Connecticut Seal

Substitute House Bill No. 5407

Public Act No. 04-122

AN ACT CONCERNING ORGAN DONATION.

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

Section 1. (NEW) (Effective October 1, 2004) (a) The Commissioner of Motor Vehicles and the Chief Information Officer of the Department of Information Technology shall enter into an agreement with one or more federally-designated organ and tissue procurement organizations to provide to such organizations access to the names, dates of birth and other pertinent information of holders of operator's licenses who have registered with the Department of Motor Vehicles an intent to become organ and tissue donors. Such access shall be provided in a manner and form to be determined by the commissioner and Chief Information Officer, following consultation with such organizations, and may include electronic transmission of initial information and periodic updating of information. The commissioner shall not charge a fee for such access pursuant to section 14-50a of the general statutes, as amended, but may charge such organizations reasonable administrative costs. Information provided to such organizations shall be used solely for identifying such license holders as organ and tissue donors.

(b) The Commissioner of Motor Vehicles shall include in regulations adopted pursuant to section 14-36f of the general statutes, a requirement that a description of the purposes and procedures of procurement organizations, as defined in section 19a-279a of the general statutes, as amended by this act, be included in driver education programs.

Sec. 2. Subsection (f) of section 14-10 of the general statutes, as amended by section 7 of public act 03-265, is repealed and the following is substituted in lieu thereof (Effective October 1, 2004):

(f) The commissioner may disclose personal information from a motor vehicle record to:

(1) Any federal, state or local government agency in carrying out its functions or to any individual or entity acting on behalf of any such agency, or

(2) Any individual, organization or entity that signs and files with the commissioner, under penalty of false statement as provided in section 53a-157b, a statement on a form approved by the commissioner, together with such supporting documentation or information as the commissioner may require, that such information will be used for any of the following purposes:

(A) In connection with matters of motor vehicle or driver safety and theft, motor vehicle emissions, motor vehicle product alterations, recalls or advisories, performance monitoring of motor vehicles and dealers by motor vehicle manufacturers and removal of nonowner records from the original owner records of motor vehicle manufacturers to implement the provisions of the federal Automobile Information Disclosure Act, 15 USC 1231 et seq. , the Clean Air Act, 42 USC 7401 et seq. , and 49 USC Chapters 301, 305 and 321 to 331, inclusive, as amended from time to time, and any provision of the general statutes enacted to attain compliance with said federal acts;

(B) In the normal course of business by the requesting party, but only to confirm the accuracy of personal information submitted by the individual to the requesting party;

(C) In connection with any civil, criminal, administrative or arbitral proceeding in any court or government agency or before any self-regulatory body, including the service of process, an investigation in anticipation of litigation by an attorney-at-law or any individual acting on behalf of an attorney-at-law and the execution or enforcement of judgments and orders, or pursuant to an order of any court provided the requesting party is a party in interest to such proceeding;

(D) In connection with matters of motor vehicle or driver safety and theft, motor vehicle emissions, motor vehicle product alterations, recalls or advisories, performance monitoring of motor vehicles and motor vehicle parts and dealers, motor vehicle market research activities including survey research, motor vehicle product and service communications, and removal of nonowner records from the original owner records of motor vehicle manufacturers, provided the personal information is not published, disclosed or used to contact individuals except as permitted under subparagraph (A) of this subdivision;

(E) By any insurer or insurance support organization or by a self-insured entity or its agents, employees or contractors, in connection with the investigation of claims arising under insurance policies, antifraud activities, rating or underwriting;

(F) In providing any notice required by law to owners or lienholders named in the certificate of title of towed, abandoned or impounded motor vehicles;

(G) By an employer or its agent or insurer to obtain or verify information relating to a holder of a passenger endorsement or commercial driver's license required under 49 USC Chapter 313, and sections 14-44 to 14-44m, inclusive, as amended;

(H) In connection with any lawful purpose of a labor organization, as defined in section 31-77, provided (i) such organization has entered into a contract with the commissioner, on such terms and conditions as the commissioner may require, and (ii) the information will be used only for the purposes specified in the contract other than campaign or political purposes;

(I) For bulk distribution for surveys, marketing or solicitations provided the commissioner has obtained the express consent of the individual to whom such personal information pertains;

(J) For the purpose of preventing fraud by verifying the accuracy of personal information contained in a motor vehicle record, including an individual's photograph or computerized image, as submitted by an individual to a legitimate business or an agent, employee or contractor of a legitimate business, provided the individual has provided express consent in accordance with subdivision (5) of subsection (a) of this section;

(K) Inclusion of personal information about persons who have indicated consent to become organ and tissue donors in a donor registry established by a procurement organization, as defined in section 19a-279a, as amended by this act.

