By: Delisi H.B. No. 1066

A BILL TO BE ENTITLED

AN ACT

relating to electronic health information, electronic health records, and creating the Texas Health Service Authority Corporation.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:

SECTION 1. Subtitle I, Title 2, Health and Safety Code, is amended by adding Chapter 182 to read as follows: CHAPTER 182. ELECTRONIC HEALTH RECORDS SUBCHAPTER A. GENERAL PROVISIONS

Sec. 182.001. DEFINITIONS. In this chapter:

(1) "Board" means the board of directors of the corporation.

(2) "Corporation" means the Texas Health Service Authority Corporation.

(3) "Health information technology" means the application of information processing, involving both computer hardware and software, that deals with the storage, retrieval, sharing, and use of health care information, data, and knowledge for communication, decision-making, quality, safety, and efficiency of clinical practice and may include:

(A) an electronic health record that electronically compiles and maintains health information that may be derived from multiple sources about the health status of an individual and may include the core functionalities such as an electronic medical record, computerized physician order entry, electronic prescribing, and clinical decision support;

(B) a personal health record through which an individual and anyone authorized by the individual can maintain and manage the individual's health information;

(C) an electronic medical record that permits electronic formation of and access to clinical information or data to support medical care of an individual;

(D) a computerized provider order entry function that permits the electronic ordering of diagnostic and treatment services, including prescription drugs;

(E) a decision support function to assist physicians and other health care providers in making clinical decisions by providing electronic alerts and reminders to improve compliance with best practices, promote regular screenings and other preventive practices, and facilitate diagnoses and treatments;

(F) error notification function that generates a warning when an order is entered that is likely to lead to a significant adverse outcome for an individual; and

(G) tools to allow for the collection, analysis, and reporting of information or data on adverse events, near misses, the quality and efficiency of care, patient satisfaction, and other health care-related performance measures.

(4) "Interoperability" means the ability of two or more systems or components to exchange information or data in an accurate, effective, secure, and consistent manner and to use the information or data that has been exchanged and includes:

(A) the capacity to connect to a network for the purpose of exchanging information or data with other users;

(B) the ability of a connected, authenticated user to demonstrate appropriate permissions to participate in the instant transaction over the network; and

(C) the capacity of a connected, authenticated user to access, transmit, receive, and exchange usable information with other users.

(5) "Recognized interoperability standard" means interoperability standards that are recognized by the Certification Commission for Healthcare Information Technology or other federally approved certification standards. [Sections 182.002-182.050 reserved for expansion] SUBCHAPTER B. ADMINISTRATION

Sec. 182.051. TEXAS HEALTH SERVICES AUTHORITY CORPORATION; PURPOSE. (a) The Texas Health Services Authority Corporation is created to promote the establishment of a privacy-protected and secure, integrated statewide network for the communication of electronic health information among authorized parties and to foster a coordinated public-private initiative for the development and operation of the health information infrastructure in this state.

(b) The corporation is a public nonprofit corporation and, except as otherwise provided in this chapter, has all the powers and duties incident to a nonprofit corporation under state law.

(c) Except as otherwise provided by law, all expenses of the corporation shall be paid from income of the corporation.

(d) The corporation is subject to Chapter 551, Government Code.

(e) Health record information collected, assembled, or maintained by the corporation is confidential and is not subject to disclosure under Chapter 552, Government Code.

Sec. 182.052. APPLICATION OF SUNSET ACT. The Texas Health Services Authority Corporation is subject to Chapter 325, Government Code (Texas Sunset Act). Unless continued in existence as provided by that chapter, the corporation is abolished and this chapter expires September 1, 2019.

Sec. 182.053. COMPOSITION OF BOARD OF DIRECTORS. (a) The corporation is governed by a board of fifteen (15) directors appointed by and serving at the discretion of the governor, who have demonstrated an interest, knowledge, or expertise in issues related to electronic health information technology and who must include:

(1) One (1) Physician Representative;

(2) One (1) Hospital Representative;

(3) One (1) Health Plan Representative;

(4) One (1) Small Employer Representative;

(5) One (1) Large Employer;

(6) One (1) Pharmacy Representative;

(7) One (1) Pharmaceutical Industry Representative;

(8) One (1) Pharmacy Benefit Manager;

(9) One (1) Clinical Laboratory Representative;

(10) One (1) Consumer Representative;

(11) CEO as an ex-officio voting member;

(12) The Executive Commissioner of Texas Health and Human Services Commission or designee as an ex-officio non-voting member;

(13) The Commissioner of the Texas Department of State Health Services or designee as an ex-officio non-voting member;

(14) The Commissioner of the Texas Department of Insurance or designee as ex-officio non-voting member; and

(15) The Texas Attorney General or designee as ex officio non-voting member.

