MISSISSIPPI LEGISLATURE
2010 Regular Session
To: Public Health and Welfare
By: Senator(s) Bryan
AN ACT TO BE KNOWN AS THE HEALTH INFORMATION TECHNOLOGY ACT; TO REQUIRE ALL AGENCIES OF THE STATE ENGAGED IN THE DELIVERY OR PROVISION OF HEALTH INFORMATION TECHNOLOGY SERVICES TO COORDINATE BETWEEN THE SEVERAL STATE AGENCIES, WITH PRIVATE NONPROFIT CORPORATIONS, AND WITH FEDERALLY FUNDED AGENCIES TO PREVENT UNNECESSARY DUPLICATION, WASTEFUL EXPENDITURES OF STATE FUNDS; TO ENCOURAGE THE DEVELOPMENT OF AN INTEROPERATIVE STATEWIDE SYSTEM OF HEALTH INFORMATION TECHNOLOGY; TO REQUIRE STATE AGENCIES, BEFORE ACQUIRING ANY HEALTH INFORMATION TECHNOLOGY SYSTEM, TO CONDUCT A SURVEY OF ALL HEALTH INFORMATION TECHNOLOGY SYSTEMS WITHIN THE GEOGRAPHIC AREA FOR WHICH THE SERVICE IS INTENDED, AND ANALYZE THE BENEFITS OF USING EXISTING PROVIDERS; TO REQUIRE THE DEPARTMENT OF INFORMATION TECHNOLOGY SERVICES TO REVIEW AND APPROVE THE ACQUISITION OF ALL HEALTH INFORMATION TECHNOLOGY SERVICES BEFORE THE RELEASE OF REQUESTS FOR PROPOSALS OR THE EXECUTION OF CONTRACTS FOR THAT ACQUISITION; TO PROVIDE THAT THE DEPARTMENT SHALL NOT GRANT APPROVAL FOR THE ACQUISITION OF HEALTH INFORMATION TECHNOLOGY SYSTEMS UNLESS ALL REASONABLE EFFORTS HAVE BEEN MADE BY THE AGENCY TO USE THE RESOURCES OF EXISTING SYSTEMS; TO AMEND SECTION 25-53-1, MISSISSIPPI CODE OF 1972, TO SPECIFICALLY INCLUDE ELECTRONIC HEALTH RECORDS, TELEMEDICINE, ELECTRONIC PRESCRIBING AND OTHER FORMS OF HEALTH INFORMATION TECHNOLOGY AS INFORMATION TECHNOLOGY AND SERVICES FOR THE PURPOSES OF THE DEPARTMENT OF INFORMATION TECHNOLOGY SERVICES LAWS; TO AMEND SECTION 25-53-3, MISSISSIPPI CODE OF 1972, TO SPECIFICALLY INCLUDE HEALTH INFORMATION TECHNOLOGY SYSTEMS IN THE DEFINITION OF COMPUTER EQUIPMENT OR SERVICES FOR THE PURPOSES OF THE DEPARTMENT OF INFORMATION TECHNOLOGY SERVICES LAWS; TO AMEND SECTION 25-53-5, MISSISSIPPI CODE OF 1972, TO SPECIFICALLY INCLUDE HEALTH INFORMATION TECHNOLOGY SYSTEMS IN THE TYPES OF INFORMATION SYSTEMS INSTALLED OR USED BY STATE AGENCIES FOR WHICH THE DEPARTMENT IS REQUIRED TO PROVIDE FOR MAXIMUM COMPATIBILITY AMONG THE SYSTEMS; TO AMEND SECTION 25-53-109, MISSISSIPPI CODE OF 1972, TO REQUIRE APPROVAL BY THE DEPARTMENT OF THE ACQUISITION OF HEALTH INFORMATION TECHNOLOGY SYSTEMS BY STATE AGENCIES; AND FOR RELATED PURPOSES.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MISSISSIPPI:
SECTION 1. This act shall be known and may be cited as the "Health Information Technology Act."
