Connecticut 2021 Regular Session

Connecticut House Bill HB06489 Compare Versions

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7	9		General Assembly Raised Bill No. 6489
8	10		January Session, 2021
9	11		LCO No. 3619
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12	14		Referred to Committee on PUBLIC HEALTH
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15	17		Introduced by:
16	18		(PH)
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20	23		AN ACT CONCERNING TH E DEPARTMENT OF PUBL IC HEALTH'S
21	24		RECOMMENDATIONS REGA RDING REMOTE ACCESS TO MEDICAL
22	25		RECORDS MAINTAINED B Y HOSPITALS AND HEAL TH CARE
23	26		PROVIDERS.
24	27		Be it enacted by the Senate and House of Representatives in General
25	28		Assembly convened:
26	29
27	30		Section 1. Section 19a-215 of the general statutes is repealed and the 1
28	31		following is substituted in lieu thereof (Effective October 1, 2021): 2
29	32		(a) For the purposes of this section: 3
30	33		(1) "Clinical laboratory" means any facility or other area used for 4
31	34		microbiological, serological, chemical, hematological, 5
32	35		immunohematological, biophysical, cytological, pathological or other 6
33	36		examinations of human body fluids, secretions, excretions or excised or 7
34	37		exfoliated tissues, for the purpose of providing information for the 8
35	38		diagnosis, prevention or treatment of any human disease or 9
36	39		impairment, for the assessment of human health or for the presence of 10
37	40		drugs, poisons or other toxicological substances. 11
38	41		(2) "Commissioner's list of reportable diseases, emergency illnesses 12 Raised Bill No. 6489
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45	47		and health conditions" and "commissioner's list of reportable laboratory 13
46	48		findings" means the lists developed pursuant to section 19a-2a. 14
47	49		(3) "Confidential" means confidentiality of information pursuant to 15
48	50		section 19a-25. 16
49	51		(4) "Health care provider" means a person who has direct or 17
50	52		supervisory responsibility for the delivery of health care or medical 18
51	53		services, including licensed physicians, nurse practitioners, nurse 19
52	54		midwives, physician assistants, nurses, dentists, medical examiners and 20
53	55		administrators, superintendents and managers of health care facilities. 21
54	56		(5) "Reportable diseases, emergency illnesses and health conditions" 22
55	57		means the diseases, illnesses, conditions or syndromes designated by 23
56	58		the Commissioner of Public Health on the list required pursuant to 24
57	59		section 19a-2a. 25
58	60		(b) A health care provider shall report each case occurring in such 26
59	61		provider's practice, of any disease on the commissioner's list of 27
60	62		reportable diseases, emergency illnesses and health conditions to the 28
61	63		director of health of the town, city or borough in which such case resides 29
62	64		and to the Department of Public Health, no later than twelve hours after 30
63	65		such provider's recognition of the disease. Such reports shall be in 31
64	66		writing, by telephone or in an electronic format approved by the 32
65	67		commissioner. [Such reports of disease shall be confidential and not 33
66	68		open to public inspection except as provided for in section 19a-25.] 34
67	69		(c) A clinical laboratory shall report each finding identified by such 35
68	70		laboratory of any disease identified on the commissioner's list of 36
69	71		reportable laboratory findings to the Department of Public Health not 37
70	72		later than forty-eight hours after such laboratory's finding. A clinical 38
71	73		laboratory that reports an average of more than thirty findings per 39
72	74		month shall make such reports electronically in a format approved by 40
73	75		the commissioner. Any clinical laboratory that reports an average of less 41
74	76		than thirty findings per month shall submit such reports, in writing, by 42
75		-	telephone or in an electronic format approved by the commissioner. [All 43 Raised Bill No. 6489
	77	+	telephone or in an electronic format approved by the commissioner. [All 43
	78	+	such reports shall be confidential and not open to public inspection 44 Raised Bill No. 6489
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82		-	such reports shall be confidential and not open to public inspection 44
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83	84		except as provided for in section 19a-25.] The Department of Public 45
84	85		Health shall provide a copy of all such reports to the director of health 46
85	86		of the town, city or borough in which the affected person resides or, in 47
86	87		the absence of such information, the town where the specimen 48
87	88		originated. 49
88	89		(d) When a local director of health, the local director's authorized 50
