HIPAA Progress in the State of California National Governors Association

1. HIPAA Progress in the State of California National Governors Association Burt Cohen, Acting Director Office of HIPAA Implementation Health & Human Services Agency April 3, 2003

2. Unique State and County Issues • HIPAA is written in the vocabulary of the private sector. • Governmental programs do not fit neatly into these concepts. • There will be problems – it’s not you!

3. And Then There’s Cost • Substantial public sector costs with little offsetting savings. • NGA has requested federal funding, but…. • Compliance is required before all the rules are known. • Sanctions

4. The Scope Is Broader Than One Might Think • HIPAA doesn’t mean just Medicaid. • Governors must think of health broadly: mental health, developmental services, alcohol and drug services, veterans, AIDS programs, corrections, state employee health plans, other health services programs. • Trading partner, data content, or other impact to still more departments: SDI, Workers’ Compensation, Emergency Srvcs.

5. Some Issues on What’s Covered • Social Services – are Children’s Services a health plan; what about special services financed under Medicaid? • Corrections – Division of Health Services; some unique applications in Privacy; 33 institutions, 38 camps, 60 parole offices. • Youth Corrections – Not automated (yet). • Multiple institutions in Mental Health, Developmental Services, and Vets Affairs.

6. Coverage Issues (continued) • Mental Health – county funded but state operated hospitals. • Public Health – Cancer detection, breast and cervical cancer treatment, AIDS, Calif. children’s services/genetically handicapped persons program, CHDP (EPSDT), genetic disease, and family planning. • CalPERS – for its own health plans. • University of Calif. – provider and research.

7. In Case You Haven’t Noticed • Complex simultaneous changes to interfacing business practices and systems. • In an uncertain environment due to sequential rules, breadth and depth of changes. • And time marches on. 10 Days to the Privacy Deadline 196 Days to the Transaction & Code Sets Deadline

8. This Requires a Strategic Approach To Implementation • Perform a statewide assessment to see where and what the HIPAA impacts are. • Develop a common terminology so that comparisons can be made across programs and departments. • Build tools collaboratively to improve quality, save money, and promote standardization.

9. Strategic Approach (continued) • Identify leaders. • Require executive sponsorship and involvement. • Build a policy and administrative infrastructure both at the statewide and the departmental levels. • Reward initiative.

10. Some California Solutions • CalOHI Statutorily Established • Website • Statewide Work Group • Policy and Information Memos • Contracting Process • Schedules, Plans, Reports, Field Reviews • Advisory Group, Communication • Legislation, preemption

11. Beware of the Five Stages of HIPAA Shock • Denial • Stalling • Whining • Trying to pass it off • Panic

12. The Stages to HIPAA Results • Awareness • Commitment • Building a Team • Productivity • Communication

13. Five Standard Steps of a Project • Initiation (awareness) • Initial assessment (inventory) • Project plan • Detailed assessment (gap analysis) • Implementation (remediation) and testing