House Bill No. 8007
House Bill No. 8007
June 18 Special Session, PUBLIC ACT NO. 97-8
AN ACT CONCERNING EXPENDITURES FOR THE PROGRAMS
AND SERVICES OF THE DEPARTMENT OF PUBLIC HEALTH.
Be it enacted by the Senate and House of
Representatives in General Assembly convened:
Section 1. Subsections (b) and (c) of section
17a-450 of the general statutes are repealed and
the following is substituted in lieu thereof:
(b) For the purposes of chapter 50, the
Department of Mental Health and Addiction Services
shall be a single budgeted agency. It shall
consist of two divisions, the Division of Mental
Health Services and the Division of Substance
Abuse Services, that shall be organized to promote
comprehensive, client-based services in the areas
of mental health treatment and substance abuse
treatment and to ensure the programmatic integrity
and clinical identity of services in each area.
The department shall perform the functions of:
Centralized administration, planning and program
development; prevention and treatment programs and
facilities, both inpatient and outpatient, for
persons with psychiatric disabilities or persons
with substance abuse disabilities, or both;
community mental health centers and community or
regional programs and facilities providing
services for persons with psychiatric disabilities
or persons with substance abuse disabilities, or
both; training and education; and research and
evaluation of programs and facilities providing
services for persons with psychiatric disabilities
or persons with substance abuse disabilities, or
both. The department shall include, but not be
limited to, the following divisions and
facilities: The office of the Commissioner of
Mental Health and Addiction Services; Capitol
Region Mental Health Center; Connecticut Valley
Hospital; [Norwich Hospital; Fairfield Hills
Hospital;] the Connecticut Mental Health Center;
the Whiting Forensic Division; Ribicoff Research
Center; Cedarcrest [Regional] Hospital; the
Franklin S. DuBois Center; the Greater Bridgeport
Community Mental Health Center; [Blue Hills
Hospital; Berkshire Woods Treatment Center; Eugene
Boneski Treatment Center; Dutcher Treatment
Center;] and any other state-operated facility for
the treatment of persons with psychiatric
disabilities or persons with substance abuse
disabilities, or both, but shall not include those
portions of such facilities transferred to the
Department of Children and Families for the
purpose of consolidation of children's services.
(c) The Department of Mental Health and
Addiction Services may:
(1) Solicit and accept for use any gift of
money or property made by will or otherwise, and
any grant of money, services or property from the
federal government, the state or any political
subdivision thereof or any private source, and do
all things necessary to cooperate with the federal
government or any of its agencies in making an
application for any grant;
(2) Keep records and engage in research and
the gathering of relevant statistics;
(3) Work with public or private agencies,
organizations, facilities or individuals to ensure
the operation of the programs set forth in
accordance with sections 17a-75 to 17a-83,
inclusive, 17a-450 to 17a-484, inclusive, AS
AMENDED BY THIS ACT, 17a-495 to 17a-528,
inclusive, 17a-540 to 17a-550, inclusive, AS
AMENDED BY THIS ACT, 17a-560 to 17a-576,
inclusive, 17a-580 to 17a-603, inclusive, and
17a-615 to 17a-618, inclusive;
(4) Hold hearings, issue subpoenas, administer
oaths, compel testimony and order production of
books, papers and records in the performance of
its duties; [and]
(5) OPERATE TRUSTEE ACCOUNTS, IN ACCORDANCE
WITH PROCEDURES PRESCRIBED BY THE COMPTROLLER, ON
BEHALF OF INPATIENT AND OUTPATIENT DEPARTMENT
CLIENTS;
(6) NOTWITHSTANDING ANY PROVISIONS OF SECTIONS
4-101 AND 17b-239 TO THE CONTRARY, ESTABLISH
MEDICAL REIMBURSEMENT RATES FOR BEHAVIORAL HEALTH
SERVICES INCLUDING, BUT NOT LIMITED TO, INPATIENT,
OUTPATIENT AND RESIDENTIAL SERVICES PURCHASED BY
THE DEPARTMENT; AND
[(5)] (7) Perform such other acts and
functions as may be necessary or convenient to
execute the authority expressly granted to it.
Sec. 2. Subsections (i) and (j) of section
17a-543 of the general statutes are repealed and
the following is substituted in lieu thereof:
(i) Unless there is a serious risk of harm to
the patient or others, based upon the patient's
past history or current condition, nothing in this
section authorizes any form of involuntary
medical, psychological or psychiatric treatment of
any patient who in the sincere practice of his
religious beliefs is being treated by prayer alone
in accordance with the principles and practices of
a church or religious denomination by a duly
accredited practitioner or ordained minister,
priest or rabbi thereof.
[(j)] The Department of Mental Health and
Addiction Services shall adopt regulations, in
accordance with chapter 54, to implement the
purposes of this [section] SUBSECTION.
Sec. 3. Section 17a-476 of the general
statutes is repealed and the following is
substituted in lieu thereof:
(a) Any general hospital, municipality or
nonprofit organization in Connecticut may apply to
the state Department of Mental Health and
Addiction Services [through a regional mental
health director] for funds to establish, expand or
maintain psychiatric or mental health services.
The application for funds shall be submitted [to
the appropriate regional mental health director]
on forms provided by the Department of Mental
Health and Addiction Services, and shall be
accompanied by (1) a definition of the towns and
areas to be served; (2) a plan by means of which
the applicant proposes to coordinate its
activities with those of other local agencies
presently supplying mental health services or
contributing in any way to the mental health of
the area; (3) a description of the services to be
provided, and the methods through which these
services will be provided, and (4) indication of
the methods that will be employed to effect a
balance in the use of state and local resources so
as to foster local initiative, responsibility and
participation. In accordance with subdivision (4)
of [subsection (b) of] section 17a-480, AS AMENDED
BY THIS ACT, and subdivisions (1) and (2) of
subsection (a) of section 17a-484, AS AMENDED BY
THIS ACT, the regional mental health [director
and] board shall [transmit] REVIEW each such
application [to] WITH the Department of Mental
Health and Addiction Services [, together with
their] AND MAKE recommendations TO THE DEPARTMENT
with respect to [and the priority ranking of] each
such application.
(b) Upon receipt of the application with the
recommendations [and priority ranking] of the
regional mental health board [,] and approval by
the [state] Department of Mental Health and
Addiction Services, [said] THE department shall
grant such funds BY WAY OF A CONTRACT OR
GRANT-IN-AID within the appropriation for any
annual fiscal year. No funds authorized by this
section shall be used for the construction or
renovation of buildings.
(c) The Commissioner of Mental Health and
Addiction Services may [make] ADOPT regulations,
IN ACCORDANCE WITH THE PROVISIONS OF CHAPTER 54,
concerning minimum standards for eligibility to
receive said state CONTRACTED funds and any
grants-in-aid. ANY SUCH FUNDS OR GRANTS-IN-AID
made by the Department of Mental Health and
Addiction Services for psychiatric or mental
health services shall be made directly to the
agency submitting the application and providing
such service or services.
Sec. 4. Section 17a-478 of the general
statutes is repealed and the following is
substituted in lieu thereof:
The Commissioner of Mental Health and
Addiction Services shall designate mental health
regions within the state. Such regions and
boundaries thereof may be redesignated by said
commissioner as he deems necessary. [With the
approval of the regional mental health board, as
established by subsection (c) of section 17a-483,
the Commissioner of Mental Health and Addiction
Services shall appoint for each such mental health
region a regional mental health director, who
shall serve at the pleasure of said commissioner
and under his direction.] For the purposes of
sections 17a-476, AS AMENDED BY THIS ACT, and
17a-478 to [17a-481] 17a-480, inclusive, AS
AMENDED BY THIS ACT, "community mental health
services" means comprehensive services, both
medical and nonmedical, designed to (1) decrease
the prevalence and incidence of psychiatric
disabilities, emotional disturbance and social
disfunctioning, and (2) promote mental health in
individuals, groups and institutions and includes,
but is not limited to, the following: Outreach and
case finding, inpatient treatment, outpatient
treatment, partial hospitalization, diagnosis and
screening, aftercare and rehabilitation,
education, consultation, emergency services,
research, evaluation, training and services to the
courts. [All divisions and facilities of the
Department of Mental Health and Addiction Services
in existence on July 1, 1975, including those
specified in subsection (b) of section 17a-458 and
subsection (b) of section 17a-450, shall be
supervised and coordinated by the regional mental
health director for the region in which they are
located in conformity with section 17a-480.
Nothing contained in sections 17a-476 and 17a-478
to 17a-481, inclusive, shall be construed as
removing from the state Commissioner of Mental
Health and Addiction Services any power or duty
regarding overall state-wide administration and
control of state hospitals and other mental
institutions granted to him by statute.] The
Commissioner of Mental Health and Addiction
Services may enter into such contracts for
services as may be required to carry out the
provisions of subsection (a) of section 17a-476,
AS AMENDED BY THIS ACT, sections 17a-478 [and
17a-479, subsection (b) of section] TO 17a-480,
INCLUSIVE, AS AMENDED BY THIS ACT, and sections
17a-482 to 17a-484, inclusive, AS AMENDED BY THIS
ACT.
Sec. 5. Section 17a-480 of the general
statutes is repealed and the following is
substituted in lieu thereof:
[(a) Regional mental health directors shall be
qualified persons with experience in the field of
mental health and shall be in the unclassified
service. The salaries of the regional directors
shall be established by the Commissioner of
Administrative Services in accordance with section
4-40.
(b) Each regional mental health director] THE
DEPARTMENT OF MENTAL HEALTH AND ADDICTION
SERVICES, in consultation with [the] regional
mental health [board] BOARDS as established by
subsection (c) of section 17a-483, (1) may
purchase [, subject to the approval of the
Commissioner of Mental Health and Addiction
Services,] services from other public agencies [,]
AND from municipal and private agencies, [and from
state hospitals,] (2) shall [, in conformity with
the programs, budget, plans, policies, regulations
and standards of the state Department of Mental
Health and Addiction Services,] supervise, plan
and coordinate mental health services [within his
region] with the goal of improving and expanding
existing services and providing new ones, (3)
shall develop joint programs [with other regions]
in conformity with state Department of Mental
Health and Addiction Services standards, (4) shall
make recommendations [and forward to the state
Commissioner of Mental Health and Addiction
Services] concerning all requests for grants and
all contract proposals emanating from [his region]
THE REGIONS, (5) shall evaluate mental health
service delivery [in his region] and monitor such
services to insure that they are in conformity
with the plans and policies of the state
Department of Mental Health and Addiction
Services, AND (6) shall report annually to the
[Commissioner] STATE BOARD of Mental Health and
Addiction Services [and the regional mental health
boards] on the status of programs and needs of
[his region and (7) shall report to the
Commissioner of Mental Health and Addiction
Services such information as the commissioner may
require] THE REGIONS.
Sec. 6. Section 17a-482 of the general
statutes is repealed and the following is
substituted in lieu thereof:
As used in subsection (a) of section 17a-476,
AS AMENDED BY THIS ACT, sections 17a-478 [and
17a-479, subsection (b) of section] TO 17a-480,
INCLUSIVE, AS AMENDED BY THIS ACT, and sections
17a-482 to 17a-484, inclusive, AS AMENDED BY THIS
ACT, unless the context otherwise requires:
"Catchment area" means any geographical area
within the state established as such by the
Commissioner of Mental Health and Addiction
Services, the boundaries of which may be
redesignated by said commissioner when deemed
necessary to equalize the population of each area
and in such manner as is consistent with the
boundaries of the municipalities therein, provided
such boundaries of any catchment area shall be
entirely within the boundaries of a mental health
region established under section 17a-478, AS
AMENDED BY THIS ACT; "council" means the catchment
area council established under section 17a-483, AS
AMENDED BY THIS ACT; "regional mental health
board" means the board appointed within each
mental health region under subsection (c) of
section 17a-483; and "provider" means any person
who receives income from private practice or any
public or private agency which delivers mental
health services.
Sec. 7. Subsection (b) of section 17a-483 of
the general statutes is repealed and the following
is substituted in lieu thereof:
(b) Each catchment area council shall study
and evaluate the delivery of mental health
services in its respective catchment area in
accordance with regulations adopted by the
Commissioner of Mental Health and Addiction
Services. Each council shall make such reports and
recommendations to the regional mental health
boards as such boards [or regional mental health
directors] may require or which the catchment area
council may deem necessary.
Sec. 8. Subsection (a) of section 17a-484 of
the general statutes is repealed and the following
is substituted in lieu thereof:
(a) Each mental health region established by
the Commissioner of Mental Health and Addiction
Services pursuant to section 17a-478, AS AMENDED
BY THIS ACT, shall be advised by a regional mental
health board. Each such board shall carry out its
duties in accordance with regulations adopted by
the Commissioner of Mental Health and Addiction
Services and shall study the needs of the region
and develop plans for improved and increased
mental health services, and shall: (1) Together
with the [regional mental health director]
DEPARTMENT OF MENTAL HEALTH AND ADDICTION
SERVICES, plan, endeavor to stimulate and
coordinate additional and expanded mental health
services, review all applications for funds, make
[joint] recommendations with respect thereto and
transmit such recommendations to the Commissioner
of Mental Health and Addiction Services and review
and make specific recommendations to the
Commissioner of Mental Health and Addiction
Services concerning the annual budget of the
region and state subsidies for regional mental
health programs; (2) report their findings and
conclusions annually to the Commissioner of Mental
Health and Addiction Services [and to the regional
mental health director] together with
recommendations for a comprehensive plan [and
priority ranking] for the establishment or
expansion of mental health services within the
region; (3) receive and expend federal, state and
local funds under the provisions of subsection (a)
of section 17a-476, AS AMENDED BY THIS ACT,
sections 17a-478, AS AMENDED BY THIS ACT, and
17a-479, [subsection (b) of] section 17a-480, AS
AMENDED BY THIS ACT, and sections 17a-482 to
17a-484, inclusive, AS AMENDED BY THIS ACT; and
(4) cooperate with federal comprehensive health
planning agencies or their successors, established
pursuant to United States Public Law 93-641, in
planning comprehensive mental health services
within its region.
Sec. 9. Section 19a-59 of the general statutes
is repealed and the following is substituted in
lieu thereof:
(a) EACH INSTITUTION, AS DEFINED IN SECTION
19a-490, THAT PROVIDES CHILDBIRTH SERVICE SHALL,
NOT LATER THAN JULY 1, 1999, INCLUDE A UNIVERSAL
NEWBORN HEARING SCREENING PROGRAM AS PART OF ITS
STANDARD OF CARE AND SHALL ESTABLISH A MECHANISM
FOR COMPLIANCE REVIEW. THE PROVISIONS OF THIS
SUBSECTION SHALL NOT APPLY TO ANY INFANT WHOSE
PARENTS OBJECT TO HEARING SCREENING AS BEING IN
CONFLICT WITH THEIR RELIGIOUS TENETS AND PRACTICE.
[(a)] (b) The Department of Public Health
shall establish a plan to implement and operate a
program of early identification of infant hearing
impairment. The purpose of such plan shall be to:
(1) Identify infants at high risk of having
hearing impairments; (2) notify parents of such
infants of the risk; (3) inform parents of
resources available to them for further testing
and treatment, including rehabilitation services
for such infants, and (4) inform parents of
financial assistance available through the
Department of Public Health, including, but not
limited to, parental eligibility criteria, which
may result in reduced cost or no cost to parents
for testing, evaluation or treatment, including
rehabilitation of such infants.
[(b)] The department shall develop such plan
in consultation with persons including, but not
limited to, pediatricians, otolaryngologists,
audiologists, educators and parents of deaf and
hearing impaired children. [The plan shall be
submitted by the department to the Governor and to
the joint standing committee of the General
Assembly having cognizance of the Department of
Public Health not later than February 1, 1982. The
department shall hold a public hearing on the plan
at least thirty days prior to its submittal.]
(c) THE COMMISSIONER OF PUBLIC HEALTH SHALL
ADOPT REGULATIONS, IN ACCORDANCE WITH CHAPTER 54
OF THE GENERAL STATUTES, TO IMPLEMENT THE
PROVISIONS OF SUBSECTION (a) OF THIS SECTION.
