Membership: (§381.90, Florida Statutes)
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:
Donald Bennett, representing the Correctional Medical Authority
Jim Bracher, representing State Treasurer/Insurance Commissioner
Dr. Michael Graven, representing University of South Florida, College of
Public Health
Dr. John Heilman, representing Pinellas County Health Department (via
conference call)
William P. "Bud" Johnston, representing the Department of
Elder Affairs
Cheryll Lesneski, representing Putnam County Health Department (via
conference call)
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
Rod Westall, representing the Department of Corrections
Council Members Absent:
Robert Anderson, representing the Attorney General's Office
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
Ron McCord, representing the Commissioner of Education
Rose Naff, representing Florida Healthy Kids Corporation
Others in Attendance:
Randy Niewenhous, DCF (via telephone conference call)
Rena Coffield, DOH
Rosemary Erwin, DOH
Jo Ann Kodaj
Wayne McDaniel, DOH
Allen Pearman, DOH
Lee Stapp, DOH
Lorene Wilson, DOH
David Darr, University of South Florida
I. Call to Order and Welcome: Linda Nelson called the Florida
Health Information Systems Council meeting to order at 2:05 pm and
welcomed participants.
II. Roll Call: A formal roll call was conducted and attendees
identified themselves and the organization they represented. A quorum
was established and attendance is reflected above.
III. Approval of Minutes: The minutes of the Florida Health
Information Systems Council meeting held July 9, 2001 were reviewed.
Upon a formal motion and second, the minutes were approved as presented.
The minutes of the Florida Health Information Systems Council meeting
held July 30, 2001 were then reviewed. Upon a formal motion and second,
the minutes were approved as presented.
IV. Florida Health Information Systems Council Strategic Plan
Revisions (Review and Adoption):
In the introduction to this agenda item was noted that the revised
strategic plan was to be submitted to the State Technology Office by
September 15, 2001. The proposed revisions were developed as a result of
workgroup discussions via regularly scheduled telephone conference calls
over the last month.
The council then proceeded to review and adopt the revised report
format along with modifications necessary to reflect changes in
governing statutes through a series of formal motions and affirmative
actions.
Changes of this type are as follows:
Page 5*, revised language for section282.005, Florida Statutes Pages
12-13*, revised language for section381.90, section282.005, and
section282.3032, Florida Statutes
In a similar manner, the council adopted substantive revisions focus
on impact of HIPAA on health data standards and health data sharing,
security, and privacy
Page 7*, underlined text adding discussion of HIPAA transactions
standards
Page 8*, underlined text adding goal (with deletion of words
"and facilitate" from 1.3, as originally drafted), objective,
and strategies (with modification of language to reference
"information forum" rather than "clearing house, as
originally drafted) related to HIPAA transaction standards Pages 9-11*,
underlined text adding discussion of HIPAA security and privacy
standards Page 11, underlined text adding goal (with deletion of words
"and facilitate" from 2.2, as originally drafted), objective,
and strategies (with modification of language to reference
"information forum" rather than "clearing house, as
originally drafted) related to HIPAA security and privacy standards
Pages 18-19*, State Technology Office Attachment, "Consistency with
State Strategic IT Goals" (with deletion of words "and
facilitate" from goals 1.3 and 2.2 and addition of positive
indication of support for "Integrity/Privacy of IT Resources"
for Goal 1.3 and Strategic Objective 1.3.1)
By the totality of its actions, the council approved the revised the
strategic plan and directed staff to make editorial changes noted during
the meeting subsequent to forwarding a final copy to the State
Technology Office (as required by statute).
Council directed staff to forward final copy of the strategic plan
for a final review to affirm that all changes made were consistent with
council editorial direction and intent.
[A copy of the draft revised strategic plan is available upon request
and is incorporated into these minutes by reference. A copy of the final
strategic plan as adopted by the council is available upon request.]
