Minutes, February 16, 2001
Membership: (Chapter 97-286, Laws of Florida, Section 27)
The council shall be composed of the following members or their senior executive-level designees:
- Secretary of the Department of Health (DOH)
- Director of the Agency for Healthcare Administration (AHCA)
- Attorney General (AG)
- Secretary of the Department of Business and Professional Regulation
- Secretary of the Department of Children and Families (DCF)
- Secretary of the Department of Corrections (DC)
- Commissioner of Education (DOE)
- Secretary of the Department of Elder Affairs (DOEA)
- State Treasurer/Insurance Commissioner (DOI)
- Secretary of the Department of Juvenile Justice (DJJ)
- Executive Director of the Correctional Medical Authority (CMA)
- Two Representatives of County Health Departments (CHD)
- A Representative of Florida schools of public health chosen by the Board of Regents
- A Representative of the Florida Association of Counties (FAC)
- A Representative of the Florida Healthy Kids Corporation
Council Members in Attendance:
Jim Bracher, representing State Treasurer/Insurance Commissioner
Lee Cornman, representing the Department of Business and Professional Regulation
Paul Cornish, representing the Correctional Medical Authority
Cretta Johnson, representing the Florida Association of Counties (via phone)
William P. Bud Johnston, representing the Department of Elder Affairs
Cheryll Lesneski, representing Putnam County Health Department (via phone)
Becky Lyons, representing the Department of Children and Families
Linda Nelson, representing the Department of Health
Livetra Paul, representing the Commissioner of Education
Kim Shafer, representing the Agency for Health Care Administration
Rod Westall, representing the Department of Corrections
Council Members Absent:
Robert Anderson, representing the Office of the Attorney General
Dr. Michael Graven, representing University of South Florida, College of Public Health
Dr. John Heilman, representing Pinellas County Health Department
George Hinchliffe, representing the Department of Juvenile Justice
Rose Naff, representing Florida Healthy Kids Corporation
Others in Attendance:
Kim Bahrami, STO
Charles Bement, DOH (EMS)
Rena Coffield, DOH
John Clarkson, AHCA
Meade Grigg, DOH
Erica McCall, DOH
Patrick Kennedy, American Heart Association
Randy Niewenhous, DCF
Lee Stapp, DOH
Allen Pearman, DOH
Rich Rasmussen, Florida Hospital Association
Lori Schultz, DCF
I. Call to Order and Welcome: Linda Nelson (DOH) called the Florida Health Information Systems Council meeting to order and welcomed participants.
II. Roll Call: In lieu of roll call, attendees identified themselves and the organization they represented. Attendance is reflected above.
III. Approval of Minutes: The minutes of the Florida Health Information Systems Council meeting held December 6, 2000 were adopted as presented.
IV. HIPPA Status Report and Update
Without objection the order of the agenda was revised and Meade Grigg (DOH) introduced to present a status report on actions being taken to address the impact of HIPPA rules on the Department of Health and other state agencies. He reported that staff in the Office of Planning, Evaluation and Data Analysis would be responsible for facilitating a DOH HIPAA team. This team will include representatives from each division of the department (including the CHD's) and will lead implementation activities for each section of the law as the guidelines are finalized. The team will first meet on Wednesday, February 21, 2001.
Two HIPPA standards have been released: 1) electronic transmission and code standards and 2) privacy standards. DOH legal experts are reviewing the privacy standards that were released in December. Privacy standards do include exemptions for public health data.
Again, Mr. Grigg indicated that the Department of Health is already in compliance with HIPAA content standards most commonly used in the CHDs (HCFA 1500). The Department of Health has had initial contact with Agency for Health Care Administration and DOH will have representatives on the AHCA workgroup set up to address HIPPA standards implementation.
Linda Nelson commented that Dr. Brooks was especially interested in the steps taken by other agencies in addressing impacts of HIPPA standards and the need to ensure that state agencies coordinate their actions to avoid duplication of effort or conflicts among agencies resulting from any steps taken.
