To amend sections 3701.261, 3701.262, 3701.263, and 3701.99 and to enact sections 3701.265, 3701.266, and 3701.267 of the Revised Code regarding the Ohio Cancer Incidence Surveillance System.

Section 1.  That sections 3701.261, 3701.262, 3701.263, and 3701.99 be amended and sections 3701.265, 3701.266, and 3701.267 of the Revised Code be enacted to read as follows:

Sec. 3701.261.  (A) The director of health shall:

(1) Establish a population-based cancer registry, which shall be known as the Ohio cancer incidence surveillance system, to monitor the incidence of various types of malignant diseases in Ohio, make appropriate epidemiologic studies to determine any causal relations of such diseases with occupational, nutritional, environmental, or infectious conditions, and alleviate or eliminate any such conditions;

(2) Advise, consult, cooperate with, and assist, by contract or otherwise, agencies of the state and federal government, agencies of the governments of other states, agencies of political subdivisions of this state, universities, private organizations, corporations, and associations for the purposes of division (A)(1) of this section;

(3) Accept and administer grants from the federal government or other sources, public or private, for carrying out any of the functions enumerated in divisions (A)(1) and (2) of this section;

(4) Make available to the public on the internet web site maintained by the department of health annual county cancer profile reports for each county that categorize the type of cancer occurring in each county according to gender, race or ethnicity, and age and that specify the number of cases of cancer occurring per category;

(5) Provide copies of the county cancer profile reports required under division (A)(4) of this section to the directors of the department of natural resources, department of agriculture, the environmental protection agency, and each health commissioner appointed by the board of health of a city or general health district or the authority having the duties of a board of health under section 3709.052 of the Revised Code.

(B) The Ohio cancer incidence surveillance system shall follow a model of cancer data collection as set forth by the survey epidemiology and end results system (SEERS).

Sec. 3701.262.  (A) As used in this section and section sections 3701.263 to 3701.267 of the Revised Code:

(1) "Physician" means a person who holds a valid certificate issued under Chapter 4731. of the Revised Code authorizing the person to practice medicine or surgery or osteopathic medicine and surgery.

(2) "Dentist" means a person who is licensed under Chapter 4715. of the Revised Code to practice dentistry.

(3) "Hospital" has the same meaning as in section 3727.01 of the Revised Code.

(4) "Cancer" includes those diseases specified by rule of the director of health under division (B)(2) of this section.

(5) "Census tract" has the same meaning and describes the same geographical boundaries as used by the United States department of commerce, bureau of the census, in reporting the most recent decennial census of Ohio.

(B) The director of health shall adopt rules in accordance with Chapter 119. of the Revised Code to do all of the following:

(1) Establish the Ohio cancer incidence surveillance system required by section 3701.261 of the Revised Code;

(2) Specify the types of cancer and other tumorous and precancerous diseases to be reported to the department of health under division (D) of this section;

(3) Establish reporting requirements for information concerning diagnosed cancer cases as the director considers necessary to conduct epidemiologic surveys of cancer in this state;

(4) Establish standards that must be met by research projects to be eligible to receive information from the department of health under division (B) of section 3701.263 of the Revised Code.

(C) The department of health shall record in the registry all reports of cancer received by it. In the development and administration of the cancer registry, the department may use information compiled by public or private cancer registries and may contract for the collection and analysis of, and research related to, the information recorded under this section.

(D) Each physician, dentist, hospital, or person providing diagnostic or treatment services to patients with cancer shall report each case of cancer to the department. Any If the patient is twenty-five years of age or younger, the report shall be made not later than thirty days after diagnosis.

Any person required to report pursuant to this section may elect to report to the department through an existing cancer registry if the registry meets the reporting standards established by the director and reports to the department.

(E) All physicians, dentists, hospitals, or persons providing diagnostic or treatment services to patients with cancer shall grant to the department or its authorized representative access to all records that identify cases of cancer or establish characteristics of cancer, the treatment of cancer, or the medical status of any identified cancer patient.