SECTION 2. The State of Mississippi has great need to reduce chronic diseases such as hypertension, heart disease, and diabetes among its residents. Because medical resources of the state are limited, particularly within the more rural areas of the state, every opportunity must be used to maximize access to adequate health care. Compounding this problem, the number of physicians engaged in the practice of providing primary care in the rural areas of the state will likely continue to decline for the foreseeable future. This continued inadequate access to primary health care will have a profound effect on the public health, education, and economy of the state unless meaningful interventions are implemented. Interoperable health information technology systems can improve individual patient care in numerous ways, including: complete, accurate, and searchable health information that is available at the point of diagnosis and care, allowing for more informed decision making to enhance the quality and reliability of health care delivery; more efficient and convenient delivery of care, without having to wait for the exchange of records or paperwork and without requiring unnecessary or repetitive tests or procedures; earlier diagnosis and characterization of disease, with the potential to thereby improve outcomes and reduce costs; reductions in adverse events through an improved understanding of each patient's particular medical history, and reduced potential for drug-drug interactions. Moreover, Congress has mandated a fully interoperable electronic medical records system though a system of rewards for health care providers achieving meaningful use. Through the enactment of the Health Information Technology Act, the Legislature expresses its intent that the several agencies of the state shall work together, along with private nonprofit and federally funded entities to create a system through which the citizens of the state may benefit from a fully interoperable health information technology network. It is also the specific intent of the Legislature that the several state agencies use existing systems and programs whenever possible, to ensure a fully interoperable statewide system and to eliminate duplication and wasteful expenditure of state funds.
SECTION 3. For the purposes of this act, the following terms shall be defined as provided in this section:
(a) "Telehealth" means the use of telecommunication equipment and computing technology to support long-distance clinical health care, patient and professional health-related education, public health concerns, and health care administration.
(b) "Telemedicine" means long-distance clinical health care, including practitioner-to-patient meetings, practitioner-to-practitioner discussions and exchange of clinical information via technology.
(c) "Electronic health records" or "EHR" means electronically maintained clinical and demographic information, used by a meaningful EHR user, about an individual patient's health history, including medications, lab tests and results, procedures, diagnoses, physician and hospital encounters, and all information related to a patient's medical record.
(d) "Health information technology" or "HIT" means the equipment and networks to be used by a meaningful EHR user and needed to provide telehealth, telemedicine and bioinformatics, including electronic health records and the technology that supports those records.
(e) "Acquisition" of HIT systems or other computer or telecommunications equipment or services means the purchase, lease, rental, or acquisition in any other manner of HIT systems or any other computer or telecommunications equipment or services.
(f) "Meaningful EHR user" means an eligible professional or eligible hospital that, during the specified reporting period, demonstrates meaningful use of certified EHR technology in a form and manner consistent with certain objectives and measures presented in applicable federal regulations. These objectives and measures shall include use of certified EHR technology in a manner that improves quality, safety, and efficiency of health care delivery, reduces health care disparities, engages patients and families, improves care coordination, improves population and public health, and ensures adequate privacy and security protections for personal health information.
(g) "Geographic area" means the area to be served by the proposed HIT service. Due to the complexity and nature of HIT services, existing providers in areas adjacent to the geographic area, or providers engaged in similar HIT services on a statewide basis shall be included in the agency's required analysis as set forth in Section 4 of this act.
(h) "Department" means the Mississippi Department of Technology Services.
(i) "Agency" means and includes all the various state agencies, officers, departments, boards, commissions, offices and institutions of the state, but does not include any agency financed entirely by federal funds.
SECTION 4. (1) Before the acquisition of any HIT system, an agency shall conduct a survey of all HIT systems within the geographic area for which the service is intended. Failure to materially comply with the provisions of this section shall constitute grounds for the setting aside, by a court of competent jurisdiction, any contract issued by an agency.
(2) The survey shall include a written report to be prominently posted on the agency's Web site for a period of not less than thirty (30) days before the issuance of any request for proposals, the execution of contracts, or any other measure that might be required by law or regulation for the acquisition of the HIT system.
