BILL ANALYSIS                                                                                                                                                                                                    



                                                                  SB 337
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          SENATE THIRD READING
          SB 337 (Alquist)
          As Amended September 4, 2009
          Majority vote 

           SENATE VOTE  :Vote not relevant 
           
           HEALTH              19-0        APPROPRIATIONS      15-0        
           
           ----------------------------------------------------------------- 
          |Ayes:|Jones, Fletcher, Adams,   |Ayes:|De Leon, Conway, Ammiano, |
          |     |Ammiano, Block, Carter,   |     |                          |
          |     |Conway, De La Torre, De   |     |Charles Calderon, Coto,   |
          |     |Leon, Emmerson, Gaines,   |     |Davis, Fuentes, Harkey,   |
          |     |Hall, Hayashi, Hernandez, |     |Miller, Nielsen, John A.  |
          |     |                          |     |Perez, Skinner, Solorio,  |
          |     |Bonnie Lowenthal, Nava,   |     |Audra Strickland,         |
          |     |V. Manuel Perez, Salas,   |     |Torlakson                 |
          |     |Audra Strickland          |     |                          |
          |-----+--------------------------+-----+--------------------------|
          |     |                          |     |                          |
           ----------------------------------------------------------------- 
           SUMMARY  :  Makes clarifying changes to requirements governing  
          reporting of unauthorized access to, or use or disclosure of,  
          patients' medical information, and provides limited exemptions  
          for law enforcement investigations.  Authorizes the California  
          Health and Human Services Agency (CHHSA) to apply for federal  
          funds available for health information technology (HIT) and  
          health information exchange (HIE), and establishes a state fund  
          for purposes of HIT/HIE.  Authorizes the Governor to  
          alternatively designate an entity to apply for federal HIT  
          funding, and establishes governance requirements for the entity.  
           Specifically,  this bill  :

          1)Requires a clinic, health facility, home health agency, or  
            hospice to report any unauthorized access to, or use or  
            disclosure of, a patient's medical information to the  
            Department of Public Health (DPH) and to the affected patient  
            or patient's representative, no later than five  business  days,  
            instead of five days, after the unlawful or unauthorized  
            access, use, or disclosure has been detected by the entity.

          2)Requires the clinic, health facility, home health agency, or  
            hospice to delay reporting any unlawful or unauthorized  








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            access, use, or disclosure of a patient's medical information  
            to DPH and the patient if a law enforcement agency or official  
            provides a written statement that notification of patients  
            would be likely to impede the law enforcement agency's  
            activities, and specifies a date on which the delay will end,  
            not to exceed 60 days.

          3)Requires the clinic, health facility, home health agency, or  
            hospice to delay reporting any unlawful or unauthorized  
            access, use, or disclosure of a patient's medical information  
            to DPH and the patient if a law enforcement agency or official  
            provides the entity with an oral statement and requires the  
            clinic, health facility, home health agency, or hospice to  
            document  the statement, including but not limited to the  
            identity of the enforcement agency or official, the date it  
            was made, and limit the delay to a date specified for the end  
            of the delay, not to exceed 30 calendar days from the date the  
            oral statement is made unless a written statement is received  
            during that time.

          4)Requires that the written statement received during the 30  
            calendar days after an oral statement is made by the law  
            enforcement agency or official shall include a date the delay  
            is to end, not to exceed 60 days. 

          5)Allows a law enforcement agency or official to request an  
            extension of the original 60-day delay based upon a written  
            declaration that there exists a bona fide, ongoing,  
            significant criminal investigation of serious wrongdoing, that  
            notification of patients will undermine the law enforcement  
            agency's activities, and that specifies a date upon which the  
            delay shall end, not to exceed 60 days after the end of the  
            original 60-day period.

          6)Requires a clinic, health facility, home health agency, or  
            hospice that is subject to a delay in reporting for law  
            enforcement purposes to report the unauthorized access to, or  
            use or disclosure of, the patient's medical information no  
            later than five  business  days, instead of five days, after the  
            date designated as the end of the delay.

          7)Authorizes CHHSA or a department within CHHSA to apply for  
            federal funds available through the American Recovery and  
            Reinvestment Act (Public Law 111-5; American Recovery and  








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            Reinvestment Act (ARRA)) for HIT/HIE. 

