| 11 | 11 | | |
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| 12 | 12 | | AN ACT IMPLEMENTING PROVISIONS OF THE BUDGET CONCERNING PUBLIC HEALTH. |
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| 13 | 13 | | |
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| 14 | 14 | | Be it enacted by the Senate and House of Representatives in General Assembly convened: |
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| 15 | 15 | | |
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| 16 | 16 | | Section 1. Section 19a-491 of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2013): |
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| 17 | 17 | | |
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| 18 | 18 | | (a) No person acting individually or jointly with any other person shall establish, conduct, operate or maintain an institution in this state without a license as required by this chapter, except for persons issued a license by the Commissioner of Children and Families pursuant to section 17a-145 for the operation of (1) a substance abuse treatment facility, or (2) a facility for the purpose of caring for women during pregnancies and for women and their infants following such pregnancies. Application for such license shall be made to the Department of Public Health upon forms provided by it and shall contain such information as the department requires, which may include affirmative evidence of ability to comply with reasonable standards and regulations prescribed under the provisions of this chapter. The commissioner may require as a condition of licensure that an applicant sign a consent order providing reasonable assurances of compliance with the Public Health Code. The commissioner may issue more than one chronic disease hospital license to a single institution until such time as the state offers a rehabilitation hospital license. |
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| 19 | 19 | | |
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| 20 | 20 | | (b) If any person acting individually or jointly with any other person owns real property or any improvements thereon, upon or within which an institution, as defined in subsection (c) of section 19a-490, is established, conducted, operated or maintained and is not the licensee of the institution, such person shall submit a copy of the lease agreement to the department at the time of any change of ownership and with each license renewal application. The lease agreement shall, at a minimum, identify the person or entity responsible for the maintenance and repair of all buildings and structures within which such an institution is established, conducted or operated. If a violation is found as a result of an inspection or investigation, the commissioner may require the owner to sign a consent order providing assurances that repairs or improvements necessary for compliance with the provisions of the Public Health Code shall be completed within a specified period of time or may assess a civil penalty of not more than one thousand dollars for each day that such owner is in violation of the Public Health Code or a consent order. A consent order may include a provision for the establishment of a temporary manager of such real property who has the authority to complete any repairs or improvements required by such order. Upon request of the Commissioner of Public Health, the Attorney General may petition the Superior Court for such equitable and injunctive relief as such court deems appropriate to ensure compliance with the provisions of a consent order. The provisions of this subsection shall not apply to any property or improvements owned by a person licensed in accordance with the provisions of subsection (a) of this section to establish, conduct, operate or maintain an institution on or within such property or improvements. |
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| 21 | 21 | | |
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| 22 | 22 | | (c) Notwithstanding any regulation to the contrary, 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, except certified home health care agencies described in subsection (d) of this section, per agency, three hundred dollars; (13) home health care agencies, except certified home health care agencies described in subsection (d) of this section, per satellite patient service office, one hundred dollars; and (14) assisted living services agencies, except such agencies participating in the congregate housing facility pilot program described in section 8-119n, per site, five hundred dollars. |
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| 23 | 23 | | |
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| 24 | 24 | | (d) Notwithstanding any regulation, the commissioner shall charge the following fees for the triennial licensing and inspection of the following institutions: (1) Residential care homes, per site, five hundred sixty-five dollars; [and] (2) residential care homes, per bed, four dollars and fifty cents; (3) home health care agencies that are certified as a provider of services by the United States Department of Health and Human Services under the Medicare or Medicaid program, three hundred dollars; and (4) certified home health care agencies, as described in section 19a-493, per satellite patient service office, one hundred dollars. |
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| 25 | 25 | | |
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| 26 | 26 | | (e) The commissioner shall charge one thousand dollars for the licensing and inspection every four years of outpatient clinics that provide either medical or mental health service, and well-child clinics, except those operated by municipal health departments, health districts or licensed nonprofit nursing or community health agencies. |
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| 27 | 27 | | |