Sec. 10. Section 17a-453a of the general
statutes is repealed and the following is
substituted in lieu thereof:
(a) The Commissioner of Mental Health and
Addiction Services shall operate a BEHAVIORAL
HEALTH MANAGED CARE program, WITHIN AVAILABLE
APPROPRIATIONS, to: (1) Provide consistent and
appropriate treatment to [a general assistance
recipient who is mentally ill, a substance abuser
or both] ELIGIBLE RECIPIENTS; (2) reduce treatment
costs for such recipients; (3) eliminate
duplicated services provided to such recipients;
and (4) assist such recipients in applying for
federally funded programs. Said commissioner shall
adopt regulations, in accordance with chapter 54,
to implement said [pilot] program. FOR PURPOSES OF
THIS SECTION "ELIGIBLE RECIPIENT" MEANS AN
UNEMPLOYABLE, TRANSITIONAL OR EMPLOYABLE
INDIVIDUAL, AS DEFINED IN SECTION 17b-689, WHO IS
ELIGIBLE FOR STATE ADMINISTERED GENERAL
ASSISTANCE, AS DETERMINED BY THE DEPARTMENT OF
SOCIAL SERVICES, OR ELIGIBLE FOR GENERAL
ASSISTANCE, AS DETERMINED BY THE MUNICIPALITY, AND
IN NEED OF BEHAVIORAL HEALTH SERVICES, AS
DETERMINED BY THE DEPARTMENT OF MENTAL HEALTH AND
ADDICTION SERVICES. NOTWITHSTANDING SECTION
17a-476, 17a-676, 17b-257 OR ANY OTHER PROVISION
OF THE GENERAL STATUTES TO THE CONTRARY, SERVICES
PROVIDED UNDER THE BEHAVIORAL HEALTH MANAGED CARE
PROGRAM ESTABLISHED BY THIS SECTION SHALL NOT BE
RESTRICTED TO SERVICES OFFERED UNDER THE MEDICAID
PROGRAM. THE DEPARTMENT OF MENTAL HEALTH AND
ADDICTION SERVICES SHALL BE RESPONSIBLE FOR ALL
SERVICES AND PAYMENTS RELATED TO THE PROVISION OF
THE BEHAVIORAL HEALTH SERVICES FOR ELIGIBLE
RECIPIENTS AND MAY CONDUCT AN AUDIT OF ALL ASPECTS
OF THE PROGRAM ESTABLISHED BY THIS SECTION
INCLUDING, BUT NOT LIMITED TO, SERVICES PROVIDED,
PRIOR AUTHORIZATIONS, PAYMENTS FOR SERVICES AND
MEDICAL RECORDS. THE COMMISSIONER SHALL ANALYZE
THE RESULTS OF SUCH AUDITS TO IDENTIFY
DISCREPANCIES AND ERRORS WITH REGARD TO SERVICES
AND PAYMENTS AND AREAS THAT INVOLVE PROGRAM
IMPLEMENTATION AND OPERATION PROBLEMS. THE
COMMISSIONER SHALL ADOPT REGULATIONS, IN
ACCORDANCE WITH THE PROVISIONS OF CHAPTER 54,
CONCERNING THE RECOVERY OF REIMBURSEMENTS MADE TO
PROVIDERS BASED ON AUDIT FINDINGS AND SETTING SUCH
PROGRESSIVE SANCTIONS AS THE COMMISSIONER DEEMS
APPROPRIATE FOR ANY PROVIDERS FOUND, AS A RESULT
OF AN AUDIT, NOT TO BE IN COMPLIANCE WITH THE
STANDARDS ESTABLISHED PURSUANT TO THIS SECTION.
THE REGULATIONS SHALL INCLUDE A PROVISION ALLOWING
THE COMMISSIONER TO TAKE ACTION TO WITHHOLD
REIMBURSEMENT FOR ANY SUCH PROVIDER AND SHALL
PROVIDE FOR A GRACE PERIOD BEFORE A SANCTION IS
IMPOSED. A PROVIDER MAY APPEAL A DECISION OF THE
COMMISSIONER TO WITHHOLD REIMBURSEMENTS OR TO
IMPOSE A SANCTION IN ACCORDANCE WITH THE
PROVISIONS OF CHAPTER 54.
(b) THE COMMISSIONER OF MENTAL HEALTH AND
ADDICTION SERVICES SHALL IMPLEMENT POLICIES AND
PROCEDURES NECESSARY FOR THE PURPOSES OF THIS
SECTION WHILE IN THE PROCESS OF ADOPTING SUCH
POLICIES AND PROCEDURES IN REGULATION FORM,
PROVIDED THE COMMISSIONER PRINTS A NOTICE OF
INTENTION TO ADOPT THE REGULATIONS IN THE
CONNECTICUT LAW JOURNAL NOT LATER THAN TWENTY DAYS
PRIOR TO IMPLEMENTING SUCH POLICIES AND
PROCEDURES. THE COMMISSIONER SHALL SUBMIT A REPORT
ON SUCH POLICIES AND PROCEDURES EACH MONTH TO THE
JOINT STANDING COMMITTEES OF THE GENERAL ASSEMBLY
HAVING COGNIZANCE OF MATTERS CONCERNING PUBLIC
HEALTH AND HUMAN SERVICES AND TO THE SECRETARY OF
THE OFFICE OF POLICY AND MANAGEMENT UNTIL FINAL
REGULATIONS ARE SUBMITTED TO THE LEGISLATIVE
REGULATION REVIEW COMMITTEE NOT LATER THAN APRIL
1, 1998. POLICIES AND PROCEDURES IMPLEMENTED
PURSUANT TO THIS SUBSECTION SHALL BE VALID UNTIL
THE TIME FINAL REGULATIONS ARE EFFECTIVE.
(c) ON AND AFTER JULY 1, 1998, THE
COMMISSIONER OF MENTAL HEALTH AND ADDICTION
SERVICES SHALL EXPAND THE PROGRAM ESTABLISHED BY
THIS SECTION TO INCLUDE SERVICES THAT PROVIDE
BASIC NEEDS SUPPORT TO ASSIST IN THE RESTORATION
OF FUNCTIONING OF RECIPIENTS DETERMINED ELIGIBLE
BY THE DEPARTMENT OF SOCIAL SERVICES.
(d) PROVIDERS OF SERVICES AND PROVIDER
NETWORKS UNDER THE PROGRAM ESTABLISHED BY THIS
SECTION SHALL BE APPROVED BY THE COMMISSIONER IN
ACCORDANCE WITH CRITERIA ESTABLISHED BY THE
COMMISSIONER, WHICH SHALL INCLUDE, BUT NOT BE
LIMITED TO, MINIMUM RESERVE FUND REQUIREMENTS.
Sec. 11. Subsection (b) of section 17a-528 of
the general statutes is repealed and the following
is substituted in lieu thereof:
(b) The expenses, if any, of necessary
transportation (1) from a state-aided, town-aided
or other municipal-aided hospital to a
state-operated facility, as defined in section
17a-458, for detention of any person under section
17a-502; (2) for any voluntary patient who wishes
to have emergency treatment for conditions defined
in section 17a-502 at any such state-operated
facility; [or] (3) for any patient who has been
released on leave from any such state-operated
facility and wishes to return; OR (4) FOR PERSONS
AUTHORIZED BY THE DEPARTMENT OF MENTAL HEALTH AND
ADDICTION SERVICES TO RECEIVE INPATIENT
PSYCHIATRIC SERVICES IN A FACILITY UNDER CONTRACT
WITH THE DEPARTMENT TO PROVIDE SUCH SERVICES,
shall be paid by the state, unless, after
investigation, the Department of Administrative
Services determines such person is able to pay for
the same. The presence of an appropriate emergency
certificate under section 17a-502 shall be
sufficient for payment by the state under
subdivision (1) of this subsection, regardless of
the eventual commitment or noncommitment of the
person to the facility. The Commissioner of Mental
Health and Addiction Services may adopt
regulations concerning the payment of
transportation expenses by the state under this
subsection.
Sec. 12. Subdivision (7) of section 17a-680 of
the general statutes is repealed and the following
is substituted in lieu thereof:
(7) "Drug-dependent person" means a person who
has a psychoactive substance dependence on drugs
as that condition is defined in the most recent
edition of the American Psychiatric Association's
"Diagnostic and Statistical Manual of Mental
Disorders". [No person shall be classified as drug
dependent who is dependent (A) upon a
morphine-type substance as an incident to current
medical treatment of a demonstrable physical
disorder other than drug dependence, or (B) upon
amphetamine-type, ataractic, barbiturate-type,
hallucinogenic or other stimulant and depressant
substances as an incident to current medical
treatment of a demonstrable physical or
psychological disorder, or both, other than drug
dependence;]
Sec. 13. Section 17a-691 of the general
statutes is repealed and the following is
substituted in lieu thereof:
As used in sections 17a-691 to 17a-701,
inclusive, AS AMENDED BY THIS ACT:
(a) "Alcohol-dependent person" means an
alcohol-dependent person as defined in section
17a-680, AS AMENDED BY THIS ACT.
(b) "Drug" means a controlled drug as defined
in section [21a-240] 17a-680, AS AMENDED BY THIS
ACT.
(c) "Drug-dependent person" means a
drug-dependent person as defined in section
[21a-240] 17a-680, AS AMENDED BY THIS ACT.
(d) "Treatment program" means a program
operated by the Department of Mental Health and
Addiction Services or approved by the Commissioner
of Mental Health and Addiction Services [or the
Department of Correction,] for treatment of both
the physical and psychological effects of alcohol
or drug dependency, provided such program is not
intended solely to detoxify an alcohol-dependent
or drug-dependent person.
Sec. 14. Section 17a-694 of the general
statutes is repealed and the following is
substituted in lieu thereof:
(a) The Commissioner of Mental Health and
Addiction Services or his designee shall appoint
[, at each facility operated by the department, an
examining committee of one or more members of the
clinical staff of the facility] ONE OR MORE
CLINICAL EXAMINERS to conduct examinations for
alcohol or drug dependency ordered pursuant to the
provisions of section 17a-693. Each [member of the
examining committee] EXAMINER shall be [a member
of the clinical staff of the facility who is
authorized by the facility] AUTHORIZED BY THE
DEPARTMENT to conduct independent evaluations.
(b) The [examining committee] EXAMINER shall
determine whether the person being examined was an
alcohol-dependent or drug-dependent person at the
time of the crime. If such person is determined to
have been dependent on alcohol or drugs, the
[committee] EXAMINER shall further determine (1)
the history and pattern of the dependency, and (2)
whether the person presently needs and is likely
to benefit from treatment for the dependency. If
the [committee] EXAMINER determines that the
person presently needs and is likely to benefit
from treatment, [it] HE shall recommend treatment
and state the date WHEN space will be available in
an appropriate treatment program, provided such
date shall not be more than forty-five days from
the date of the examination report. A
recommendation for treatment shall include
provisions for APPROPRIATE placement and the type
and length of treatment and may include provisions
for outpatient treatment.
(c) The [examining committee] EXAMINER shall
prepare and sign, without notarization, a written
examination report and deliver it to the court,
the Office of Adult Probation, the state's
attorney and defense counsel no later than thirty
days after the examination was ordered. An
examination report ordered pursuant to this
section and section 17a-693 shall otherwise be
confidential and not open to public inspection or
subject to disclosure.
(d) No statement made by the person in the
course of an examination under the provisions of
this section may be admitted in evidence on the
issue of guilt in a criminal proceeding concerning
the person.
Sec. 15. Section 17a-695 of the general
statutes is repealed and the following is
substituted in lieu thereof:
After receipt by the court of the examination
report, the accused person may make a motion for
suspension of prosecution and an order of
treatment for alcohol or drug dependency pursuant
to the provisions of section 17a-696. Unless the
opportunity for a hearing is waived by both the
accused person and the state's attorney, the court
shall hear the motion. The [examining committee]
CLINICAL EXAMINER shall not be required to be
present to testify on the report unless the
presence of the [examining committee] CLINICAL
EXAMINER is requested by the court, the accused
person or the state's attorney. [Any member of the
examining committee shall be competent to testify
as to the determinations of the examining
committee.]
Sec. 16. Subsection (b) of section 17a-696 of
the general statutes is repealed and the following
is substituted in lieu thereof:
(b) The court may order suspension of
prosecution and order treatment for alcohol or
drug dependency as provided in this section and
sections 17a-697 and 17a-698 if it, after
considering information before it concerning the
alcohol or drug dependency of the person,
including the examination report made pursuant to
the provisions of section 17a-694, finds that (1)
the accused person was an alcohol-dependent or
drug-dependent person at the time of the crime,
(2) the person presently needs and is likely to
benefit from treatment for the dependency, and (3)
suspension of prosecution will advance the
interests of justice. Treatment may begin no
[sooner] EARLIER than the date the [examining
committee] CLINICAL EXAMINER reports under the
provisions of section 17a-694 that space is
available in a treatment program.
Sec. 17. Subsection (c) of section 17a-699 of
the general statutes is repealed and the following
is substituted in lieu thereof:
(c) The court may, after imposing sentence,
(1) suspend execution of a sentence of
imprisonment, either entirely or after a period
set by the court, (2) impose a period of probation
as provided in this section and subsections (b)
and (c) of section 53a-28 and (3) as a condition
of probation, order the Office of Adult Probation
to place the person in an appropriate treatment
program for alcohol or drug dependency. The court
may require that a probation officer have at least
one contact per week with the treatment program in
which the person is participating and at least one
contact per week with the person when such person
is not participating in an inpatient program.
Placement in a treatment program shall be no
earlier than the date that space is available in a
treatment program as reported by the [examining
committee] CLINICAL EXAMINER under section
17a-694, AS AMENDED BY THIS ACT.
Sec. 18. Section 17a-683 of the general
statutes is amended by adding subsection (h) as
follows:
(NEW) (h) Each provider under contract with
the Department of Social Services or the
Department of Mental Health and Addiction Services
for the provision of comprehensive health care
coverage on a prepayment or per capita basis for
Medicaid or other public assistance recipients
pursuant to section 17b-266 shall be liable for
payment, in accordance with applicable
reimbursement rates, to any treatment facility
that provides inpatient treatment for
detoxification to any person brought to such
treatment facility under this section without
regard to whether such treatment facility is under
contract with the comprehensive health care
provider for the provision of inpatient treatment
for such recipients.
Sec. 19. Section 17b-90 of the general
statutes is repealed and the following is
substituted in lieu thereof:
(a) The commissioner shall [make] ADOPT
regulations, IN ACCORDANCE WITH CHAPTER 54,
necessary to enable him to carry out the
provisions of sections 17b-22, 17b-75 to 17b-77,
inclusive, 17b-79 to 17b-103, inclusive, 17b-114,
17b-180 to 17b-183, inclusive, 17b-260 to 17b-262,
inclusive, 17b-264 to 17b-285, inclusive, 17b-357
to 17b-362, inclusive, 17b-600 to 17b-604,
inclusive, 17b-807 and 17b-808, including any
regulations necessary for receiving grants from
the federal government to this state if the
absence of any such regulation would result in the
loss of such grants and regulations governing the
custody and use of the records, papers, files and
communications concerning persons applying for or
receiving assistance under said sections. When
names and addresses of recipients of such
assistance are required by law to be furnished to
or held by any other government agency, such
agency shall adopt regulations to prevent the
publication of lists thereof or their use for
purposes not directly connected with the
administration of said sections.
(b) No person shall, except for purposes
directly connected with the administration of
programs of the Department of Social Services and
in accordance with the regulations of the
commissioner, solicit, disclose, receive or make
use of, or authorize, knowingly permit,
participate in or acquiesce in the use of, any
list of the names of, or any information
concerning, persons applying for or receiving
assistance from the Department of Social Services
or persons participating in a program administered
by said department, directly or indirectly derived
from the records, papers, files or communications
of the state or its subdivisions or agencies, or
acquired in the course of the performance of
official duties; provided the state Department of
Social Services shall disclose (1) to any
authorized representative of the Commissioner of
Administrative Services or the Commissioner of
Public Safety such information as the state
Commissioner of Social Services determines is
directly related to and necessary for the
Department of Administrative Services or the
Department of Public Safety for purposes of
performing their functions of collecting social
services recoveries and overpayments or amounts
due as support in social services cases,
investigating social services fraud or locating
absent parents of public assistance recipients;
[or] (2) to any authorized representative of the
Commissioner of Children and Families the address
and telephone number of a child or the immediate
family of a child receiving services from the
Department of Social Services if the Commissioner
of Children and Families has determined that
imminent danger to such child's health, safety or
welfare exists; and provided no such
representative shall disclose any information
obtained thereby except to carry out such purpose;
OR (3) TO ANY AUTHORIZED REPRESENTATIVE OF THE
COMMISSIONER OF MENTAL HEALTH AND ADDICTION
SERVICES FOR THE PURPOSES OF THE BEHAVIORAL HEALTH
MANAGED CARE PROGRAM ESTABLISHED BY SECTION
17a-453, AS AMENDED BY THIS ACT.
(c) The Commissioner of Social Services shall
provide written notice to a person applying for or
receiving assistance from the Department of Social
Services or a person participating in a program
administered by said department that such person's
address and telephone number may be provided to
the Department of Children and Families pursuant
to subdivision (2) of subsection (b) of this
section.
(d) Penalties prescribed by subsection (b) of
section 17b-97 shall apply to violations of this
section.
Sec. 20. Section 17b-234 of the general
statutes is repealed and the following is
substituted in lieu thereof:
[For the fiscal year commencing July 1, 1988,
and each fiscal year thereafter, the Comptroller,
on behalf of the Department of Public Health,
shall make a grant to the Newington Children's
Hospital equal to the amount appropriated to the
department for the purposes of such grant. The
Comptroller shall pay such grant in monthly
instalments during the ensuing twelve-month
period.] The Department of Social Services shall
notify the Newington Children's Hospital of each
referral for whom said department can apply for
federal matching grants. Newington Children's
Hospital shall charge the Department of Social
Services for said eligible referrals only and
shall retain all such payments received from the
department. Such payments by the state shall be in
lieu of all other payments to said hospital by the
state or any town in this state except payments by
the Department of Social Services as provided in
this section, the State Board of Education or the
Department of Public Health. Such payments shall
not prevent payments to said hospital from private
sources for the care and support of any child in
said hospital or for the balance of such operating
expense. The Office of Health Care Access, in
establishing rates to be charged by the Newington
Children's Hospital, shall not include the grant
made to said hospital pursuant to this section. In
order to be eligible for the grant authorized by
this section, the Newington Children's Hospital
shall cooperate with The University of Connecticut
Health Center in order to provide consolidated and
coordinated pediatric services.
Sec. 21. Section 17b-349 of the general
statutes is repealed and the following is
substituted in lieu thereof:
(a) The rates paid by the state to community
health centers and free-standing medical clinics
participating in the Medicaid program may be
adjusted annually on the basis of the cost reports
submitted to the Commissioner of Social Services,
except that rates effective July 1, 1989, shall
remain in effect through June 30, 1990.
(b) FOR THE FISCAL YEAR ENDING JUNE 30, 1998,
ANY GRANT AWARDS MADE TO A COMMUNITY HEALTH CENTER
OR ITS SUCCESSOR FOR THE PURPOSE OF SUPPORTING THE
COMMUNITY HEALTH CENTER INFRASTRUCTURE SERVICES TO
THE UNINSURED OR EXPANSION INITIATIVE PROJECTS
SHALL BE EQUIVALENT TO BASE GRANT AWARDS MADE IN
THE FISCAL YEAR ENDING JUNE 30, 1997, PROVIDED, IF
ANY PORTION OF THE AMOUNT IS NOT REQUIRED BY A
GIVEN COMMUNITY HEALTH CENTER, THE DIFFERENTIAL
SHALL BE DISTRIBUTED AMONG ALL THE OTHER HEALTH
CENTERS ACCORDING TO THEIR SHARE OF TOTAL FUNDING.