(3) The survey shall, at a minimum, include the following:
(a) The description, purpose, and intent of the proposed service or system; and
(b) The name, location, and specific nature of all existing HIT providers within the geographic area to be served; and
(c) The extent to which existing entities can be used to provide the proposed service, in whole or in part, including letters of commitment, memoranda of agreement, or other supporting documentation; or
(d) The absence of support from existing providers, including the name and location of all those providers contacted, written response from the providers setting out the reasons for the inability to participate in the proposed service, or certification by the agency that no provider of HIT services exists within the geographic area to be served.
(4) The agency proposing to provide HIT services shall analyze the benefits of using existing providers and reduce the analysis to a final written report. The report shall be published on the agency's Web site, submitted as a part of its request for approval from the department, and provided via United States mail, 1st class postage paid, to all HIT providers within the geographic area proposed to be served.
SECTION 5. (1) In addition to the approval requirements set forth in Section 25-53-115, the department shall review and approve, in writing, the acquisition of all HIT systems before the release of requests for proposals, or the execution of contracts for that acquisition. The department shall review applications from requesting agencies using, at a minimum, the standards set forth in Section 4 of this act.
(2) The department shall not grant approval for the acquisition of HIT systems unless all reasonable efforts have been made by the agency to use the resources of existing systems. If proposed systems are not able to take advantage of existing systems, then the proposed systems must be capable of fully integrating with existing systems, unless the intent of the proposed system is to fully replace the existing system.
SECTION 6. Section 25-53-1, Mississippi Code of 1972, is amended as follows:
25-53-1. The Legislature * * * recognizes that in order for the State of Mississippi to receive the maximum use and benefit from information technology and services, specifically including, but not limited to, the creation and deployment of electronic health records, telemedicine services, electronic prescribing, and all other forms of health information technology, now in operation or which will in the future be placed in operation, there should be full cooperation and cohesive planning and effort by and between the several state agencies and that it is the responsibility of the * * * Legislature to provide statutory authority therefor. The Legislature, therefore, declares and determines that for these and other related purposes there is * * * established an agency of state government to be known as the Mississippi Department of Information Technology Services (MDITS).
SECTION 7. Section 25-53-3, Mississippi Code of 1972, is amended as follows:
25-53-3. (1) Whenever the term "Central Data Processing Authority" or the term "authority," when referring to the Central Data Processing Authority, is used in any law, rule, regulation, document or elsewhere, it shall be construed to mean the Mississippi Department of Information Technology Services.
(2) For the purposes of this chapter, the following terms shall have the meanings ascribed in this section unless the context otherwise requires:
(a) "Central Data Processing Authority" and "CDPA" mean "Mississippi Department of Information Technology Services (MDITS)" and the term "authority" means "board of the MDITS."
(b) "Bureau of Systems Policy and Planning," "Bureau of Telecommunications," "Bureau of Central Data Processing" and "bureau" mean "Mississippi Department of Information Technology Services."
(c) "Computer equipment or services" means any information technology, computer or computer related telecommunications equipment, electronic word processing and office systems, or services used in connection therewith, including, but not limited to, all phases of computer software and consulting services, health information technology systems, and insurance on all state-owned computer equipment.
(d) "Acquisition" of computer or telecommunications equipment or services means the purchase, lease, rental, or acquisition in any other manner of any such computer or telecommunications equipment or services.
(e) "Agency" means and includes all the various state agencies, officers, departments, boards, commissions, offices and institutions of the state but does not include any agency financed entirely by federal funds.
(f) "Governing authority" means boards of supervisors, governing boards of all school districts, all boards of directors of public water supply districts, boards of directors of master public water supply districts, municipal public utility commissions, governing authorities of all municipalities, port authorities, commissioners and boards of trustees of any public hospitals and any political subdivision of the state supported wholly or in part by public funds of the state or political subdivisions thereof.
