Senate File 229 - Introduced




                                 SENATE FILE       
                                 BY  COMMITTEE ON HUMAN
                                     RESOURCES

                                 (SUCCESSOR TO SSB
                                     1102)

                                      A BILL FOR

  1 An Act relating to the Iowa health information network, and
  2    including effective date provisions.
  3 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
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PAG LIN



  1  1                           DIVISION I
  1  2  IOWA HEALTH INFORMATION NETWORK == FUTURE ADMINISTRATION BY
  1  3                        DESIGNATED ENTITY
  1  4    Section 1.  NEW SECTION.  135D.1  Short title.
  1  5    This chapter shall be known and may be cited as the "Iowa
  1  6 Health Information Network Act".
  1  7    Sec. 2.  NEW SECTION.  135D.2  Definitions.
  1  8    As used in this chapter, unless the context otherwise
  1  9 requires:
  1 10    1.  "Board of directors" or "board" means the entity that
  1 11 governs and administers the Iowa health information network.
  1 12    2.  "Care coordination" means the management of all aspects
  1 13 of a patient's care to improve health care quality.
  1 14    3.  "Department" means the department of public health.
  1 15    4.  "Designated entity" means the nonprofit corporation
  1 16 designated by the department through a competitive process as
  1 17 the entity responsible for administering and governing the Iowa
  1 18 health information network.
  1 19    5.  "Exchange" means the authorized electronic sharing of
  1 20 health information between health care professionals, payors,
  1 21 consumers, public health agencies, the designated entity, the
  1 22 department, and other authorized participants utilizing the
  1 23 Iowa health information network and Iowa health information
  1 24 network services.
  1 25    6.  "Health care professional" means a person who is
  1 26 licensed, certified, or otherwise authorized or permitted by
  1 27 the law of this state to administer health care in the ordinary
  1 28 course of business or in the practice of a profession.
  1 29    7.  "Health information" means health information as defined
  1 30 in 45 C.F.R. {160.103 that is created or received by an
  1 31 authorized participant.
  1 32    8.  "Health information technology" means the application
  1 33 of information processing, involving both computer hardware
  1 34 and software, that deals with the storage, retrieval, sharing,
  1 35 and use of health care information, data, and knowledge for
  2  1 communication, decision making, quality, safety, and efficiency
  2  2 of clinical practice, and may include but is not limited to:
  2  3    a.  An electronic health record that electronically compiles
  2  4 and maintains health information that may be derived from
  2  5 multiple sources about the health status of an individual and
  2  6 may include a core subset of each care delivery organization's
  2  7 electronic medical record such as a continuity of care record
  2  8 or a continuity of care document, computerized physician order
  2  9 entry, electronic prescribing, or clinical decision support.
  2 10    b.  A personal health record through which an individual and
  2 11 any other person authorized by the individual can maintain and
  2 12 manage the individual's health information.
  2 13    c.  An electronic medical record that is used by health care
  2 14 professionals to electronically document, monitor, and manage
  2 15 health care delivery within a care delivery organization, is
  2 16 the legal record of the patient's encounter with the care
  2 17 delivery organization, and is owned by the care delivery
  2 18 organization.
  2 19    d.  A computerized provider order entry function that permits
  2 20 the electronic ordering of diagnostic and treatment services,
  2 21 including prescription drugs.
  2 22    e.  A decision support function to assist physicians and
  2 23 other health care providers in making clinical decisions by
  2 24 providing electronic alerts and reminders to improve compliance
  2 25 with best practices, promote regular screenings and other
  2 26 preventive practices, and facilitate diagnosis and treatments.
  2 27    f.  Tools to allow for the collection, analysis, and
  2 28 reporting of information or data on adverse events, the quality
  2 29 and efficiency of care, patient satisfaction, and other health
  2 30 care=related performance measures.
  2 31    9.  "Health Insurance Portability and Accountability Act"
  2 32 or "HIPAA" means the federal Health Insurance Portability and
  2 33 Accountability Act of 1996, Pub. L. No. 104=191, including
  2 34 amendments thereto and regulations promulgated thereunder.
