AN ACT IMPLEMENTING THE RECOMMENDATIONS OF THE HOSPITAL TASK FORCE.

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

Section 1. Subsection (g) of section 17b-192 of the 2008 supplement to the general statutes is repealed and the following is substituted in lieu thereof (Effective from passage):

(g) On or before [January 1, 2008] June 30, 2009, the Commissioner of Social Services shall [seek] conduct a study on the impact of implementing a waiver of federal law for the purpose of extending health insurance coverage under Medicaid to persons with income not in excess of one hundred per cent of the federal poverty level who otherwise qualify for medical assistance under the state-administered general assistance program. The provisions of section 17b-8 of the 2008 supplement to the general statutes shall apply to this section.

Sec. 2. (NEW) (Effective July 1, 2008) (a) The Departments of Mental Health and Addiction Services, Children and Families, and Social Services shall jointly identify areas of the state where there is high utilization of behavioral health hospital emergency department services, including inappropriate use of, or extended lengths of stay for, hospital emergency department patients waiting to receive behavioral health services. For each area identified, said agencies shall develop recommendations regarding the appropriate combination of services that, based on cost and quality outcomes, would most effectively reduce hospital emergency department demand. The Department of Mental Health and Addiction Services shall submit such recommendations to the Secretary of the Office of Policy and Management on or before November 30, 2008.

(b) The Departments of Mental Health and Addiction Services, Children and Families, and Social Services shall jointly assess the existing capacity and volume of community mental health services and other programs to identify gaps in services and thereafter may adjust funding allocations, service designs and geographic service areas, as appropriate, to provide more uniform state-wide coverage.

Sec. 3. (NEW) (Effective July 1, 2008) (a) The Departments of Mental Health and Addiction Services, Children and Families, and Social Services, in consultation with the Office of Health Care Access and representatives of the health care industry, shall identify effective and feasible models of care for psychiatric emergency assessment or crisis response centers in order to expand access to behavioral health crisis and emergency services for adults and children.

(b) Not later than January 1, 2009, the Department of Mental Health and Addiction Services shall, within available appropriations, implement a pilot psychiatric emergency assessment or crisis response center. Such pilot program shall be based on the models of care identified pursuant to subsection (a) of this section.

Sec. 4. (NEW) (Effective July 1, 2008) The Department of Social Services, in consultation with the Departments of Mental Health and Addiction Services and Correction, the Judicial Department, and The University of Connecticut Health Center, and with the approval of the Secretary of the Office of Policy and Management, shall develop a plan for expedited eligibility for state-administered general assistance program benefits for individuals being released from prison. In addition, such plan shall identify gaps in the services available to such individuals and develop primary care services and other programs that are designed to ensure that such individuals are not inappropriately directed to hospital emergency departments, but instead are appropriately served in the community.

Sec. 5. (NEW) (Effective from passage) Not later than June 30, 2009, and annually thereafter, each general hospital licensed by the Department of Public Health under chapter 368v of the general statutes shall develop a plan to reduce the number of inpatients that have extended lengths of stay within the hospital's emergency department. Such plan shall be maintained on site at each hospital and made available to the Department of Public Health upon request. The Commissioner of Public Health may specify the form and format of such plans.

Sec. 6. Section 19a-7 of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2008):

(a) The Department of Public Health shall be the lead agency for public health planning and shall assist communities in the development of collaborative health planning activities which address public health issues on a regional basis or which respond to public health needs having state-wide significance. [The] Not later than October 1, 2010, and every five years thereafter, the department shall prepare a multiyear state health plan [which will provide] that provides an assessment of the health of Connecticut's population and the availability of health facilities. The plan shall include: (1) Policy recommendations regarding allocation of resources; (2) public health priorities; (3) quantitative goals and objectives with respect to the appropriate supply, distribution and organization of public health resources; [and (4) evaluation of the implications of new technology for the organization, delivery and equitable distribution of services] (4) an evaluation of the unmet needs of persons at risk and vulnerable populations as determined by the commissioner; and (5) recommendations regarding the public health and health care workforce. The plan shall incorporate both the state-wide health care facilities plan developed by the Office of Health Care Access pursuant to section 19a-634, as amended by this act, and the mental health and substance abuse services plan developed by the Department of Mental Health and Addiction Services pursuant to section 8 of this act. In the development of the plan, the department shall consider the recommendations of any advisory bodies which may be established by the [commissioner] Commissioner of Public Health. The commissioner may also incorporate the recommendations of authoritative organizations whose mission is to promote policies based on best practices or evidence-based research and may also consider the future direction of the health care industry based on review of general hospital strategic planning documents.

(b) For the purposes of establishing a state health plan as required by subsection (a) of this section and consistent with state and federal law on patient records, the department is entitled to access hospital strategic planning documents, hospital discharge data, emergency room and ambulatory surgery encounter data, data on home health care agency client encounters and services, data from community health centers on client encounters and services and all data collected or compiled by the Office of Health Care Access pursuant to section 19a-613.