(g) "Bid" means any of the valid source selection techniques and competitive procurement methods appropriate to information technology procurement in the public sector, including but not limited to, competitive sealed bidding, competitive sealed proposals, simplified small purchase procedures, sole source procurements, and emergency procurements.
(h) "Telecommunications transmission facility" means any transmission medium, switch, instrument, inside wiring system or other facility that is used, in whole or part, to provide any transmission.
(i) "Equipment support contract" means a contract that covers a single, specific class or classes of telecommunications equipment or service and all features associated with that class, through which state agencies may purchase or lease the item of equipment or service specified by issuing a purchase order under the terms of the contract without the necessity of further competitive bidding.
(j) "Inside wiring system" means any wiring that:
(i) Directly or indirectly, interconnects any terminal equipment with any other terminal equipment or with any regulated facility or common carrier services; and
(ii) Is located at the premises of the customer and is not inside any terminal equipment.
(k) "Procurement" means the selling, buying, purchasing, renting, leasing or otherwise obtaining telecommunications equipment, system or related services, as well as activities engaged in, resulting in or expected to result in selling, buying, purchasing, renting, leasing or otherwise obtaining telecommunications equipment.
(l) "Telecommunications equipment, systems, related services" are limited to the equipment and means to provide:
(i) Telecommunications transmission facilities.
(ii) Telephone systems, including voice processing systems.
(iii) Facsimile systems.
(iv) Radio paging services.
(v) Mobile telephone services, including cellular mobile telephone service.
(vi) Intercom and paging systems.
(vii) Video teleconferencing systems.
(viii) Personal communications networks and services.
(ix) Any and all systems based on emerging and future telecommunications technologies relative to (i) through (viii) above.
(m) "Telecommunications system lease contract" means a contract between a supplier of telecommunications systems, including equipment and related services, and the Mississippi Department of Information Technology Services through which telecommunications systems, including equipment and related services, may be leased for a term that shall not exceed sixty (60) months for a system lease valued less than One Million Dollars ($1,000,000.00) and shall not exceed one hundred twenty (120) months for a system lease valued One Million Dollars ($1,000,000.00) or more.
(n) "Tariffed or regulated service" means telecommunications service offered by common carriers and subject to control by the Mississippi Public Service Commission or the Federal Communications Commission.
SECTION 8. Section 25-53-5, Mississippi Code of 1972, is amended as follows:
25-53-5. The authority shall have the following powers, duties, and responsibilities:
(a) The authority shall provide for the development of plans for the efficient acquisition and utilization of computer equipment and services by all agencies of state government, and provide for their implementation. In so doing, the authority may use the MDITS' staff, at the discretion of the executive director of the authority, or the authority may contract for the services of qualified consulting firms in the field of information technology and utilize the service of such consultants as may be necessary for those purposes.
(b) The authority shall immediately institute procedures for carrying out the purposes of this chapter and supervise the efficient execution of the powers and duties of the office of executive director of the authority. In the execution of its functions under this chapter, the authority shall maintain as a paramount consideration the successful internal organization and operation of the several agencies so that efficiency existing therein shall not be adversely affected or impaired. In executing its functions in relation to the institutions of higher learning and junior colleges in the state, the authority shall take into consideration the special needs of those institutions in relation to the fields of teaching and scientific research.
(c) Title of whatever nature of all computer equipment now vested in any agency of the State of Mississippi is * * * vested in the authority, and no such equipment shall be disposed of in any manner except in accordance with the direction of the authority or under the provisions of such rules and regulations as may hereafter be adopted by the authority in relation thereto.
(d) The authority shall adopt rules, regulations, and procedures governing the acquisition of computer and telecommunications equipment and services that shall, to the fullest extent practicable, insure the maximum of competition between all manufacturers of supplies or equipment or services. In the writing of specifications, in the making of contracts relating to the acquisition of that equipment and services, and in the performance of its other duties, the authority shall provide for the maximum compatibility of all information systems, including health information technology systems, hereafter installed or used by all state agencies, and may require the use of common computer languages where necessary to accomplish the purposes of this chapter. The authority may establish by regulation and charge reasonable fees on a nondiscriminatory basis for the furnishing to bidders of copies of bid specifications and other documents issued by the authority.
