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Florida Health Information Systems Council

Minutes, July 30, 2001

Membership: (§381.90, F.S.)

  • 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 (DBPR)
  • 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 (BOR)
  • 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 (via conference call)
  • Dr. Michael Graven, representing University of South Florida, College of Public Health (via conference call)
  • Dr. John Heilman, representing Pinellas County Health Department (via conference call)
  • William P. "Bud" Johnston, representing the Department of Elder Affairs
  • Linda Nelson, representing the Department of Health
  • Lori Schultz, representing Department of Children & Families (via conference call)
  • Kim Shafer, representing the Agency for Health Care Administration

Council Members Absent:.

  • Robert Anderson, representing the Attorney General's Office
  • Donald Bennett, representing the Correctional Medical Authority
  • John Burke, representing the Department of Corrections
  • Lee Cornman, representing the Department of Business and Professional Regulation
  • George Hinchliffe, representing the Department of Juvenile Justice
  • Cretta Johnson, representing the Florida Association of Counties
  • Cheryll Lesneski, representing Putnam County Health Department
  • Ron McCord, representing the Commissioner of Education
  • Rose Naff, representing Florida Healthy Kids Corporation

Others in Attendance: 

  • Barry Bruder, Centers for Medicare and Medicaid Services
  • Sen-Yoni Musingo, DCF
  • Marshall Kelly, DOEA
  • Ed Neu, DOEA
  • Susan Smith, DOEA
  • Horatio Soberon, DOEA
  • Susan Tucker, DOEA
  • Jeff Couch, DOH
  • Susan Dilmore, DOH
  • Meade Grigg, DOH
  • Amy Jones, DOH
  • Linda Keen, DOH
  • Gary Mahoney, DOH
  • Allen Pearman, DOH
  • Jacki Seabrooks, DOH
  • Susan Veal, DOH
  • Van Walker, DOH
  • Rhonda White, DOH
  • Rich Rasmussen, Florida Hospital Association
  • Kathy Reep, Florida Hospital Association
  • Richard Archambault, Healthcare.com
  • Dawn Barkett, Healthcare.com
  • Dan Guidice, Healthcare.com
  • Michele Parrott, Healthcare.com

I. Call to Order and Welcome: Linda Nelson called the Florida Health Information Systems Council meeting to order at 2:08 pm and welcomed participants.

II. Roll Call: A formal roll call was conducted and 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 July 9, 2001 were reviewed and one correction noted (correcting name of DOE representative from "Rod McCord" to "Ron McCord"). No formal approval of the minutes was made due to the absence of a quorum necessary to conduct business.

IV. Heath Insurance & Accountability Act of 1996 (HIPAA) Status Report & Update: Kathy Reep representing the Florida Hospital Association (FHA) began by indicating that the next speaker (Barry Bruder) was identified through contacts with the Southern HIPAA Administrative Regional Process (SHARP) Workgroup (http://www.sharpworkgroup.com/). SHARP was established to meet the immediate need of assessing regional HIPAA Administrative Simplification implementation readiness to bring about regional coordination for successful HIPAA compliance by all stakeholders in the seven state southern region.

Barry Burder then presented an overview and status report on implementation of HIPAA. Major HIPAA provisions and rules were reviewed including those related to transaction standards, privacy, security, standard identifiers, and enforcement. The PowerPoint slides used by Mr. Bruder in his briefing are attached to these minutes in lieu of a narrative summary of his presentation.

V. Enterprise Master Person Index: A approach to data integration

Upon completion of the HIPAA presentation by Mr. Bruder, representatives of Healthcare.com (Ron Archambault and Michele Parrott) provided an overview of the use of an enterprise master person index and integration broker as a tools, which must address certain requirements, set forth in HIPAA regulations. The PowerPoint slides used in the Healthcare.com briefing are attached to these minutes in lieu of a narrative summary. (Handouts provided during the presentation are on file and copies can be provided upon request: "Functional Presentation," Security Overview," and "Readying the IT Environment for HIPAA++.")

 

VI. Question and Answer and Discussion of HIPAA Compliance Issue:

Upon completion of the presentation by Healthcare.com, the floor was opened to questions and discussion.

Five basic areas were the focus of questions and discussion:

· Definition of the concept of "enterprise": It was noted that the concept might vary in scope depending upon the issue or problem under consideration. For many issues, an individual department or agency (and associated programs) might be viewed as an "enterprise." For other purposes, such as those related more broadly to the area of information technology, state government as whole might be viewed as the "enterprise." [Note: Formation of the Florida State Technology Office is explicitly based upon the perspective that all of state government can be viewed as an "enterprise."]

· Issues related to use of probabilistic matching: Use of probabilistic matching raises issues related to requirements for data validation and development of sets of detailed business rules to address "data merging" or changes to data related to an individual. Since any matching using such algorithms is probabilistic, human intervention is required in terms of use of information produced. Depending upon the nature of the intervention, introduction of error is possible with respect to data "assigned" to an individual patient or client.

· Need for clarification of the roles of the State Technology Office, the State Medicaid Office (AHCA), and the Florida Health Information Systems Council in addressing HIPAA compliance: The potential for Medicaid funding of system changes led to questions concerning the possible roles of various affected parties in responding to the demands imposed by HIPAA. To the extent possible, the specific roles to be played should be addressed in the Council's strategic plan modifications.

· Approaches to addressing HIPAA requirements: A number of approaches were discussed that could be used by state agencies to address HIPAA requirements. Approaches ranged from the development of centralized systems to use of translators and information brokers to address data integration and standardization requirements. A system procurement employed by the Georgia Technology Office "to design and implement new information systems; to provide claims and customer service, and to provide administrative support for all of its health benefit programs, including Medicaid."

[Note: System specifically included the following:

§ State Health Benefit Plan (SHBP) consists of approximately 570,000 members in indemnity and Preferred Provider Organizations (PPO) plans and Health Maintenance Organizations (HMO);

§ Board of Regents Health Plan (BORHP) consists of approximately 90,000 members in indemnity and PPO plans and Health Maintenance Organizations (HMO); and

§ Medicaid and PeachCare for Kids consist of approximately 1.1 million members.

For additional information on the Georgia procurement process see: http://www2.state.ga.us/Departments/doas/procure/rfp/rfp-GTA-000011-cover.html]

· Determination of applicability of HIPAA requirements to specific state programs and agencies: A number of questions were raised about the applicability of HIPAA requirements to specific state programs such as those administered by Department of Elder Affairs and non-Medicaid programs in the Agency for Health Care Administration. Need for further analysis of the HIPAA requirements as they relate to specific state programs was identified and emphasized.

 

VII. Other Business:

 

During the discussion of the issues raised, the need to schedule another face-to-face meeting of the Council to consider strategic plan revisions was emphasized. To permit participation by the Secretary of the Department of Health and to permit completion of strategic plan revisions by September 15, 2001, a meeting would need to be scheduled during the first week of September. [Subsequently, a meeting date of September 5, 2001 was identified and noticed.]

 

A motion was then made (and seconded) to close the current discussion; to continue to address the issues raised as part of the development of revisions of the Council's strategic plan, and to adjourn. Without objection, the meeting was adjourned at 4:20 p.m.

.

Summary of Pending 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, July 9, 2001, and July 30, 2001 meetings)

2. Schedule and present status report on Privacy and Technology Task Force recommendations—issue meeting from previous meeting (February 16, 2001)

3. 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.)

   
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