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        PRIOR PRINTER'S NOS. 477, 896                 PRINTER'S NO. 1089



No. 8 Session of 2007

           WASHINGTON, MARCH 14, 2007


                                     AN ACT

     1  Establishing the Medical Safety Automation Account FUND; and      <--
     2     providing grants to implement medical safety automation
     3     systems.

     4     The General Assembly of the Commonwealth of Pennsylvania
     5  hereby enacts as follows:
     6  Section 1.  Short title.
     7     This act shall be known and may be cited as the Medical
     8  Safety Automation Fund (M-SAF) Act.
     9  Section 2.  Definitions.
    10     The following words and phrases when used in this act shall
    11  have the meanings given to them in this section unless the
    12  context clearly indicates otherwise:
    13     "Community-based health care provider."  Any of the following
    14  nonprofit health care centers which provide primary health care
    15  services:
    16         (1)  A federally qualified health center as defined in
    17     section 1905(l)(2)(B) of the Social Security Act (49 Stat.

     1     620, 42 U.S.C. § 1396d(l)(2)(B).
     2         (2)  A rural health clinic as defined in section
     3     1861(aa)(2) of the Social Security Act (49 Stat. 620, 42
     4     U.S.C. § 1395x(aa)(2)), certified by Medicare.
     5         (3)  A freestanding hospital clinic serving a federally
     6     designated health care professional shortage area.
     7         (4)  A free or partial-pay health clinic which provides
     8     services by volunteer medical providers.
     9     "Department."  The Department of Health of the Commonwealth.
    10     "Health care provider."  A health care facility or health
    11  care practitioner as defined in the act of July 19, 1979
    12  (P.L.130, No.48), known as the Health Care Facilities Act, a
    13  group practice or a community-based health care provider.
    14     "Health information."  The medical records of a patient.
    15     "Health information technology."  The application of
    16  information processing utilizing products, devices, including
    17  hardware and software, or systems that allow for the electronic
    18  collection, storage, retrieval, exchange, sharing, management or
    19  use of health information.
    20     "Health insurer."  Any of the following providers of health
    21  care insurance coverage:
    22         (1)  An insurer licensed under the act of May 17, 1921
    23     (P.L.682, No.284), known as The Insurance Company Law of
    24     1921.
    25         (2)  A health maintenance organization as defined in the
    26     act of December 29, 1972 (P.L.1701, No.364), known as the
    27     Health Maintenance Organization Act.
    28         (3)  A not-for-profit health plan corporation operating
    29     pursuant to 40 Pa.C.S. Chs. 61 (relating to health plan
    30     corporations) and 63 (relating to professional health
    20070S0008B1089                  - 2 -     

     1     services plan corporations).
     2     "Interoperability."  The ability to communicate and exchange
     3  data accurately, effectively, securely and consistently among
     4  different technology systems, software applications and networks
     5  in a way that maintains and preserves the clinical purpose of
     6  the data.
     7     "Medical safety automation system."  An automated,
     8  interoperable system that utilizes health information technology
     9  to integrate health information, clinical activities and data
    10  sharing in any of the following areas: pharmacy ordering and
    11  tracking, laboratory testing and results, physician order
    12  management, access by clinicians, access by consumers,
    13  telemedicine, data sharing among health care facilities,
    14  physicians and health insurers or other transaction monitoring
    15  or health information exchange that promotes patient safety and
    16  efficiency in the delivery of health care.
    17     "Program."  The medical safety automation program established
    18  under section 3.
    19     "Regional health information organization."  A not-for-profit
    20  organization that adopts bylaws, memoranda of understanding or
    21  other charter documents that provide for the establishment of a
    22  governance structure and processes and enable participation by
    23  multiple health care providers in the development of a medical
    24  safety automation program.
    25  Section 3.  Medical safety automation program.
    26     (a)  Establishment.--A medical safety automation program is
    27  hereby established to provide grants to health care providers or
    28  to regional health information organizations to implement
    29  medical safety automation systems.
    30     (b)  Grants.--The medical safety automation program shall
    20070S0008B1089                  - 3 -     

