AN ACT PROMOTING THE USE OF HEALTH INFORMATION TECHNOLOGY.

This bill requires the Senate president pro tempore and House speaker, the lieutenant governor, and the public health commissioner, by June 1, 2009, to designate an entity to serve as the state's lead health information exchange organization beginning on July 1, 2009. It requires this entity to:

1. seek funds for developing a statewide health information exchange,

2. implement the statewide health information technology plan the bill requires the Public Health Department (DPH) to submit to the legislature by July 1, 2009, and

3. develop standards and protocols for privacy in sharing electronic health information.

The bill also requires DPH to develop conflict of interest policies to govern the designated entity's actions.

The bill requires the House speaker and Senate president pro tempore to consult with the Public Health Committee's chairpersons and ranking members in making the lead organization designation.

The bill requires the designated entity, in consultation with DPH, to seek federal and private funds for the initial development of a statewide health information exchange. It specifically permits the entity to pursue federal stimulus funds. The entity can use any funds it receives to establish health information technology pilot programs.

The bill requires the designated entity to help implement and periodically revise the health information technology plan DPH submits. This can include implementing an integrated statewide electronic infrastructure that permits health care facilities, professionals, public and private payors, and patients to share health information.

The bill requires the entity to develop privacy standards and protocols for sharing electronic health information. These must be at least as stringent as the standards established under the 1996 federal Health Insurance Portability and Accountability Act (HIPAA). They must require security for individual health records and the ability to use an electronic audit trail to trace these who accessed records.

1. quarterly, beginning October 1, 2009, on the funds it has received and how it has spent them, including the total amount received and the funding sources (this report also goes to DPH) and

2. annually, beginning February 1, 2010, on the status of implementing the statewide plan. The report can also include recommendations on plan revisions, statutory changes and funding needed for plan implementation, and proposed funding sources.

PA 07-2, June Special Session, required DPH to contract for the development of a statewide health information technology plan. It designated the entity that received this contract as the state's lead health information exchange organization until June 30, 2009. The bill requires DPH to submit this plan to the Public Health Committee by July 1, 2009. By law, the plan must include (1) standards and protocols for health information exchange; (2) standards to facilitate the development of a statewide, integrated electronic health information system for use by state-funded health care providers and institutions; and (3) pilot programs for health information exchange, including costs and funding sources.

The bill requires DPH to develop conflict of interest policies that apply to the designated entity's directors, employees, and agents. DPH must do this by June 1, 2009 in consultation with the attorney general and within available resources. To ensure that their deliberations and decisions are fair and equitable, these individuals must follow these policies in carrying out the entity's responsibilities under the bill.

HIEOs provide the capability to electronically move clinical information between different health care information systems (e. g. , a doctor's office and a hospital). Their goal is to facilitate access to and retrieval of clinical data to provide safer, more timely, efficient, effective, and patient-centered care. Typically, they are geographically defined entities, governed by representatives of a broad array of institutions and providers, that develop and maintain technical standards based on national standards and the ability to operate with other exchanges and arrange for the infrastructure needed to electronically exchange information.

The ARRA appropriated $ 2 billion for competitive grants to (1) states or state-designated entities for planning or implementing health information technology exchanges and (2) states to establish loan programs to (a) help health providers to purchase technology, (b) train people to use the technology, and (c) improve security.

Planning and implementation grants awarded before October 1, 2009 may require a state match; grants approved after that date require one according to the following schedule: FY 11, at least $ 1 in state fund for every $ 10 federal dollars; FY 12, at least $ 1: $ 7; and FY 13 and beyond, at least $ 1: $ 3. A $ 1: $ 5 state: federal match is required for grants to establish loan funds.

HIPAA limits health care providers and insurers' release of protected health information (PHI). PHI includes medical information that contains information that could identify a person, including name, Social Security number, telephone number, medical record number, and ZIP code. Federal regulations protect this information regardless of how it is stored or transmitted.

The penalty under HIPAA for wrongful disclosure of individually identifiable health information is a $ 50,000 fine, imprisonment up to one year, or both. Wrongful disclosure under false pretenses is punishable by a $ 100,000 fine, imprisonment up to five years, or both. Committing wrongful disclosure with intent to sell the information is punishable by a $ 250,000 fine, imprisonment up to 10 years, or both.

The Senate referred this bill (File 598) to the Appropriations Committee. That committee reported this substitute, requiring DPH to develop the conflict of interest policies within its budget and in consultation with the attorney general.

Yea

Nay

(03/25/2009)

Yea

Nay

(05/05/2009)