Connecticut Seal

General Assembly

 

Committee Bill No. 37

January Session, 2017

 

LCO No. 4744

 

*04744SB00037PH_*

Referred to Committee on PUBLIC HEALTH

 

Introduced by:

 

(PH)

 

AN ACT CONCERNING HEALTH EMERGENCY RESPONSE OPERATIONS.

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

Section 1. Section 19a-131 of the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2017):

As used in sections 19a-131 to 19a-131i, inclusive, as amended by this act, [and section 19a-221] and sections 2 to 10, inclusive, of this act:

(1) "Animal" means all vertebrate and invertebrate species;

(2) "Bioterrorism" means the intentional use of any microorganism, virus, infectious substance or biological product that may be engineered as a result of biotechnology, or any naturally occurring or bioengineered component of any such microorganism, virus, infectious substance, or biological product, to cause death, disease or other biological malfunction in a human, animal, plant or another living organism in order to influence the conduct of government or to harm, intimidate or coerce a civilian population;

(3) "Commissioner" means Commissioner of Public Health;

(4) "Communicable disease" means a disease or condition, the infectious agent of which may pass or be carried, directly or indirectly, from the body of one person or animal to the body of another person or animal;

(5) "Contaminated" or "contamination" means contaminated or contamination by a biological toxin or a chemical, radioactive or any other substance sufficient to pose a substantial risk of death, disability, injury or harm to other persons;

(6) "Direct active monitoring" means actively monitoring through direct observation by a public health authority;

(7) "Exigent circumstance" means any circumstance in which the relative threat to public health or safety is so immediate and severe that there is no time for the commissioner or local health director to secure a court order without jeopardizing the health or safety of others;

(8) "Final public health order" means an order issued by a judge of the Superior Court after a due process hearing in accordance with section 6 of this act;

(9) "Infection prevention and control measure" means a measure designed to ensure the protection of a person who may be vulnerable to acquiring an infection in a health care or other settings. Infection prevention and control measure includes, but not limited to, handwashing and the use of personal protective equipment;

[(6)] (10) "Isolation" means the physical separation and confinement of [an individual] a person, group of [individuals or individuals] persons or persons present within a geographic area who are infected with a communicable disease or are contaminated [, or whom the commissioner reasonably believes to be infected with a communicable disease or to be contaminated] and pose a risk of infecting or contaminating others, in order to prevent or limit the transmission of the disease or contamination to the general public;

(11) "Local health director" means a municipal health director or district director of health as defined in chapters 368e and 368f;

(12) "Personal protective equipment" means equipment worn to minimize exposure to infectious pathogens and other contaminations that can result in illness or injury, including, but not limited to, gloves, masks and gowns;

(13) "Preliminary public health order" means an order issued in accordance with section 5 or 6 of this act;

[(7)] (14) "Public health authority" means a person or entity authorized to respond to a public health emergency in accordance with the plan for emergency responses to a public health emergency prepared in accordance with section 19a-131g, as amended by this act, including, but not limited to, licensed health care providers or local and district health directors;

[(8)] (15) "Public health emergency" means an occurrence or imminent threat of a communicable disease, except sexually transmitted disease, or contamination caused or believed to be caused by bioterrorism, an epidemic or pandemic disease, a natural disaster, a chemical attack or accidental release or a nuclear attack or accident that poses a substantial risk of a significant number of human fatalities or incidents of permanent or long-term disability;

[(9)] (16) "Quarantine" means the physical separation and confinement of [an individual, group of individuals or individuals] a person or group of persons present within a geographic area who [are] (A) have been exposed to a communicable disease or [are contaminated] contamination, or [whom the commissioner reasonably believes have been exposed to a communicable disease or to be contaminated or have been exposed] to others who have been exposed to a communicable disease or contamination, and (B) do not have any recognized signs or symptoms of the communicable disease or contamination and may or may not become contagious, in order to prevent or limit the transmission of the communicable disease or contamination to [the general public] others;

[(10)] (17) "Respondent" means [an individual] a person ordered isolated or quarantined under section 19a-131b or [19a-221] subject to a public health order under sections 4 to 6, inclusive, of this act.

(18) "Significant risk to public health" means a circumstance in which there exists a reasonable probability of substantial harm to public health;

(19) "Social distancing measure" means any measure taken to restrict when and where persons may gather in order to prevent, stop or slow the spread of an infectious disease or contamination;

(20) "Travel restriction" means any restriction placed on a person's use of commercial conveyances or freedom to travel; and

(21) "Work or school restriction" means any restriction imposed on a person's attendance at a place of employment, school, child care facility or institution of higher education.

Sec. 2 (NEW) (Effective October 1, 2017) (a) The commissioner and any local health director may seek a preliminary public health order pursuant to the provisions of section 4 of this act from a judge of the Superior Court for any person believed to be (1) infected or at a reasonable risk of becoming infected with a communicable disease, or (2) contaminated or at reasonable risk of becoming contaminated. The judge may issue a preliminary public health order if he or she determines there is probable cause that such person poses a significant risk to public health and imposition of a preliminary public health order is necessary and the least restrictive means to protect or preserve the public health. Pursuant to section 5 of this act, the commissioner and local health director may issue an emergency preliminary public health order in exigent circumstances with respect to any person whom the commissioner or local health director has reasonable grounds to believe is infected or has a reasonable risk of becoming infected with a communicable disease or contaminated, if such commissioner or local health director determines that such person poses a significant risk to the public health and imposition of an emergency preliminary public health order is necessary and the least restrictive means to protect or preserve the public health. Following the imposition of such preliminary public health order pursuant to section 4 or 5 of this act, the individual subject to such order shall receive a due process hearing in accordance with section 6 of this act, at which point the judge may issue a final public health order. In the event the Governor declares a public health emergency, pursuant to section 19a-131a of the general statutes, as amended by this act, each local health director shall comply with and carry out any order the commissioner issues in furtherance of the Governor's declaration of the public health emergency.

