LCO No. 4657 1 of 10 General Assembly Raised Bill No. 6978 January Session, 2025 LCO No. 4657 Referred to Committee on PUBLIC HEALTH Introduced by: (PH) AN ACT CONCERNING THE DEPARTMENT OF PUBLIC HEALTH'S RECOMMENDATIONS REGARDING VARIOUS REVISIONS TO THE PUBLIC HEALTH STATUTES. Be it enacted by the Senate and House of Representatives in General Assembly convened: Section 1. Section 19a-6t of the general statutes is amended by adding 1 subsection (h) as follows (Effective from passage): 2 (NEW) (h) The council may apply for and accept grants, gifts, 3 bequests, sponsorships and in-kind donations of funds from federal and 4 interstate agencies, private firms, individuals and foundations for the 5 purpose of carrying out its responsibilities. 6 Sec. 2. Subsections (d) and (e) of section 19a-59h of the general 7 statutes are repealed and the following is substituted in lieu thereof 8 (Effective July 1, 2025): 9 (d) A hospital shall provide the department with access, including 10 remote access, to the entirety of a patient's medical record, as the 11 department deems necessary, to review case information related to a 12 maternal death case under review by the program. Such remote access 13 Raised Bill No. 6978 LCO No. 4657 2 of 10 shall be provided on or before October 1, 2022, if technically feasible. All 14 personal information obtained from the medical record [shall not be 15 divulged to anyone and] shall be held strictly confidential pursuant to 16 section 19a-25, as amended by this act, by the department. 17 (e) All information obtained by the department for the maternal 18 mortality review program shall be confidential pursuant to section 19a-19 25, as amended by this act. The department may use such information 20 to improve the accuracy of vital statistics data. 21 Sec. 3. Subsection (d) of section 19a-59i of the general statutes is 22 repealed and the following is substituted in lieu thereof (Effective July 1, 23 2025): 24 (d) Whenever a meeting of the maternal mortality review committee 25 takes place, the committee shall consult with relevant experts to 26 evaluate the information and findings obtained from the department 27 pursuant to section 19a-59h, as amended by this act, and make 28 recommendations regarding the prevention of maternal deaths. Not 29 later than ninety days after such meeting, the committee shall report, to 30 the Commissioner of Public Health, any recommendations and findings 31 of the committee in a manner that complies with section 19a-25, as 32 amended by this act. The department may use any finding of the 33 committee to improve the accuracy of vital statistics data. 34 Sec. 4. Subsection (a) of section 19a-25 of the general statutes is 35 repealed and the following is substituted in lieu thereof (Effective July 1, 36 2025): 37 (a) All information, records of interviews, written reports, statements, 38 notes, memoranda or other data, including personal data as defined in 39 subdivision (9) of section 4-190, procured by: (1) The Department of 40 Public Health, by staff committees of facilities accredited by the 41 Department of Public Health, the maternity mortality review 42 committee, established pursuant to section 19a-59i, as amended by this 43 act, or the infant mortality review committee, established pursuant to 44 Raised Bill No. 6978 LCO No. 4657 3 of 10 section 19a-59k, in connection with studies of morbidity and mortality 45 conducted by the Department of Public Health, such staff committees, 46 the maternal mortality review committee or the infant mortality review 47 committee, or carried on by said department, such staff committees or 48 the maternal mortality review committee jointly with other persons, 49 agencies or organizations, (2) the directors of health of towns, cities or 50 boroughs or the Department of Public Health pursuant to section 19a-51 215, or (3) the Department of Public Health or such other persons, 52 agencies or organizations, for the purpose of reducing the morbidity or 53 mortality from any cause or condition, shall be confidential and shall be 54 used solely for the purposes of (A) medical or scientific research, [and,] 55 (B) for information obtained pursuant to section 19a-215, disease 56 prevention and control by the local director of health and the 57 Department of Public Health, [and] (C) reducing the morbidity or 58 mortality from any cause or condition, (D) for information obtained by 59 the department for the maternal mortality review program pursuant to 60 section 19a-59h, as amended by this act, improving the accuracy of vital 61 statistics data, and (E) for findings of the maternal mortality review 62 committee, established pursuant to section 19a-59i, as amended by this 63 act, improving the accuracy of vital statistics data. Such information, 64 records, reports, statements, notes, memoranda or other data shall not 65 be admissible as evidence in any action of any kind in any court or 66 before any other tribunal, board, agency or person, nor shall it be 67 exhibited or its contents disclosed in any way, in whole or in part, by 68 any officer or representative of the Department of Public Health or of 69 any such facility, by any person participating in such a research project 70 or by any other person, except as may be necessary for the purpose of 71 furthering the research project or public health use to which it relates. 