Added by Stats. 1995, Ch. 415, Sec. 9. Effective January 1, 1996.
This chapter shall be known as the Health Data and Advisory Council Consolidation Act.
California Health and Safety Code — §§ 128675-128810
Added by Stats. 1995, Ch. 415, Sec. 9. Effective January 1, 1996.
This chapter shall be known as the Health Data and Advisory Council Consolidation Act.
Amended by Stats. 2011, Ch. 32, Sec. 20. (AB 106) Effective June 29, 2011. Operative January 1, 2012, by Sec. 73 of Stats. 2011, Ch. 32.
The Legislature hereby finds and declares that:
state agency. It is the further intent of the Legislature that the single state agency only collect that data from health facilities that are essential. The data should be collected, to the extent practical on consolidated, multipurpose report forms for use by all state agencies.
data items. However, the office shall neither add nor delete data items to the Hospital Discharge Abstract Data Record or the quarterly reports without prior authorizing legislation, unless specifically required by federal law or judicial decision.
Added by Stats. 1995, Ch. 415, Sec. 9. Effective January 1, 1996.
Intermediate care facilities/developmentally disabled-habilitative, as defined in subdivision (e) of Section 1250, are not subject to this chapter.
Amended by Stats. 2021, Ch. 143, Sec. 195. (AB 133) Effective July 27, 2021.
Intermediate care facilities/developmentally disabled—nursing, as defined in subdivision (h) of Section 1250, and intermediate care facilities/developmentally disabled-continuous nursing, as defined in subdivision (m) of Section 1250, are not subject to this chapter.
Amended by Stats. 2021, Ch. 143, Sec. 196. (AB 133) Effective July 27, 2021.
As used in this chapter, the following terms mean:
assessing and treating the condition of the patient at a given contact and exercises
independent judgment in the care of the patient.
Amended by Stats. 2021, Ch. 143, Sec. 197. (AB 133) Effective July 27, 2021.
On and after January 1, 1986, any reference in this code to the Advisory Health Council or the California Health Policy and Data Advisory Commission shall be deemed a reference to the department.
Amended by Stats. 2021, Ch. 143, Sec. 198. (AB 133) Effective July 27, 2021.
128737 shall be made available to the State Department of Health Care Services, the State Department of Public Health, and the California Health Benefit Exchange. The departments and the Exchange shall ensure that the patient’s rights to confidentiality shall not be violated in any manner. The departments and the Exchange shall comply with all applicable policies and requirements involving review and oversight by the State Committee for the Protection of Human Subjects.
legislation, unless specifically required by federal law or regulation or judicial decision.
Amended by Stats. 2021, Ch. 143, Sec. 199. (AB 133) Effective July 27, 2021.
facility, and any other information requested by the department. If goods, fees, and services collectively worth ten thousand dollars ($10,000) or more per year are delivered to the skilled nursing facility, the disclosure required pursuant to this subdivision shall include the related party’s profit and loss statement, and the Payroll-Based Journal public use data of the previous quarter for the skilled nursing facility’s direct caregivers.
related party for the most recent year available.
department.
Amended by Stats. 2022, Ch. 28, Sec. 108. (SB 1380) Effective January 1, 2023.
prepared using the accrual basis. If the organization has prepared an audit by a certified public accountant of its annual consolidated financial report for any reason, that audit shall be filed with the office, and, in that instance, no review of the consolidated financial report shall be necessary. The reviewed or audited report, as applicable, shall, in addition to the requirements set forth in Section 128735, include, but not be limited to, the following statements:
addition to the consolidated financial report, the following information shall be provided to the office as an attachment to the consolidated financial report:
facility, or supply to the skilled nursing facility.
(ii) Unrelated parties that provide services, facilities, or supplies to the skilled nursing facility or facilities that are operated, conducted, owned, managed, or maintained by the organization, including, but not limited to, management companies and property companies, and that are paid more than two hundred thousand dollars ($200,000) by the skilled nursing facility.