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| 28 | 28 | | (f) The commissioner shall charge a fee of five hundred sixty-five dollars for the technical assistance provided for the design, review and development of an institution's construction, renovation, building alteration, sale or change in ownership, when the cost of such project is one million dollars or less and one-quarter of one per cent of the total project cost when the cost of such project is more than one million dollars. Such fee shall include all department reviews and on-site inspections. For purposes of this subsection, "institution" does not include a facility owned by the state. |
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| 29 | 29 | | |
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| 30 | 30 | | (g) The commissioner may require as a condition of the licensure of home health care agencies and homemaker-home health aide agencies that each agency meet minimum service quality standards. In the event the commissioner requires such agencies to meet minimum service quality standards as a condition of their licensure, the commissioner shall adopt regulations, in accordance with the provisions of chapter 54, to define such minimum service quality standards, which shall (1) allow for training of homemaker-home health aides by adult continuing education, (2) require a registered nurse to visit and assess each patient receiving homemaker-home health aide services as often as necessary based on the patient's condition, but not less than once every sixty days, and (3) require the assessment prescribed by subdivision (2) of this subsection to be completed while the homemaker-home health aide is providing services in the patient's home. |
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| 31 | 31 | | |
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| 32 | 32 | | (h) On and after June 15, 2012, until June 30, 2017, the commissioner shall not issue or renew a license under this chapter for any hospital certified to participate in the Medicare program as a long-term care hospital under Section 1886(d)(1)(B)(iv) of the Social Security Act (42 USC 1395ww) unless such hospital was so certified under said federal act on January 1, 2012. |
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| 33 | 33 | | |
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| 34 | 34 | | Sec. 2. Section 19a-88 of the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2013): |
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| 35 | 35 | | |
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| 36 | 36 | | (a) Each person holding a license to practice dentistry, optometry, midwifery or dental hygiene shall, annually, during the month of such person's birth, register with the Department of Public Health, upon payment of the professional services fee for class I, as defined in section 33-182l, plus five dollars, in the case of a dentist, except as provided in sections 19a-88b and 20-113b; [,] the professional services fee for class H, as defined in section 33-182l, in the case of an optometrist, fifteen dollars in the case of a midwife; [,] and one hundred dollars in the case of a dental hygienist. [,] Such registration shall be on blanks to be furnished by the department for such purpose, giving such person's name in full, such person's residence and business address and such other information as the department requests. Each person holding a license to practice dentistry who has retired from the profession may renew such license, but the fee shall be ten per cent of the professional services fee for class I, as defined in section 33-182l, or [ninety] ninety-five dollars, whichever is greater. Any license provided by the department at a reduced fee pursuant to this subsection shall indicate that the dentist is retired. |
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| 37 | 37 | | |
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| 38 | 38 | | (b) Each person holding a license to practice medicine, surgery, podiatry, chiropractic or natureopathy shall, annually, during the month of such person's birth, register with the Department of Public Health, upon payment of the professional services fee for class I, as defined in section 33-182l. [,] Each person holding a license to practice medicine or surgery shall pay five dollars in addition to such services fee. Such registration shall be on blanks to be furnished by the department for such purpose, giving such person's name in full, such person's residence and business address and such other information as the department requests. |
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| 39 | 39 | | |
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| 40 | 40 | | (c) (1) Each person holding a license to practice as a registered nurse, shall, annually, during the month of such person's birth, register with the Department of Public Health, upon payment of one hundred five dollars, on blanks to be furnished by the department for such purpose, giving such person's name in full, such person's residence and business address and such other information as the department requests. Each person holding a license to practice as a registered nurse who has retired from the profession may renew such license, but the fee shall be ten per cent of the professional services fee for class B, as defined in section 33-182l. Any license provided by the department at a reduced fee shall indicate that the registered nurse is retired. |
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| 41 | 41 | | |
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| 42 | 42 | | (2) Each person holding a license as an advanced practice registered nurse shall, annually, during the month of such person's birth, register with the Department of Public Health, upon payment of one hundred [twenty] twenty-five dollars, on blanks to be furnished by the department for such purpose, giving such person's name in full, such person's residence and business address and such other information as the department requests. No such license shall be renewed unless the department is satisfied that the person maintains current certification as either a nurse practitioner, a clinical nurse specialist or a nurse anesthetist from one of the following national certifying bodies which certify nurses in advanced practice: The American Nurses' Association, the Nurses' Association of the American College of Obstetricians and Gynecologists Certification Corporation, the National Board of Pediatric Nurse Practitioners and Associates or the American Association of Nurse Anesthetists. Each person holding a license to practice as an advanced practice registered nurse who has retired from the profession may renew such license, but the fee shall be ten per cent of the professional services fee for class C, as defined in section 33-182l, plus five dollars. Any license provided by the department at a reduced fee shall indicate that the advanced practice registered nurse is retired. |