[Cretta Johnson joined meeting at this point via phone.]
John Clarkson, AHCA commented that discussions with the STO have resulted in a preliminary conclusion that a special task force (similar to Y2K) may need to be established to address HIPPA impacts.
Rich Rasmussen, Florida Hospital Association, commented that hospitals anticipate significant impacts resulting from HIPPA implementation. He extended the offer to provide expert assistance and to, perhaps, host statewide HIPPA meeting to address issues from both a public and private perspective.
Jim Bracher, DOI, commented that his department did not anticipate any major impacts on its operations, but entities regulated by DOI will face major impacts. DOI has not, up to this point, taken any steps to address the private sector impacts.
Meade Grigg commented that the HIPPA impacts would vary significantly between payers and providers.
Rich Rasmussen, Florida Hospital Association comments further noted the implications of privatization of Medicaid, especially Medicaid HMOs. A discussion ensured as to whether smaller or larger Medicaid HMOs would face the larger challenges in addressing HIPPA requirements.
Further discussion focused on representation from private sector on AHCA workgroup (to meet sometime during March). In addition, it was agreed that all members of Council be included on the invitation list for the first meeting of the AHCA HIPPA workgroup.
Further discussion on the code set focused upon additional information required beyond specific HIPPA requirements (i.e., discharge notes). It was noted that future HIPPA standards will address Claims Attachments to be included in HIPPA set.
Linda Nelson noted that HIPPA would be included as a standing agenda item (including any Council recommendations regarding HIPPA as part of strategic plan revision process). Further, she noted the need to reconfirm that representative to vote on specific positions presented to Council. She reemphasized the need for a status review of actions being taken by state agencies to address HIPPA implementation issues.
Motion was made and seconded to accept the following four points: 1) Council members will be invited to participate in the AHCA HIPPA workgroup; 2) member agencies will review status of actions taken to address HIPPA requirements; 3) HIPPA compliance will remain as a standing item on the agenda (including consideration of specific recommendations as part of the FHISC strategic plan); and, 4) agency feedback on interest in a HIPPA summit in cooperation with the Florida Hospital Association was to be obtained.
V. State Technology Office: Status of Strategic Planning Efforts
Kim Bahrami, representing the State Technology Office (STO), began by indicating that Roy Cales had been invited to present a status report on STO strategic planning efforts but was unable to attend the meeting due to scheduling conflicts. She continued by outlining STO strategic planning initiatives for statewide information technology management.
The PowerPoint presentation given by Ms Bahrami is attached to these minutes in lieu of a narrative summary of her presentation.
VI Task Force on Privacy and Technology
Linda Nelson suggested further modification of the agenda by skipping the two agenda items related to integrated health information systems and the enterprise master person index.
Directing member attention to the agenda item related to the Task Force on Privacy and Technology, she noted that the executive summary of task force policy recommendations were included in the meeting package. In addition, a representative from the task force will be invited to make a presentation to the Council in May. Additional information was also provided to Council members regarding perspectives on privacy and technology issues.
VII FHISC Strategic Plan Revisions and Update
Allen Pearman presented a brief overview of the FHISC strategic plan. He again noted the change in the deadline for FHISC strategic plan revision from March 1 to June 1. He directed the attention of the Council members to three items included on the meeting agenda for review and comment by Council members:
· Development of business process models for the health and human services (HHS) sector of state government & health related processes crossing knowledge domains
· Identification and implementation of more specific actions to outline how goals and objectives are to be achieved
· Identification and review of duplicative approval requirements for access to confidential data where purpose of access has generally been accepted as appropriate
Allen Pearman further noted that the FHISC is currently divided into two major parts: 1) the identification, collection, and standardization of health-related data among federal, state, local and private entities and 2) the sharing and coordination of health-related data among federal, state, local and private entities.