(b) The commissioner and local health directors shall adhere to the following conditions and principles when imposing public health orders:

(1) Preliminary and final public health orders shall be by the least restrictive means necessary to prevent the spread of a communicable disease or contamination to others and may include, but need not be limited to, direct active monitoring, social distancing measures, travel, work or school restrictions, or quarantine or isolation in private homes or other private or public premises;

(2) When issuing a preliminary public health order, the commissioner or local health director shall comply with the petition, notice and hearing procedures set forth in section 4 of this act, except in exigent circumstances, in which case the commissioner or local health director may issue an emergency preliminary order pursuant to section 5 of this act;

(3) The health status of persons under preliminary and final public health orders shall be monitored frequently to determine if continued adherence to the restrictions imposed by the order is required;

(4) Preliminary and final public health orders shall be immediately lifted when persons subject to such orders no longer pose a threat to public health or upon the order of a court of competent jurisdiction;

(5) The needs of persons under preliminary and final public health order shall be addressed in a systematic and competent fashion by the issuing authority pursuant to section 7 of this act; and

(6) The final public health order, the conditions of quarantine or isolation and the failure of the commissioner or local health director to provide for any unmet needs that arise as a direct result of a final public health order that is less restrictive than quarantine or isolation shall be appealable pursuant to section 8 of this act.

Sec. 3. (NEW) (Effective October 1, 2017) (a) Preliminary and final public health orders shall be issued in writing in a language understood by the person subject to the public health order and shall set forth:

(1) The name of the persons subject to the public health order;

(2) The type of public health order, including any travel restriction, social distancing measure, direct active monitoring, quarantine or isolation;

(3) A description of the suspected communicable disease or contaminate, if known, that is the basis for the public health order and the public health risk posed by the suspected communicable disease or contaminate;

(4) The period of time during which the public health order shall remain effective, the length of incubation of the communicable disease or contamination, the date of the person's potential exposure and the person's medical risk of exposing others to such communicable disease or contamination;

(5) The medical basis for the commissioner or local health director's belief that the person has a communicable disease or has been contaminated and poses a significant risk to the public health and that the public health order is necessary to protect or preserve the public health;

(6) The basis for the commissioner or local health director's belief that the public health order is the least restrictive means to protect or preserve the public health, including, but not limited to, a list of less restrictive alternatives considered and rejected and the reasons for such rejection;

(7) An account of the reasonable efforts made to obtain voluntary compliance with a request for an emergency public health action, including requests for testing, medical examination, treatment or prophylaxis, counseling, vaccination, decontamination of persons or animals, isolation, quarantine or inspection and closure of facilities, or an explanation as to why reasonable efforts to obtain voluntary compliance are not possible and why the pursuit of such efforts creates a risk of serious harm to others;

(8) The scope and specifications of the public health order, including, but not limited to, the location and conditions of isolation or quarantine or the nature of the social distancing measures or travel restrictions imposed; and

(9) Such other terms and conditions as may be necessary to protect and preserve the public health.

(b) Such order shall inform the persons subject to the public health order (1) of the issuing authority's obligation to maintain safe and hygienic conditions of quarantine and isolation in accordance with section 7 of this act, (2) that such person has the right to a due process hearing in Superior Court in accordance with section 6 of this act, (3) that such person has the right to appeal an adverse determination of the Superior Court in accordance with section 8 of this act, (4) that such person has the right to consult with and be represented by counsel at the due process hearing, (5) that counsel will be provided at the state's expense if such person is unable to pay for such counsel, and (6) that such person may waive his or her right to due process hearing and legal representation by submission of a written waiver.

(c) In nonexigent circumstances, the commissioner or the local health director shall provide a copy of the public health order to the person subject to the order pursuant to section 4 of this act or, in exigent circumstances, pursuant to section 5 of this act.

(d) Not later than six hours after the issuance of a public health order by a local health director, the local health director shall notify the commissioner that an order has been issued and transmit a copy of the order to the commissioner by electronic mail or facsimile.

(e) A final public health order shall be effective for not more than twenty days, provided additional public health orders may be issued with regard to any person for successive periods of not more than twenty days if an additional order is issued before the last business day of the period for which the preceding public health order was issued. If the public health authority wishes to extend the public health order after the initial or any subsequent twenty-day period, the commissioner or local health director may seek a renewal from the judge of the Superior Court who previously issued the final public health order pursuant to section 6 of this act, at which time the judge shall make a determination on the request for renewal. A person subject to a public health order may request a full due process hearing pursuant to section 6 of this act on the ground that the circumstances that were the basis for such order have changed.

Sec. 4. (NEW) (Effective October 1, 2017) (a) In the absence of exigent circumstances, the commissioner or local health director may begin proceedings against any person the commissioner or local health director reasonably believes is infected with a communicable disease by petitioning the Superior Court for an ex-parte preliminary public health order attesting that probable cause for the order exists. If the Superior Court determines that probable cause exists to issue the public health order, the court shall grant the petition and the order shall go into effect. If the Superior Court determines that probable cause does not exist, the court shall deny the petition.

(b) The commissioner or local health director shall make reasonable efforts to serve the person or group of persons identified in the preliminary public health order with the petition before the petition is filed, except that the commissioner or a local health director need not provide prior notice of an ex-parte proceeding at which the petition is being considered by the court.

(c) The petition to the court and the court's ex-parte preliminary public health order, if any, shall include the information described in section 3 of this act.

(d) Not later than twelve hours after the issuance of an ex-parte preliminary public health order, the person or group of persons subject to the ex-party preliminary public health order shall be personally served by a state marshal or other proper officer with written notice and a copy of the order. If copies of the notice and order cannot be personally served in a timely manner to a group of persons because the number of persons in the group makes personal service impracticable, as determined by the commissioner or local health director, the commissioner or local health director shall post the notice and order in a conspicuous place where the notice and order can be viewed by those isolated, quarantined or restricted or shall find other means to meaningfully communicate the information in the notice and order to those isolated, quarantined or restricted.

