Health care providers: medical information.

(1) Existing law provides for the licensing and regulation of clinics, health facilities, home health agencies, and hospices by the State Department of Public Health. Existing law requires these entities to prevent unlawful or unauthorized access to, and use or disclosure of, a patient's medical information. A violation of these provisions is a crime. Existing law requires these entities to report an instance of unlawful or unauthorized access to, and use or disclosure of, a patient's medical information to the department and to the affected patient or patient's representative, as prescribed, within 5 business days of its detection, except that an entity is required to delay compliance with this reporting requirement beyond this 5 business day period if a law enforcement agency or official provides the entity with a written or oral statement that compliance with the reporting requirement would impede the law enforcement agency's activities that relate to the unlawful or unauthorized access to, and use or disclosure of, a patient's medical information and specifies the date upon which the delay shall end, as prescribed. This bill would, instead, apply the provision requiring a delay in compliance with the reporting requirement only to a statement that compliance with that requirement would impede the law enforcement agency's investigations, rather than activities. By expanding circumstances to which a crime would apply, the bill would create a state-mandated local program. Under existing law, the department is authorized to assess a penalty of $100 against a clinic, health facility, home health agency, or hospice to which the above provisions apply, for each day that an unlawful or unauthorized access, use, or disclosure is not reported. This bill would specify that the disclosure is required to be reported to the department or the affected patient. The bill would create a rebuttable presumption, for enforcement purposes, that the facility did not notify the affected patient if the notification was not documented. (2) Existing law establishes the Office of Health Information Integrity within the California Health and Human Services Agency to ensure the enforcement of state law mandating confidentiality of medical information and to impose administrative fines for the unauthorized use of medical information. Existing law authorizes the California Health and Human Services Agency, or one of the departments under its jurisdiction, to apply for federal funds made available through the federal American Recovery and Reinvestment Act (ARRA) for health information technology and exchange and, if no application is made, requires the Governor to designate a nonprofit entity to be the state-designated entity for purposes of health information exchange. Existing law requires the agency or state-designated entity to facilitate and expand the use and disclosure of health information electronically among organizations, as prescribed, while protecting individual privacy and the confidentiality of electronic medical records. This bill would, in addition, require the agency or state-designated entity to facilitate and expand the use and disclosure of health information electronically among organizations in accordance with applicable state and federal law. (3) Existing law, the Health Insurance Portability and Accountability Implementation Act of 2001 (the act) , provides for the implementation of the federal Health Insurance Portability and Accountability Act (HIPAA) by the state under the direction of the Office of HIPAA Implementation, which was established by the Governor in the California Health and Human Services Agency. Under existing law, the act will become inoperative on July 1, 2010, and will be repealed January 1, 2011, unless a later enacted statute, that is enacted before January 1, 2011, deletes or extends that date, and all unexpended or unencumbered funds under the act will revert to the General Fund on July 1, 2010. This bill would extend the act's duration to January 1, 2013, when it would be repealed, and all funds under the act that are unexpended or unencumbered as of that date would revert to the General Fund. (4) The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement. This bill would provide that no reimbursement is required by this act for a specified reason. (5) This bill would declare that it is to take effect immediately as an urgency statute.