CALIFORNIA LEGISLATURE 20212022 REGULAR SESSION Assembly Bill No. 2326Introduced by Assembly Member ReyesFebruary 16, 2022 An act to amend Section 124130 of the Health and Safety Code, relating to health. LEGISLATIVE COUNSEL'S DIGESTAB 2326, as introduced, Reyes. Lead poisoning prevention: laboratory reporting.Existing law, the Childhood Lead Poisoning Prevention Act of 1991, requires the State Department of Public Health to adopt regulations establishing a standard of care at least as stringent as the most recent federal Centers for Disease Control and Prevention (CDC) screening guidelines, whereby all children are evaluated for risk of lead poisoning by health care providers during each childs periodic health assessment. Existing law requires a laboratory that performs a blood lead analysis on a specimen of human blood drawn in California to report specified information to the State Department of Public Health for each analysis on every person tested and requires other specified information to be reported when the laboratory has that information. Existing law authorizes the department to fine a laboratory that knowingly fails to meet the reporting requirements.This bill would require the laboratory to report additional information, including the National Provider Identifier (NPI) of the health care provider that ordered the analysis, the Clinical Laboratory Improvement Amendments (CLIA) number and the NPI of the laboratory, and the persons race, ethnicity, and pregnancy status. The bill would require a laboratory to request all of the required information from the health care provider who obtained the blood sample or ordered the test, but would waive the laboratorys reporting requirement when the health care provider cannot, or will not, provide the requested information.Existing law requires the laboratory to report within 3 working days if the result of the blood lead analysis is a blood lead level equal to or greater than 10 micrograms of lead per deciliter of blood and within 30 working days if the blood lead level is lower that threshold.This bill would make the threshold for reporting within 3 working days the most recent CDC reference level for an elevated blood lead level.Existing law requires that all information reported be confidential, except that the department is authorized to share the information for the purpose of surveillance, case management, investigation, environmental assessment, environmental remediation, or abatement with the local health department, environmental health agency, or building department, and with the State Department of Health Care Services for the purpose of determining whether children enrolled in Medi-Cal are being screened for lead poisoning and receiving appropriate related services.This bill would authorize the department to share the information for purposes of care coordination as well. The bill would authorize the department to share the information with health care providers and with the person to whom the information pertains, with the voluntary written consent of the person to whom the information pertains, and when required by state or federal law, or court order. The bill would also authorize the department to share the information for research, as specified.Digest Key Vote: MAJORITY Appropriation: NO Fiscal Committee: YES Local Program: NO Bill TextThe people of the State of California do enact as follows:SECTION 1. Section 124130 of the Health and Safety Code is amended to read:124130. (a) A laboratory that performs a blood lead analysis on a specimen of human blood drawn in California shall report the information specified in this section to the department for each analysis on every person tested.(b) The analyzing laboratory shall report all of the following:(1) The test results in micrograms of lead per deciliter.(2) The name of the person tested.(3) The persons birth date if the analyzing laboratory has that information, or if not, the persons age. date.(4) The persons address, including the ZIP Code, if the analyzing laboratory has that information, or if not, a telephone number by which the person may be contacted. and telephone number.(5) The name, address, and telephone number number, and National Provider Identifier (NPI) of the health care provider that ordered the analysis.(6) The name, address, and telephone number number, Clinical Laboratory Improvement Amendments (CLIA) number, and NPI of the analyzing laboratory.(7) The accession number of the specimen.(8) The date the analysis was performed.(c)The analyzing laboratory shall report all of the following information that it possesses:(9) The persons Medi-Cal client identification number (CIN) or, for other health plans, the name of the health plan and the medical plan identification number. (1)(10) The persons gender. sex.(11) The persons race and ethnicity.(12) The persons sexual orientation, if the information and a reporting mechanism are available.(13) The persons pregnancy status. (2)(14) The name, address, and telephone number of the persons employer, if any.(3)(15) The date the specimen was drawn.(4)(16) The source of the specimen, specified as venous, capillary, arterial, cord blood, or other.(17) The name, address, telephone number, and CLIA number of the referring laboratory, if any.(18) The testing methodology used for blood lead analysis specified as point of care, inductively coupled plasma mass spectrometry, graphite furnace atomic spectroscopy, or other. (d)(c) The analyzing laboratory may report to the department other information that directly relates to the blood lead analysis or to the identity, location, medical health care management, or environmental management of the person tested.(e)(d) If the result of the blood lead analysis is a blood lead level equal to or greater than 10 micrograms of lead per deciliter of blood, the most recent federal Centers for Disease Control and Prevention (CDC) reference level for an elevated blood lead level (BLL), the report required by this section shall be submitted within three working days of the analysis. If the result is less than 10 micrograms per deciliter, the CDC reference level for an elevated BLL, the report required by this section shall be submitted within 30 calendar days. days of the analysis. Timing of reporting shall be based on rounding of results to the nearest whole number.(f)(e) A report required by this section shall be submitted by electronic transfer.(g)(f) All information reported pursuant to this section shall be confidential, as provided in Section 100330, except that the department may share the information for as follows:(1) To the individual to whom the information pertains.(2) With the prior written voluntary consent of the individual to whom the information pertains.(3) When required by state or federal law.(4) When compelled by an order of the court or an administrative hearing officer, if a protective order that prohibits any further disclosure is secured prior to disclosure.(5) For the purpose of surveillance, case management, coordination of care, investigation, environmental assessment, environmental remediation, or abatement with the local health department, environmental health agency authorized pursuant to Section 101275, or building department, and with health care providers licensed or certified pursuant to Division 2 (commencing with Section 500) of the Business and Professions Code, or a federal, state, or local governmental agency.(6) For research, as defined in Part 46 of Title 45 of the Code of Federal Regulations, as may be amended, if the request for information is approved by the Committee for the Protection of Human Subjects (CPHS) for the California Health and Human Services Agency, the requesting entity provides documentation to the department that demonstrates, to the departments satisfaction, that the entity has established the procedures and ability to maintain the confidentiality of the information, and the requesting entity has agreed, in writing, to maintain the confidentiality of the information.