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ILHIE Legal Task Force Meeting Minutes - April 5 2011 

ILHIE Legal Task Force Executive Committee Meeting

April 5, 2011

In-person Attendees:

  • Bernadette Broccolo - McDermott, Will & Emery

Office of Health Information Technology

  • Sarah Byers
  • Mark Chudzinski
  • Vaughn Ganiyu
  • David Kim

Attendance by Phone:

  • Mark Deaton, Illinois Hospital Association
  • Laurel Fleming, Northwestern Medical Faculty Foundation
  • Patricia Foltz, Anderson, Rasor & Partners, LLP
  • Patricia King, Swedish Covenant Hospital
  • Marilyn Lamar, Liss & Lamar
  • Mary Lucie, Northwestern Memorial Hospital
  • Anne Murphy, Holland & Knight
  • Jay Ready, Chicago Lawyers' Committee for Civil Rights under Law
  • Maia Thiagarajan, Ingalls Health System

Bernadette Broccolo, co-chair of the Executive Committee, opened the meeting at 2:00 p.m. hosted by OHIT at the State of Illinois J.R. Thompson Center in Downtown Chicago, with a telephone conference call-in number. It was noted that notice of the meeting and the agenda were posted on the OHIT Web site and at the Chicago meeting location no later than 48 hours prior to the meeting. Roll was taken, and the ability of those attending by telephone to hear and participate was confirmed.

Ms. Broccolo moved to approve the minutes from the previous meetings (October 27, 2010; December 17, 2010; January 19, 2011, and March 3, 2011). A correction was noted to the minutes from the March 3, 2011, meeting; motions to approve all of the prior meeting minutes (as amended) were approved.

Ms. Broccolo noted that a discussion of the HIV/AIDS group will be added to the agenda for the meeting.

Mark Chudzinski, General Counsel of OHIT, provided a brief Illinois and Federal HIE update.

  1. The inaugural meeting of the IL HIE Authority has been scheduled for Wednesday, April 27, 2011.
  2. Mr. Ivan Handler, formerly the CIO with the Department of Healthcare and Family Services (HFS), has been hired as the new CTO for OHIT.
  3. At the Federal level, HHS/ONC has announced that necessary technical standards for the Direct Project have been finalized and released, and pilot projects using Direct for facilitating the transmission of data have been launched.
  4. Planning and implementation of "local" HIEs throughout Illinois is accelerating. Additional information regarding the status of seven such initiatives can be found at: http://www.hie.illinois.gov/031411tiwgminutes.html.
  5. Illinois State pending legislation
    1. HB1338, the Immunization Data Registry Act, has passed in the Illinois House and has been sent to the Senate. It changes the current patient "Opt-In" policy for immunization data deposited in the I-Care system with a patient "Opt-Out" policy for immunization data sent to the new Registry. Under the leadership of Maria Pekar, a number of recommendations were made by Task Force members to improve the Act, but were not ultimately incorporated by the sponsor; the revisions proposed will be shared with other work groups as a potential template for amendments to other Illinois statutes.
    2. SB1234 is at the third reading stage in the Illinois Senate. It changes the Mental Health and Developmental Disabilities Confidentiality Act (740 ILCS 110/11) to allow for the disclosure for treatment purposes of patient pharmaceutical records without prior patient consent. Under the leadership of Laurel Fleming, a number of recommendations were made by Task Force members to improve the Act, but have not yet been incorporated by the sponsor.
  6. David Kim, OHIT Legal intern, delivered a summary of HIE development in other states.
    1. Further his report at the last meeting, there were no significant new updates in Texas, California, and Kansas.
    2. Nevada has a bill, S.B. 43, to establish Nevada's HIE. The bill adopts an opt-in consent model with the exception of Medicaid recipients and insurance pursuant to the Children's Health Insurance Program. Disclosure of PHI through the HIE is governed by HIPAA.
    3. North Carolina has introduced a bill, SB 375, to establish North Carolina's HIE. It adopts an opt-out consent model. Disclosure of PHI through the HIE is governed by HIPAA.

Next, the group heard updates from the work groups:

General PHI

Patricia King, co-chair, gave the following update:
  • General PHI has revised the analysis worksheet and tracking tool on relevant statutes.
  • Members have analyzing the relevant statutes and case law
  • A work product is scheduled to be delivered in May, 2011.

Behavioral Health

Laurel Flemming, co-chair, gave the following update:
  • She stated that everything was going on schedule.
  • There were two subgroups; one group is looking into licensing laws while the other group is looking into confidentiality laws.
  • The group has been discussing the initial work product.
  • The group is meeting on April 29, 2011, to work on a white paper.

Substance Abuse

Jay Readey, co-chair, gave the following update:
  • The Substance Abuse group has been working on edits on their legal analysis.
  • The group has not received any further Federal guidance on 42 CFR.
  • The group feels that the Alcoholism Act can be addressed in the OHIT legislative plan.
  • Their next scheduled meeting is for April 14, 2011.

Public Health

Maria Pekar, co-chair, gave the following update:
  • The group has divided into subgroups that are looking at the relevant statutes.
  • The group is meeting every two weeks.
  • The group was working on SB 1338 changes. They have developed a template for wording for other workgroups that deal with consent.
  • Their next scheduled meeting is for April 6, 2011.

Genetic Testing

Mary Lucie, co-chair, gave the following update:
  • The group has divided into two groups. One group is examining the Genetic Counseling Act, while the other group is examining the Genetic Privacy Act.
  • The group is developing a timeline for deliverables.

Liability Group

Patricia Foltz, co-chair, gave the following update:
  • The group has divided into subgroup with each subgroup focusing on different issues and statutes
  • All the subgroups will provide work product.
  • The Liability Group work product will be finalized by May, 2011.
  • Next meeting is scheduled for April, 14, 2011.

Interstate Issues

Marilyn Lamar, co-chair, gave the following update:
  • Ms. Lamar has continued to participate in the Upper Midwest Working Group.
  • The group is continuing its work on a multistate consent agreement that would work across state lines. However, Minnesota's medical privacy law is making the task difficult.
  • The group is not yet certain about recommendations to be reflected within a white paper.
  • It appears, however, that Illinois would benefit from having a "break the glass" emergency exception embodied within Illinois statute.
  • The next meeting is scheduled for April 18, 2011.

The group next discussed the desirability of maintaining a separate HIV/AIDS work group within the Task Force, or incorporating this topic into another work group. In the following discussion, one participant shared her recent experience in working on the legal issues concerning HIV/AIDS, and stated that she found that there is still a stigma that is attached to HIV/AIDS and discrimination against patients with HIV/AIDS, meriting continued special attention in the IL HIE Legal Task Force. The names of several potential members for addition to the HIV/AIDS workgroup were suggested.

In response to the chair's invitation, there were no comments offered from the general public.

The next meeting was tentatively set for early May, 2011.

The meeting was adjourned at 2:55 p.m.