack of
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access to mental health records restricts the coroner's and/or
medical examiner's ability to consider all potential causes of
death, and access to mental health records by a coroner or
medical examiner can help contribute to the understanding of
how the effects of mental health illness relate to cause of
death, as well as educate the general public and medical
communities about those findings. The author states this bill
would authorize a provider of mental health services to
disclose mental health records regarding a patient to a
coroner, medical examiner, or forensic pathologist when
requested in the course of an investigation by a coroner,
medical examiner, or forensic pathologist, and the patient is
the decedent who is the subject of the investigation.
2)BACKGROUND. Epidemiologic studies have provided evidence of a
link between mental illness, mental health, and physical
health, especially as it relates to chronic disease
occurrence, course, and treatment. For example, depression
has been shown to affect the occurrence, treatment, and
outcome of several chronic diseases and conditions, including
heart disease, diabetes, hypertension, cancer, and obesity.
Mental illnesses such as depression and indicators of mental
illness such as frequent mental distress are related to
certain risk behaviors, including physical inactivity,
smoking, drinking, and insufficient sleep. Emerging evidence
shows that positive mental health is associated with improved
health outcomes. For example, in one study, individuals with
mentally healthy attributes (such as optimism) had a lower
risk for coronary heart disease. Other studies have shown
that persons with a diagnosis of bipolar disorder may have
higher incidences of cardiovascular disease.
3)SUPPORT. This bill is sponsored by the County of Santa Clara
who states that, current law does not grant coroners and
medical examiners access to a decedent's private medical
records unless approved by the next-of-kin or through a court
order. The sponsor notes that often if the deceased is
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homeless, the next-of-kin cannot be identified and a court
order is problematic for a number of reasons. In this
process, the judge reviews the mental health records in closed
chambers and decides which records may be released to the
coroner or medical examiner. The sponsor contends, generally,
judges are not trained to read medical or mental health
records and, as a result, may not recognize the significance
of certain details contained in the records and the time
involved in securing a court order delays completion of an
autopsy and, ultimately, the determination of cause and manner
of death.
4)PREVIOUS LEGISLATION. AB 1297 (John A. Pérez), Chapter 341,
Statutes of 2013, facilitates the sharing of information
between coroners and organ procurement organizations regarding
cases in which an anatomical gift may be available from a
person whose demise is imminent and that person's body will be
subject to a death investigation by the coroner post mortem.
5)DOUBLE REFERRAL. This bill is double referred; upon passage
in this Committee, this bill will be referred to the Assembly
Privacy and Consumer Protection Committee.
REGISTERED SUPPORT / OPPOSITION:
Support
Santa Clara County (sponsor)
AB 2119
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Opposition
None on file.
Analysis Prepared by:Lara Flynn / HEALTH / (916) 319-2097