(7) With the State Department of Health Care Services for the purpose of determining whether children enrolled in Medi-Cal are being screened for lead poisoning and receiving appropriate related services. The(g) (1) The State Department of Health Care Services and health care providers may further disclose the information reported pursuant to this section to a managed health care plan in which a beneficiary who is the subject of the information is enrolled, who may further disclose this information to the beneficiarys health care provider to proactively offer and coordinate care and treatment services and administer payment programs. The(2) The local health department, environmental health agency, or building department department, researcher, or federal, state, or local governmental entity shall not further disclose the information and shall otherwise maintain the confidentiality of the information in the manner provided in Section 100330. The(3) Notwithstanding any other law, a disclosure authorized pursuant to this section, except to the State Department of Health Care Services and to health care providers, shall include only the information necessary for the stated purpose of the requested disclosure, be used only for the approved purpose, and not be further disclosed.(4) The State Department of Health Care Services and health care providers shall use, disclose, and maintain the confidentiality of information shared with it pursuant to this subdivision in accordance with the federal Health Insurance Portability and Accountability Act of 1996, as may be amended, and pursuant to regulations promulgated thereto, and other laws applicable to information in possession of the State Department of Health Care Services. The Services and health care providers.Legislature finds and declares that under existing law this information is not subject to public disclosure.(h) The director may assess a fine up to five hundred dollars ($500) against any a laboratory that knowingly fails to meet the reporting requirements of this section.(i) A laboratory shall not be fined or otherwise penalized for failure to provide the patients birth date, age, address, or telephone number patient information required by this section if the result of the blood lead analysis is a blood lead level less than 25 micrograms of lead per deciliter of blood, the most recent CDC reference level for an elevated BLL and if all of the following circumstances exist:(1) The test sample was sent to the laboratory by another medical health care provider.(2) The laboratory requested the information from the medical health care provider who obtained the sample.(3) The medical health care provider that who obtained the sample and sent it to the laboratory failed to provide the patients birth date, age, address, or telephone number. information.(j) A laboratory shall request from the health care provider who obtained the blood sample or ordered the test all information required by this section, as applicable. If the health care provider cannot, or will not, provide the requested information, the laboratory is not required to report the information. CALIFORNIA LEGISLATURE 20212022 REGULAR SESSION Assembly Bill No. 2326Introduced by Assembly Member ReyesFebruary 16, 2022 An act to amend Section 124130 of the Health and Safety Code, relating to health. LEGISLATIVE COUNSEL'S DIGESTAB 2326, as introduced, Reyes. Lead poisoning prevention: laboratory reporting.Existing law, the Childhood Lead Poisoning Prevention Act of 1991, requires the State Department of Public Health to adopt regulations establishing a standard of care at least as stringent as the most recent federal Centers for Disease Control and Prevention (CDC) screening guidelines, whereby all children are evaluated for risk of lead poisoning by health care providers during each childs periodic health assessment. Existing law requires a laboratory that performs a blood lead analysis on a specimen of human blood drawn in California to report specified information to the State Department of Public Health for each analysis on every person tested and requires other specified information to be reported when the laboratory has that information. Existing law authorizes the department to fine a laboratory that knowingly fails to meet the reporting requirements.This bill would require the laboratory to report additional information, including the National Provider Identifier (NPI) of the health care provider that ordered the analysis, the Clinical Laboratory Improvement Amendments (CLIA) number and the NPI of the laboratory, and the persons race, ethnicity, and pregnancy status. The bill would require a laboratory to request all of the required information from the health care provider who obtained the blood sample or ordered the test, but would waive the laboratorys reporting requirement when the health care provider cannot, or will not, provide the requested information.Existing law requires the laboratory to report within 3 working days if the result of the blood lead analysis is a blood lead level equal to or greater than 10 micrograms of lead per deciliter of blood and within 30 working days if the blood lead level is lower that threshold.This bill would make the threshold for reporting within 3 working days the most recent CDC reference level for an elevated blood lead level.Existing law requires that all information reported be confidential, except that the department is authorized to share the information for the purpose of surveillance, case management, investigation, environmental assessment, environmental remediation, or abatement with the local health department, environmental health agency, or building department, and with the State Department of Health Care Services for the purpose of determining whether children enrolled in Medi-Cal are being screened for lead poisoning and receiving appropriate related services.This bill would authorize the department to share the information for purposes of care coordination as well. The bill would authorize the department to share the information with health care providers and with the person to whom the information pertains, with the voluntary written consent of the person to whom the information pertains, and when required by state or federal law, or court order. The bill would also authorize the department to share the information for research, as specified.Digest Key Vote: MAJORITY Appropriation: NO Fiscal Committee: YES Local Program: NO CALIFORNIA LEGISLATURE 20212022 REGULAR SESSION Assembly Bill No. 2326 Introduced by Assembly Member ReyesFebruary 16, 2022 Introduced by Assembly Member Reyes February 16, 2022 An act to amend Section 124130 of the Health and Safety Code, relating to health. LEGISLATIVE COUNSEL'S DIGEST ## LEGISLATIVE COUNSEL'S DIGEST AB 2326, as introduced, Reyes. Lead poisoning prevention: laboratory reporting. Existing law, the Childhood Lead Poisoning Prevention Act of 1991, requires the State Department of Public Health to adopt regulations establishing a standard of care at least as stringent as the most recent federal Centers for Disease Control and Prevention (CDC) screening guidelines, whereby all children are evaluated for risk of lead poisoning by health care providers during each childs periodic health assessment. Existing law requires a laboratory that performs a blood lead analysis on a specimen of human blood drawn in California to report specified information to the State Department of Public Health for each analysis on every person tested and requires other specified information to be reported when the laboratory has that information. Existing law authorizes the department to fine a laboratory that knowingly fails to meet the reporting requirements.This bill would require the laboratory to report additional information, including the National Provider Identifier (NPI) of the health care provider that ordered the analysis, the Clinical Laboratory Improvement Amendments (CLIA) number and the NPI of the laboratory, and the persons race, ethnicity, and pregnancy status. The bill would require a laboratory to request all of the required information from the health care provider who obtained the blood sample or ordered the test, but would waive the laboratorys reporting requirement when the health care provider cannot, or will not, provide the requested information.Existing law requires the laboratory to report within 3 working days if the result of the blood lead analysis is a blood lead level equal to or greater than 10 micrograms of lead per deciliter of blood and within 30 working days if the blood lead level is lower that threshold.This bill would make the threshold for reporting within 3 working days the most recent CDC reference level for an elevated blood lead level.Existing law requires that all information reported be