2005 Legislation
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HOUSE BILL NO. 148 – Health Data Act


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Bill Status

H0148.................................................by HEALTH AND WELFARE
HEALTH CARE DATA - Adds to and amends existing law relating to collection
and analysis of health care data to adopt an Idaho Health Care Data Act; to
define terms; to establish a Bureau of Health Care Statistics; to proscribe
disclosure of reimbursement contracts, to proscribe health care provider
comparisons; to prohibit disclosure of identifiable health data; to provide
a Health Data Plan Advisory Committee; and to exempt disclosure of health
care data submitted to the Bureau of Health Care Statistics.
02/09    House intro - 1st rdg - to printing
02/10    Rpt prt - to Health/Wel

Bill Text

  ]]]]              LEGISLATURE OF THE STATE OF IDAHO             ]]]]
 Fifty-eighth Legislature                   First Regular Session - 2005
                              IN THE HOUSE OF REPRESENTATIVES
                                     HOUSE BILL NO. 148
                              BY HEALTH AND WELFARE COMMITTEE
  1                                        AN ACT
 11    Be It Enacted by the Legislature of the State of Idaho:
 12        SECTION  1.  That Title 56, Idaho Code, be, and the same is hereby amended
 13    by the addition thereto of a NEW CHAPTER, to be known and designated as  Chap-
 14    ter 14, Title 56, Idaho Code, and to read as follows:
 15                                      CHAPTER 14
 16                                   HEALTH DATA ACT
 17        56-1401.  SHORT  TITLE.  This  act  may be cited as the "Idaho Health Data
 18    Act."
 19        56-1402.  DEFINITIONS. For the purposes of  this  chapter,  the  following
 20    terms have the meanings set forth:
 21        (1)  "Bureau"  means  the  bureau of health care statistics created in the
 22    department of health and welfare.
 23        (2)  "Data supplier" means  a health care facility, health care  provider,
 24    self-funded  employer,  third-party payer, health maintenance organization, or
 25    government department which could reasonably be  expected  to  provide  health
 26    data under this chapter.
 27        (3)  "Director"  means  the  director of the department of health and wel-
 28    fare.
 29        (4)  "Disclosure" means the communication or release of health  care  data
 30    to  any  individual  or organization outside the committee, its staff and con-
 31    tracting agencies.
 32        (5)  "Health care facility" means an organization  delivering  service  or
 33    supplies  for  patient  care.  This includes hospitals, outpatient facilities,
 34    surgery centers, nursing homes, rehabilitation centers, mental health clinics,
 35    or other organized entities charging for and delivering health care.
 36        (6)  "Health care provider" means any professional person  delivering  and
 37    charging for health care services or supplies.
 38        (7)  "Health  data"  means  information  relating  to the health status of
 39    individuals, health services delivered, the availability  of  health  manpower
 40    and  facilities,  and  the  use and cost of resources and services to the con-
 41    sumer, except "vital records."
  1        (8)  "Identifiable health data" means any item, collection or grouping  of
  2    health  data that makes the individual described or providing the data identi-
  3    fiable.
  4        (9)  "Individual" means a natural person.
  5        (10) "Plan" means the plan developed by the bureau pursuant to this  chap-
  6    ter.
  7        (11) "Research and analysis" means activities using health data including:
  8        (a)  Describing the group characteristics of individuals or organizations;
  9        (b)  Analyzing  variance and noncompliance among individuals and organiza-
 10        tions;
 11        (c)  Conducting statistical procedures to improve the  quality  of  health
 12        data;
 13        (d)  Designing  surveys and selecting samples of individuals and organiza-
 14        tions;
 15        (e)  Preparing and publishing reports describing these matters.
 16        (12) "Self-funded employer" means an employer who provides for the payment
 17    of health care services directly from  employer  funds  thereby  assuming  the
 18    financial risks rather than passing them on to an outside insurer through pre-
 19    mium payments.
 20        (13) "Third  party payer" means an insurer offering health insurance, man-
 21    aged care plan, or any program funded or administered by the  state  of  Idaho
 22    for the provision of health care services, including medicaid or other medical
 23    assistance,  any  other similar corporation, organization, association, entity
 24    or person.
 25        56-1403.  BUREAU OF HEALTH CARE STATISTICS. The director is authorized  to
 26    establish  the  bureau of health care statistics within the division of public
