BILL ANALYSIS
AB 278
Page 1
CONCURRENCE IN SENATE AMENDMENTS
AB 278 (Monning)
As Amended August 17, 2010
Majority vote
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|ASSEMBLY: | |(May 18, 2009) |SENATE: |23-12|(August 19, |
| | | | | |2010) |
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(vote not relevant)
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|COMMITTEE VOTE: |18-0 |(August 24, 2010) |RECOMMENDATION: |concur |
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Original Committee Reference: REV. & TAX.
SUMMARY : Permits the California Office of Health Information
Integrity (CalOHII) to establish and administer up to four
demonstration projects annually to evaluate potential solutions to
facilitate health information exchange that promote quality of
care, respect the privacy of personal health information, and
enhance the trust of stakeholders.
The Senate amendments delete the Assembly approved version of this
bill and instead:
1)Authorize CalOHII to establish and administer up to four
demonstration projects a year, as defined, to evaluate potential
solutions to facilitate health information exchange (HIE) that
promote quality of care, respect the privacy and security of
personal health information, and enhance the trust of the
stakeholders.
2)Authorize health care entities, as defined, to submit an
application to CalOHII to be approved as a demonstration project
participant, as defined.
3)Require CalOHII, upon receiving a demonstration project
application, to assist applicants in soliciting federal funds for
the demonstration project and work with applicants to define the
scope of the demonstration project.
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4)Authorize the Director of CalOHII to approve demonstration
projects to test for, but not limited to policies and practices
related to patient consent, information, and notification, new
technologies and applications that enable the transmission of
protected health information, as specified; and implementation
issues, if any, encountered by small solo health care providers
as a result of exchanging electronic health information.
5)Require that the selection of demonstration projects be based on,
but not limited to, the following criteria:
a) Areas critical to building consumer trust and confidence in
the HIE system;
b) Projects that help support the exchange of information
critical to meeting the federal meaningful use provisions, as
defined; and,
c) Areas recommended by the California HIE consumer and
industry stakeholder advisory process.
6)Require CalOHII to engage with stakeholders to evaluate issues
identified by the demonstration projects, comment upon proposed
regulations, discuss HIE solutions, and work collaboratively with
approved demonstration project participants to identify a set of
common data elements that will be used to collect, analyze, and
measure performance.
7)Authorize the Director of CalOHII to adopt regulations to ensure
all approved HIE service participants, as defined, and
demonstration project participants follow rules, and work within
parameters, as defined by the office, that are consistent for the
exchange of information.
8)Exempt adoption of, and changes to, such regulations from
provisions in existing law related to procedures for public
participation, the review of proposed regulations by the Office
of Administrative Law, and filing and publication requirements
that specify an effective date that is 30 days after the date of
filing with the Secretary of State.
9)Require the Director of CalOHII to file any regulation adopted
pursuant to this bill with the Office of Administrative Law, for
filing with the Secretary of State and publication in the
California Code of Regulations. Requires such filings to cite
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the appropriate section of this bill and any other applicable
state or federal laws.
10)Require CalOHII, prior to adopting a regulation or changing an
existing regulation pursuant to this bill, to adopt the standards
requiring CalOHII to:
a) Post the proposed regulation on its website at least 45
days prior to adoption;
b) Accept public comments for at least 30 days after the
proposed regulation has been posted online; and,
c) Hold a hearing prior to adoption of the regulation if a
member of the public requests a public hearing during the
30-day review period.
11)Specify that any regulation adopted shall become effective on
the date it is filed with the Secretary of State unless the
director prescribes a later date in the regulation, or in a
written instrument filed with the regulation.
12)Require regulations adopted to expire upon repeal of the
authorizing statute.
13)Require CalOHII to receive reports from demonstration project
participants on the outcome of the demonstration project no later
than 60 days after the end of the project, review the results of
the demonstration projects, and report to the Joint Legislative
Budget Committee, the Senate Committee on Appropriations, the
Senate Committee on Budget and Fiscal Review, the Senate
Committee on Health, the Assembly Committee on Appropriations,
the Assembly Committee on Budget, and the Assembly Committee on
Health, within six months after the end of the project.
14)Specify that demonstration projects carried out utilizing
federal grant funds may be subject to federal auditing
requirements.
15)Require costs associated with the support, assistance and
evaluation of approved demonstration projects to be funded
exclusively by federal funds or other non-General Fund sources.
16)Repeal the provisions of the bill on the date the Director of
CalOHII executes a declaration stating that the grant period for
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the State Cooperative Grant Agreement for HIE has ended.
17)Make various legislative findings and declarations.
AS PASSED BY THE ASSEMBLY , this bill deleted an erroneous reference
in Revenue and Taxation Code (R&TC) Section 18639 to non-existing
Title 15 of the Internal Revenue Code (IRC).
FISCAL EFFECT : According to Senate Appropriations Committee:
Fiscal Impact (in thousands)
Major Provisions 2010-11 2011-12 2012-13 Fund
Demonstration project $360 $360 $360Special*
procurement, administration,
and oversight
* California Health Information Technology and Exchange Fund
(federal HITECH funds)
COMMENTS : According to the author, current state privacy laws,
while extensive, are problematic when it comes to electronic HIE.
For example, current state law does not specifically address
widespread HIE, which results in ambiguity of some state rules in
an electronic environment. Additionally, the current health
privacy framework is built upon an interaction of state and federal
requirements, and it is not easily determined which requirements
apply. Last of all, no agency or office at the state level is
authorized to establish requirements, or interpret California
medical privacy law, when it is applied to health information
exchanged electronically.
Analysis Prepared by : Martin Radosevich / HEALTH / (916)
319-2097
FN: 0006740