89	90		agent or the Department of Public Health receives a report of a disease 51
90	91		or laboratory finding on the commissioner's lists of reportable diseases, 52
91	92		emergency illnesses and health conditions and laboratory findings, the 53
92	93		local director of health, the local director's authorized agent or the 54
93	94		Department of Public Health may contact first the reporting health care 55
94	95		provider and then the person with the reportable finding to obtain such 56
95	96		information as may be necessary to lead to the effective control of 57
96	97		further spread of such disease. In the case of reportable communicable 58
97	98		diseases and laboratory findings, this information may include 59
98	99		obtaining the identification of persons who may be the source or 60
99	100		subsequent contacts of such infection. 61
100	101		(e) A hospital, as defined in section 19a-490 and licensed pursuant to 62
101	102		chapter 368v, shall provide the Department of Public Health with access, 63
102	103		including remote access if technically feasible, in a manner approved by 64
103	104		the Commissioner of Public Health, to the entirety of each electronic 65
104	105		medical record that concerns a reportable disease, emergency illness or 66
105	106		health condition listed by the commissioner pursuant to subdivision (9) 67
106	107		of section 19a-2a that occurs at such hospital. 68
107	108		[(e)] (f) All personal information obtained from disease prevention 69
108	109		and control investigations [as performed in subsections (c) and (d) of] 70
109	110		pursuant to this section including the health care provider's name and 71
110	111		the identity of the reported case of disease and suspected source persons 72
111	112		and contacts shall not be divulged to anyone and shall be held strictly 73
112	113		confidential pursuant to section 19a-25, by the local director of health 74
113	114		and the director's authorized agent and by the Department of Public 75
114	115		Health. 76 Raised Bill No. 6489
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121	121		[(f)] (g) Any person who violates any reporting or confidentiality 77
122	122		provision of this section shall be fined not more than five hundred 78
123	123		dollars. No provision of this section shall be deemed to supersede 79
124	124		section 19a-584. 80
125	125		Sec. 2. Subsection (c) of section 19a-72 of the general statutes is 81
126	126		repealed and the following is substituted in lieu thereof (Effective October 82
127	127		1, 2021): 83
128	128		(c) [The] (1) A health care provider shall provide the Department of 84
129	129		Public Health, [shall be provided such] at the request of the department, 85
130	130		with access to the clinical records of any [health care provider] patient, 86
131	131		as the department deems necessary, to perform case finding or other 87
132	132		quality improvement audits to ensure completeness of reporting and 88
133	133		data accuracy consistent with the purposes of this section. 89
134	134		(2) A hospital shall provide the Department of Public Health with 90
135	135		access, including remote access if technically feasible, to the entirety of 91
136	136		a patient's medical record, as the department deems necessary, to 92
137	137		perform case finding or other quality improvement audits to ensure 93
138	138		completeness of reporting and data accuracy consistent with the 94
139	139		purposes of this section. No personal information obtained from the 95
140	140		medical record shall be divulged to anyone and shall be held strictly 96
141	141		confidential pursuant to section 19a-25 by the Department of Public 97
142	142		Health. 98
143	143		Sec. 3. (NEW) (Effective July 1, 2021) (a) On or after July 1, 2021, the 99
144	144		Department of Public Health shall establish a one-year pilot program to 100
145	145		initially test the impact of providing remote access to electronic medical 101
146	146		records maintained by a hospital, for the purposes of carrying out its 102
147	147		duties pursuant to sections 7-48, 7-60, 7-62b and 19a-53 of the general 103
148	148		statutes. A hospital, as identified by the Connecticut Hospital 104
149	149		Association, shall provide the Department of Public Health with remote 105
150	150		access to the entirety of a medical record, as the department deems 106
151	151		necessary, to perform quality improvement audits to ensure 107
152	152		completeness of reporting and data accuracy of birth, fetal death and 108 Raised Bill No. 6489
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159	158		death occurrences. No personal information obtained from the medical 109
160	159		record shall be divulged to anyone and shall be held strictly confidential 110
161	160		pursuant to section 19a-25 of the general statutes by the Department of 111
162	161		Public Health. 112
163	162		(b) On or after July 1, 2022, following implementation of the pilot 113
