BILL ANALYSIS Ó
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|SENATE RULES COMMITTEE | AB 2119|
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THIRD READING
Bill No: AB 2119
Author: Chu (D)
Amended: 8/15/16 in Senate
Vote: 21
SENATE JUDICIARY COMMITTEE: 7-0, 6/28/16
AYES: Jackson, Moorlach, Anderson, Hertzberg, Leno, Monning,
Wieckowski
SENATE APPROPRIATIONS COMMITTEE: 7-0, 8/11/16
AYES: Lara, Bates, Beall, Hill, McGuire, Mendoza, Nielsen
ASSEMBLY FLOOR: 78-0, 5/12/16 (Consent) - See last page for
vote
SUBJECT: Medical information: disclosure: medical examiners
and forensic pathologists
SOURCE: Santa Clara County Board of Supervisors
DIGEST: This bill authorizes 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 additionally 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 a medical
examiner, forensic pathologist, or coroner, as specified, upon
request, when a patient dies from any cause, natural or
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otherwise.
ANALYSIS:
Existing law:
1)Prohibits, under the federal Health Insurance Portability and
Accountability Act, a covered entity (health plan, health care
provider, and health care clearing house) from disclosing
medical information, except as specified or as authorized by
the patient in writing. (45 C.F.R. Sec. 164.500 et seq.)
2)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. (Civ. Code Sec. 56 et seq.)
3)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. (Civ. Code Sec. 56.05(g).)
4)Defines "individually identifiable" as medical information
that includes or contains any element of personal identifying
information sufficient to allow identification of the
individual, such as the patient's name, address, electronic
mail address, telephone number, or Social Security number, or
other information that, alone or in combination with other
publicly available information, reveals the individual's
identity. (Civ. Code Sec. 56.05(g).)
5)Defines a "licensed health care professional" as any person
licensed or certified pursuant to the Business and Professions
Code, the Osteopathic Initiative Act or the Chiropractic
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Initiative Act, or the Health and Safety Code, as specified.
(Civ. Code Sec. 56.05(h).)
6)Subjects any provider of health care, a health care service
plan, pharmaceutical company, or contractor, who negligently
creates, maintains, preserves, stores, abandons, destroys, or
disposes of written or electronic medical records, to damages
in a civil action or an administrative fine, as specified.
(Civ. Code Sec. 56.36.)
7)Requires, as an exception to the above prohibition against
sharing a patient's medical information, 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 coroner, provided that the coroner's request is for the
purpose of an investigation to identify the decedent or
locating 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.
(Civ. Code Sec. 56.10(b)(8).)
8)Authorizes a provider of health care or a health care service
plan to disclose medical information to a county coroner, when
requested for all purposes not included in the above exception
(Civ. Code Secs. 56.10(b)(8), 56.10(c)(6).)
This bill:
1)Requires 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
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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.
2)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.
3)Prohibits a medical examiner, forensic pathologist, or coroner
from disclosing medical information obtained under this bill
to a third party, unless there is a court order.
4)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.
5)Strikes a provision of law that prohibits the Department of
Developmental Services (DDS), 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,
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.
6)Provides that the DDS, the physician and surgeon in charge of
the client, or the professional in charge of the facility or
his or her designee, shall release the patient's medical
record to the medical examiner, forensic pathologist, or
coroner, upon request.
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7)Provides, that except 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, a medical examiner, forensic
pathologist, or coroner shall not disclose any information
contained in the medical record without a court order.
8)Makes legislative findings necessary to limit public access to
records shared with a medical examiner or forensic pathologist
under this bill.
9)Makes other technical, non-substantive changes to statute.
Background
While many types of medical doctors are capable of performing
autopsies, most state or local government laws mandate that an
appointed forensic pathologist do the work. These appointees are
called medical examiners and have an official position in the
county medical examiner system. However, not all counties use
the medical examiner system; some counties use coroners and a
coroner's system. Many coroners are qualified pathologists with
years of experience, and some are physicians in unrelated
fields. However, depending on the county laws, a coroner may
require no medical qualifications at all in order to perform his
or her duty.
In California, 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. This bill, sponsored by the
Santa Clara County Board of Supervisors, authorizes medical
examiners and forensic pathologists working with a county
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coroner's office to access the medical records of deceased
persons as well.
FISCAL EFFECT: Appropriation: No Fiscal
Com.:YesLocal: No
According to the Senate Appropriations Committee:
County health and behavioral health facilities: Potential
increase in ongoing non-reimbursable local costs for local
agencies to accept and respond to requests for the disclosure
of specified medical death records. The statewide fiscal
impact would be dependent on the administrative process
involved and the volume of annual requests, which is unknown.
DDS/DSH/CDCR: Minor and absorbable fiscal impact to the 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.
SUPPORT: (Verified8/15/16)
Santa Clara County Board of Supervisors (source)
California State Coroners' Association
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County of San Diego
Urban Counties of California
OPPOSITION: (Verified8/12/16)
None received
ARGUMENTS IN SUPPORT: The Santa Clara County Board of
Supervisors, sponsor, writes:
Medical diagnoses and mental health issues affect one another
and are more complex than once realized. The lack of access
to mental health records limits the ability of a coroner or
medical examiner to consider all potential causes of death.
Access to mental health records can help contribute to the
understanding of how the effects of mental health illness
relates to cause of death[.]
ASSEMBLY FLOOR: 78-0, 5/12/16
AYES: Achadjian, Alejo, Travis Allen, Arambula, Atkins, Baker,
Bigelow, Bloom, Bonilla, Bonta, Brough, Brown, Calderon,
Campos, Chang, Chau, Chávez, Chiu, Chu, Cooley, Cooper,
Dababneh, Dahle, Daly, Dodd, Eggman, Frazier, Beth Gaines,
Gallagher, Cristina Garcia, Eduardo Garcia, Gatto, Gipson,
Gomez, Gonzalez, Gordon, Gray, Grove, Hadley, Harper, Roger
Hernández, Holden, Irwin, Jones, Kim, Lackey, Levine, Linder,
Lopez, Low, Maienschein, Mathis, Mayes, McCarty, Medina,
Melendez, Mullin, Nazarian, Obernolte, O'Donnell, Olsen,
Patterson, Quirk, Ridley-Thomas, Rodriguez, Salas, Santiago,
Steinorth, Mark Stone, Thurmond, Ting, Wagner, Waldron, Weber,
Wilk, Williams, Wood, Rendon
NO VOTE RECORDED: Burke, Jones-Sawyer
Prepared by:Nichole Rapier / JUD. / (916) 651-4113
8/15/16 20:33:26
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