BILL ANALYSIS Ó
SENATE COMMITTEE ON APPROPRIATIONS
Senator Ricardo Lara, Chair
2015 - 2016 Regular Session
AB 2119 (Chu) - Medical information: disclosure: medical
examiners and forensic pathologists
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|Version: August 2, 2016 |Policy Vote: JUD. 7 - 0 |
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|Urgency: No |Mandate: Yes |
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|Hearing Date: August 8, 2016 |Consultant: Jolie Onodera |
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This bill meets the criteria for referral to the Suspense File.
Bill
Summary: AB 2119 would authorize licensed physicians who
perform official autopsies on behalf of a county coroner's
office or the medical examiner's office to receive medical
information for specified purposes. This bill would additionally
require a health facility, as defined, a health or behavioral
health facility or clinic, and the physician in charge of the
patient to release a patient's medical record relating to
community mental health services, voluntary admissions and
judicial commitments to mental hospitals, and county psychiatric
hospitals to a medical examiner, forensic pathologist, or
coroner, as specified, upon request, when a patient dies from
any cause, natural or otherwise.
Fiscal
Impact:
County health and behavioral health facilities : Potential
increase in ongoing costs, potentially state-reimbursable
(General Fund), for local agencies to accept and respond to
requests for the disclosure of specified medical records
AB 2119 (Chu) Page 1 of
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beyond what is mandated under the CMIA. The statewide fiscal
impact would be dependent on the administrative process
involved and the volume of annual requests, which is unknown.
To the extent the Commission on State Mandates determines the
provisions of this bill impose a higher level of service on
local agencies, the state could be required to provide
reimbursement for those costs. To the extent requests for
disclosure include records for deceased persons going back
numerous years, the costs could be significant.
DDS/DSH/CDCR : Minor and absorbable fiscal impact to the
Department of Developmental Services (DDS), Department of
State Hospitals (DSH), and the Department of Corrections and
Rehabilitation (CDCR) to disclose medical information.
Disclosure by health care providers/contractors : Private and
non-reimbursable local costs to disclose medical records to
medical examiners and forensic pathologists, in addition to
coroners' offices.
Background: Existing law prohibits, under the state Confidentiality of
Medical Information Act (CMIA), 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. (Civil Code § 56 et seq.)
Existing law defines "medical information" as individually
identifiable information, in electronic or physical form, in
possession of or derived from a provider of health care, health
care service plan, pharmaceutical company, or contractor
regarding a patient's medical history, mental or physical
condition, or treatment. (Civil Code § 56.05(g).)
Under existing law, county coroners are authorized to access a
deceased person's medical information for the purpose of
identifying the decedent, locating next of kin, or investigating
cause of death, among other reasons. (Civil Code § 56.10(b)(8).)
For any other purpose not described above, a county coroner may
be provided access (although a health care provider, service
plan, or contractor is not required to disclose the information
under circumstances not specified in Civil Code § 56.10(b)(8))
to a deceased person's medical information.
This bill would authorize medical examiners and forensic
pathologists working with a county coroner's office to access
AB 2119 (Chu) Page 2 of
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the medical records of deceased persons as provided to coroners
under existing law.
Proposed Law:
This bill would require a provider of health care, a health
care service plan, or contractor to disclose, without delay,
medical information about a patient if requested by a medical
examiner or forensic pathologist, provided the request is for
the purpose of a coroner's office investigation to identify the
decedent or locate next of kin, or when investigating deaths
that may involve public health concerns, organ or tissue
donation, child abuse, elder abuse, suicides, poisonings,
accidents, sudden infant deaths, suspicious deaths, unknown
deaths, or criminal deaths, or upon notification of, or
investigation of, imminent deaths that may involve organ or
tissue donation, or when otherwise authorized by the decedent's
representative. Additionally, this bill:
Authorizes a provider of health care or a health care
service plan to disclose medical information to a medical
examiner or forensic pathologist of a county coroner's
office, when requested for all purposes not included in the
above provision.
Prohibits a medical examiner, forensic pathologist, or
coroner from disclosing information contained in the
medical record obtained under this bill to a third party,
without a court order or authorization from a beneficiary
or personal representative of a deceased patient.
Specifies that a "medical examiner, forensic
pathologist, or coroner" is limited to a licensed physician
who currently performs official autopsies on behalf of a
county coroner's office or medical examiner's office,
whether as a government employee or under contract to that
office.
Strikes a provision of law that prohibits the Department
of Developmental Services, the physician and surgeon in
charge of the client, or the professional in charge of the
facility or his or her designee, from releasing any notes,
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summaries, transcripts, tapes, or records of conversations
between the resident and health professional personnel of
the hospital relating to the personal life of the resident
that is not related to the diagnosis and treatment of the
resident's physical condition.
Requires a health facility, as defined, a health or
behavioral health facility or clinic, and the physician in
charge of the patient to release a patient's medical record
relating to community mental health services, voluntary
admissions and judicial commitments to mental hospitals,
and county psychiatric hospitals to the medical examiner,
forensic pathologist, or coroner, as specified, upon
request, when a patient dies from any cause, natural or
otherwise. The bill would prohibit a medical examiner,
forensic pathologist, or coroner from disclosing any
information contained in the medical records obtained
pursuant to these provisions without a court order or
authorization of the beneficiary or personal representative
of the deceased patient.
Makes legislative findings necessary to limit public
access to records shared with a medical examiner or
forensic pathologist under this bill.
Makes other technical, non-substantive changes to
statute.
Related
Legislation: SB 1443 (Galgiani) 2016 would revise the
Confidentiality of Medical Information Act (CMIA) to require
disclosure of medical records between county and state
correctional facilities to ensure the continuity of health care
for inmates being transferred. SB 1443 was held on the Suspense
File of this Committee.
Staff
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Comments: By requiring county health and behavioral health
facilities to disclose patient medical records related to
community mental health services, voluntary admissions and
judicial commitments to mental hospitals, and county psychiatric
hospitals to a medical examiner, forensic pathologist, or
coroner, as specified, upon request, when a patient dies from
any cause, natural or otherwise, this bill potentially imposes a
higher level of service on local agencies beyond what is
required under the provisions of the CMIA with regard to the
disclosure of medical information. While the magnitude of the
fiscal impact on local agencies would be dependent on the
administrative workload involved and the volume of requests for
disclosure, which is unknown, any costs determined by the
Commission on State Mandates to impose a higher level of service
on local agencies could require reimbursement from the state.
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