S1996

An Act concerning certain minor patients’ demographic information and amending P.L.2021, c.454.

Be It Enacted by the Senate and General Assembly of the State of New Jersey:

1. Section 1 of P.L.2021, c.454 (C.26:2H-5.36) is amended to read as follows:

1. a. Each general acute care hospital that collects data concerning patient race, ethnicity, sexual orientation, or gender identity for any reason shall implement an evidence-based cultural competency training program for all staff members employed by or working under the supervision of the general acute hospital who have direct contact with patients and are responsible for collecting race and ethnicity, sexual orientation, and gender identity information from patients.

b. Each cultural competency training program implemented pursuant to subsection a. of this section shall include training on how to collect race, ethnicity, sexual orientation, and gender identity in a culturally competent and sensitive manner. This may include the following topics:

(1) common terminology for race and ethnicity, sexual orientation, and gender identity data;

(2) information on the relationship between patient health and collecting race and ethnicity, sexual orientation, and gender identity data;

(3) information on how race and ethnicity, sexual orientation, and gender identity data will be used;

(4) information on how to navigate discomfort in patients and staff when asking patients for their race and ethnicity, sexual orientation, and gender identity information; and

(5) information on how to create an inclusive and affirming environment for all patients.

c. Each staff member who is employed by or working under the supervision of the general acute care hospital, has direct contact with patients, and is responsible for collecting race and ethnicity, sexual orientation, and gender identity information from patients, shall:

(1) complete the cultural competency training program implemented pursuant to subsection a. of this section at such times and intervals as the hospital shall require; and

(2) complete a cultural competency refresher course at least once biennially if completion of the course is deemed necessary by the hospital.

d. If the patient is a minor under the age of 18, a general acute care hospital shall not collect, or request to collect, data concerning patient sexual orientation or gender identity, unless the patient of the patient’s parent or guardian voluntarily provides the data, which data shall solely be used for the purposes of medical diagnosis and treatment and shall not be used for any other purpose.

(cf: P.L.2022, c.44, s.1)

2. Section 2 of P.L.2021, c.454 (C.45:9-42.46) is amended to read as follows:

2. a. (1) A clinical laboratory shall electronically record the race, ethnicity, sexual orientation, and gender identity of each patient who presents with a non-electronic order for testing at a clinical laboratory patient service center, except that, if the patient is a minor under the age of 18, a clinical laboratory shall not collect, or request to collect, data concerning patient sexual orientation or gender identity unless the patient or the patient’s parent or guardian voluntarily provides the data, which data shall solely be used for the purposes of medical diagnosis and treatment and shall not be used for any other purpose. If a clinical laboratory processes a specimen without the presence of a patient, the clinical laboratory shall not be responsible for recording and reporting the patient's gender identity, sexual orientation, and racial and ethnic information and may record "not provided" in lieu of the other selections provided under paragraphs (2) through (4) of this subsection.

(2) Race and ethnicity selections shall include: Alaska Native or American Indian, non-Hispanic; Asian, non-Hispanic; Black or African American, non-Hispanic; Hispanic or Latino; Multiracial, non-Hispanic; Native Hawaiian or other Pacific Islander, non-Hispanic; other race, non-Hispanic; White, non-Hispanic; does not wish to disclose; and not provided.

(3) Sexual orientation selections shall include: bisexual; straight; gay or lesbian; something else; does not wish to disclose; and not provided.

(4) Gender identity selections shall include: male, female, gender nonconforming, transgender male-to-female, transgender female-to-male, does not wish to disclose, and not provided.

b. Any healthcare-related data that is required under State law to be reported by a clinical laboratory to the Department of Health shall include any corresponding gender identity, sexual orientation, and racial and ethnic data recorded pursuant to this section, and shall be incorporated into the appropriate disease surveillance reporting system. The Commissioner of Health shall issue guidance concerning the healthcare-related data that is subject to the requirements of this subsection.

c. A non-electronic specimen collection and analysis requisition form distributed by a clinical laboratory shall contain a section for the manual entry of the patient's racial, ethnic, sexual orientation, and gender identity information on the form.

d. Race and ethnicity, sexual orientation, and gender identity information that is required to be recorded or reported pursuant to this section shall be recorded or reported using a program that is compatible with the State's disease surveillance reporting system using such data fields as may be available or necessary in the version of Health Level Seven International recording and reporting standards or equivalent standards adopted by the laboratory, or using any other program or standard as may be designated by the Commissioner of Health that produces superior data collection and related benefits or that is otherwise in accordance with best practice.

e. The Commissioner of Health may modify, by regulation, the race, ethnicity, sexual orientation, and gender identity selections provided in subsection a. of this section as appropriate or pursuant to federal requirements.