  2 35    10.  "Hospital" means a licensed hospital as defined in
  3  1 section 135B.1.
  3  2    11.  "Interoperability" means the ability of two or more
  3  3 systems or components to exchange information or data in an
  3  4 accurate, effective, secure, and consistent manner and to use
  3  5 the information or data that has been exchanged and includes
  3  6 but is not limited to:
  3  7    a.  The capacity to connect to a network for the purpose of
  3  8 exchanging information or data with other users.
  3  9    b.  The ability of a connected, authenticated user to
  3 10 demonstrate appropriate permissions to participate in the
  3 11 instant transaction over the network.
  3 12    c.  The capacity of a connected, authenticated user to
  3 13 access, transmit, receive, and exchange usable information with
  3 14 other users.
  3 15    12.  "Iowa health information network" or "network" means the
  3 16 statewide health information technology network that is the
  3 17 sole statewide network for Iowa pursuant to this chapter.
  3 18    13.  "Iowa Medicaid enterprise" means the centralized
  3 19 medical assistance program infrastructure, based on a business
  3 20 enterprise model, and designed to foster collaboration among
  3 21 all program stakeholders by focusing on quality, integrity, and
  3 22 consistency.
  3 23    14.  "Participant" means an authorized health care
  3 24 professional, payor, patient, health care organization, public
  3 25 health agency, or the department that has agreed to authorize,
  3 26 submit, access, or disclose health information through the Iowa
  3 27 health information network in accordance with this chapter
  3 28 and all applicable laws, rules, agreements, policies, and
  3 29 standards.
  3 30    15.  "Patient" means a person who has received or is
  3 31 receiving health services from a health care professional.
  3 32    16.  "Payor" means a person who makes payments for health
  3 33 services, including but not limited to an insurance company,
  3 34 self=insured employer, government program, individual, or other
  3 35 purchaser that makes such payments.
  4  1    17.  "Protected health information" means protected health
  4  2 information as defined in 45 C.F.R. {160.103 that is created or
  4  3 received by an authorized participant.
  4  4    18.  "Public health activities" means actions taken by a
  4  5 participant in its capacity as a public health authority under
  4  6 the Health Insurance Portability and Accountability Act or as
  4  7 required or permitted by other federal or state law.
  4  8    19.  "Public health agency" means an entity that is governed
  4  9 by or contractually responsible to a local board of health or
  4 10 the department to provide services focused on the health status
  4 11 of population groups and their environments.
  4 12    20.  "Record locator service" means the functionality of the
  4 13 Iowa health information network that queries data sources to
  4 14 locate and identify potential patient records.
  4 15    Sec. 3.  NEW SECTION.  135D.3  Iowa health information network
  4 16 == findings and intent.
  4 17    1.  The general assembly finds all of the following:
  4 18    a.  Technology used to support health care=related functions
  4 19 is known as health information technology. Health information
  4 20 technology provides a mechanism to transform the delivery of
  4 21 health and medical care in Iowa and across the nation.
  4 22    b.  Health information technology is rapidly evolving to
  4 23 contribute to the goals of improving the experience of care,
  4 24 improving the health of populations, and reducing per capita
  4 25 costs of health care.
  4 26    c.  A health information network involves the secure
  4 27 electronic sharing of health information across the boundaries
  4 28 of individual practice and institutional health settings and
  4 29 with consumers. The broad use of health information technology
  4 30 and a health information network should improve health care
  4 31 quality and the overall health of the population, increase
  4 32 efficiencies in administrative health care, reduce unnecessary
  4 33 health care costs, and help prevent medical errors.
  4 34    d.  All health information technology efforts shall endeavor
  4 35 to represent the interests and meet the needs of consumers and
  5  1 the health care sector, protect the privacy of individuals
  5  2 and the confidentiality of individuals' information, promote
  5  3 best practices, and make information easily accessible to
  5  4 the members of the patient=centered care coordination team,
  5  5 including but not limited to patients, providers, and payors.