(c) FOR THE FISCAL YEAR ENDING JUNE 30, 1999,
ANY GRANT AWARDS MADE TO A COMMUNITY HEALTH CENTER
OR ITS SUCCESSOR FOR THE PURPOSE OF SUPPORTING THE
COMMUNITY HEALTH CENTER INFRASTRUCTURE SERVICES TO
THE UNINSURED OR EXPANSION INITIATIVE PROJECTS
SHALL BE EQUIVALENT TO BASE GRANT AWARDS MADE IN
THE FISCAL YEAR ENDING JUNE 30, 1997, PROVIDED, IF
ANY PORTION OF THE AMOUNT IS NOT REQUIRED BY A
GIVEN COMMUNITY HEALTH CENTER, THE DIFFERENTIAL
SHALL BE DISTRIBUTED AMONG ALL THE OTHER HEALTH
CENTERS ACCORDING TO THEIR SHARE OF TOTAL FUNDING.
Sec. 22. Section 17a-210 of the general
statutes is repealed and the following is
substituted in lieu thereof:
(a) There shall be a Department of Mental
Retardation. The Department of Mental Retardation,
with the advice of a Council on Mental
Retardation, shall be responsible for the
planning, development and administration of
complete, comprehensive and integrated state-wide
services for persons with mental retardation and
[on and after July 1, 1995,] persons medically
diagnosed as having Prader-Willi syndrome. The
Department of Mental Retardation shall be under
the supervision of a Commissioner of Mental
Retardation, who shall be appointed by the
Governor in accordance with the provisions of
sections 4-5 to 4-8, inclusive. The Council on
Mental Retardation may advise the Governor on the
appointment. The commissioner shall be a person
who has background, training, education or
experience in administering programs for the care,
training, education, treatment and custody of
persons with mental retardation. The commissioner
shall be responsible, with the advice of the
council, for planning and developing complete,
comprehensive and integrated state-wide services
for persons with mental retardation; for the
implementation and where appropriate the funding
of such services; and for the coordination of the
efforts of the Department of Mental Retardation
with those of other state departments and
agencies, municipal governments and private
agencies concerned with and providing services for
persons with mental retardation. The commissioner
shall be responsible for the administration and
operation of the state training school, state
mental retardation regions and all state-operated
community-based residential facilities established
for the diagnosis, care and training of persons
with mental retardation. The commissioner shall be
responsible for establishing standards, providing
technical assistance and exercising the requisite
supervision of all state-supported residential,
day and program support services for persons with
mental retardation and work activity programs
operated pursuant to section 17a-226. The
commissioner shall conduct investigations into
allegations of abuse and neglect and file reports
as requested by state agencies having statutory
responsibility for the conduct and oversight of
such investigations. The commissioner shall
stimulate research by public and private agencies,
institutions of higher learning and hospitals, in
the interest of the elimination and amelioration
of retardation and care and training of persons
with mental retardation.
(b) The commissioner shall be responsible for
the development of criteria as to the eligibility
of any person with mental retardation for
residential care in any public or state-supported
private institution and, after considering the
recommendation of a properly designated diagnostic
agency, may assign such person to a public or
state-supported private institution. He may
transfer such persons from one such institution to
another when necessary and desirable for their
welfare, provided such person and such person's
parent, conservator, guardian or other legal
representative receives written notice at least
ten days prior to the proposed transfer of such
person from any such institution or facility. Such
prior notice shall not be required when transfers
are made between residential units within the
training school or a state mental retardation
region or when necessary to avoid a serious and
immediate threat to the life or physical or mental
health of such person or others residing in such
institution or facility. The notice required by
this subsection shall notify the recipient of his
or her right to request a hearing in accordance
with subsection (c) OF THIS SECTION and shall
include the name, address and telephone number of
the Office of Protection and Advocacy for Persons
with Disabilities. In the event of an emergency
transfer, such notice shall be given within ten
days following said transfer. In the event that a
hearing is requested prior to the proposed
transfer, the transfer shall be stayed pending
final disposition of the hearing.
(c) The parent, guardian, conservator or other
legal representative of any person with mental
retardation who resides at any institution or
facility operated by the Department of Mental
Retardation, or any person with mental retardation
himself, who is eighteen years of age or older and
who resides at any such institution or facility,
may make a request, in writing, to the
Commissioner of Mental Retardation for a hearing
on any transfer of such person from one
institution or facility to another for any reason
other than medical. IN ANY SUCH TRANSFER HEARING,
THE PROPONENT OF A TRANSFER SHALL HAVE THE BURDEN
OF SHOWING, BY CLEAR AND CONVINCING EVIDENCE, THAT
THE PROPOSED TRANSFER IS IN THE BEST INTEREST OF
THE RESIDENT BEING CONSIDERED FOR TRANSFER AND
THAT THE FACILITY AND PROGRAMS TO WHICH TRANSFER
IS PROPOSED (1) ARE SAFE AND EFFECTIVELY
SUPERVISED AND MONITORED AND (2) PROVIDE A GREATER
OPPORTUNITY FOR PERSONAL DEVELOPMENT THAN THE
RESIDENT'S PRESENT SETTING. Such hearing shall be
conducted in accordance with the provisions of
sections 4-176e to 4-184, inclusive.
(d) The parent, guardian, conservator or other
legal representative of a person, or the person
himself, may request a hearing for any final
determination by the department which (1) denies
such person eligibility for programs and services
of the department, (2) approves a program for such
person which includes the use of
behavior-modifying medications or aversive
procedures, or (3) determines that community
placement is inappropriate for such person placed
under the direction of the commissioner. A request
for a hearing shall be in writing to the
commissioner. Such hearing shall be conducted in
accordance with the provisions of sections 4-176e
to 4-184, inclusive.
Sec. 23. Section 19a-7f of the general
statutes is repealed and the following is
substituted in lieu thereof:
The standard of care for immunization for the
children of this state shall be the recommended
schedule for active immunization for normal
infants and children published by the committee on
infectious diseases of the American Academy of
Pediatrics or the schedule published by the
National Immunization Practices Advisory
Committee, as determined by the Commissioner of
Public Health. The commissioner shall establish,
within available appropriations, an immunization
program which shall: (1) Provide vaccine at no
cost to health care providers in Connecticut to
administer to children so that cost of vaccine
will not be a barrier to age-appropriate
vaccination in this state; (2) with the assistance
of hospital maternity programs, provide all
parents in this state with the recommended
immunization schedule for normal infants and
children, a booklet to record immunizations at the
time of the infant's discharge from the hospital
nursery and a list of sites where immunization may
be provided; (3) inform in a timely manner all
health care providers of changes in the
recommended immunization schedule; (4) assist
hospitals, local health providers and local health
departments to develop and implement
record-keeping and outreach programs to identify
and immunize those children who have fallen behind
the recommended immunization schedule or who lack
access to regular preventative health care and
have the authority to gather such data as may be
needed to evaluate such efforts; (5) assist in the
development of a program to assess the vaccination
status of children who are clients of state and
federal programs serving the health and welfare of
children and make provision for vaccination of
those who are behind the recommended immunization
schedule; (6) access available STATE AND federal
funds including, but not limited to, any funds
available through the federal Childhood
Immunization Reauthorization or any funds
available through the Medicaid program; (7)
SOLICIT, RECEIVE AND EXPEND FUNDS FROM ANY PUBLIC
OR PRIVATE SOURCE; and [(7)] (8) develop and make
available to parents and health care providers
public health educational materials about the
benefits of timely immunization.
Sec. 24. Section 19a-26 of the general
statutes is repealed and the following is
substituted in lieu thereof:
The Department of Public Health may establish,
maintain and control state laboratories to perform
examinations of supposed morbid tissues, other
laboratory tests for the diagnosis and control of
preventable diseases, and laboratory work in the
field of sanitation, environmental and
occupational testing and research studies for the
protection and preservation of the public health.
Such laboratory services shall be performed upon
the application of licensed physicians, other
laboratories, licensed dentists, licensed
podiatrists, local directors of health, public
utilities or state departments or institutions,
subject to regulations prescribed by the
Commissioner of Public Health, and upon payment of
any applicable fee as hereinafter provided. [, and
for] FOR such purposes the department may provide
necessary buildings and apparatus, employ, subject
to the provisions of chapter 67, administrative
and scientific personnel and assistants and do all
things necessary for the conduct of such
laboratories. The Commissioner of Public Health
shall establish a schedule of fees directly
related to operating costs or fair market value
for such laboratory services, provided such
laboratory services shall be performed without
charge for local directors of health and LOCAL LAW
ENFORCEMENT AGENCIES AND MAY BE PERFORMED WITHOUT
CHARGE FOR others if, in the determination of said
commissioner, the public health requires that such
services be furnished without charge. The
commissioner shall also establish a fair handling
fee which a client of a state laboratory may
charge a person or third party payer for arranging
for the services of the laboratory. Such client
shall not charge an amount in excess of such
handling fee.
Sec. 25. Section 19a-28 of the general
statutes is repealed and the following is
substituted in lieu thereof:
The Commissioner of Public Health shall
establish and maintain within the Department of
Public Health a special laboratory for
examination, research and analysis of poisons,
body fluids, tissues and all related toxicological
matters. The facilities of such laboratory and of
its personnel shall, under the supervision of the
commissioner, be available, WITHOUT CHARGE, to the
Office of the Chief Medical Examiner and all duly
constituted prosecuting, police and investigating
agencies of the state.
Sec. 26. Section 19a-55 of the general
statutes is repealed and the following is
substituted in lieu thereof:
(a) The administrative officer or other person
in charge of each institution caring for infants
twenty-eight days or less of age shall cause to
have administered to every such infant in its or
his care a test for phenylketonuria,
hypothyroidism, galactosemia, sickle cell disease,
maple syrup urine disease, homocystinuria,
biotinidase deficiency, CONGENITAL ADRENAL
HYPERPLASIA and such other tests for inborn errors
of metabolism as shall be prescribed by the
Department of Public Health. The Commissioner of
Public Health shall (1) administer the newborn
screening program, (2) direct persons identified
through the screening program to appropriate
specialty centers for treatments, and (3) set the
fees to be charged to institutions to cover all
expenses of the comprehensive screening program
including testing, tracking and treatment. The
commissioner shall adopt regulations specifying
the abnormal conditions to be tested for and the
manner of recording and reporting results.
(b) The provisions of this section shall not
apply to any infant whose parents object to the
test or treatment as being in conflict with their
religious tenets and practice.
Sec. 27. Section 19a-611 of the general
statutes is repealed and the following is
substituted in lieu thereof:
As used in sections 19a-610 to [19a-622]
19a-614, inclusive:
(1) "Certified health plan" means a plan that
provides the standard benefits package and meets
the requirements established by the Office of
Health Care Access;
(2) "Office" means the Office of Health Care
Access;
(3) "Standard benefits package" means the
specified set of health services, as determined by
federal law or in the absence of such applicable
federal law, as determined by state law, that are
the minimum which must be available from each
certified health plan;
(4) "Health care provider" or "provider" means
a state licensed or certified person or
state-authorized facility, which delivers
diagnostic, treatment, inpatient or ambulatory
health care services; AND
(5) "Health plan" means any hospital or
medical policy or certificate or contract,
hospital or medical service plan contract, or
health care center contract. The term does not
include accident-only, specific disease,
individual hospital indemnity, credit,
dental-only, vision-only, Medicare supplement,
long-term care, or disability income insurance;
coverage issued as a supplement to liability
insurance; workers' compensation or similar
insurance; or automobile medical-payment
insurance. [;]
[(6) "Institute" means the Connecticut Health
Care Data Institute established pursuant to
section 19a-616 and operated by The University of
Connecticut Health Center.]
Sec. 28. Subsection (b) of section 19a-613 of
the general statutes is repealed and the following
is substituted in lieu thereof:
(b) The office shall: (1) Authorize and
oversee the collection of data required to carry
out the provisions of [sections 19a-610 to 19a-622
and coordinate with the Connecticut Health Care
Data Institute on issues relating to the
collection and analysis of health care data
described in sections 19a-619 to 19a-622,
inclusive] THIS CHAPTER; (2) oversee and
coordinate health system planning for the state;
(3) monitor health care costs; [(4) continue the
functions and duties of chapter 368z; and (5)] AND
(4) implement and oversee health care reform as
enacted by the General Assembly.
Sec. 29. Subsection (b) of section 17b-28a of
the general statutes is repealed and the following
is substituted in lieu thereof:
(b) There is established a Medicaid waiver
unit within the Department of Social Services for
the purposes of developing the waiver under
subsection (a) OF THIS SECTION. The Medicaid
waiver unit's responsibilities shall include but
not be limited to the following: (1)
Administrating the Medicaid managed care program,
established pursuant to section 17b-28; (2)
contracting with and evaluating prepaid health
plans providing Medicaid services, including
negotiation and establishment of capitated rates;
(3) assessing quality assurance information
compiled by the federally required independent
quality assurance contractor; (4) monitoring
contractual compliance; (5) evaluating enrolment
broker performance; [(6) providing Medicaid data
to the Health Care Data Institute, established
pursuant to section 19a-616, for the purpose of
establishing a Medicaid database; (7)] (6)
providing assistance to the Insurance Department
for the regulation of Medicaid managed care health
plans; and [(8)] (7) developing a system to
compare performance levels among prepaid health
plans providing Medicaid services.
Sec. 30. Subsection (b) of section 21a-251 of
the general statutes is repealed and the following
is substituted in lieu thereof:
(b) Original and continuing orders for
schedule II controlled substances shall be limited
to a period not exceeding [seventy-two hours from
the time the order is entered but may be extended
for further periods of seventy-two hours each by
the signing or initialing thereof by a prescribing
practitioner; except that such orders for schedule
II controlled substances of the nonnarcotic type,
including but not limited to barbiturates and
amphetamines, shall be limited to a period not
exceeding] seven days from the time the order is
entered, but may be extended for additional
periods of seven days each by the signing or
initialing of the order by a prescribing
practitioner.
Sec. 31. Section 52-146h of the general
statutes is repealed and the following is
substituted in lieu thereof:
(a) Any [mental health] facility [may] OR
INDIVIDUAL UNDER CONTRACT WITH THE DEPARTMENT OF
MENTAL HEALTH AND ADDICTION SERVICES TO PROVIDE
BEHAVIORAL HEALTH SERVICES SHALL transmit
information and records, if requested, to the
Commissioner of Mental Health and Addiction
Services pursuant to his obligation under section
17a-451 to maintain [, subject to the approval of
the Board of Mental Health and Addiction
Services,] the overall responsibility for the care
and treatment of [the mentally ill] PERSONS WITH
PSYCHIATRIC DISORDERS OR SUBSTANCE USE DISORDERS.
The Commissioner of Mental Health and Addiction
Services may collect and use the information and
records for administration, planning or research,
subject to the provisions of section 52-146g. The
Commissioner of Mental Health and Addiction
Services may enter into contracts within the state
and into interstate compacts for the efficient
storage and retrieval of the information and
records.
(b) Identifiable data shall be removed from
all information and records before issuance from
the [mental health] INDIVIDUAL OR facility which
prepared them, and a code, the key to which shall
remain in possession of the issuing facility and
be otherwise available only to the Commissioner of
Mental Health and Addiction Services for purposes
of planning, administration or research, shall be
the exclusive means of identifying patients. The
key to the code shall not be available to any data
banks in which the information is stored or to any
other persons, corporations or agencies, private
or governmental.
Sec. 32. Section 54-56g of the general
statutes is repealed and the following is
substituted in lieu thereof:
(a) There shall be a pretrial alcohol
education system for persons charged with a
violation of section 14-227a. Upon application by
any such person for participation in such system
and payment to the court of an application fee of
fifty dollars, the court shall, but only as to the
public, order such information or complaint to be
filed as a sealed information or complaint,
provided such person states under oath, in open
court or before any person designated by the clerk
and duly authorized to administer oaths, under
penalties of perjury that he has never had such
system invoked in his behalf and that he has not
been convicted of a violation of section 53a-56b
or 53a-60d, a violation of subsection (a) of
section 14-227a before or after October 1, 1981,
or a violation of subdivision (1) or (2) of
subsection (a) of section 14-227a on or after
October 1, 1985, and that he has not been
convicted in any other state at any time of an
offense the essential elements of which are
substantially the same as section 53a-56b or
53a-60d or subdivision (1) or (2) of subsection
(a) of section 14-227a. Unless good cause is
shown, a person shall be ineligible for
participation in such pretrial alcohol education
system if his alleged violation of section 14-227a
caused the serious physical injury, as defined in
section 53a-3, of another person. The fee imposed
by this subsection shall be credited to the
Criminal Injuries Compensation Fund established by
section 54-215.
(b) The court, after consideration of the
recommendation of the state's attorney, assistant
state's attorney or deputy assistant state's
attorney in charge of the case, may, in its
discretion, grant such application. If the court
grants such application, it shall refer such
person to the Bail Commission for assessment and
confirmation of the eligibility of the applicant.