     1  provide grants to health care providers and regional medical
     2  safety automation organizations for the following:
     3         (1)  Purchase of health information or telecommunications
     4     technology necessary to create an interoperable and
     5     integrated medical safety automation system.
     6         (2)  Payment of costs and expenses associated with
     7     preparation of plans, specifications, studies and surveys
     8     necessary to determine the scope of a medical safety
     9     automation system and the practicality and effectiveness of
    10     its use.
    11         (3)  Training of physicians and personnel in the use of a
    12     medical safety automation system.
    13     (c)  Standards.--A health care provider or regional health
    14  information organization must comply with standards adopted by
    15  the Federal Office of the National Coordinator for Health
    16  Information Technology, including all standards relating to
    17  interoperability. A health care provider or regional health
    18  information organization that is in compliance with the
    19  standards of the Office of the National Coordinator for Health
    20  Information Technology shall be eligible to receive a grant
    21  under this act.
    22     (d)  Formula.--The department shall develop a methodology to
    23  determine the grant amount to be awarded. For a hospital health
    24  care provider that is a hospital, the methodology shall take
    25  into account the number of medical assistance days as a
    26  percentage of total inpatient days based on the most recent
    27  available data, the financial need of the hospital based on net
    28  patient revenue and other factors as determined by the
    29  department. The department shall develop a similar methodology
    30  for other health care providers.
    20070S0008B1089                  - 4 -     

     1     (e)  Limitation.--The amount of a grant to any specific
     2  health care provider or regional medical safety automation
     3  organization under this program shall not exceed $1,000,000. No
     4  less than 60% of available funds shall be used for grants to
     5  health care providers in counties of the fourth, fifth, sixth,
     6  seventh or eighth class.
     7     (f)  Matching funds.--An applicant for a grant under this
     8  section shall provide matching funds in the amount of 100% of
     9  the amount of the grant. If the applicant is a community-based
    10  health care provider, the applicant shall provide matching funds
    11  in the amount of 50% of the amount of the grant.
    12     (g)  Term.--A grant under this section shall be for a term
    13  not to exceed two years.
    14  Section 4.  Fund.
    15     A restricted receipt account is hereby established in the
    16  State Treasury to be known as the Medical Safety Automation
    17  Fund. The following shall be deposited into the fund:
    18         (1)  Money appropriated to the fund by the General
    19     Assembly.
    20         (2)  Earnings derived from the investment of the money in
    21     the account, after deducting investment expenses.
    22  Section 5.  Eligibility.
    23     In order to be eligible for a grant under this act, a health
    24  care provider must provide medically necessary services to
    25  individuals regardless of the individual's ability to pay for
    26  the services and must be a participating provider with the
    27  Department of Public Welfare of services to individuals eligible
    28  for medical assistance.
    29  Section 6.  Application.
    30     (a)  Submission.--In order to be eligible to receive a grant
    20070S0008B1089                  - 5 -     

     1  under this act, a health care provider or regional medical
     2  safety automation organization shall submit an application in a
     3  form and manner prescribed by the department.
     4     (b)  Requirements.--An application submitted under subsection
     5  (a) shall set forth the manner in which the medical safety
     6  automation system will do the following:
     7         (1)  Protect privacy and security of health information.
     8         (2)  Maintain and provide permitted access to health
     9     information in an electronic format.
    10         (3)  Ensure compliance with standards adopted by the
    11     department and the Office of the National Coordinator for
    12     Health Information Technology.
    13         (4)  Improve health care quality, reduce health care
    14     costs resulting from inefficiency, medical errors,
    15     inappropriate care and incomplete information and advance the
    16     delivery of patient-centered medical care.
    17         (5)  Ensure interoperability with other systems and
    18     health care providers.
    19         (6)  Improve the coordination of care and information
    20     among health care providers, health insurers and other
    21     entities through an effective infrastructure for the secure
    22     and authorized exchange of health care information.
    23         (7)  Improve public health reporting and facilitate the
    24     early identification and rapid response to public health
    25     threats and emergencies, including bioterror events and
    26     infectious disease outbreaks.
    27         (8)  Facilitate health research.
    28         (9)  Promote prevention of chronic diseases.
    29         (10)  Provide for consumer access to personal medical
    30     information.
    20070S0008B1089                  - 6 -     