  5  6    2.  It is the intent of the general assembly that the Iowa
  5  7 health information network shall not constitute a health
  5  8 benefit network or a health insurance network.
  5  9    Sec. 4.  NEW SECTION.  135D.4  Iowa health information network
  5 10 == principles == technical infrastructure requirements.
  5 11    1.  The Iowa health information network shall be
  5 12 administered and governed by a designated entity using, at a
  5 13 minimum, the following principles:
  5 14    a.  Be patient=centered and market=driven.
  5 15    b.  Comply with established national standards.
  5 16    c.  Protect the privacy of consumers and the security and
  5 17 confidentiality of all health information.
  5 18    d.  Promote interoperability.
  5 19    e.  Increase the accuracy, completeness, and uniformity of
  5 20 data.
  5 21    f.  Preserve the choice of the patient to have the patient's
  5 22 health information available through the record locator
  5 23 service.
  5 24    g.  Provide education to the general public and provider
  5 25 communities on the value and benefits of health information
  5 26 technology.
  5 27    2.  Widespread adoption of health information technology is
  5 28 critical to a successful Iowa health information network and is
  5 29 best achieved when all of the following occur:
  5 30    a.  The network, through the designated entity complying
  5 31 with chapter 504 and reporting as required under this chapter,
  5 32 operates in an entrepreneurial and businesslike manner in which
  5 33 it is accountable to all participants utilizing the network's
  5 34 products and services.
  5 35    b.  The network provides a variety of services from which to
  6  1 choose in order to best fit the needs of the user.
  6  2    c.  The network is financed by all who benefit from the
  6  3 improved quality, efficiency, savings, and other benefits that
  6  4 result from use of health information technology.
  6  5    d.  The network is operated with integrity and freedom from
  6  6 political influence.
  6  7    3.  The Iowa health information network technical
  6  8 infrastructure shall provide a mechanism for all of the
  6  9 following:
  6 10    a.  The facilitation and support of the secure electronic
  6 11 exchange of health information between participants.
  6 12    b.  Participants without an electronic health records system
  6 13 to access health information from the Iowa health information
  6 14 network.
  6 15    4.  Nothing in this chapter shall be interpreted to
  6 16 impede or preclude the formation and operation of regional,
  6 17 population=specific, or local health information networks
  6 18 or the participation of such networks in the Iowa health
  6 19 information network.
  6 20    Sec. 5.  NEW SECTION.  135D.5  Designated entity ==
  6 21 administration and governance.
  6 22    1.  The Iowa health information network shall be
  6 23 administered and governed by a designated entity selected by
  6 24 the department through a competitive process. The designated
  6 25 entity shall be established as a nonprofit corporation
  6 26 organized under chapter 504. Unless otherwise provided in
  6 27 this chapter, the corporation is subject to the provisions of
  6 28 chapter 504. The designated entity shall be established for
  6 29 the purpose of administering and governing the statewide Iowa
  6 30 health information network.
  6 31    2.  The designated entity shall collaborate with the
  6 32 department, but the designated entity shall not be considered,
  6 33 in whole or in part, an agency, department, or administrative
  6 34 unit of the state.
  6 35    a.  The designated entity shall not be required to comply
  7  1 with any requirements that apply to a state agency, department,
  7  2 or administrative unit and shall not exercise any sovereign
  7  3 power of the state.
  7  4    b.  The designated entity does not have authority to pledge
  7  5 the credit of the state.  The assets and liabilities of
  7  6 the designated entity shall be separate from the assets and
  7  7 liabilities of the state and the state shall not be liable
  7  8 for the debts or obligations of the designated entity. All
  7  9 debts and obligations of the designated entity shall be payable
  7 10 solely from the designated entity's funds. The state shall
  7 11 not guarantee any obligation of or have any obligation to the
  7 12 designated entity.
  7 13    3.  The articles of incorporation of the designated entity
  7 14 shall provide for its governance and its efficient management.