The Bail Commission, in making its assessment and
confirmation, may rely on the representations made
by the applicant under oath in open court with
respect to convictions in other states of offenses
specified in subsection (a) of this section. Upon
confirmation of eligibility, the defendant shall
be referred to the Department of Mental Health and
Addiction Services by the Bail Commission for
evaluation and placement in an appropriate alcohol
program for one year. Any person who enters the
system shall agree: (1) To the tolling of the
statute of limitations with respect to such crime,
(2) to a waiver of his right to a speedy trial,
(3) to participate in at least [eight meetings or]
TEN counseling sessions in an alcohol program
pursuant to this section and complete the assigned
program, and (4) to accept placement in a
treatment program upon recommendation of a
provider under contract with the Department of
Mental Health and Addiction Services pursuant to
subsection (d) of this section or placement in a
treatment program which has standards
substantially similar to, or higher than, a
program of a provider under contract with the
Department of Mental Health and Addiction Services
if the Bail Commission deems it appropriate. The
suspension of the motor vehicle operator's license
of any such person pursuant to section 14-227b
shall be effective during the period such person
is participating in such program, provided such
person shall have the option of not commencing the
participation in such program until the period of
such suspension is completed. If the Bail
Commission informs the court that the defendant is
ineligible for the system and the court makes a
determination of ineligibility or if the program
provider certifies to the court that the defendant
did not successfully complete the assigned program
or is no longer amenable to treatment, the court
shall order the information or complaint to be
unsealed, enter a plea of not guilty for such
defendant and immediately place the case on the
trial list. If such defendant satisfactorily
completes the assigned program he may apply for
dismissal of the charges against him and the
court, on reviewing the record of his
participation in such program submitted by the
Bail Commission and on finding such satisfactory
completion, shall dismiss the charges. If the
defendant does not apply for dismissal of the
charges against him after satisfactorily
completing the assigned program the court, upon
receipt of the record of his participation in such
program submitted by the Bail Commission, may on
its own motion make a finding of such satisfactory
completion and dismiss the charges. Upon motion of
the defendant and a showing of good cause, the
court may extend the one-year placement period for
a reasonable period for the defendant to complete
the assigned program. A record of participation in
such program shall be retained by the Bail
Commission for a period of seven years from the
date of application. The Bail Commission shall
transmit to the Department of Motor Vehicles a
record of participation in such program for each
person who satisfactorily completes such program.
The Department of Motor Vehicles shall maintain
for a period of seven years the record of a
person's participation in such program as part of
such person's driving record.
(c) At the time the court grants the
application for participation in the pretrial
alcohol education system, such person shall also
pay to the court a nonrefundable program fee of
[three hundred fifty] FOUR HUNDRED TWENTY-FIVE
dollars, except that no person may be excluded
from such program for inability to pay such fee,
provided (1) such person files with the court an
affidavit of indigency or inability to pay, (2)
such indigency is confirmed by the Bail
Commission, and (3) the court enters a finding
thereof. If the court denies the application, such
person shall not be required to pay the program
fee. If the court grants the application, and such
person is later determined to be ineligible for
participation in such pretrial alcohol education
system or fails to complete the assigned program,
the [three-hundred-fifty-dollar]
FOUR-HUNDRED-TWENTY-FIVE-DOLLAR program fee shall
not be refunded. All such program fees shall be
credited to the General Fund.
(d) The Department of Mental Health and
Addiction Services shall contract with service
providers, develop standards and oversee
appropriate alcohol programs to meet the
requirements of this section. Said department
shall adopt regulations in accordance with chapter
54 to establish standards for such alcohol
programs. Any defendant whose employment or
residence makes it unreasonable to attend an
alcohol program in this state may attend a program
in another state which has standards substantially
similar to, or higher than, those of this state,
subject to the approval of the court and payment
of the application and program fees as provided in
this section.
Sec. 33. Funds appropriated to the Office of
Policy and Management in sections 1 and 11 of
special act 97-21 for the fiscal year ending June
30, 1998, and the fiscal year ending June 30,
1999, to the private provider account, shall be
distributed by the Secretary of the Office of
Policy and Management to the Departments of Mental
Health and Addiction Services, Mental Retardation,
Social Services and Children and Families and
shall be used by said departments for supplemental
payments to private providers under contract to
such agencies. Not more than four million five
hundred thousand dollars of such funds shall be
distributed, in the fiscal year ending June 30,
1998, to private provider agencies that settle
wage and benefit contracts with unionized
employees between April 1, 1997, and August 1,
1997, for the otherwise unreimbursed costs of
collective bargaining agreements incurred in the
fiscal year ending June 30, 1998, and for
proportional increases in personnel costs for the
nonunionized employees of such agencies. Not more
than four million five hundred thousand dollars of
such funds shall be distributed, in the fiscal
year ending June 30, 1998, to: (1) Private
provider agencies that do not settle wage and
benefit contracts with unionized employees between
April 1, 1997, and August 1, 1997, for the
otherwise unreimbursed costs of collective
bargaining agreements incurred in the fiscal year
ending June 30, 1998, and for proportional
increases in personnel costs for the nonunionized
employees of such agencies; and (2) nonunionized
private provider agencies for increases in
personnel costs. The use of funds distributed
pursuant to this section to the Department of
Social Services shall be limited to intermediate
care facilities for the mentally retarded. The
Office of Policy and Management shall, in
consultation with the Office of Fiscal Analysis,
determine which appropriation accounts or portions
of appropriation accounts are eligible to receive
funds to be distributed pursuant to this section.
The Secretary of the Office of Policy and
Management shall determine the amount of funds
distributed to all such identified accounts of
portions of accounts within such agencies.
Sec. 34. (NEW) The Departments of Mental
Retardation, Mental Health and Addiction Services
and Children and Families shall provide technical
support to selected private providers in order to
implement work-site based projects. The projects
to be implemented at the private provider
facilities shall be supported by the departments
within budgeted resources and shall reflect
injury-reducing initiatives. On or before October
1, 1997, and annually thereafter, the departments
shall submit reports to the joint standing
committee of the General Assembly having
cognizance of matters relating to public health
identifying (1) potential savings associated with
such initiatives and with the overall promotion of
work-site safety and (2) total workers'
compensation costs incurred by private providers
funded by the departments.
Sec. 35. Section 19a-507a of the general
statutes is repealed and the following is
substituted in lieu thereof:
As used in section 8-3g and sections 19a-507a
to 19a-507d, inclusive, AS AMENDED BY THIS ACT:
(1) "Mentally ill adult" means any adult who has a
mental or emotional condition which has
substantial adverse effects on his ability to
function and who requires care and treatment but
shall not mean any adult who is dangerous to
himself or herself or others, as defined in
section 17a-495, or who is an alcohol-dependent
person or a drug-dependent person, as defined in
section 17a-680, or who has been placed in any
community-based residential home by order of the
Superior Court or has been released to any
community-based residential home by the Department
of Correction or any person found not competent to
stand trial for any crime pursuant to section
54-56d or committed pursuant to sections 17a-580
to 17a-602, inclusive; (2) "regional mental health
board" means a regional mental health board, as
defined in section 17a-482, AS AMENDED BY THIS
ACT; [(3) "regional mental health director" means
a director appointed by the Commissioner of Mental
Health and Addiction Services under section
17a-480; (4)] (3) "community residence" means a
facility which houses the staff of such facility
and eight or fewer mentally ill adults which is
licensed by the Commissioner of Public Health and
which provides supervised, structured group living
activities and psychosocial rehabilitation and
other support services to mentally ill adults
discharged from a state-operated or licensed
facility or referred by a licensed physician
specializing in psychiatry or a licensed
psychologist.
Sec. 36. Subsection (c) of section 19a-507b of
the general statutes is repealed and the following
is substituted in lieu thereof:
(c) An applicant for a license to operate a
community residence shall mail a copy of the
application made to the Department of Public
Health to the regional mental health board [, the
regional mental health director] and the governing
body of the municipality in which the community
residence is to be located, by certified mail,
return receipt requested. All applications shall
specify the number of community residences in the
municipality, the address of each such residence
and the number of residents in each and the
address of the proposed community residence, and
shall include population and occupancy statistics
reflecting compliance with the limits established
pursuant to subsection (a) of this section.
Sec. 37. Section 7-51 of the general statutes
is repealed and the following is substituted in
lieu thereof:
With the exception of the chief executive
officer of the municipality or his authorized
agent, the local director of health OR HIS
AUTHORIZED AGENT, attorneys at law, title
examiners and members of genealogical societies
incorporated or authorized to do business or
conduct affairs in this state, no person, except
the person whose birth is recorded, if over
eighteen years of age, his children or spouse or
his parent, guardian or grandparent if a minor,
shall have any access to or be permitted to
examine the original or any copy of the birth
certificate or birth record, of any person, nor
shall he disclose any matters contained therein or
any information concerning such birth, which
original, copy or information is in the custody of
any registrar of vital statistics or of the
Department of Public Health, nor shall he be
entitled to any copy of any such certificate,
record or information, except upon written order
of a court of record or upon written request of a
state department or the federal government when
approved by the Department of Public Health.
Sec. 38. Section 17a-218a of the general
statutes is repealed and the following is
substituted in lieu thereof:
(a) The Commissioner of Mental Retardation
shall continue the operation of The Southbury
Training School and shall establish criteria to
evaluate the current population of the training
school in regard to community placement and
training school placement. The criteria shall
include, at a minimum, consideration of the
client's age, physical disabilities, medical
fragility, level of mental retardation, length of
residence at the school and availability of an
appropriate placement. Not later than January 1,
1996, the commissioner shall report his findings
to the joint standing committee of the General
Assembly having cognizance of matters relating to
public health, in accordance with section 11-4a.
(b) THE COMMISSIONER SHALL NO LONGER ACCEPT
NEW ADMISSIONS AT THE SOUTHBURY TRAINING SCHOOL.
(c) FOR THE FISCAL YEARS ENDING JUNE 30, 1998,
AND JUNE 30, 1999, THE COMMISSIONER SHALL NOT
CERTIFY ADDITIONAL BEDS AS IMMEDIATE CARE
FACILITIES FOR THE MENTALLY RETARDED (ICFMR) AT
THE SOUTHBURY TRAINING SCHOOL BEYOND A TOTAL OF
SIX HUNDRED SIXTEEN.
(d) ON OCTOBER 1, 1997, AND ANNUALLY
THEREAFTER, THE COMMISSIONER SHALL SUBMIT A REPORT
TO THE JOINT STANDING COMMITTEES OF THE GENERAL
ASSEMBLY HAVING COGNIZANCE OF MATTERS RELATING TO
APPROPRIATIONS AND BUDGETS OF STATE AGENCIES AND
PUBLIC HEALTH. THE REPORT SHALL DESCRIBE THE
STATUS OF THE REDUCTION OF THE WAITING LIST AND
THE ESTABLISHMENT OF A RECREATION AND RESPITE CARE
SERVICES DIVISION, TO THE EXTENT REQUIRED BY THE
APPROPRIATION OF FUNDS TO THE DEPARTMENT, AND
SHALL INCLUDE, BUT NOT BE LIMITED TO, THE MANNER
IN WHICH FUNDS HAVE BEEN OR WILL BE SPENT IN
MEETING SAID REQUIREMENTS.
Sec. 39. Section 4 of public act 97-204 is
repealed and the following is substituted in lieu
thereof:
(a) The provisions of section 19a-638 of the
general statutes, as amended by [this act] PUBLIC
ACT 97-204, and subsection (a) of section 19a-639
of the general statutes, as amended by [this act]
PUBLIC ACT 97-204, shall not apply to: (1) An
outpatient clinic or program operated exclusively
by, or contracted to be operated exclusively for,
a municipality or municipal agency, a health
district, as defined in section 19a-240 of the
general statutes, or a board of education; (2) a
nursing home; (3) a home for the aged; (4) a rest
home; OR (5) a residential facility for the
mentally retarded licensed pursuant to section
17a-227 of the general statutes and certified to
participate in the Title XIX Medicaid program as
an intermediate care facility for the mentally
retarded. [; or (6) a home health agency.] When a
facility or institution otherwise exempt under
this subsection is, or will be, created, acquired,
operated or in any other way related to or
affiliated with, or under the complete or partial
ownership or control of a facility or institution
or related entity subject to the provisions of
section 19a-638 of the general statutes, as
amended by [this act] PUBLIC ACT 97-204, or
subsection (a) of section 19a-639 of the general
statutes, as amended by [this act] PUBLIC ACT
97-204, the exemptions in this section shall not
apply.
(b) (1) The provisions of section 19a-638 of
the general statutes, as amended by [this act]
PUBLIC ACT 97-204, and subsection (a) of section
19a-639 of the general statutes, as amended by
[this act] PUBLIC ACT 97-204, shall not apply to:
(A) An outpatient rehabilitation service agency
operated exclusively on an outpatient basis and
eligible, or whenever operational will be
eligible, to receive reimbursement under section
17b-243 of the general statutes; (B) a clinical
laboratory; (C) an assisted living services
agency; (D) a primary care clinic owned or
operated by a nonprofit corporation that does not
charge for any service at that clinic; (E) a
satellite clinic that is (i) operated for not more
than sixteen hours per week by an existing
facility licensed on or before July 1, 1997, by
the Department of Public Health or the Department
of Children and Families, and (ii) offering only
outpatient primary, preventive, dental, mental
health or substance abuse services, or some
combination thereof; (F) an outpatient service
offering chronic dialysis; [or] (G) a program of
ambulatory services established and conducted by a
health maintenance organization; OR (H) A HOME
HEALTH AGENCY. (2) Each health care facility or
institution exempted under this subsection shall
register with the office by filing the information
required by subdivision (4) of subsection (a) of
section 19a-638 of the general statutes, as
amended by [this act] PUBLIC ACT 97-204, for a
letter of intent at least ten business days but
not more than sixty calendar days prior to
commencing operations and prior to changing,
expanding, terminating or relocating any facility
or service covered by section 19a-638 of the
general statutes, as amended by [this act] PUBLIC
ACT 97-204, or subsection (a) of section 19a-639
of the general statutes, as amended by [this act]
PUBLIC ACT 97-204, except that, if the facility or
institution is in operation on the effective date
of this act, said information shall be filed not
more than sixty days after said date. Not later
than ten business days after the office receives a
completed filing required under this subsection,
the office shall provide the health care facility
or institution with written acknowledgement of
receipt. Such acknowledgment shall constitute
permission to operate or change, expand, terminate
or relocate such a facility or institution or to
make an expenditure consistent with an
authorization received under subsection (a) of
said section 19a-639.
Sec. 40. Section 19a-29a of the general
statutes is repealed and the following is
substituted in lieu thereof:
(a) As used in this section, "environmental
laboratory" means any facility or other area used
for biological, chemical, physical or other
examination of drinking waters, ground waters, sea
waters, rivers, streams and surface waters,
recreational waters, fresh water sources,
wastewaters, swimming pools, air, soil, solid
waste, hazardous waste, food, food utensils, dairy
and dairy products, sewage, sewage effluent, or
sewage sludge for the purpose of providing
information on the sanitary quality or the amount
of pollution and any substance prejudicial to
health or the environment.
(b) The Department of Public Health shall, in
its Public Health Code, adopt regulations and
reasonable standards governing environmental
laboratory operations and facilities, personnel
qualifications and certification, levels of
acceptable proficiency in testing programs
approved by the department, the collection,
acceptance and suitability of samples for analysis
and such other pertinent laboratory functions,
including the establishment of advisory
committees, as may be necessary to insure
environmental quality, public health and safety.
Each registered environmental laboratory shall
comply with all standards for environmental
laboratories set forth in the Public Health Code
and shall be subject to inspection by said
department, including inspection of all records
necessary to carry out the purposes of this
section.
(c) Each application for registration of an
environmental laboratory or application for
approval shall be made on forms provided by said
department, shall be accompanied by a fee of one
thousand dollars and shall be executed by the
owner or owners or by a responsible officer of the
firm or corporation owning the laboratory. Upon
receipt of any such application, the department
shall make such inspections and investigations as
are necessary and shall deny registration or
approval when operation of the environmental
laboratory would be prejudicial to the health of
the public. Registration or approval shall not be
in force until notice of its effective date and
term has been sent to the applicant.
(d) Each registration or certificate of
approval shall be issued for a period of not less
than twenty-four, nor more than twenty-seven
months from the deadline for applications. Renewal
applications shall be made (1) biennially within
the twenty-fourth month of the current
registration or certificate of approval; (2)
before any change in ownership or change in
director is made; and (3) prior to any major
expansion or alteration in quarters.
(e) This section shall not apply to any
environmental laboratory which only provides
laboratory services or information for the agency,
person, firm or corporation which owns or operates
such laboratory AND THE FEE REQUIRED UNDER
SUBSECTION (c) OF THIS SECTION SHALL NOT BE
REQUIRED OF LABORATORIES OPERATED BY A STATE
AGENCY.
Sec. 41. Section 19a-219 of the general
statutes is repealed and the following is
substituted in lieu thereof:
(a) Any inflammation, swelling or unusual
redness in the eyes of any infant, either apart
from or with any unnatural discharge from the eyes
of such infant, occurring at any time within two
weeks after the birth of such infant, shall, for
the purposes of this section, be designated as
"inflammation of the eyes of the newborn". [The
professional attendant or other person caring for
a newborn infant shall report any such
inflammation of the eyes of the newborn to the
local director of health within six hours after
such condition is observed.] The person in
attendance at the birth of any infant shall
instill into the eyes of such infant, immediately
after birth, [one or two drops of] a prophylactic
[solution] PREPARATION approved by the Department
of Public Health FOR THE PURPOSE OF PREVENTING
INFLAMMATION OF THE EYES OF NEWBORNS. [The
Department of Public Health shall furnish in a
convenient form for such use a prophylactic
solution for gratuitous distribution to persons
licensed to practice the healing arts or
midwifery.] Any person who violates any provision
of this section shall be fined not less than ten
dollars nor more than fifty dollars.
(b) THE PROPHYLACTIC TREATMENT REQUIRED BY
SUBSECTION (a) OF THIS SECTION SHALL NOT APPLY TO
ANY INFANT WHOSE PARENTS OBJECT TO THE TREATMENT
AS BEING IN CONFLICT WITH THEIR RELIGIOUS TENETS
AND PRACTICE. ANY PERSON WHO OBJECTS TO SUCH
TREATMENT SHALL INDEMNIFY ATTENDING MEDICAL
PERSONNEL FOR EXPENSES INCURRED IN CONNECTION WITH
ANY CIVIL ACTION BASED ON LACK OF SUCH TREATMENT.