          8)Authorizes the Governor to designate a qualified nonprofit  
            entity as the state designated entity (SDE) for the purposes  
            of HIE, pursuant to requirements set forth in ARRA, if CHHSA  
            elects not to submit an application for ARRA funds described  
            in 7) above. 

          9)Requires CHHSA or the SDE to facilitate and expand the use and  
            disclosure of electronic health information according to  
            nationally recognized standards and specifications, and  
            execute tasks related to accessing ARRA funds while protecting  
            the privacy and confidentiality of medical records to the  
            greatest extent possible. 

          10)Requires CHHSA or the SDE to develop a plan to ensure that  
            HIE capabilities are developed, adopted, and utilized  
            statewide to minimize disparities in access to HIT, as  
            specified.

          11)Requires CHHSA or the SDE to plan for a self-sustaining  
            funding mechanism that uses no General Fund (GF) moneys and  
            sustains administration of HIE when federal funds are no  
            longer available. 

          12)Requires the SDE to continually meet any conditions for the  
            designation, as determined by the Secretary of CHHSA, and  
            specifies that failure to do so may result in loss of the  
            designation. 

          13)Requires the SDE, as a condition of the designation, to be  
            subject to oversight by CHHSA.

          14)Requires the SDE to be governed by a board which has diverse  
            composition; represents multiple types of organizations and  
            regions; and, includes the Secretary of CHHSA or his or her  
            designee, chairs of the Assembly and Senate Health Committees  
            or their designees, at least two consumer representatives, one  
            with expertise in privacy and security of health information,  
            and a majority of non-governmental employees.

          15)Requires any workgroups or subcommittees of the board to  
            represent multiple types of organizations and regions and to  
            meet publicly and transparently.








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          16)Requires the board to have nondiscrimination and conflict of  
            interest policies, as specified.

          17)Requires the SDE to report to CHHSA and the Legislature at  
            least annually.

          18)Creates the California Health Information Technology and  
            Exchange Fund (Fund) in the State Treasury, in the event that  
            CHHSA receives ARRA HIT/HIE funds, and does not designate an  
            SDE.

          19)Specifies that the Fund consists of, but is not limited to,  
            ARRA HIT and HIE funds, requires interest and dividends earned  
            to be retained in the Fund, and subjects all moneys in the  
            Fund to appropriation by the Legislature for purposes related  
            to HIT/HIE. 

          20)Declares the intent of the Legislature that activities  
            associated with HIE be funded solely through federal funds,  
            private contributions, and funds generated by the  
            self-sustaining funding mechanism in 11) above.

           EXISTING FEDERAL LAW  :

          1)Prohibits, under federal regulations implementing the federal  
            Health Insurance Portability and Accountability Act, a health  
            plan, health care clearinghouse, or a health care provider,  
            who transmits health information in electronic form (covered  
            entity), from using or disclosing protected health  
            information, for purposes other than medical treatment or  
            payment, or health care operations, as defined, without  
            written authorization of the patient, with exceptions.

          2)Requires, under ARRA, covered entities and their business  
            associates to provide notice of medical privacy breaches  
            involving the unauthorized acquisition, access, use, or  
            disclosure of protected health information to each individual  
            whose information has been subject to a breach within 60 days  
            of the discovery of the breach.

          3)Provides that if a law enforcement official determines that  
            notice of a medical privacy breach would impede a criminal  
            investigation or cause damage to national security, the notice  








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            shall be delayed, in a specified manner.

           EXISTING STATE LAW  :

          1)Prohibits, under the Confidentiality of Medical Information  
            Act (CMIA), licensed or certified health care professionals,  
            clinics and health facilities, health plans, and contracting  
            entities, as defined, from disclosing or using a patient's  
            medical information for any purpose not necessary to provide  
            health care services to the patient and related administrative  
            functions, without first obtaining authorization from the  
            patient or the patient's representative, as specified, with  
            exceptions.

          2)Provides for administrative fines and civil penalties for  
            persons and entities subject to the CMIA who negligently  
            disclose, or who knowingly and willfully obtain, disclose, or  
            use, medical information in violation of the CMIA, and  
            authorizes the Attorney General, any district attorney, any  
            county counsel acting pursuant to an agreement with the  
            district attorney, or a city attorney, to seek civil penalties  
            for violations.

