BILL ANALYSIS                                                                                                                                                                                                    �



                                                                  AB 439
                                                                  Page 1

          Date of Hearing:  May 10, 2011

                           ASSEMBLY COMMITTEE ON JUDICIARY
                                  Mike Feuer, Chair
                     AB 439 (Skinner) - As Amended: April 7, 2011
                                           
                               As Proposed to be Amended
                                           
          SUBJECT  :  HEALTH CARE INFORMATION

           KEY ISSUE  :  SHOULD CALIFORNIA RECOGNIZE A NEW AFFIRMATIVE 
          DEFENSE AGAINST SPECIFIED LIABILITY WHEN A COVERED ENTITY HAS 
          ACTED APPROPRIATELY?

           FISCAL EFFECT  :  As currently in print this bill is keyed 
          non-fiscal.

                                      SYNOPSIS
          
          This bill reflects the author's substantial and ongoing efforts 
          to establish a fair and balanced policy regarding the protection 
          of confidential medical information and records.  It seeks to 
          preserve the important deterrence and compensation values of 
          existing law while avoiding undue penalties for companies that 
          conduct themselves responsibly.  As proposed to be amended, the 
          bill reflects the current state of the author's negotiations 
          with interested stakeholders subject to further potential 
          revisions as discussions continue.

           SUMMARY  :  Establishes an affirmative defense against specified 
          liability under the California Medical Information Act.  
          Specifically,  this bill  :  

          1)Provides that in an action brought by an individual(s) 
            pursuant to Civil Code section 56.36(b)(1) on or after January 
            1, 2012, the court shall award any actual damages, and 
            reasonable attorneys' fees and costs, but may not award 
            nominal damages for a violation of this part if the defendant 
            establishes all of the following as an affirmative defense:


             a)   The defendant is a covered entity, as defined in Section 
               160.103 of Title 45 of the Code of Federal Regulations;  
             b)   The defendant has complied with any obligations to 
               notify all persons entitled to receive notice regarding the 








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               release of the information or records;  
              c)   The release of confidential information or records was 
               solely to another covered entity;  
              d)   The defendant took appropriate preventive actions to 
               protect the confidential information or records against 
               release, retention, or use by any person or entity other 
               than the covered entity that received the information or 
               records, including but not limited (1) to developing and 
               implementing security policies and procedures; (2) 
               designating a security official who is responsible for 
               developing and implementing its security policies and 
               procedures, including educating and training the workforce; 
               (3) encryption of the information or records; and (4) 
               protection against the release or use of the encryption key 
               and passwords;  
              e)   The defendant took appropriate corrective action after 
               the release of the confidential records or information and 
               the covered entity that received the information or records 
               immediately destroyed or returned the information or 
               records;
             f)   The covered entity that received the confidential 
               information or records did not retain, use, or release the 
               information or records; and
             g)   The defendant has not previously violated this part.


          1)Provides that a defendant shall not be liable for more than 

            one judgment on the merits for a violation of this section.


           EXISTING LAW  provides that in addition to any other remedies 
          available at law, any individual may bring an action against any 
          person or entity who has negligently released confidential 
          information or records concerning him or her in violation of 
          this part, for either or both of the following: (1) nominal 
          damages of one thousand dollars ($1,000).  In order to recover 
          under this paragraph, it shall not be necessary that the 
          plaintiff suffered or was threatened with actual damages; (2) 
          the amount of actual damages, if any, sustained by the patient.

           COMMENTS  :  A negligent release of confidential medical 
          information or records may be remedied by an action for damages 
          under the California Medical Information Act (CMIA).  In 
          addition to an award of actual damages, the CMIA allows recovery 








                                                                  AB 439
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          of nominal damages of $1,000 for each violation.  Prompted by a 
          recent law suit, the author is concerned that this general rule 
          may lead to inappropriate results in particular types of cases 
          where the defendant has conducted itself reasonably, and a 
          measure of damages that may be out of proportion to the gravity 
          of the harm or the financial penalty needed to deter careless 
          behavior.  The bill does not seek to change the outcome or the 
          law applicable to any pending case, but to revise the law to 
          avoid incongruous results in future cases.

          The author has conducted extensive negotiations among interested 
          stakeholders in this highly sensitive area over many months.  As 
          proposed to be amended, the bill reflects what the author 
          believes to be an emerging consensus, subject to further 
          revisions as her negotiations proceed.

           Author's Proposed Amendments.   In order to accomplish the goals 
          of this bill without undermining the important structure and 
          incentives of the CMIA, the author proposes to substitute the 
          following amendments for the current contents of the bill, 
          acknowledging that there are still to be further discussions 
          with interested stakeholders and the Committee as the bill moves 
          forward:

          Amend Civil Code Section 56.36(b) to read: 

            (b) In addition to any other remedies available at law, any 

            individual may bring an action 

            against any person or entity who has negligently released 

            confidential information or 

            records concerning him or her in violation of this part, for 

            either or both of the following: 

             (I) Except as provided in subdivision (e),  Nominal  nominal 

            damages of one thousand 

             dollars ($1,000). In order to recover under this paragraph, 

            it shall not be necessary that 








                                                                  AB 439
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             the plaintiff suffered or was threatened with actual 

            damages. 

             (2) The amount of actual damages, if any, sustained by the 

             patient. 



          Add new Civil Code Section 56.36(e) to read: 



          (e)(1)  In an action brought by an individual(s) pursuant to 

          subdivision (b)(1) on or after January 1, 2012, the court shall 

          award any actual damages, and reasonable attorneys' fees and 

          costs, but may not award nominal damages for a violation of this 

          part if the defendant establishes all of the following as an 

          affirmative defense:



               a.     The defendant is a covered entity, as defined in 
                 Section 160.103 of Title 45 of the Code of Federal 
                 Regulations;  
                b.     The defendant has complied with any obligations to 
                 notify all persons entitled to receive notice regarding 
                 the release of the information or records;  
                c.     The release of confidential information or records 
                 was solely to another covered entity;  
                d.     The defendant took appropriate preventive actions to 
                 protect the confidential information or records against 
                 release, retention, or use by any person or entity other 
                 than the covered entity that received the information or 
                 records, including but not limited (1) to developing and 
                 implementing security policies and procedures; (2) 
                 designating a security official who is responsible for 
                 developing and implementing its security policies and 








                                                                  AB 439
                                                                  Page 5

                 procedures, including educating and training the 
                 workforce; (3) encryption of the information or records; 
                 and (4) protection against the release or use of the 
                 encryption key and passwords;  
                e.     The defendant took appropriate corrective action 
                 after the release of the confidential records or 
                 information and the covered entity that received the 
                 information or records immediately destroyed or returned 
                 the information or records;
               f.     The covered entity that received the confidential 
                 information or records did not retain, use, or release 
                 the information or records; and
               g.     The defendant has not previously violated this part.


          (e)(2)  A plaintiff in an action under this subdivision shall be 

          entitled to recover reasonable attorney's fees and costs without 

          regard to an award of actual or nominal damages. 

          

          (e)(3)  A defendant shall not be liable for more than one 
          judgment on the merits for a violation of this section.

           REGISTERED SUPPORT / OPPOSITION  :   

           Support 
           
          None on file

           Opposition 
           
          None on file
           

          Analysis Prepared by  :  Kevin G. Baker / JUD. / (916) 319-2334