California Legislature—2015–16 Regular Session

Assembly BillNo. 2588


Introduced by Assembly Member Chu

February 19, 2016


An act to amend Sections 103875 and 103885 of the Health and Safety Code, relating to cancer data.

LEGISLATIVE COUNSEL’S DIGEST

AB 2588, as introduced, Chu. Cancer data.

Existing law requires the State Public Health Officer to establish a statewide system for the collection of information determining the incidence of cancer, as specified. Existing law authorizes the State Department of Public Health to designate any demographic parts of the state as regional cancer incidence reporting areas and establish regional cancer registries to carry out the intent of existing law.

This bill would require the State Department of Public Health to analyze data collected pursuant to this program to assess, measure, and publicly report on the quality of cancer care in the state, as specified. The bill would require the development of a public reporting system on the quality of cancer care in the state. The bill also would require the department to develop a system for routine, automated linkages between data collected pursuant to the program and public and private health insurance payer cancer claims data, and would require the State Public Health Officer to convene a cancer care stakeholder committee to study and make recommendations for developing the automated linkage system.

Vote: majority. Appropriation: no. Fiscal committee: yes. State-mandated local program: no.

The people of the State of California do enact as follows:

P2    1

SECTION 1.  

Section 103875 of the Health and Safety Code
2 is amended to read:

3

103875.  

(a) The department shall conduct a program of
4epidemiological assessments of the incidence of cancer. The
5program shall encompass all areas of the state for which cancer
6incidence data are available. The program shall include the
7monitoring of cancers associated with suspected carcinogens
8encountered by the general public both in occupational locations
9and in the environment generally.

10(b) The program shall be under the direction of thebegin delete directorend deletebegin insert State
11Public Health Officerend insert
, who may enter into contracts as are
12necessary for the conduct of the program and may accept, on behalf
13of the state, grants of public or private funds for the program. The
14begin delete directorend deletebegin insert departmentend insert shall analyze available incidence data and
15prepare reports and perform studies as necessary to identify cancer
16hazards to the public health and their remedies.

begin insert

17(c) The department shall analyze data collected pursuant to the
18program to assess, measure, and publicly report on the quality of
19cancer care in the state. In assessing and measuring the quality
20of cancer care in the state, the department shall define and identify
21oncology providers. In publicly reporting on the quality of cancer
22care in the state, the department shall identify oncology providers,
23but not individual cancer patients. The department may contract
24with an entity to assess, measure, and publicly report on the quality
25of cancer care in the state.

end insert
begin insert

26(d) The department shall develop a system for routine,
27automated linkages between data collected pursuant to the program
28and public and private health insurance payer cancer claims data.
29The State Public Health Officer shall convene a cancer care
30stakeholder committee, including public and private payer
31representatives and persons with appropriate technical experience,
32to study and make recommendations for developing the automated
33linkage system. The State Public Health Officer may contract with
34entities or persons to provide the committee with appropriate
35 technical expertise.

end insert
begin delete

36(c)

end delete

37begin insert(e)end insert It is the intent of the Legislature that an appropriation be
38included in each Budget Act in an amount sufficient to provide
P3    1for the annual cost of the program.begin insert It is further the intent of the
2Legislature that the cancer care quality measures be available for
3the public to use to improve health care and population health as
4it relates to the prevention and treatment of cancer, including the
5cancer patients themselves.end insert

6

SEC. 2.  

Section 103885 of the Health and Safety Code is
7amended to read:

8

103885.  

(a) Thebegin delete directorend deletebegin insert departmentend insert shall establish a statewide
9system for the collection of information determining the incidence
10of cancer, using population-based cancer registries modeled after
11the Cancer Surveillance Program of Orange County.begin insert The
12department shall also identify and include in the statewide system,
13cancer care quality measures for use in public reporting.end insert
As of
14the effective date of this section thebegin delete directorend deletebegin insert departmentend insert shall begin
15phasing in the statewide cancer reporting system. By July 1, 1988,
16all county or regional registries shall be implemented or initiated.
17By July 1, 1990, the statewide cancer reporting system shall be
18fully operational. Within 60 days of the effective date of this
19section, thebegin delete directorend deletebegin insert State Public Health Officerend insert shall submit an
20implementation and funding schedule to the Legislature.

