BILL ANALYSIS �
AB 861
Page 1
ASSEMBLY THIRD READING
AB 861 (Hill and Nestande)
As Amended May 27, 2011
Majority vote
HEALTH 16-0 APPROPRIATIONS 17-0
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|Ayes:|Monning, Logue, Ammiano, |Ayes:|Fuentes, Harkey, |
| |Atkins, Bonilla, Eng, | |Blumenfield, Bradford, |
| |Gordon, Hayashi, Roger | |Charles Calderon, Campos, |
| |Hern�ndez, Bonnie | |Davis, Donnelly, Gatto, |
| |Lowenthal, Mitchell, | |Hall, Hill, Lara, |
| |Nestande, Pan, | |Mitchell, Nielsen, Norby, |
| |V. Manuel P�rez, Smyth, | |Solorio, Wagner |
| |Williams | | |
| | | | |
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SUMMARY : Establishes the California Stroke Registry (CSR)
within the Department of Public Health (DPH) to serve as a
centralized repository for stroke data to promote quality
improvement for acute stroke treatment. Requires that the
program will only be implemented to the extent funds from
federal or private sources are made available for this purpose.
Specifically, this bill :
1)Requires DPH to establish a statewide CSR to serve as a
centralized repository for stroke data to promote quality
improvement for acute stroke treatment.
2)Requires CSR to align with the stroke consensus metrics
developed by national health organizations such as the federal
Centers for Disease Control and Prevention (CDC), the Joint
Commission, the American Heart Association (AHA), and the
American Stroke Association (ASA).
3)Requires the acquisition of data for CSR to be by voluntary
reports and encompass all areas of the state for which stroke
data are available.
4)Requires CSR to be under the direction of the Director of DPH
and housed within DPH's California Heart Disease and Stroke
Prevention Program (CHDSP) and permits CHDSP to accept, on
behalf of the state, grants of public or private funds for
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CSR.
5)Permits DPH to contract with an agency, including, but not
limited to, a health systems agency, single county health
department, multicounty health department groupings, or
nonprofit professional associations, representing a designated
reporting region for the purposes of collecting and collating
acute stroke data.
6)Permits DPH to contract, or provide grant awards, to implement
public health activities to fulfill required funding award
objectives.
7)Requires the Director of DPH, in establishing the CSR, to do
the following:
a) Maintain a statewide stroke database that compiles
information and statistics voluntarily reported on stroke
care. Requires DPH, to the extent possible, to coordinate
with the CDC, the Joint Commission, AHA and ASA to avoid
duplication and redundancy;
b) Recommend that hospitals and emergency medical services
agencies report case-specific data that is voluntarily
reported on the treatment of individuals with suspected
acute stroke to the representative of DPH, or any
individual, agency, or organization designated to cooperate
with that representative;
c) Encourage sharing of information and data among health
care providers to improve the quality of care for stroke;
d) Facilitate the communication and analysis of health
information and data among the health care professionals
providing care for individuals with stroke; and,
e) Consult with the Stroke Advisory Committee regarding
ways in which to improve the quality of stroke care and
delivery in California.
8)Requires all information collected for the CSR to be
confidential.
9)Authorizes persons with a valid scientific interest who are
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engaged in demographic, epidemiological, or other similar
studies related to health, and who meet qualifications
determined by DPH, and who agree, in writing, to maintain
confidentiality, to access confidential information.
Requires, before confidential information for research
purposes is disclosed for study, researchers to do both of the
following:
a) Obtain approval of their committee for the protection of
human subjects established in accordance with existing law;
and,
b) Provide documentation to DPH that demonstrates to DPH's
satisfaction that the entity has established the procedures
and ability to maintain the confidentiality of the
information.
10)Requires an entity that receives confidential information
from DPH to ensure the confidentiality of the information.
Requires DPH to provide only information that does not
identify individual cases or institutional or individual
sources of information.
11)Requires any disclosure authorized by this bill to include
only the information necessary for the stated purpose of the
requested disclosure, used for the approved purpose, and not
to be further disclosed.
12)Requires that the furnishing of confidential information to
DPH or its authorized representative, in accordance with this
bill, to not expose any person, agency, or entity furnishing
information to liability, and is prohibited from being
considered a waiver of any privilege or a violation of a
confidential relationship.
13)Requires DPH to maintain an accurate record of all persons
who are given access to confidential information. Requires
the record to include the name of the person authorizing
access; name, title, address, and organizational affiliation
of persons given access; dates of access; and, the specific
purpose for which information is to be used. Requires the
record of access to be open to public inspection during normal
operating hours of DPH.
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14)Prohibits any part of the confidential information from being
available for subpoena, from being disclosed, discoverable, or
compelled to be produced in any civil, criminal,
administrative, or other proceeding, or from being deemed
admissible as evidence in any civil, criminal, administrative,
or other tribunal or court for any reason.
15)Requires that this bill not prohibit the publication of
reports and statistical compilations that do not in any way
identify individual cases or institutional or individual
sources of information.
16)Requires that the individual to whom the information pertains
have access to his or her own information in accordance with
existing law.
17)Makes the following definitions:
a) "Ischemic stroke" means an occlusion of a blood vessel
that blocks blood flow to the brain, depriving the brain of
oxygen, and resulting in brain tissue death. This
definition includes transient ischemic attacks, defined as
stoke-like symptoms for less than 24 hours; and,
b) "Hemorrhagic stroke" means as a rupture of a blood
vessel, resulting in bleeding into or around the brain.
18)Prohibits this bill from preempting the authority of
facilities or individuals providing diagnostic or treatment
services to patients with stroke to maintain their own
facility-based stroke registries.
19)Prohibits this bill from being construed as a medical
practice guideline and from being used to restrict the
authority of a hospital to provide services for which it has
received a license under state law.
20)Requires this bill to be implemented only to the extent funds
from federal or private sources are made available for this
purpose.
21)Makes various finding and declarations regarding the
prevalence of stroke in California and the importance of rapid
identification, diagnosis, and treatment of stroke to save
lives.
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FISCAL EFFECT : According to the Assembly Appropriations
Committee, one-time start-up costs, likely in the range of
$200,000 to $400,000, and ongoing costs of around $800,000
annually to fund stroke registry operations. The bill is
contingent on receipt of federal or private funding for this
purpose.
COMMENTS : According to the author, a voluntary stroke registry
was established in DPH in 2007 and approximately 42 hospitals
across the state have participated. The author maintains that
codifying the voluntary registry will likely lead to greater
rate participation and an increased amount of information that
can be collected on strokes, the types of treatment victims
receive, and the impacts of those treatments will provide
medical professionals with a roadmap to improved care.
Additionally, the author maintains that establishment of a
stroke registry in statute will improve the potential for
California to receive and accept federal grants through CDC.
The author asserts that the CDC has been tasked with
implementing state-based registries to measure and track acute
stroke care. According to the author, a second round of CDC
funding is forthcoming but absent a stroke registry in statute,
California will be ineligible to receive those federal funds.
Analysis Prepared by : Tanya Robinson-Taylor / HEALTH / (916)
319-2097 FN: 0000997