 27    health services. The purpose of the bureau is to perform  collection,  valida-
 28    tion, analysis, display and dissemination of health and related data to facil-
 29    itate  the  promotion  and  accessibility of quality and cost-effective health
 30    care.
 31        The bureau shall:
 32        (1)  Develop by rule, following public hearing and comment, a health  data
 33    plan that shall:
 34        (a)  Identify the key health care issues, questions, and problems amenable
 35        to  resolution or improvement through better data, more extensive or care-
 36        ful analysis or imparted dissemination of health data;
 37        (b)  Document existing health data activities in the  state  pertinent  to
 38        paragraph (a) of this subsection;
 39        (c)  Describe  and  prioritize  actions  to  be taken by the department of
 40        health and welfare or the legislature in response to the needs identified;
 41        (d)  Detail the types of data needed for the bureau's work,  the  intended
 42        data suppliers and the form in which the data is to be supplied;
 43        (e)  Describe  the  types  and  methods  of  validation to be performed to
 44        assure validity and accuracy;
 45        (f)  Explain the intended uses and expected benefits. These benefits  must
 46        relate  to  promoting  health care quality, managing health care costs, or
 47        improving access to health care services;
 48        (g)  Describe the processes for interpretation and  analysis,  noting  the
 49        expertise and participation in the process;
 50        (h)  Describe the types of reports to be made available and their intended
 51        audiences and uses.
 52        (2)  Have  the  authority to collect, validate, analyze and present health
 53    data in accordance with the plan.
 54        (3)  Evaluate existing identification coding methods  and,  if  necessary,
  1    require  by rule that health data suppliers use a uniform system for identifi-
  2    cation of individuals, facilities and providers.
  3        (4)  Report annually to the governor and the legislature on how the bureau
  4    is exercising its responsibilities under this chapter.
  5        The bureau may promulgate rules pursuant to chapter 52,  title  67,  Idaho
  6    Code, to implement the provisions of this chapter.
  7        Except for data collection, analysis and validation functions described in
  8    this  section, nothing shall be construed to authorize or permit the bureau to
  9    perform regulatory functions delegated by law to other agencies of  the  state
 10    or federal government, or to perform quality assurance or medical record audit
 11    functions  that  health  care  facilities, providers or third party payers are
 12    required to perform.
 13        Nothing in this chapter shall be construed to require a data  supplier  to
 14    supply  health data identifying a patient by name or describing detail about a
 15    patient beyond that needed to achieve the approved purposes  included  in  the
 16    plan.
 17        No  request  for health data shall be made until a plan for the use of the
 18    data is approved.
 19        56-1404.  NONDISCLOSURE OF REIMBURSEMENT CONTRACTS. The  bureau  does  not
 20    have the authority to require any data supplier to submit fee schedules, maxi-
 21    mum  allowable  costs,  area  prevailing costs, terms of contracts, discounts,
 22    fixed reimbursement arrangements, capitations or other  specific  arrangements
 23    for reimbursements to a health care provider.
 24        The  bureau shall not publish any health care data that would disclose any
 25    of the information acquired as provided in this section.
 26        Nothing shall prevent the bureau from requiring the submission  of  health
 27    data  on  the  reimbursements  actually made to health care providers from any
 28    source of payment, including consumers.
 29        56-1405.  HEALTH CARE PROVIDER COMPARISONS. The bureau shall  not  release
 30    reports  that  compare  or  identify  health care providers or data submitters
 31    unless:
 32        (1)  The comparisons are validated by a private, independent analyst;
 33        (2)  The data submitter or health care provider is allowed to  verify  the
 34    accuracy and submit corrections and comments;
 35        (3)  The bureau corrects data found to be in error;
 36        (4)  The  bureau  allows  the data supplier a reasonable amount of time to
 37    review the report and prepare a response.
 39    tion,  reports,  statements, memoranda or other data received by the bureau is
 40    privileged and confidential, and shall not be directly or  indirectly  subject
 41    to  subpoena  or  discovery  proceedings or be admitted as evidence, nor shall
 42    testimony relating thereto be admitted as evidence, or in any  action  of  any
 43    kind  in any court or before any administrative body, agency or person for any
 44    purpose whatsoever. Any release or publication shall be done  in  such  a  way
