SB 343-1_ Filed 04/24/2003, 16:30
CONFERENCE COMMITTEE REPORT
DIGEST FOR ESB 343
Citations Affected:
IC 12-15-12-19
;
IC 16-18-2-55.5
;
IC 16-38-6
;
IC 16-41-6-1
;
IC 16-41-10
;
IC 34-30-2-77.4
;
IC 34-30-2-81.5.
Synopsis: Health management and chronic disease registry. Conference committee report for
ESB 343. Removes HIV and AIDS and population parameters from the state's disease
management program and adds hypertension to the program. Sets implementation dates for the
statewide program. Creates a chronic disease registry administered by the state department of
health. Provides for testing and notification to an emergency medical services provider who has
potentially been exposed to a dangerous communicable disease. (This conference committee
report: (1) removes a provision specifying authority to determine initial placement
designations in mental health facilities; (2) adds licensed physicians to the definition of
"emergency medical services provider"; (3) makes a cross reference concerning consent
for testing of communicable diseases; and (4) makes technical stylistic changes.)
Effective: Upon passage; July 1, 2003.
Text Box
Adopted Rejected
[
]
CONFERENCE COMMITTEE REPORT
MR. SPEAKER:
Your Conference Committee appointed to confer with a like committee from the Senate
upon Engrossed House Amendments to Engrossed Senate Bill No. 343 respectfully reports
that said two committees have conferred and agreed as follows to wit:
that the Senate recede from its dissent from all House amendments and that
the Senate now concur in all House amendments to the bill and that the bill
be further amended as follows:
Delete everything after the enacting clause and insert the following:
SOURCE: IC 12-15-12-19; (03)CC034302.1. -->
SECTION 1.
IC 12-15-12-19
, AS AMENDED BY P.L.66-2002,
SECTION 2, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
UPON PASSAGE]: Sec. 19. (a) This section applies to an individual
who:
(1) is a Medicaid recipient;
and
(2) is not enrolled in the risk-based managed care program.
and
(3) resides in a county having a population of more than one
hundred thousand (100,000).
(b) Subject to subsection (c), the office shall develop the following
programs regarding individuals described in subsection (a):
(1) A disease management program for recipients with any of the
following
chronic diseases:
(A) Asthma.
(B) Diabetes.
(C) Congestive heart failure or coronary heart disease.
(D) HIV or AIDS. (D) Hypertension.
(2) A case management program for recipients
whose per recipient
Medicaid cost is in the highest ten percent (10%) of all individuals
described in subsection (a)
who are at high risk of chronic
disease, that is based on a combination of cost measures,
clinical measures, and health outcomes identified and
developed by the office with input and guidance from the state
department of health and other experts in health care case
management or disease management programs.
(c) The office shall implement:
(1) a pilot program for at least two (2) of the diseases listed in
subsection (b) not later than July 1, 2003; and
(2) a statewide chronic disease program as soon as practicable
after the office has done the following:
(A) Evaluated a pilot program described in subdivision (1).
(B) Made any necessary changes in the program based on the
evaluation performed under clause (A).
(d) The office shall develop and implement a program required
under this section in cooperation with the state department of
health and shall use the following health care providers to the
extent possible:
(1) Community health centers.
(2) Federally qualified health centers (as defined in 42 U.S.C.
1396d(l)(2)(B)).
(3) Rural health clinics (as defined in 42 U.S.C. 1396d(l)(1)).
(4) Local health departments.
(5) Hospitals.
(e) The office shall may contract with an outside vendor or vendors
to assist in the develop development and implement implementation
of the programs required under subsection (b). this section. The office
shall begin the contract procurement process not later than October 1,
2001. The contract required under this subsection must be effective not
later than July 1, 2002.
(d) (f) The vendor or vendors with whom the office contracts under
subsection (c) and the state department of health shall provide the
office and the select joint commission on Medicaid oversight
established by
IC 2-5-26-3
with an evaluation and recommendations on
the costs, benefits, and health outcomes of the pilot programs required
under subsection (b). this section. The evaluations required under this
subsection must be provided not more than nine (9) twelve (12) months
after the effective implementation date of the contract. pilot
programs.
(e) (g) The office and the state department of health shall report
to the select joint commission on Medicaid oversight established by
IC 2-5-26-3
not later than December 31, 2002, November 1 of each
year regarding the programs developed under this section.
SOURCE: IC 16-18-2-55.5; (03)CC034302.2. -->
SECTION 2.
IC 16-18-2-55.5
IS ADDED TO THE INDIANA CODE
AS A NEW SECTION TO READ AS FOLLOWS [EFFECTIVE
UPON PASSAGE]: Sec. 55.5. "Chronic disease", for purposes of
IC 16-38-6
, has the meaning set forth in
IC 16-38-6-1.