  7 15 In providing for its governance, the articles of the designated
  7 16 entity shall address the following:
  7 17    a.  A board of directors to govern the designated entity.
  7 18    b.  The appointment of a chief executive officer by the board
  7 19 to manage the designated entity's daily operations.
  7 20    c.  The delegation of such powers and responsibilities to the
  7 21 chief executive officer as may be necessary for the designated
  7 22 entity's efficient operation.
  7 23    d.  The employment of personnel necessary for the efficient
  7 24 performance of the duties assigned to the designated entity.
  7 25 All such personnel shall be considered employees of a private,
  7 26 nonprofit corporation and shall be exempt from the personnel
  7 27 requirements imposed on state agencies, departments, and
  7 28 administrative units.
  7 29    e.  The financial operations of the designated entity
  7 30 including the authority to receive and expend funds from public
  7 31 and private sources and to use its property, money, or other
  7 32 resources for the purpose of the designated entity.
  7 33    Sec. 6.  NEW SECTION.  135D.6  Board of directors ==
  7 34 composition == duties.
  7 35    1.  The designated entity shall be administered by a board
  8  1 of directors.
  8  2    2.  A single industry shall not be disproportionately
  8  3 represented as voting  members of the board.  The board shall
  8  4 include at least one member who is a consumer of health
  8  5 services and a majority of the voting members of the board
  8  6 shall be representative of participants in the Iowa health
  8  7 information network. The director of public health or the
  8  8 director's  designee and the director of the Iowa Medicaid
  8  9 enterprise or the director's designee shall act as voting
  8 10 members of the board. The commissioner of insurance shall act
  8 11 as an ex officio, nonvoting member of the board. Individuals
  8 12 serving in an ex officio, nonvoting capacity shall not be
  8 13 included in the total number of individuals authorized as
  8 14 members of the board.
  8 15    3.  The board of directors shall do all of the following:
  8 16    a.  Ensure that the designated entity enters into contracts
  8 17 with each state agency necessary for state reporting
  8 18 requirements.
  8 19    b.  Develop, implement, and enforce the following:
  8 20    (1)  A single patient identifier or alternative mechanism to
  8 21 share secure patient information that is utilized by all health
  8 22 care professionals.
  8 23    (2)  Standards, requirements, policies, and procedures for
  8 24 access to, use, secondary use, privacy, and security of health
  8 25 information exchanged through the Iowa health information
  8 26 network, consistent with applicable federal and state standards
  8 27 and laws.
  8 28    c.  Direct a public and private collaborative effort to
  8 29 promote the adoption and use of health information technology
  8 30 in the state to improve health care quality, increase patient
  8 31 safety, reduce health care costs, enhance public health,
  8 32 and empower individuals and health care professionals with
  8 33 comprehensive, real=time medical information to provide
  8 34 continuity of care and make the best health care decisions.
  8 35    d.  Educate the public and the health care sector about
  9  1 the value of health information technology in improving
  9  2 patient care, and methods to promote increased support and
  9  3 collaboration of state and local public health agencies,
  9  4 health care professionals, and consumers in health information
  9  5 technology initiatives.
  9  6    e.  Work to align interstate and intrastate interoperability
  9  7 standards in accordance with national health information
  9  8 exchange standards.
  9  9    f.  Provide an annual budget and fiscal report for the Iowa
  9 10 health information network to the governor, the department
  9 11 of public health, the department of management, the chairs
  9 12 and ranking members of the legislative government oversight
  9 13 standing committees, and the legislative services agency.
  9 14 The report shall also include information about the services
  9 15 provided through the network and information on the participant
  9 16 usage of the network.
  9 17    Sec. 7.  NEW SECTION.  135D.7  Legal and policy == liability
  9 18 == confidentiality.
  9 19    1.  The board shall implement industry=accepted security
  9 20 standards, policies, and procedures to protect the transmission
  9 21 and receipt of protected health information exchanged through
  9 22 the Iowa health information network, which shall, at a minimum,
  9 23 comply with HIPAA and shall include all of the following:
  9 24    a.  A secure and traceable electronic audit system to
  9 25 document and monitor the sender and recipient of health
  9 26 information exchanged through the Iowa health information
  9 27 network.