Sec. 3. Section 19a-279a of the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2004):

As used in sections 19a-279a to 19a-279l, inclusive, as amended by this act:

(1) "Anatomical gift" means a donation of all or part of a human body to take effect upon or after death.

(2) "Decedent" means a deceased person and includes a stillborn infant or fetus.

(3) "Document of gift" means [a card] an organ and tissue donor card, inclusion in a donor registry, a statement attached to or imprinted on a motor vehicle operator's or chauffeur's license, an indication on a signed motor vehicle operator's license application or renewal form, a will or other writing used to make an anatomical gift.

(4) "Donor" means a person who makes an anatomical gift of all or part of his or her body.

(5) "Hospital" means a hospital licensed under chapter 368v or licensed, accredited or approved as a hospital under the law of any state or a facility operated as a hospital by the United States government, a state or a subdivision of a state.

(6) "Donor registry" means an electronic database developed and maintained by any procurement organization to identify donors.

[(6)] (7) "Part" means an organ, tissue, eye, bone, artery, blood, fluid or other portion of a human body.

[(7)] (8) "Person" means an individual, corporation, limited liability company, business trust, estate, trust, partnership, joint venture, association, government, governmental subdivision or agency or any other legal or commercial entity.

[(8)] (9) "Physician" or "surgeon" means a person licensed to practice medicine and surgery under chapter 370 or the law of any other state.

[(9)] (10) "Procurement organization" means a person licensed, accredited or approved under federal law or the laws of any state as a nonprofit organ and tissue procurement organization for procurement, distribution or storage of human bodies or parts.

[(10)] (11) "State" means a state, territory or possession of the United States, the District of Columbia or the Commonwealth of Puerto Rico.

[(11)] (12) "Technician" means a technician of an organ or tissue procurement organization which meets the requirements of the American Association of Tissue Banks or the Eyebank Association of America.

Sec. 4. Section 19a-279b of the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2004):

(a) A person who is at least eighteen years of age may (1) make an anatomical gift for any of the purposes stated in subsection (a) of section 19a-279f, (2) limit an anatomical gift to one or more of such purposes, or (3) refuse to make an anatomical gift.

(b) An anatomical gift may be made by a document of gift signed by the donor. If the donor cannot sign, the document of gift shall be signed by another person and by two witnesses, all of whom have signed at the direction and in the presence of the donor and of each other, and state that it has been so signed. In the absence of a revocation or amendment of any document of gift, health care providers licensed in this state and procurement organizations shall act in accordance with the donor's intention and may take appropriate actions to effect the anatomical gift.

(c) If a document of gift is attached to or imprinted on a donor's motor vehicle operator's license, the document of gift shall comply with subsection (b) of this section. Revocation, suspension, expiration or cancellation of the license shall not invalidate the anatomical gift.

(d) A document of gift may designate a particular physician or surgeon to carry out the appropriate procedures. In the absence of a designation or if the designee is not available, the donee or other person authorized to accept the anatomical gift may employ or authorize any physician or surgeon to carry out the appropriate procedure.

(e) An anatomical gift by will shall take effect upon the death of the testator, whether or not the will is probated. If, after death, the will is declared invalid for testamentary purposes, the validity of the anatomical gift is unaffected.

(f) A donor may amend or revoke an anatomical gift, not made by will, [only] by: (1) A signed statement, [or] (2) the delivery of a signed statement to a procurement organization or a specified donee to whom a document of gift had been delivered, or (3) any form of communication during a terminal illness or injury addressed to a physician.

(g) The donor of an anatomical gift made by will may amend or revoke the gift in the manner provided for amendment or revocation of wills, or as provided in subsection (f) of this section.

(h) An anatomical gift that is not revoked by the donor before death is irrevocable and shall not require the consent or concurrence of any person after the death of the donor.

(i) A person may refuse to make an anatomical gift of [his] such person's body or part by (1) a writing signed in the same manner as a document of gift, or (2) [a statement attached to or imprinted on a donor's motor vehicle operator's or chauffeur's license or (3)] any other writing used to identify the person as refusing to make an anatomical gift. During a terminal illness or injury, the refusal may be an oral statement or other form of communication addressed to a physician.