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| 43 | 43 | | |
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| 44 | 44 | | (3) Each person holding a license as a licensed practical nurse shall, annually, during the month of such person's birth, register with the Department of Public Health, upon payment of [sixty] sixty-five dollars, on blanks to be furnished by the department for such purpose, giving such person's name in full, such person's residence and business address and such other information as the department requests. Each person holding a license to practice as a licensed practical nurse who has retired from the profession may renew such license, but the fee shall be ten per cent of the professional services fee for class A, as defined in section 33-182l, plus five dollars. Any license provided by the department at a reduced fee shall indicate that the licensed practical nurse is retired. |
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| 45 | 45 | | |
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| 46 | 46 | | (4) Each person holding a license as a nurse-midwife shall, annually, during the month of such person's birth, register with the Department of Public Health, upon payment of one hundred [twenty] twenty-five dollars, on blanks to be furnished by the department for such purpose, giving such person's name in full, such person's residence and business address and such other information as the department requests. No such license shall be renewed unless the department is satisfied that the person maintains current certification from the American College of Nurse-Midwives. |
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| 47 | 47 | | |
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| 48 | 48 | | (5) (A) Each person holding a license to practice physical therapy shall, annually, during the month of such person's birth, register with the Department of Public Health, upon payment of the professional services fee for class B, as defined in section 33-182l, on blanks to be furnished by the department for such purpose, giving such person's name in full, such person's residence and business address and such other information as the department requests. |
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| 49 | 49 | | |
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| 50 | 50 | | (B) Each person holding a physical therapist assistant license shall, annually, during the month of such person's birth, register with the Department of Public Health, upon payment of the professional services fee for class A, as defined in section 33-182l, on blanks to be furnished by the department for such purpose, giving such person's name in full, such person's residence and business address and such other information as the department requests. |
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| 51 | 51 | | |
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| 52 | 52 | | (6) Each person holding a license as a physician assistant shall, annually, during the month of such person's birth, register with the Department of Public Health, upon payment of a fee of one hundred fifty dollars, on blanks to be furnished by the department for such purpose, giving such person's name in full, such person's residence and business address and such other information as the department requests. No such license shall be renewed unless the department is satisfied that the practitioner has met the mandatory continuing medical education requirements of the National Commission on Certification of Physician Assistants or a successor organization for the certification or recertification of physician assistants that may be approved by the department and has passed any examination or continued competency assessment the passage of which may be required by said commission for maintenance of current certification by said commission. |
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| 53 | 53 | | |
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| 54 | 54 | | (d) No provision of this section shall be construed to apply to any person practicing Christian Science. |
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| 55 | 55 | | |
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| 56 | 56 | | (e) (1) Each person holding a license or certificate issued under section 19a-514, 20-65k, 20-74s, 20-195cc or 20-206ll and chapters 370 to 373, inclusive, 375, 378 to 381a, inclusive, 383 to 383c, inclusive, 384, 384b, 384d, 385, 393a, 395, 399 or 400a and section 20-206n or 20-206o shall, annually, during the month of such person's birth, apply for renewal of such license or certificate to the Department of Public Health, giving such person's name in full, such person's residence and business address and such other information as the department requests. |
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| 57 | 57 | | |
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| 58 | 58 | | (2) Each person holding a license or certificate issued under section 19a-514 and chapters 384a, 384c, 386, 387, 388 and 398 shall apply for renewal of such license or certificate once every two years, during the month of such person's birth, giving such person's name in full, such person's residence and business address and such other information as the department requests. |
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| 59 | 59 | | |
