04/11/2001 02:51 PM Senate HES

           SB 135-MENTAL HEALTH INFORMATION AND RECORDS                                                                     
                                                                                                                                
SENATOR  WARD  moved to  adopt  CSSB  135(HES),  Version  C, as  the                                                            
working document  of the committee.   There being no objection,  the                                                            
motion carried.                                                                                                                 
                                                                                                                                
CHAIRWOMAN GREEN  asked Mr. Elmer Lindstrom to describe  the changes                                                            
made in the committee substitute.                                                                                               
                                                                                                                                
MR.  ELMER  LINDSTROM   explained  that  in  December   of  2000,  a                                                            
legislative  audit was released that  took the Department  of Health                                                            
and Social  Services  (DHSS)  to task for  its inability  to  gather                                                            
client-specific  data  from  community  mental  health  centers  for                                                            
persons served  with general fund  grant dollars.  Community  health                                                            
centers are  funded through two mechanisms;  one being Medicaid  and                                                            
the  other a  grant-in-aid  program.   DHSS  has very  good data  on                                                            
clients served  through Medicaid  but the same  type of data  is not                                                            
collected   for  services   provided  with   grant-in-aid   dollars.                                                            
Legislative  Budget and Audit (LBA)  pointed out that DHSS  ought to                                                            
know the cost  per client, who is served, the services  provided and                                                            
the outcomes of  clients who receive services from  the grant-in-aid                                                            
dollars.   DHSS  concurs with  the  legislative audit,  however  the                                                            
statute is  very ambiguous  as to DHSS's  authority to collect  that                                                            
information,  which CSSB 135(HES)  will clarify.  DHSS has  a lot of                                                            
experience  dealing  with confidentiality  issues;  virtually  every                                                            
division has  confidential records.   He is frequently asked  by the                                                            
legislature why  DHSS cannot make more information  available rather                                                            
than being accosted for leaking information.                                                                                    
                                                                                                                                
SENATOR LEMAN  asked if DHSS has a  system for archiving  or purging                                                            
records that are no longer useful.                                                                                              
                                                                                                                                
MR. LINDSTROM  said  he does  not know  the exact  procedure but  he                                                            
guessed that most records are ultimately archived or destroyed.                                                                 
                                                                                                                                
CHAIRWOMAN  GREEN referred to page  30 of the legislative  audit and                                                            
read:                                                                                                                           
                                                                                                                                
     Without this ability, the  Department of Health and Social                                                                 
     Services  cannot identify the  total population of mental                                                                  
     health  clients served,  nor detect  if Medicaid payments                                                                  
     are  being made  for  clients also  funded  through  state                                                                 
     grants.                                                                                                                    
                                                                                                                                
She noted that  feeds in with cost  containment efforts underway  by                                                            
the Legislature.  She pointed  out that  regarding confidentiality,                                                             
the same  information  is required  of  an insurance  company.   She                                                            
informed  committee  members  that  Pat  Davidson  from Legislative                                                             
Budget and  Audit was present  to answer  any questions members  may                                                            
have.                                                                                                                           
                                                                                                                                
CHAIRWOMAN  GREEN  said  that  SB  135 is  prospective  and  she  is                                                            
concerned that many people  are being asked to offer information but                                                            
have refused.   She asked  Mr. Lindstrom if  it would be helpful  to                                                            
put a retroactive clause in the bill.                                                                                           
                                                                                                                                
MR. LINDSTROM  clarified  that the committee  substitute contains  a                                                            
retroactive  clause.  He stated that  although a retroactive  clause                                                            
makes  sense  on  a  conceptual   level,  providers  have   resisted                                                            
providing that information  in the past.  A working group made up of                                                            
DHSS  employees,  providers  and consumers  has  been  assembled  to                                                            
determine which data should  be provided.  He expressed concern that                                                            
the working  group may come  up with a slightly  different  data set                                                            
than what is  required in the bill.   DHSS would prefer not  to have                                                            
the retroactive clause as it is likely to generate opposition.                                                                  
                                                                                                                                
Number 619                                                                                                                      
                                                                                                                                
CHAIRWOMAN  GREEN commented  that the information  requested  in the                                                            
bill is  what the legislature  needs.   She asked  if SB 135  should                                                            
include any other information that DHSS needs.                                                                                  
                                                                                                                                
MR.  LINDSTROM  said in  an  ideal world,  without  the retroactive                                                             
clause,  DHSS will  probably  have good  baseline  data for  several                                                            
years in the future if  it begins on July 1.  It would be useful for                                                            
DHSS  collect retroactive  data  but  he suspects  that  may not  be                                                            
possible as a practical matter.                                                                                                 
                                                                                                                                
CHAIRWOMAN GREEN  asked if there is any way to frame  it in terms of                                                            
disputed claims.                                                                                                                
                                                                                                                                
MR. LINDSTROM  said he did not know and would need  time to get more                                                            
information.                                                                                                                    
                                                                                                                                
CHAIRWOMAN  GREEN decided  to leave  the retroactive  clause in  the                                                            
bill and  pass it on to  the Senate Judiciary  Committee, where  Mr.                                                            
Lindstrom could present that information.                                                                                       
                                                                                                                                
SENATOR  WARD moved  CSSB 135(HES)  from committee  with  individual                                                            
recommendations.  There being no objection, the motion carried.