Senate Bill sb2500

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    Florida Senate - 2006                                  SB 2500

    By Senator Campbell





    32-1194-06                                              See HB

  1                      A bill to be entitled

  2         An act relating to patient records; amending s.

  3         395.3025, F.S.; requiring disclosure by a

  4         licensed facility concerning individually

  5         identifiable health information transmitted to

  6         a site outside the United States; requiring

  7         notice to and consent of the patient; providing

  8         for renewal and revocation of consent;

  9         providing for a consent form and contents

10         thereof; prohibiting discrimination based on

11         refusal to grant consent; providing an

12         effective date.

13  

14  Be It Enacted by the Legislature of the State of Florida:

15  

16         Section 1.  Section 395.3025, Florida Statutes, is

17  amended to read:

18         395.3025  Patient and personnel records; copies;

19  examination; transmission of records; consent.--

20         (1)  Any licensed facility shall, upon written request,

21  and only after discharge of the patient, furnish, in a timely

22  manner, without delays for legal review, to any person

23  admitted therein for care and treatment or treated thereat, or

24  to any such person's guardian, curator, or personal

25  representative, or in the absence of one of those persons, to

26  the next of kin of a decedent or the parent of a minor, or to

27  anyone designated by such person in writing, a true and

28  correct copy of all patient records, including X rays, and

29  insurance information concerning such person, which records

30  are in the possession of the licensed facility, provided the

31  person requesting such records agrees to pay a charge. The

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    Florida Senate - 2006                                  SB 2500
    32-1194-06                                              See HB




 1  exclusive charge for copies of patient records may include

 2  sales tax and actual postage, and, except for nonpaper records

 3  that are subject to a charge not to exceed $2, may not exceed

 4  $1 per page. A fee of up to $1 may be charged for each year of

 5  records requested. These charges shall apply to all records

 6  furnished, whether directly from the facility or from a copy

 7  service providing these services on behalf of the facility.

 8  However, a patient whose records are copied or searched for

 9  the purpose of continuing to receive medical care is not

10  required to pay a charge for copying or for the search. The

11  licensed facility shall further allow any such person to

12  examine the original records in its possession, or microforms

13  or other suitable reproductions of the records, upon such

14  reasonable terms as shall be imposed to assure that the

15  records will not be damaged, destroyed, or altered.

16         (2)  This section does not apply to records maintained

17  at any licensed facility the primary function of which is to

18  provide psychiatric care to its patients, or to records of

19  treatment for any mental or emotional condition at any other

20  licensed facility which are governed by the provisions of s.

21  394.4615.

22         (3)  This section does not apply to records of

23  substance abuse impaired persons, which are governed by s.

24  397.501.

25         (4)  Patient records are confidential and must not be

26  disclosed without the consent of the person to whom they

27  pertain, but appropriate disclosure may be made without such

28  consent to:

29         (a)  Licensed facility personnel and attending

30  physicians for use in connection with the treatment of the

31  patient.

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    Florida Senate - 2006                                  SB 2500
    32-1194-06                                              See HB




 1         (b)  Licensed facility personnel only for

 2  administrative purposes or risk management and quality

 3  assurance functions.

 4         (c)  The agency, for purposes of health care cost

 5  containment.

 6         (d)  In any civil or criminal action, unless otherwise

 7  prohibited by law, upon the issuance of a subpoena from a

 8  court of competent jurisdiction and proper notice by the party

 9  seeking such records to the patient or his or her legal

10  representative.

11         (e)  The agency upon subpoena issued pursuant to s.

12  456.071, but the records obtained thereby must be used solely

13  for the purpose of the agency and the appropriate professional

14  board in its investigation, prosecution, and appeal of

15  disciplinary proceedings. If the agency requests copies of the

16  records, the facility shall charge no more than its actual

17  copying costs, including reasonable staff time. The records

18  must be sealed and must not be available to the public

19  pursuant to s. 119.07(1) or any other statute providing access

20  to records, nor may they be available to the public as part of

21  the record of investigation for and prosecution in

22  disciplinary proceedings made available to the public by the

23  agency or the appropriate regulatory board. However, the

24  agency must make available, upon written request by a

25  practitioner against whom probable cause has been found, any

26  such records that form the basis of the determination of

27  probable cause.