(cf: P.L.2022, c.44, s.2)

3. Section 3 of P.L.2021, c.454 (C.45:9-42.47) is amended to read as follows:

3. Any electronic medical records or laboratory information management systems used by acute care hospitals and licensed clinical laboratories in this State or sold by a vendor of such systems in this State for use by acute care hospitals and licensed clinical laboratories, on or after the effective date of this act, shall be configured in a manner that prevents an authorized user from saving or storing a patient's demographic information into the electronic medical records or laboratory information management systems unless a selection for a patient's gender identity, sexual orientation, and racial and ethnic information is recorded. If the patient is a minor under the age of 18, the electronic medical records or laboratory information management system shall be configured in a manner that does not require a selection for the patient's gender identity and sexual orientation in order to save or store the patient's demographic information. Nothing in this act shall prohibit a clinical laboratory from receiving, processing, or saving data related to specimens that are ordered or received from outside of this State. The gender identity, sexual orientation, and racial and ethnic information of a patient shall be included in laboratory orders generated by electronic medical record systems. The Department of Health may impose necessary corrective actions to achieve compliance with the provisions of this section, which may include, but need not be limited to, an attestation to be completed by an acute care hospital or a licensed clinical laboratory that: indicates specific steps that will be taken to achieve compliance within 120 days following the date of attestation; acknowledges legal obligations and penalties under this section; and provides relevant vendor information. A vendor of electronic medical records or laboratory information management systems that fails to comply with the provisions of this section shall be liable to a civil penalty of up to $1,000 for each day during which the vendor's system is out of compliance. A civil penalty assessed pursuant to this section shall be collected by and in the name of the Department of Health in summary proceedings before a court of competent jurisdiction pursuant to the provisions of the "Penalty Enforcement Law of 1999," P.L.1999, c.174 (C.2A:58-10 et seq.).

(cf: P.L.2022, c.44, s.3)

4. The Commissioner of Health shall adopt rules and regulations, in accordance with the “Administrative Procedure Act,” P.L.1968, c.410 (C.52:14B-1 et seq.), as are necessary to effectuate the provisions of this act.

5. This act shall take effect immediately.

STATEMENT

This bill revises certain laws pertaining to electronic medical records and the recording of patients’ demographic information.

It is the sponsor’s intent that this bill will prohibit general acute care hospitals and clinical laboratories from collecting, or requesting to collect, data concerning sexual orientation or gender identity from minor patients, unless the minor patient’s parent or guardian voluntarily provides such information. If such information is voluntarily provided by a parent or guardian, the provisions of the bill should not be construed as prohibiting a health care provider from discussing and recording the information, as necessary for the provision of health care services.

Specifically, this bill provides that a general acute care hospital or clinical laboratory will not collect, or request to collect, data concerning patient sexual orientation or gender identity for a patient who is a minor under the age of 18, unless the patient or patient’s parent or guardian voluntarily provides the data. The bill also revises current law concerning electronic medical records or laboratory information management systems to provide that, in the case of a minor patient under the age of 18, certain electronic medical records or laboratory information management systems will be configured in a manner that does not require a selection for the patient's gender identity and sexual orientation in order to save or store the patient’s demographic information.

Under current law, a clinical laboratory is required to electronically record the race, ethnicity, sexual orientation, and gender identity of each patient who presents with a non-electronic order for testing at a clinical laboratory patient service center. Current law also requires that certain electronic medical records or laboratory information management systems used by acute care hospitals and licensed clinical laboratories are to be configured in a manner that prevents an authorized user from saving or storing a patient's demographic information into the electronic medical records or laboratory information management systems unless a selection for a patient's gender identity, sexual orientation, and racial and ethnic information is recorded.