General Assembly Raised Bill No. 1184
January Session, 2011 LCO No. 4545
*04545_______PH_*
Referred to Committee on Public Health
Introduced by:
(PH)
General Assembly
Raised Bill No. 1184
January Session, 2011
LCO No. 4545
*04545_______PH_*
Referred to Committee on Public Health
Introduced by:
(PH)
AN ACT CONCERNING HEALTH CARE FACILITIES.
Be it enacted by the Senate and House of Representatives in General Assembly convened:
Section 1. Section 19a-494a of the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2011):
If the Commissioner of Public Health finds that the health, safety or welfare of any patient [or patients] served by an institution [, as defined in subsections (d) and (e) of section 19a-490,] imperatively requires emergency action, [and he incorporates a finding to that effect in his order, he] the commissioner may issue a summary order incorporating such finding to the holder of a license issued pursuant to section 19a-493 pending completion of any proceedings conducted pursuant to section 19a-494, as amended by this act. [These] Such proceedings shall be promptly instituted and determined. The [orders which the] commissioner may issue [shall include] orders including, but not [be] limited to: (1) Revoking or suspending the license; (2) prohibiting such institution from contracting with new patients or terminating its relationship with current patients; (3) limiting the license of such institution in any respect, including reducing the patient capacity or services which may be provided by such institution; and (4) compelling compliance with the applicable statutes or regulations of the department. For purposes of this section, "institution" means the entities defined in subsections (b) to (h), inclusive, (k) and (l) of section 19a-490.
Sec. 2. (NEW) (Effective October 1, 2011) (a) (1) If the Commissioner of Public Health determines, upon an inquiry, examination, investigation or inspection made pursuant to section 19a-498 of the general statutes, that a hospital, as defined in section 19a-490 of the general statutes, has violated any provision of the general statutes or any regulation in the Public Health Code or the State Fire Safety Code relating to the operation or maintenance of a hospital, the commissioner may impose a civil penalty of not more than twenty-five thousand dollars for each violation.
(2) If the commissioner determines, upon an inquiry, examination, investigation or inspection made pursuant to section 19a-498 of the general statutes, that an institution has violated any provision of the general statutes or any regulation in the Public Health Code or the State Fire Safety Code relating to the operation or maintenance of an institution, the commissioner may impose a civil penalty of not more than three thousand dollars for each violation. For purposes of this section, "institution" has the same meaning as provided in section 19a-490 of the general statutes, but does not include hospitals, residential care homes, nursing homes and rest homes.
(b) In setting a civil penalty pursuant to subsection (a) of this section, the commissioner shall consider all factors that the commissioner deems relevant, including, but not limited to:
(1) The amount of assessment necessary to ensure immediate and continued compliance;
(2) The character and degree of impact of the violation on the health, safety and welfare of any patient in the hospital or institution;
(3) The conduct of the hospital or institution against whom the civil penalty is assessed in taking all feasible steps or procedures necessary or appropriate to comply or to correct the violation; and
(4) Any prior violations by the hospital or institution of the general statutes, any regulation in the Public Health Code, or the State Fire Safety Code, or orders administered, adopted or issued by the Commissioner of Public Health.
(c) If the commissioner determines that a violation has occurred for which a civil penalty is authorized by this section, the commissioner shall send to the hospital or institution, by certified mail, return receipt requested, or personal service, a notice which shall include:
(1) A reference to each general statute or regulation that the hospital or institution has allegedly violated;
(2) A short and plain statement of the alleged violations;
(3) A statement of the amount of the civil penalty or penalties that may be imposed upon finding after hearing that a violation has occurred or upon a default; and
(4) A statement of the party's right to a hearing to contest the commissioner's determination.
(d) The hospital or institution to whom the notice is addressed shall have three days from the date of receipt of the notice, excluding Saturdays, Sundays and legal holidays, as defined in section 1-4 of the general statutes, to submit a written request to the commissioner for a hearing to contest the imposition of a civil penalty. If a hearing is requested, the commissioner may issue a final order after a hearing and, upon a finding that a violation has occurred, may assess a civil penalty under this section which shall be no greater than the penalty stated in the notice. If a hospital or institution does not request a hearing within such three-day period, or if a request for a hearing is later withdrawn, then the notice shall become a final order of the commissioner, effective upon the expiration of such three-day period or on the first day after the withdrawal of such request for hearing, whichever is later, and the matters asserted or charged in the notice shall be deemed admitted unless modified by a consent order, which shall become the final order.
(e) Any hearing under this section shall be conducted pursuant to chapter 54 of the general statutes. Any penalty assessed pursuant to this section may be mitigated or waived by the commissioner upon such terms and conditions as the commissioner deems proper or necessary after consideration of (1) the factors set forth in subsection (b) of this section, and (2) any extenuating factors or circumstances. The commissioner may grant an extension of time for filing required information or data.
