Assigned to HHS                                                                                                 AS PASSED BY COMMITTEE

 


 

 

 


ARIZONA STATE SENATE

Fifty-Fourth Legislature, First Regular Session

 

AMENDED

FACT SHEET FOR S.B. 1352

 

health care directives registry; transfer

Purpose

            Transfers the health care directives registry (registry) from the Secretary of State (SOS) to a qualifying health information exchange organization (HIO) designated by the Department of Health Services (DHS).

Background

            A health care directive is a document, such as a living will or mental health care power of attorney, that is drafted to deal with a person's future healthcare decisions. Current statute requires the SOS to establish and maintain the registry on a website, and conditions this requirement on the availability of monies. Information contained in the registry is confidential and can only be disclosed to the person who submitted the document, the person's personal representative or an authorized healthcare provider. The registry is funded by the Health Care Directives Registry Fund (Fund) that consists of gifts, grants, donations, bequests and other contributions to support, promote and maintain the registry (A.R.S. §§ 36-3201; 36-3291; 36- 3295; and 36- 3297).

            Laws 2011, Chapter 268 establishes requirements for HIOs in Arizona, including requirements governing the maintenance and release of medical records and health information. An HIO is an organization that oversees and governs the exchange of individually identifiable health information according to nationally-recognized standards. Statute requires that an HIO provide certain rights to individuals, including the ability to: 1) opt out of the HIO; 2) request a list of individuals who have accessed the individual's health information through the HIO; and
3) request an amendment of incorrect individually-identifiable health information available through the HIO (A.R.S. § 36-3802).

            There is no anticipated fiscal impact to the state General Fund associated with this legislation.

Provisions

1.      Directs DHS to designate a qualifying HIO to operate a registry and requires the qualifying HIO to maintain a registry, rather than the SOS.

2.      Directs the SOS, by July 1, 2020, to provide the qualifying HIO with the documents and contact information of individuals who have submitted documents to the registry maintained by the SOS and requires the qualifying HIO to contact the individuals to determine if the individuals want their submitted documents transferred to the directory maintained by the HIO.

3.      Directs the qualifying HIO to transfer active documents to the new registry.

4.      Permits a person to submit health care directives, including prehospital medical care directives, and any amendments to or revocation of submitted documents.

5.      Requires the qualifying HIO to establish processes for:

a)      authenticating the identity of a person who submits a document to the registry;

b)      transmitting registry documents to the HIO;

c)      allowing individuals to submit documents to the registry;

d)      allowing individuals to review, retrieve, revoke and replace the document; and

e)      removing and distinguishing documents that have been revoked or replaced by more recent documents.

6.      Directs the qualifying HIO to adopt industry standard safeguards to ensure the privacy, security and integrity of documents submitted to and maintained by the registry.

7.      Requires the qualifying HIO to provide a person who submits a document to the registry with a viewable record of the information entered into the registry and allow the person to correct submitted information.

8.      Directs the qualifying HIO to activate the entry of a document submitted to the registry only after receiving confirmation that the information is correct.

9.      Specifies that information contained in the registry is confidential and can only be disclosed as allowed by federal and state law.

10.  Permits a person who submits a document to the registry, and a person who is the subject of a document submitted to the registry, to access the document in the registry in a manner prescribed by the qualifying HIO.

11.  Establishes that the qualifying HIO is not subject to civil liability for any claims or demands arising out of the administration or operation of the registry, with certain exceptions.

12.  Exempts the registry as operated by the qualifying HIO from participation, notice, disclosure and maintenance requirements otherwise prescribed for HIOs.

13.  Specifies that the requirement that a prehospital medical care directive be on an orange form does not apply to a healthcare provider who relies on a prehospital medical care directive displayed through the registry.

14.  Authorizes the qualifying HIO to accept gifts, grants, donations, bequests and other contributions to support, promote and maintain the registry.

15.  Requires the Arizona Health Care Cost Containment System to administer the Fund and to distribute Fund monies to the designated HIO to support, maintain and promote the registry.

16.  Defines qualifying HIO.

17.  Adds the organ procurement organization that maintains the donor registry to the definition of healthcare provider as it relates to the registry.

18.  Makes technical and conforming changes.

19.  Becomes effective on January 1, 2021.

Amendments Adopted by Committee

1.      Requires DHS, rather than the Arizona Health Care Cost Containment System, to designate a qualifying HIO to operate and maintain the registry.

2.      Adds the organ procurement organization that maintains the organ donor registry as a healthcare provider as it relates to the registry.

3.      Eliminates language prohibiting the Fund from containing state General Fund monies.

4.      Adds a delayed effective date.

5.      Makes technical and conforming changes.

Senate Action

HHS                2/20/19      DPA    7-0-1

Prepared by Senate Research

February 22, 2019

CRS/kja