FOR PURPOSES OF THIS SUBSECTION, "EXPENSES"
INCLUDES, BUT IS NOT LIMITED TO, JUDGMENTS,
SETTLEMENTS, ATTORNEYS' FEES AND COURT COSTS.
Sec. 42. Section 19a-223 of the general
statutes is repealed and the following is
substituted in lieu thereof:
(a) [Any town, city or borough may, by vote of
its legislative body, enter into a contractual
agreement with another such municipality to
furnish or procure public health services, if the
Department of Public Health approves such action.]
ANY MUNICIPAL DEPARTMENTS OF HEALTH, PURSUANT TO
MUNICIPAL CHARTER OR ORDINANCE, AND HEALTH
DISTRICTS MAY CONTRACT AMONG THEMSELVES FOR THE
JOINT USE OR BENEFIT OF THE MUNICIPALITY FOR
SERVICES, PERSONNEL, FACILITIES, EQUIPMENT OR ANY
OTHER PROPERTY OR RESOURCES FOR MATTERS AFFECTING
PUBLIC HEALTH. Any officer or employee of a
municipality furnishing such services under such
an agreement shall have, in the municipality OR
DISTRICT to which the services are furnished, the
same authority, RESPONSIBILITIES and duties as to
public health as [he] THE OFFICER OR EMPLOYEE has
in the municipality OR DISTRICT employing him.
(b) WHEN NECESSARY TO PROTECT AND PRESERVE THE
PUBLIC HEALTH AND PREVENT THE SPREAD OF DISEASE
AND INJURY, ANY MUNICIPAL DEPARTMENT OF HEALTH,
PURSUANT TO ANY MUNICIPAL CHARTER OR ORDINANCE AND
WITH THE APPROVAL OF THE CHIEF EXECUTIVE OFFICER
OF THE MUNICIPALITY, OR ANY HEALTH DISTRICT MAY
REQUEST EMERGENCY ASSISTANCE AND THE USE OF
RESOURCES FROM ANY OTHER MUNICIPAL DEPARTMENT OF
HEALTH OR HEALTH DISTRICT. ANY OFFICER OR EMPLOYEE
OF A MUNICIPALITY OR HEALTH DISTRICT, WHILE ACTING
IN RESPONSE TO SUCH A REQUEST, SHALL HAVE, IN THE
MUNICIPALITY OR DISTRICT TO WHICH THE SERVICES ARE
FURNISHED, THE SAME POWERS, DUTIES, PRIVILEGES AND
IMMUNITIES AS ARE CONFERRED ON PUBLIC HEALTH
OFFICERS AND EMPLOYEES OF THE MUNICIPALITY OR
DISTRICT REQUESTING ASSISTANCE.
Sec. 43. Section 7-42 of the general statutes
is repealed and the following is substituted in
lieu thereof:
Each registrar of vital statistics shall
ascertain as accurately as he can all marriages
and deaths, and all births, upon the affidavit of
the father or mother, occurring in his town, and
record the same in a book or books kept by him for
that purpose, in such form and with such
particulars as are prescribed by the Department of
Public Health. He shall give licenses to marry,
according to provisions of law; shall make and
perfect all records of the birth and death of the
persons born or deceased in his town, and, when
any birth or death happens of which no certificate
is returned to him, shall obtain the information
required by law respecting such birth or death. He
shall distribute to all persons in his town who,
in his judgment, are likely to need them, blank
forms for the certificates and returns required by
law to be made to him; shall amend or correct such
certificates and the records thereof whenever he
discovers errors upon the face thereof, and shall
insert or supply therein omissions of facts
existing at the time of the recording of such
certificates except that all errors or omissions
concerned with questions of parentage OR GENDER
shall be within the sole jurisdiction of the
Department of Public Health as provided in section
19a-42, [; and] AS AMENDED BY THIS ACT. HE shall
keep the records of his office, when a fire-proof
safe is not provided for his use, in the vaults
provided for the land records of his town. He may,
with the approval of the Department of Public
Health, store any records not in current use in a
location other than his office or said vaults,
provided such location shall be approved by the
Public Records Administrator, and provided such
location is within the limits of such town. He
shall, on or before the seventh day of each month,
send to the Commissioner of Public Health an
attested copy of each certificate of death
received by him for the calendar month next
preceding or a notification that no such
certificate has been received and on or before the
fifteenth day of every month an attested copy of
each certificate of birth and of each certificate
of marriage received by him for the month next
preceding or a notification that no such
certificate has been received. Both such
notifications shall be in a form prescribed by the
Department of Public Health. The registrar shall
also transmit from time to time to said
commissioner an attested copy of all other
certificates of births, marriages and deaths which
he acquires in amending or completing his records.
The copy shall be made in a form prescribed by the
Department of Public Health and upon blanks
provided by said department. Copies of
certificates of births, marriages and deaths,
transmitted to said commissioner as required in
this section, shall be plain and legible
transcripts of the certificates. If a transcript
is illegible, in the opinion of the commissioner,
he shall require of the registrar another copy
legibly transcribed. When a registrar having
custody of an original of a certificate of birth,
marriage or death corrects the certificate, he
shall, within ten days, forward an amended
certificate to any registrar having a copy of the
certificate. Each registrar shall inscribe upon
the back of each certificate of birth, marriage or
death received for record the date of its
reception. Each registrar of vital statistics
shall also transmit to the registrars of voters
for his town a notice of the death of any person
seventeen years of age or older, at the same time
the registrar transmits the attested copy of the
certificate of death for such person to the
Commissioner of Public Health under this section.
Sec. 44. Section 19a-42 of the general
statutes is repealed and the following is
substituted in lieu thereof:
(a) To protect the integrity and accuracy of
vital records, a certificate registered under
chapter 93 may be amended only in accordance with
sections 19a-41 to 19a-45, inclusive, chapter 93
and regulations adopted by the Commissioner of
Public Health pursuant to chapter 54. When a
certificate is amended under this section the
commissioner shall report the amendment to the
registrars of vital statistics affected and their
records shall be amended accordingly.
(b) [A] EXCEPT AS PROVIDED IN SUBSECTIONS (c)
AND (e) OF THIS SECTION, A certificate that is
amended under this section shall be marked
"Amended" on the original. The date of amendment
and a summary description of the evidence
submitted in support of the amendment shall be
endorsed on or made a part of the record. The
original birth, death or marriage certificate
shall be sealed and kept in a confidential file at
the Department of Public Health and may be
unsealed only upon the order of the Commissioner
of Public Health. A copy of the original shall be
made and such copy shall be amended in such a
manner that the language to be changed is no
longer visible. The copy shall be a public record.
The Commissioner of Public Health shall prescribe
by regulation, adopted in accordance with chapter
54, the conditions under which additions or minor
corrections may be made to vital records within
one year after the date of the event without the
vital record being marked "Amended".
(c) Upon written request of both parents,
receipt of a sworn acknowledgment of paternity
signed by both parents of a child born out of
wedlock and receipt of a fee of twenty-five
dollars, the Commissioner of Public Health shall
amend the birth certificate to show such paternity
if paternity is not already shown on the birth
certificate or to change the surname of the child
or both. Such certificate shall not be marked
"Amended".
(d) Upon receipt of a certified copy of an
order of a court of competent jurisdiction
changing the name of a person born in this state
and upon request of such person or his parents,
guardian, or legal representative, the
Commissioner of Public Health shall amend the
birth certificate to show the new name.
(e) UPON REQUEST OF AN INDIVIDUAL BORN WITH
HERMAPHRODITISM AND RECEIPT OF A SIGNED STATEMENT
FROM A PHYSICIAN ATTESTING TO SUCH CONDITION, THE
COMMISSIONER SHALL AMEND THE CERTIFICATE TO
ACCURATELY REFLECT THE GENDER OF THE INDIVIDUAL,
AS DETERMINED BY THE PERSON AND HIS PHYSICIAN.
SUCH CERTIFICATE SHALL NOT BE MARKED "AMENDED" AND
A COPY SHALL BE MADE IN A MANNER THAT PREVENTS
ASCERTAINMENT OF THE NATURE OF THE AMENDMENT.
[(e)] (f) When an applicant submits the
documentation required by the regulations to amend
a vital record the Commissioner of Public Health
shall hold a hearing, in accordance with chapter
54, if the commissioner has reasonable cause to
doubt the validity or adequacy of such
documentation.
[(f)] (g) When an amendment under this section
involves the changing of existing language on a
death certificate due to an error pertaining to
the cause of death, the death certificate shall be
amended in such a manner that the original
language is still visible. A copy of the death
certificate shall be made. The original death
certificate shall be sealed and kept in a
confidential file at the Department of Public
Health and only the Commissioner of Public Health
may order it unsealed. The copy shall be amended
in such a manner that the language to be changed
is no longer visible. The copy shall be a public
document.
Sec. 45. Section 19a-41 of the general
statutes is repealed and the following is
substituted in lieu thereof:
The Commissioner of Public Health shall adopt
regulations in accordance with the provisions of
chapter 54 specifying the methods of recording,
preserving, indexing and amending vital records
and statistics collected under the provisions of
sections 19a-42 to 19a-45, inclusive, chapter 93
[,] OR chapter 815e. [or section 46b-68.] The
commissioner shall prepare such forms as he deems
necessary to carry out the provisions of sections
19a-42 to 19a-45, inclusive, chapter 93 [,] AND
chapter 815e. [and section 46b-68.] The penalty
provided for by section 7-41 shall not apply to
registrars of vital statistics not complying with
such regulations, if such registrars have complied
in all other respects with the provisions of the
statutes to which said penalty is applicable.
Sec. 46. (NEW) As used in sections 46 to 51,
inclusive, of this act:
(1) "Commissioner" means the Commissioner of
Mental Health and Addiction Services.
(2) "Center" means the Connecticut Mental
Health Center established pursuant to section
17a-459 of the general statutes.
Sec. 47. (NEW) (a) The center, when authorized
by the commissioner, may participate in local,
regional or state-wide provider networks,
preferred provider organizations,
physician-hospital organizations or other similar
organizations.
(b) Participation by the center in provider
networks, preferred provider organizations,
physician-hospital organizations or other similar
organizations, when authorized by the
commissioner, may include (1) membership in a
network organization; (2) participation in network
or organization contracts, cooperative agreements,
and joint ventures; (3) participation in the
governance of networks and organizations; and (4)
payment of reasonable network or organization
dues, fees and assessments.
Sec. 48. (NEW) (a) The center, when authorized
by the commissioner, may enter into provider
agreements and other contractual arrangements with
Medicaid and Medicare managed care plans,
governmental health plans, health maintenance
organizations, health insurance plans, employer
and union health plans, preferred provider
organizations, physician-hospital organizations,
managed care plans, networks and other similar
arrangements or plans offered by insurers,
third-party payers or other entities offering
health care plans to their members or employees
and their dependents.
(b) The agreements and other contractual
arrangements identified in subsection (a) of this
section may include plans and arrangements
certified by the Department of Social Services,
the Department of Mental Health and Addiction
Services, or the federal Health Care Financing
Administration, to provide services to Medicaid,
Medicare, general assistance, Department of Mental
Health and Addiction Services or Health Care
Financing Administration beneficiaries, as well as
private plans and arrangements satisfactory to the
commissioner.
(c) Participation in the agreements and other
contractual arrangements identified in this
section and approved by the commissioner shall not
be subject to the review and approval of other
state agencies except as otherwise required by
law.
(d) To the extent the commissioner permits,
the center may bill and accept as reimbursement
for services provided pursuant to the agreements
and other contractual arrangements identified in
this section negotiated rates, including rates
based on charges, discounted charges, per diem or
per case rates or other forms of reimbursement.
Such reimbursement shall be subject to review or
approval by the Secretary of the Office of Policy
and Management based on demonstrated impact on
federal reimbursement.
Sec. 49. (NEW) (a) Whenever the commissioner
deems it appropriate and grants approval, the
center may enter into contracts, agreements,
leases, or other arrangements for the following:
(1) The acquisition of commodities, goods,
services and equipment; (2) office, clinic,
laboratory or other needed space whether on or off
the center's main campus; and (3) necessary
capital expenditures.
(b) Contracts, agreements, leases or other
arrangements approved under this section by the
commissioner shall not be subject to the review or
approval of other state agencies or any other
state-mandated purchasing or acquisition
procedures, unless and to the extent the
commissioner deems it necessary.
Sec. 50. (NEW) The center may do the
following, if approved by the commissioner as
furthering the purposes of the center as set forth
in section 47 of this act:
(1) Employ or retain accountants, attorneys
and architectural, engineering, financial and
other consultants on a project basis, and fix
their compensation;
(2) Procure insurance, or obtain
indemnification, against any loss in connection
with the activities of the center;
(3) Develop innovative solutions to patient
care and service system problems;
(4) Own, manage, and use real property or any
interest in such property;
(5) Purchase, receive by gift or otherwise,
lease, exchange, or otherwise acquire and
construct, reconstruct, improve, maintain, equip
and furnish such mental health facilities as are
required;
(6) Accept gifts, grants or loans of funds,
property or service from any source, public,
quasi-public or private, and comply, subject to
the provisions of section 47 of this act, with
their respective terms and conditions; and
(7) Accept from federal agencies or private
sources loans or grants for use in carrying out
its purposes and enter into agreements respecting
any such loans or grants.
Sec. 51. (NEW) With the approval of the
commissioner, the center shall establish rules and
criteria for determining whether any of the
center's accounts receivable shall be treated as
uncollectible. Such rules and criteria shall be
fully consistent with customary hospital
accounting practices consistently applied. The
center shall determine, in accordance with such
rules and criteria, which of the accounts
receivable of the center shall be so treated. Upon
the commissioner's approval, a determination by
the center made in accordance with such rules and
criteria that an account receivable shall be
treated as uncollectible shall be conclusive and
the center shall not be required to pursue further
collection procedures.
Sec. 52. The sum of one hundred seventy-five
thousand dollars appropriated to the Department of
Public Health for the fiscal year ending June 30,
1998, within section 1 of special act 97-21 under
the school-based health clinics account is to be
used for grants-in-aid to school-based health
centers or to school-based dental clinics for the
purpose of staffing and equipping dental
operatories, including, but not limited to,
construction, alterations, equipment and supplies
to increase access to dental services. The moneys
shall be distributed equally among Hartford,
Stamford and Bridgeport.
Sec. 53. The sum of one hundred seventy-five
thousand dollars appropriated to the Department of
Public Health for the fiscal year ending June 30,
1998, within section 1 of special act 97-21 is to
be used for grants-in-aid to community health
centers for the purpose of staffing and equipping
dental operatories, including, but not limited to,
construction, alterations, equipment and supplies
to increase access to dental care. The moneys
shall be distributed equally among New London,
Willimantic, New Haven and Waterbury.
Sec. 54. Section 19a-266 of the general
statutes is repealed and the following is
substituted in lieu thereof:
(a) For purposes of this section:
(1) "Breast cancer treatment services" means a
procedure intended to treat cancer of the human
breast, including, but not limited to, surgery,
radiation therapy, chemotherapy, hormonal therapy
and related medical follow-up services.
(2) "Cervical cancer treatment services" means
a procedure intended to treat cancer of the human
cervix, including, but not limited to, surgery,
radiation therapy, cryotherapy, electrocoagulation
and related medical follow-up services.
(3) "Unserved or underserved populations"
means women who are: (A) At or below two hundred
per cent of the federal poverty level for
individuals; (B) without health insurance that
covers breast cancer screening mammography or
cervical cancer screening services; and (C)
[forty] NINETEEN to sixty-four years of age.
(b) There is established, within existing
appropriations, a breast and cervical cancer early
detection and treatment referral program, within
the Department of Public Health, to promote
screening detection and treatment of breast cancer
and cervical cancer among unserved or underserved
populations, to educate the public regarding
breast cancer and cervical cancer and the benefits
of early detection and to provide counseling and
referral services for treatment.
(c) The program shall include, but not be
limited to:
(1) Establishment of a public education and
outreach initiative to publicize breast cancer and
cervical cancer early detection services and the
extent of coverage for such services by health
insurance, the medical assistance program and
other public and private programs and the benefits
of early detection of cervical cancer and the
recommended frequency of pap tests;
(2) Development of professional education
programs, including the benefits of early
detection of breast cancer and the recommended
frequency of mammography and the benefits of early
detection of cervical cancer and the recommended
frequency of pap tests;
(3) Establishment of a system for the purpose
of tracking and follow-up of all women screened
for breast cancer and cervical cancer in the
program. The system shall include, but not be
limited to, follow-up of abnormal screening tests
and referral to treatment when needed and tracking
women to be screened at recommended screening
intervals;
(4) Insurance that all participating providers
of breast cancer and cervical cancer screening are
in compliance with national and state quality
assurance legislative mandates.
(d) The Department of Public Health shall
provide UNSERVED OR UNDERSERVED POPULATIONS,
within existing appropriations and through
contracts with health care providers: (1) One
mammogram every [two years] YEAR for [unserved or
underserved] populations [under the age of fifty]
AGE FORTY-FIVE TO SIXTY-FOUR; (2) one mammogram
every year for [unserved or underserved]
populations [over the age of fifty; and] AGE
THIRTY-FIVE TO FORTY-FOUR WITH A FIRST DEGREE
FEMALE RELATIVE WHO HAS HAD BREAST CANCER OR WITH
OTHER RISK FACTORS OF EQUAL WEIGHT; (3) one pap
test for cervical cancer per year for [unserved
and underserved] populations AGE NINETEEN TO
SIXTY-FOUR WHO HAVE HAD A POSITIVE FINDING,
OTHERWISE ONE EVERY THREE YEARS OR MORE FREQUENTLY
AS DIRECTED BY A PHYSICIAN; (4) A SIXTY-DAY
FOLLOW-UP PAP TEST FOR VICTIMS OF SEXUAL ASSAULT;
AND (5) A PAP TEST EVERY SIX MONTHS FOR WOMEN WHO
HAVE TESTED HIV POSITIVE.