(j) In the absence of contrary indications by the donor, an anatomical gift of a part is neither a refusal to give other parts nor a limitation on an anatomical gift under section 19a-279c or on a removal or release of other parts under section 19a-279d.

(k) In the absence of contrary indications by the donor, a revocation or amendment of an anatomical gift is not a refusal to make another anatomical gift. If the donor intends a revocation to be a refusal to make an anatomical gift, the donor shall make the refusal pursuant to subsection (i) of this section.

Sec. 5. Section 19a-279e of the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2004):

(a) If, at or near the time of death of a patient, there is no [medical record] document of gift or other record that the patient has made or refused to make an anatomical gift, the hospital administrator or a representative designated by the administrator shall discuss the option to make or refuse to make an anatomical gift and request the making of an anatomical gift pursuant to subsection (a) of section 19a-279c. The request shall be made with reasonable discretion and sensitivity to the circumstances of the family. A request is not required if the gift is not suitable, based upon accepted medical standards, for a purpose specified in section 19a-279f. An entry shall be made in the medical record of the patient stating the name and affiliation of the person making the request, and the name, response and relationship to the patient of the person to whom the request was made.

(b) The following persons shall make a reasonable search for a document of gift or other information identifying the bearer as a donor or as a person who has refused to make an anatomical gift: (1) A law enforcement officer, fireman, paramedic or other emergency rescuer finding a person who the searcher believes is dead or near death; [and] (2) a hospital, upon the admission of a person at or near the time of death, if there is not immediately available any other source of that information; and (3) a procurement organization.

(c) If a document of gift or evidence of refusal to make an anatomical gift is located by the search required by subdivision (1) of subsection (b) of this section, and the person or body to whom it relates is taken to a hospital, the hospital shall be notified of the contents and the document or other evidence shall be sent to the hospital.

(d) If, at or near the time of death of a patient, a hospital knows that an anatomical gift has been made pursuant to subsection (b) of section 19a-279b, as amended by this act, and subsection (a) of section 19a-279c or a release and removal of a part has been permitted pursuant to section 19a-279d, or that a patient or a person identified as in transit to the hospital is a donor, the hospital shall notify the donee if one is named and known to the hospital; if not, it shall notify an appropriate procurement organization. The hospital shall cooperate in the implementation of the anatomical gift or release and removal of a part.

(e) A person who fails to discharge the duties imposed by this section shall not be subject to criminal or civil liability but shall be subject to appropriate administrative sanctions.

Sec. 6. Subsection (a) of section 19a-279j of the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2004):

(a) An anatomical gift shall authorize any reasonable examination necessary to assure medical acceptability of the gift for the purposes intended, including, but not limited to, serological and compatibility testing. Notwithstanding any provision of the general statutes, a procurement organization may access and review the medical record of the potential donor for purposes of assessing donor suitability.

Sec. 7. Section 19a-583 of the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2004):

(a) No person who obtains confidential HIV-related information may disclose or be compelled to disclose such information, except to the following:

(1) The protected individual, his legal guardian or a person authorized to consent to health care for such individual;

(2) Any person who secures a release of confidential HIV-related information;

(3) A federal, state or local health officer when such disclosure is mandated or authorized by federal or state law;

(4) A health care provider or health facility when knowledge of the HIV-related information is necessary to provide appropriate care or treatment to the protected individual or a child of the individual or when confidential HIV-related information is already recorded in a medical chart or record and a health care provider has access to such record for the purpose of providing medical care to the protected individual;

(5) A medical examiner to assist in determining the cause or circumstances of death;

(6) Health facility staff committees or accreditation or oversight review organizations which are conducting program monitoring, program evaluation or service reviews;

