103875-103885

HEALTH AND SAFETY CODE
SECTION 103875-103885




103875.  (a) The department shall conduct a program of
epidemiological assessments of the incidence of cancer. The program
shall encompass all areas of the state for which cancer incidence
data are available. The program shall include the monitoring of
cancers associated with suspected carcinogens encountered by the
general public both in occupational locations and in the environment
generally.
   (b) The program shall be under the direction of the director, who
may enter into contracts as are necessary for the conduct of the
program and may accept, on behalf of the state, grants of public or
private funds for the program. The director shall analyze available
incidence data and prepare reports and perform studies as necessary
to identify cancer hazards to the public health and their remedies.
   (c) It is the intent of the Legislature that an appropriation be
included in each Budget Act in an amount sufficient to provide for
the annual cost of the program.



103885.  (a) The director shall establish a statewide system for the
collection of information determining the incidence of cancer, using
population-based cancer registries modeled after the Cancer
Surveillance Program of Orange County. As of the effective date of
this section the director shall begin phasing in the statewide cancer
reporting system. By July 1, 1988, all county or regional registries
shall be implemented or initiated. By July 1, 1990, the statewide
cancer reporting system shall be fully operational. Within 60 days of
the effective date of this section, the director shall submit an
implementation and funding schedule to the Legislature.
   (b) The department may designate any demographic parts of the
state as regional cancer incidence reporting areas and may establish
regional cancer registries, with the responsibility and authority to
carry out the intent of this section in designated areas. Designated
regional registries shall provide, on a timely basis, cancer
incidence data as designated by the state department to the
department. The department may contract with an agency, including,
but not limited to, a health systems agency, single county health
department, multicounty health department grouping, or nonprofit
professional association, representing a designated cancer reporting
region for the purposes of collecting and collating cancer incidence
data.
   (c) The director shall designate cancer as a disease required to
be reported in the state or any demographic parts of the state in
which cancer information is collected under this section. All cancers
diagnosed or treated in the reporting area shall thereafter be
reported to the representative of the department authorized to
compile the cancer data, or any individual, agency, or organization
designated to cooperate with that representative.
   (d) (1) Any hospital or other facility providing therapy to cancer
patients within an area designated as a cancer reporting area shall
report each case of cancer to the department or the authorized
representative of the department in a format prescribed by the
department. If the hospital or other facility fails to report in a
format prescribed by the department, the department's authorized
representative may access the information from the hospital or the
facility and report it in the appropriate format. In these cases, the
hospital or other health facility shall reimburse the state
department or the authorized representative for its cost to access
and report the information.
   (2) Any physician and surgeon, dentist, podiatrist, or other
health care practitioner diagnosing or providing treatment for cancer
patients shall report each cancer case to the department or the
authorized representative of the department except for those cases
directly referred to a treatment facility or those previously
admitted to a treatment facility for diagnosis or treatment of that
instance of cancer.
   (e) Any hospital or other facility that is required to reimburse
the department or its authorized representative for the cost to
access and report the information pursuant to subdivision (d) shall
provide payment to the department or its authorized representative
within 60 days of the date this payment is demanded. In the event any
hospital or other facility fails to make the payment to the
department or its authorized representative within 60 days of the
date the payment is demanded, the department or its authorized
representative may, at its discretion, assess a late fee not to
exceed 1 1/2 percent per month of the outstanding balance. Further,
in the event that the department or its authorized representative
takes a legal action to recover its costs and any associated fees,
and the department or its authorized representative receives a
judgment in its favor, the hospital or other facility shall also
reimburse the department or its authorized representative for any
additional costs it incurred to pursue the legal action. Late fees
and payments made to the department by hospitals or other facilities
pursuant to this subdivision shall be considered as reimbursements of
the additional costs incurred by the department.
   (f) All physicians and surgeons, hospitals, outpatient clinics,