confidential, except that the department is authorized to share the information for the purpose of surveillance, case management, investigation, environmental assessment, environmental remediation, or abatement with the local health department, environmental health agency, or building department, and with the State Department of Health Care Services for the purpose of determining whether children enrolled in Medi-Cal are being screened for lead poisoning and receiving appropriate related services.This bill would authorize the department to share the information for purposes of care coordination as well. The bill would authorize the department to share the information with health care providers and with the person to whom the information pertains, with the voluntary written consent of the person to whom the information pertains, and when required by state or federal law, or court order. The bill would also authorize the department to share the information for research, as specified. Existing law, the Childhood Lead Poisoning Prevention Act of 1991, requires the State Department of Public Health to adopt regulations establishing a standard of care at least as stringent as the most recent federal Centers for Disease Control and Prevention (CDC) screening guidelines, whereby all children are evaluated for risk of lead poisoning by health care providers during each childs periodic health assessment. Existing law requires a laboratory that performs a blood lead analysis on a specimen of human blood drawn in California to report specified information to the State Department of Public Health for each analysis on every person tested and requires other specified information to be reported when the laboratory has that information. Existing law authorizes the department to fine a laboratory that knowingly fails to meet the reporting requirements. This bill would require the laboratory to report additional information, including the National Provider Identifier (NPI) of the health care provider that ordered the analysis, the Clinical Laboratory Improvement Amendments (CLIA) number and the NPI of the laboratory, and the persons race, ethnicity, and pregnancy status. The bill would require a laboratory to request all of the required information from the health care provider who obtained the blood sample or ordered the test, but would waive the laboratorys reporting requirement when the health care provider cannot, or will not, provide the requested information. Existing law requires the laboratory to report within 3 working days if the result of the blood lead analysis is a blood lead level equal to or greater than 10 micrograms of lead per deciliter of blood and within 30 working days if the blood lead level is lower that threshold. This bill would make the threshold for reporting within 3 working days the most recent CDC reference level for an elevated blood lead level. Existing law requires that all information reported be confidential, except that the department is authorized to share the information for the purpose of surveillance, case management, investigation, environmental assessment, environmental remediation, or abatement with the local health department, environmental health agency, or building department, and with the State Department of Health Care Services for the purpose of determining whether children enrolled in Medi-Cal are being screened for lead poisoning and receiving appropriate related services. This bill would authorize the department to share the information for purposes of care coordination as well. The bill would authorize the department to share the information with health care providers and with the person to whom the information pertains, with the voluntary written consent of the person to whom the information pertains, and when required by state or federal law, or court order. The bill would also authorize the department to share the information for research, as specified. ## Digest Key ## Bill Text The people of the State of California do enact as follows:SECTION 1. Section 124130 of the Health and Safety Code is amended to read:124130. (a) A laboratory that performs a blood lead analysis on a specimen of human blood drawn in California shall report the information specified in this section to the department for each analysis on every person tested.(b) The analyzing laboratory shall report all of the following:(1) The test results in micrograms of lead per deciliter.(2) The name of the person tested.(3) The persons birth date if the analyzing laboratory has that information, or if not, the persons age. date.(4) The persons address, including the ZIP Code, if the analyzing laboratory has that information, or if not, a telephone number by which the person may be contacted. and telephone number.(5) The name, address, and telephone number number, and National Provider Identifier (NPI) of the health care provider that ordered the analysis.(6) The name, address, and telephone number number, Clinical Laboratory Improvement Amendments (CLIA) number, and NPI of the analyzing laboratory.(7) The accession number of the specimen.(8) The date the analysis was performed.(c)The analyzing laboratory shall report all of the following information that it possesses:(9) The persons Medi-Cal client identification number (CIN) or, for other health plans, the name of the health plan and the medical plan identification number. (1)(10) The persons gender. sex.(11) The persons race and ethnicity.(12) The persons sexual orientation, if the information and a reporting mechanism are available.(13) The persons pregnancy status. (2)(14) The name, address, and telephone number of the persons employer, if any.(3)(15) The date the specimen was drawn.(4)(16) The source of the specimen, specified as venous, capillary, arterial, cord blood, or other.(17) The name, address, telephone number, and CLIA number of the referring laboratory, if any.(18) The testing methodology used for blood lead analysis specified as point of care, inductively coupled plasma mass spectrometry, graphite furnace atomic spectroscopy, or other. (d)(c) The analyzing laboratory may report to the department other information that directly relates to the blood lead analysis or to the identity, location, medical health care management, or environmental management of the person tested.(e)(d) If the result of the blood lead analysis is a blood lead level equal to or greater than 10 micrograms of lead per deciliter of blood, the most recent federal Centers for Disease Control and Prevention (CDC) reference level for an elevated blood lead level (BLL), the report required by this section shall be submitted within three working days of the analysis. If the result is less than 10 micrograms per deciliter, the CDC reference level for an elevated BLL, the report required by this section shall be submitted within 30 calendar days. days of the analysis. Timing of reporting shall be based on rounding of results to the nearest whole number.(f)(e) A report required by this section shall be submitted by electronic transfer.(g)(f) All information reported pursuant to this section shall be confidential, as provided in Section 100330, except that the department may share the information for as follows:(1) To the individual to whom the information pertains.(2) With the prior written voluntary consent of the individual to whom the information pertains.(3) When required by state or federal law.(4) When compelled by an order of the court or an administrative hearing officer, if a protective order that prohibits any further disclosure is secured prior to disclosure.(5) For the purpose of surveillance, case management, coordination of care, investigation, environmental assessment, environmental remediation, or abatement with the local health department, environmental health agency authorized pursuant to Section 101275, or building department, and with health care providers licensed or certified pursuant to Division 2 (commencing with Section 500) of the Business and Professions Code, or a federal, state, or local governmental agency.(6) For research, as defined in Part 46 of Title 45 of the Code of Federal Regulations, as may be amended, if the request for information is approved by the Committee for the Protection of Human Subjects (CPHS) for the California Health and Human Services Agency, the requesting entity provides documentation to the department that demonstrates, to the departments satisfaction, that the entity has established the procedures and ability to maintain the confidentiality of the information, and the requesting entity has agreed, in writing, to maintain the confidentiality of the information.