Beth DeLair, JD, RNDeLair Consulting, LLC

Discussion TopicsBackground

Existing WI Requirements State Efforts to Change Law

Senate Bill 487 Changes to 51.30Changes to 146.82

Future EffortsBroader changes to 146.81-84?Technology changesHISPC Phase III

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Wisconsin Statute Chapter 51.30 Today Informed Consent Requirement

Except as provided below, for treatment purposes treatment records created in the course of providing services to individuals for mental illness, developmental disabilities, or AODA at a treatment facility require consent before disclosing

Exceptions to Informed Consent requirement In a medical emergency The following elements in a related health care entity:

Patient’s name Medications Address Allergies

Date of birth Other relevant demographic information Date of service (s) Name of mental health provider (s) Diagnosis

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“Current” 146.82-146.83Requires all disclosures of patient health care

records to be documented146.82(2)(d)146.82(3)(c)

Does not permit re-disclosures of patient health care records received except by court order146.82(2)(b)

Requires written, informed consent to disclosure patient health care records to family and/or friends that accompany or request information about a patient146.82(1)146.82(2)146.836 4

State Efforts to Address Changes November 2, 2005—Governor Doyle signs executive

order creating the eHealth Care Quality and Patient Safety BoardDevelops Wisconsin ehealth Action Plan—a roadmap for the

adoption of electronic health records and the exchange of health information in Wisconsin

Wisconsin applies for and receives funding through DHHS Office of the National Coordinator via Research Triangle Institute (HISPC Grant) Phase I--July 2006-March 20074 workgroups assigned to:

Assess variations in organization-level business policies and state laws that affect health information exchange

Review and account for all relevant state and federal legal requirements

Propose practical solutions that protect privacy and security of health information and permit interoperable exchange

Develop plans to implement solutions 5

State Efforts to Address Changes HIPSC Grant Phase II-July 2007-December

2007Refined recommendations from Phase I

A 51.30 workgroup was convened Stakeholders were approached regarding changes to 146.82

and 146.83

Bill drafted January-February 2008

Draft bill is reviewed/amendedDraft bill is discussed and introduced into senate

and assemblyMarch 17, 2008—Governeor Doyle signs bill

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Changes 51.30Adds to the list of elements that may be

disclosedDiagnostic test resultsSymptoms

Removes “within” a covered entity

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Changes to 146.82-146.83Deletes 146.82(2)(d) and 146.83(3) Deletes 146.82(2)(b) and replaces it with language

that:Allows re-disclosure for any purpose otherwise permitted

under 146.82 for covered entitiesLimits re-disclosure of health care records by non-covered

entities to those made Pursuant to court order Per patient written authorization For the purpose initially received

Creates 146.82(4), whichAllows disclosure to :family and friends” involved in the care of

the patient” with informal permission from the patient If patient is not available, or is not cognitively or physically

able to give permission, clinician may use “professional judgment”

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Future EffortsBroader Changes to 146.81-84 to make it

more aligned with HIPAA?

Changes in state law to accommodate technology?

HISPC Phase III-interstate collaboration

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