  9 28    b.  A required standard participation agreement which
  9 29 defines the minimum privacy and security obligations of all
  9 30 participants using the Iowa health information network and
  9 31 services available through the Iowa health information network.
  9 32    c.  The opportunity for a patient to decline exchange of the
  9 33 patient's health information through the record locator service
  9 34 of the Iowa health information network.
  9 35    (1)  A patient shall not be denied care or treatment for
 10  1 declining to exchange the patient's health information, in
 10  2 whole or in part, through the network.
 10  3    (2)  The board shall provide the means and process by which
 10  4 a patient may decline participation. The means and process
 10  5 utilized shall minimize the burden on patients and health care
 10  6 professionals.
 10  7    (3)  Unless otherwise authorized by law or rule, a patient's
 10  8 decision to decline participation means that none of the
 10  9 patient's health information shall be accessible through the
 10 10 record locator service function of the Iowa health information
 10 11 network. A patient's decision to decline having health
 10 12 information shared through the record locator service function
 10 13 shall not limit a health care professional with whom the
 10 14 patient has or is considering a treatment relationship from
 10 15 sharing health information concerning the patient through
 10 16 the secure messaging function of the Iowa health information
 10 17 network.
 10 18    (4)  A patient who declines participation in the Iowa health
 10 19 information network may later decide to have health information
 10 20 shared through the network. A patient who is participating in
 10 21 the network may later decline participation in the network.
 10 22    2.  A participant shall not be compelled by subpoena, court
 10 23 order, or other process of law to access health information
 10 24 through the Iowa health information network in order to gather
 10 25 records or information not created by the participant.
 10 26    3.  A participant exchanging health information and data
 10 27 through the Iowa health information network shall grant to
 10 28 other participants of the network a nonexclusive license to
 10 29 retrieve and use that information in accordance with applicable
 10 30 state and federal laws, and the policies and standards
 10 31 established by the board.
 10 32    4.  A health care professional who relies reasonably and
 10 33 in good faith upon any health information provided through
 10 34 the Iowa health information network in treatment of a patient
 10 35 who is the subject of the health information shall be immune
 11  1 from criminal or civil liability arising from the damages
 11  2 caused by such reasonable, good=faith reliance. Such immunity
 11  3 shall not apply to acts or omissions constituting negligence,
 11  4 recklessness, or intentional misconduct.
 11  5    5.  A participant who has disclosed health information
 11  6 through the Iowa health information network in compliance with
 11  7 applicable law and the standards, requirements, policies,
 11  8 procedures, and agreements of the network shall not be subject
 11  9 to criminal or civil liability for the use or disclosure of the
 11 10 health information by another participant.
 11 11    6.  The following records shall be confidential records
 11 12 pursuant to chapter 22, unless otherwise ordered by a court or
 11 13 consented to by the patient or by a person duly authorized to
 11 14 release such information:
 11 15    a.  The health information contained in, stored in, submitted
 11 16 to, transferred or exchanged by, or released from the Iowa
 11 17 health information network.
 11 18    b.  Any health information in the possession of the board due
 11 19 to its administration of the Iowa health information network.
 11 20    7.  Unless otherwise provided in this chapter, when sharing
 11 21 health information through the Iowa health information network
 11 22 or a private health information network maintained in this
 11 23 state that complies with the privacy and security requirements
 11 24 of this chapter for the purposes of patient treatment, payment
 11 25 or health care operations, as such terms are defined in
 11 26 HIPAA, or for the purposes of public health activities or
 11 27 care coordination, a participant authorized by the designated
 11 28 entity to use the record locator service is exempt from any
 11 29 other state law that is more restrictive than HIPAA that would
 11 30 otherwise prevent or hinder the exchange of patient information
 11 31 by the participant.