(7) With the State Department of Health Care Services for the purpose of determining whether children enrolled in Medi-Cal are being screened for lead poisoning and receiving appropriate related services. The(g) (1) The State Department of Health Care Services and health care providers may further disclose the information reported pursuant to this section to a managed health care plan in which a beneficiary who is the subject of the information is enrolled, who may further disclose this information to the beneficiarys health care provider to proactively offer and coordinate care and treatment services and administer payment programs. The(2) The local health department, environmental health agency, or building department department, researcher, or federal, state, or local governmental entity shall not further disclose the information and shall otherwise maintain the confidentiality of the information in the manner provided in Section 100330. The(3) Notwithstanding any other law, a disclosure authorized pursuant to this section, except to the State Department of Health Care Services and to health care providers, shall include only the information necessary for the stated purpose of the requested disclosure, be used only for the approved purpose, and not be further disclosed.(4) The State Department of Health Care Services and health care providers shall use, disclose, and maintain the confidentiality of information shared with it pursuant to this subdivision in accordance with the federal Health Insurance Portability and Accountability Act of 1996, as may be amended, and pursuant to regulations promulgated thereto, and other laws applicable to information in possession of the State Department of Health Care Services. The Services and health care providers.Legislature finds and declares that under existing law this information is not subject to public disclosure.(h) The director may assess a fine up to five hundred dollars ($500) against any a laboratory that knowingly fails to meet the reporting requirements of this section.(i) A laboratory shall not be fined or otherwise penalized for failure to provide the patients birth date, age, address, or telephone number patient information required by this section if the result of the blood lead analysis is a blood lead level less than 25 micrograms of lead per deciliter of blood, the most recent CDC reference level for an elevated BLL and if all of the following circumstances exist:(1) The test sample was sent to the laboratory by another medical health care provider.(2) The laboratory requested the information from the medical health care provider who obtained the sample.(3) The medical health care provider that who obtained the sample and sent it to the laboratory failed to provide the patients birth date, age, address, or telephone number. information.(j) A laboratory shall request from the health care provider who obtained the blood sample or ordered the test all information required by this section, as applicable. If the health care provider cannot, or will not, provide the requested information, the laboratory is not required to report the information. The people of the State of California do enact as follows: ## The people of the State of California do enact as follows: SECTION 1. Section 124130 of the Health and Safety Code is amended to read:124130. (a) A laboratory that performs a blood lead analysis on a specimen of human blood drawn in California shall report the information specified in this section to the department for each analysis on every person tested.(b) The analyzing laboratory shall report all of the following:(1) The test results in micrograms of lead per deciliter.(2) The name of the person tested.(3) The persons birth date if the analyzing laboratory has that information, or if not, the persons age. date.(4) The persons address, including the ZIP Code, if the analyzing laboratory has that information, or if not, a telephone number by which the person may be contacted. and telephone number.(5) The name, address, and telephone number number, and National Provider Identifier (NPI) of the health care provider that ordered the analysis.(6) The name, address, and telephone number number, Clinical Laboratory Improvement Amendments (CLIA) number, and NPI of the analyzing laboratory.(7) The accession number of the specimen.(8) The date the analysis was performed.(c)The analyzing laboratory shall report all of the following information that it possesses:(9) The persons Medi-Cal client identification number (CIN) or, for other health plans, the name of the health plan and the medical plan identification number. (1)(10) The persons gender. sex.(11) The persons race and ethnicity.(12) The persons sexual orientation, if the information and a reporting mechanism are available.(13) The persons pregnancy status. (2)(14) The name, address, and telephone number of the persons employer, if any.(3)(15) The date the specimen was drawn.(4)(16) The source of the specimen, specified as venous, capillary, arterial, cord blood, or other.(17) The name, address, telephone number, and CLIA number of the referring laboratory, if any.(18) The testing methodology used for blood lead analysis specified as point of care, inductively coupled plasma mass spectrometry, graphite furnace atomic spectroscopy, or other. (d)(c) The analyzing laboratory may report to the department other information that directly relates to the blood lead analysis or to the identity, location, medical health care management, or environmental management of the person tested.(e)(d) If the result of the blood lead analysis is a blood lead level equal to or greater than 10 micrograms of lead per deciliter of blood, the most recent federal Centers for Disease Control and Prevention (CDC) reference level for an elevated blood lead level (BLL), the report required by this section shall be submitted within three working days of the analysis. If the result is less than 10 micrograms per deciliter, the CDC reference level for an elevated BLL, the report required by this section shall be submitted within 30 calendar days. days of the analysis. Timing of reporting shall be based on rounding of results to the nearest whole number.(f)(e) A report required by this section shall be submitted by electronic transfer.(g)(f) All information reported pursuant to this section shall be confidential, as provided in Section 100330, except that the department may share the information for as follows:(1) To the individual to whom the information pertains.(2) With the prior written voluntary consent of the individual to whom the information pertains.(3) When required by state or federal law.(4) When compelled by an order of the court or an administrative hearing officer, if a protective order that prohibits any further disclosure is secured prior to disclosure.(5) For the purpose of surveillance, case management, coordination of care, investigation, environmental assessment, environmental remediation, or abatement with the local health department, environmental health agency authorized pursuant to Section 101275, or building department, and with health care providers licensed or certified pursuant to Division 2 (commencing with Section 500) of the Business and Professions Code, or a federal, state, or local governmental agency.(6) For research, as defined in Part 46 of Title 45 of the Code of Federal Regulations, as may be amended, if the request for information is approved by the Committee for the Protection of Human Subjects (CPHS) for the California Health and Human Services Agency, the requesting entity provides documentation to the department that demonstrates, to the departments satisfaction, that the entity has established the procedures and ability to maintain the confidentiality of the information, and the requesting entity has agreed, in writing, to maintain the confidentiality of the information.