72 Sec. 5. Subsection (a) of section 19a-493 of the general statutes is 73 repealed and the following is substituted in lieu thereof (Effective October 74 1, 2025): 75 (a) Upon receipt of an application for an initial license, the 76 Department of Public Health, subject to the provisions of section 19a-77 Raised Bill No. 6978 LCO No. 4657 4 of 10 491a, shall issue such license if, upon conducting a scheduled inspection 78 and investigation, the department finds that the applicant and facilities 79 meet the requirements established under section 19a-495, provided a 80 license shall be issued to or renewed for an institution, as defined in 81 section 19a-490, only if such institution is not otherwise required to be 82 licensed by the state. If an institution, as defined in [subsections (b), (d), 83 (e) and (f) of] section 19a-490, except for a nursing home or nursing 84 home facility, as defined in section 19a-490, applies for license renewal 85 and, [has been] at the time of such application for license renewal, is 86 certified as a provider of services by the United States Department of 87 Health and Human Services under Medicare or Medicaid programs 88 [within the immediately preceding twelve-month period, or if an 89 institution, as defined in subsection (b) of section 19a-490, is currently 90 certified,] the commissioner or the commissioner's designee may waive, 91 on renewal of the institution's license, the inspection and investigation 92 of such [facility] institution required by this section and, in such event, 93 any such [facility] institution shall be deemed to have satisfied the 94 requirements of section 19a-495 for the purposes of licensure. Such 95 license shall be valid for two years or a fraction thereof and shall 96 terminate on March thirty-first, June thirtieth, September thirtieth or 97 December thirty-first of the appropriate year. A license issued pursuant 98 to this chapter, unless sooner suspended or revoked, shall be renewable 99 biennially (1) after an unscheduled inspection is conducted by the 100 department, and (2) upon the filing by the licensee, and approval by the 101 department, of a report upon such date and containing such information 102 in such form as the department prescribes and satisfactory evidence of 103 continuing compliance with requirements established under section 104 19a-495. In the case of an institution, as defined in subsection (d) of 105 section 19a-490, that is also certified as a provider under the Medicare 106 program, the license shall be issued for a period not to exceed three 107 years, to run concurrently with the certification period. In the case of an 108 institution, as defined in subsection (m) of section 19a-490, that is 109 applying for renewal, the license shall be issued pursuant to section 19a-110 491. Except in the case of a multicare institution, each license shall be 111 Raised Bill No. 6978 LCO No. 4657 5 of 10 issued only for the premises and persons named in the application. Such 112 license shall not be transferable or assignable. Licenses shall be posted 113 in a conspicuous place in the licensed premises. 114 Sec. 6. Section 19a-2a of the general statutes is repealed and the 115 following is substituted in lieu thereof (Effective from passage): 116 The Commissioner of Public Health shall employ the most efficient 117 and practical means for the prevention and suppression of disease and 118 shall administer all laws under the jurisdiction of the Department of 119 Public Health and the Public Health Code. The commissioner shall have 120 responsibility for the overall operation and administration of the 121 Department of Public Health. The commissioner shall have the power 122 and duty to: (1) Administer, coordinate and direct the operation of the 123 department; (2) adopt and enforce regulations, in accordance with 124 chapter 54, as are necessary to carry out the purposes of the department 125 as established by statute; (3) establish rules for the internal operation 126 and administration of the department; (4) establish and develop 127 programs and administer services to achieve the purposes of the 128 department as established by statute; (5) enter into a contract, including, 129 but not limited to, a contract with another state, for facilities, services 130 and programs