 45    that  no  person  is  identifiable. The bureau may disclose information if the
 46    individual identified has agreed to the disclosure.
 47        The penalty for disclosure in violation of this section is a misdemeanor.
 48        56-1407.  HEALTH DATA PLAN ADVISORY COMMITTEE. The bureau shall develop  a
 49    health  data  plan advisory committee, the members of which shall be appointed
 50    by the director and shall include at least one (1) licensed physician, one (1)
 51    licensed pharmacist, a hospital executive, a health plan executive,  a  county
  1    commissioner, and a lay person. There shall be no less than seven (7) nor more
  2    than  eleven  (11)  members on the committee. These members should, as much as
  3    possible, be knowledgeable in health data issues and represent  the  diversity
  4    of  data  suppliers  and the geographic diversity of the state. The purpose of
  5    this advisory committee is to provide input into the effectiveness of the plan
  6    and the bureau, and the effect of data collections and reports on the  practi-
  7    tioners and patients.
  8        SECTION  2.  That  Section  9-340C, Idaho Code, be, and the same is hereby
  9    amended to read as follows:
 12    are exempt from disclosure:
 13        (1)  Except as provided in this subsection, all  personnel  records  of  a
 14    current or former public official other than the public official's public ser-
 15    vice  or  employment  history,  classification, pay grade and step, longevity,
 16    gross salary and salary history, status, workplace and employing  agency.  All
 17    other personnel information relating to a public employee or applicant includ-
 18    ing,  but  not  limited  to,  information regarding sex, race, marital status,
 19    birth date, home address  and  telephone  number,  applications,  testing  and
 20    scoring  materials,  grievances,  correspondence  and performance evaluations,
 21    shall not be disclosed to the public without  the  employee's  or  applicant's
 22    written  consent.  A  public official or authorized representative may inspect
 23    and copy his personnel records, except for material used to  screen  and  test
 24    for employment.
 25        (2)  Retired employees' and retired public officials' home addresses, home
 26    telephone  numbers  and  other  financial and nonfinancial membership records;
 27    active and inactive member financial and membership records and mortgage port-
 28    folio loan documents maintained by  the  public  employee  retirement  system.
 29    Financial  statements  prepared by retirement system staff, funding agents and
 30    custodians concerning the investment of assets of the public employee  retire-
 31    ment system of Idaho are not considered confidential under this chapter.
 32        (3)  Information  and records submitted to the Idaho state lottery for the
 33    performance of background investigations of employees, lottery  retailers  and
 34    major procurement contractors; audit records of lottery retailers, vendors and
 35    major  procurement  contractors  submitted  to or performed by the Idaho state
 36    lottery; validation and security tests of the state lottery for lottery games;
 37    business records and information submitted pursuant to sections 67-7412(8) and
 38    (9) and 67-7421(8) and (9), Idaho Code, and  such  documents  and  information
 39    obtained  and  held  for  the  purposes  of lottery security and investigative
 40    action as determined by lottery rules unless the public interest in disclosure
 41    substantially outweighs the private need for protection  from  public  disclo-
 42    sure.
 43        (4)  Records of a personal nature as follows:
 44        (a)  Records  of  personal  debt filed with a public agency or independent
 45        public body corporate and politic pursuant to law;
 46        (b)  Personal bank records compiled by a public depositor for the  purpose
 47        of public funds transactions conducted pursuant to law;
 48        (c)  Records  of  ownership  of financial obligations and instruments of a
 49        public agency or independent public body corporate and  politic,  such  as
 50        bonds,  compiled by the public agency or independent public body corporate
 51        and politic pursuant to law;
 52        (d)  Records, with regard to the ownership of, or security  interests  in,
 53        registered public obligations;
  1        (e)  Vital statistics records; and
  2        (f)  Military  records  as  described  in  and pursuant to section 65-301,
  3        Idaho Code.
  4        (5)  Information in an income or other tax return  measured  by  items  of
  5    income  or  sales,  which  is  gathered  by a public agency for the purpose of
  6    administering the tax, except such information to the extent  disclosed  in  a
  7    written  decision  of  the  tax commission pursuant to a taxpayer protest of a
  8    deficiency determination by the tax commission, under the provisions  of  sec-