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| 60 | 60 | | (3) Each person holding a license or certificate issued pursuant to section 20-475 or 20-476 shall, annually, during the month of such person's birth, apply for renewal of such license or certificate to the department. |
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| 61 | 61 | | |
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| 62 | 62 | | (4) Each entity holding a license issued pursuant to section 20-475 shall, annually, during the anniversary month of initial licensure, apply for renewal of such license or certificate to the department. |
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| 63 | 63 | | |
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| 64 | 64 | | (5) Each person holding a license issued pursuant to section 20-162bb shall, annually, during the month of such person's birth, apply for renewal of such license to the Department of Public Health, upon payment of a fee of three hundred fifteen dollars, giving such person's name in full, such person's residence and business address and such other information as the department requests. |
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| 65 | 65 | | |
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| 66 | 66 | | (f) Any person or entity which fails to comply with the provisions of this section shall be notified by the department that such person's or entity's license or certificate shall become void ninety days after the time for its renewal under this section unless it is so renewed. Any such license shall become void upon the expiration of such ninety-day period. |
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| 67 | 67 | | |
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| 68 | 68 | | (g) [On or before July 1, 2008, the] The Department of Public Health shall [establish and implement] administer a secure on-line license renewal system for persons holding a license to practice medicine or surgery under chapter 370, dentistry under chapter 379 or nursing under chapter 378. The department shall [allow any such person who renews his or her license using the on-line license renewal system to pay his or her] require such persons to renew their licenses using the on-line renewal system and to pay professional service fees on-line by means of a credit card or electronic transfer of funds from a bank or credit union account. [and may charge such person a service fee not to exceed five dollars for any such on-line payment made by credit card or electronic funds transfer. On or before January 1, 2009, the department shall submit, in accordance with section 11-4a, a report on the feasibility and implications of the implementation of a biennial license renewal system for persons holding a license to practice nursing under chapter 378 to the joint standing committee of the General Assembly having cognizance of matters relating to public health.] |
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| 69 | 69 | | |
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| 70 | 70 | | Sec. 3. (NEW) (Effective July 1, 2013) (a) The Commissioner of Public Health shall, within available appropriations, establish and administer a program to provide financial assistance to community health centers. For purposes of this section, "community health center" means a public or nonprofit private medical care facility that meets the requirements of section 19a-490a of the general statutes and has been designated by the United States Department of Health and Human Services as a federally qualified health center or a federally qualified health center look-alike. |
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| 71 | 71 | | |
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| 72 | 72 | | (b) The commissioner shall establish a formula to disburse program funds to community health centers. Such formula shall include, but not be limited to, the following factors: (1) The number of uninsured patients served by the community health center; and (2) the types of services provided by the community health center. |
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| 73 | 73 | | |
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| 74 | 74 | | (c) The commissioner may establish requirements for participation in the program, provided the commissioner provides reasonable notice of such requirements to all community health centers. Community health centers shall use program funds only for purposes approved by the commissioner. |
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| 75 | 75 | | |
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| 76 | 76 | | Sec. 4. Subsection (a) of section 19a-7j of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2013): |
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| 77 | 77 | | |
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| 78 | 78 | | (a) Not later than September first, annually, the Secretary of the Office of Policy and Management, in consultation with the Commissioner of Public Health, shall (1) determine the amount appropriated for the following purposes: (A) To purchase, store and distribute vaccines for routine immunizations included in the schedule for active immunization required by section 19a-7f; (B) to purchase, store and distribute (i) vaccines to prevent hepatitis A and B in persons of all ages, as recommended by the schedule for immunizations published by the National Advisory Committee for Immunization Practices, (ii) antibiotics necessary for the treatment of tuberculosis and biologics and antibiotics necessary for the detection and treatment of tuberculosis infections, and (iii) antibiotics to support treatment of patients in communicable disease control clinics, as defined in section 19a-216a; [and] (C) to administer the immunization program described in section 19a-7f; and (D) to provide services needed to collect up-to-date information on childhood immunizations for all children enrolled in Medicaid who reach two years of age during the year preceding the current fiscal year, to incorporate such information into the childhood immunization registry, as defined in section 19a-7h, and (2) inform the Insurance Commissioner of such amount. |
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| 79 | 79 | | |