SOURCE: IC 16-38-6; (03)CC034302.3. -->
SECTION 3.
IC 16-38-6
IS ADDED TO THE INDIANA CODE AS
A
NEW CHAPTER TO READ AS FOLLOWS [EFFECTIVE UPON
PASSAGE]:
Chapter 6. Chronic Disease Registry
Sec. 1. As used in this chapter, "chronic disease" means one (1)
of the following conditions:
(1) Asthma.
(2) Diabetes.
(3) Congestive heart failure or coronary heart disease.
(4) Hypertension.
Sec. 2. The state department, with the cooperation of the office
of Medicaid policy and planning, shall establish a chronic disease
registry for the purpose of:
(1) recording chronic disease cases that are diagnosed or
treated in Indiana; and
(2) compiling necessary and appropriate information
determined by the state department concerning cases described
in subdivision (1) in order to do the following:
(A) Conduct epidemiologic and environmental surveys of
chronic disease and use appropriate preventive and control
measures.
(B) Inform citizens regarding programs designed to manage
chronic disease.
(C) Provide guidance to the office of Medicaid policy and
planning to identify and develop cost and clinical measures
for use in a program required by
IC 12-15-12-19.
Sec. 3. The state department shall use information compiled by
a public or private entity to the greatest extent possible in the
development of a statewide chronic disease registry under this
chapter.
Sec. 4. (a) The following persons may report confirmed cases of
chronic disease to the chronic disease registry:
(1) Physicians.
(2) Hospitals.
(3) Medical laboratories.
(b) A person who reports information to the state chronic disease
registry under this section may use:
(1) information submitted to any other public or private
chronic disease registry; or
(2) information required to be filed with federal, state, or local
agencies;
when completing a report under this chapter. However, the state
department may require additional, definitive information.
(c) The office of Medicaid policy and planning shall provide data
concerning services for chronic diseases reimbursed by the state
Medicaid program to the chronic disease registry. The office shall
work with the state department to identify the data available and
to determine a means to transmit the information to assist the state
department in data collection for the chronic disease registry.
Sec. 5. Except as provided in sections 6, 7, and 8 of this chapter,
information obtained by the state department under this chapter
concerning chronic disease patients is confidential and may be used
by the state department only for the purposes of this chapter.
Sec. 6. The state department may grant a researcher access to
confidential information obtained under this chapter concerning
individual chronic disease patients if the researcher who is
requesting additional information for research purposes or
soliciting the patient's participation in a research project obtains
the following:
(1) First, the oral or written consent of the patient's attending
physician.
(2) Second, the patient's written consent by completing a
confidential medical release form.
Sec. 7. The state department may release confidential
information obtained under this chapter concerning individual
chronic disease patients to the following:
(1) The chronic disease registry of another state if the following
conditions are met:
(A) The other state has entered into a reciprocal agreement
with the state department.
(B) The reciprocal agreement under clause (A) states that
information that identifies a patient will not be released to
any other person without the written consent of the patient.
(2) Physicians and local health officers for diagnostic and
treatment purposes if the following conditions are met:
(A) The patient's attending physician gives oral or written
consent to the release of the information.
(B) The patient gives written consent by completing a
confidential medical release form.
(3) The office of Medicaid policy and planning for purposes
related to administering the state Medicaid plan.
Sec. 8. A person who reports information for the chronic disease
registry under this chapter is immune from any civil or criminal
liability that might otherwise be imposed because of the release of
confidential information.
Sec. 9. This chapter does not prevent the release to any interested
person of epidemiological information that does not identify a
chronic disease patient.
Sec. 10. The state department may adopt rules under
IC 4-22-2
necessary to carry out this chapter.
SOURCE: IC 16-41-6-1; (03)CC034302.4. -->
SECTION 4.
IC 16-41-6-1
, AS AMENDED BY P.L.293-2001,
SECTION 3, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
JULY 1, 2003]: Sec. 1. (a) Except as provided in
IC 16-41-10-2.5
and
subsection (b), a person may not perform a screening or confirmatory
test for the antibody or antigen to the human immunodeficiency virus
(HIV) without the consent of the individual to be tested or a
representative as authorized under
IC 16-36-1.
A physician ordering
the test or the physician's authorized representative shall document
whether or not the individual has consented.
(b) The test for the antibody or antigen to HIV may be performed if
one (1) of the following conditions exists:
(1) If ordered by a physician who has obtained a health care
consent under
IC 16-36-1
or an implied consent under emergency
circumstances and the test is medically necessary to diagnose or
treat the patient's condition.
(2) Under a court order based on clear and convincing evidence of
a serious and present health threat to others posed by an individual.
A hearing held under this subsection shall be held in camera at the
request of the individual.
(3) If the test is done on blood collected or tested anonymously as
part of an epidemiologic survey under
IC 16-41-2-3
or
IC 16-41-17-10
(a)(5).