to implement the purposes of the department as 131 established by statute; (6) designate a deputy commissioner or other 132 employee of the department to sign any license, certificate or permit 133 issued by said department; (7) conduct a hearing, issue subpoenas, 134 administer oaths, compel testimony and render a final decision in any 135 case when a hearing is required or authorized under the provisions of 136 any statute dealing with the Department of Public Health; (8) with the 137 health authorities of this and other states, secure information and data 138 concerning the prevention and control of epidemics and conditions 139 affecting or endangering the public health, and compile such 140 information and statistics and shall disseminate among health 141 authorities and the people of the state such information as may be of 142 value to them; (9) annually issue a list of reportable diseases, emergency 143 illnesses and health conditions and a list of reportable laboratory 144 Raised Bill No. 6978 LCO No. 4657 6 of 10 findings and amend such lists as the commissioner deems necessary and 145 distribute such lists as well as any necessary forms to each licensed 146 physician, licensed physician assistant, licensed advanced practice 147 registered nurse and clinical laboratory in this state. The commissioner 148 shall prepare printed forms for reports and returns, with such 149 instructions as may be necessary, for the use of directors of health, 150 boards of health and registrars of vital statistics; and (10) specify 151 uniform methods of keeping statistical information by public and 152 private agencies, organizations and individuals, including a client 153 identifier system, and collect and make available relevant statistical 154 information, including the number of persons treated, frequency of 155 admission and readmission, and frequency and duration of treatment. 156 The client identifier system shall be subject to the confidentiality 157 requirements set forth in section 17a-688 and regulations adopted 158 thereunder. The commissioner may designate any person to perform 159 any of the duties listed in subdivision (7) of this section. The 160 commissioner shall have authority over directors of health and may, for 161 cause, remove any such director; but any person claiming to be 162 aggrieved by such removal may appeal to the Superior Court which 163 may affirm or reverse the action of the commissioner as the public 164 interest requires. The commissioner shall assist and advise local 165 directors of health and district directors of health in the performance of 166 their duties, and may require the enforcement of any law, regulation or 167 ordinance relating to public health. In the event the commissioner 168 reasonably suspects impropriety on the part of a local director of health 169 or district director of health, or employee of such director, in the 170 performance of his or her duties, the commissioner shall provide 171 notification and any evidence of such impropriety to the appropriate 172 governing authority of the municipal health authority, established 173 pursuant to section 19a-200, or the district department of health, 174 established pursuant to section 19a-244, for purposes of reviewing and 175 assessing a director's or an employee's compliance with such duties. 176 Such governing authority shall provide a written report of its findings 177 from the review and assessment to the commissioner not later than 178 Raised Bill No. 6978 LCO No. 4657 7 of 10 ninety days after such review and assessment. When requested by local 179 directors of health or district directors of health, the commissioner shall 180 consult with them and investigate and advise concerning any condition 181 affecting public health within their jurisdiction. The commissioner shall 182 investigate nuisances and conditions affecting, or that he or she has 183 reason to suspect may affect, the security of life and health in any 184 locality and, for that purpose, the commissioner, or any person 185 authorized by the commissioner, may enter and examine any ground, 186 vehicle, apartment, building or place, and any person designated by the 187 commissioner shall have the authority conferred by law upon 188 constables. Whenever the commissioner determines that any provision 189 of the general statutes or regulation of the Public Health Code is not 190 being enforced effectively by a local health department or health district, 191 he or she shall forthwith take such measures, including the performance 192 of any act required of the local health department or health district, to 193 ensure enforcement of such statute or regulation and shall inform the 194 local health department or health district of such measures. In 195 September of each year the commissioner shall certify to the Secretary 196 