(7) A health care provider or other person in cases where such provider or person in the course of his occupational duties has had a significant exposure to HIV infection, provided the following criteria are met: (A) The worker is able to document significant exposure during performance of his occupation, (B) the worker completes an incident report within forty-eight hours of exposure, identifying the parties to the exposure, witnesses, time, place and nature of the event, (C) the worker submits to a baseline HIV test within seventy-two hours of the exposure and is negative on that test for the presence of the AIDS virus, (D) the patient's or person's physician or, if the patient or person does not have a personal physician or if the patient's or person's physician is unavailable, another physician or health care provider has approached the patient or person and sought voluntary consent to disclosure and the patient or person refuses to consent to disclosure, except in an exposure where the patient or person is deceased, (E) the worker would be able to take meaningful immediate action as defined in regulations adopted pursuant to section 19a-589 which could not otherwise be taken, (F) an exposure evaluation group determines that the criteria specified in subparagraphs (A), (B), (C), (D) and (E) of this subdivision are met and that a worker has a significant exposure to the blood of a patient or person and the patient or person or the patient's or person's legal guardian refuses to consent to release of the information. No member of the exposure evaluation group who determines that a worker has sustained a significant exposure and authorizes the disclosure of confidential HIV-related information nor the health facility, correctional facility or other institution nor any person in a health facility, correctional facility or other institution who relies in good faith on the group's determination and discloses the result shall have any liability as a result of his action carried out under this section, unless such persons acted in bad faith. If the information is not held by a health facility, correctional facility or other institution, a physician not directly involved in the exposure has certified in writing that the criteria specified in subparagraphs (A), (B), (C), (D) and (E) of this subdivision are met and that a significant exposure has occurred;

(8) Employees of hospitals for mental illness operated by the Department of Mental Health and Addiction Services if the infection control committee of the hospital determines that the behavior of the patient poses a significant risk of transmission to another patient of the hospital. Disclosure shall only be allowed if it is likely to prevent or reduce the risk of transmission and no reasonable alternatives exist that will achieve the same goal and also preserve the confidentiality of the information. Such "reasonable alternatives" include counseling the patient concerning behaviors that pose a risk of transmission and other efforts to prevent or address the behaviors that pose a significant risk of transmission without disclosing the patient's HIV status or other confidential HIV-related information. Disclosure shall be limited to as few employees as possible and only to those employees with a direct need to receive the information to achieve the purpose authorized by this subdivision;

(9) Employees of facilities operated by the Department of Correction to provide services related to HIV infection or if the medical director and chief administrator of the facility determine that the behavior of an inmate poses significant risk of transmission to another inmate or has resulted in a significant exposure of another inmate of the facility. Such a disclosure shall only be made if it is specifically required to enable the inmate to receive such services or is likely to prevent or reduce the risk of transmission and no reasonable alternatives exist that will achieve the same goal and also preserve the confidentiality of the information. Such "reasonable alternatives" include counseling the inmate concerning behaviors that pose a risk of transmission or other efforts to prevent or address the behaviors that pose a significant risk of transmission without disclosing the patient's HIV status or other confidential HIV-related information. Disclosure shall be limited to as few employees as possible and only to those employees with a direct need to receive the information to achieve a purpose authorized by this subdivision;

(10) Any person allowed access to such information by a court order which is issued in compliance with the following provisions: (A) No court of this state shall issue such order unless the court finds a clear and imminent danger to the public health or the health of a person and that the person has demonstrated a compelling need for the test results which cannot be accommodated by other means. In assessing compelling need, the court shall weigh the need for disclosure against the privacy interest of the test subject and the public interest which may be disserved by disclosure which deters future testing or which may lead to discrimination. (B) Pleadings pertaining to disclosure of confidential HIV-related information shall substitute a pseudonym for the true name of the subject of the test. The disclosure to the parties of the subject's true name shall be communicated confidentially, in documents not filed with the court. (C) Before granting any such order, the court shall provide the individual whose test result is in question with notice and a reasonable opportunity to participate in the proceedings if he is not already a party. (D) Court proceedings as to disclosure of confidential HIV-related information shall be conducted in camera unless the subject of the test agrees to a hearing in open court or unless the court determines that a public hearing is necessary to the public interest and the proper administration of justice. (E) Upon the issuance of an order to disclose test results, the court shall impose appropriate safeguards against unauthorized disclosure, which shall specify the persons who may have access to the information, the purposes for which the information shall be used, and appropriate prohibitions on future disclosure;

(11) Life and health insurers, government payers and health care centers and their affiliates, reinsurers, and contractors, except agents and brokers, in connection with underwriting and claim activity for life, health, and disability benefits; [and]

(12) Any health care provider specifically designated by the protected individual to receive such information received by a life or health insurer or health care center pursuant to an application for life, health or disability insurance; and

(13) A procurement organization, for the purposes of assessing donor suitability pursuant to section 19a-279j, as amended by this act.

(b) No person, except the protected individual, his legal guardian or a person authorized to consent to health care for such individual, to whom confidential HIV-related information is disclosed may further disclose such information, except as provided in this section and sections 19a-584 and 19a-585.

Approved May 21, 2004