BILL ANALYSIS Ó
AB 2119
Page 1
CONCURRENCE IN SENATE AMENDMENTS
AB
2119 (Chu)
As Amended August 15, 2016
Majority vote
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|ASSEMBLY: |78-0 |(May 12, 2016) |SENATE: |39-0 |(August 22, |
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Original Committee Reference: HEALTH
SUMMARY: 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. 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 otherwise.
The Senate amendments define medical examiner, forensic
pathologist, and coroner for purposes of the bill, remove the
state-mandated local program designation, and make other
technical and clarifying changes.
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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:
1)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.
2)Minor and absorbable fiscal impact to the Department of
Developmental Services, Department of State Hospitals, and the
Department of Corrections and Rehabilitation to disclose
medical information.
3)Private and non-reimbursable local costs to disclose medical
records to medical examiners and forensic pathologists, in
addition to coroners' offices.
COMMENTS: 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 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
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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.
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.
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 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
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time involved in securing a court order delays completion of an
autopsy and, ultimately, the determination of cause and manner
of death.
Analysis Prepared by:
Lara Flynn / HEALTH / (916) 319-2097 FN:
0004166