What is the California Data Sharing Agreement?

The California Data Sharing Agreement sets a new standard for ways that providers will share health and social services information with each other.

In 2021, Assembly Bill 133 (AB 133) was signed into law, requiring the California Health and Human Services Agency (CalHHS) to create a Data Exchange Framework (DxF). One component of the DxF is the development of a Data Sharing Agreement (DSA)

The DSA, finalized in July 2022, describes how health and social services information should be shared between organizations in order to improve patient care and break down silos between health and social services organizations. 

Here are five key facts about the DSA and its implementation.

  • The DSA is an agreement, not a technology.

The DSA lays out the manner in which health and social services information should be shared, but it doesn’t establish a particular platform or technology for entities to use to do so. The DSA provides the “rules of the road” for data sharing.

  • Many health care organizations are required to sign the DSA.
As of January 31, 2023, most providers were required to sign the DSA. These required signatories include:
  • General acute care hospitals
  • Physician organizations and medical groups
  • Skilled nursing facilities that currently maintain electronic records
  • Health care service plans and disability insurers 
  • Clinical laboratories
  • Acute psychiatric hospitals
The following entities are required to sign the DSA by January 31, 2026:
  • Physician practices of fewer than 25 physicians
  • Rehabilitation hospitals
  • Long-term acute care hospitals
  • Acute psychiatric hospitals
  • Critical access hospitals
  • Rural general acute care hospitals with fewer than 100 acute care beds
  • State-run acute psychiatric hospitals
  • Nonprofit clinics with fewer than 10 health care providers

As of March 2023, over 1,400 organizations have signed the DSA, and more are required to sign immediately. 

  • The DSA begins to go into effect in January 2024. 

Signatories will be required to implement the DSA beginning in January 2024. This gives participants time to develop the infrastructure needed to comply and share data according to the DSA. Entities that aren’t required to sign on until 2026 won’t have to implement the DSA until then.

  • Policies and procedures (P&Ps) governing the implementation of the DSA are still under development.

P&Ps provide more detailed guidance on how participants can comply with the DSA. Some P&Ps have already been finalized while some are still under development. The final list of P&Ps is expected to address the following:

  • Requirement to exchange health and social services information
  • Data elements to be exchanged 
  • Methods to exchange data 
  • Permitted, required, and prohibited uses
  • Breach notification
  • Individual access services
  • State-specific information-blocking prohibitions 
  • Technical requirements for exchange 
  • Real-time exchange and early exchange
  • Additional privacy standards and security safeguards


  • Support is available to help participants implement the DSA.

Administered in three rounds in 2023, DSA Signatory Grants can support organizations in building capacity to meet DSA standards. DSA signatories can apply for this funding either for technical assistance (TA) to help set up their own systems to support data sharing or for initial costs to partner with a Qualified Health Information Organization (QHIO) that will provide them with adequate data sharing capabilities.

For more information, visit our California data exchange information hub.


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