(e) Persons subject to an ex-parte preliminary public health order under this section shall have a right to a hearing in Superior Court in accordance with section 6 of this act. Notice of the ex-parte order shall inform the respondent of his or her right to a hearing and specify the full scope of respondent's accordant rights set forth in subsection (c) of section 6 of this act.

Sec. 5. (NEW) (Effective October 1, 2017) (a) In exigent circumstances, the commissioner or local health director may issue an emergency preliminary public health order if the commissioner or local health director has probable cause to believe that such public health order is required in order to avoid a clear and immediate danger to others and that considerations of safety do not allow initiation of the petition process set forth in section 4 of this act.

(b) An emergency preliminary public health order issued under this section shall include the information described in subsections (a) and (b) of section 3 of this act.

(c) Not later than twelve hours after the issuance of an emergency preliminary public health order, the person or group of persons subject to the order shall be personally served by a state marshal or other proper officer with written notice and a copy of the order issued. If copies of the notice and order cannot be personally served in a timely manner to a group of persons because the number of persons in the group makes personal service impracticable, as determined by the commissioner or local health director, the commissioner or local health director shall post the notice and order in a conspicuous place where the notice and order can be viewed by those isolated, quarantined or restricted, or shall find other means to meaningfully communicate the information in the notice and order to those detained or restricted.

(d) Persons subject to an emergency preliminary public health order under this section shall have a right to a hearing in Superior Court in accordance with section 6 of this act. Notice of this order shall inform the respondent of their right to a hearing, and shall specify the full scope of the respondent's rights set forth in subsection (c) of section 6 of this act.

Sec. 6. (NEW) (Effective October 1, 2017) (a) A person subject to a preliminary public health order shall have the right to a hearing in Superior Court not later than seventy-two hours after the issuance of the preliminary order, including on Saturdays, Sundays and legal holidays, unless the person or the person's attorney affirmatively postpones or waives the hearing through express written request. The hearing shall be held to determine if (1) the person subject to preliminary public health order is infected or has a realistic potential of being infected with a communicable disease or is contaminated or has a realistic potential of being contaminated, (2) the person poses a significant risk to the public health, and (3) the restrictions laid out in the public health order are necessary and the least restrictive means to protect and preserve the public health. The commissioner shall have the right to be made a party to the proceedings.

(b) Jurisdiction shall be vested in the Superior Court for the district in which such person resides or is subject to preliminary public health order.

(c) Notice of the hearing shall be given to the respondent. If copies of the notice cannot be personally served by a state marshal or other proper officer in a timely manner to a group of persons because the number of persons in the group makes personal service impracticable, as determined by the commissioner or local health director, the commissioner or local health director shall post the notice and order in a conspicuous place where the notice and order can be viewed by those isolated, quarantined or restricted, or shall find other means to meaningfully communicate the information in the notice and order to those isolated, quarantined or restricted. The notice shall inform the respondent that where practicable, (1) he or she has a right to be heard at the hearing in person, via videoconference or via teleconference or, where a hearing in person, via videoconference or via teleconference is not practicable, via a designated personal representative; (2) the respondent has a right to counsel; (3) the respondent, if indigent or otherwise unable to pay for or obtain counsel, has a right to have counsel appointed to represent the respondent; (4) the respondent has a right to cross-examine witnesses testifying at the hearing himself or herself, through his or her counsel or through his or her personal representative; and (5) the respondent has the right to waive or postpone the hearing through written request. If the court finds such respondent is indigent or otherwise unable to pay for counsel, the court shall appoint counsel for such respondent, unless such respondent refuses counsel and the court finds that the respondent understands the nature of his or her refusal. The court shall provide such respondent a reasonable opportunity to select his or her own counsel to be appointed by the court. If the respondent does not select counsel or if counsel selected by the respondent refuses to represent such respondent or is not available for such representation, the court shall appoint counsel for the respondent from a panel of attorneys admitted to practice in this state provided by the Chief Court Administrator. The term of the attorney's representation of the respondent shall extend as long as the respondent is subject to the public health order or associated proceedings, unless the respondent terminates the representation. If the respondents comprise a group of persons present in a described geographic area, the court may appoint one or more attorneys to represent all the respondents present in the described geographic area where there is a commonality of interests of such respondents, except that a respondent may choose to be represented by his or her own attorney on an individual basis. The reasonable compensation of appointed counsel shall be established by and paid from funds appropriated to the Judicial Department, but, if funds have not been included in the budget of the Judicial Department for such purposes, such compensation shall be established by the Chief Court Administrator and paid from the Probate Court Administration Fund.

(d) Prior to the hearing, the Superior Court, the respondent or the respondent's counsel, and the commissioner shall be afforded access to all records including, but not limited to, hospital records if the respondent is hospitalized, and shall be entitled to take notes from such records. If the respondent is hospitalized at the time of the hearing, the hospital shall make available at the hearing for use by the respondent or the respondent's counsel all records in its possession relating to the condition of the respondent. All records relating to the condition of the respondent shall be admissible at the request of any party or the Superior Court at the hearing. Nothing in this subsection shall prevent timely objection to the admissibility of evidence in accordance with the rules of civil procedure.

(e) At such due process hearing, the court shall cause a recording of the testimony to be made, which shall be transcribed only in the event of an appeal from the order rendered. A copy of such transcript shall be furnished without charge to any appellant whom the Superior Court finds unable to pay for the same. The cost of such transcript shall be paid from the funds appropriated by the Judicial Department or, if funds have not been included in the budget of the Judicial Department for such purposes, the cost of such transcription shall be established by the Chief Court Administrator and paid from the Probate Court Administration Fund.