(e) The Department of Public Health may apply
for and receive money from public and private
sources and from the federal government for the
purposes of a program for breast cancer and
cervical cancer early detection and treatment
referral.
(f) The Commissioner of Public Health shall
report annually to the joint standing committee of
the General Assembly having cognizance of matters
relating to public health AND APPROPRIATIONS. The
report shall include, but not be limited to, a
description of the rate of breast cancer and
cervical cancer morbidity and mortality in this
state and the extent of participation in breast
cancer and cervical cancer screening.
(g) THE ORGANIZATIONS PROVIDING THE TESTING
AND TREATMENT SERVICES SHALL REPORT TO THE
DEPARTMENT OF PUBLIC HEALTH THE NAMES OF THE
INSURER OF EACH UNDERINSURED WOMAN BEING TESTED TO
FACILITATE RECOUPMENT.
Sec. 55. (NEW) The Commissioner of Social
Services and the Commissioner of Mental Health and
Addiction Services shall seek a waiver from
federal law for the purposes of conducting
community based services for rehabilitation and
restoration of functions for persons eligible
under the behavioral health managed care program
established by section 17a-453a of the general
statutes, as amended by this act.
Sec. 56. Section 19a-59e of the general
statutes is repealed and the following is
substituted in lieu thereof:
(a) The Department of Public Health, in
consultation with the Department of Social
Services, shall create a joint program between
public and private organizations to design and
establish a three-year media campaign entitled
"Campaign For Our Children" for the purpose of
reducing adolescent pregnancy in the state.
(b) Said media campaign shall HAVE AS ITS
CENTRAL FOCUS THE REDUCTION OF TEEN PREGNANCY AND
SHALL include the following strategies: (1)
Delaying sexual intercourse among adolescents; (2)
promoting pregnancy prevention among adolescents;
(3) educating male adolescents about sexual and
parenting responsibilities including child
support; (4) promoting communication skills to
parents of adolescents to assist such parents in
educating their children about sexual and
parenting responsibilities; (5) promoting
community involvement by adolescents for the
purpose of building self-esteem and individual
skills; and (6) educating the community about the
offenses of sexual assault of a minor, pursuant to
sections 53a-70, 53a-71 and 53a-73a.
(c) Notwithstanding the provisions of sections
4-212 to 4-219, inclusive, the Department of
Public Health, in consultation with the Department
of Social Services, shall solicit bids from
private organizations for the design and operation
of said media campaign. Such bids shall be
solicited by sending notice to prospective
organizations and by posting notice on public
bulletin boards within said departments. Each bid
shall be opened publicly at the time stated in the
notice soliciting such bid. Acceptance of a bid by
said departments shall be based on standard
specifications adopted by said departments. The
department may accept gifts, donations, bequests,
grants or funds from public or private agencies
for any or all of the purposes of this section.
(d) ON OCTOBER 1, 1997, AND ANNUALLY
THEREAFTER, THE COMMISSIONER OF PUBLIC HEALTH
SHALL SUBMIT A REPORT TO THE JOINT STANDING
COMMITTEES OF THE GENERAL ASSEMBLY HAVING
COGNIZANCE OF MATTERS RELATING TO APPROPRIATIONS
AND BUDGETS OF STATE AGENCIES AND PUBLIC HEALTH.
THE REPORT SHALL DESCRIBE THE STATUS OF THE
PROGRAM ESTABLISHED BY THIS SECTION AND SHALL
INCLUDE, BUT NOT BE LIMITED TO, THE MANNER IN
WHICH FUNDS HAVE BEEN OR WILL BE SPENT IN MEETING
THE MANDATES OF SUBDIVISIONS (1) TO (6),
INCLUSIVE, OF SUBSECTION (b) OF THIS SECTION.
Sec. 57. Section 2 of public act 97-99 is
repealed and the following is substituted in lieu
thereof:
On [January 15] MARCH 1, 1999, and annually
thereafter, the Insurance Commissioner shall
submit a report, to the Governor [,] and to the
joint standing committees of the General Assembly
having cognizance of matters relating to public
health and relating to insurance and real estate,
concerning the commissioner's responsibilities
under the provisions of [this act] PUBLIC ACT
97-99, AS AMENDED BY THIS ACT. The report shall
include: (1) A summary of the quality assurance
plans submitted by managed care organizations
pursuant to section 4 of [this act] PUBLIC ACT
97-99, AS AMENDED BY THIS ACT, along with
suggested changes to improve such plans; (2)
suggested modifications to the consumer report
card developed under the provisions of section 13
of [this act] PUBLIC ACT 97-99; (3) a summary of
the commissioner's procedures and activities in
conducting market conduct examinations of
utilization review companies, including, but not
limited to: (A) The number of desk and field
audits completed during the previous calendar
year; (B) a summary of findings of the desk and
field audits, including any recommendations made
for improvements or modifications; (C) a
description of complaints concerning managed care
companies, including a summary and analysis of any
trends or similarities found in the MANAGED CARE
complaints filed by enrollees; (4) a summary of
the complaints received by the Insurance
Department's Consumer Affairs Division and the
commissioner under section 20 of [this act] PUBLIC
ACT 97-99, AS AMENDED BY THIS ACT, including a
summary and analysis of any trends or similarities
found in the complaints received; (5) a summary of
any violations the commissioner has found against
any managed care organization; and (6) a summary
of the issues discussed related to health care or
managed care organizations at the Insurance
Department's quarterly forums throughout the
state.
Sec. 58. Section 8 of public act 97-99 is
repealed and the following is substituted in lieu
thereof:
(a) Each managed care contract delivered,
issued for delivery, renewed, amended or continued
in this state on or after October 1, 1997, shall
be in writing and a copy thereof furnished to the
group contract holder or individual contract
holder, as appropriate. Each such contract shall
contain the following provisions: (1) Name and
address of the managed care organization; (2)
eligibility requirements; (3) a statement of
copayments, deductibles or other out-of-pocket
expenses the enrollee must pay; (4) a statement of
the nature of the health care services, benefits
or coverages to be furnished and the period during
which they will be furnished and, if there are any
services, benefits or coverages to be excepted, a
detailed statement of such exceptions; [, provided
such services, benefits or coverages to be
furnished conform at a minimum to the requirements
of the federal Health Maintenance Organization
Act;] (5) a statement of terms and conditions upon
which the contract may be cancelled or otherwise
terminated at the option of either party; (6)
claims procedures; (7) enrollee grievance
procedures; (8) continuation of coverage; (9)
conversion; (10) extension of benefits, if any;
(11) subrogation, if any; (12) description of the
service area, and out-of-area benefits and
services, if any; (13) a statement of the amount
the enrollee or others on his behalf must pay to
the managed care organization and the manner in
which such amount is payable; (14) a statement
that the contract includes the endorsement thereon
and attached papers, if any, and contains the
entire contract; (15) a statement that no
statement by the enrollee in his application for a
contract shall void the contract or be used in any
legal proceeding thereunder, unless such
application or an exact copy thereof is included
in or attached to such contract; and (16) a
statement of the grace period for making any
payment due under the contract, which shall not be
less than ten days. The commissioner may waive the
[filing] requirements of this subsection for any
managed care organization [required to file under]
SUBJECT TO THE PROVISIONS OF section 38a-182 of
the general statutes.
(b) Each managed care organization shall
provide every enrollee with a plan description.
The plan description shall be in plain language as
commonly used by the enrollees and consistent with
chapter 699a of the general statutes. The plan
description shall be made available to each
enrollee and potential enrollee prior to the
enrollee's entering into the contract and during
any open enrolment period. The plan description
shall not contain provisions or statements that
are inconsistent with the plan's medical
protocols. The plan description shall contain:
(1) A clear summary of the provisions set
forth in subdivisions (1) to (12), inclusive, of
subsection (a) of this section, subdivision (3) of
SUBSECTION (a) OF section 4 of [this act] PUBLIC
ACT 97-99, AS AMENDED BY THIS ACT, sections 11, 12
and 13 of [this act] PUBLIC ACT 97-99, AS AMENDED
BY THIS ACT;
(2) A statement of the number of managed care
organization's utilization review determinations
not to certify an admission, service, procedure or
extension of stay, and the denials upheld and
reversed on appeal within the managed care
organization's utilization review procedure;
(3) A description of emergency services, the
appropriate use of emergency services, including
to the use of E 9-1-1 telephone systems, any cost
sharing applicable to emergency services and the
location of emergency departments and other
settings in which participating physicians and
hospitals provide emergency services and post
stabilization care;
(4) Coverage of the plans, including
exclusions of specific conditions, ailments or
disorders;
(5) The use of drug formularies or any limits
on the availability of prescription drugs AND THE
PROCEDURE FOR OBTAINING INFORMATION ON THE
AVAILABILITY OF SPECIFIC DRUGS COVERED;
(6) The number, types and specialties and
geographic distribution of direct health care
providers;
(7) Participating and nonparticipating
provider reimbursement procedure;
(8) Preauthorization and utilization review
requirements and procedures, internal grievance
procedures and internal and external complaint
procedures;
(9) The medical loss ratio, or percentage of
total premium revenue spent on medical care
compared to administrative costs and plan
marketing;
(10) The plan's for-profit, nonprofit
incorporation and ownership status;
(11) Telephone numbers for obtaining further
information, including the procedure for enrollees
to contact the organization concerning coverage
and benefits, claims grievance and complaint
procedures after normal business hours;
(12) How notification is provided to an
enrollee when the plan is no longer contracting
with an enrollee's primary care provider;
(13) The procedures for obtaining referrals to
specialists or for consulting a physician other
than the primary care physician;
(14) The status of the National Committee for
Quality Assurance (NCQA) accreditation;
(15) Enrollee satisfaction information; and
(16) Procedures for protecting the
confidentially of medical records and other
patient information.
Sec. 59. Section 11 of public act 97-99 is
repealed and the following is substituted in lieu
thereof:
Each managed care plan that requires a
percentage coinsurance payment by the insured
shall calculate the insured's coinsurance payment
on the lesser of the provider's or vendor's
charges for the goods or services or the amount
payable by the managed care organization for such
goods or services, EXCEPT AS OTHERWISE REQUIRED BY
THE LAWS OF A FOREIGN STATE WHEN APPLICABLE TO
PROVIDERS, VENDORS OR PATIENTS IN SUCH FOREIGN
STATE.
Sec. 60. Subdivision (2) of subsection (b) of
section 20 of public act 97-99 is repealed and the
following is substituted in lieu thereof:
(2) The filing fee shall be twenty-five
dollars AND SHALL BE DEPOSITED INTO THE INSURANCE
FUND ESTABLISHED IN SECTION 38a-52 OF THE GENERAL
STATUTES. If the commissioner finds that an
enrollee is indigent or unable to pay the fee, the
commissioner shall waive the fee.
Sec. 61. Section 26 of public act 97-99 is
repealed and the following is substituted in lieu
thereof:
(a) Each provider, as defined in section 1 of
[this act] PUBLIC ACT 97-99, shall code for the
presenting symptoms of all emergency claims and
each hospital shall record such code for such
claims on locater 76 on the UB92 form or its
successor.
(b) The presenting symptoms, as coded by the
provider and recorded by the hospital on the UB92
form or its successor, OR THE FINAL DIAGNOSIS,
WHICHEVER REASONABLY INDICATES AN EMERGENCY
MEDICAL CONDITION, shall be the basis for
reimbursement or coverage, provided such symptoms
reasonably indicated an emergency medical
condition.
(c) For the purposes of this section, in
accordance with the National Committee for Quality
Assurance, an emergency medical condition is a
condition such that a prudent lay-person, acting
reasonably, would have believed that emergency
medical treatment is needed.
(d) The Insurance Commissioner, after
consultation with the working group convened
pursuant to section 22 of [this act] PUBLIC ACT
97-99, may develop and disseminate to hospitals in
this state a claims form system that will ensure
that all hospitals consistently code for the
presenting and diagnosis symptoms on all emergency
claims.
Sec. 62. Section 27 of public act 97-99 is
repealed and the following is substituted in lieu
thereof:
No group health insurance policy delivered,
issued for delivery, renewed, amended or continued
in this state on or after October 1, 1997, whether
issued by an insurance company, a hospital service
corporation, a medical service corporation or a
health care center, as defined in section 38a-175
of the general statutes, shall be delivered,
issued for delivery, renewed or continued in this
state and no such policy shall be amended to
substantially alter or change benefits or coverage
unless persons covered under such policy will be
eligible for expenses arising from
biologically-based mental or nervous conditions
that are at least equal to coverage provided for
medical or surgical conditions. For purposes of
this section, "biologically-based mental illness"
means [any mental or nervous condition that is
caused by a biological disorder of the brain and
results in a clinically significant or
psychological syndrome or pattern that
substantially limits the functioning of the person
with the illness, including schizophrenia] THE
FOLLOWING, AS DEFINED IN THE MOST RECENT EDITION
OF THE AMERICAN PSYCHIATRIC ASSOCIATION'S
"DIAGNOSTIC AND STATISTICAL MANUAL OF MENTAL
DISORDERS": SCHIZOPHRENIA, schizoaffective
disorder, major depressive disorder, bipolar
disorder, paranoia and other psychotic disorders,
obsessive-compulsive disorder, panic disorder and
pervasive developmental disorder or autism.
Sec. 63. (NEW) No individual health insurance
policy delivered, issued for delivery, renewed,
amended or continued in this state on or after
October 1, 1997, whether issued by an insurance
company, a hospital service corporation, a medical
service corporation or a health care center, as
defined in section 38a-175 of the general
statutes, shall be delivered, issued for delivery,
renewed or continued in this state and no such
policy shall be amended to substantially alter or
change benefits or coverage unless persons covered
under such policy will be eligible for expenses
arising from biologically-based mental or nervous
conditions that are at least equal to coverage
provided for medical or surgical conditions. For
purposes of this section, "biologically-based
mental illness" means the following, as defined in
the most recent edition of the American
Psychiatric Association's "Diagnostic and
Statistical Manual of Mental Disorders":
Schizophrenia, schizoaffective disorder, major
depressive disorder, bipolar disorder, paranoia
and other psychotic disorders,
obsessive-compulsive disorder, panic disorder and
pervasive developmental disorder or autism.
Sec. 64. Section 28 of public act 97-99 is
repealed and the following is substituted in lieu
thereof:
Nothing in sections 1 to 14, inclusive, 20 and
21 of [this act] PUBLIC ACT 97-99, AS AMENDED BY
THIS ACT, shall be construed to apply to [a
managed care organization to the extent it is
exempt from state law under] THE ARRANGEMENTS OF
MANAGED CARE ORGANIZATIONS OFFERED TO INDIVIDUALS
COVERED UNDER SELF-INSURED EMPLOYEE WELFARE
BENEFIT PLANS ESTABLISHED PURSUANT TO the federal
Employee Retirement Income Security Act OF 1974.
Sec. 65. Section 38a-476 of the general
statutes is repealed and the following is
substituted in lieu thereof:
(a) (1) For the purposes of this section,
"health insurance plan" means any hospital and
medical expense incurred policy, hospital or
medical service plan contract and health care
center subscriber contract and does not include
(A) short-term health insurance issued on a
nonrenewable basis with a duration of six months
or less, accident only, credit, dental, vision,
Medicare supplement, long-term care or disability
insurance, hospital indemnity coverage, coverage
issued as a supplement to liability insurance,
insurance arising out of a workers' compensation
or similar law, automobile medical payments
insurance, or insurance under which beneficiaries
are payable without regard to fault and which is
statutorily required to be contained in any
liability insurance policy or equivalent
self-insurance, or (B) policies of specified
disease or limited benefit health insurance,
provided that the carrier offering such policies
files on or before March first of each year a
certification with the Insurance Commissioner that
contains the following: (i) A statement from the
carrier certifying that such policies are being
offered and marketed as supplemental health
insurance and not as a substitute for hospital or
medical expense insurance; (ii) a summary
description of each such policy including the
average annual premium rates, or range of premium
rates in cases where premiums vary by age, gender
or other factors, charged for such policies in the
state; and (iii) in the case of a policy that is
described in this subparagraph and that is offered
for the first time in this state on or after
October 1, 1993, the carrier files with the
commissioner the information and statement
required in this subparagraph at least thirty days
prior to the date such policy is issued or
delivered in this state.
(2) "Insurance arrangement" means any
"multiple employer welfare arrangement", as
defined in Section 3 of the Employee Retirement
Income Security Act of 1974 (ERISA), as amended,
except for any such arrangement which is fully
insured within the meaning of Section 514(b)(6) of
said act, as amended.
(3) "Preexisting conditions provision" means a
policy provision which [excludes coverage for
charges or expenses incurred during a specified
period following the insured's effective date of
coverage as] LIMITS OR EXCLUDES BENEFITS RELATING
to a condition [which, during a specified period
immediately preceding the effective date of
coverage, had manifested itself in such a manner
as would cause an ordinary prudent person to seek
diagnosis, care or treatment or for which] BASED
ON THE FACT THAT THE CONDITION WAS PRESENT BEFORE
THE EFFECTIVE DATE OF COVERAGE, FOR WHICH ANY
medical advice, diagnosis, care or treatment was
recommended or received [as to that condition or
as to a pregnancy existing on the effective date
of coverage] BEFORE SUCH EFFECTIVE DATE. Routine
follow-up care to determine whether a breast
cancer has reoccurred in a person who has been
previously determined to be breast cancer free
shall not be considered as medical advice,
diagnosis, care or treatment for purposes of this
section unless evidence of breast cancer is found
during or as a result of such follow-up. GENETIC
INFORMATION SHALL NOT BE TREATED AS A CONDITION IN
THE ABSENCE OF A DIAGNOSIS OF THE CONDITION
RELATED TO SUCH INFORMATION. PREGNANCY SHALL NOT
BE CONSIDERED A PREEXISTING CONDITION.