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| 80 | 80 | | Sec. 5. Section 19a-639 of the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2013): |
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| 81 | 81 | | |
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| 82 | 82 | | (a) In any deliberations involving a certificate of need application filed pursuant to section 19a-638, the office shall take into consideration and make written findings concerning each of the following guidelines and principles: |
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| 83 | 83 | | |
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| 84 | 84 | | (1) Whether the proposed project is consistent with any applicable policies and standards adopted in regulations by the Department of Public Health; |
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| 85 | 85 | | |
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| 86 | 86 | | (2) The relationship of the proposed project to the state-wide health care facilities and services plan; |
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| 87 | 87 | | |
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| 88 | 88 | | (3) Whether there is a clear public need for the health care facility or services proposed by the applicant; |
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| 89 | 89 | | |
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| 90 | 90 | | (4) Whether the applicant has satisfactorily demonstrated how the proposal will impact the financial strength of the health care system in the state or that the proposal is financially feasible for the applicant; |
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| 91 | 91 | | |
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| 92 | 92 | | (5) Whether the applicant has satisfactorily demonstrated how the proposal will improve quality, accessibility and cost effectiveness of health care delivery in the region, including, but not limited to, (A) provision of or any change in the access to services for Medicaid recipients and indigent persons, and (B) the impact upon the cost effectiveness of providing access to services provided under the Medicaid program; |
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| 93 | 93 | | |
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| 94 | 94 | | (6) The applicant's past and proposed provision of health care services to relevant patient populations and payer mix, including, but not limited to, access to services by Medicaid recipients and indigent persons; |
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| 95 | 95 | | |
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| 96 | 96 | | (7) Whether the applicant has satisfactorily identified the population to be served by the proposed project and satisfactorily demonstrated that the identified population has a need for the proposed services; |
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| 97 | 97 | | |
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| 98 | 98 | | (8) The utilization of existing health care facilities and health care services in the service area of the applicant; [and] |
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| 99 | 99 | | |
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| 100 | 100 | | (9) Whether the applicant has satisfactorily demonstrated that the proposed project shall not result in an unnecessary duplication of existing or approved health care services or facilities; [.] and |
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| 101 | 101 | | |
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| 102 | 102 | | (10) Whether an applicant, who has failed to provide or reduced access to services by Medicaid recipients or indigent persons, has demonstrated good cause for doing so, which shall not be demonstrated solely on the basis of differences in reimbursement rates between Medicaid and other health care payers. |
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| 103 | 103 | | |
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| 104 | 104 | | (b) The office, as it deems necessary, may revise or supplement the guidelines and principles through regulation prescribed in subsection (a) of this section. |
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| 105 | 105 | | |
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| 106 | 106 | | Sec. 6. Section 19a-127k of the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2013): |
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| 107 | 107 | | |
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| 108 | 108 | | (a) As used in this section: |
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| 109 | 109 | | |
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| 110 | 110 | | (1) "Community benefits program" means any voluntary program to promote preventive care and to improve the health status for working families and populations at risk in the communities within the geographic service areas of a managed care organization or a hospital in accordance with guidelines established pursuant to subsection [(c)] (e) of this section; |
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| 111 | 111 | | |
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| 112 | 112 | | (2) "Community health needs assessment" means the needs assessment that a hospital organization is required to conduct every three years pursuant to Section 501(c)(3) of the Internal Revenue Code of 1986, or any subsequent corresponding internal revenue code of the United States, as amended from time to time; |
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| 113 | 113 | | |
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| 114 | 114 | | [(2)] (3) "Managed care organization" has the same meaning as provided in section 38a-478; |
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| 115 | 115 | | |
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| 116 | 116 | | [(3)] (4) "Hospital" has the same meaning as provided in section 19a-490; [.] |
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| 117 | 117 | | |