(f) At such hearing, the commissioner or local health director who initiated the preliminary public health order against the respondent shall have the burden of showing by clear and convincing evidence that (1) the respondent is infected or has a realistic potential of being infected with a communicable disease or is contaminated or has a realistic potential of being contaminated, (2) the respondent poses a significant risk to the public health, and (3) the restrictions imposed by the preliminary public health order are necessary and the least restrictive means to protect and preserve the public health.

(g) If the court finds by clear and convincing evidence at such hearing that (1) the respondent is infected or has a realistic potential of being infected with a communicable disease or is contaminated or has a realistic potential of being contaminated, (2) the respondent poses a significant risk to the public health, and (3) the preliminary public health order is necessary and the least restrictive alternative to protect and preserve the public health, then the court shall issue a final public health order under such terms and conditions as it deems appropriate until such time as it is determined that the respondent's release from the public health order would not constitute a reasonable threat to the public health.

(h) If the court finds at such hearing that the conditions required for a final public health order have not been proven by clear and convincing evidence, it shall order the immediate release of the respondent or, when appropriate, the imposition of less restrictive means.

(i) When issuing a final public health order pursuant to this section, the court shall affirmatively verify that the conditions of the order comply with the requirements set forth in section 7 of this act and that the ordering authority tasked with overseeing the final public health order is prepared to meet the respondent's needs for the duration of the final public health order.

(j) Any person subject to a final public health order may, not more than every twenty days, move the court to terminate or modify the public health order if there are changed circumstances. If the court fails to find at a hearing held upon a motion of the respondent or its own motion that the conditions that required the public health order still exist, the court shall order the immediate release of the respondent. If the court finds that such conditions still exist but that a different remedy is appropriate under this section, the court shall modify its order accordingly.

Sec. 7. (NEW) (Effective October 1, 2017) (a) A person subject to a preliminary or final public health order mandating isolation or quarantine under sections 4 to 6, inclusive, of this act shall be isolated or quarantined in a place designated by the commissioner or local health director until such time as such commissioner or local health director determines such person no longer poses a significant risk to the public health or is released by a court of competent jurisdiction for the district in which such person is isolated or quarantined.

(b) Quarantine or isolation shall take place in the least restrictive setting possible under the circumstances. The needs of persons isolated or quarantined shall be addressed in a systematic and competent fashion by the commissioner or local health director who initiated the public health order. Persons isolated or quarantined shall be provided adequate food that accommodates any dietary restrictions, clothing appropriate for the environment, shelter with an adequate number of beds, means of communication with others in isolation or quarantine and persons outside those settings, medication and competent medical care. Public health officials shall take efforts to ensure that personal information and identifying details of persons subject to public health order are kept confidential.

(c) If a quarantined person subsequently becomes infected or is reasonably believed to have become infected with a communicable disease or contaminated, such person shall be promptly moved to isolation and provided with appropriate medical care.

(d) Steps shall be taken to ensure quarantined persons remain safe and are not infected by others.

(e) Any person in quarantine with others shall be told, where applicable, basic infection prevention and control measures that may be employed to ensure quarantined persons do not infect one another.

(f) Any person in quarantine with others shall be provided with personal protective equipment, as appropriate, and be taught how to use such equipment;

(g) The premises used for isolation and quarantine shall be maintained in a safe and hygienic manner and designed to minimize the likelihood of further transmission of infection or other harms to persons isolated or quarantined.

(h) To the extent possible without jeopardizing the public health, family members and members of a household shall be kept together and guardians shall stay with their minor wards.

(i) To the extent possible, cultural and religious beliefs shall be considered in addressing the needs of a person and establishing and maintaining the premises used for quarantine and isolation of such person. Any person who desires treatment by prayer or spiritual means through the use of the principles, tenets or teachings of any religious corporation incorporated under chapter 598 of the general statutes and without the use of any drugs or material remedies shall receive such treatment during such person's isolation or quarantine, provided quarantine or isolation is maintained.

(j) For preliminary or final public health orders that are less restrictive than isolation and quarantine, including, but not limited to, direct active monitoring and travel restrictions, the issuing authority shall provide for any unmet needs necessary to comply with the order, including, but not limited to, medical monitoring equipment or means of communication.

Sec. 8. (NEW) (Effective October 1, 2017) (a) Any person aggrieved by a final public health order of the Superior Court issued under section 6 of this act, or a vaccination order issued under section 19a-131e of the general statutes, may appeal to the Appellate Court. If the Appellate Court fails to find that the conditions that required the final public health order or vaccination order exist, it shall order the immediate release of the respondent from the final public health order. If the Appellate Court finds that such conditions still exist but that a different remedy is appropriate under this section, the Appellate Court shall modify the Superior Court's final public health order accordingly.

(b) Any person subject to quarantine or isolation may, at any time, appeal the conditions of the quarantine or isolation to the Superior Court for the district in which such person is isolated or quarantined.

(c) Any person subject to a final public health order that is less restrictive than isolation and quarantine, including, but not limited to, direct active monitoring or social distancing measures, may appeal the issuing authority's failure to provide for any unmet needs that arise as a direct result of the order.

Sec. 9. (NEW) (Effective October 1, 2017) (a) As used in this section:

(1) "Qualifying employee" means a person who performs services for hire in the state and who has been subject to a public health order issued under sections 2 to 8, inclusive, of this act, or sections 19a-131b to 19a-131d, inclusive, of the general statutes, as amended by this act. The term applies to persons who comply with public health restrictions because of:

(A) A commissioner's emergency preliminary public health order;

(B) A local director's emergency preliminary public health order;

(C) An ex-parte probable cause order;

(D) A final public health order issued by a court; or

(E) An order of a federal quarantine officer; and

(2) "Employer" means any person having one or more employees in the state and includes the state and any political subdivision of the state.

