1 of 1 SENATE DOCKET, NO. 803 FILED ON: 1/18/2023 SENATE . . . . . . . . . . . . . . No. 1344 The Commonwealth of Massachusetts _________________ PRESENTED BY: John J. Cronin _________________ To the Honorable Senate and House of Representatives of the Commonwealth of Massachusetts in General Court assembled: The undersigned legislators and/or citizens respectfully petition for the adoption of the accompanying bill: An Act to improve outcomes for individuals with Parkinson’s disease. _______________ PETITION OF: NAME:DISTRICT/ADDRESS :John J. CroninWorcester and Middlesex 1 of 7 SENATE DOCKET, NO. 803 FILED ON: 1/18/2023 SENATE . . . . . . . . . . . . . . No. 1344 By Mr. Cronin, a petition (accompanied by bill, Senate, No. 1344) of John J. Cronin for legislation to improve outcomes for individuals with Parkinson’s disease. Public Health. The Commonwealth of Massachusetts _______________ In the One Hundred and Ninety-Third General Court (2023-2024) _______________ An Act to improve outcomes for individuals with Parkinson’s disease. Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority of the same, as follows: 1 SECTION 1. Chapter 111 of the General Laws is hereby amended by striking Section 2243 and inserting in place thereof the following new section: - 3 Section 243: Parkinson’s disease registry 4 (a) As used in this section, the following words shall, unless the context clearly requires 5otherwise, have the following meanings: 6 “Parkinson’s disease”, a chronic and progressive neurologic disorder resulting from 7deficiency of the neurotransmitter dopamine as the consequence of specific degenerative changes 8in the area of the brain called the basal ganglia. It is characterized by tremor at rest, slow 9movements, muscle rigidity, stooped posture, and unsteady or shuffling gait. 10 “Parkinsonisms”, related conditions that causes a combination of the movement 11abnormalities seen in Parkinson's disease — such as tremor at rest, slow movement, muscle 12rigidity, impaired speech or muscle stiffness — which often overlap with and can evolve from 2 of 7 13what appears to be Parkinson’s disease. Example Parkinsonisms of particular interest include, 14but are not exclusive to, the following: Multiple System Atrophy (MSA), Dementia with Lewy 15Bodies (DLB), Corticobasal Degeneration (CBD), and Progressive Supranuclear Palsy (PSP). 16 (a) The department shall establish a Parkinson's disease registry for the collection of 17information necessary to determine the incidence and prevalence of Parkinson's disease and 18Parkinsonisms in the commonwealth. 19 (b) There shall be within the department a Parkinson's disease registry advisory 20committee to advise and assist in the development, implementation and progress of the 21Parkinson's disease registry established in subsection (a). The committee shall review and submit 22recommendations on: (i) what data shall be collected, including, but not limited to, demographic 23information and data by areas and regions of the commonwealth, with specific data from urban, 24low and median income communities and minority communities of the commonwealth; (ii) the 25means of collecting and disseminating such data; (iii) how to ensure privacy and confidentiality 26of such data; (iv) the purpose, design and functionality of the registry; and (v) the 27implementation of the registry. The committee shall recommend to the department any 28information deemed necessary and appropriate for the statistical identification and planning for 29treatment and education of health care providers and persons diagnosed with Parkinson's disease. 30 The committee shall consist of the commissioner, or a designee, and 10 members to be 31appointed by the commissioner as follows: 3 physicians, 1 of whom shall be a general 32neurologist, 1 of whom shall be a movement disorder specialist and 1 of whom shall be a 33primary care physician; 1 health informaticist; 2 population health researchers familiar with 34registries; 2 Parkinson's disease researchers; and 2 persons diagnosed with Parkinson's disease. 3 of 7 35The committee shall meet at least bi-annually to assess registry progress and recommend 36changes. 37 (c) The registry and system of collection and dissemination of information shall be under 38the direction of the commissioner, who may enter into contracts, grants or other agreements as 39are necessary for the conduct of the program. 40 (d) All patients diagnosed with Parkinson’s disease or related Parkinsonisms, as advised 41by an Advisory Committee, shall be provided a notice in writing and orally regarding the 42collection of information and patient data on Parkinson’s disease. Patients who do not wish to 43participate in the collection of data for purposes of research in this registry shall affirmatively 44opt-out in writing after an opportunity to review the documents and ask questions. No patient 45shall be forced to participate in this registry. Patients may change their participation status at any 46time by submitting a request in writing. 47 (e) The department shall establish a system for the collection and dissemination of 48information determining the incidence and prevalence of Parkinson’s disease and related 49Parkinsonisms, as advised by the advisory committee. The department shall designate 50Parkinson’s disease and related Parkinsonisms as advised by the advisory committee as diseases 51required to be reported in the state or any part of the state. 52 All cases of Parkinson’s disease diagnosed or treated in the commonwealth shall be 53reported to the department. However, the mere incidence of a patient with Parkinson’s shall be 54the sole required information for this registry for any patient who chooses not to participate. For 55the subset of patients who choose not to participate, no further data shall be reported to the 56registry. 4 of 7 57 The department may create, review and revise a list of data points required as part of 58mandated Parkinson’s disease reporting under this Section. 