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| 118 | 118 | | (5) "Hospital organization" means a hospital that is or seeks to be recognized under Section 501(c)(3) of the Internal Revenue Code of 1986, or any subsequent corresponding internal revenue code of the United States, as amended from time to time; |
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| 119 | 119 | | |
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| 120 | 120 | | (6) "Widely available to the public" has the same meaning as in guidelines issued by the United States Internal Revenue Service. |
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| 121 | 121 | | |
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| 122 | 122 | | (b) Not later than January 1, 2014, each hospital organization shall make its community health needs assessment widely available to the public not later than fifteen days after submission to the United States Internal Revenue Service. Following completion of the initial community health needs assessment, each hospital organization, in accordance with the Internal Revenue Service requirements, shall complete and make widely available to the public an assessment once every three years. Unless contained in its community health needs assessment, a hospital organization shall make available to the public a description of the community served by the hospital organization, including a geographic description, a description of the general population served by the hospital organization and information concerning the leading causes of death, levels of chronic illness, and descriptions of the medically underserved, low-income, minority and chronically ill populations in the community. |
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| 123 | 123 | | |
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| 124 | 124 | | (c) Each hospital organization shall make widely available to the public a community benefit implementation strategy not later than one year after completing its community health needs assessment. In developing the community benefit implementation strategy, the hospital organization shall consult with community-based organizations and stakeholders, and local public health jurisdictions, as well as any additional consultations the hospital decides to undertake. Unless contained in the community benefit implementation strategy, the hospital organization shall provide a brief explanation for not accepting recommendations for community benefit proposals identified in the community health needs assessment through the stakeholder consultation process, such as excessive expense to implement or infeasibility of implementation of the proposal. Community benefit implementation strategies shall be evidence-based, when available, or development and implementation of innovative programs and practices shall be supported by evaluation measures. |
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| 125 | 125 | | |
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| 126 | 126 | | [(b)] (d) On or before January 1, 2005, and biennially thereafter, each managed care organization and each hospital shall submit to the Healthcare Advocate, or the Healthcare Advocate's designee, a report on whether the managed care organization or hospital has in place a community benefits program. If a managed care organization or hospital elects to develop a community benefits program, the report required by this subsection shall comply with the reporting requirements of subsection [(d)] (f) of this section. |
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| 127 | 127 | | |
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| 128 | 128 | | [(c)] (e) A managed care organization or hospital may develop community benefit guidelines intended to promote preventive care and to improve the health status for working families and populations at risk, whether or not those individuals are enrollees of the managed care plan or patients of the hospital. The guidelines shall focus on the following principles: |
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| 129 | 129 | | |
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| 130 | 130 | | (1) Adoption and publication of a community benefits policy statement setting forth the organization's or hospital's commitment to a formal community benefits program; |
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| 131 | 131 | | |
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| 132 | 132 | | (2) The responsibility for overseeing the development and implementation of the community benefits program, the resources to be allocated and the administrative mechanisms for the regular evaluation of the program; |
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| 133 | 133 | | |
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| 134 | 134 | | (3) Seeking assistance and meaningful participation from the communities within the organization's or hospital's geographic service areas in developing and implementing the program and in defining the targeted populations and the specific health care needs it should address. In doing so, the governing body or management of the organization or hospital shall give priority to the public health needs outlined in the most recent version of the state health plan prepared by the Department of Public Health pursuant to section 19a-7; and |
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| 135 | 135 | | |
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| 136 | 136 | | (4) Developing its program based upon an assessment of the health care needs and resources of the targeted populations, particularly low and middle-income, medically underserved populations and barriers to accessing health care, including, but not limited to, cultural, linguistic and physical barriers to accessible health care, lack of information on available sources of health care coverage and services, and the benefits of preventive health care. The program shall consider the health care needs of a broad spectrum of age groups and health conditions. |
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| 137 | 137 | | |