Section 7922.505 of the Government Code and is subject to disclosure pursuant to the California Public Records Act (Division 10 (commencing with Section 7920.000) of Title 1 of the Government Code).
and insurance services; providers of supplies and equipment; financial advisors and consultants; banking and financial entities; any and all parent companies, holding companies, and sister organizations; and any entity in which an immediate family member of an owner of those organizations has an ownership interest of 5 percent or more. “Immediate family member” includes spouse, natural parent, child, sibling, adopted child, adoptive parent, stepparent, stepchild, stepsister, stepbrother, father-in-law, mother-in-law, sister-in-law, brother-in-law, son-in-law, daughter-in-law, grandparent, and grandchild.
in subparagraph (B) of paragraph (3) of subdivision (a). This section shall not be construed to require a government entity licenseholder, that is not a related party, to file a consolidated financial report for a nursing home management company that operates under its license.
Amended by Stats. 2022, Ch. 28, Sec. 109. (SB 1380) Effective January 1, 2023.
An organization that operates, conducts, owns, or maintains a health facility, and the officers thereof, shall make and file with the department, at the times as the department shall require, all of the following reports on forms specified by the department that are in accord, if applicable, with the systems of accounting and uniform reporting required by this part, except that the reports required pursuant to subdivision (g) shall be limited to hospitals:
for the annual fiscal period, and a statement of ancillary utilization and patient census.
revenue from associated comprehensive group practice prepayment health care service plans and that is operated as a unit of a coordinated group of health facilities under
common management may report the information required pursuant to subdivisions (a) and (d) for the group and not for each separately licensed health facility.
Section 128738.
Amended by Stats. 2023, Ch. 131, Sec. 132. (AB 1754) Effective January 1, 2024.
record.
not be violated in any manner. Patient social security numbers and any other data elements that the department believes could be used to determine the identity of an individual patient shall be exempt from the disclosure requirements of the California Public Records Act (Division 10 (commencing with Section 7920.000) of Title 1 of the Government Code).
2004.
Amended by Stats. 2022, Ch. 28, Sec. 111. (SB 1380) Effective January 1, 2023.
the requirements of subdivision (a).
Amended by Stats. 2021, Ch. 143, Sec. 203. (AB 133) Effective July 27, 2021.
of data.
Amended by Stats. 2023, Ch. 6, Sec. 2. (AB 112) Effective May 15, 2023.
staffed beds.
commercial coverage, other third parties, and other payers.
payer, including, but not limited to, Medicare, Medi-Cal, county indigent programs,
commercial coverage, other third parties, self-pay, and other payers.
Amended by Stats. 2022, Ch. 28, Sec. 112. (SB 1380) Effective January 1, 2023.
Reports for subsequent years shall include conditions and procedures and cover periods as appropriate.
subdivision (a) shall be divided among medical, surgical, and obstetric conditions or procedures and shall be selected by the department. The department shall publish the risk-adjusted outcome reports for selected conditions and procedures by individual hospital, individual medical group, or individual physician as selected by the department in consultation with medical specialists in the relevant area of practice. The selections, under this subdivision, shall be in accordance with all of the following criteria:
relative importance of the procedure and condition in terms of the cost of cases and the number of cases and the seriousness of the health consequences of the procedure or condition.
department shall publish at least one risk-adjusted outcome report for coronary artery bypass graft surgery, transcatheter aortic valve replacement, or any type of interventional cardiovascular procedure for procedures performed in the state. For any type of interventional cardiovascular procedure other than coronary artery bypass graft surgery or transcatheter aortic valve replacement, the department shall only select from interventional cardiovascular procedures recommended by the clinical panel established by Section 128748, not to exceed one additional interventional cardiovascular procedure every three years. In each year, the reports shall compare risk-adjusted outcomes by hospital, medical group, or physician as selected by the department after consultation with the clinical panel. Upon the recommendation of the clinical panel based on statistical and technical considerations, information on
individual hospitals, individual medical groups, or individual physicians may be excluded from the reports.