(f) A final order of the commissioner assessing a civil penalty shall be subject to appeal as set forth in section 4-183 of the general statutes after a hearing held pursuant to subsection (e) of this section, except that any such appeal shall be taken to the superior court for the judicial district of New Britain and shall have precedence in the order of trial as provided in section 52-191 of the general statutes. Such final order shall not be subject to appeal under any other provision of the general statutes. No challenge to any final order of the commissioner assessing a civil penalty shall be allowed as to any issue which could have been raised by an appeal of an earlier order, notice, permit, denial or other final decision by the commissioner.
(g) If any hospital or institution fails to pay any civil penalty, the Attorney General, upon request of the Commissioner of Public Health, may bring an action in the superior court for the judicial district of Hartford to obtain enforcement of the penalty by the court. All actions brought by the Attorney General pursuant to the provisions of this section shall have precedence in the order of trial as provided in section 52-191 of the general statutes.
Sec. 3. Subsection (a) of section 19a-494 of the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2011):
(a) The Commissioner of Public Health, after a hearing held in accordance with the provisions of chapter 54, may take any of the following actions, singly or in combination, in any case in which [he] the commissioner finds that there has been a substantial failure to comply with the requirements established under this chapter, the Public Health Code [and] or licensing regulations:
(1) Revoke a license or certificate;
(2) Suspend a license or certificate;
(3) Censure a licensee or certificate holder;
(4) Issue a letter of reprimand to a licensee or certificate holder;
(5) Place a licensee or certificate holder on probationary status and require him to report regularly to the department on the matters which are the basis of the probation;
(6) Restrict the acquisition of other facilities for a period of time set by the commissioner; [and]
(7) Issue an order compelling compliance with applicable statutes or regulations of the department;
(8) Impose a directed plan of correction; or
(9) Impose a civil penalty.
Sec. 4. Subsection (c) of section 19a-491 of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2011):
(c) [Notwithstanding any regulation to the contrary, the] The Commissioner of Public Health shall charge the following fees for the biennial licensing and inspection of the following institutions: (1) Chronic and convalescent nursing homes, per site, four hundred forty dollars; (2) chronic and convalescent nursing homes, per bed, five dollars; (3) rest homes with nursing supervision, per site, four hundred forty dollars; (4) rest homes with nursing supervision, per bed, five dollars; (5) outpatient dialysis units and outpatient surgical facilities, six hundred twenty-five dollars; (6) mental health residential facilities, per site, three hundred seventy-five dollars; (7) mental health residential facilities, per bed, five dollars; (8) hospitals, per site, nine hundred forty dollars; (9) hospitals, per bed, seven dollars and fifty cents; (10) nonstate agency educational institutions, per infirmary, one hundred fifty dollars; [and] (11) nonstate agency educational institutions, per infirmary bed, twenty-five dollars; (12) home health care agencies, per site, three hundred dollars and, for each additional office, one hundred dollars; (13) homemaker-home health aide agency, per site, two hundred dollars; and (14) assisted living services agencies, per site, five hundred dollars.
Sec. 5. Subsection (f) of section 19a-491 of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2011):
(f) The commissioner shall charge a fee of [five hundred sixty-five dollars] one thousand two hundred dollars for a hospital and seven hundred dollars for an institution other than a hospital for the technical assistance provided for the design, review and development of a hospital's or an institution's construction, sale or change in ownership. The commissioner shall charge a fee of two hundred fifty dollars for a hospital and one hundred fifty dollars for an institution other than a hospital for each on-site visit.
Sec. 6. Subsection (e) of section 19a-632 of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2011):
(e) If any assessment is not paid when due, [a late fee of ten dollars shall be added thereto and interest at the rate of one and one-fourth per cent per month or fraction thereof shall be paid on such assessment and late fee] the commissioner shall impose a fee equal to (1) two per cent of the assessment if such failure to pay is for not more than five days, (2) five per cent of the assessment if such failure to pay is for more than five days but not more than fifteen days, or (3) ten per cent of the assessment if such failure to pay is for more than fifteen days. If a hospital fails to pay any assessment for more than thirty days after the date when due, the commissioner may, in addition to the fees imposed pursuant to this subsection, impose a civil penalty of up to one thousand dollars per day for each day past the initial thirty days that the assessment is not paid. Any civil penalty authorized by this subsection shall be imposed by the commissioner in accordance with subsections (b) to (e), inclusive, of section 19a-653, as amended by this act.
