Connecticut Seal

Substitute House Bill No. 5715

Public Act No. 02-125

AN ACT CREATING A PROGRAM FOR QUALITY IN HEALTH CARE.

Be it enacted by the Senate and House of Representatives in General Assembly convened:

Section 1. (NEW) (Effective October 1, 2002) (a) There is established a quality of care program within the Department of Public Health. The department shall develop for the purposes of said program (1) a standardized data set to measure the clinical performance of health care facilities, as defined in section 19a-630 of the general statutes, and require such data to be collected and reported periodically to the department, including, but not limited to, data for the measurement of comparable patient satisfaction, and (2) methods to provide public accountability for health care delivery systems by such facilities. The department shall develop such set and methods for hospitals during the fiscal year ending June 30, 2003, and the committee established pursuant to subsection (c) of this section shall consider and may recommend to the joint standing committee of the General Assembly having cognizance of matters relating to public health the inclusion of other health care facilities in each subsequent year.

(b) In carrying out its responsibilities under subsection (a) of this section, the department shall develop the following for the quality of care program:

(1) Comparable performance measures to be reported;

(2) Selection of patient satisfaction survey measures and instruments;

(3) Methods and format of standardized data collection;

(4) Format for a public quality performance measurement report;

(5) Human resources and quality measurements;

(6) Medical error reduction methods;

(7) Systems for sharing and implementing universally accepted best practices;

(8) Systems for reporting outcome data;

(9) Systems for continuum of care;

(10) Recommendations concerning the use of an ISO 9000 quality auditing program;

(11) Recommendations concerning the types of statutory protection needed prior to collecting any data or information under this act; and

(12) Any other issues that the department deems appropriate.

(c) There is established a Quality of Care Advisory Committee which shall advise the Department of Public Health on the issues set forth in subdivisions (1) to (12), inclusive, of subsection (b) of this section. The advisory committee shall meet at least quarterly.

(d) The advisory committee shall consist of (1) four members who represent and shall be appointed by the Connecticut Hospital Association, including three members who represent three separate hospitals that are not affiliated of which one such hospital is an academic medical center; (2) one member who represents and shall be appointed by the Connecticut Nursing Association; (3) two members who represent and shall be appointed by the Connecticut Medical Society, including one member who is an active medical care provider; (4) two members who represent and shall be appointed by the Connecticut Business and Industry Association, including one member who represents a large business and one member who represents a small business; (5) one member who represents and shall be appointed by the Home Health Care Association; (6) one member who represents and shall be appointed by the Connecticut Association of Health Care Facilities; (7) one member who represents and shall be appointed by the Connecticut Association of Not-For-Profit Providers for the Aging; (8) two members who represent and shall be appointed by the AFL-CIO; (9) one member who represents consumers of health care services and who shall be appointed by the Commissioner of Public Health; (10) one member who represents a school of public health and who shall be appointed by the Commissioner of Public Health; (11) one member who represents and shall be appointed by the Office of Health Care Access; (12) the Commissioner of Public Health or said commissioner's designee; (13) the Commissioner of Social Services or said commissioner's designee; (14) the Secretary of the Office of Policy and Management or said secretary's designee; (15) two members who represent licensed health plans and shall be appointed by the Connecticut Association of Health Care Plans; (16) one member who represents and shall be appointed by the federally designated state peer review organization; and (17) one member who represents and shall be appointed by the Connecticut Pharmaceutical Association. The chairperson of the advisory committee shall be the Commissioner of Public Health or said commissioner's designee. The chairperson of the committee, with a vote of the majority of the members present, may appoint ex-officio nonvoting members in specialties not represented among voting members. Vacancies shall be filled by the person who makes the appointment under this subsection.

(e) The chairperson of the advisory committee may designate one or more working groups to address specific issues and shall appoint the members of each working group. Each working group shall report its findings and recommendations to the full advisory committee.

(f) The Commissioner of Public Health shall report on the quality of care program on or before June 30, 2003, and annually thereafter, in accordance with section 11a-4 of the general statutes, to the joint standing committee of the General Assembly having cognizance of matters relating to public health and to the Governor. Each report on said program shall include activities of the program during the prior year and a plan of activities for the following year.

(g) On or before April 1, 2004, the Commissioner of Public Health shall prepare a report, available to the public, that compares all licensed hospitals in the state based on the quality performance measures developed under the quality of care program.

(h) The Department of Public Health may seek out funding for the purpose of implementing the provisions of this section. Said provisions shall be implemented upon receipt of said funding.

Sec. 2. (NEW) (Effective October 1, 2002) All hospitals, licensed pursuant to provisions of the general statutes, shall be required to implement performance improvement plans. Such plans shall be submitted on or before June 30, 2003, and annually thereafter by each hospital to the Department of Public Health as a condition of licensure.

Sec. 3. (NEW) (Effective July 1, 2002) (a) For purposes of this section, an "adverse event" means an injury that was caused by or is associated with medical management and that results in death or measurable disability. Such events shall also include those sentinel events for which remediation plans are required by the Joint Commission on the Accreditation of Healthcare Organizations.

(b) Adverse events shall be classified into the following categories:

(1) "Class A adverse event" means an event that has resulted in or is associated with a patient's death or the immediate danger of death;

(2) "Class B adverse event" means an event that has resulted in or is associated with a patient's serious injury or disability or the immediate danger of serious injury or disability;

(3) "Class C adverse event" means an event that has resulted in or is associated with the physical or sexual abuse of a patient; and

(4) "Class D adverse event" means an adverse event that is not reported under subdivisions (1) to (3), inclusive, of this subdivision.

(c) On and after October 1, 2002, a hospital or outpatient surgical facility shall report to the Department of Public Health on Class A, B and C adverse events as follows: (1) A verbal report shall be made not later than twenty-four hours after the adverse event occurred; (2) a written report not later than seventy-two hours after the adverse event occurred; and (3) a corrective action plan shall be filed not later than seven days after the adverse event occurred.

(d) A hospital or outpatient surgical facility shall report to the Department of Public Health on Class D adverse events on a quarterly basis. Such reports shall include corrective action plans. For purposes of this subsection and subsection (c) of this section, "corrective action plan" means a plan that implements strategies that reduce the risk of similar events occurring in the future. Said plan shall measure the effectiveness of such strategies by addressing the implementation, oversight and time lines of such strategies. Failure to implement a corrective action plan may result in disciplinary action by the Commissioner of Public Health, pursuant to section 19a-494 of the general statutes.

(e) The Commissioner of Public Health shall adopt regulations, in accordance with chapter 54 of the general statutes, to carry out the provisions of this section. Such regulations shall include, but shall not be limited to, a prescribed form for the reporting of adverse events pursuant to subsections (c) and (d) of this section. The commissioner may require the use of said form prior to the adoption of said regulations.

(f) On or before March first annually, the commissioner shall report, in accordance with the provisions of section 11-4a of the general statutes, on adverse event reporting, to the joint standing committee of the General Assembly having cognizance of matters relating to public health.

(g) Information collected pursuant to this section shall not be required to be disclosed pursuant to subsection (a) of section 1-210 of the general statutes, for a period of six months from the date of submission of the written report required pursuant to subsection (c) of this section and shall not be subject to subpoena or discovery or introduced into evidence in any judicial or administrative proceeding except as otherwise specifically provided by law.

Approved June 7, 2002