Surgeons’ database, or other relevant databases, the following factors shall be considered:
this subdivision for which auditing is appropriate, the department shall conduct periodic auditing of data at hospitals.
Amended by Stats. 2021, Ch. 143, Sec. 206. (AB 133) Effective July 27, 2021.
Commencing July 1, 2002, and biennially thereafter, the department shall evaluate the impact of the department’s published risk-adjusted outcome reports required by Section 128745 on mortality rates in California and on any other measure of quality the department deems appropriate. The department shall also coordinate with other state agencies in promoting prevention and educational initiatives on those reported procedures and conditions.
Amended by Stats. 2021, Ch. 143, Sec. 207. (AB 133) Effective July 27, 2021.
department. In the event that the department finds any errors, omissions, discrepancies, or other problems with submitted data, the department shall contact either the hospital or physician’s office that maintains the data to resolve the problems.
an individual physician or an individual medical group authorized by subdivision (b) of Section 128745, the department director shall appoint a clinical panel, which shall have nine members. Three members shall be appointed from a list of three or more names submitted by the physician specialty society that most represents physicians performing the medical, surgical, and obstetric procedure for which data is collected. Three members shall be appointed from a list of three or more names submitted by the California Medical Association. Three members shall be appointed from lists of names submitted by consumer organizations. At least one-half of the appointees from the lists submitted by the physician specialty society and the California Medical Association, and at least one appointee from the lists submitted by consumer organizations, shall be experts in collecting and reporting outcome measurements
for physicians, medical groups, or hospitals. The panel may include physicians from another state. The panel shall review and approve the development of the risk-adjustment model to be used in preparation of the outcome report.
panel. Three members shall be appointed from a list of three or more names submitted by the California Chapter of the American College of
Cardiology. Three members shall be appointed from a list of three or more names submitted by the California Medical Association. Three members shall be appointed from lists of names submitted by consumer organizations. Any additional members shall be appointed at the discretion of the department director. If, at the time the department decides to report on a procedure, the panel does not have members with expertise in that procedure, the department shall seek to appoint two new members with expertise in that procedure from a list submitted by the California Chapter of the American College of Cardiology. At least one-half of the appointees from the lists submitted by the California Chapter of the American College of Cardiology, and the California Medical Association, and at least one appointee from the lists submitted by consumer organizations, shall be experts in collecting and reporting
outcome measurements. The panel may include physicians from another state.
their duties as members of the clinical panel.
Amended by Stats. 2021, Ch. 143, Sec. 208. (AB 133) Effective July 27, 2021.
has submitted a statement shall be displayed wherever the report presents outcome scores for the hospital.
the outcomes do not accurately reflect the quality of care provided by the physician or medical group.
is made, the report using that risk-adjustment model shall not be issued until the flaw is corrected.
the physician or medical group or the hospital of the physician or medical group redacted, or shall adopt other means to ensure the physician or medical group’s identity is not revealed to the panel. The clinical panel shall promptly review the statement and the conclusion of the office and shall respond by either upholding the conclusion or reaching one of the other conclusions set forth in this subdivision. The panel decision shall be the final determination regarding the statement. The process set forth in this subdivision shall be completed within 60 days from the date the department sends the report to each physician or medical group included in the report. If a decision by either the department or the clinical panel cannot be reached within the 60-day period, then the outcome report may be issued but shall not include data for the physician or medical group submitting the statement.
addition of data elements to the discharge abstract should take into consideration the technical feasibility of developing reliable risk-adjustment factors for additional procedures and conditions as determined by the department with the advice of the research community, physicians and surgeons, hospitals, consumer or patient advocacy groups, and medical records personnel.
