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California Getting Ready for HITECH Funds

January 15, 2010
by David Raths
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Although California has yet to receive official word from the federal government on the approximately $38 million it is expecting to receive to coordinate e-health efforts, the state is hard at work on developing its operational plans for how it will use the HITECH funding.

Because its process is quite transparent, with regular webinars held to explain the progress and hear concerns about issues, the Golden State provides a great opportunity to study how state governments are meeting the challenge of preparing to responsibly take advantage of a huge influx of federal money.

Despite California’s deep economic crisis and “Furlough Fridays,” the state Health and Human Services Department effort, led by Jonah Frolich, deputy secretary for health IT, has been fast-paced and impressive.

As Frolich explained during a Jan. 14 webinar for stakeholders, one piece of unfinished business is choosing the nonprofit health information exchange governance entity. (In many states, there’s one obvious choice because a certain public/private organization has led statewide e-health developments, but it California it has been less obvious who should lead the effort.) At the request of the state, board members of the two main contending organizations, CalRHIO and the California eHealth Collaborative, delivered a joint proposal on Jan. 11. A review committee will accept or reject the proposal later this month. It’s not clear yet who would lead this newly created entity.

Four committees have been established to work toward contributing content to the operational plan, which has a self-imposed deadline of March 31. Those committees include one on underserved and vulnerable patients, another on patient engagement, one on a sustainable business model, and a technical committee and working group. Another group, the California Privacy and Security Advisory Board, is working on security and privacy issues, such as whether HIE consent should be opt-in or opt-out. (That group faces a big challenge, because the consent question is just one of the thorny issues about which there is legal ambiguity and very little consensus.)

Frolich also mentioned that one regional extension center proposal called Cal-REC, which plans to operate in areas of both Northern and Southern California, has received signals that it will receive funding in the first round, while two other organizations, LA Care and CalOptima, look like they will get funded in the second round.

Responding to a question about sustainable funding, Frolich acknowledged that the $38 million over four years was going to get the state “only part way down a path, with much of the track unlaid.” The state will need more capital to fully build it out as well as ongoing funding. The finance committee, will look at transaction fees, subscription fees and fees on claims. “Everything will be considered,” he said.

Have readers noticed other states doing a good job of preparing to play their role in HIE development and meaningful use of health IT?

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