          3)Requires every provider of health care to establish and  
            implement administrative, technical, and physical safeguards  
            to protect the privacy of patients' medical information, and  
            requires every provider to reasonably safeguard confidential  
            medical information from any unauthorized access or unlawful  
            access, use, or disclosure.

          4)Defines unauthorized access as the inappropriate review or  
            viewing of patient medical information without a direct need  
            for diagnosis, treatment, or other lawful use of the  
            information.

          5)Requires a clinic, health facility, home health agency, or  
            hospice to report any unlawful or unauthorized access to, or  
            use or disclosure of, a patient's medical information to DPH  
            and to the affected patient or patient's representative, no  
            later than five days after the unlawful or unauthorized  
            access, use, or disclosure has been detected by the entity.   
            Allows DPH to assess a penalty of $100 for each day the  
            unlawful or unauthorized access, use, or disclosure is not  
            reported, following the initial five-day period, not to exceed  








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            $250,000 per reported event.

          6)Requires other persons or businesses that own or license  
            computerized data that includes personal information,  
            including medical information, to disclose any breach of the  
            security of the system to a resident whose unencrypted  
            personal information was acquired by an unauthorized person.   
            Provides that the notification may be delayed if a law  
            enforcement agency determines that notification will impede a  
            criminal investigation, as specified.

           FISCAL EFFECT  :  According to the Assembly Appropriations  
          Committee:

          1)California is expected to qualify for $3 billion (federal) in  
            provider incentives and grants from 2011 to 2016.  No state  
            match is required in 2010, but the state will be required to  
            provide contributions to draw down federal funding in future  
            years as follows:  $1 for $10 of federal funds in 2011, $1 for  
            $7 of federal funds in 2012, and $1 for $3 of federal funds in  
            2013-2016.  According to stakeholders, possibilities for  
            non-General Fund (GF) state contributions include support from  
            health technology industry groups, provider associations, or  
            non-profit groups.  The state contribution may also be  
            generated via the self-funding mechanism described above. 

          2)Future GF savings in Medi-Cal likely if HIT efforts are  
            successful.  The RAND Corporation estimates national net  
            annual savings of $34 billion following the adoption of HIT.   
            The Legislative Analyst's Office estimates savings to  
            fee-for-service Medi-Cal of up to $300 million GF annually by  
            increasing coordination and reducing duplication across a  
            variety of patient service areas. 

           COMMENTS  :   The author states this bill is intended to make two  
          revisions to existing medical privacy requirements in SB 541  
          (Alquist), Chapter 605, Statutes of 2008, that health facilities  
          notify patients and DPH when they detect any unlawful or  
          unauthorized access to, or use or disclosure of, a patient's  
          medical information.  The first is to revise the timeline for  
          reporting such breaches from five days to five business days.   
          The second is to allow for a delay in the reporting of such  
          breaches when a law enforcement agency or official makes a  
          statement that it would impede a law enforcement investigation  








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          of the breach.  The author states that these are reasonable  
          revisions of the reporting requirements for medical privacy  
          breaches that are consistent with the intent of the original  
          legislation.  

          The author also states that ARRA, which includes $36 billion in  
          federal funding to encourage the adoption and use of HIT/HIE,  
          provides an unprecedented opportunity to develop and implement  
          the HIT/HIE infrastructure needed to modernize and improve  
          California's health care system. The author argues that this  
          bill is needed because it is critical that California implement  
          HIE as soon as possible, as it is the mechanism for sharing  
          health records across providers, and lack of HIE jeopardizes the  
          ability of the state and providers to meet ARRA requirements and  
          draw down an expected $3 billion in Medicare and Medicaid  
          incentive payments beginning in October 2010.  According to the  
          author, the federal grant application for ARRA HIE funding is  
          due by October 16, 2009 and the state is expected to receive $40  
          million for HIE.  Only the state or an SDE may submit an  
          application, and the federal government has indicated a desire  
          to distribute ARRA funds as expeditiously as possible.  The  
          author contends that in order for California to establish HIE  
          before federal deadlines and draw down ARRA incentive payments,  
          legislation is needed immediately.


           Analysis Prepared by  :   Marjorie Swartz and Allegra Kim / HEALTH  
          / (916) 319-2097 


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