164	163		program established under subsection (a) of this section, the 114
165	164		Commissioner of Public Health shall evaluate said pilot program to 115
166	165		ascertain specific improved data accuracy, timeliness and any cost 116
167	166		efficiencies achieved. Not later than thirty days following completion of 117
168	167		said pilot program, the commissioner shall determine whether the 118
169	168		program shall be fully implemented. If the pilot program is to be fully 119
170	169		implemented, remote access shall be given on a continual basis to the 120
171	170		Department of Public Health to perform quality improvement audits to 121
172	171		ensure completeness of reporting and data accuracy of birth, fetal death 122
173	172		and death occurrences. 123
174	173		Sec. 4. Section 19a-59h of the general statutes is repealed and the 124
175	174		following is substituted in lieu thereof (Effective October 1, 2021): 125
176	175		(a) As used in this section and section 19a-59i, "maternal death" 126
177	176		means the death of a woman while pregnant or not later than one year 127
178	177		after the date on which the woman ceases to be pregnant, regardless of 128
179	178		whether the woman's death is related to her pregnancy, and 129
180	179		"department" means the Department of Public Health. 130
181	180		(b) There is established, within the department, a maternal mortality 131
182	181		review program. The program shall be responsible for identifying 132
183	182		maternal death cases in Connecticut and reviewing medical records and 133
184	183		other relevant data related to each maternal death case, including, but 134
185	184		not limited to, information collected from death and birth records, files 135
186	185		from the Office of the Chief Medical Examiner, and physician office and 136
187	186		hospital records. 137
188	187		(c) Licensed health care providers, health care facilities and 138
189		-	pharmacies shall provide the maternal mortality review program, 139 Raised Bill No. 6489
	188	+	pharmacies shall provide the maternal mortality review program, 139
	189	+	established under this section with reasonable access to all relevant 140 Raised Bill No. 6489
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196		-	established under this section with reasonable access to all relevant 140
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197	195		medical records associated with a maternal death case under review by 141
198	196		the program. 142
199	197		(d) A hospital shall provide the department with access, including 143
200	198		remote access if technically feasible, to the entirety of a patient's medical 144
201	199		record, as the department deems necessary, to review case information 145
202	200		related to a maternal death case under review by the program. All 146
203	201		personal information obtained from the medical record shall not be 147
204	202		divulged to anyone and shall be held strictly confidential pursuant to 148
205	203		section 19a-25 by the department. 149
206	204		[(d)] (e) All information obtained by the department for the maternal 150
207	205		mortality review program shall be confidential pursuant to section 19a-151
208	206		25. 152
209	207		[(e)] (f) Notwithstanding subsection [(d)] (e) of this section, the 153
210	208		department may provide the maternal mortality review committee, 154
211	209		established pursuant to section 19a-59i, with information as is necessary, 155
212	210		in the department's discretion, for the committee to make 156
213	211		recommendations regarding the prevention of maternal death. 157
214	212		This act shall take effect as follows and shall amend the following
215	213		sections:
216	214
217	215		Section 1 October 1, 2021 19a-215
218	216		Sec. 2 October 1, 2021 19a-72(c)
219	217		Sec. 3 July 1, 2021 New section
220	218		Sec. 4 October 1, 2021 19a-59h
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222		-	PH Joint Favorable
	220	+	Statement of Purpose:
	221	+	To allow the Department of Public Health to have remote access to
	222	+	electronic medical records of hospitals that involve reportable diseases,
	223	+	emergency illnesses and health conditions or reportable tumors, to
	224	+	establish a pilot program to determine the impact of providing remote
	225	+	access to certain electronic medical records maintained by a hospital and
	226	+	to require hospitals to provide the Department of Public Health with
	227	+	access to certain medical records related to maternal death. Raised Bill No. 6489
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	233	+	[Proposed deletions are enclosed in brackets. Proposed additions are indicated by underline, except
	234	+	that when the entire text of a bill or resolution or a section of a bill or resolution is new, it is not
	235	+	underlined.]
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