(F) The Arthur G. James and Richard J. Solove research institute of the Ohio state university, shall analyze and evaluate the cancer reports collected pursuant to this section. The department shall publish and make available to the public reports summarizing the information collected, including the reports and maps required under section 3701.265 of the Revised Code. Reports Except as provided in section 3701.265 of the Revised Code, reports shall be made on a calendar year basis and published not later than ninety days after the end of each calendar year.

(G) Furnishing information, including records, reports, statements, notes, memoranda, or other information, to the department of health, either voluntarily or as required by this section, or to a person or governmental entity designated as a medical research project by the department, does not subject a physician, dentist, hospital, or person providing diagnostic or treatment services to patients with cancer to liability in an action for damages or other relief for furnishing the information.

(H) This section does not affect the authority of any person or facility providing diagnostic or treatment services to patients with cancer to maintain facility-based tumor registries, in addition to complying with the reporting requirements of this section.

(I) No person shall fail to make the cancer reports required by division (D) of this section.

Sec. 3701.263.  (A) Any information, data, and reports with respect to a case of malignant disease which that are furnished to, or procured by, any cancer registry in this state or the department of health shall be confidential and shall be used only for statistical, scientific, and medical research for the purpose of reducing the morbidity or mortality of malignant disease. No physician, dentist, person, or hospital furnishing such information, data, or report reports to any such cancer registry or the department of health, with respect to a case of malignant disease treated or examined by such physician, dentist, or person, or confined in such hospital, shall by reason of such furnishing be deemed to have violated any confidential relationship, or be held liable in damages to any person, or be held to answer for willful betrayal of a professional confidence within the meaning and intent of section 4731.22 of the Revised Code.

(B)(1) The department of health shall prescribe a release of confidential information form for use under this division (C) of this section.

(2) Information concerning individual cancer patients obtained by the department of health for the Ohio cancer incidence surveillance system is for the confidential use of the department only, except as follows:

(1) The that the department shall may grant to a person involved in a medical research project that meets the standards established by the director of health under section 3701.262 of the Revised Code access to confidential information concerning individual cancer patients if all of the following conditions are met:

(a) The person conducting the research submits evidence of the researcher's credentials and the credentials of any other individual involved in the research project.

(b) The person conducting the research provides written information about the purpose of the research project, the nature of the data to be collected and how the researcher intends to analyze it, the records the researcher seeks to review, and the safeguards the researcher will take to protect the identity of patients whose records the researcher will be reviewing.

(b)(c) In the view of the director of health, the proposed safeguards are adequate to protect the identity of each patient whose records will be reviewed. Safeguards for the protection of the identity of each patient shall include provisions to limit access to identifying data to only those individuals who, during the course of the research project, need access to such information for research purposes, and to provide for the maintenance of the confidentiality of identifying information after the termination of the research project.

(c)(d) An agreement is executed between the department and the researcher that specifies the terms of the researcher's use of the records and prohibits the publication or release of the names of individual cancer patients or any facts tending to lead to the identification of individual cancer patients.

(2)(e) The research project has clearly defined goals that pertain to cancer prevention and control.

(f) For case control studies, the research design used in the research project will involve a sufficiently large sample size that any meaningful difference between cases and controls will be statistically significant. For other studies, the research project will provide enough cases for meaningful analysis of the data for identification of potential risk factors and intervention strategies for cancer prevention and control.

(g) The research project will be conducted at a university, hospital, or other medical research institution by researchers who have expertise in analyzing and interpreting data.

(C) Notwithstanding division (B)(1)(2) of this section, a:

(1) A researcher may, with the approval of the department, use the names of individual cancer patients when requesting additional information for research purposes or soliciting a patient's participation in a research project. If a researcher requests additional information or a cancer patient's participation in a research project, the researcher shall first obtain the oral or written consent of the patient's attending physician. If the consent of the patient's attending physician is obtained, the researcher shall obtain the patient's written consent by having the patient complete a release of confidential information form.

(3)(2) The department may release confidential information concerning individual cancer patients to physicians for diagnostic and treatment purposes if the patient's attending physician gives oral or written consent to the release of the information and the patient gives written consent by completing a release of confidential information form.

