BILL ANALYSIS Ó
SENATE COMMITTEE ON APPROPRIATIONS
Senator Ricardo Lara, Chair
2015 - 2016 Regular Session
SB 1443 (Galgiani) - Incarcerated persons: health records
-----------------------------------------------------------------
| |
| |
| |
-----------------------------------------------------------------
|--------------------------------+--------------------------------|
| | |
|Version: April 26, 2016 |Policy Vote: PUB. S. 6 - 0, |
| | JUD. 7 - 0 |
| | |
|--------------------------------+--------------------------------|
| | |
|Urgency: No |Mandate: Yes |
| | |
|--------------------------------+--------------------------------|
| | |
|Hearing Date: May 9, 2016 |Consultant: Jolie Onodera |
| | |
-----------------------------------------------------------------
This bill meets the criteria for referral to the Suspense File.
Bill
Summary: SB 1443 would require the disclosure of medical,
dental, and mental health information, by electronic
transmission when possible, between a county correctional
facility, a county medical facility, a state correctional
facility, a state hospital, or a state-assigned mental health
provider when the jurisdiction of an inmate is transferred from
or between state and county facilities caring for inmates, as
specified.
Fiscal
Impact:
Department of Corrections and Rehabilitation (CDCR) : Minor,
absorbable ongoing costs (General Fund), as existing resources
include a records office at each institution and centralized
processing of requests for inmate records.
Department of State Hospitals (DSH): Negligible costs
(General Fund), as existing processes in place comply with the
SB 1443 (Galgiani) Page 1 of
?
provisions of this bill.
County facilities : Major ongoing workload likely in the
millions of dollars annually. Local costs are potentially
state-reimbursable (General Fund) and may additionally be
subject in part to Proposition 30* funding requirements, for
county jails to comply with the information sharing mandate.
Costs would vary by county facility and would be dependent on
the number of requests and volume of records to be shared, as
well as the infrastructure in place and method utilized by
each county facility to share/disclose medical information.
Staff notes this bill creates a reporting mandate for the
sharing of information between county facilities which appears
unnecessary.
Proposition 30* : Exempts the State from mandate reimbursement
for realigned responsibilities for "public safety services"
including the managing of local jails and the provision of
services for and supervision of juvenile and adult offenders.
However, legislation enacted after September 30, 2012, that
has an overall effect of increasing the costs already borne by
a local agency for public safety services apply to local
agencies only to the extent that the State provides annual
funding for the cost increase. The provisions of Proposition
30 have not been interpreted through the formal court process
to date, however, to the extent the county jail costs
resulting from this measure are determined to be applicable
under the provisions of Proposition 30, county jails would not
be obligated to provide the level of service required by the
bill above the level for which funding is provided by the
State.
Background: Existing law under the Confidentiality of Medical Information
Act (CMIA) generally prohibits the sharing of a patient's
medical information but allows health care providers, service
plans, contractors, or other health care professionals or
facilities to disclose medical information for purposes of
diagnosis or treatment. (Civil Code § 56.10 (c)(1).)
Existing law provides that unless the information is
unavailable, the Department of Corrections and Rehabilitation
(CDCR) is required to electronically transmit to a county agency
an inmate's tuberculosis status, specific medical, mental
health, and outpatient clinic needs, and any medical concerns or
disabilities for the county to consider as the offender
transitions onto postrelease community supervision (PRCS) for
SB 1443 (Galgiani) Page 2 of
?
the purpose of identifying the medical and mental health needs
of the individual. Existing law provides that all transmissions
to the county agency are to be incompliance with applicable
provisions of HIPAA, the HITECH Act, and the implementing of
federal privacy and security regulations, as specified. (Penal
Code § 3003(e)(2).)
This bill seeks to improve prisoner healthcare and provide
continuity of care through the disclosure of medical and mental
health information of an inmate when jurisdiction is transferred
from or between state and county correctional facilities, while
complying with all federal and state laws regarding
confidentiality and security.
Proposed Law:
This bill would provide that when the jurisdiction of an inmate
is transferred from or between the CDCR, DSH, and county
agencies caring for inmates, these agencies shall disclose, by
electronic transmission when possible, medical, dental, and
mental health information regarding each transferred or released
inmate. Additionally, this bill:
Requires information to be disclosed between a county
correctional facility, a county medical facility, a state
correctional facility, a state hospital, or a
state-assigned mental health provider to ensure the
continuity of health care of an inmate being transferred
between those facilities.
Requires all transmissions made pursuant to this section
to comply with the Confidentiality of Medical Information
Act, the Information Practices Act, the federal Health
Insurance Portability and Accountability Act of 1996
(HIPAA) (Public Law 104-191), the federal Health
Information Technology for Clinical Health Act (HITECH)
(Public Law 111-005), and the corresponding implementing
federal regulations relating to privacy and security, as
specified.
SB 1443 (Galgiani) Page 3 of
?
Deletes the existing provision of law requiring the CDCR
to electronically transmit to a county agency an inmate's
tuberculosis status, specific medical, mental health, and
outpatient clinic needs, and any medical concerns or
disabilities for the county to consider as the offender
transitions onto PRCS, for the purpose of identifying the
medical and mental health needs of the individual.
Under the CMIA provision of law enumerating the
circumstances in which health care providers or service
plans may disclose medical information, this bill requires
information to be disclosed between a county correctional
facility, a county medical facility, a state correctional
facility, or a state hospital to ensure the continuity of
health care of an inmate being transferred between those
facilities.
Staff
Comments: The CMIA authorizes the disclosure of medical
information by health care providers, contractors, service
plans, and health care professionals or facilities for the
purposes of diagnosis and treatment. As a result, it appears the
state and local agencies specified in this measure currently
have the authority to disclose this information to each other.
Further, by mandating the local agencies to disclose this
information, which would include sharing the information between
county agencies themselves, this bill creates a significant
state-mandated local program, potentially requiring
reimbursement from the state for these costs.
Recommended
Amendments: Staff recommends the following technical amendments
to Penal Code § 2601, on page 11, in lines 31-21:
(c) Subject to paragraphs paragraph (23) and (24) of subdivision
(c) of Section 56.10 of the Civil Code, as those paragraphs
relate that paragraph relates to medically necessary sharing of
personal medical and mental health information to further the
continuity of care for offenders, to all privacy rights legally
applicable to inmates.
SB 1443 (Galgiani) Page 4 of
?
-- END --