28         (f)  The Department of Health or its agent, for the

29  purpose of establishing and maintaining a trauma registry and

30  for the purpose of ensuring that hospitals and trauma centers

31  are in compliance with the standards and rules established

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    Florida Senate - 2006                                  SB 2500
    32-1194-06                                              See HB




 1  under ss. 395.401, 395.4015, 395.4025, 395.404, 395.4045, and

 2  395.405, and for the purpose of monitoring patient outcome at

 3  hospitals and trauma centers that provide trauma care

 4  services.

 5         (g)  The Department of Children and Family Services or

 6  its agent, for the purpose of investigations of cases of

 7  abuse, neglect, or exploitation of children or vulnerable

 8  adults.

 9         (h)  The State Long-Term Care Ombudsman Council and the

10  local long-term care ombudsman councils, with respect to the

11  records of a patient who has been admitted from a nursing home

12  or long-term care facility, when the councils are conducting

13  an investigation involving the patient as authorized under

14  part II of chapter 400, upon presentation of identification as

15  a council member by the person making the request.  Disclosure

16  under this paragraph shall only be made after a competent

17  patient or the patient's representative has been advised that

18  disclosure may be made and the patient has not objected.

19         (i)  A local trauma agency or a regional trauma agency

20  that performs quality assurance activities, or a panel or

21  committee assembled to assist a local trauma agency or a

22  regional trauma agency in performing quality assurance

23  activities. Patient records obtained under this paragraph are

24  confidential and exempt from s. 119.07(1) and s. 24(a), Art. I

25  of the State Constitution.

26         (j)  Organ procurement organizations, tissue banks, and

27  eye banks required to conduct death records reviews pursuant

28  to s. 395.2050.

29         (k)  The Medicaid Fraud Control Unit in the Department

30  of Legal Affairs pursuant to s. 409.920.

31  

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    Florida Senate - 2006                                  SB 2500
    32-1194-06                                              See HB




 1         (l)  The Department of Financial Services, or an agent,

 2  employee, or independent contractor of the department who is

 3  auditing for unclaimed property pursuant to chapter 717.

 4         (m)  A regional poison control center for purposes of

 5  treating a poison episode under evaluation, case management of

 6  poison cases, or compliance with data collection and reporting

 7  requirements of s. 395.1027 and the professional organization

 8  that certifies poison control centers in accordance with

 9  federal law.

10         (5)  The Department of Health may examine patient

11  records of a licensed facility, whether held by the facility

12  or the Agency for Health Care Administration, for the purpose

13  of epidemiological investigations. The unauthorized release of

14  information by agents of the department which would identify

15  an individual patient is a misdemeanor of the first degree,

16  punishable as provided in s. 775.082 or s. 775.083.

17         (6)  Patient records shall contain information required

18  for completion of birth, death, and fetal death certificates.

19         (7)(a)  If the content of any record of patient

20  treatment is provided under this section, the recipient, if

21  other than the patient or the patient's representative, may

22  use such information only for the purpose provided and may not

23  further disclose any information to any other person or

24  entity, unless expressly permitted by the written consent of

25  the patient. A general authorization for the release of

26  medical information is not sufficient for this purpose. The

27  content of such patient treatment record is confidential and

28  exempt from the provisions of s. 119.07(1) and s. 24(a), Art.

29  I of the State Constitution.

30         (b)  Absent a specific written release or authorization

31  permitting utilization of patient information for solicitation

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    Florida Senate - 2006                                  SB 2500
    32-1194-06                                              See HB




 1  or marketing the sale of goods or services, any use of that

 2  information for those purposes is prohibited.

 3         (c)  A person or entity that has contracted or

 4  subcontracted with a licensed facility as defined in s.

 5  395.002(17) to receive individually identifiable health

 6  information must disclose to the licensed facility whether any

 7  of the information will be transmitted to a site outside the

 8  United States.

 9         (d)  A licensed facility, or person or entity that has

10  contracted or subcontracted with a licensed facility, may not

11  transmit individually identifiable health information to a

12  site outside the United States unless all of the following

13  apply:

14         1.  The licensed facility has disclosed to the patient

15  upon admission, or as soon as practicable after admission,

16  that his or her individually identifiable health information

17  may be transmitted to a site outside the United States.

18         2.  The licensed facility has obtained written consent

19  from the patient to transmit his or her individually

20  identifiable health information to a site outside the United

21  States.

22         3.  The consent of the patient has been granted or

23  renewed on an annual basis.