V. Health Data Reports
A. Status Report on Federally Mandated Healthcare Integrity and
Protection Data Bank Allen Pearman
The Healthcare Integrity and Protection Data Bank (HIBDB) was
established by the Health Insurance Portability and Accountability Act
of 1996 (HIPAA) to combat fraud and abuse in healthcare. HIPDB is a
national health care data collection program for the reporting and
disclosure of certain adverse actions taken against health care
providers, suppliers, or practitionersection
Note: Reportable adverse actions include civil judgments related to
health care delivery, Federal or State criminal convictions against
health care providers, suppliers, or practitioners related to health
care delivery, Federal or State licensing or certification agency
actions, exclusions from participation in health care programs, and
similar adjudicated actions or decisions against health care providers,
suppliers, or practitioners.
Within the Department of Health, all Medical Quality Assurance (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. Physical therapy and chiropractic professions
are being reported through national organizations as well. The MQA
legacy data project is presently underway and being researched for
missing data elements and will be forwarded to HIPDB upon completion.
Missing data elements for legacy data is a major issue slowing
submission. In addition, the lack of a batch processing option for
legacy data presents an additional barrier to submission of completed
data.
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. Staff has been
trained and initial steps taken to begin entering the required data.
Other agencies reported on the status of HIPDB compliance efforts
including Department of Insurance (Jim Bracher) and Agency for Health
Care Administration (Kim Shafer). The Department of Insurance has been
reporting as required with attempts to avoid duplicate reporting in
cases (involving health insurance companies and agents and Health
Maintenance Organizations) where criminal actions have been taken and
therefore reported by the Attorney General's Office (or individual
state's attorney's offices). Medicaid actions are being reported by
Agency for Health Care Administration (AHCA) as required. Other AHCA
units have yet to report any other actions due, in part, to on-going
review by AHCA legal counsel.
B. Status Report on Specific Health Data Sharing Efforts Between
State Agencies OPEN Discussion
Dr. Michael Graven presented background on data merging effort for
state sponsored projects and planning grant applications. He noted that
efforts involving multiple state agencies were unsuccessful, at least in
part, due to multiple and perhaps duplicative approval requirements for
access to confidential patient data. In addition, certain technical
requirements related to data standards and formats presented significant
challenges that prohibited or limited timely access to required data.
Agency data sets are generally designed as transactions based system
with no explicit consideration for efficient download or extractions
from the database for analytical purposes.
Dr. Graven then proposed that steps be taken to systematically
download and maintain analytical data sets based upon data extractions
from multiple state agencies. The intent would be to avoid costly,
custom data extraction and merging jobs that result in significant
delays in obtaining required analytical data sets.
Cheryll Lesneski urged that any effort include all publicly financed
health care including Medicare. Others noted the difficulty in obtaining
data from Health Maintenance Organizations who participate in publicly
financed programs.
The issue was presented as one that could be addressed as part of the
strategic planning and implementation efforts for participating state
agencies as well as the Florida Health Information Systems Council and
State Technology Office.
Linda Nelson suggested that a workgroup be formed to engage in
fact-finding related into the issues highlighted during the discussion
of issues presented by Dr. Graven. Kim Shafer and others noted that
Medicaid appeared to be a key player in terms of the proposed
"solution" and should be represented in any workgroup
addressing this issue. Dr. Graven noted that the issues raised were not
simply restricted to the Medicaid program. Medicaid data issues were
highlighted for illustrative purposes only.
Based upon the discussion, staff was directed to review issues raised
and to develop a draft charge to an informal council workgroup.
Volunteer members will be solicited and comments and suggestions
(including a possible formal system survey of issues related to data
sharing and data merging efforts) sought from those members expressing
interested in participating in the proposed workgroup.
VI. Other Business:
Conference calls scheduled for September 10 and 17, 2001, were
cancelled at the direction of the chair.
A motion was then made (and seconded) to adjourn. Without objection,
the meeting was adjourned at 4:00 p.m. .
Summary of Pending Action Items:
1. Schedule and present status report on Privacy and Technology Task
Force recommendations-issue from previous meeting (February 16,
2001)
2. Take steps necessary to form an informal workgroup to address issue
related to data extraction and merging for state sponsored projects and
similar issues that might be addressed by formally establishing and
maintaining health related analytical data sets.
3. Prepare and present summary on status of the HIPAA rule adoption and
implementation of agency plans for next Council meeting. (Incorporate
specific recommendations regarding steps required to meet HIPAA
regulations in Florida Health Information Systems Council strategic plan
as appropriate.)