(7) With the State Department of Health Care Services for the purpose of determining whether children enrolled in Medi-Cal are being screened for lead poisoning and receiving appropriate related services. The(g) (1) The State Department of Health Care Services and health care providers may further disclose the information reported pursuant to this section to a managed health care plan in which a beneficiary who is the subject of the information is enrolled, who may further disclose this information to the beneficiarys health care provider to proactively offer and coordinate care and treatment services and administer payment programs. The(2) The local health department, environmental health agency, or building department department, researcher, or federal, state, or local governmental entity shall not further disclose the information and shall otherwise maintain the confidentiality of the information in the manner provided in Section 100330. The(3) Notwithstanding any other law, a disclosure authorized pursuant to this section, except to the State Department of Health Care Services and to health care providers, shall include only the information necessary for the stated purpose of the requested disclosure, be used only for the approved purpose, and not be further disclosed.(4) The State Department of Health Care Services and health care providers shall use, disclose, and maintain the confidentiality of information shared with it pursuant to this subdivision in accordance with the federal Health Insurance Portability and Accountability Act of 1996, as may be amended, and pursuant to regulations promulgated thereto, and other laws applicable to information in possession of the State Department of Health Care Services. The Services and health care providers.Legislature finds and declares that under existing law this information is not subject to public disclosure.(h) The director may assess a fine up to five hundred dollars ($500) against any a laboratory that knowingly fails to meet the reporting requirements of this section.(i) A laboratory shall not be fined or otherwise penalized for failure to provide the patients birth date, age, address, or telephone number patient information required by this section if the result of the blood lead analysis is a blood lead level less than 25 micrograms of lead per deciliter of blood, the most recent CDC reference level for an elevated BLL and if all of the following circumstances exist:(1) The test sample was sent to the laboratory by another medical health care provider.(2) The laboratory requested the information from the medical health care provider who obtained the sample.(3) The medical health care provider that who obtained the sample and sent it to the laboratory failed to provide the patients birth date, age, address, or telephone number. information.(j) A laboratory shall request from the health care provider who obtained the blood sample or ordered the test all information required by this section, as applicable. If the health care provider cannot, or will not, provide the requested information, the laboratory is not required to report the information. SECTION 1. Section 124130 of the Health and Safety Code is amended to read: ### SECTION 1. 124130. (a) A laboratory that performs a blood lead analysis on a specimen of human blood drawn in California shall report the information specified in this section to the department for each analysis on every person tested.(b) The analyzing laboratory shall report all of the following:(1) The test results in micrograms of lead per deciliter.(2) The name of the person tested.(3) The persons birth date if the analyzing laboratory has that information, or if not, the persons age. date.(4) The persons address, including the ZIP Code, if the analyzing laboratory has that information, or if not, a telephone number by which the person may be contacted. and telephone number.(5) The name, address, and telephone number number, and National Provider Identifier (NPI) of the health care provider that ordered the analysis.(6) The name, address, and telephone number number, Clinical Laboratory Improvement Amendments (CLIA) number, and NPI of the analyzing laboratory.(7) The accession number of the specimen.(8) The date the analysis was performed.(c)The analyzing laboratory shall report all of the following information that it possesses:(9) The persons Medi-Cal client identification number (CIN) or, for other health plans, the name of the health plan and the medical plan identification number. (1)(10) The persons gender. sex.(11) The persons race and ethnicity.(12) The persons sexual orientation, if the information and a reporting mechanism are available.(13) The persons pregnancy status. (2)(14) The name, address, and telephone number of the persons employer, if any.(3)(15) The date the specimen was drawn.(4)(16) The source of the specimen, specified as venous, capillary, arterial, cord blood, or other.(17) The name, address, telephone number, and CLIA number of the referring laboratory, if any.(18) The testing methodology used for blood lead analysis specified as point of care, inductively coupled plasma mass spectrometry, graphite furnace atomic spectroscopy, or other. (d)(c) The analyzing laboratory may report to the department other information that directly relates to the blood lead analysis or to the identity, location, medical health care management, or environmental management of the person tested.(e)(d) If the result of the blood lead analysis is a blood lead level equal to or greater than 10 micrograms of lead per deciliter of blood, the most recent federal Centers for Disease Control and Prevention (CDC) reference level for an elevated blood lead level (BLL), the report required by this section shall be submitted within three working days of the analysis. If the result is less than 10 micrograms per deciliter, the CDC reference level for an elevated BLL, the report required by this section shall be submitted within 30 calendar days. days of the analysis. Timing of reporting shall be based on rounding of results to the nearest whole number.(f)(e) A report required by this section shall be submitted by electronic transfer.(g)(f) All information reported pursuant to this section shall be confidential, as provided in Section 100330, except that the department may share the information for as follows:(1) To the individual to whom the information pertains.(2) With the prior written voluntary consent of the individual to whom the information pertains.(3) When required by state or federal law.(4) When compelled by an order of the court or an administrative hearing officer, if a protective order that prohibits any further disclosure is secured prior to disclosure.(5) For the purpose of surveillance, case management, coordination of care, investigation, environmental assessment, environmental remediation, or abatement with the local health department, environmental health agency authorized pursuant to Section 101275, or building department, and with health care providers licensed or certified pursuant to Division 2 (commencing with Section 500) of the Business and Professions Code, or a federal, state, or local governmental agency.(6) For research, as defined in Part 46 of Title 45 of the Code of Federal Regulations, as may be amended, if the request for information is approved by the Committee for the Protection of Human Subjects (CPHS) for the California Health and Human Services Agency, the requesting entity provides documentation to the department that demonstrates, to the departments satisfaction, that the entity has established the procedures and ability to maintain the confidentiality of the information, and the requesting entity has agreed, in writing, to maintain the confidentiality of the information.(7) With the State Department of Health Care Services for the purpose of determining whether children enrolled in Medi-Cal are being screened for lead poisoning and receiving appropriate related services. The(g) (1) The State Department of Health Care Services and health care providers may further disclose the information reported pursuant to this section to a managed health care plan in which a beneficiary who is the subject of the information is enrolled, who may further disclose this information to the beneficiarys health care provider to proactively offer and coordinate care and treatment services and administer payment programs. The(2) The local health department, environmental health agency, or building department department, researcher, or federal, state, or local governmental entity shall not further disclose the information and shall otherwise maintain the confidentiality of the information in the manner provided in Section 100330. The(3) Notwithstanding any other law, a disclosure authorized pursuant to this section, except to the State Department of Health Care Services and to health care providers, shall include only the information necessary for the stated purpose of the requested disclosure, be used only for the approved purpose, and not be further disclosed.