24         4.  The patient has been informed that he or she may

25  revoke consent in writing at any time.

26         (e)  Except for a request for health care services

27  initiated by a person seeking diagnosis or treatment outside

28  the United States, a licensed facility must use a form to

29  obtain consent to transmit individually identifiable health

30  information to a site outside the United States. The form must

31  meet the following criteria:

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    Florida Senate - 2006                                  SB 2500
    32-1194-06                                              See HB




 1         1.  It must be a separate document and may not be

 2  attached to any other document.

 3         2.  It must be dated and signed by the patient whose

 4  health care information is identifiable.

 5         3.  It must clearly state all of the following:

 6         a.  That by signing, the patient is consenting to the

 7  transmission of his or her individually identifiable health

 8  information to a site outside the United States where the

 9  information is not protected by United States confidentiality

10  laws.

11         b.  That the licensed facility is obligated to obtain

12  the consent of the patient annually.

13         c.  That the patient may revoke consent at any time

14  using a procedure specified on the form.

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16  A licensed facility may not discriminate against an individual

17  or deny an individual health care service because the

18  individual has not provided consent pursuant to this

19  subsection.

20         (8)  Patient records at hospitals and ambulatory

21  surgical centers are exempt from disclosure under s.

22  119.07(1), except as provided by subsections (1)-(5).

23         (9)  A licensed facility may prescribe the content and

24  custody of limited-access records which the facility may

25  maintain on its employees. Such records shall be limited to

26  information regarding evaluations of employee performance,

27  including records forming the basis for evaluation and

28  subsequent actions, and shall be open to inspection only by

29  the employee and by officials of the facility who are

30  responsible for the supervision of the employee. The custodian

31  of limited-access employee records shall release information

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    Florida Senate - 2006                                  SB 2500
    32-1194-06                                              See HB




 1  from such records to other employers or only upon

 2  authorization in writing from the employee or upon order of a

 3  court of competent jurisdiction. Any facility releasing such

 4  records pursuant to this part shall be considered to be acting

 5  in good faith and may not be held liable for information

 6  contained in such records, absent a showing that the facility

 7  maliciously falsified such records. Such limited-access

 8  employee records are exempt from the provisions of s.

 9  119.07(1) for a period of 5 years from the date such records

10  are designated limited-access records.

11         (10)  The home addresses, telephone numbers, and

12  photographs of employees of any licensed facility who provide

13  direct patient care or security services; the home addresses,

14  telephone numbers, and places of employment of the spouses and

15  children of such persons; and the names and locations of

16  schools and day care facilities attended by the children of

17  such persons are confidential and exempt from s. 119.07(1) and

18  s. 24(a), Art. I of the State Constitution. However, any state

19  or federal agency that is authorized to have access to such

20  information by any provision of law shall be granted such

21  access in the furtherance of its statutory duties,

22  notwithstanding the provisions of this subsection. The

23  Department of Financial Services, or an agent, employee, or

24  independent contractor of the department who is auditing for

25  unclaimed property pursuant to chapter 717, shall be granted

26  access to the name, address, and social security number of any

27  employee owed unclaimed property.

28         (11)  The home addresses, telephone numbers, and

29  photographs of employees of any licensed facility who have a

30  reasonable belief, based upon specific circumstances that have

31  been reported in accordance with the procedure adopted by the

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    Florida Senate - 2006                                  SB 2500
    32-1194-06                                              See HB




 1  facility, that release of the information may be used to

 2  threaten, intimidate, harass, inflict violence upon, or

 3  defraud the employee or any member of the employee's family;

 4  the home addresses, telephone numbers, and places of

 5  employment of the spouses and children of such persons; and

 6  the names and locations of schools and day care facilities

 7  attended by the children of such persons are confidential and

 8  exempt from s. 119.07(1) and s. 24(a), Art. I of the State

 9  Constitution. However, any state or federal agency that is

10  authorized to have access to such information by any provision

11  of law shall be granted such access in the furtherance of its

12  statutory duties, notwithstanding the provisions of this

13  subsection. The licensed facility shall maintain the

14  confidentiality of the personal information only if the

15  employee submits a written request for confidentiality to the

16  licensed facility.

17         Section 2.  This act shall take effect July 1, 2006.

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