(4) The test is ordered under section 4 of this chapter.
(5) The test is required or authorized under
IC 11-10-3-2.5.
(c) A court may order a person to undergo testing for HIV under
IC 35-38-1-10.5
(a) or
IC 35-38-2-2.3
(a)(16).
SOURCE: IC 16-41-10-1; (03)CC034302.5. -->
SECTION 5.
IC 16-41-10-1
IS AMENDED TO READ AS
FOLLOWS [EFFECTIVE JULY 1, 2003]: Sec. 1. As used in this
chapter, "emergency medical services provider" means a firefighter, a
law enforcement officer, a paramedic, an emergency medical
technician, a physician licensed under IC 25-22.5, a nurse licensed
under IC 25-23, or other person who provides emergency medical
services in the course of the person's employment.
SOURCE: IC 16-41-10-2; (03)CC034302.6. -->
SECTION 6.
IC 16-41-10-2
IS AMENDED TO READ AS
FOLLOWS [EFFECTIVE JULY 1, 2003]: Sec. 2. (a) A provider of An
emergency medical services provider who is exposed to blood or body
fluids while providing emergency medical services to a patient may
request notification concerning exposure to a dangerous communicable
disease under this chapter if the exposure is of a type that has been
demonstrated epidemiologically to transmit a dangerous communicable
disease.
(b) If a provider of an emergency medical services provider desires
to be notified of results of testing following a possible exposure to
a dangerous communicable disease under this chapter, the provider
of emergency medical services provider shall notify the emergency
service facility medical services provider's employer not more than
twenty-four (24) hours after the patient emergency medical services
provider is admitted to the facility exposed on a form that is
prescribed by the state department and the Indiana emergency medical
services commission.
(c) The provider of emergency medical services provider shall
distribute a copy of the completed form required under subsection (b)
to the following:
(1) If applicable, the receiving medical director of the
emergency department of the medical facility:
(A) to which the patient was admitted following the
exposure; or
(B) in which the patient was located at the time of the
exposure.
(2) The facility that employs the provider of emergency medical
services provider's employer.
(3) The state department.
SOURCE: IC 16-41-10-2.5; (03)CC034302.7. -->
SECTION 7.
IC 16-41-10-2.5
IS ADDED TO THE INDIANA CODE
AS A
NEW SECTION TO READ AS FOLLOWS [EFFECTIVE JULY
1, 2003]:
Sec. 2.5. (a) A patient (including a patient who is unable
to consent due to physical or mental incapacity) to whose blood or
body fluids an emergency medical services provider is exposed as
described in section 2 of this chapter is considered to have
consented to:
(1) testing for the presence of a dangerous communicable
disease of a type that has been epidemiologically demonstrated
to be transmittable by an exposure of the kind experienced by
the emergency medical services provider; and
(2) release of the testing results to a medical director or
physician described in section 3 of this chapter.
The medical director or physician shall notify the emergency
medical services provider of the test results.
(b) If a patient described in subsection (a) refuses to provide a
blood or body fluid specimen for testing for a dangerous
communicable disease, the exposed emergency medical services
provider, the exposed emergency medical services provider's
employer, or the state department may petition the circuit or
superior court having jurisdiction in the county:
(1) of the patient's residence; or
(2) where the employer of the exposed emergency medical
services provider has the employer's principal office;
for an order requiring that the patient provide a blood or body
fluid specimen.
SOURCE: IC 16-41-10-3; (03)CC034302.8. -->
SECTION 8.
IC 16-41-10-3
IS AMENDED TO READ AS
FOLLOWS [EFFECTIVE JULY 1, 2003]: Sec. 3. (a) Except as
provided in subsection (b),
if a patient to whose blood or body fluids
an emergency medical services provider is exposed as described in
section 2 of this chapter:
(1) is admitted to a medical facility following the exposure or
is located in a medical facility at the time of the exposure, a
physician designated by
an emergency the medical
service facility
shall,
not more than seventy-two (72) hours after the medical
facility is notified under section 2 of this chapter:
(A) cause a blood or body fluid specimen to be obtained from
the patient and testing to be performed for a dangerous
communicable disease of a type that has been
epidemiologically demonstrated to be transmittable by an
exposure of the kind experienced by the emergency medical
services provider; and
(B) notify the medical director of
a facility employing the
provider of emergency medical services
described in section 2
of this chapter if (1) not more than seventy-two (72) hours after
a patient
is admitted to the facility the facility obtains
information from the patient's records or a diagnosis at the
facility that the patient has a dangerous communicable disease;
and (2) the provider of emergency medical services has complied
with section 2 of this chapter; provider's employer; or
(2) is not described in subdivision (1), the exposed emergency
medical services provider, the exposed emergency medical
services provider's employer, or the state department may:
(A) arrange for testing of the patient as soon as possible; or
(B) petition the circuit or superior court having jurisdiction
in the county of the patient's residence or where the
employer of the exposed emergency medical services
provider has the employer's principal office for an order
requiring that the patient provide a blood or body fluid
specimen.
