Minutes of November 18, 1998 Meeting

A meeting of the Law Revision Commission Committee on Confidentiality of Medical Records was held commencing at 4:00 p.m. on Wednesday, November 18, 1998 in Hearing Room 1A in the Legislative Office Building in Hartford, Connecticut. Those attending were: Commission members Committee Chairman Joseph J. Selinger, Jr., William R, Breetz, and Joel I. Rudikoff; advisors Charlotte Acquaviva, Regina Dacier, Mary H. Hess, Peter Kane, Stephen Lewis, Richard J. Lynch, David W. Parke, Mick Meacham for Marybeth Reinhart, Robert Scalettar, Anita L. Schepker, Jeannette C. Schreiber, Nadine Schwab, Patricia Shea, and Gail Sturges; and Commission staff David Hemond.

Mr. Hemond called the meeting to order.

The minutes of the November 4 meeting were approved.

The Committee then continued the review of the Uniform Health-Care Information Act, beginning with Article V, section 5-101 concerning notice of information practices.

With respect to section 5-101, the Committee agreed that, in keeping with other models, the notice required should be more specific in detailing the nature of the disclosures that may be made without authorization and the rights of patients with respect to medical records. It was also agreed that providers have a responsibility to ensure that patients are aware of their right to information concerning the disclosure practices. Mr. Hemond agreed to prepare draft language including such a more specific approach. In that context, there was also general agreement that disclosure authorizations should be more specific as to the limitations on disclosure under section 2-102. Mr. Hemond agreed to review the language suggested in the working draft.

Under section 6-101, it was suggested that the initial language should read "A person permitted…" rather than "A person authorized…" It was also suggested that further analysis was necessary to review the impact of the proposed language with respect to minors and existing statutory inconsistencies in the treatment of minority. Mr. Hemond agreed to review and compiled provisions concerning minority.

Under section 6-102, it was agreed that more specific language should be substituted for the term "personal representative". Mr. Hemond agreed to review the issue and propose more specific language. The Committee also discussed at length the potential conflict between the need of the personal representative to access the decedent's health care information to properly represent the decedent and the fact that the information accessed might be sensitive and prejudice the decedent's privacy expectations. It was agreed that models would be reviewed that might allow a third party review of sensitive information as allowed by the draft with respect to other sensitive disclosures.

Under section 7-101, it was agreed that more specific language concerning the obligation to adopt security safeguards should be proposed. Mr. Hemond was asked to review alternative model provisions specifying more specific requirements.

Under section 7-102, concern was expressed over the proposal to extend the retention requirement for an additional year following receipt of an authorization to disclose. It was agreed that the various retention schedules currently in effect should be reviewed but that the automatic extension provision appeared to be superfluous in the light of existing standards.

Under section 8-101, it was agreed that the criminal penalty standards should be expanded to differentiate further based on the nature of the disclosure. Mr. Hemond agreed to review other models and provide new proposed language.

Under section 8-102, Committee members questioned whether such an authorization to a public official to enforce the act was necessary or appropriate.

Under section 8-103, Committee members seemed generally agreed on adopting an appropriate private right of action analogous to that currently available under the Insurance Information and Privacy Protection Act. Mr. Hemond agreed to provide new proposed language.

Mr. Hemond noted that the next meeting is set for December 2, 1998 at 4:00 p.m. in the Legislative Office Building in Hartford, Connecticut. The primary item on the agenda for that meeting is a presentation by Margo Goldman concerning the initiative in Massachusetts to enact a medical privacy bill. Mr. Hemond also noted that a group of provider representatives will be making a presentation at the December 16 meeting concerning information flow and other issues of concern. The meeting adjourned at 5:50 p.m.

Respectfully submitted,

/S/ 

David L. Hemond
Reporter/Drafter

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