(4)(3) The department may release confidential information concerning individual cancer patients to the cancer registry of another state, if the other state has entered into a reciprocal agreement with the department and the agreement provides that the state will comply with this section and that information identifying a patient will not be released to any person without the written consent of the patient.

(C)(D) Nothing in this section prevents the release to any person of epidemiological information that does not identify individual cancer patients.

Sec. 3701.265.  (A)(1) The department of health shall make the following available to the public on the department's web site on a calendar year basis:

(a) Quarterly reports of the cancer incidence rates of each age group of children reported under division (B)(1) of this section. The reports shall be made available on the last day of each March, June, September, and December. Each report shall contain the following information:

(i) For each age group in each census tract, the name of each type of cancer, and the number of cases of each type, reported in that quarter at an address located in that census tract;

(ii) For the reports made available in June, September, and December, the cumulative number of cases of each type of cancer occurring within each age group in each census tract between the first day of the preceding January and the end of the quarter being reported.

(b) Biannual reports of the cancer incidence rates of adults in each county in this state. The reports shall be made available on the last day of each June and December. Each report shall contain the following information:

(i) For each census tract in each county, the name of each type of cancer, and the number of cases of each type, reported in that six-month period at an address located in that census tract.

(ii) For the report made available in December, the cumulative number of cases of each type of cancer occurring in each census tract in each county between the first day of the preceding January and the end of the year.

(2) With each report prepared under division (A)(1) of this section, the department shall present the information contained in the reports in map form and make the maps available to the public on the department's web site. When preparing the maps, the department shall do the following:

(a) For maps representing the cancer incidence rates of children, divide a state map into census tracts and indicate within each tract the type of cancer occurring in that tract. To indicate the type of cancer occurring in each tract, the department shall use a color coding system in which the department assigns a color to each type of cancer and, if the cancer occurs in a tract, the department shall fill the tract with one or more colors representing the types of cancer occurring in that tract.

The state map shall include a key that specifies the color assigned to each type of cancer, the number of cases of each cancer type occurring in each age group of children, and for the maps made available in June, September, and December, the cumulative number of cases of each type of cancer occurring within each age group between the first day of the preceding January and the end of the quarter being reported.

(b) For maps representing the cancer incidence rates of adults, divide maps representing each county in this state into census tracts, and indicate within each tract the type of cancer occurring in that tract. To indicate the type of cancer occurring in each tract, the department shall use a color coding system in which the department assigns a color to each type of cancer and, if the cancer occurs in a tract, the department shall fill the tract with one or more colors representing the types of cancer occurring in that tract.

The county maps shall include a key that specifies the color assigned to each type of cancer, the number of cases of each cancer type, and for the maps made available in December, the cumulative number of cases of each type of cancer occurring between the first day of the preceding January and the end of the year being reported.

(B) When reporting the information required under division (D) of section 3701.262 of the Revised Code, each physician, dentist, hospital, or person providing diagnostic or treatment services to patients with cancer shall also, for purposes of this section, report the following data:

(1) For a patient twenty-five years of age or younger, the age group in which the patient falls at the time of diagnosis, according to the following:

(a) Under five years of age;

(b) Five years of age through nine years of age;

(c) Ten years of age through fourteen years of age;

(d) Fifteen years of age through nineteen years of age;

(e) Twenty years of age through twenty-five years of age.

(2) For a patient twenty-five years of age or younger, the addresses of all current and former schools and child care providers attended by the patient;

(3) For all patients, the addresses of all of the patient's current and former primary residences;

(4) For all patients with a history of employment, the addresses of all of the patient's current and former places of employment.

(C) The department shall do all of the following regarding the reports and maps required under this section:

(1) Prepare all reports and maps in a legible and easily understood manner;

(2) Clearly display the date of publication of all reports and maps on its web site in a month, day, and year format;

(3) Retain indefinitely all reports and maps required under this section on its web site and make all reports and maps continually available to the public, regardless of the date of publication;

(4) Report, and prepare maps of, the information collected under section 3701.262 of the Revised Code prior to the effective date of this section in the same manner as required under this section;

(5) If the release of the reports or maps under this section would identify any patient, combine the minimum number of reports or maps as necessary to preserve patient confidentiality.