Linda Nelson then suggested that strategic plan revisions be undertaken using electronic means such as email rather than requiring face-to-face meetings. She observed that face-to-face meeting if needed to resolve issues could be scheduled if needed. Voting on recommendations to be included in the revised strategic would also be done electronically (if possible)
Randy Niewenhous observed functional units need to take lead in effort in FHISC strategic plan revisions with support provided by representatives of IT units potentially affected.
Bud Johnson followed up with the suggestion that clarification of the roles STO and FHISC be made explicitfor example, infrastructure (the tools) is STO responsibility and data standards and institutional barriers to data sharing would be the responsibility of the Council
Allen Pearman commented that at time council was formed (which was prior to the creation of the STO) the two basic issues were bundled together.
Kim Bahrami observed that she view the Council serving as an executive steering committeeproviding guidance but not doing the grunt work.
It was suggested that Dr. Brooks, as FHISC chair, communicate with other agency heads represented on the Council to urge their commitment and that of appropriate staff to address those strategic planning issues related to health related data standards and identification and ultimate reduction of barriers to data sharing.
Council approved the use of electronic methods for FHISC strategic plan revisions by formal motion. In addition, a deadline was set for the May Council meeting for presentation of strategic plan revisions for formal adoption.
VIII Status Report on Federally Mandated Healthcare Integrity and Protection Data Bank
Linda Nelson and Allen Pearman presented a summary of the Healthcare Integrity and Protection Data Bank (HIPDB) reporting requirements and summarized status of DOH compliance with the requirements. HIPDB was created to combat fraud and abuse in health insurance and health care delivery. The Healthcare Integrity and Protection Data Bank is a national data collection program for the reporting and disclosure of certain final adverse actions (as opposed to adverse incidents such as the administering of a drug over dose) taken against health care providers, suppliers, or practitioners. The reporting requirements (effective in October 1999 with a retroactive reporting requirement back to August 21, 1996) apply to licensed and unlicensed health care providers, suppliers, and practitioners.
Specifically, within the Department of Health, compliance with HIPDB reporting requirement has not been consistent across functional units. All MQA professions are currently reporting actions directly to HIPDB, with the exception of nursing which is being reported to the National Council of State Boards of Nursing. The MQA legacy data project is presently underway and being researched for missing data elements and will be forwarded to HIPDB upon completion. Review of the reporting by Department of Health units did reveal a gap in reporting of adverse actions against paramedics, emergency medical technicians, and ambulance services. The Division of Emergency Medical Services and Community Health Resources is undertaking steps necessary to comply with federal reporting requirements.
Discussion of reporting requirements indicated that the Agency for Health Care Administration and the Department of Insurance had taken steps to comply with HIPDB regulations. Other agencies indicated that more information might be required to determine whether or not reporting requirements applied.
Since this is a requirement that affects a number of state agencies, it was suggested that all agencies review current status regarding compliance with HIPDB reporting requirements. Further, revision of the FHISC strategic plan might be used to develop specific recommendations or suggestions related specifically to federal reporting requirements such as HIPDB.
IX Other Business:
Linda Nelson concluded the meeting with a brief review of the two agenda items which were skipped earlier in the meeting: 1) integrated health information systems and 2) the enterprise master person index She noted that these presentations may be rescheduled for a future FHISC meeting.
There being no further business, the meeting was adjourned.
Summary of Action Items:
1. Develop and present a revised FHISC strategic plan for formal Council approval. (Draft should be based upon issues identified during the February 16, 2001 meeting)
2. Schedule and present status report Privacy and Technology Task Force recommendations
3. Prepare and present summary on status of the HIPPA rule adoption and implementation agency plans and actions for next Council meeting. (Incorporate specific recommendations regarding steps required to meet HIPPA regulations in FHISC strategic plan as appropriate.)
4. Prepare and present summary on State agency compliance with the federally mandated health practitioner integrity data bank for next Council meeting. (Incorporate specific recommendations regarding steps required to meet HIPDB reporting requirements in FHISC strategic plan as appropriate.)
5. Follow up with Florida Hospital Association, Agency for Health Care Administration, and the State Technology Office on possible scheduling of a HIPPA summit sometime during the summer.