June 20, 2023

Assemblymember Phil Ting

Chair, Assembly Committee on Budget 1021 O Street, Suite 8230

Sacramento, CA 95814

Senator Nancy Skinner

Chair, Senate Committee on Budget 1020 N Street, Room 502

Sacramento, CA 95814

Re: Data Exchange Framework Proposed Trailer Bill Language

Dear Assembly and Senate Budget Committee chairs,

On behalf of Connecting for Better Health, we thank you for your leadership in advancing California’s Data Exchange Framework. The proposed Trailer Bill Language from the Center for Data Insights and Innovation (“the Center”), published February 24, 2023, will make needed changes to California law to grant the Center the authority needed to set up a Data Exchange Framework governing board and continue to refine the Data Sharing Agreement and its policies and procedures, and we recommend that the budget committees reconsider adopting Trailer Bill Language related to the Data Exchange Framework.

Connecting for Better Health is a coalition representing diverse health care organizations and leaders including consumers, providers, and health plans, that supports the advancement of health data exchange policy in California. Our vision is that every Californian and their care team have the information and insights they need to make health care seamless, high quality, and affordable. A robust Data Exchange Framework is key to advancing this vision, and we appreciate your leadership in moving stakeholder conversations forward on how best to improve California law on the subject.

We urge the legislature and the Center for Data Insights and Innovation to consider our proposed recommendations and amendments below that would clarify the required signatories to the Data Sharing Agreement; grant the Center clear statutory authority to interpret state law and issue new rules and regulations; and require a formal mechanism for engaging state agencies and other entities like qualified health information organizations in advisory groups, among other needed changes. We believe these changes strengthen the proposed language and provide a clearer path forward to encourage entities to sign the Data Sharing Agreement, promote transparent state agency and stakeholder engagement, and allow additional changes to be made to the Data Sharing Agreement and its Policies and Procedures—all while we continue to encourage CDII to work with stakeholders to clarify necessary details in the Policies and Procedures to ensure efficient and aligned implementation of the DxF.

Specifically, we recommend the Committee make the following changes:

· Include references to both health and social services information, to reinforce the intent of the Data Exchange Framework to take a whole-person approach to data sharing.

· Provide clear definitions and references for the entities required to sign and share data under the Data Sharing Agreement in particular leveraging other legal definitions to define required signatories.

· Adjust dates to reflect revisions to the list of required signatories and given that current deadlines may be unrealistic due to lack of compliance with the requirement to sign the Data Sharing Agreement.

· Grant clear authority to the Center to further clarify the categories of entities to the required list of signatories to the Data Sharing Agreement, and clear authority to promulgate regulations and conduct investigations in relation to the Data Sharing Agreement and its policies and procedures.

· Grant authority to the Center to enforce the Data Sharing Agreement to ensure compliance with the Data Exchange Framework.

· Reduce the number of representatives on the proposed Data Exchange Board, and clarify the intent of establishing the board in advancing California’s health care access, equity, affordability, public health and quality programs and goals, including California Advancing and Innovating Medi-Cal (“CalAIM”).

· Call on the Center to establish a cross-agency task force comprised of representatives from state agencies to coordinate funding and policy strategies related to data sharing, and a Qualified Health Information Advisory Group to provide recommendations on technical standards and policies and procedures affecting the qualified health information organizations that will serve as data sharing intermediaries for signatories to the Data Sharing Agreement.

To that end, please find included below the signature line our recommendations indicated in red for amendments to the Health and Safety Code, based on the Center’s proposed Trailer Bill Language published February 24, 2023.

We thank you for your leadership and consideration of these amendments.