(b) An employer shall not discharge, discipline, threaten or penalize a qualifying employee, or otherwise discriminate in the work terms, conditions, location or privileges of the qualifying employee, because the qualifying employee has been subject to a public health order.

(c) A qualifying employee claiming a violation of subsection (b) of this section may bring a civil action for recovery of lost wages or benefits, for reinstatement or for other relief not later than one hundred eighty days after the claimed violation or after the end of the public health order, whichever is later. A qualifying employee who prevails on such claim shall be granted reasonable attorney fees by the court.

(d) Nothing in this section is intended to alter sick leave or sick pay terms of the employment relationship.

(e) The protections of subsections (b) to (d), inclusive, of this section shall not apply to work absences due to isolation or quarantine for periods longer than twenty-one consecutive workdays. Any absence from work due to isolation or quarantine for periods longer than twenty-one consecutive workdays that results in loss of employment shall be treated for purposes of unemployment compensation in the same manner as loss of employment due to a serious illness.

Sec. 10. (NEW) (Effective October 1, 2017) Not later than December first annually, the commissioner shall submit to the Governor and to the joint standing committee of the General Assembly having cognizance of matters relating to public health a report, in accordance with section 11-4a of the general statutes, on the implementation of the provisions of sections 2 to 9, inclusive, of this act over the preceding twelve-month period if one or more public health orders were issued during such twelve-month period. Such report shall include, but not be limited to, the number and nature of any (1) preliminary public health orders sought by each local health director, (2) preliminary public health orders sought by the commissioner, (3) preliminary public health orders issued by the Superior Court, (4) emergency preliminary public health orders issued by each local health director, (5) emergency preliminary public health orders issued by the commissioner, and (6) final public health orders issued by the Superior Court. In describing the nature of any preliminary or final public health order, the report shall denote the type of restrictions imposed by the order, the type of disease or contamination risk that triggered the public health order, the disposition of all judicial proceedings related to the public health order, the total duration of the public health order and the present status of the public health order.

Sec. 11. Section 19a-131a of the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2017):

(a) In the event of a state-wide or regional public health emergency, the Governor shall make a good faith effort to inform the legislative leaders specified in subsection (b) of this section before declaring that the emergency exists and may do any of the following: (1) Order the commissioner to implement all or a portion of the public health emergency response plan developed pursuant to section 19a-131g, as amended by this act; (2) authorize the commissioner to isolate or quarantine persons in accordance with section 19a-131b, as amended by this act; (3) order the commissioner to vaccinate persons in accordance with section 19a-131e; (4) apply for and receive federal assistance; or (5) order the commissioner to suspend certain license renewal and inspection functions during the period of the emergency and during the six-month period following the date the emergency is declared to be over.

(b) (1) Any declaration issued pursuant to this section shall become effective upon its filing with the Secretary of the State and with the clerks of the House of Representatives and Senate. The declaration shall state the nature of the public health emergency, the public health risks presented by the emergency, including, but not limited to, all relevant scientific research and evidence, the political subdivisions or geographic area subject to the declaration, the conditions that have brought about the public health emergency, the duration of the public health emergency if such duration was less than six months and the public health authority responding to the emergency. Any such declaration issued by the Governor may be disapproved and nullified by majority vote of a committee consisting of the president pro tempore of the Senate, the speaker of the House of Representatives, the majority and minority leaders of both houses of the General Assembly and the cochairpersons and ranking members of the joint standing committee of the General Assembly having cognizance of matters relating to public health. [Such disapproval shall not be effective unless filed with the Secretary of the State not later than seventy-two hours after the filing of the Governor's declaration with the Secretary of the State.]

(2) Any declaration issued pursuant to this section may be renewed by the Governor upon its filing with the Secretary of the State and with the clerks of the House of Representatives and Senate every six months. The renewal declaration shall state the nature of the continuing public health emergency, the public health risks presented by the emergency, including all relevant scientific research and evidence, the political subdivisions or geographic area subject to the renewal, the conditions that have brought about the renewal declaration, the duration of the renewal declaration and the public health authority responding to the public health emergency. Any such renewal declaration issued by the Governor may be disapproved and nullified by majority vote of a committee consisting of the legislative leaders specified in subsection (b) of this section. [Such disapproval shall not be effective unless filed with the Secretary of the State not later than seventy-two hours after the filing of the Governor's renewal declaration with the Secretary of the State.]

(3) The Governor shall declare a public health emergency to be terminated before the duration stated in the declaration, upon a finding, after informing the legislative leaders specified in subsection (b) of this section, that the circumstances that caused such emergency to be declared no longer pose a substantial risk of a significant number of human fatalities or incidents of permanent or long-term disability.

(c) The Governor shall ensure that any declaration or order issued pursuant to the provisions of this section shall [be] (1) be published in full at least once in a newspaper having general circulation in each county, (2) be provided to news media, [and] (3) be posted on the state Internet web site, and (4) contain information concerning the transmission of a disease or contamination to dispel any erroneous beliefs about such transmission for purposes of preventing quarantined or isolated persons from being subjected to violence or discrimination based on misinformation and fear about the disease or contamination. Failure to take the actions specified in subdivisions (1) to [(3)] (4), inclusive, of this subsection shall not impair the validity of such declaration or order.

(d) Any individual who, during the course of a public health emergency declared under this section, violates the provisions of any order issued pursuant to sections 19a-131 to 19a-131i, inclusive, as amended by this act, or sections 2 to 10, inclusive, of this act, or who intentionally obstructs, resists, hinders or endangers any person who is authorized to carry out, and who is engaged in an activity that carries out, any of the provisions of the order shall be fined not more than one thousand dollars [or imprisoned not more than one year, or both,] for each offense.

[(e) The commissioner may request the Attorney General to apply to the Superior Court for an order enforcing the provisions of any order issued by the commissioner pursuant to sections 19a-131 to 19a-131i, inclusive, and such other equitable relief as the court deems appropriate.]