Sec. 7. Subsection (b) of section 19a-653 of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2011):
(b) If the Department of Public Health has reason to believe that a violation has occurred for which a civil penalty is authorized by subsection (a) of this section, or subsection (e) of section 19a-632, as amended by this act, it shall notify the person or health care facility or institution by first-class mail or personal service. The notice shall include: (1) A reference to the sections of the statute or regulation involved; (2) a short and plain statement of the matters asserted or charged; (3) a statement of the amount of the civil penalty or penalties to be imposed; (4) the initial date of the imposition of the penalty; and (5) a statement of the party's right to a hearing.
Sec. 8. Subsection (a) of section 19a-631 of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2011):
(a) As used in this section, [and] section 19a-632, as amended by this act, and sections 9 and 10 of this act, "hospital" means each hospital subject to the provisions of this chapter and licensed as a short-term acute-care general hospital or a children's hospital or both by the Department of Public Health.
Sec. 9. (NEW) (Effective July 1, 2011) (a) For purposes of this section, "electronic funds transfer" has the same meaning as provided in section 12-685 of the general statutes.
(b) The Department of Public Health may require a hospital to pay an assessment levied pursuant to section 19a-632 of the general statutes, as amended by this act, by way of an approved method of electronic funds transfer.
(c) A hospital making an electronic funds transfer pursuant to this section shall initiate such transfer in a timely fashion to ensure that a bank account designated by the department is credited by electronic funds transfer for the amount of the assessment required to be made by such method on or before the date such assessment is due.
(d) Where an assessment is required to be made by electronic funds transfer, any payment made by a method other than electronic funds transfer shall be treated as an assessment not made in a timely manner, and any payment made by electronic funds transfer, where the bank account designated by the department is not credited for the amount of the assessment on or before the date such assessment is due, shall be treated as an assessment not made in a timely manner. Any assessment treated under this subsection as an assessment not made in a timely manner shall be subject to a penalty in accordance with subsection (e) of this section.
(e) Where any assessment is treated under subsection (d) of this section as an assessment not made in a timely manner because it is made by means other than electronic funds transfer, there shall be imposed a penalty equal to ten per cent of the assessment required to be made by electronic funds transfer. Where any assessment made by electronic funds transfer is treated under subsection (d) of this section as an assessment not made in a timely manner because the bank account designated by the department is not credited by electronic funds transfer for the amount of the assessment on or before the date such assessment is due, there shall be imposed a penalty equal to (1) two per cent of the assessment required to be made by electronic funds transfer, if such failure to pay by electronic funds transfer is for not more than five days; (2) five per cent of the assessment required to be made by electronic funds transfer, if such failure to pay by electronic funds transfer is for more than five days but not more than fifteen days; or (3) ten per cent of the assessment required to be made by electronic funds transfer, if such failure to pay by electronic funds transfer is for more than fifteen days.
(f) The department shall deposit all payments received pursuant to this section with the State Treasurer. The moneys so deposited shall be credited to the General Fund and shall be accounted for as expenses recovered from hospitals.
Sec. 10. (NEW) (Effective from passage) Not later than September 30, 2012, and quarterly thereafter, each hospital shall file with the Commissioner of Public Health a statement of operations and utilization statistics as specified in regulations adopted by the commissioner. Not later than July 1, 2012, the commissioner shall adopt regulations, in accordance with chapter 54 of the general statutes, to establish the content required in said statement.
This act shall take effect as follows and shall amend the following sections:
Section 1 October 1, 2011 19a-494a
Sec. 2 October 1, 2011 New section
Sec. 3 October 1, 2011 19a-494(a)
Sec. 4 July 1, 2011 19a-491(c)
Sec. 5 July 1, 2011 19a-491(f)
Sec. 6 July 1, 2011 19a-632(e)
Sec. 7 July 1, 2011 19a-653(b)
Sec. 8 July 1, 2011 19a-631(a)
Sec. 9 July 1, 2011 New section
Sec. 10 from passage New section
This act shall take effect as follows and shall amend the following sections:
Section 1
October 1, 2011
19a-494a
Sec. 2
October 1, 2011
New section
Sec. 3
October 1, 2011
19a-494(a)
Sec. 4
July 1, 2011
19a-491(c)
Sec. 5
July 1, 2011
19a-491(f)
Sec. 6
July 1, 2011
19a-632(e)
Sec. 7
July 1, 2011
19a-653(b)
Sec. 8
July 1, 2011
19a-631(a)
Sec. 9
July 1, 2011
New section
Sec. 10
from passage
New section
Statement of Purpose:
To increase the Department of Public Health's ability to: Issue summary orders when patients are at risk, impose civil penalties on health care institutions for violations of statutes and regulations, collect fees from health care providers for licensing, inspections and technical visits, impose late fees when hospitals fail to pay assessments on time, and collect statistics from hospitals.
[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.]