21(b) The department may designate any demographic parts of
22the state as regional cancer incidence reporting areas and may
23establish regional cancer registries, with the responsibility and
24authority to carry out the intent of this section in designated areas.
25Designated regional registries shall provide, on a timely basis,
26cancer incidencebegin delete dataend deletebegin insert data,end insert asbegin delete designatedend deletebegin insert requiredend insert by thebegin delete state
27department to theend delete
department. The department may establish a
28competitive process to receive applications for, and issue, the
29award of a contract, grant, or allocation of funds, including, but
30not limited to, a cooperative agreement, subvention agreement, or
31any other agreement allowed by law, to an agency, including, but
32not limited to, a health systems agency, single county health
33department, multicounty health department grouping, or nonprofit
34professional association to operate the statewide cancer reporting
35system and to enter into contracts, or issue grants or funding
36allocations to other agencies representing a designated cancer
37reporting region for the purposes of collecting and collating cancer
38incidence data. The award of these contracts, grants, or funding
39allocations shall be exempt from Part 2 (commencing with Section
4010100) of Division 2 of the Public Contract Code. The department
P4    1shall include appropriate terms and conditions in a contract, grant,
2or funding allocation to ensure the proper use of state funds,
3including provision for reimbursement of allowable costs, financial
4reporting, program performance reporting, monitoring of subgrants,
5subcontracts, or suballocations to an agency representing a
6designated cancer reporting region, retention and access
7requirements for records, data use and management, independent
8auditing, termination, and disposition of assets acquired under the
9contract, grant, or funding allocation.

10(c) Thebegin delete directorend deletebegin insert State Public Health Officerend insert shall designate
11cancer as a disease required to be reported in the state or any
12demographic parts of the state in which cancer information is
13collected under this section. All cancers diagnosed or treated in
14the reporting area shall thereafter be reported to the representative
15of the department authorized to compile the cancer data, or any
16individual, agency, or organization designated to cooperate with
17that representative.

18(d) (1) begin deleteAny end deletebegin insertA end inserthospital or other facility providing therapy to
19cancer patients within an area designated as a cancer reporting
20area shall report each case of cancer to the department or the
21authorized representative of the department in a format prescribed
22by the department. If the hospital or other facility fails to report
23in a format prescribed by the department, the department’s
24authorized representative may access the information from the
25hospital or the facility and report it in the appropriate format. In
26these cases, the hospital or other health facility shall reimburse the
27begin delete stateend delete department or the authorized representative for its cost to
28access and report the information.

29(2) begin deleteAny end deletebegin insertA end insertphysician and surgeon, dentist, podiatrist, or other
30health care practitioner diagnosing or providing treatment for
31cancer patients shall report each cancer case to the department or
32the authorized representative of the department except for those
33cases directly referred to a treatment facility or those previously
34admitted to a treatment facility for diagnosis or treatment of that
35instance of cancer.

36(e) begin deleteAny end deletebegin insertA end inserthospital or other facility that is required to reimburse
37the department or its authorized representative for the cost to access
38and report the information pursuant to subdivision (d) shall provide
39payment to the department or its authorized representative within
4060 days of the date this payment is demanded. In the eventbegin delete anyend deletebegin insert aend insert
P5    1 hospital or other facility fails to make the payment to the
2 department or its authorized representative within 60 days of the
3date the payment is demanded, the department or its authorized
4representative may, at its discretion, assess a late fee not to exceed
5112 percent per month of the outstanding balance. Further, in the
6event that the department or its authorized representative takes a
7legal action to recover its costs and any associated fees, and the
8department or its authorized representative receives a judgment in
9its favor, the hospital or other facility shall also reimburse the
10department or its authorized representative for any additional costs
11it incurred to pursue the legal action. Late fees and payments made
12to the department by hospitals or other facilities pursuant to this
13subdivision shall be considered as reimbursements of the additional
14costs incurred by the department.

15(f) All physicians and surgeons, hospitals, outpatient clinics,
16nursing homes and all other facilities, individuals, or agencies
17providing diagnostic or treatment services to patients with cancer
18shall grant to the department or the authorized representative access
19to all records that would identify cases of cancer or would establish
20characteristics of the cancer, treatment of the cancer, or medical
21status of any identified cancer patient. Willful failure to grant
22access to those records shall be punishable by a fine of up to five
23hundred dollars ($500) each day access is refused.begin delete Any finesend deletebegin insert Finesend insert
24 collected pursuant to this subdivision shall be deposited in the
25General Fund.

26(g) (1) Except as otherwise provided in this section, all
27information collected pursuant to this section shall be confidential.
28For purposes of this section, this information shall be referred to
29as “confidential information.”