[(f)] (e) The commissioner may delegate to an employee of the Department of Public Health or any local health director, as much of the authority of the commissioner described in this section as the commissioner determines appropriate. Such authorized employee or director shall act as an agent of the commissioner.

Sec. 12. Section 19a-131b of the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2017):

(a) Notwithstanding the provisions of section [19a-221 or] 19a-265, or sections 2 to 8, inclusive, of this act, if the Governor has declared a public health emergency, the commissioner, if so authorized by the Governor pursuant to section 19a-131a, as amended by this act, may [order into quarantine or isolation, as appropriate,] seek a preliminary public health order from a judge of the Superior Court under section 4 of this act or, in exigent circumstances, issue an emergency preliminary public health order under section 5 of this act, to any [individual] person, group of [individuals or individuals] persons or persons present within a geographic area whom the commissioner has reasonable grounds to believe to be infected [with, or exposed to, a communicable disease or to be contaminated or exposed to contamination or at reasonable risk of having a communicable disease or being contaminated or passing such communicable disease or contamination to other persons] or contaminated if the commissioner determines that such [individual or individuals] person or persons pose a significant threat to the public health and that quarantine or isolation is necessary and the least restrictive alternative to protect or preserve the public health. No [individual] person or group of [individuals or individuals] persons or persons present in a geographic area shall be [quarantined or isolated] subject to public health order unless they meet the conditions in this subsection.

(b) The commissioner shall adhere to the [following] conditions and principles [when quarantining or isolating individuals, groups of individuals or individuals present within a geographic area: (1) Quarantine and isolation shall be by the least restrictive means necessary to prevent the spread of a communicable disease or contamination to others and may include, but not be limited to, confinement to private homes or other private or public premises; (2) quarantined individuals shall be confined separately from isolated individuals; (3) the health status of quarantined or isolated individuals shall be monitored frequently to determine if they continue to require quarantine or isolation; (4) if a quarantined individual subsequently becomes infected or contaminated or is reasonably believed to have become infected with a communicable disease or contaminated, such individual shall be promptly moved to isolation; (5) quarantined or isolated individuals shall be immediately released when they are no longer infectious or capable of contaminating others or upon the order of a court of competent jurisdiction; (6) the needs of individuals quarantined or isolated shall be addressed in a systematic and competent fashion, including, but not limited to, providing adequate food, clothing, shelter, means of communication with those in quarantine or isolation and outside those settings, medication and competent medical care; (7) premises used for quarantine and isolation shall be maintained in a safe and hygienic manner and be designed to minimize the likelihood of further transmission of infection or other harms to individuals quarantined or isolated; (8) to the extent possible without jeopardizing the public health, family members and members of a household shall be kept together, and guardians shall stay with their minor wards; and (9) to the extent possible, cultural and religious beliefs shall be considered in addressing the needs of individuals and establishing and maintaining premises used for quarantine and isolation.

(c) An order to quarantine or isolate issued by the commissioner shall be in writing and shall include: (1) The name of any individual, group of individuals or individuals present within a geographic area to be quarantined or isolated, or the geographic area where such communicable disease is present or contamination exists; (2) the basis for the commissioner's belief regarding the presence of a communicable disease or that contamination exists within the geographical area; (3) the period of time during which the order shall remain effective; (4) the premises subject to quarantine or isolation, that may include, but need not be limited to, private homes or other private or public premises; and (5) other terms and conditions as may be necessary to protect and preserve the public health. In determining the length of such order, the commissioner shall consider, to the extent known, the length of incubation of the communicable disease or contamination, the date of the individual's exposure and the individual's medical risk of exposing others to such communicable disease or contamination. The order shall be effective for not more than twenty days, provided further orders of quarantine or isolation meeting the requirements of this section may be issued as to any respondent for successive periods of not more than twenty days if issued before the last business day of the preceding period of quarantine or isolation.

(d) Such order shall also inform the individuals quarantined or isolated that they have the right to consult an attorney, the right to a hearing pursuant to this section, clear instructions on how to request a hearing, and that if such a hearing is requested, such individual has the right to be represented by counsel, that counsel will be provided at the state's expense if such individual is unable to pay for such counsel, and that if such a hearing is requested, court fees shall be waived. A copy of the order shall be provided to each individual quarantined or isolated or notice of the order shall be provided by a means likely to reach those affected] required under section 7 of this act when imposing a preliminary public health order of persons, groups of persons or persons present within a geographic area. A preliminary public health order issued by the commissioner pursuant to this section shall (1) contain all of the information required under section 3 of this act, and (2) comply with the applicable notice requirements set forth in section 4 or 5 of this act.

[(e)] (c) Any [individual] person subject to a preliminary public health order mandating quarantine or isolation [order] under this section shall be confined in a place designated by the commissioner until such time as the commissioner determines such [individual] person is no longer infectious or capable of contaminating others, or is released by order of a court of competent jurisdiction for the district in which such [individual is isolated or quarantined] person is subject to the public health order. Any [individual] person who desires treatment by prayer or spiritual means without the use of any drugs or material remedies, but through the use of the principles, tenets or teachings of any church incorporated under chapter 598 or any other religious or spiritual practice, may be so treated during such [individual's] person's quarantine or isolation.