 11 32    8.  A patient aggrieved or adversely affected by the
 11 33 designated entity's failure to comply with subsection 1,
 11 34 paragraph "c", may bring a civil action for equitable relief as
 11 35 the court deems appropriate.
 12  1    Sec. 8.  REPEAL.  Sections 135.154, 135.155, 135.155A,
 12  2 135.156, 135.156A, 135.156B, 135.156C, 135.156D, 135.156E,
 12  3 and 135.156F, are repealed upon the assumption of the
 12  4 administration and governance, including but not limited to the
 12  5 assumption of the assets and liabilities, of the Iowa health
 12  6 information network by the designated entity.  The department
 12  7 of public health shall notify the Code editor of the date of
 12  8 such assumption by the designated entity.
 12  9    Sec. 9.  EFFECTIVE DATES.  This division of this Act
 12 10 takes effect upon the assumption of the administration and
 12 11 governance, including but not limited to the assumption of the
 12 12 assets and liabilities, of the Iowa health information network
 12 13 by the designated entity. The department of public health
 12 14 shall notify the Code editor of the date of such assumption by
 12 15 the designated entity.
 12 16                           DIVISION II
 12 17                 SELECTION OF DESIGNATED ENTITY
 12 18                    AND TRANSITION PROVISIONS
 12 19    Sec. 10.  Section 135.154, Code 2015, is amended by adding
 12 20 the following new subsections:
 12 21    NEW SUBSECTION.  3A.  "Care coordination" means the
 12 22 management of all aspects of a patient's care to improve health
 12 23 care quality.
 12 24    NEW SUBSECTION.  19A.  "Public health activities" means
 12 25 actions taken by a participant in its capacity as a public
 12 26 health authority under the Health Insurance Portability and
 12 27 Accountability Act or as required or permitted by other federal
 12 28 or state law.
 12 29    NEW SUBSECTION.  23.  "Record locator service" means the
 12 30 functionality of the Iowa health information network that
 12 31 queries data sources to locate and identify potential patient
 12 32 records.
 12 33    Sec. 11.  Section 135.155, subsection 2, Code 2015, is
 12 34 amended by adding the following new paragraph:
 12 35    NEW PARAGRAPH.  f.  Preserve the choice of the patient to
 13  1 have the patient's health information available through the
 13  2 record locator service.
 13  3    Sec. 12.  Section 135.156E, subsections 2 and 13, Code 2015,
 13  4 are amended to read as follows:
 13  5    2.  A patient shall have the opportunity to decline exchange
 13  6 of the patient's health information through the record locator
 13  7 service of the Iowa health information network. A patient
 13  8 shall not be denied care or treatment for declining to exchange
 13  9 the patient's health information, in whole or in part, through
 13 10 the record locator service of the Iowa health information
 13 11 network. The board shall provide by rule the means and process
 13 12 by which patients may decline participation. The means and
 13 13 process utilized under the rules shall minimize the burden on
 13 14 patients and health care professionals.
 13 15    13.  Unless otherwise provided in this division, when
 13 16 using sharing health information through the Iowa health
 13 17 information network or a private health information network
 13 18 maintained in this state that complies with the privacy and
 13 19 security requirements of this chapter for the purposes of
 13 20 patient treatment, payment, or health care operations, as
 13 21 such terms are defined in the Health Insurance Portability
 13 22 and Accountability Act, or for the purposes of public health
 13 23 activities or care coordination, a health care professional
 13 24 or a hospital participant authorized to use the record
 13 25 locator service is exempt from any other state law that is
 13 26 more restrictive than the Health Insurance Portability and
 13 27 Accountability Act that would otherwise prevent or hinder the
 13 28 exchange of patient information by the patient's health care
 13 29 professional or hospital such participant.
 13 30    Sec. 13.  SELECTION OF A DESIGNATED ENTITY.  The department
 13 31 of public health shall utilize a competitive process to select
 13 32 a designated entity to administer and govern the Iowa health
 13 33 information network.