     1     (c)  Additional information.--In addition to the application
     2  the applicant shall provide:
     3         (1)  A feasibility study of the proposed medical safety
     4     automation system.
     5         (2)  A business or financial plan that describes the
     6     long-term sustainability, financial cost to the applicant and
     7     the proposed benefits of the plan.
     8         (3)  A strategic plan and schedule for the development
     9     and implementation of the medical safety automation system.
    10  Section 7.  Accountability.
    11     (a)  Information required.--Within one year of receipt of a
    12  grant under this act, the recipient shall provide the following
    13  to the department:
    14         (1)  A report on the status of the strategic plan and the
    15     development of the medical safety automation system.
    16         (2)  An accounting of the expenditure of funds from the
    17     grant and all funds received from other sources.
    18         (3)  A report on any reductions in medical errors,
    19     increases in efficiency and advances in the delivery of
    20     patient-centered medical care.
    21     (b)  Annual report.--The department shall submit an annual
    22  report to the chairman and minority chairman of the Public
    23  Health and Welfare Committee of the Senate and the chairman and
    24  minority chairman of the Health and Human Services Committee of
    25  the House of Representatives which shall include the number and
    26  amount of grants awarded, a description of each medical safety
    27  automation system being funded, the impact on the delivery of
    28  medical care and the total amount of funds spent.
    29  Section 8.  Duties of department.
    30     The department shall:
    20070S0008B1089                  - 7 -     

     1         (1)  Administer the medical safety automation program and
     2     award grants from the fund.
     3         (2)  Facilitate the adoption and implementation of a
     4     Statewide interoperable medical safety automation system
     5     among all health care providers, health insurers and
     6     consumers.
     7         (3)  Distribute grants among all geographic areas of this
     8     Commonwealth.
     9         (4)  Adopt standards for a medical safety automation
    10     system that are consistent with those developed by the Office
    11     of the National Coordinator for Health Information Technology
    12     and approved by the Secretary of the Department of Health and
    13     Human Services.
    14         (5)  Within 90 days of the effective date of this act,
    15     develop and provide an application form consistent with
    16     section 6.
    17         (6)  Ensure that health information technology policy and
    18     programs of the department are coordinated with the
    19     Department of Public Welfare and other executive branch
    20     agencies and Federal agencies to implement a medical safety
    21     automation system for all health care-related programs
    22     administered by the Commonwealth.
    23         (7)  Share all data relating to the use of medical safety
    24     automation systems with the Department of Public Welfare, the
    25     Health Care Cost Containment Council, the Patient Safety
    26     Authority and other State agencies. The Health Care Cost
    27     Containment Council and other State agencies shall share data
    28     obtained from medical safety automation systems with the
    29     department.
    30         (8)  Give preference to applications which provide
    20070S0008B1089                  - 8 -     

     1     regional medical safety automation systems that link multiple
     2     health care providers and which provide direct patient access
     3     to health care information.
     4         (9)  Audit grants awarded pursuant to this act to ensure
     5     that funds have been used in accordance with the terms and
     6     standards adopted by the department.
     7         (10)  Provide ongoing assessment of the benefits and
     8     costs of medical safety automation systems, to include
     9     information relating to reduction in medical errors,
    10     reduction in physician visits, economic impact, efficiencies
    11     experienced and other information.
    12         (11)  Develop a public information program to inform the
    13     public about the efficiency and safety advantages to be
    14     achieved by the adoption of medical safety automation
    15     systems.
    16  Section 9 20.  Effective date.                                    <--
    17     This act shall take effect in 60 days.

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