[(f) An individual] (d) (A) person subject to a [quarantine or isolation order under this section may appeal such order to the Probate Court for the district in which such person is quarantined or isolated and, if such individual or such individual's representative asks the court, in writing, including, but not limited to, by means of first class mail, facsimile machine or the Internet, for a hearing, notwithstanding the form of such request, the court shall hold a hearing not later than seventy-two hours after receipt of such request, excluding Saturdays, Sundays and legal holidays. The court may extend the time for a hearing based on extraordinary circumstances. No fee shall be charged to file an appeal in the Probate Court under this section. If such individual cannot appear personally before the court, a hearing shall be conducted only if his or her representative is present. The commissioner shall be a party to the proceedings. Such hearing may be held via any means that allows all parties to fully participate in the event an individual may infect or contaminate others. A request for a hearing shall not stay the order of quarantine or isolation issued by the commissioner under this section. The hearing shall concern, but need not be limited to, a determination of whether (1) the individual ordered confined is infected with a communicable disease or is contaminated or has a reasonable risk of having a communicable disease or having been contaminated or passing a communicable disease or contamination to other individuals, (2) the individual poses a reasonable threat to the public health, and (3) the quarantine or isolation of the individual is necessary and the least restrictive alternative to prevent the spread of a communicable disease or contamination to others in order to protect and preserve the public health] preliminary public health order under this section shall be afforded a due process hearing before a judge of the Superior Court as provided in section 6 of this act.

[(g)] (e) Notice of the [hearing shall be given to the respondent and shall inform the respondent that his or her representative has a right to be present at the hearing; that the respondent has a right to counsel; that the respondent, if indigent or otherwise unable to pay for or obtain counsel, has a right to have counsel appointed to represent the respondent; and that the respondent has a right to cross-examine witnesses testifying at the hearing. If the court finds such respondent is indigent or otherwise unable to pay for or obtain counsel, the court shall appoint counsel for such respondent, unless such respondent refuses counsel and the court finds that the respondent understands the nature of his or her refusal. The court shall provide such respondent a reasonable opportunity to select such respondent's own counsel to be appointed by the court. If the respondent does not select counsel or if counsel selected by the respondent refuses to represent the respondent or is not available for such representation, the court shall appoint counsel for the respondent from a panel of attorneys admitted to practice in this state provided by the Probate Court Administrator] due process hearing shall be given to the respondent in accordance with section 6 of this act. If the order of quarantine or isolation applies to individuals present in a described geographic area, the court may appoint one or more attorneys to represent all the individuals present in the described geographic area where there is a commonality of interests of such individuals, except that an individual may choose to be represented by his or her own attorney on an individual basis. The reasonable compensation of appointed counsel shall be established by, and paid from funds appropriated to, the Judicial Department, but, if funds have not been included in the budget of the Judicial Department for such purposes, such compensation shall be established by the [Probate] Chief Court Administrator and paid from the Probate Court Administration Fund.

[(h)] (f) Prior to such due process hearing, the [Probate] Superior Court, [such] the respondent or [such] respondent's counsel and the commissioner shall be afforded access to all records [including, but not limited to, hospital records if such respondent is hospitalized, and shall be entitled to take notes therefrom. If such respondent is hospitalized at the time of the hearing, the hospital, upon order of the Probate Court, shall make available at such hearing for use by the respondent or his or her counsel all records in its possession relating to the condition of the respondent. All records relating to the condition of the respondent shall be admissible at the request of any party or the Probate Court at the hearing. Nothing in this subsection shall prevent timely objection to the admissibility of evidence in accordance with the rules of civil procedure.

(i) The court shall cause a recording of the testimony at such hearing to be made, to be transcribed only in the event of an appeal from the order rendered. A copy of such transcript shall be furnished without charge to any appellant whom the Probate Court finds unable to pay for the same. The cost of such transcript shall be paid from the funds appropriated by the Judicial Department, but, if funds have not been included in the budget of the Judicial Department for such purposes, the cost of such transcription shall be established by the Probate Court Administrator and paid from the Probate Court Administration Fund.

(j) At such hearing, the commissioner shall have the burden of showing, by a preponderance of the evidence, that the conditions of this subsection are met. If the court, at such hearing, finds that the respondent is infected with a communicable disease or is contaminated, or is reasonably believed to have been exposed to a communicable disease or to contamination, or is at reasonable risk of having a communicable disease or having been contaminated and poses a reasonable threat to the public health and that quarantine or isolation of the respondent is necessary and the least restrictive alternative to protect and preserve the public health, it shall order (1) the continued quarantine or isolation of the respondent under such terms and conditions as the court deems necessary to prevent the exposure of others to a communicable disease or contamination, until such time as it is determined by the commissioner that release of the respondent would not constitute a reasonable threat to the public health, or (2) the release of the respondent under such terms and conditions as it deems appropriate to protect the public health.

(k) If the court, at such hearing, fails to find that the conditions required for an order for quarantine or isolation under subsection (a) of this section have been proven, it shall order the immediate release of the respondent] in accordance with section 6 of this act. At such due process hearing, the court shall cause a recording of the testimony to be made in accordance with section 6 of this act. If the court fails to find that the commissioner has proven by clear and convincing evidence the conditions required for the issuance of the public health order under subsection (a) of this section, it shall order the immediate release of the respondent or, where necessary, the imposition of less restrictive means to protect or preserve the public health.

[(l)] (g) A respondent may, not more than every [thirty] twenty days, request a full due process hearing pursuant to section 6 of this act and move the court to terminate or modify an order made under subsection (j) of this section [, in which case a hearing shall be held in accordance with this section] if there are changed circumstances. If the court, at a hearing held upon motion of the respondent or its own motion, fails to find that the conditions which required [quarantine or isolation] the public health order still exist, it shall order the immediate release of the respondent. If the court finds that such conditions still exist but that a different remedy is appropriate under this section, the court shall modify its order accordingly.

[(m)] (h) Any person aggrieved by an order of the [Probate] Superior Court under this section may appeal to the [Superior] Appellate Court. The appeal shall be confined to the record, which shall consist of the transcript of the hearing and all evidence received or considered by the [Probate] Superior Court.