 13 34    Sec. 14.  CONTINUATION OF PARTICIPATION AGREEMENTS.  If
 13 35 the department of public health selects a designated entity
 14  1 pursuant to this division of this Act, the designated entity
 14  2 shall continue any agreement between an authorized participant
 14  3 and the Iowa health information network existing upon the
 14  4 transition of the assumption of the administration and
 14  5 governance, including but not limited to the assumption of
 14  6 the assets and liabilities  of the Iowa health information
 14  7 network by the designated entity, under the same terms through
 14  8 completion of the original agreement period.
 14  9    Sec. 15.  IOWA HEALTH INFORMATION NETWORK FUND.  If the
 14 10 department of public health selects a designated entity
 14 11 pursuant to this division of this Act, any moneys remaining
 14 12 in the Iowa health information network fund established
 14 13 pursuant to section 135.156C, Code 2015, that are obligated or
 14 14 encumbered for expenses related to the Iowa health information
 14 15 network prior to the assumption of the administration and
 14 16 governance, including but not limited to the assumption of the
 14 17 assets and liabilities,  of the Iowa health information network
 14 18 by the designated entity, shall be retained by the department.
 14 19 The remainder of the moneys in the fund shall be transferred to
 14 20 the designated entity upon the assumption of the administration
 14 21 and governance of the Iowa health information network.
 14 22    Sec. 16.  TRANSFER OF ASSETS AND LIABILITIES AND
 14 23 ADMINISTRATIVE RESPONSIBILITIES TO THE DESIGNATED ENTITY.  If
 14 24 the department of public health selects a designated entity
 14 25 pursuant to this division of this Act, the department shall
 14 26 continue to provide administrative support to the Iowa health
 14 27 information network as provided in section 135.156, Code
 14 28 2015, until such time as the designated entity assumes such
 14 29 responsibilities.  Upon selection of the designated entity, the
 14 30 assets and liabilities of the Iowa health information network
 14 31 shall be transferred to the designated entity.
 14 32    Sec. 17.  EFFECTIVE UPON ENACTMENT.  This division of this
 14 33 Act, being deemed of immediate importance, takes effect upon
 14 34 enactment.
 14 35                           EXPLANATION
 15  1 The inclusion of this explanation does not constitute agreement with
 15  2 the explanation's substance by the members of the general assembly.
 15  3    This bill provides for the administration and governance of
 15  4 an Iowa health information network by a nonprofit designated
 15  5 entity.  The bill creates a new Code chapter, 135D, the Iowa
 15  6 health information network. The new Code chapter includes
 15  7 many of the same provisions existing under Code chapter
 15  8 135, division XXI, which provides for the administration and
 15  9 governance of the Iowa health information network by the
 15 10 department of public health, an electronic health information
 15 11 advisory council, and an executive committee. The bill instead
 15 12 places these functions under a designated entity, which is a
 15 13 nonprofit corporation designated by the department through a
 15 14 competitive process as the entity responsible for administering
 15 15 and governing the network. The bill includes definitions,
 15 16 findings and intent, principles and technical infrastructure
 15 17 requirements, requirements for administration and governance
 15 18 by the designated entity, requirements for the composition and
 15 19 duties of the board of directors of the designated entity, and
 15 20 legal and policy requirements. These provisions take effect
 15 21 only upon the assumption of the administration and governance
 15 22 of the network by the designated entity.
 15 23    The bill makes changes to current Code relating to the
 15 24 definitions of "care coordination", "public health activities",
 15 25 and "record locator service"; the sharing of patient health
 15 26 information available through the record locator service;
 15 27 and the privacy and security requirements applicable to the
 15 28 sharing of patient information by participants authorized
 15 29 to use the record locator service for treatments, payment,
 15 30 health care operations, public health activities, and care
 15 31 coordination. The provisions are effective upon enactment and
 15 32 would continue in effect through the transition period. The
 15 33 bill also provides for the transition of the administration
 15 34 and governance of the Iowa health information network to the
 15 35 designated entity and provides for the repeal of the current
 16  1 provisions related to the Iowa health information network upon
 16  2 the assumption of the designated entity of the administration
 16  3 and governance of the network.
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