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| 138 | 138 | | [(d)] (f) Each managed care organization and each hospital that chooses to participate in developing a community benefits program shall include in the biennial report required by subsection [(b)] (d) of this section the status of the program, if any, that the organization or hospital established. If the managed care organization or hospital has chosen to participate in a community benefits program, the report shall include the following components: (1) The community benefits policy statement of the managed care organization or hospital; (2) the mechanism by which community participation is solicited and incorporated in the community benefits program; (3) identification of community health needs that were considered in developing and implementing the community benefits program; (4) a narrative description of the community benefits, community services, and preventive health education provided or proposed, which may include measurements related to the number of people served and health status outcomes; (5) measures taken to evaluate the results of the community benefits program and proposed revisions to the program; (6) to the extent feasible, a community benefits budget and a good faith effort to measure expenditures and administrative costs associated with the community benefits program, including both cash and in-kind commitments; and (7) a summary of the extent to which the managed care organization or hospital has developed and met the guidelines listed in subsection [(c)] (e) of this section. Each managed care organization and each hospital shall make a copy of the report available, upon request, to any member of the public. |
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| 139 | 139 | | |
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| 140 | 140 | | [(e)] (g) The Healthcare Advocate, or the Healthcare Advocate's designee, shall, within available appropriations, develop a summary and analysis of the community benefits program reports submitted by managed care organizations and hospitals under this section and shall review such reports for adherence to the guidelines set forth in subsection [(c)] (e) of this section. Not later than October 1, 2005, and biennially thereafter, the Healthcare Advocate, or the Healthcare Advocate's designee, shall make such summary and analysis available to the public upon request. |
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| 141 | 141 | | |
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| 142 | 142 | | [(f)] (h) The Healthcare Advocate may, after notice and opportunity for a hearing, in accordance with chapter 54, impose a civil penalty on any managed care organization or hospital that fails to submit the report required pursuant to this section by the date specified in subsection [(b)] (d) of this section. Such penalty shall be not more than fifty dollars a day for each day after the required submittal date that such report is not submitted. |
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| 143 | 143 | | |
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| 144 | 144 | | Sec. 7. Subsection (b) of section 19a-323 of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2013): |
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| 145 | 145 | | |
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| 146 | 146 | | (b) If death occurred in this state, the death certificate required by law shall be filed with the registrar of vital statistics for the town in which such person died, if known, or, if not known, for the town in which the body was found. The Chief Medical Examiner, Deputy Chief Medical Examiner, associate medical examiner, an authorized assistant medical examiner or other authorized designee shall complete the cremation certificate, stating that such medical examiner or other authorized designee has made inquiry into the cause and manner of death and is of the opinion that no further examination or judicial inquiry is necessary. The cremation certificate shall be submitted to the registrar of vital statistics of the town in which such person died, if known, or, if not known, of the town in which the body was found, or with the registrar of vital statistics of the town in which the funeral director having charge of the body is located. Upon receipt of the cremation certificate, the registrar shall authorize such certificate, keep such certificate on permanent record, and issue a cremation permit, except that if the cremation certificate is submitted to the registrar of the town where the funeral director is located, such certificate shall be forwarded to the registrar of the town where the person died to be kept on permanent record. If a cremation permit must be obtained during the hours that the office of the local registrar of the town where death occurred is closed, a subregistrar appointed to serve such town may authorize such cremation permit upon receipt and review of a properly completed cremation permit and cremation certificate. A subregistrar who is licensed as a funeral director or embalmer pursuant to chapter 385, or the employee or agent of such funeral director or embalmer shall not issue a cremation permit to himself or herself. A subregistrar shall forward the cremation certificate to the local registrar of the town where death occurred, not later than seven days after receiving such certificate. The estate of the deceased person, if any, shall pay the sum of one hundred fifty dollars for the issuance of the cremation certificate, provided the Office of the Chief Medical Examiner shall not assess any fees for costs that are associated with the cremation of a stillborn fetus. Upon request of the Chief Medical Examiner, the Secretary of the Office of Policy and Management may waive payment of such cremation certificate fee. No cremation certificate shall be required for a permit to cremate the remains of bodies pursuant to section 19a-270a. When the cremation certificate is submitted to a town other than that where the person died, the registrar of vital statistics for such other town shall ascertain from the original removal, transit and burial permit that the certificates required