(4) "Qualifying coverage" means (A) any group
health insurance plan, insurance arrangement or
self-insured plan, (B) Medicare or Medicaid, or
(C) an individual health insurance plan that
provides benefits which are actuarially equivalent
to or exceeding the benefits provided under the
small employer health care plan, as defined in
subdivision (12) of section 38a-564, whether
issued in this state or any other state.
(5) "Applicable waiting period" means the
period of time imposed by the group policyholder
or contractholder before an individual is eligible
for participating in the group policy or contract.
(b) (1) No group health insurance plan or
insurance arrangement may impose a preexisting
conditions provision which excludes coverage for a
period beyond twelve months following the
insured's effective date of coverage. Any
preexisting conditions provision may only relate
to conditions, [manifesting themselves or] WHETHER
PHYSICAL OR MENTAL, for which medical advice,
diagnosis or care or treatment was recommended or
received during the six months immediately
preceding the effective date of coverage. [or to a
pregnancy existing on the effective date of
coverage.]
(2) No individual health insurance plan or
insurance arrangement may impose a preexisting
conditions provision which excludes coverage
beyond twelve months following the insured's
effective date of coverage. Any preexisting
conditions provision may only relate to
conditions, WHETHER PHYSICAL OR MENTAL, WHICH
MANIFEST [manifesting] themselves, or for which
medical advice, diagnosis or care or treatment was
recommended or received during the twelve months
immediately preceding the effective date of
coverage. [or to pregnancy existing on the
effective date of coverage.]
(c) All health insurance plans and insurance
arrangements shall provide coverage, under the
terms and conditions of its policies or contracts,
for the preexisting conditions of any newly
insured individual who was previously covered for
such preexisting condition under the terms of his
preceding qualifying coverage, provided the
preceding coverage was continuous to a date [not
more] LESS than [thirty] SIXTY-THREE days prior to
the effective date of the new coverage, exclusive
of any applicable waiting period, except in the
case of a newly insured group member whose
previous coverage was terminated due to an
involuntary loss of employment, the preceding
coverage must have been continuous to a date not
more than ninety days prior to the effective date
of the new coverage, exclusive of any applicable
waiting period, provided such newly insured group
member or dependent applies for such succeeding
coverage within [thirty] SIXTY-THREE days of his
initial eligibility.
(d) With respect to a newly insured individual
who was previously covered under qualifying
coverage, but who was not covered under such
qualifying coverage for a preexisting condition,
as defined under the new health insurance plan or
arrangement, such plan or arrangement shall credit
the time such person was previously covered by
qualifying coverage to the exclusion period of the
preexisting condition provision, provided the
preceding coverage was continuous to a date [not
more] LESS than [thirty] SIXTY-THREE days prior to
the effective date of the new coverage, exclusive
of any applicable waiting period under such plan,
except in the case of a newly insured group member
whose preceding coverage was terminated due to an
involuntary loss of employment, the preceding
coverage must have been continuous to a date not
more than ninety days prior to the effective date
of the new coverage, exclusive of any applicable
waiting period, provided such newly insured group
member or dependent applies for such succeeding
coverage within [thirty] SIXTY-THREE days of their
initial eligibility.
(e) EACH INSURANCE COMPANY, FRATERNAL BENEFIT
SOCIETY, HOSPITAL SERVICE CORPORATION, MEDICAL
SERVICE CORPORATION OR HEALTH CARE CENTER WHICH
ISSUES IN THIS STATE GROUP HEALTH INSURANCE
SUBJECT TO SECTION 2701 OF THE PUBLIC HEALTH
SERVICE ACT, AS SET FORTH IN THE HEALTH INSURANCE
PORTABILITY AND ACCOUNTABILITY ACT OF 1996 (P.L.
104-191) (HIPAA), AS AMENDED FROM TIME TO TIME,
SHALL COMPLY WITH THE PROVISIONS OF SAID SECTION
WITH RESPECT TO SUCH GROUP HEALTH INSURANCE,
EXCEPT THAT THE LONGER PERIOD OF DAYS SPECIFIED IN
SUBSECTIONS (c) AND (d) OF THIS SECTION SHALL
APPLY TO THE EXTENT EXCEPTED FROM PREEMPTION IN
SECTION 2723(B)(2)(iii) OF SAID PUBLIC HEALTH
SERVICE ACT.
[(e)] (f) The provisions of this section shall
apply to every health insurance plan or insurance
arrangement issued, renewed or continued in this
state on or after October 1, 1993. For purposes of
this section, the date a plan or arrangement is
continued shall be the anniversary date of the
issuance of the plan or arrangement. THE
PROVISIONS OF SUBSECTION (e) OF THIS SECTION SHALL
APPLY ON AND AFTER THE DATES SPECIFIED IN SECTIONS
2747 AND 2792 OF THE PUBLIC HEALTH SERVICE ACT AS
SET FORTH IN HIPAA.
[(f)] (g) A short-term health insurance policy
issued on a nonrenewable basis for six months or
less shall not be subject to this section,
provided, any policy, application or sales
brochure issued for such short-term insurance
which imposes a preexisting conditions provision
shall disclose that such preexisting conditions
are not covered.
(h) THE COMMISSIONER MAY ADOPT REGULATIONS, IN
ACCORDANCE WITH THE PROVISIONS OF CHAPTER 54, TO
ENFORCE THE PROVISIONS OF HIPAA CONCERNING
PREEXISTING CONDITIONS AND PORTABILITY.
Sec. 66. (NEW) (a) Each insurance company,
fraternal benefit society, hospital service
corporation, medical service corporation and
health care center shall comply with sections
2742, 2743, and 2747 of the Public Health Service
Act, as set forth in the Health Insurance
Portability and Accountability Act of 1996 (P.L.
104-191) (HIPAA), as amended from time to time,
concerning guaranteed renewability of individual
health insurance coverage and certification of
coverage.
(b) Each insurance company, fraternal benefit
society, hospital service corporation, medical
service corporation and health care center shall
comply with sections 2702, 2704, 2705 and 2712 of
the Public Health Service Act, as set forth in the
Health Insurance Portability and Accountability
Act of 1996 (P.L. 104-191 and 104-204) (HIPAA), as
amended from time to time, concerning
discrimination based on health status, newborns'
and mothers' health, parity of mental health
benefits and guaranteed renewability of coverage
for employers in the group market, with respect to
health insurance coverage offered in the small and
large group markets as defined in said Public
Health Service Act.
(c) Each insurance company, fraternal benefit
society, hospital service corporation, medical
service corporation and health care center shall
comply with sections 2711 and 2713 of the Public
Health Service Act, as set forth in the Health
Insurance Portability and Accountability Act of
1996 (P.L. 104-191) (HIPAA), as amended from time
to time, concerning guaranteed availability and
disclosure of information for employers with
respect to health insurance coverage offered in
the small group market as defined in said Public
Health Service Act.
(d) No provision of the general statutes
concerning a HIPAA requirement shall be construed
to supersede any other provision of the general
statutes except to the extent that such other
provision prevents the application of a
requirement of HIPAA.
(e) This section shall apply to insurance
companies, fraternal benefit societies, hospital
service corporations, medical service corporations
and health care centers on and after the dates
specified in the Public Health Service Act, as set
forth in the Health Insurance Portability and
Accountability Act of 1996, (P.L. 104-191 and
104-204) (HIPAA), as amended from time to time.
(f) The commissioner may adopt regulations, in
accordance with the provisions of chapter 54 of
the general statutes, to implement the provisions
of this section and the provisions of the Public
Health Service Act, as set forth in the Health
Insurance Portability and Accountability Act of
1996, as amended from time to time.
Sec. 67. Section 38a-551 of the general
statutes is amended by adding subsection (u) as
follows:
(NEW) (u) "HIPAA eligible individual" means an
eligible individual as defined in subsection (b)
of section 2741 of the Public Health Service Act,
as set forth in the Health Insurance Portability
and Accountability Act of 1996 (P.L. 104-191)
(HIPAA).
Sec. 68. Section 38a-553 of the general
statutes is amended by adding subsection (i) as
follows:
(NEW) (i) No comprehensive health care plan
issued through the Health Reinsurance Association
to a HIPAA eligible individual shall include any
limitation or exclusion of benefits based on a
preexisting condition.
Sec. 69. Subsection (a) of section 38a-556 of
the general statutes is repealed and the following
is substituted in lieu thereof:
(a) (1) The board of directors of the
association shall be made up of nine individuals
selected by participating members, subject to
approval by the commissioner, two of whom shall be
appointed by the commissioner on or before July 1,
1993, to represent health care centers. To select
the initial board of directors, and to initially
organize the association, the commissioner shall
give notice to all members of the time and place
of the organizational meeting. In determining
voting rights at the organizational meeting each
member shall be entitled to vote in person or
proxy. The vote shall be a weighted vote based
upon the net health insurance premium derived from
this state in the previous calendar year. If the
board of directors is not selected within sixty
days after notice of the organizational meeting,
the commissioner may appoint the initial board. In
approving or selecting members of the board, the
commissioner may consider, among other things,
whether all members are fairly represented.
Members of the board may be reimbursed from the
moneys of the association for expenses incurred by
them as members, but shall not otherwise be
compensated by the association for their services.
(2) The board shall submit to the commissioner a
plan of operation for the association necessary or
suitable to assure the fair, reasonable and
equitable administration of the association. The
plan of operation shall become effective upon
approval in writing by the commissioner consistent
with the date on which the coverage under sections
38a-505, 38a-546 and 38a-551 to 38a-559,
inclusive, must be made available. The
commissioner shall, after notice and hearing,
approve the plan of operation provided such plan
is determined to be suitable to assure the fair,
reasonable and equitable administration of the
association, and provides for the sharing of
association gains or losses on an equitable
proportionate basis. If the board fails to submit
a suitable plan of operation within one hundred
eighty days after its appointment, or if at any
time thereafter the board fails to submit suitable
amendments to the plan, the commissioner shall,
after notice and hearing, adopt and promulgate
such reasonable rules as are necessary or
advisable to effectuate the provisions of this
section. Such rules shall continue in force until
modified by the commissioner or superseded by a
plan submitted by the board and approved by the
commissioner. The plan of operation shall, in
addition to requirements enumerated in sections
38a-505, 38a-546 and 38a-551 to 38a-559,
inclusive: (A) Establish procedures for the
handling and accounting of assets and moneys of
the association; (B) establish regular times and
places for meetings of the board of directors; (C)
establish procedures for records to be kept of all
financial transactions, and for the annual fiscal
reporting to the commissioner; (D) establish
procedures whereby selections for the board of
directors shall be made and submitted to the
commissioner; (E) establish procedures to amend,
subject to the approval of the commissioner, the
plan of operations; (F) establish procedures for
the selection of an administering carrier and set
forth the powers and duties of the administering
carrier; (G) contain additional provisions
necessary or proper for the execution of the
powers and duties of the association; [and] (H)
establish procedures for the advertisement on
behalf of all participating carriers of the
general availability of the comprehensive coverage
under sections 38a-505, 38a-546 and 38a-551 to
38a-559, inclusive; AND (I) CONTAIN ADDITIONAL
PROVISIONS NECESSARY FOR THE ASSOCIATION TO
QUALIFY AS AN ACCEPTABLE ALTERNATIVE MECHANISM IN
ACCORDANCE WITH SECTION 2744 OF THE PUBLIC HEALTH
SERVICE ACT, AS SET FORTH IN THE HEALTH INSURANCE
PORTABILITY AND ACCOUNTABILITY ACT OF 1996 (P.L.
104-191). THE COMMISSIONER MAY ADOPT REGULATIONS
IN ACCORDANCE WITH THE PROVISIONS OF CHAPTER 54 TO
ESTABLISH CRITERIA FOR THE ASSOCIATION TO QUALIFY
AS AN ACCEPTABLE ALTERNATIVE MECHANISM.
Sec. 70. Subsection (f) of section 38a-556 of
the general statutes is repealed and the following
is substituted in lieu thereof:
(f) [The] UNLESS OTHERWISE PERMITTED BY THE
PLAN OF OPERATION, THE association shall not
issue, [nor] reissue OR CONTINUE IN FORCE
comprehensive health care plan coverage with
respect to any person who is already covered under
an individual or group comprehensive health care
plan, or who is sixty-five years of age or older
and eligible for Medicare or who is not a resident
of this state. COVERAGE PROVIDED TO A HIPAA
ELIGIBLE INDIVIDUAL MAY BE TERMINATED TO THE
EXTENT PERMITTED BY HIPAA.
Sec. 71. (NEW) Notwithstanding the provisions
of section 38a-476 of the general statutes, as
amended by this act, the Insurance Commissioner
may adopt regulations, in accordance with the
provisions of chapter 54 of the general statutes,
to allow exclusionary riders to be issued for
individual health insurance policies that are not
subject to section 2701 of the Public Health
Service Act, as set forth in the Health Insurance
Portability and Accountability Act of 1996 (P.L.
104-191) (HIPAA), as amended from time to time.
Sec. 72. Subsection (t) of section 38a-551 of
the general statutes is repealed and the following
is substituted in lieu thereof:
(t) "Resident" means (1) a person who
maintains a residence in this state for a period
of at least one hundred eighty days OR (2) A HIPAA
ELIGIBLE INDIVIDUAL WHO MAINTAINS A RESIDENCE IN
THIS STATE.
Sec. 73. Subsection (c) of section 14-36 of
the general statutes, as amended by section 1 of
public act 97-1 and section 24 of public act
97-236, is repealed and the following is
substituted in lieu thereof:
(c) (1) On or after January 1, 1997, a person
who is sixteen or seventeen years of age and who
has not had a motor vehicle operator's license or
right to operate a motor vehicle in this state
suspended or revoked may apply to the Commissioner
of Motor Vehicles for a learner's permit. The
commissioner may issue a learner's permit to an
applicant after the applicant has passed a vision
screening and test as to knowledge of the laws
concerning motor vehicles and the rules of the
road, has paid the fee required by subsection (v)
of section 14-49 and has filed a certificate, in
such form as the commissioner prescribes,
requesting or consenting to the issuance of the
learner's permit and the motor vehicle operator's
license, signed by (A) one or both parents or
foster parents of the applicant, as the
commissioner requires, (B) the legal guardian of
the applicant, (C) the applicant's spouse, if the
spouse is eighteen years of age or older, or (D)
if the applicant has no qualified spouse and his
parent or foster parent or legal guardian is
deceased, incapable, domiciled without the state
or otherwise unavailable or unable to sign or file
the certificate, the applicant's stepparent, or
uncle or aunt by blood or marriage, provided such
person is eighteen years of age or older. The
commissioner may, for the more efficient
administration of his duties, appoint any drivers'
school licensed in accordance with the provisions
of section 14-69 or any secondary school providing
instruction in motor vehicle operation and highway
safety in accordance with section 14-36e to issue
a learner's permit, subject to such standards and
requirements as the commissioner may prescribe in
regulations adopted in accordance with chapter 54.
Each learner's permit shall expire on the date the
holder of the permit is issued a motor vehicle
operator's license or on the date the holder
attains the age of eighteen years, whichever is
earlier. (2) The learner's permit shall entitle
the holder, while he has the permit in his
immediate possession, to operate a motor vehicle
on the public highways, except as provided in this
subdivision, provided he is under the instruction
of, and accompanied by, a person who holds an
instructor's license issued under the provisions
of section 14-73 or a person twenty years of age
or older who has been licensed to operate, for at
least four years preceding the instruction, a
motor vehicle of the same class as the motor
vehicle being operated and who has not had his
motor vehicle operator's license suspended by the
commissioner during the four-year period preceding
the instruction. The learner's permit shall
entitle the holder to operate a motor vehicle on a
multiple-lane limited access highway sixty days
from the date of issuance, except that if the
holder is under the instruction of a person who
holds an instructor's license issued under the
provisions of section 14-73, the learner's permit
shall entitle such holder to operate a motor
vehicle on such a highway thirty days from the
date of issuance. THE HOLDER OF A LEARNER'S PERMIT
WHO (A) IS AN ACTIVE MEMBER OF A CERTIFIED
AMBULANCE SERVICE, AS DEFINED IN SECTION 19a-175,
(B) HAS COMMENCED AN EMERGENCY VEHICLE OPERATOR'S
COURSE THAT CONFORMS TO THE NATIONAL STANDARD
CURRICULUM DEVELOPED BY THE UNITED STATES
DEPARTMENT OF TRANSPORTATION AND (C) HAS HAD STATE
AND NATIONAL CRIMINAL HISTORY RECORDS CHECKS
CONDUCTED BY THE CERTIFIED AMBULANCE SERVICE OR BY
THE MUNICIPALITY IN WHICH SUCH AMBULANCE SERVICE
IS PROVIDED, SHALL BE EXEMPT FROM THE PROVISIONS
OF THIS SUBDIVISION ONLY WHEN SUCH HOLDER IS
ENROUTE TO OR FROM THE LOCATION OF THE AMBULANCE
FOR PURPOSES OF RESPONDING TO AN EMERGENCY CALL.
(3) The commissioner may revoke any learner's
permit used in violation of the limitations
imposed by subdivision (2) of this subsection.
Sec. 74. Section 19a-43 of the general
statutes is repealed and the following is
substituted in lieu thereof:
To preserve vital records, [, and reports
received under section 46b-68,] the Commissioner
of Public Health is authorized to prepare
typewritten, photographic, electronic, or other
reproductions of certificates or reports in the
Department of Public Health. Such reproductions
when certified by the commissioner shall be
accepted as the original records. The documents
from which permanent reproductions have been made
and verified may be disposed of as provided by
regulation.
Sec. 75. For the fiscal years ending June 30,
1998, and June 30, 1999, the Finance Advisory
Committee may transfer between the Department of
Mental Health and Addiction Services and the
Department of Social Services funds in an amount
agreed to by the departments and the Office of
Policy and Management as necessary to implement
the general assistance programs of the
departments.
