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17a-450 of the  general  statutes are repealed and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