Sec. 13. Section 19a-131c of the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2017):

Notwithstanding the provisions of section 19a-220, in the event of a public health emergency declared by the Governor under section 19a-131a, as amended by this act, if any [individual] person refuses to obey [an order of quarantine or isolation] a public health order issued by the commissioner pursuant to section 19a-131b, as amended by this act, or section 4 of this act or by a judge of the Superior Court pursuant to section 5 or 6 of this act, the commissioner may direct any law enforcement officer to immediately take such [individual] person into custody and place him or her into quarantine or isolation, or otherwise subject the person to the public health order, as the case may be. The commissioner shall notify the law enforcement officer or other personnel concerning any necessary infection prevention and control procedures, [required] personal protective equipment and the conditions of the public health order imposed under section 7 of this act.

Sec. 14. Section 19a-131d of the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2017):

Entry into quarantine or isolation premises shall be limited to authorized individuals. The authorized individuals shall be determined by the commissioner and adjudicated by the judge of the Superior Court reviewing the case, and shall include, but need not be limited to, any physician licensed under chapter 370, other licensed, certified or registered health care providers, any attorney admitted to the bar of any state, or other individuals, including family or household members, the commissioner or judge deems necessary to meet the needs of quarantined or isolated individuals. The commissioner or local health director may require infection prevention and control training for any individual before authorizing him or her to enter the quarantine or isolation premises.

Sec. 15. Section 19a-131g of the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2017):

(a) The Commissioner of Public Health shall establish a Public Health Preparedness Advisory Committee. The advisory committee shall consist of the Commissioner of Public Health, the Commissioner of Emergency Services and Public Protection, the president pro tempore of the Senate, the speaker of the House of Representatives, the majority and minority leaders of both houses of the General Assembly and the chairpersons and ranking members of the joint standing committees of the General Assembly having cognizance of matters relating to public health, public safety and the judiciary, and representatives of town, city, borough and district directors of health, as appointed by the commissioner, and any other organization or persons that the commissioner deems relevant to the issues of public health preparedness. The Public Health Preparedness Advisory Committee shall develop the plan for emergency responses to a public health emergency. Such plan may include an emergency notification service. Not later than January 1, 2004, and annually thereafter, the committee shall submit a report, in accordance with section 11-4a, to the Governor and the joint standing committees of the General Assembly having cognizance of matters relating to public health and public safety, on the status of a public health emergency plan and the resources needed for implementation of such plan.

(b) Not later than ten business days after the issuance of an emergency declaration pursuant to section 19a-131a, as amended by this act, the Public Health Preparedness Advisory Committee shall produce and disseminate a report describing the commissioner's emergency response plan. The report shall describe the nature and scope of the public health emergency, the public health and safety measures being undertaken in response to such emergency, anticipated impacts that such measures might have on populations within the state and the actions the state will take to protect vulnerable populations and address resource shortfalls that arise as a result of such emergency. The report shall provide actionable, evidence-based public health and safety guidelines designed to educate the public and prevent the spread of misinformation.

(c) The Public Health Preparedness Advisory Committee shall ensure that any report issued pursuant to the provisions of this section shall be (1) published in full at least once in a newspaper having general circulation in each county, (2) provided to news media, and (3) posted on the state Internet web site. Said committee shall issue updated reports when necessary as circumstances change, but not less than every six months.

Sec. 16. Subsection (e) of section 19a-585 of the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2017):

(e) Except as provided in subparagraph (G) of subdivision (5) of subsection (d) of section 19a-582, nothing in this chapter shall prohibit the recording of HIV and AIDS-related information in the medical chart or medical records of a protected individual or the listing of AIDS, HIV-related illness or HIV infection in a certificate of death or autopsy report. This chapter shall not be construed to modify regulations relating to access to death certificates or autopsy reports. This chapter shall not be construed to modify the provisions of section 19a-25. [or 19a-221.]

Sec. 17. Subsection (c) of section 45a-82 of the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2017):

(c) All payments from the fund established by this section that are authorized by sections 5-259, 17a-77, 17a-274, 17a-498, 17a-510, 19a-131b, as amended by this act, 19a-131e, [19a-221,] 45a-1 to 45a-12, inclusive, 45a-18 to 45a-26, inclusive, 45a-34 to 45a-56, inclusive, 45a-62 to 45a-68, inclusive, 45a-74 to 45a-83, inclusive, 45a-85, 45a-90 to 45a-93, inclusive, 45a-98, 45a-99, 45a-105, 45a-119 to 45a-123a, inclusive, 45a-128, 45a-130, 45a-131, 45a-133, 45a-152, 45a-175 to 45a-180, inclusive, 45a-199 and 45a-202, shall be made upon vouchers approved by the Probate Court Administrator.

Sec. 18. Section 19a-221 of the general statutes is repealed. (Effective October 1, 2017)

This act shall take effect as follows and shall amend the following sections:

Section 1

October 1, 2017

19a-131

Sec. 2

October 1, 2017

New section

Sec. 3

October 1, 2017

New section

Sec. 4

October 1, 2017

New section

Sec. 5

October 1, 2017

New section

Sec. 6

October 1, 2017

New section

Sec. 7

October 1, 2017

New section

Sec. 8

October 1, 2017

New section

Sec. 9

October 1, 2017

New section

Sec. 10

October 1, 2017

New section

Sec. 11

October 1, 2017

19a-131a

Sec. 12

October 1, 2017

19a-131b

Sec. 13

October 1, 2017

19a-131c

Sec. 14

October 1, 2017

19a-131d

Sec. 15

October 1, 2017

19a-131g

Sec. 16

October 1, 2017

19a-585(e)

Sec. 17

October 1, 2017

45a-82(c)

Sec. 18

October 1, 2017

Repealer section

Statement of Purpose:

To establish conditions and protocols upon the imposition of public health orders regarding quarantine, isolation or other public health restrictions.

[Proposed deletions are enclosed in brackets. Proposed additions are indicated by underline, except that when the entire text of a bill or resolution or a section of a bill or resolution is new, it is not underlined.]

Co-Sponsors:

SEN. GERRATANA, 6th Dist.

S.B. 37