(b) A provider of An emergency medical services provider may, on
the form described in section 2 of this chapter, designate a physician
other than the medical director of the facility that employs the provider
of emergency medical services provider's employer to receive
notification. on the form described in section 2 of this chapter. the test
results.
(c) The notification required by this section shall be made The
medical director or physician described in section 3 of this chapter
shall notify the emergency medical services provider of the test
results not more than forty-eight (48) hours after the facility
determines that a patient medical director or physician receives the
test results. has a dangerous communicable disease that is potentially
transmissible through the incident.
SOURCE: IC 16-41-10-3.5; (03)CC034302.9. -->
SECTION 9.
IC 16-41-10-3.5
IS ADDED TO THE INDIANA CODE
AS A NEW SECTION TO READ AS FOLLOWS [EFFECTIVE JULY
1, 2003]: Sec. 3.5. (a) A medical facility may not physically restrain
a patient described in section 2.5 of this chapter in order to test the
patient for the presence of a dangerous communicable disease.
(b) Nothing in this chapter prohibits a patient from being
discharged from a medical facility before:
(1) a test is performed under section 2.5 or 3 of this chapter; or
(2) the results of a test are released under section 3 of this
chapter.
(c) A provider or a facility that tests a patient for the presence of
a dangerous communicable disease under section 2.5 or section 3
of this chapter is immune from liability for the performance of the
test over the patient's objection or without the patient's consent.
However, this subsection does not apply to an act or omission that
constitutes gross negligence or willful or wanton misconduct.
SOURCE: IC 16-41-10-4; (03)CC034302.10. -->
SECTION 10.
IC 16-41-10-4
IS AMENDED TO READ AS
FOLLOWS [EFFECTIVE JULY 1, 2003]: Sec. 4. (a) If medically
indicated, A medical director or physician notified under section 3 of
this chapter shall, not more than forty-eight (48) hours after
receiving the notification under section 3 of this chapter, contact the
provider of emergency medical services provider described in section
2 of this chapter to do the following:
(1) Explain, without disclosing information about the patient, the
infectious dangerous communicable disease to which the
provider of emergency medical services provider was exposed.
(2) Provide for any medically necessary treatment and counseling
to the provider of emergency medical services provider.
(b) Expenses of testing or treatment and counseling are the
responsibility of the provider of emergency medical services provider
or the provider's employer.
SOURCE: IC 16-41-10-5; (03)CC034302.11. -->
SECTION 11.
IC 16-41-10-5
IS AMENDED TO READ AS
FOLLOWS [EFFECTIVE JULY 1, 2003]: Sec. 5. (a) Except as
otherwise provided in
sections 3 and 4 of this chapter,
the medical
information referred to in this chapter is confidential, and a person
may not disclose or be compelled to disclose medical or
epidemiological information referred to in this chapter.
(b) A person responsible for recording, reporting, or maintaining
information referred to in this chapter who recklessly, knowingly, or
intentionally discloses or fails to protect medical or epidemiological
information classified as confidential under this section commits a
Class A misdemeanor.
(c) In addition to the penalty prescribed by subsection (b), a public
employee who violates this section is subject to discharge or other
disciplinary action under the personnel rules of the agency that
employs the employee.
SOURCE: IC 34-30-2-77.4; (03)CC034302.12. -->
SECTION 12.
IC 34-30-2-77.4
IS ADDED TO THE INDIANA
CODE AS A NEW SECTION TO READ AS FOLLOWS
[EFFECTIVE UPON PASSAGE]: Sec. 77.4.
IC 16-38-6-8
(Concerning persons who report information to the chronic disease
registry).
SOURCE: IC 34-30-2-81.5; (03)CC034302.13. -->
SECTION 13.
IC 34-30-2-81.5
IS ADDED TO THE INDIANA
CODE AS A NEW SECTION TO READ AS FOLLOWS
[EFFECTIVE JULY 1, 2003]: Sec. 81.5.
IC 16-41-10-3.5
(Concerning
a provider who tests a patient for the presence of a dangerous
communicable disease).
SOURCE: ; (03)CC034302.14. -->
SECTION 14.
An emergency is declared for this act.
(Reference is to ESB 343 as reprinted April 11, 2003.)
Conference Committee Report
on
Engrossed Senate Bill 343
Text Box
S
igned by:
____________________________ ____________________________
Senator MillerRepresentative Brown C
Chairperson
____________________________ ____________________________
Senator SimpsonRepresentative Brown T
Senate Conferees House Conferees