HIPAA Progress HIPAA Progress in thein the

State of CaliforniaState of California

National Governors Association

Burt Cohen, Acting Director

Office of HIPAA Implementation

Health & Human Services Agency

April 3, 2003

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!

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

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.

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.

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.

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.

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.

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.

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

Beware of the Five Stages of HIPAA Shock

Denial Stalling Whining Trying to pass it off Panic

The Stages to HIPAA Results

Awareness Commitment Building a Team Productivity Communication

Five Standard Steps of a Project

Initiation (awareness) Initial assessment

(inventory) Project plan Detailed assessment

(gap analysis) Implementation

(remediation) and testing