CONFERENCE COMMITTEE REPORT NO.92

                            Honolulu, Hawaii
                                            , 1999

                            RE:   H.B. No. 351
                                  H.D. 2
                                  S.D. 1
                                  C.D. 1




Honorable Calvin K.Y. Say
Speaker, House of Representatives
Twentieth State Legislature
Regular Session of 1999
State of Hawaii

Honorable Norman Mizuguchi
President of the Senate
Twentieth State Legislature
Regular Session of 1999
State of Hawaii

Sir:

     Your Committee on Conference on the disagreeing vote of the
House of Representatives to the amendments proposed by the Senate
in H.B. No. 351, H.D. 2, S.D. 1, entitled:

    "A BILL FOR AN ACT RELATING TO PRIVACY OF HEALTH CARE
    INFORMATION,"

having met, and after full and free discussion, has agreed to
recommend and does recommend to the respective Houses the final
passage of this bill in an amended form.

     The purpose of this bill is to provide for the comprehensive
regulation of the handling and disclosure of medical records
that:

     (1) Encompasses the multiple parties that are included in
         the contemporary relationship between patient and health
         care provider;


 
 
 
 
 
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     (2) Protects an individual's constitutional right to privacy
         of their medical information;

     (3) Accommodates the legitimate interests and needs of
         health care providers, hospitals, insurers, and other
         entities other than the patient, and serves to improve
         the provision of quality health care; and

     (4) Furthers the interest of society in medical research
         resulting in new treatments that relieve suffering and
         save lives.

     Your Committee on Conference has made amendments to this
measure that include, among other things:

     (1) Amending the definition of "insurer" to include health
         maintenance organizations, mutual benefit societies,
         group insurance policies issued by these organizations,
         and individual health policies;

     (2) Adding definitions of "educational institution" and
         "entity" for purposes of clarity and brevity; 

     (3) Providing individuals who are refused access to their
         health information for safety and other reasons, an
         alternative procedure for further review of their
         requests;

     (4) Strengthening the notice provisions; and

     (5) Specifying that any civil penalties collected for
         violation of the law shall be deposited into the general
         fund.


 
 
 
 
 
 
 
 
 
 
 
 
 
 
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     Your Committee on Conference has further amended this bill
by removing language in the bill providing immunity from
liability under the common law, for entities making disclosures
permitted under the measure.  However it is your Committee on
Conference's intent that the new chapter established by this bill
provide guidance to courts dealing with lawsuits concerning the
disclosure of medical information brought under common law tort
theories, such as invasion of privacy.  Additionally, compliance
with this new law is intended to provide strong evidence that
medical information was properly handled and disclosed.  Thus,
your Committee on Conference believes that this measure will
encourage proper confidentiality practices with regards to
medical information, and discourage litigation.

     Finally, your Committee on Conference has removed language
providing that the Office of Information Practices shall be
responsible for the enforcement of the new chapter, and retaining
language providing for rule adoption by the Office of Information
Practices to implement the new law.  Instead, your Committee on
Conference believes that further discussion regarding the most
appropriate agency to enforce this law is necessary, and has
added a provision requesting that the Legislative Reference
Bureau to examine the question and report its recommendations to
the 2000 Legislature.

     Your Committee on Conference finds that this bill is in
large part the product of the dedicated and collaborative efforts
of an informal task force representing the range of parties
included in the contemporary health care relationship.  Your
Committee on Conference further finds that this bill represents a
workable balance between the interests of those parties that will
provide protections where needed, and benefit society by
establishing clearcut guidelines facilitating the appropriate
transmission and beneficial use of medical information.


 
 
 
 
 
 
 
 
 
 
 
 
 
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     Your Committee on Conference is in accord with the intent
and purpose of H.B. No. 351, H.D. 2, S.D. 1, as amended herein,
and recommends that it pass Final Reading in the form attached
hereto as H.B. No. 351, H.D. 2, S.D. 1, C.D. 1.

                                   Respectfully submitted,

MANAGERS ON THE PART OF THE        MANAGERS ON THE PART OF THE
           SENATE                              HOUSE
                                   
                                   
                                   
______________________________     ______________________________
SUZANNE CHUN OAKLAND, Co-Chair     ALEXANDER C. SANTIAGO, Co-
                                   Chair
                                   
                                   
                                   
______________________________     ______________________________
AVERY B. CHUMBLEY, Co-Chair        RON MENOR, Co-Chair
                                   
                                   
                                   
______________________________     ______________________________
MATTHEW M. MATSUNAGA, Co-Chair     ERIC G. HAMAKAWA, Co-Chair
                                   
                                   
                                   
______________________________     ______________________________
BRIAN KANNO, Member                NESTOR R. GARCIA, Member
                                   
                                   
                                   
______________________________     ______________________________
WHITNEY ANDERSON, Member           PAUL WHALEN, Member