  9    tion 63-3045B, Idaho Code.
 10        (6)  Records  of  a  personal nature related directly or indirectly to the
 11    application for and provision of statutory services rendered to persons apply-
 12    ing for public care for the elderly, indigent, or mentally or physically hand-
 13    icapped, or participation in an environmental or a public health  study,  pro-
 14    vided  the provisions of this subsection making records exempt from disclosure
 15    shall not apply to the extent that such records or  information  contained  in
 16    those  records  are  necessary for a background check on an individual that is
 17    required by federal law regulating the sale of firearms, guns or ammunition.
 18        (7)  Employment security information and  unemployment  insurance  benefit
 19    information,  except that all interested parties may agree to waive the exemp-
 20    tion.
 21        (8)  Any personal records, other than names, business addresses and  busi-
 22    ness  phone  numbers,  such as parentage, race, religion, sex, height, weight,
 23    tax identification and social security numbers,  financial  worth  or  medical
 24    condition  submitted to any public agency or independent public body corporate
 25    and politic pursuant to a statutory requirement for licensing,  certification,
 26    permit or bonding.
 27        (9)  Unless  otherwise  provided  by  agency rule, information obtained as
 28    part of an inquiry into a person's fitness to be granted or retain a  license,
 29    certificate,  permit,  privilege,  commission or position, private association
 30    peer review committee records authorized in title 54, Idaho Code.  Any  agency
 31    which  has records exempt from disclosure under the provisions of this subsec-
 32    tion shall annually make available a statistical summary  of  the  number  and
 33    types of matters considered and their disposition.
 34        (10) The records, findings, determinations and decisions of any prelitiga-
 35    tion screening panel formed under chapters 10 and 23, title 6, Idaho Code.
 36        (11) Complaints  received  by the board of medicine and investigations and
 37    informal proceedings, including informal proceedings of any committee  of  the
 38    board  of  medicine,  pursuant  to chapter 18, title 54, Idaho Code, and rules
 39    adopted thereunder.
 40        (12) Records of the department of health and welfare or  a  public  health
 41    district that identify a person infected with a reportable disease.
 42        (13) Records  of  hospital care, medical records, including prescriptions,
 43    drug orders, records or any other prescription information  that  specifically
 44    identifies an individual patient, prescription records maintained by the board
 45    of pharmacy under section 37-2730A, Idaho Code, records of psychiatric care or
 46    treatment and professional counseling records relating to an individual's con-
 47    dition,  diagnosis, care or treatment, provided the provisions of this subsec-
 48    tion making records exempt from disclosure shall not apply to the extent  that
 49    such  records  or  information  contained in those records are necessary for a
 50    background check on an individual that is required by federal  law  regulating
 51    the sale of firearms, guns or ammunition.
 52        (14) Information  collected  pursuant  to  the directory of new hires act,
 53    chapter 16, title 72, Idaho Code.
 54        (15) Personal information contained in motor vehicle  and  driver  records
 55    that  is  exempt  from disclosure under the provisions of chapter 2, title 49,
  1    Idaho Code.
  2        (16) Records of the financial status of prisoners pursuant  to  subsection
  3    (2) of section 20-607, Idaho Code.
  4        (17) Records  of  the  Idaho  state  police  or  department  of correction
  5    received or maintained pursuant to section 19-5514, Idaho  Code,  relating  to
  6    DNA databases and databanks.
  7        (18) Records of the department of health and welfare relating to a survey,
  8    resurvey  or  complaint  investigation of a licensed nursing facility shall be
  9    exempt from disclosure. Such records shall, however, be subject to  disclosure
 10    as public records as soon as the facility in question has received the report,
 11    and  no  later  than  the fourteenth day following the date that department of
 12    health and welfare representatives officially exit the  facility  pursuant  to
 13    federal  regulations.  Provided however, that for purposes of confidentiality,
 14    no record shall be released under this section which  specifically  identifies
 15    any nursing facility resident.
 16        (19) Records  and  information  contained in the registry of immunizations
 17    against childhood diseases maintained in the department of health and welfare,
 18    including information disseminated to others from the registry by the  depart-
 19    ment of health and welfare.