Amended by Stats. 2021, Ch. 143, Sec. 209. (AB 133) Effective July 27, 2021.
put in suspense, the facility shall file the reports required by subdivisions (a), (b), (c), and (d) of Section 128735 within two months after the last day of active licensure.
approved by the department. The department shall approve or reject each report within 15 days of receiving it. If a report does not meet the standards established by the department, it shall not be approved as filed and shall be rejected. The report shall be considered not filed as of the date the facility is notified that the report is rejected. A report shall be available from the department no later than 15 days after the date that the report is approved.
it. If a report does not meet the standards established by the department, it shall not be approved as filed and shall be rejected. The report shall be considered not filed as of the date the facility is notified that the report is rejected. A report shall be available from the department no later than 15 days after the date that the report is approved.
be rejected. The report shall be considered not filed as of the date the facility is notified that the report is rejected. A report shall be available from the department no later than 15 days after the report is approved.
the report is rejected. A report shall be available from the department no later than 15 days after the report is approved.
128730 shall be filed with the department on the dates required by applicable law and shall be available from the department no later than six months after the date that the report was filed.
department shall make the reports available at cost.
Amended by Stats. 2021, Ch. 143, Sec. 210. (AB 133) Effective July 27, 2021.
services rendered by health facilities.
discharge data items not specified pursuant to Section 128735.
ability to process the data or interfere with the purposes of this chapter. The modification authority shall not permit the department to require administratively the reporting of ambulatory surgery data items not specified in subdivision (a) of Section 128737.
Amended by Stats. 2021, Ch. 143, Sec. 211. (AB 133) Effective July 27, 2021.
that shall include, but not be limited to, a discussion of findings, conclusions, and trends concerning the overall quality of medical outcomes, including a comparison to reports from prior years, for the procedure or condition studied by the report. The department shall disseminate the reports as widely as practical to interested parties, including, but not limited to, hospitals, providers, the media, purchasers of health care, consumer or patient advocacy groups, and individual consumers. The reports shall be posted on the department’s internet website.
hearing, investigation, or other proceeding held, made, or taken by any state, county, or local governmental agency, board, or commission that participates as a purchaser of health facility services pursuant to the provisions of a publicly financed state or federal health care program. Each of these state, county, or local governmental agencies, boards, and commissions shall weigh and consider the reports made available to it pursuant to this subdivision in its formulation and implementation of policies, regulations, or procedures regarding reimbursement methods and rates in the administration of these publicly financed programs.
shall include summaries of observation services data, in a format prescribed by the department. The summaries shall be posted on the department’s internet website. The department may initiate and conduct studies as it determines will advance the purposes of this chapter.
Amended by Stats. 2021, Ch. 143, Sec. 212. (AB 133) Effective July 27, 2021.
Health Resources and Services Administration, the Indian Health Service, Tribal Epidemiology Centers, which are defined as public health authorities pursuant to the federal Indian Health Care Improvement Act (25 U.S.C. Sec. 1601 et seq.), the National Institutes of Health, or the National Cancer Institute, or the Veterans Health Care Administration within the United States Department of Veterans Affairs, for the purposes of conducting a statutorily authorized activity. All disclosures made pursuant to this section shall be consistent with the standards and limitations applicable to the disclosure of limited data sets as provided in Section 164.514 of Part 164 of Title 45 of the Code of Federal Regulations, relating to the privacy of health information.
disclose that information to any person or entity, except in response to a court order, search warrant, or subpoena, or as otherwise required or permitted by the federal medical privacy regulations contained in Parts 160 and 164 of Title 45 of the Code of Federal Regulations. In no case shall a hospital, contractor, or subcontractor reidentify or attempt to reidentify any information received pursuant to this section.
Amended by Stats. 2021, Ch. 143, Sec. 213. (AB 133) Effective July 27, 2021.
($5,000).