by the state statutes have been received and recorded, that the body has been prepared in accordance with the Public Health Code and that the entry regarding the place of disposal is correct. Whenever the registrar finds that the place of disposal is incorrect, the registrar shall issue a corrected removal, transit and burial permit and, after inscribing and recording the original permit in the manner prescribed for sextons' reports under section 7-66, shall then immediately give written notice to the registrar for the town where the death occurred of the change in place of disposal stating the name and place of the crematory and the date of cremation. Such written notice shall be sufficient authorization to correct these items on the original certificate of death. The fee for a cremation permit shall be three dollars and for the written notice one dollar. The Department of Public Health shall provide forms for cremation permits, which shall not be the same as for regular burial permits and shall include space to record information about the intended manner of disposition of the cremated remains, and such blanks and books as may be required by the registrars. |
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| 147 | 147 | | |
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| 148 | 148 | | |
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| 149 | 149 | | |
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| 150 | 150 | | |
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| 151 | 151 | | This act shall take effect as follows and shall amend the following sections: |
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| 152 | 152 | | Section 1 July 1, 2013 19a-491 |
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| 153 | 153 | | Sec. 2 October 1, 2013 19a-88 |
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| 154 | 154 | | Sec. 3 July 1, 2013 New section |
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| 155 | 155 | | Sec. 4 July 1, 2013 19a-7j(a) |
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| 156 | 156 | | Sec. 5 October 1, 2013 19a-639 |
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| 157 | 157 | | Sec. 6 October 1, 2013 19a-127k |
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| 158 | 158 | | Sec. 7 July 1, 2013 19a-323(b) |
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| 159 | 159 | | |
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| 160 | 160 | | This act shall take effect as follows and shall amend the following sections: |
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| 161 | 161 | | |
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| 162 | 162 | | Section 1 |
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| 163 | 163 | | |
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| 164 | 164 | | July 1, 2013 |
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| 165 | 165 | | |
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| 166 | 166 | | 19a-491 |
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| 167 | 167 | | |
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| 168 | 168 | | Sec. 2 |
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| 169 | 169 | | |
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| 170 | 170 | | October 1, 2013 |
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| 171 | 171 | | |
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| 172 | 172 | | 19a-88 |
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| 173 | 173 | | |
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| 174 | 174 | | Sec. 3 |
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| 175 | 175 | | |
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| 176 | 176 | | July 1, 2013 |
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| 177 | 177 | | |
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| 178 | 178 | | New section |
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| 179 | 179 | | |
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| 180 | 180 | | Sec. 4 |
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| 181 | 181 | | |
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| 182 | 182 | | July 1, 2013 |
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| 183 | 183 | | |
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| 184 | 184 | | 19a-7j(a) |
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| 185 | 185 | | |
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| 186 | 186 | | Sec. 5 |
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| 187 | 187 | | |
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| 188 | 188 | | October 1, 2013 |
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| 189 | 189 | | |
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| 190 | 190 | | 19a-639 |
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| 191 | 191 | | |
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| 192 | 192 | | Sec. 6 |
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| 193 | 193 | | |
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| 194 | 194 | | October 1, 2013 |
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| 195 | 195 | | |
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| 196 | 196 | | 19a-127k |
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| 197 | 197 | | |
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| 198 | 198 | | Sec. 7 |
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| 199 | 199 | | |
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| 200 | 200 | | July 1, 2013 |
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| 201 | 201 | | |
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| 202 | 202 | | 19a-323(b) |
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| 203 | 203 | | |
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| 204 | 204 | | |
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| 205 | 205 | | |
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| 206 | 206 | | PH Joint Favorable Subst. |
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| 207 | 207 | | APP Joint Favorable |
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