 20        (20) Records  of the Idaho housing and finance association (IHFA) relating
 21    to the following:
 22        (a)  Records containing personal financial, family, health or similar per-
 23        sonal information submitted to or otherwise obtained by the IHFA;
 24        (b)  Records submitted to or otherwise obtained by the IHFA with regard to
 25        obtaining and servicing mortgage loans and all  records  relating  to  the
 26        review, approval or rejection by the IHFA of said loans;
 27        (c)  Mortgage portfolio loan documents;
 28        (d)  Records  of  a  current  or former employee other than the employee's
 29        duration of employment with the association, position held and location of
 30        employment. This exemption from disclosure does not include the  contracts
 31        of employment or any remuneration, including reimbursement of expenses, of
 32        the executive director, executive officers or commissioners of the associ-
 33        ation. All other personnel information relating to an association employee
 34        or  applicant  including,  but  not limited to, information regarding sex,
 35        race, marital status, birth  date,  home  address  and  telephone  number,
 36        applications,  testing  and scoring materials, grievances, correspondence,
 37        retirement plan information and performance evaluations, shall not be dis-
 38        closed to the public without the employee's or  applicant's  written  con-
 39        sent.  An  employee or authorized representative may inspect and copy that
 40        employee's personnel records, except for material used to screen and  test
 41        for  employment  or  material  not  subject to disclosure elsewhere in the
 42        Idaho public records act.
 43        (21) Records of the department of health and welfare related to child sup-
 44    port services in cases in which there is reasonable evidence of domestic  vio-
 45    lence,  as  defined  in  chapter 63, title 39, Idaho Code, that can be used to
 46    locate any individuals in the child support case except in response to a court
 47    order.
 48        (22) Records of the Idaho state bar lawyer's assistance  program  pursuant
 49    to  chapter  49,  title  54,  Idaho  Code, unless a participant in the program
 50    authorizes the release pursuant to subsection (4) of  section  54-4901,  Idaho
 51    Code.
 52        (23) Records  and  information contained in the trauma registry created by
 53    chapter 20, title 57, Idaho Code, together with any reports, analyses and com-
 54    pilations created from such information and records.
 55        (24) Records contained in the court files, or other  records  prepared  as
  1    part  of  proceedings  for  judicial authorization of sterilization procedures
  2    pursuant to chapter 39, title 39, Idaho Code.
  3        (25) The physical voter registration card on file in  the  county  clerk's
  4    office;  however, a redacted copy of said card shall be made available consis-
  5    tent with the requirements of this section. Information from the voter  regis-
  6    tration card maintained in the statewide  voter registration database, includ-
  7    ing  age,  will be made available except for the voter's driver's license num-
  8    ber, date of birth and, upon showing of good cause by the voter to the  county
  9    clerk in consultation with the county prosecuting attorney, the physical resi-
 10    dence  address  of  the  voter. For the purposes of this subsection good cause
 11    shall include the protection of life and property and protection of victims of
 12    domestic violence and similar crimes.
 13        (26)  All reports, statements, memoranda or other  data  received  by  the
 14    bureau of health care data pursuant to chapter 14, title 56, Idaho Code.

Statement of Purpose / Fiscal Impact

                       STATEMENT OF PURPOSE

                             RS 14774

This bill will establish a Bureau, parallel to the Bureau of
Vital Statistics, in the Department of Health.  The Health Data
Bureau will, with the advice of the committee of those submitting
data, develop a plan to acquire, analyze and report the needed
data.  It also authorizes changes required in the existing law to
protect the individual's identity and health care history.

                           FISCAL NOTE

$200,000 is anticipated for the first year of operation.  There
are grants available for the development of a state health
database (AHPR/NIH)for one source.  Operations can be supported
through contracts with CMS and others needing reports on state
healthcare usage.  Currently, Utah covers about 3/4 of the
operations cost with such revenue. The savings to the State and
the citizens are difficult to estimate, but as the cost of Idaho
healthcare paid by Medicaid, Medicare and the BlueCross
BlueShield plans is over 4 billion dollars, one improved policy
decision would probably pay for the program.  

Name:  Rep. John Rusche 
Phone: 208-750-6048