Honorable Robert Bunda

President of the Senate

Twenty-Second State Legislature

Regular Session of 2003

State of Hawaii

Sir:

Your Committee on Health, to which was referred S.B. No. 1356 entitled:

begs leave to report as follows:

The purpose of this measure is to streamline the process of registering death events in the State, redefine fetal death, and convert the recording of fetal deaths from a certificate-based system to a report-based system.

Testimony supporting this measure was received from the Department of Health. Healthcare Association of Hawaii, Queen's Medical Center, Kapiolani Health, Dodo Mortuary, Inc., and Hawaii Funeral Directors Association submitted testimony opposing this measure.

Your Committee finds that several of the provisions in this measure generally make the process of registering death events in the State more efficient. However, testimony received in opposition to this measure indicated that certain provisions transferred information gathering duties to the hospitals which would increase the financial burdens and possibly delay the process of registering death events in the State. Your Committee requested that the Department of Health and the hospitals collaborate on refining this measure. They produced a proposed draft of this measure, which your Committee finds acceptable and fulfills the intent of streamlining the process of registering death events in the State.

Your Committee has adopted the proposed draft and amended this measure by:

Your Committee affirmatively voted on this measure, as amended, on February 27, 2003. However, after that decision-making, your Committee was made aware of a related issue. Currently, Hawaii law does not allow a patient's spouse and relatives to access medical records without a power of attorney or similar instrument. This situation becomes more problematic when the patient is deceased. In addition, when the privacy provisions of the federal Health Insurance Portability and Accountability Act of 1996 (HIPAA) take effect, health care providers will not be allowed to provide any person access to the medical records of a patient without legal authorization.

A deceased individual's spouse or relative may require access to the medical records for death certificate, insurance, and other purposes, but may not have authority to access the records under existing Hawaii law without an acceptable legal instrument. In many cases, spouses and relatives do not possess such an instrument that extends beyond the death of the individual. A state "next of kin" statute will resolve that problem.

Therefore, your Committee reconsidered its previous decision making on this measure to reaffirm its previous amendments and to add provisions that statutorily allow a health care provider to release copies of a patient's medical records to the patient's next of kin, including the spouse and relatives, if the patient or the patient's attorney is unable to do so. A health care provider may decide to not release the medical records if it would not be in the best interest of the individual.

As affirmed by the record of votes of the members of your Committee on Health that is attached to this report, your Committee is in accord with the intent and purpose of S.B. No. 1356, as amended herein, and recommends that it pass Second Reading in the form attached hereto as S.B. No. 1356, S.D. 1, and be placed on the calendar for Third Reading.