Download 040203HIPAA_COHEN - National Governors Association

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
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