SB 99 HEALTH CARE DATA; BIRTH REGISTRATIONS  Number 252 CHAIRMAN WILKEN introduced SB 99 as the next order of business before the committee. AL ZANGRI , Chief of the Bureau of Vital Statistics for DHSS, explained that Sections 1 and 2 of SB 99 establish civil immunity for institutions and providers who report diseases and conditions to the department as required under other portions of the statute. Without SB 99, the department could lose $300,000 to $400,000 per year in cancer grants. Sections 3 and 4 clarify the language in the Vital Statistics Act regarding the reporting requirements for births and institutions as well as shortening the time period from seven to five days. There is also a language change in determining how reports are made for moving conveyances. Mr. Zangri noted the most important change as being the elimination of a signature for every birth certificate produced in a hospital. This would allow the bureau to operate its electronic birth certificate system. All but two hospitals in the state have electronic birth certificate systems. Currently, each hospital must send a paper copy of the birth certificate with a hand signature. SB 99 would allow electronic signatures or group signatures for all the births during a week. In response to Senator Green, AL ZANGRI clarified that SB 99 does not release information. SB 99 grants civil immunity to facilities already required to report that information. Current law requires that providers report this information to the department, however if the information has not been properly used then the individual can be sued. SB 99 grants civil immunity for providing that information unless the case is pure negligence. Mr. Zangri pointed out that this immunity is required under federal statutes if the cancer grant is to continue. Number 318 DR. JOHN MIDDAUGH , Chief of the Epidemiology Section in DHSS, explained that the immunity protection is only for those reporting in compliance with state law. The data is being reported to the Division of Public Health. The data is not disclosable under Alaska's public records law and can only be released if there is an eminent and direct public health threat to another person. Dr. Middaugh noted that the data is provided with identifiers only so that duplicate reporting can be eliminated. Dr. Middaugh reiterated that the data is protected by the Alaska statutes regarding confidentiality. SENATOR GREEN expressed concern with the sectional analysis of Section 1 which says that, "This immunity protects the person reporting the information regardless of how the Department uses the information." Senator Green did not know if that accurately reflected the intent of the bill. Senator Green wanted to be sure that a medical provider would not be required to provide information that would not ordinarily be provided. DR. JOHN MIDDAUGH said that the bill only provides protection for the information required to be reported under Alaska statutes and regulations. CHAIRMAN WILKEN pointed out that he had a list of the diseases required to be reported on a daily basis. SENATOR WARD asked if this was necessary to receive the first of five increments of $420,000; is this a new program? DR. JOHN MIDDAUGH clarified that the grant was awarded in October of 1994. During the first year, regulations were revised in order to be in compliance with establishing the cancer registry component of the reporting requirements. The regulations went into effect in January of 1996. The first year of collection of this information on cancer statewide has been completed. The other disease reports for infectious disease in some cases go back to territorial days. The funds received to establish the cancer registry are part of the federal legislative program, the Cancer Registries Amendment Act, which establishes uniform cancer registries in all 50 states. Dr. Middaugh noted that work to establish a cancer registry in Alaska had been going on for 20 years; these funds allowed such a registry. In order to maintain compliance of the requirements of the federal law, these three provisions require statutory changes and cannot be dealt with in regulation. Dr. Middaugh informed the committee that SB 99 has been endorsed by the Alaska Hospital & Nursing Home Association, the Alaska State Medical Association, and the Alaska Division of the American Cancer Society. Number 375 SENATOR WARD asked if the program comes out of the $420,000 or is this an additional program. Are there matching funds? DR. JOHN MIDDAUGH said that there are no matching funds involved. This is an ongoing grant which is now in the third year of a five year project. Without these additional statutory changes, there may be a risk in losing the award. Dr. Middaugh noted that this really protects the data, the patients, and the providers. In response to Senator Ward, Dr. Middaugh replied that there has not been any implication that the money would be withdrawn without the implementation. However as part of the federal law and the grant award, the department has to certify that efforts attempting to comply with the federal legislation have been made. SENATOR WARD inquired as to what portion of the funds goes towards the cancer reporting. DR. JOHN MIDDAUGH specified that all of the funds are used for cancer reporting. All other diseases are required to be reported to the Division of Public Health for public health protection. Dr. Middaugh noted that the other diseases were included due to the rationale for uniformity and protection for patients, physicians, and the state. In response to Senator Ward, Dr. John Middaugh agreed that the inclusion of the other diseases was not necessary to receive the funds. DR. MIDDAUGH reiterated the strong support for SB 99 from the medical community. CHAIRMAN WILKEN said that he would entertain a motion to report SB 99 to its next committee of referral. SENATOR WARD moved to report SB 99 out of committee with individua recommendations and a zero fiscal note. Without objection, it was so ordered.