(e) The authority shall adopt rules and regulations governing the sharing with, or the sale or lease of information technology services to any nonstate agency or person. Those regulations shall provide that any such sharing, sale or lease shall be restricted in that same shall be accomplished only where those services are not readily available otherwise within the state, and then only at a charge to the user not less than the prevailing rate of charge for similar services by private enterprise within this state.
(f) The authority may, in its discretion, establish a special technical advisory committee or committees to study and make recommendations on technology matters within the competence of the authority as the authority may see fit. Persons serving on the Information Resource Council, its task forces, or any such technical advisory committees shall be entitled to receive their actual and necessary expenses actually incurred in the performance of such duties, together with mileage as provided by law for state employees, provided the same has been authorized by a resolution duly adopted by the authority and entered on its minutes before the performance of those duties.
(g) The authority may provide for the development and require the adoption of standardized computer programs and may provide for the dissemination of information to and the establishment of training programs for the personnel of the various information technology centers of state agencies and personnel of the agencies utilizing the services thereof.
(h) The authority shall adopt reasonable rules and regulations requiring the reporting to the authority through the office of executive director of such information as may be required for carrying out the purposes of this chapter and may also establish such reasonable procedures to be followed in the presentation of bills for payment under the terms of all contracts for the acquisition of computer equipment and services now or hereafter in force as may be required by the authority or by the executive director in the execution of their powers and duties.
(i) The authority shall require such adequate documentation of information technology procedures used by the various state agencies and may require the establishment of such organizational structures within state agencies relating to information technology operations as may be necessary to effectuate the purposes of this chapter.
(j) The authority may adopt such further reasonable rules and regulations as may be necessary to fully implement the purposes of this chapter. All rules and regulations adopted by the authority shall be published and disseminated in readily accessible form to all affected state agencies, and to all current suppliers of computer equipment and services to the state, and to all prospective suppliers requesting the same. Those rules and regulations shall be kept current, be periodically revised, and copies thereof shall be available at all times for inspection by the public at reasonable hours in the offices of the authority. Whenever possible no rule, regulation or any proposed amendment to those rules and regulations shall be finally adopted or enforced until copies of the proposed rules and regulations have been furnished to all interested parties for their comment and suggestions.
(k) The authority shall establish rules and regulations which shall provide for the submission of all contracts proposed to be executed by the executive director for computer equipment or services to the authority for approval before final execution, and the authority may provide that those contracts involving the expenditure of less than such specified amount as may be established by the authority may be finally executed by the executive director without first obtaining such approval by the authority.
(l) The authority is authorized to purchase, lease, or rent computer equipment or services and to operate that equipment and use those services in providing services to one or more state agencies when in its opinion that operation will provide maximum efficiency and economy in the functions of any such agency or agencies.
(m) Upon the request of the governing body of a political subdivision or instrumentality, the authority shall assist the political subdivision or instrumentality in its development of plans for the efficient acquisition and utilization of computer equipment and services. An appropriate fee shall be charged the political subdivision by the authority for that assistance.
(n) The authority shall adopt rules and regulations governing the protest procedures to be followed by any actual or prospective bidder, offerer or contractor who is aggrieved in connection with the solicitation or award of a contract for the acquisition of computer equipment or services. Those rules and regulations shall prescribe the manner, time and procedure for making protests and may provide that a protest not timely filed shall be summarily denied. The authority may require the protesting party, at the time of filing the protest, to post a bond, payable to the state, in an amount that the authority determines sufficient to cover any expense or loss incurred by the state, the authority or any state agency as a result of the protest if the protest subsequently is determined by a court of competent jurisdiction to have been filed without any substantial basis or reasonable expectation to believe that the protest was meritorious; however, in no event may the amount of the bond required exceed a reasonable estimate of the total project cost. The authority, in its discretion, also may prohibit any prospective bidder, offerer or contractor who is a party to any litigation involving any such contract with the state, the authority or any agency of the state to participate in any other such bid, offer or contract, or to be awarded any such contract, during the pendency of the litigation.