(b) Appointments to the board shall be made without regard to the race, color, disability, sex, religion, age, or national origin of the appointees.

(c) Each board member must be a Texas resident.

Sec. 182.054. TERMS OF OFFICE. Members of the board appointed by the governor serve for a term of two-years and may continue to serve until a successor has been appointed by the governor.

Sec. 182.055. VACANCIES. (a) A member of the board vacates the office if the member ceases to be a member of the field from which he or she was appointed.

(b) A vacancy on the board shall be filled by the original appointing authority for the remainder of the unexpired term.

Sec. 182.056. EXPENSES. Members of the board serve without compensation but are entitled to reimbursement for actual and necessary expenses in attending meetings of the board or performing other official duties authorized by the presiding officer.

Sec. 182.057. OFFICERS. (a) The governor shall designate a member of the board as chairman of the board, and the board shall elect among its members a vice-chairman and other officers that the board considers necessary. The chairman, vice-chairman, and other officers serve for a term of two years, and may be reappointed or reelected for additional terms.

(b) The board shall elect from its membership such additional officers that the board considers necessary, and these officers serve for a term of one year and may be reelected.

(c) Any board member or a member of a committee formed by the board with direct interest in a matter, personally or through an employer, before the board shall abstain from deliberations and actions on the matter in which the conflict of interest arises and shall further abstain on any vote on the matter, and not otherwise participate in a decision on the matter.

Sec. 182.058. MEETINGS. (a) The board may meet as often as necessary, but shall meet at least twice a year.

(b) The board shall develop and implement policies that provide the public with a reasonable opportunity to appear before the board and to speak on any issue under the jurisdiction of the corporation.

Sec. 182.059. CHIEF EXECUTIVE OFFICER; PERSONNEL. (a) The board shall hire a chief executive officer to administer the corporation and carrying out the policies of the board. The chief executive officer serves at the will of the board.

(b) The board may appoint employees and may fix their compensation and prescribe their duties.

(c) The board may delegate any of its powers to the chief executive officer and corporation employees.

(d) The governor's office shall deliver a biennial report to the legislature based on the information received from the board. The report may be made separately or as part of other biennial reports made to the legislature.

(e) The board shall develop and implement policies that clearly separate the policymaking responsibilities of the board and the management responsibilities of the chief executive officer and the staff of the corporation.

Sec. 182.060. PUBLIC INTEREST INFORMATION AND COMPLAINTS. (a) The corporation shall maintain a system to promptly and efficiently act on complaints filed with the corporation. The corporation shall maintain information about parties to the complaint, the subject matter of the complaint, a summary of the results of the review or investigation of the complaint, and its disposition.

(b) The corporation shall make information available describing its procedures for complaint investigation and resolution.

(c) The corporation shall periodically notify the complaint parties of the status of the complaint until final disposition.

Sec. 182.061. TECHNOLOGY POLICY. The board shall implement a policy requiring the corporation to use appropriate technological solutions to improve the corporation's ability to perform its functions. The policy must ensure that the public is able to interact with the corporation on the Internet.

Sec. 182.062. APPLICATION OF TEXAS NON-PROFIT CORPORATION ACT. The corporation is subject to state law governing nonprofit corporations, except that:

(1) the corporation may not make donations for the public welfare or for charitable or scientific purposes or in aid of war activities;

(2) the corporation is not required to file articles of incorporation;

(3) the corporation is not subject to voluntary or involuntary dissolution;

(4) the corporation may not be placed in receivership; and

(5) the corporation is not required to make reports to the secretary of state under Section 22.357, Business Organizations Code.

Sec. 182.063. LIABILITIES OF CORPORATION. Liabilities created by the corporation are not debts of the state, and the corporation may not secure any liability with funds or assets of the state except as otherwise provided by law.

Sec. 182.064. AUTHORITY TO PARTICIPATE IN OTHER REVENUE-GENERATING ACTIVITIES; LIMITATIONS. The corporation may participate in a revenue-generating activity that is consistent with the corporation's purposes if the board determines that the revenue from the activity is sufficient to cover the costs of the activity. [Sections 182.065-182.100 reserved for expansion] SUBCHAPTER C. POWERS AND DUTIES OF CORPORATION

Sec. 182.101. STATEWIDE HEALTH INFORMATION NETWORK. (a) The corporation shall assist in the development of a statewide, integrated electronic health information network as a public-private partnership among the state's providers, payers, consumers, employers, public health officials, medical researchers, and other health care stakeholders.

(b) The corporation shall develop, implement, and periodically update a plan and performance standards for the operation of a statewide, integrated electronic health information network. The corporation may implement the plan for a statewide, integrated electronic health information network in phases or by using pilot projects or a regional approach.