30(2) The department and any regional cancer registry designated
31by the department shall use the information to determine the
32sources of malignant neoplasms and evaluate measures designed
33to eliminate, alleviate, or ameliorate theirbegin delete effect.end deletebegin insert effect, and assess
34and publicly report on the quality of cancer care in the state.end insert

begin delete

35(3) Persons with a valid scientific interest who are engaged in
36demographic, epidemiological, or other similar studies related to
37health who meet qualifications as determined by the department,
38and who agree, in writing, to maintain confidentiality, may be
39authorized access to confidential information.

end delete
begin insert

P6    1(3) The following persons who meet qualifications determined
2by the department and who agree, in writing, to maintain
3confidentiality, may be authorized access to confidential
4information:

end insert
begin insert

5(A) A person with a valid scientific background who is engaged
6in demographic, epidemiologic, quality of care assessment or
7improvement, or other similar studies related to health.

end insert
begin insert

8(B) A person engaged in the dissemination of data to the public
9as it relates to the prevention and treatment of cancer.

end insert
begin insert

10(C) A person engaged in improving health care and population
11health as it relates to the treatment and prevention of cancer,
12including cancer patients themselves.

end insert

13(4) The department and any regional cancer registry designated
14by the department may enter into agreements to furnish confidential
15information to other states’ cancer registries, federal cancer control
16agencies, local health officers, or health researchers for the
17purposes of determining the sources of cancer and evaluating
18measures designed to eliminate, alleviate, or ameliorate theirbegin delete effect.end delete
19begin insert effect, and assessing and publicly reporting on the quality of cancer
20care in the state.end insert
Before confidential information is disclosed to
21those agencies, officers, researchers, or out-of-state registries, the
22requesting entity shall agree in writing to maintain the
23confidentiality of the information, and in the case of researchers,
24shall also do both of the following:

25(A) Obtain approval of their committee for the protection of
26human subjects established in accordance with Part 46
27(commencing with Section 46.101) of Title 45 of the Code of
28Federal Regulations.

29(B) Provide documentation to the department that demonstrates
30to the department’s satisfaction that the entity has established the
31procedures and ability to maintain the confidentiality of the
32information.

33(5) Notwithstanding any otherbegin delete provision ofend delete law,begin delete anyend delete disclosure
34authorized by this section shall include only the information
35necessary for the stated purpose of the requested disclosure, used
36for the approved purpose, and not be further disclosed.

37(6) The furnishing of confidential information to the department
38or its authorized representative in accordance with this section
39shall not expose any person, agency, or entity furnishing
P7    1 information to liability, and shall not be considered a waiver of
2any privilege or a violation of a confidential relationship.

3(7) The department shall maintain an accurate record of all
4persons who are given access to confidential information. The
5record shall include: the name of the person authorizing access;
6name, title, address, and organizational affiliation of persons given
7access; dates of access; and the specific purpose for which
8information is to be used. The record of access shall be open to
9public inspection during normal operating hours of the department.

10(8) Notwithstanding any otherbegin delete provision ofend delete law, no part of the
11confidential information shall be available for subpoena, nor shall
12it be disclosed, discoverable, or compelled to be produced inbegin delete anyend delete
13begin insert aend insert civil, criminal, administrative, or other proceeding, nor shall this
14information be deemed admissible as evidence inbegin delete anyend deletebegin insert aend insert civil,
15criminal, administrative, or other tribunal or court for any reason.

16(9) Nothing in this subdivision shall prohibit the publication by
17the department of reports and statistical compilations that do not
18in any way identify individual cases or individual sources of
19information.

20(10) Notwithstanding the restrictions in this subdivision, the
21individual to whom the information pertains shall have access to
22his or her own information in accordance with Chapter 1
23(commencing with Section 1798) of Title 1.8 of the Civil Code.

24(h) For the purpose of this section, “cancer” means either of the
25following:

26(1) All malignant neoplasms, regardless of the tissue of origin,
27including malignant lymphoma, Hodgkins disease, and leukemia,
28but excluding basal cell and squamous cell carcinoma of the skin.

29(2) All primary intracranial and central nervous system (CNS)
30tumors occurring in the following sites, irrespective of histologic
31type: brain, meninges, spinal cord, caudae equina, cranial nerves
32and other parts of the CNS, pituitary gland, pineal gland, and
33craniopharyngeal duct.

34(i) Nothing in this section shall preempt the authority of facilities
35or individuals providing diagnostic or treatment services to patients
36with cancer to maintain their own facility-based cancer registries.

P8    1(j) It is the intent of the Legislature that the department, in
2establishing a system pursuant to this section, maximize the use
3of available federal funds.



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