Sec. 3701.266.  (A) When reporting data pursuant to section 3701.265 of the Revised Code, the department of health shall determine whether either of the following occurs:

(1) Two or more children were diagnosed with one of the following and reside in the same county or in adjacent census tracts:

(a) Bladder, brain, central nervous system, lung, bronchial, pancreatic, testicular, thyroid, or pelvic cancer;

(b) Hodgkin's lymphoma;

(c) Leukemia;

(d) Liver cancer and inflammatory bowel disease;

(e) Corpus uteri;

(f) Uterine cancer of an unspecified origin;

(g) Kidney cancer, including renal cell carcinoma.

(2) The cancer incidence rate for adults in a single county or in adjacent census tracts for one of the following is proportionately more than, equal to, or within ten percentage points of reaching the national cancer incidence rate for that type of cancer:

(a) Bladder, brain, central nervous system, lung, bronchial, pancreatic, testicular, thyroid, or pelvic cancer;

(b) Hodgkin's lymphoma;

(c) Leukemia;

(d) Liver cancer and inflammatory bowel disease;

(e) Corpus uteri;

(f) Uterine cancer of an unspecified origin;

(g) Kidney cancer, including renal cell carcinoma.

(B) If either of the circumstances under division (A) of this section occurs, the department shall do the following:

(1) Devise an early diagnosis and cancer prevention outreach program and implement the program in the census tract where the cancer type has occurred;

(2) Devise and implement a water and air quality monitoring program to identify substances that impact the cancer incidence rates of the type of cancer occurring as described under division (A) of this section.

Sec. 3701.267.  (A) If the department of health determines that either of the circumstances specified in division (A) of section 3701.266 of the Revised Code has occurred, any person may petition the department to investigate, or take other similar action to determine, the cause of the cancer conditions for which the determination was made within the specified group of individuals, geographical area, or period of time.

(B) Not later than sixty days after the date on which the petition is submitted to the department under division (A) of this section, the department shall provide the petitioner with a written description of the investigation or other action being taken to determine the causes of the cancer cases described in division (A) of this section. The description shall include a time frame for the investigation or action, an explanation of the methods of investigation or actions used, and an explanation of the reasons for which the investigation method or other action was taken by the director.

(C) If, after an investigation or other action is taken under division (B) of this section, the department determines that the causes of the cancer cases described in division (A) of this section are related, the department shall take one or more of the following actions most appropriate for the investigation:

(1) Devise an early diagnosis and cancer prevention outreach program and implement such program in all census tracts where the individuals with cancer reside;

(2) Devise and implement a water, soil, and air quality monitoring program to identify substances that impact the cancer incidence rates of the type of cancer under investigation;

(3) Make reasonable efforts to reduce exposure, among the residents in the census tracts where the individuals with cancer reside, to sources strongly linked to causing the type of cancer under investigation;

(4) Seek assistance from any local, state, or federal agencies in identifying, monitoring, alleviating, or eliminating the possible causes of the cancer under investigation.

(D) Not later than thirty days after the effective date of this section, the department shall make available to the public on the internet web site maintained by the department all of the following:

(1) The procedures and time frame for submitting a petition under this section;

(2) A description of the department's responsibilities in conducting an investigation under this section;

(3) Notice of opportunity for community participation in an investigation conducted under this section.

Sec. 3701.99.  (A) Whoever violates division (C) of section 3701.23, division (C) of section 3701.232, division (C) of section 3701.24, division (B) of section 3701.25, division (I) of section 3701.262, division (D) of section 3701.263, or sections 3701.46 to 3701.55 of the Revised Code is guilty of a minor misdemeanor on a first offense; on each subsequent offense, the person is guilty of a misdemeanor of the fourth degree.

(B) Whoever violates section 3701.82 of the Revised Code is guilty of a misdemeanor of the first degree.

(C) Whoever violates section 3701.352 or 3701.81 of the Revised Code is guilty of a misdemeanor of the second degree.

Section 2.  That existing sections 3701.261, 3701.262, 3701.263, and 3701.99 of the Revised Code are hereby repealed.