Amended by Stats. 2021, Ch. 143, Sec. 214. (AB 133) Effective July 27, 2021.
department, the hearing shall be held in accordance with any procedures as the office shall prescribe. If held before an administrative law judge employed by the Office of Administrative Hearings, the hearing shall be held in accordance with Chapter 5 (commencing with Section 11500) of Part 1 of Division 3 of Title 2 of the Government Code. The employee or administrative law judge shall prepare a recommended decision including findings of fact and conclusions of law and present it to the department for its adoption. The decision of the department shall be in writing and shall be final. The decision of the department shall be made within 60 calendar days after the conclusion of the hearing and shall be effective upon filing and service upon the petitioner.
by any party to the proceedings as provided in Section 1094.5 of the Code of Civil Procedure. The decision of the department shall be upheld against a claim that its findings are not supported by the evidence unless the court determines that the findings are not supported by substantial evidence.
Added by Stats. 1995, Ch. 415, Sec. 9. Effective January 1, 1996.
Notwithstanding any other provision of law, the disclosure aspects of this chapter shall be deemed complete with respect to district hospitals, and no district hospital shall be required to report or disclose any additional financial or utilization data to any person or other entity except as is required by this chapter.
Amended by Stats. 2021, Ch. 143, Sec. 215. (AB 133) Effective July 27, 2021.
Notwithstanding any other provision of law, upon the request of a small and rural hospital, as defined in Section 124840, the department shall do all of the following:
department shall, on a case-by-case basis, do one of the following:
software to create an electronic file of patient discharge abstract data records. The program or software shall incorporate validity checks and edit standards.
that the reports required by subdivision (a) of Section 128737 be filed by online transmission. The assistance shall include the provision to the hospital by the department of a computer program or computer software to create an electronic file of ambulatory surgery data records. The program or software shall incorporate validity checks and edit standards.
Amended by Stats. 2021, Ch. 143, Sec. 216. (AB 133) Effective July 27, 2021.
On January 1, 1986, all regulations previously adopted by the California Health Facilities Commission that relate to functions vested in the department and that are in effect on that date, shall remain in effect and shall be fully enforceable to the extent that they are consistent with this chapter, as determined by the department, unless and until readopted, amended, or repealed by the department.
Amended by Stats. 2021, Ch. 143, Sec. 217. (AB 133) Effective July 27, 2021.
Pursuant to Section 16304.9 of the Government Code, the Controller shall transfer to the department the unexpended balance of funds as of January 1, 1986, in the California Health Facilities Commission Fund, available for use in connection with the performance of the functions of the California Health Facilities Commission to which it has succeeded pursuant to this chapter.
Amended by Stats. 2021, Ch. 143, Sec. 218. (AB 133) Effective July 27, 2021.
All officers and employees of the California Health Facilities Commission who, on December 31, 1985, are serving the state civil service, other than as temporary employees, and engaged in the performance of a function vested in the department by this chapter shall be transferred to the department. The status, positions, and rights of persons shall not be affected by the transfer and shall be retained by them as officers and employees of the department, pursuant to the State Civil Service Act except as to positions exempted from civil service.
Amended by Stats. 2021, Ch. 143, Sec. 219. (AB 133) Effective July 27, 2021.
The department shall have possession and control of all records, papers, offices, equipment, supplies, moneys, funds, appropriations, land, or other property, real or personal, held for the benefit or use of the California Health Facilities Commission for the performance of functions transferred to the department by this chapter.
Amended by Stats. 2021, Ch. 143, Sec. 220. (AB 133) Effective July 27, 2021.
The department may enter into agreements and contracts with any person, department, agency, corporation, or legal entity as are necessary to carry out the functions vested in the department by this chapter or any other law.
Amended by Stats. 2021, Ch. 143, Sec. 221. (AB 133) Effective July 27, 2021.
The department shall administer this chapter and shall make all regulations necessary to implement the provisions and achieve the purposes stated herein.