(c) The corporation shall:

(1) provide leadership related to, and encourage the adoption and effective use of, health information technology by conducting pilot projects, demonstration programs, and other initiatives and by administering programs providing financial incentives, including grants and loans for the creation of local, regional, or statewide health information networks to facilitate the development of interoperability across health care settings;

(2) promote the widespread use of a statewide, integrated electronic health information network, including assembling, analyzing, and widely disseminating to health care providers and the general public evidence and experience related to the adoption, implementation, effective use, and value of health information technology;

(3) identify, adopt, and promote the use of standards for interoperability, which must include provisions relating to security, privacy, data content, structures and format, vocabulary, and transmission protocols and which must take into account and be compatible with any national data standards in order to allow for interstate interoperability:

(4) procure outside sources of funding by seeking public or private grants or contracting with local, state, or federal entities or private business to finance the formation and expansion of a statewide integrated electronic health information exchange network;

(5) provide consumer access to information on price and quality of health care goods and services, and health insurance products; and

(6) adopt rules necessary to implement this chapter in accordance with Chapter 2001, Government Code.

(d) The corporation shall regularly assess the adoption of electronic health records systems and use of the statewide health information network by providers, consumers, public health officers, and other health care stakeholders to identify and regularly reevaluate the state's health information infrastructure strengths and weaknesses, assess opportunities to increase consumer access to the consumer's health records, and incorporate the information into the corporation's regular strategic planning process.

(e) In developing and periodically revising a health information technology plan, the corporation shall request public comment on the proposed plan, hold one or more public meetings to receive public comments on the plan or modifications to the plan, and take steps to assure the greatest possible collaboration between the private and public sectors, including the federal government.

Sec. 182.102. LOCAL, REGIONAL, STATE HEALTH INFORMATION NETWORKS. The corporation shall:

(1) assist in the development and expansion of existing local or regional health information networks and the creation of new networks that may include:

(A) medical trading areas that may be defined as:

(i) areas within the state in which physicians or other health care providers deliver, either formally or informally, health care to individuals by utilizing health information technology;

(ii) areas selected based on criteria that meet recognized interoperability standards; and

(iii) areas receiving planning, technical assistance, or monetary support from the corporation that promote the spread or use of an integrated electronic health information exchange network;

(B) centers of excellence that may assist the corporation to create the statewide integrated electronic health information exchange network, where a center of excellence may be:

(i) established at a local, regional, or state level;

(ii) designated to promote the spread or use of an integrated electronic health information exchange network; and

(iii) demonstrated to have excellence in health information technology application or utilization, or both; and

(2) promulgate interoperability standards among local, regional, or statewide integrated electronic health information networks that promote effective statewide and interstate interoperability.

Sec. 182.103. PRIVACY OF INFORMATION. The corporation shall develop privacy, security, operational, and technical standards to assist regional and local health information networks to ensure effective statewide privacy, data security, efficiency, and interoperability across networks. The network's standards shall be guided by reference to the Certification Commission for Healthcare Information Technology, or other federally approved certification standards, as existing on the date of adoption, as the process of implementation, acquisition, upgrade, or installation of electronic health information technology.

Sec. 182.104. ANNUAL BUDGET. The corporation shall develop an annual budget that includes funding from public and private entities, including user fees.

Sec. 182.105. INTELLECTUAL PROPERTY. The corporation shall take commercially reasonable measures to protect its intellectual property, including obtaining patents, trademarks, and copyrights where appropriate.

Sec. 182.106. REPORT TO LEGISLATURE. (a) The corporation shall submit an annual report to the Governor, the Lieutenant Governor, the Speaker of the House, and the appropriate oversight committee in the Senate and the House of Representatives.

(b) The annual report submitted by the corporation must include:

(1) an assessment of progress in developing and implementing the health information technology plan;

(2) an assessment of the impact of the plan, including the results of pilot projects and other initiatives undertaken by and financial incentives provided by the state;

(3) a summary description of health information technology in use by state programs, including technology used to administer Medicaid, the state child health plan, and health benefit plans for public employees of the state;

(4) recommendations for additional funding and legislation needed to accelerate the deployment and effective use of health information technology; and

(5) recommendations for reform of the state's laws regarding medical records and the collection of medical records data.

Sec. 182.107. COMPLIANCE WITH STANDARDS. Each state agency collecting health data shall comply with the data standards for interoperability adopted by the corporation and shall implement procedures to enable receipt of statutorily mandated and voluntarily reported health information in a standard electronic format.

Sec. 182.108. FUNDING. The corporation may be funded through the General Appropriations Act and may seek funding through public and private entities to accomplish its goals and duties.

SECTION 2. This Act takes effect immediately if it receives a vote of two-thirds of all the members elected to each house, as provided by Section 39, Article III, Texas Constitution. If this Act does not receive the vote necessary for immediate effect, this Act takes effect September 1, 2007.