(o) The authority shall make a report in writing to the Legislature each year in the month of January. The report shall contain a full and detailed account of the work of the authority for the preceding year as specified in Section 25-53-29(3).
All acquisitions of computer equipment and services involving the expenditure of funds in excess of the dollar amount established in Section 31-7-13(c), or rentals or leases in excess of the dollar amount established in Section 31-7-13(c) for the term of the contract, shall be based upon competitive and open specifications, and contracts therefor shall be entered into only after advertisements for bids are published in one or more daily newspapers having a general circulation in the state not less than fourteen (14) days before receiving sealed bids therefor. The authority may reserve the right to reject any or all bids, and if all bids are rejected, the authority may negotiate a contract within the limitations of the specifications so long as the terms of any such negotiated contract are equal to or better than the comparable terms submitted by the lowest and best bidder, and so long as the total cost to the State of Mississippi does not exceed the lowest bid. If the authority accepts one (1) of those bids, it shall be the bid that is the lowest and best.
(p) When applicable, the authority may procure equipment, systems and related services in accordance with the law or regulations, or both, that govern the Bureau of Purchasing of the Office of General Services or that govern the Mississippi Department of Information Technology Services procurement of telecommunications equipment, software and services.
(q) The authority is authorized to purchase, lease, or rent information technology and services for the purpose of establishing pilot projects to investigate emerging technologies. These acquisitions shall be limited to new technologies and shall be limited to an amount set by annual appropriation of the Legislature. These acquisitions shall be exempt from the advertising and bidding requirement.
(r) All fees collected by the Mississippi Department of Information Technology Services shall be deposited into the Mississippi Department of Information Technology Services Revolving Fund unless otherwise specified by the Legislature.
(s) The authority shall work closely with the council to bring about effective coordination of policies, standards and procedures relating to procurement of remote sensing and geographic information systems (GIS) resources. In addition, the authority is responsible for development, operation and maintenance of a delivery system infrastructure for geographic information systems data. The authority shall provide a warehouse for Mississippi's geographic information systems data.
SECTION 9. Section 25-53-109, Mississippi Code of 1972, is amended as follows:
25-53-109. The bureau is * * * authorized and empowered to exercise such duties and powers necessary to effectuate the purposes of Sections 25-53-101 through 25-53-125 including the following:
(a) Form an advisory council made up of persons with expertise, and experience in the field of telecommunications for the purpose of setting goals, establishing long-range plans and policies and to oversee and assist in the procurement activities regarding telecommunications equipment and services;
(b) Provide more effective management of state telecommunications resources and implement long-range plans and procurement;
(c) Manage, plan and coordinate all telecommunications systems under the jurisdiction of the state. This centralized management function would be provided throughout the following activities:
(i) Administration of existing systems including coordination of activities, vendors, service orders and billing/record-keeping functions;
(ii) Planning of new systems or services;
(iii) Design of replacement systems;
(iv) Project management during specification writing, bid letting, proposal evaluation and contract negotiations;
(v) Implementation supervision of new systems and ongoing support;
(vi) Implementation of long-term state plans; and
(vii) Management of intra-LATA and inter-LATA networks;
(d) Review and approve, in writing, the acquisition of all health information technology systems before the release of requests for proposals, or the execution of contracts for that acquisition. The department shall review applications from requesting agencies using, at a minimum, the standards set forth in Section 4 of this act. In order to assist in the evaluation of the applications, the department shall form an advisory group comprised of persons knowledgeable in health information technology systems and technologies from both the public and private nonprofit sectors.
SECTION 10. If there is any conflict between any provision of Sections 1 through 5 of this act and any provision of Section 25-53-1 et seq., the provisions of Sections 1 through 5 of this act shall control to the extent of the conflict.
SECTION 11. This act shall take effect and be in force from and after its passage.