(4) The State Department of Health Care Services and health care providers shall use, disclose, and maintain the confidentiality of information shared with it pursuant to this subdivision in accordance with the federal Health Insurance Portability and Accountability Act of 1996, as may be amended, and pursuant to regulations promulgated thereto, and other laws applicable to information in possession of the State Department of Health Care Services. The Services and health care providers.Legislature finds and declares that under existing law this information is not subject to public disclosure.(h) The director may assess a fine up to five hundred dollars ($500) against any a laboratory that knowingly fails to meet the reporting requirements of this section.(i) A laboratory shall not be fined or otherwise penalized for failure to provide the patients birth date, age, address, or telephone number patient information required by this section if the result of the blood lead analysis is a blood lead level less than 25 micrograms of lead per deciliter of blood, the most recent CDC reference level for an elevated BLL and if all of the following circumstances exist:(1) The test sample was sent to the laboratory by another medical health care provider.(2) The laboratory requested the information from the medical health care provider who obtained the sample.(3) The medical health care provider that who obtained the sample and sent it to the laboratory failed to provide the patients birth date, age, address, or telephone number. information.(j) A laboratory shall request from the health care provider who obtained the blood sample or ordered the test all information required by this section, as applicable. If the health care provider cannot, or will not, provide the requested information, the laboratory is not required to report the information. 124130. (a) A laboratory that performs a blood lead analysis on a specimen of human blood drawn in California shall report the information specified in this section to the department for each analysis on every person tested.(b) The analyzing laboratory shall report all of the following:(1) The test results in micrograms of lead per deciliter.(2) The name of the person tested.(3) The persons birth date if the analyzing laboratory has that information, or if not, the persons age. date.(4) The persons address, including the ZIP Code, if the analyzing laboratory has that information, or if not, a telephone number by which the person may be contacted. and telephone number.(5) The name, address, and telephone number number, and National Provider Identifier (NPI) of the health care provider that ordered the analysis.(6) The name, address, and telephone number number, Clinical Laboratory Improvement Amendments (CLIA) number, and NPI of the analyzing laboratory.(7) The accession number of the specimen.(8) The date the analysis was performed.(c)The analyzing laboratory shall report all of the following information that it possesses:(9) The persons Medi-Cal client identification number (CIN) or, for other health plans, the name of the health plan and the medical plan identification number. (1)(10) The persons gender. sex.(11) The persons race and ethnicity.(12) The persons sexual orientation, if the information and a reporting mechanism are available.(13) The persons pregnancy status. (2)(14) The name, address, and telephone number of the persons employer, if any.(3)(15) The date the specimen was drawn.(4)(16) The source of the specimen, specified as venous, capillary, arterial, cord blood, or other.(17) The name, address, telephone number, and CLIA number of the referring laboratory, if any.(18) The testing methodology used for blood lead analysis specified as point of care, inductively coupled plasma mass spectrometry, graphite furnace atomic spectroscopy, or other. (d)(c) The analyzing laboratory may report to the department other information that directly relates to the blood lead analysis or to the identity, location, medical health care management, or environmental management of the person tested.(e)(d) If the result of the blood lead analysis is a blood lead level equal to or greater than 10 micrograms of lead per deciliter of blood, the most recent federal Centers for Disease Control and Prevention (CDC) reference level for an elevated blood lead level (BLL), the report required by this section shall be submitted within three working days of the analysis. If the result is less than 10 micrograms per deciliter, the CDC reference level for an elevated BLL, the report required by this section shall be submitted within 30 calendar days. days of the analysis. Timing of reporting shall be based on rounding of results to the nearest whole number.(f)(e) A report required by this section shall be submitted by electronic transfer.(g)(f) All information reported pursuant to this section shall be confidential, as provided in Section 100330, except that the department may share the information for as follows:(1) To the individual to whom the information pertains.(2) With the prior written voluntary consent of the individual to whom the information pertains.(3) When required by state or federal law.(4) When compelled by an order of the court or an administrative hearing officer, if a protective order that prohibits any further disclosure is secured prior to disclosure.(5) For the purpose of surveillance, case management, coordination of care, investigation, environmental assessment, environmental remediation, or abatement with the local health department, environmental health agency authorized pursuant to Section 101275, or building department, and with health care providers licensed or certified pursuant to Division 2 (commencing with Section 500) of the Business and Professions Code, or a federal, state, or local governmental agency.(6) For research, as defined in Part 46 of Title 45 of the Code of Federal Regulations, as may be amended, if the request for information is approved by the Committee for the Protection of Human Subjects (CPHS) for the California Health and Human Services Agency, the requesting entity provides documentation to the department that demonstrates, to the departments satisfaction, that the entity has established the procedures and ability to maintain the confidentiality of the information, and the requesting entity has agreed, in writing, to maintain the confidentiality of the information.(7) With the State Department of Health Care Services for the purpose of determining whether children enrolled in Medi-Cal are being screened for lead poisoning and receiving appropriate related services. The(g) (1) The State Department of Health Care Services and health care providers may further disclose the information reported pursuant to this section to a managed health care plan in which a beneficiary who is the subject of the information is enrolled, who may further disclose this information to the beneficiarys health care provider to proactively offer and coordinate care and treatment services and administer payment programs. The(2) The local health department, environmental health agency, or building department department, researcher, or federal, state, or local governmental entity shall not further disclose the information and shall otherwise maintain the confidentiality of the information in the manner provided in Section 100330. The(3) Notwithstanding any other law, a disclosure authorized pursuant to this section, except to the State Department of Health Care Services and to health care providers, shall include only the information necessary for the stated purpose of the requested disclosure, be used only for the approved purpose, and not be further disclosed.(4) The State Department of Health Care Services and health care providers shall use, disclose, and maintain the confidentiality of information shared with it pursuant to this subdivision in accordance with the federal Health Insurance Portability and Accountability Act of 1996, as may be amended, and pursuant to regulations promulgated thereto, and other laws applicable to information in possession of the State Department of Health Care Services. The Services and health care providers.Legislature finds and declares that under existing law this information is not subject to public disclosure.