59 i. This list shall include, but not be limited to, necessary triggering diagnostic conditions, 60consistent with the latest International Statistical Classification of Diseases and Related Health 61Problems, and resulting case data including, but not limited to, diagnosis, treatment and survival. 62 ii. The department may implement and administer this subdivision through a bulletin, or 63similar instruction, to providers without taking regulatory action. 64 (f) The department shall provide notification of the mandatory reporting of Parkinson’s 65disease and Parkinsonism on its website and may also provide that information to professional 66associations representing physicians, nurse practitioners, and hospitals at least 90 days prior to 67requiring information be reported. 68 (g) Any hospital, facility, physician, surgeon, physician assistant or nurse practitioner 69who diagnoses or is responsible for providing primary treatment to Parkinson’s disease or 70Parkinsonism patients shall report each case of Parkinson’s disease and Parkinsonisms, as 71required by subsection (e), to the department in a format prescribed by the department. The 72Department shall be authorized to enter into data sharing contracts with data reporting entities 73and their associated electronic medical record systems vendors to securely and confidentially 74receive information related to Parkinson’s disease testing, diagnosis and treatment. 75 (h) The department may enter into agreements to furnish data collected in this registry to 76other states’ Parkinson’s disease registries, federal Parkinson’s disease control agencies, local 77health officers, or health researchers for the study of Parkinson’s disease. Before confidential 78information is disclosed to those agencies, officers, researchers, or out-of-state registries, the 5 of 7 79requesting entity shall agree in writing to maintain the confidentiality of the information, and in 80the case of researchers, shall also do both of the following: 81 i. obtain approval of their committee for the protection of human subjects established in 82accordance with Part 46 (commencing with Section 46.101) of Title 45 of the Code of Federal 83Regulations; and 84 ii. provide documentation to the department that demonstrates to the department’s 85satisfaction that the entity has established the procedures and ability to maintain the 86confidentiality of the information 87 (i) Except as otherwise provided in this section, all information collected pursuant to this 88section shall be confidential. For purposes of this section, this information shall be referred to as 89confidential information. To ensure privacy, the department shall promulgate a coding system 90that removes any identifying information about the patient. 91 (j) Notwithstanding any other law, a disclosure authorized by this section shall include 92only the information necessary for the stated purpose of the requested disclosure, used for the 93approved purpose, and not be further disclosed. 94 i. Provided the security of confidentiality has been documented, the furnishing of 95confidential information to the department or its authorized representative in accordance with 96this section shall not expose any person, agency or entity furnishing information to liability, and 97shall not be considered a waiver of any privilege or a violation of a confidential relationship. 98 (k) The department shall maintain an accurate record of all persons who are given access 99to confidential information. The record shall include: the name of the person authorizing access; 6 of 7 100name, title, address, and organizational affiliation of persons given access; dates of access; and 101the specific purpose for which information is to be used. The record of access shall be open to 102public inspection during normal operating hours of the department. 103 (l) Notwithstanding any other law, confidential information shall not be available for 104subpoena, shall not be disclosed, discoverable or compelled to be produced in any civil, criminal, 105administrative or other proceeding. Confidential information shall not be deemed admissible as 106evidence in any civil, criminal, administrative or other tribunal or court for any reason. 107 This subsection does not prohibit the publication by the department of reports and 108statistical compilations that do not in any way identify individual cases or individual sources of 109information. 110 Notwithstanding the restrictions in this subsection, the individual to whom the 111information pertains shall have access to his or her own information. 112 (m) This section does not preempt the authority of facilities or individuals providing 113diagnostic or treatment services to patients with Parkinson’s disease to maintain their own 114facility-based Parkinson’s disease registries. 115 SECTION 2. On or before December 21, 2024, and every year thereafter, the Department 116shall report to the House Committee on Ways and Means, the Senate Committee on Ways and 117Means, and the Joint Committee on Public Health, a yearly program summary update on the 118incidents and prevalence of Parkinson’s in the state by county, how many records have been 119included and reported into the registry, and demographic information such as patients by age, 120gender and race. This yearly report shall also be published in a downloadable format on the 121Department’s webpage or designated Massachusetts Parkinson’s Research Registry webpage. 7 of 7 122 SECTION 3. The Department shall create and maintain a webpage titled “an overview 123from the Massachusetts Parkinson’s Research Registry” within the Department’s public 124information website to allow public access to information related to the registry, a yearly 125program summary, and any other relevant or helpful information related to the registry as 126deemed necessary by the Parkinson’s Disease Registry Advisory Committee. This information 127may be published in any form deemed appropriate by the Department. 128 This section will take effect January 1, 2025.