Sec. 76. Subsection (a) of section 7 of public
act 97-248 is repealed and the following is
substituted in lieu thereof:
(a) Not later than [October 1, 1997] JANUARY
1, 1998, but in no event sooner than the
establishment of the pilot research drug education
program under section 8 of this act, the
Department of Mental Health and Addiction Services
shall establish a pretrial drug education program
for persons charged with a violation of section
21a-267 or subsection (c) of section 21a-279 of
the general statutes.
Sec. 77. Subsection (a) of section 7 of public
act 96-249 is repealed and the following is
substituted in lieu thereof:
(a) Notwithstanding any provision of the
general statutes to the contrary, the Commissioner
of Mental Health and Addiction Services shall
convey to the town of Preston, subject to the
approval of the State Properties Review Board and
at a cost equal to the administrative costs of
making such conveyance, a parcel of land located
in the [town] TOWNS of Preston AND LEDYARD, having
an area of approximately twenty-four acres and
identified as the parcel of land which is the
subject of the "Property Use Agreement by and
between the Department of Mental Health and the
Town of Preston" executed on November 28, 1994.
Said parcel of land is described in Schedule A of
said agreement.
Sec. 78. Section 70 of special act 97-21 is
amended to read as follows:
Up to [$340,000] $475,191 of the funds
appropriated to the Department of Public Health in
section 11 of special act 95-12, as amended by
section 1 of special act 96-8, for other expenses,
shall not lapse on June 30, 1997, and such funds
shall continue to be available for expenditure for
a microfilming project during the fiscal year
ending June 30, 1998.
Sec. 79. Section 79 of special act 97-21 is
amended to read as follows:
The unexpended balance of the funds
appropriated to the Department of Public Health in
section 11 of special act 95-12, as amended by
section 1 of special act 96-8, for Community
Health [Centers] SERVICES, shall not lapse on June
30, 1997, and such funds shall continue to be
available for expenditures for such purpose during
the fiscal year ending June 30, 1998.
Sec. 80. Section 17a-548 of the general
statutes is repealed and the following is
substituted in lieu thereof:
(a) Any patient shall be permitted to wear his
or her own clothes; to keep and use personal
possessions including toilet articles; except for
patients hospitalized in Whiting Forensic
Division; to be present during any search of his
personal possessions; to have access to individual
storage space for such possessions; and in such
manner as determined by the facility to spend a
reasonable sum of his or her own money for canteen
expenses and small purchases. These rights shall
be denied only if the superintendent, director, or
his authorized representative determines that it
is medically harmful to the patient to exercise
such rights. An explanation of such denial shall
be placed in the patient's permanent clinical
record.
(b) In connection with any litigation related
to hospitalization, or at any time following
discharge from the facility, any patient or his or
her attorney shall have the right, upon written
request, to inspect all of such patient's hospital
records, and to make copies thereof. Unless the
request is made in connection with any litigation
related to hospitalization, [the] A MENTAL HEALTH
facility, AS DEFINED IN SUBDIVISION (5) OF SECTION
52-146d, may refuse to disclose any portion of a
patient's record which the MENTAL HEALTH facility
determines: (1) Would [be medically harmful to the
patient] CREATE A SUBSTANTIAL RISK THAT THE
PATIENT WOULD INFLICT LIFE-THREATENING INJURY TO
SELF OR TO OTHERS OR EXPERIENCE A SEVERE
DETERIORATION IN MENTAL STATE; (2) would
constitute an invasion of privacy of another
person; or (3) would violate an assurance of
confidentiality furnished to another person,
PROVIDED ONLY SUCH PORTION OF THE RECORD THE
DISCLOSURE OF WHICH WOULD NOT CONSTITUTE AN
INVASION OF PRIVACY OF ANOTHER PERSON OR VIOLATE
AN ASSURANCE OF CONFIDENTIALITY FURNISHED TO
ANOTHER PERSON SHALL BE DISCLOSED. Any patient
aggrieved by a facility's refusal to disclose
under this subsection may petition the Superior
Court for relief in the same manner as a patient
proceeding under section 4-105, except that in
addition to notice and a hearing, the court may
conduct an in camera review of the record. The
court shall order disclosure of the record by
[the] SUCH facility unless the court determines
that the disclosure [will be medically harmful to
the patient] (A) WOULD CREATE A SUBSTANTIAL RISK
THAT THE PATIENT WOULD INFLICT LIFE-THREATENING
INJURY TO SELF OR TO OTHERS OR EXPERIENCE A SEVERE
DETERIORATION IN MENTAL STATE, or (B) would
constitute an invasion of privacy of another
person, or (C) would violate an assurance of
confidentiality furnished to another person,
PROVIDED IF THE COURT ORDERS DISCLOSURE OF THE
RECORD, ONLY SUCH PORTION OF THE RECORD THE
DISCLOSURE OF WHICH WOULD NOT CONSTITUTE AN
INVASION OF PRIVACY OF ANOTHER PERSON OR VIOLATE
AN ASSURANCE OF CONFIDENTIALITY FURNISHED TO
ANOTHER PERSON SHALL BE DISCLOSED.
(c) A list of all in-hospital rights shall be
prominently posted in each ward [of all mental
health facilities] WHERE MENTAL HEALTH SERVICES
ARE PROVIDED.
(d) Nothing in subsection (b) of this section
shall limit a patient's right of access to his
records under section 4-104.
Sec. 81. The unexpended balance of funds
appropriated to the Department of Mental Health
and Addiction Services in section 1 of special act
96-8 for the provision of services to general
assistance clients shall not lapse on June 30,
1997, and such funds shall continue to be
available for expenditure for such purpose during
the fiscal year ending June 30, 1998.
Sec. 82. Section 52-146f of the general
statutes is repealed and the following is
substituted in lieu thereof:
Consent of the patient shall not be required
for the disclosure or transmission of
communications or records of the patient in the
following situations as specifically limited:
(1) Communications or records may be disclosed
to other persons engaged in the diagnosis or
treatment of the patient or may be transmitted to
another mental health facility to which the
patient is admitted for diagnosis or treatment if
the psychiatrist in possession of the
communications or records determines that the
disclosure or transmission is needed to accomplish
the objectives of diagnosis or treatment. The
patient shall be informed that the communications
or records will be so disclosed or transmitted.
For purposes of this subsection, persons in
professional training are to be considered as
engaged in the diagnosis or treatment of the
patients.
(2) Communications or records may be disclosed
when the psychiatrist determines that there is
substantial risk of imminent physical injury by
the patient to himself or others or when a
psychiatrist, in the course of diagnosis or
treatment of the patient, finds it necessary to
disclose the communications or records for the
purpose of placing the patient in a mental health
facility, by certification, commitment or
otherwise, provided the provisions of sections
52-146d to 52-146j, inclusive, shall continue in
effect after the patient is in the facility.
(3) Except as provided in section 17b-225, the
name, address and fees for psychiatric services to
a patient may be disclosed to individuals or
agencies involved in the collection of fees for
such services. In cases where a dispute arises
over the fees or claims or where additional
information is needed to substantiate the fee or
claim, the disclosure of further information shall
be limited to the following: (A) That the person
was in fact a patient; (B) the diagnosis; (C) the
dates and duration of treatment; and (D) a general
description of the treatment, which shall include
evidence that a treatment plan exists and has been
carried out and evidence to substantiate the
necessity for admission and length of stay in a
health care institution or facility. If further
information is required, the party seeking the
information shall proceed in the same manner
provided for hospital patients in section 4-105.
(4) Communications made to or records made by
a psychiatrist in the course of a psychiatric
examination ordered by a court or made in
connection with the application for the
appointment of a conservator by the Probate Court
for good cause shown may be disclosed at judicial
or administrative proceedings in which the patient
is a party, or in which the question of his
incompetence because of mental illness is an
issue, or in appropriate pretrial proceedings,
provided the court finds that the patient has been
informed before making the communications that any
communications will not be confidential and
provided the communications shall be admissible
only on issues involving the patient's mental
condition.
(5) Communications or records may be disclosed
in a civil proceeding in which the patient
introduces his mental condition as an element of
his claim or defense, or, after the patient's
death, when his condition is introduced by a party
claiming or defending through or as a beneficiary
of the patient and the court or judge finds that
it is more important to the interests of justice
that the communications be disclosed than that the
relationship between patient and psychiatrist be
protected.
(6) Communications or records may be disclosed
to the Commissioner of Public Health in connection
with any inspection, investigation or examination
of an institution, as defined in subsection (a) of
section 19a-490, authorized under section 19a-498.
(7) Communications or records may be disclosed
to a member of the immediate family or legal
representative of the victim of a homicide
committed by the patient where such patient has,
on or after July 1, 1989, been found not guilty of
such offense by reason of mental disease or defect
pursuant to section 53a-13, provided such family
member or legal representative requests the
disclosure of such communications or records not
later than six years after such finding, and
provided further, such communications shall only
be available during the pendency of, and for use
in, a civil action relating to such person found
not guilty pursuant to section 53a-13.
(8) IF A PROVIDER OF BEHAVIORAL HEALTH
SERVICES THAT CONTRACTS WITH THE DEPARTMENT OF
MENTAL HEALTH AND ADDICTION SERVICES REQUESTS
PAYMENT, THE NAME AND ADDRESS OF THE PERSON, A
GENERAL DESCRIPTION OF THE TYPES OF SERVICES
PROVIDED, AND THE AMOUNT REQUESTED SHALL BE
DISCLOSED TO THE DEPARTMENT, PROVIDED NOTIFICATION
THAT SUCH DISCLOSURE WILL BE MADE IS SENT, IN
WRITING, TO THE PERSON NOT LESS THAN THIRTY DAYS
PRIOR TO SUCH DISCLOSURE. IN CASES WHERE A DISPUTE
ARISES OVER THE FEES OR CLAIMS, OR WHERE
ADDITIONAL INFORMATION IS NEEDED TO SUBSTANTIATE
THE CLAIM, THE DISCLOSURE OF FURTHER INFORMATION
SHALL BE LIMITED TO ADDITIONAL INFORMATION
NECESSARY TO CLARIFY ONLY THE FOLLOWING: (A) THAT
THE PERSON IN FACT RECEIVED THE BEHAVIORAL HEALTH
SERVICES IN QUESTION, (B) THE DATES OF SUCH
SERVICES, AND (C) A GENERAL DESCRIPTION OF THE
TYPES OF SERVICES. INFORMATION THE DEPARTMENT
RECEIVES PURSUANT TO THIS SUBDIVISION SHALL BE
DISCLOSED ONLY TO FEDERAL OR STATE AUDITORS AND
ONLY AS NECESSARY FOR THE PURPOSES OF AUDITING.
Sec. 83. The Department of Social Services
shall develop, by December 1, 1997, in conjunction
with the Office of Fiscal Analysis, a cost-based
reimbursement system for the allocation of
Medicaid funds for federally qualified health
centers.
Sec. 84. Section 7-314a of the general
statutes is repealed and the following is
substituted in lieu thereof:
(a) Except as provided in subsections (e) and
(f) of this section, active members of volunteer
fire departments AND ACTIVE MEMBERS OF
ORGANIZATIONS CERTIFIED AS A VOLUNTEER OR
MUNICIPAL AMBULANCE SERVICE IN ACCORDANCE WITH
SECTION 19a-180 shall be construed to be employees
of the municipality for the benefit of which
volunteer fire services OR SUCH AMBULANCE SERVICES
are rendered while in training or engaged in
volunteer fire duty OR SUCH AMBULANCE SERVICE and
shall be subject to the jurisdiction of the
Workers' Compensation Commission and shall be
compensated in accordance with the provisions of
chapter 568 for death, disability or injury
incurred while in training for or engaged in
volunteer fire duty OR SUCH AMBULANCE SERVICE.
(b) For the purpose of this section, the
average weekly wage of a volunteer fireman OR
VOLUNTEER OR MUNICIPAL AMBULANCE SERVICE PROVIDER
shall be construed to be the average production
wage in the state as determined by the Labor
Commissioner under the provisions of section
31-309.
(c) For the purpose of this section, there
shall be no prorating of compensation benefits
because of other employment by a volunteer fireman
OR VOLUNTEER OR MUNICIPAL AMBULANCE SERVICE
PROVIDER.
(d) For the purpose of adjudication of claims
for the payment of benefits under the provisions
of chapter 568, any condition of impairment of
health occurring to an active member of a
volunteer fire department OR ORGANIZATION
CERTIFIED AS A VOLUNTEER OR MUNICIPAL AMBULANCE
SERVICE IN ACCORDANCE WITH SECTION 19a-180 while
such member is in training for or engaged in
volunteer fire duty OR SUCH AMBULANCE SERVICE,
caused by hypertension or heart disease resulting
in death or temporary or permanent total or
partial disability, shall be presumed to have been
suffered in the line of duty and within the scope
of his employment, provided such member had
previously successfully passed a physical
examination by a licensed physician appointed by
such department OR AMBULANCE SERVICE which
examination failed to reveal any evidence of such
condition.
(e) Any member of a volunteer fire company or
department OR ORGANIZATION CERTIFIED AS A
VOLUNTEER OR MUNICIPAL AMBULANCE SERVICE IN
ACCORDANCE WITH SECTION 19a-180 performing fire
duties OR SUCH AMBULANCE SERVICE pursuant to a
mutual aid understanding between municipalities
shall be entitled to all benefits pursuant to this
section and shall be construed to be an employee
of the municipality in which his fire company or
department OR SUCH AMBULANCE SERVICE is located.
(f) Any member of a volunteer fire company or
department and any person summoned by the State
Forest Fire Warden or by any state forest fire
personnel or district or deputy fire warden under
the supervision of the State Forest Fire Warden
pursuant to section 23-37, who performs fire
duties under the direction of such personnel or
warden pursuant to section 23-37, shall be
construed to be an employee of the state for the
purpose of receiving compensation in accordance
with the provisions of chapter 568 for death,
disability or injury incurred while performing
such fire duties under such direction.
Sec. 85. Section 7-314b of the general
statutes is repealed and the following is
substituted in lieu thereof:
(a) Any active member of a volunteer fire
company or department engaged in volunteer fire
duties OR ANY ACTIVE MEMBER OF AN ORGANIZATION
CERTIFIED AS A VOLUNTEER OR MUNICIPAL AMBULANCE
SERVICE IN ACCORDANCE WITH SECTION 19a-180 may
collect benefits under the provisions of chapter
568 based on the salary of his employment or the
amount specified in subsection (b) of section
7-314a, AS AMENDED BY SECTION 84 OF THIS ACT,
whichever is greater, if said firefighter OR
VOLUNTEER OR MUNICIPAL AMBULANCE SERVICE PROVIDER
is injured while engaged in fire duties OR
VOLUNTEER OR MUNICIPAL AMBULANCE SERVICE.
(b) As used in this section, the [term] TERMS
"fire duties" includes duties performed while at
fires, answering alarms of fire, answering calls
for mutual aid assistance, returning from calls
for mutual aid assistance, AT FIRE DRILLS OR
TRAINING EXERCISES, and directly returning from
fires, [and] "active member of a volunteer fire
company or department" includes all active members
of said fire company or department, fire patrol or
fire and police patrol company, whether paid or
not paid for their services, "AMBULANCE SERVICE"
INCLUDES ANSWERING ALARMS, CALLS FOR EMERGENCY
MEDICAL SERVICE OR INCLUDES DIRECTLY RETURNING
FROM CALLS FOR THE EMERGENCY SITUATIONS, DUTIES
PERFORMED WHILE PERFORMING TRANSPORTATION OR
TREATMENT SERVICES TO PATIENTS UNDER EMERGENCY
CONDITIONS, WHILE AT ANY LOCATION WHERE EMERGENCY
MEDICAL SERVICE IS RENDERED, WHILE ENGAGED IN
DRILLS OR TRAINING EXERCISES, WHILE AT TESTS OR
TRIALS OF ANY APPARATUS OR EQUIPMENT NORMALLY USED
IN THE PERFORMANCE OF SUCH MEDICAL SERVICE DRILLS,
AND "ACTIVE MEMBER OF AN ORGANIZATION CERTIFIED AS
A VOLUNTEER OR MUNICIPAL AMBULANCE SERVICE IN
ACCORDANCE WITH SECTION 19a-180" INCLUDES ALL
ACTIVE MEMBERS OF SAID AMBULANCE SERVICE WHETHER
PAID OR NOT PAID FOR THEIR SERVICES.
(c) The provisions of subsection (a) of this
section shall only apply if the volunteer
firefighter OR VOLUNTEER OR MUNICIPAL AMBULANCE
SERVICE PROVIDER is unable to perform his regular
employment duties.
Sec. 86. Subsection (e) of section 7-322b of
the general statutes is repealed and the following
is substituted in lieu thereof:
(e) Any member of a volunteer fire company or
emergency medical service organization who
responds to an emergency pursuant to the
provisions of this section shall be entitled to
receive all benefits payable under the provisions
of sections 7-314 and 7-314a, [or sections 19a-191
and 19a-192] AS AMENDED BY SECTION 84 OF THIS ACT.
Such payments shall be made by the municipality in
which the fire company or the emergency medical
service organization of which such a fireman or
technician is a member is located.
Sec. 87. (a) Section 17a-481 of the general
statutes is repealed.
(b) Sections 10a-132c, 19a-189 to 19a-192,
inclusive, 19a-201, 19a-217, 19a-218, 19a-616,
19a-618 to 19a-622, inclusive, and 46b-68 of the
general statutes are repealed.
(c) In codifying the provisions of this act,
the Legislative Commissioners shall delete the
reference to the section repealed by subsection
(a) of this section that appears in section
17a-450a of the general statutes.
Sec. 88. This act shall take effect July 1,
1997, except sections 9, 26, 41, 43, 44 and 46 to
51, inclusive, shall take effect October 1, 1997.
Approved July 1, 1997