nursing homes and all other facilities, individuals or agencies
providing diagnostic or treatment services to patients with cancer
shall grant to the department or the authorized representative access
to all records that would identify cases of cancer or would
establish characteristics of the cancer, treatment of the cancer, or
medical status of any identified cancer patient. Willful failure to
grant access to those records shall be punishable by a fine of up to
five hundred dollars ($500) each day access is refused. Any fines
collected pursuant to this subdivision shall be deposited in the
General Fund.
   (g) (1) Except as otherwise provided in this section, all
information collected pursuant to this section shall be confidential.
For purposes of this section, this information shall be referred to
as "confidential information."
   (2) The department and any regional cancer registry designated by
the department shall use the information to determine the sources of
malignant neoplasms and evaluate measures designed to eliminate,
alleviate, or ameliorate their effect.
   (3) Persons with a valid scientific interest who are engaged in
demographic, epidemiological, or other similar studies related to
health who meet qualifications as determined by the department, and
who agree, in writing, to maintain confidentiality, may be authorized
access to confidential information.
   (4) The department and any regional cancer registry designated by
the department may enter into agreements to furnish confidential
information to other states' cancer registries, federal cancer
control agencies, local health officers, or health researchers for
the purposes of determining the sources of cancer and evaluating
measures designed to eliminate, alleviate, or ameliorate their
effect. Before confidential information is disclosed to those
agencies, officers, researchers, or out-of-state registries, the
requesting entity shall agree in writing to maintain the
confidentiality of the information, and in the case of researchers,
shall also do both of the following:
   (A) Obtain approval of their committee for the protection of human
subjects established in accordance with Part 46 (commencing with
Section 46.101) of Title 45 of the Code of Federal Regulations.
   (B) Provide documentation to the department that demonstrates to
the department's satisfaction that the entity has established the
procedures and ability to maintain the confidentiality of the
information.
   (5) Notwithstanding any other provision of law, any disclosure
authorized by this section shall include only the information
necessary for the stated purpose of the requested disclosure, used
for the approved purpose, and not be further disclosed.
   (6) The furnishing of confidential information to the department
or its authorized representative in accordance with this section
shall not expose any person, agency, or entity furnishing information
to liability, and shall not be considered a waiver of any privilege
or a violation of a confidential relationship.
   (7) The department shall maintain an accurate record of all
persons who are given access to confidential information. The record
shall include: the name of the person authorizing access; name,
title, address, and organizational affiliation of persons given
access; dates of access; and the specific purpose for which
information is to be used. The record of access shall be open to
public inspection during normal operating hours of the department.
   (8) Notwithstanding any other provision of law, no part of the
confidential information shall be available for subpoena, nor shall
it be disclosed, discoverable, or compelled to be produced in any
civil, criminal, administrative, or other proceeding, nor shall this
information be deemed admissible as evidence in any civil, criminal,
administrative, or other tribunal or court for any reason.
   (9) Nothing in this subdivision shall prohibit the publication by
the department of reports and statistical compilations that do not in
any way identify individual cases or individual sources of
information.
   (10) Notwithstanding the restrictions in this subdivision, the
individual to whom the information pertains shall have access to his
or her own information in accordance with Chapter 1 (commencing with
Section 1798) of Title 1.8 of the Civil Code.
   (h) For the purpose of this section, "cancer" means either of the
following:
   (1) All malignant neoplasms, regardless of the tissue of origin,
including malignant lymphoma, Hodgkins disease, and leukemia, but
excluding basal cell and squamous cell carcinoma of the skin.
   (2) All primary intracranial and central nervous system (CNS)
tumors occurring in the following sites, irrespective of histologic
type: brain, meninges, spinal cord, caudae equina, cranial nerves and
other parts of the CNS, pituitary gland, pineal gland, and
craniopharyngeal duct.
   (i) Nothing in this section shall preempt the authority of
facilities or individuals providing diagnostic or treatment services
to patients with cancer to maintain their own facility-based cancer
registries.
   (j) It is the intent of the Legislature that the department, in
establishing a system pursuant to this section, maximize the use of
available federal funds.