05/01/2001 09:55 AM House RLS

SB 135-MENTAL HEALTH INFO/RECORDS/COMMUNICATIONS                                                                              
                                                                                                                                
[The  tape counter  numbers indicate  the number  of minutes  that                                                              
have elapsed.]                                                                                                                  
                                                                                                                                
CHAIR KOTT  announced that  the first order  of business  would be                                                              
CS  FOR SENATE  BILL  NO. 135(JUD),  "An  Act  relating to  mental                                                              
health  records, communications,  and  information; and  providing                                                              
for an effective date."                                                                                                         
                                                                                                                                
00.7                                                                                                                            
                                                                                                                                
REPRESENTATIVE HUGH  FATE, Alaska State Legislature,  presented SB
.    He explained  that  SB  135  would  do the  following  two                                                              
things.   The  bill would  require  agencies to  report the  exact                                                              
consumer  data as  recommended by  the  state auditor.   The  bill                                                              
would  hold harmless  agencies for  breech  of confidentiality  in                                                              
reporting   that   data   which   settled   a   pending   lawsuit.                                                              
Representative  Fate  emphasized   that  this  [legislation]  will                                                              
settle  a pending  lawsuit by  community agencies.   He  explained                                                              
that  the state  maintains all  records in  a confidential  manner                                                              
using  sophisticated  encryption  methods.    Representative  Fate                                                              
specified  that  this is  really  about accountability  for  state                                                              
grant funds.   The auditor was  unable to track grant  funds under                                                              
the current  system.   Therefore, this  [legislation] is  the fix.                                                              
In response  to Chair Kott,  Representative Fate stated  that CSSB
(JUD) is the companion to HB 174.                                                                                            
                                                                                                                                
REPRESENTATIVE  McGUIRE asked whether  there is  any other  way to                                                              
disclose  the   confidential  mental   health  information   of  a                                                              
patient.                                                                                                                        
                                                                                                                                
02.3                                                                                                                            
                                                                                                                                
ELMER LINDSTROM,  Special Assistant,  Office of the  Commissioner,                                                              
Department  of Health  & Social  Services  (DHSS), explained  that                                                              
the community  mental  health centers  are funded  in two  ways by                                                              
DHSS.   The  community mental  health centers  are funded  through                                                              
Medicaid and the  grant aid program.  He pointed  out that all the                                                              
information  being sought for  the grant  funds through  this bill                                                              
are already provided  through the Medicaid  management information                                                              
system.   Therefore, the legislative  auditor noted  that although                                                              
that  information  is  available  through  the  Medicaid  program,                                                              
there is  no way to determine  who is receiving services  and what                                                              
type of services  from the grant program.  As  the Medicaid budget                                                              
grew,  there was  some  concern from  those  requesting the  audit                                                              
that there  should be  knowledge regarding  how these  grant funds                                                              
are being  spent, particularly in  relation to the  services being                                                              
provided by Medicaid.                                                                                                           
                                                                                                                                
MR.  LINDSTROM  highlighted  that  DHSS  deals  with  confidential                                                              
records in  every aspect of its  business.  In the ten  years that                                                              
he has  worked with  DHSS he  was unaware  of any circumstance  in                                                              
which   the   department   has   inappropriately   divulged   that                                                              
information.   He  noted  that the  information  does  have to  be                                                              
client-specific information,  which is aggregated.   Although this                                                              
is a necessary  fix to a specific statute, it  isn't extraordinary                                                              
in regard to the way [DHSS] does business elsewhere.                                                                            
                                                                                                                                
04.1                                                                                                                            
                                                                                                                                
REPRESENTATIVE  McGUIRE referred  to  Section 1  of CSSB  135(JUD)                                                              
which  says "when  disclosure is  authorized  under AS  47.30.540,                                                              
47.30.590, 47.30.845,  47.31.032."  She asked what  those statutes                                                              
are.                                                                                                                            
                                                                                                                                
MR. LINDSTROM  answered that  he believes  those statutes  are the                                                              
underlying health  statutes for the community mental  health grant                                                              
program.   He explained that the  point of that provision  is that                                                              
providers  must  provide  that   information  to  the  department.                                                              
Therefore,  the department  wants the providers  to have  immunity                                                              
for  doing so.   Without  the  clarification,  the providers  were                                                              
concerned that  they could  be sued by  a person in  the community                                                              
for providing  that information.   This bill  makes it  clear that                                                              
the provider must  provide that information to  the department and                                                              
it also  makes it clear that  the community mental  health centers                                                              
can't be sued for doing so.                                                                                                     
                                                                                                                                
REPRESENTATIVE  McGUIRE  asked  if  there  would be  any  harm  in                                                              
narrowing  the  language  such  that it  would  require  that  the                                                              
patient must agree to the release of their records.                                                                             
                                                                                                                                
MR. LINDSTROM deferred  to Ms. Henry because he  wasn't certain of                                                              
the  release that  patient's currently  sign.   He explained  that                                                              
the clients in  these cases don't have a  contractual relationship                                                              
with the department  because it is a grant and  aid process rather                                                              
than (indisc.) the community mental health center.                                                                              
                                                                                                                                
05.5                                                                                                                            
                                                                                                                                
ANNE  HENRY,  Special Projects  Coordinator,  Division  of  Mental                                                              
Health  &  Developmental  Disabilities,  Department  of  Health  &                                                              
Social Services,  informed  the committee  that the person's  name                                                              
and social security  number are not required.  Rather,  there is a                                                              
unique identifier  that includes initials, date of  birth, and the                                                              
last  for   digits  of  the   person's  social  security   number.                                                              
Currently,  there  is no  release  required for  this  information                                                              
because it  is encrypted.  Ms.  Henry also informed  the committee                                                              
that due to the  federal regulations that will be  coming on line,                                                              
all individuals that  use any type of health care  will be using a                                                              
unique identifier in the next two or three years.                                                                               
                                                                                                                                
06.5                                                                                                                            
                                                                                                                                
REPRESENTATIVE  PORTER  moved  to  report  CSSB  135(JUD)  out  of                                                              
committee  with individual  recommendations  and the  accompanying                                                              
fiscal  notes.    There being  no  objection,  CSSB  135(JUD)  was                                                              
reported from the House Rules Standing Committee.