(c) The Commissioner of Public Health shall develop a process to ensure that the state health plan is communicated to state agencies, health care providers and the public.

[(c)] (d) The Commissioner of Public Health shall adopt regulations in accordance with the provisions of chapter 54 to assure the confidentiality of personal data and patient-identifiable data collected or compiled pursuant to this section.

Sec. 7. Section 19a-634 of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2008):

(a) The Office of Health Care Access [, in consultation with the Department of Public Health, shall carry out a continuing] shall conduct, on an annual basis, a state-wide health care facility utilization study. [, including a study of existing health care delivery systems; recommend improvements in health care procedures to the health care facilities and institutions; recommend to the commissioner legislation in the area of health care programs; and report annually to the Governor and the General Assembly its findings, recommendations and proposals, as of January first, for improving efficiency, lowering health care costs, coordinating use of facilities and services and expanding the availability of health care throughout the state.] Such study shall include, but not be limited to, an assessment of: (1) Current availability and utilization of acute hospital care, hospital emergency care, specialty hospital care, outpatient surgical care, primary care and clinic care; (2) geographic areas and subpopulations that may be underserved or have reduced access to specific types of health care services; and (3) other factors that the commissioner deems pertinent to health care facility utilization. Not later than June thirtieth of each year, the commissioner shall report, in accordance with section 11-4a, to the Governor and the joint standing committees of the General Assembly having cognizance of matters relating to public health and human services on the findings of the study. Such report may also include the commissioner's recommendations for addressing identified gaps in the provision of health care services and recommendations concerning a lack of access to health care services.

(b) The office, in consultation with other state agencies as the commissioner deems appropriate, shall establish and maintain a state-wide health care facilities plan. [, including provisions for an ongoing evaluation of the facility utilization study conducted pursuant to subsection (a) of this section to: (1) Determine the availability of acute care, long-term care and home health care services in private and public institutional and community-based facilities providing diagnostic or therapeutic services for residents of this state; (2) determine the scope of such services; and (3) anticipate future needs for such facilities and services.] Such plan may include, but not be limited to: (1) An assessment of the availability of acute hospital care, hospital emergency care, specialty hospital care, outpatient surgical care, primary care, and clinic care; (2) an evaluation of the unmet needs of persons at risk and vulnerable populations as determined by the commissioner; (3) a projection of future demand for health care services and the impact that technology may have on the demand, capacity or need for such services; and (4) recommendations for the expansion, reduction or modification of health care facilities or services. In the development of the plan, the office shall consider the recommendations of any advisory bodies which may be established by the commissioner. The commissioner may also incorporate the recommendations of authoritative organizations whose mission is to promote policies based on best practices or evidence-based research. The commissioner shall develop a process that encourages hospitals to incorporate the state-wide health care facilities plan into hospital long-range planning and shall facilitate communication between appropriate state agencies concerning innovations or changes that may affect future health planning. The office shall update the state-wide health care facilities plan on or before July 1, 2010, and every five years thereafter. Said plan shall be considered part of the state health plan for purposes of office deliberations pursuant to section 19a-637.

Sec. 8. (NEW) (Effective July 1, 2008) (a) Not later than July 1, 2010, and every five years thereafter, the Commissioner of Mental Health and Addiction Services shall prepare a multiyear state mental health and substance abuse services plan that provides an assessment of the behavioral health of the state's population and the availability of behavioral services on a state-wide basis. Such plan shall incorporate the state substance abuse plan required by section 17a-451 of the 2008 supplement to the general statutes. The plan shall include: (1) Policy recommendations regarding allocation of resources; (2) public behavioral health priorities; (3) quantitative goals and objectives with respect to the appropriate supply, distribution and organization of public behavioral health resources; (4) an evaluation of the implications of new technology for the organization, delivery and equitable distribution of services; and (5) an evaluation of the unmet needs of persons at risk and vulnerable populations as determined by the commissioner. In developing the plan, the commissioner shall consider the recommendations of relevant statutory advisory bodies and advisory bodies established by the commissioner. The commissioner may also incorporate the recommendations of authoritative organizations whose mission is to promote policies based on best practices or evidence-based research. The commissioner shall submit the state mental health and substance abuse services plan to the Commissioner of Public Health for incorporation into the state-wide health plan required pursuant to section 19a-7 of the general statutes, as amended by this act.

Sec. 9. (NEW) (Effective July 1, 2008) The Commissioners of Public Health and Higher Education and the Labor Commissioner, or their designees, and the director of the Office of Workforce Competitiveness, in collaboration with representatives of the health care industry, shall meet not less than quarterly to coordinate efforts to provide and enhance programs that increase the training, recruitment and retention of the health care and public health workforce. The Commissioner of Public Health or his designee shall serve as the chairperson and convene such quarterly meetings.