(h) The director may assess a fine up to five hundred dollars ($500) against any a laboratory that knowingly fails to meet the reporting requirements of this section.(i) A laboratory shall not be fined or otherwise penalized for failure to provide the patients birth date, age, address, or telephone number patient information required by this section if the result of the blood lead analysis is a blood lead level less than 25 micrograms of lead per deciliter of blood, the most recent CDC reference level for an elevated BLL and if all of the following circumstances exist:(1) The test sample was sent to the laboratory by another medical health care provider.(2) The laboratory requested the information from the medical health care provider who obtained the sample.(3) The medical health care provider that who obtained the sample and sent it to the laboratory failed to provide the patients birth date, age, address, or telephone number. information.(j) A laboratory shall request from the health care provider who obtained the blood sample or ordered the test all information required by this section, as applicable. If the health care provider cannot, or will not, provide the requested information, the laboratory is not required to report the information. 124130. (a) A laboratory that performs a blood lead analysis on a specimen of human blood drawn in California shall report the information specified in this section to the department for each analysis on every person tested.(b) The analyzing laboratory shall report all of the following:(1) The test results in micrograms of lead per deciliter.(2) The name of the person tested.(3) The persons birth date if the analyzing laboratory has that information, or if not, the persons age. date.(4) The persons address, including the ZIP Code, if the analyzing laboratory has that information, or if not, a telephone number by which the person may be contacted. and telephone number.(5) The name, address, and telephone number number, and National Provider Identifier (NPI) of the health care provider that ordered the analysis.(6) The name, address, and telephone number number, Clinical Laboratory Improvement Amendments (CLIA) number, and NPI of the analyzing laboratory.(7) The accession number of the specimen.(8) The date the analysis was performed.(c)The analyzing laboratory shall report all of the following information that it possesses:(9) The persons Medi-Cal client identification number (CIN) or, for other health plans, the name of the health plan and the medical plan identification number. (1)(10) The persons gender. sex.(11) The persons race and ethnicity.(12) The persons sexual orientation, if the information and a reporting mechanism are available.(13) The persons pregnancy status. (2)(14) The name, address, and telephone number of the persons employer, if any.(3)(15) The date the specimen was drawn.(4)(16) The source of the specimen, specified as venous, capillary, arterial, cord blood, or other.(17) The name, address, telephone number, and CLIA number of the referring laboratory, if any.(18) The testing methodology used for blood lead analysis specified as point of care, inductively coupled plasma mass spectrometry, graphite furnace atomic spectroscopy, or other. (d)(c) The analyzing laboratory may report to the department other information that directly relates to the blood lead analysis or to the identity, location, medical health care management, or environmental management of the person tested.(e)(d) If the result of the blood lead analysis is a blood lead level equal to or greater than 10 micrograms of lead per deciliter of blood, the most recent federal Centers for Disease Control and Prevention (CDC) reference level for an elevated blood lead level (BLL), the report required by this section shall be submitted within three working days of the analysis. If the result is less than 10 micrograms per deciliter, the CDC reference level for an elevated BLL, the report required by this section shall be submitted within 30 calendar days. days of the analysis. Timing of reporting shall be based on rounding of results to the nearest whole number.(f)(e) A report required by this section shall be submitted by electronic transfer.(g)(f) All information reported pursuant to this section shall be confidential, as provided in Section 100330, except that the department may share the information for as follows:(1) To the individual to whom the information pertains.(2) With the prior written voluntary consent of the individual to whom the information pertains.(3) When required by state or federal law.(4) When compelled by an order of the court or an administrative hearing officer, if a protective order that prohibits any further disclosure is secured prior to disclosure.(5) For the purpose of surveillance, case management, coordination of care, investigation, environmental assessment, environmental remediation, or abatement with the local health department, environmental health agency authorized pursuant to Section 101275, or building department, and with health care providers licensed or certified pursuant to Division 2 (commencing with Section 500) of the Business and Professions Code, or a federal, state, or local governmental agency.(6) For research, as defined in Part 46 of Title 45 of the Code of Federal Regulations, as may be amended, if the request for information is approved by the Committee for the Protection of Human Subjects (CPHS) for the California Health and Human Services Agency, the requesting entity provides documentation to the department that demonstrates, to the departments satisfaction, that the entity has established the procedures and ability to maintain the confidentiality of the information, and the requesting entity has agreed, in writing, to maintain the confidentiality of the information.(7) With the State Department of Health Care Services for the purpose of determining whether children enrolled in Medi-Cal are being screened for lead poisoning and receiving appropriate related services. The(g) (1) The State Department of Health Care Services and health care providers may further disclose the information reported pursuant to this section to a managed health care plan in which a beneficiary who is the subject of the information is enrolled, who may further disclose this information to the beneficiarys health care provider to proactively offer and coordinate care and treatment services and administer payment programs. The(2) The local health department, environmental health agency, or building department department, researcher, or federal, state, or local governmental entity shall not further disclose the information and shall otherwise maintain the confidentiality of the information in the manner provided in Section 100330. The(3) Notwithstanding any other law, a disclosure authorized pursuant to this section, except to the State Department of Health Care Services and to health care providers, shall include only the information necessary for the stated purpose of the requested disclosure, be used only for the approved purpose, and not be further disclosed.(4) The State Department of Health Care Services and health care providers shall use, disclose, and maintain the confidentiality of information shared with it pursuant to this subdivision in accordance with the federal Health Insurance Portability and Accountability Act of 1996, as may be amended, and pursuant to regulations promulgated thereto, and other laws applicable to information in possession of the State Department of Health Care Services. The Services and health care providers.Legislature finds and declares that under existing law this information is not subject to public disclosure.(h) The director may assess a fine up to five hundred dollars ($500) against any a laboratory that knowingly fails to meet the reporting requirements of this section.(i) A laboratory shall not be fined or otherwise penalized for failure to provide the patients birth date, age, address, or telephone number patient information required by this section if the result of the blood lead analysis is a blood lead level less than 25 micrograms of lead per deciliter of blood, the most recent CDC reference level for an elevated BLL and if all of the following circumstances exist:(1) The test sample was sent to the laboratory by another medical health care provider.