Joint Committee on Public Health
The Massachusetts Health & Hospital Association, on behalf of our member hospitals, health systems, physician organizations, and allied healthcare providers, appreciates the opportunity to submit comments on a number of late-filed and miscellaneous bills before the committee.
MHA strongly supports HB1895 which would provide a mechanism for health care providers to obtain information regarding potential exposure to HIV/AIDS in those circumstances when the provider has come into contact with blood or other bodily fluids while providing medically necessary services. MHA supports the principle that appropriate protections need to be in place to ensure the safety of all health care professionals during the delivery of health care services. We also believe that health care professionals should be afforded the fullest possible set of facts and knowledge when they have potentially been exposed to a disease or illness to assist with treatment decisions. It is important to note that when a potential exposure occurs, time is of the essence in regard to testing and administering appropriate medication or clinical support to a person who may be infected. Delays necessitated by waiting for a court order or informed consent for release of records could further compromise the safety of clinical staff. HB1895 provides substantial patient protection by limiting the release to only the person who was infected to ensure that health care providers have accurate and timely information for their own health and safety.
MHA strongly supports SB1339, which provides for a structured process for first responders to receive test results of an infectious disease if they are exposed when responding to an emergency call or transporting a patient to a healthcare facility. While we believe that this bill should be expanded to include all healthcare providers, we believe that first responders should be given the necessary information to safeguard their own health. It is critical to note that this bill does not require testing without the patient’s consent. Instead, it directly provides the first responder with the test information if the patient consents or provides the first responder with notice that the patient did not consent and how to seek a court order requiring such testing. When an exposure occurs, there is a short window of time for gaining knowledge about the type of exposure and the prescriptive treatment that is necessary to prevent major illness. SB1339 will help advance access to needed information for first responders.
HB2001 would move the Health Planning Council to the Health Policy Commission (HPC) and would update the charge of the HPC to include monitoring the location and distribution of healthcare services and healthcare resources in the Commonwealth. However, while this proposal is much more comprehensive in terms of the development of a state health plan, there is no language included in the bill that provides resources to the Commission to cover the costs of the operation of the Health Planning Council. Therefore, funding for the Council and its additional responsibilities would fall to the current HPC assessment on hospitals, ambulatory surgery centers and surcharge payors. Should the committee seek to give a favorable recommendation to this legislation, MHA would recommend the inclusion of language that explicitly states that the assessment on hospitals, ambulatory surgery centers and surcharge payors shall not increase due to the additional responsibilities of the Health Policy Commission.
MHA supports HB1907, HB1971, and HB1915, which provide state authorization to local health agencies to collect information on any fetal or infant death that occurs in the agency’s jurisdiction. MHA strongly endorses this proposal, which will provide actual local data and analysis of deaths that may be used to enhance local health policy programs. A significant problem with many statewide reporting requirements, such as those related to fetal and infant mortality reviews, is that the data is never made available to local public health agencies or facilities that can best utilize the data to develop internal quality improvement actions or consider community benefits programs that target societal risk factors that might help prevent or reduce such deaths. By providing a local healthcare authority with the ability to obtain and analyze such data, this legislation will create greater opportunities for healthcare provider partnerships and evidence-based solutions to address public health concerns for vulnerable populations.
MHA supports HB2002 that would broaden the mission of the Massachusetts E-Health Institute to: partner with the healthcare and technology community to accelerate digital health sector activity; advance the Commonwealth’s economic competitiveness by supporting this sector, including its role in improving the quality of healthcare delivery and patient outcomes; and prioritizing digital health by utilizing mechanisms at its disposal that are currently reserved for the advancement of electronic health record adoption.
SB2408 will align state law with federal Health Insurance Portability and Accountability Act (HIPAA) provisions to improve and standardize the process for accessing and sharing health information between healthcare providers and insurers, whether through an electronic medical record (EMR) or through other commonly used communication platforms. In particular, streamlining the process for sharing information related to an individual’s diagnoses, co-morbidities, medications, laboratory tests, and treatment goals is critical to ensure such information is available to all members of the care team to ensure consistency and coordination of patient care.
As the state continues to promote the adoption of integrated health care systems, it is crucial that members of diverse care teams be able to access medically necessary information, following the federal HIPAA standards for reviewing and releasing information. Currently, providers must routinely spend considerable time attempting to interpret and negotiate state versus federal law requirements for release of healthcare information - time that would be better spent on patient care. SB2408 would streamline this process by ensuring providers have a uniform standard for the release of information.
It is important to note that this bill does NOT eliminate or reduce any privacy or security protections on the release of healthcare information. Adopting the uniform standard set forth in SB2408 will simply eliminate the current disjunction between the M.G.L and federal standards and thus advance care coordination strategies and the appropriate sharing of treatment information in a timely manner.
The statutory update provided by SB2408 is also essential to advancing the evolution of the health care payment system toward alternative payment methodologies and the increased use of integrated EMRs and health information exchange systems. By advancing a single standard for information communication, SB2408 will: facilitate the timely and secure sharing of essential health information; reduce costs; and improve patient care. For all of these reasons, MHA urges the committee to issue this bill a favorable report.
Thank you for the opportunity to offer testimony on this matter. If you have any questions regarding this testimony, or require further information, please contact Michael Sroczynski, MHA’s Senior Vice President of Government Advocacy, at (781) 262-6055 or msroczynski@mhalink.org.