(2) The laboratory requested the information from the medical health care provider who obtained the sample.(3) The medical health care provider that who obtained the sample and sent it to the laboratory failed to provide the patients birth date, age, address, or telephone number. information.(j) A laboratory shall request from the health care provider who obtained the blood sample or ordered the test all information required by this section, as applicable. If the health care provider cannot, or will not, provide the requested information, the laboratory is not required to report the information. 124130. (a) A laboratory that performs a blood lead analysis on a specimen of human blood drawn in California shall report the information specified in this section to the department for each analysis on every person tested. (b) The analyzing laboratory shall report all of the following: (1) The test results in micrograms of lead per deciliter. (2) The name of the person tested. (3) The persons birth date if the analyzing laboratory has that information, or if not, the persons age. date. (4) The persons address, including the ZIP Code, if the analyzing laboratory has that information, or if not, a telephone number by which the person may be contacted. and telephone number. (5) The name, address, and telephone number number, and National Provider Identifier (NPI) of the health care provider that ordered the analysis. (6) The name, address, and telephone number number, Clinical Laboratory Improvement Amendments (CLIA) number, and NPI of the analyzing laboratory. (7) The accession number of the specimen. (8) The date the analysis was performed. (c)The analyzing laboratory shall report all of the following information that it possesses: (9) The persons Medi-Cal client identification number (CIN) or, for other health plans, the name of the health plan and the medical plan identification number. (1) (10) The persons gender. sex. (11) The persons race and ethnicity. (12) The persons sexual orientation, if the information and a reporting mechanism are available. (13) The persons pregnancy status. (2) (14) The name, address, and telephone number of the persons employer, if any. (3) (15) The date the specimen was drawn. (4) (16) The source of the specimen, specified as venous, capillary, arterial, cord blood, or other. (17) The name, address, telephone number, and CLIA number of the referring laboratory, if any. (18) The testing methodology used for blood lead analysis specified as point of care, inductively coupled plasma mass spectrometry, graphite furnace atomic spectroscopy, or other. (d) (c) The analyzing laboratory may report to the department other information that directly relates to the blood lead analysis or to the identity, location, medical health care management, or environmental management of the person tested. (e) (d) If the result of the blood lead analysis is a blood lead level equal to or greater than 10 micrograms of lead per deciliter of blood, the most recent federal Centers for Disease Control and Prevention (CDC) reference level for an elevated blood lead level (BLL), the report required by this section shall be submitted within three working days of the analysis. If the result is less than 10 micrograms per deciliter, the CDC reference level for an elevated BLL, the report required by this section shall be submitted within 30 calendar days. days of the analysis. Timing of reporting shall be based on rounding of results to the nearest whole number. (f) (e) A report required by this section shall be submitted by electronic transfer. (g) (f) All information reported pursuant to this section shall be confidential, as provided in Section 100330, except that the department may share the information for as follows: (1) To the individual to whom the information pertains. (2) With the prior written voluntary consent of the individual to whom the information pertains. (3) When required by state or federal law. (4) When compelled by an order of the court or an administrative hearing officer, if a protective order that prohibits any further disclosure is secured prior to disclosure. (5) For the purpose of surveillance, case management, coordination of care, investigation, environmental assessment, environmental remediation, or abatement with the local health department, environmental health agency authorized pursuant to Section 101275, or building department, and with health care providers licensed or certified pursuant to Division 2 (commencing with Section 500) of the Business and Professions Code, or a federal, state, or local governmental agency. (6) For research, as defined in Part 46 of Title 45 of the Code of Federal Regulations, as may be amended, if the request for information is approved by the Committee for the Protection of Human Subjects (CPHS) for the California Health and Human Services Agency, the requesting entity provides documentation to the department that demonstrates, to the departments satisfaction, that the entity has established the procedures and ability to maintain the confidentiality of the information, and the requesting entity has agreed, in writing, to maintain the confidentiality of the information. (7) With the State Department of Health Care Services for the purpose of determining whether children enrolled in Medi-Cal are being screened for lead poisoning and receiving appropriate related services. The (g) (1) The State Department of Health Care Services and health care providers may further disclose the information reported pursuant to this section to a managed health care plan in which a beneficiary who is the subject of the information is enrolled, who may further disclose this information to the beneficiarys health care provider to proactively offer and coordinate care and treatment services and administer payment programs. The (2) The local health department, environmental health agency, or building department department, researcher, or federal, state, or local governmental entity shall not further disclose the information and shall otherwise maintain the confidentiality of the information in the manner provided in Section 100330. The (3) Notwithstanding any other law, a disclosure authorized pursuant to this section, except to the State Department of Health Care Services and to health care providers, shall include only the information necessary for the stated purpose of the requested disclosure, be used only for the approved purpose, and not be further disclosed. (4) The State Department of Health Care Services and health care providers shall use, disclose, and maintain the confidentiality of information shared with it pursuant to this subdivision in accordance with the federal Health Insurance Portability and Accountability Act of 1996, as may be amended, and pursuant to regulations promulgated thereto, and other laws applicable to information in possession of the State Department of Health Care Services. The Services and health care providers. Legislature finds and declares that under existing law this information is not subject to public disclosure. (h) The director may assess a fine up to five hundred dollars ($500) against any a laboratory that knowingly fails to meet the reporting requirements of this section. (i) A laboratory shall not be fined or otherwise penalized for failure to provide the patients birth date, age, address, or telephone number patient information required by this section if the result of the blood lead analysis is a blood lead level less than 25 micrograms of lead per deciliter of blood, the most recent CDC reference level for an elevated BLL and if all of the following circumstances exist: (1) The test sample was sent to the laboratory by another medical health care provider. (2) The laboratory requested the information from the medical health care provider who obtained the sample. (3) The medical health care provider that who obtained the sample and sent it to the laboratory failed to provide the patients birth date, age, address, or telephone number. information. (j) A laboratory shall request from the health care provider who obtained the blood sample or ordered the test all information required by this section, as applicable. If the health care provider cannot, or will not, provide the requested information, the laboratory is not required to report the information.