of the Office of Policy and Management the population of each 197 municipality. The commissioner may solicit and accept for use any gift 198 of money or property made by will or otherwise, and any grant of or 199 contract for money, services or property from the federal government, 200 the state, any political subdivision thereof, any other state or any private 201 source, and do all things necessary to cooperate with the federal 202 government or any of its agencies in making an application for any grant 203 or contract. The commissioner may enter into such contracts or 204 agreements, in accordance with any established procedures, as may be 205 necessary for the distribution or use of said money, services or property 206 in accordance with any requirements to fulfill any conditions of a gift, 207 grant or contract. The commissioner may establish state-wide and 208 regional advisory councils. For purposes of this section, "employee of 209 such director" means an employee of, a consultant employed or retained 210 by or an independent contractor retained by a local director of health, a 211 district director of health, a local health department or a health district. 212 Raised Bill No. 6978 LCO No. 4657 8 of 10 Sec. 7. Section 20-99 of the general statutes is amended by adding 213 subsection (c) as follows (Effective from passage): 214 (NEW) (c) Nothing in this section shall prohibit the board from 215 holding a contested case hearing, in accordance with the provisions of 216 chapter 54, before (1) one or more hearing officers, or (2) one or more 217 members of the board pursuant to section 4-176e. 218 Sec. 8. Subsection (a) of section 19a-494 of the general statutes is 219 repealed and the following is substituted in lieu thereof (Effective from 220 passage): 221 (a) The Commissioner of Public Health, after a hearing held in 222 accordance with the provisions of chapter 54, may take any of the 223 following actions, singly or in combination, in any case in which the 224 commissioner finds that there has been a substantial failure to comply 225 with the requirements established under this chapter or requirements 226 relating to institutions established under this title, the Public Health 227 Code or licensing regulations: 228 (1) Revoke a license or certificate; 229 (2) Suspend a license or certificate; 230 (3) Censure a licensee or certificate holder; 231 (4) Issue a letter of reprimand to a licensee or certificate holder; 232 (5) Place a licensee or certificate holder on probationary status and 233 require such licensee or certificate holder to report regularly to the 234 department on the matters which are the basis of the probation; 235 (6) Restrict the acquisition of other facilities for a period of time set 236 by the commissioner; 237 (7) Issue an order compelling compliance with applicable statutes or 238 regulations of the department; 239 Raised Bill No. 6978 LCO No. 4657 9 of 10 (8) Impose a directed plan of correction; or 240 (9) Assess a civil penalty not to exceed twenty-five thousand dollars, 241 provided no such penalty shall be assessed for violations arising from 242 the investigation of a complaint filed with the Department of Public 243 Health before July 1, 2024, except for violations of regulatory 244 requirements relating to abuse or neglect of patients, as such terms are 245 defined in 42 CFR 483.5. 246 Sec. 9. Subsection (g) of section 19a-565 of the general statutes is 247 repealed and the following is substituted in lieu thereof (Effective from 248 passage): 249 (g) A license issued under this section may be revoked or suspended 250 in accordance with chapter 54 or subject to any other disciplinary action 251 specified in section [19a-17] 19a-494, as amended by this act, if the 252 licensed clinical laboratory, blood collection facility or source plasma 253 donation center has engaged in fraudulent practices, fee-splitting 254 inducements or bribes, including, but not limited to, in the case of a 255 clinical laboratory, violations of subsection (h) of this section, or violated 256 any other provision of this section or regulations adopted under this 257 section after notice and a hearing is provided in accordance with the 258 provisions of said chapter. 259 This act shall take effect as follows and shall amend the following sections: Section 1 from passage 19a-6t(h) Sec. 2 July 1, 2025 19a-59h(d) and (e) Sec. 3 July 1, 2025 19a-59i(d) Sec. 4 July 1, 2025 19a-25(a) Sec. 5 October 1, 2025 19a-493(a) Sec. 6 from passage 19a-2a Sec. 7 from passage 20-99(c) Sec. 8 from passage 19a-494(a) Sec. 9 from passage 19a-565(g) Raised Bill No. 6978 LCO No. 4657 10 of 10 Statement of Purpose: To implement the Department of Public Health's recommendations regarding various revisions to the public health statutes. [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.]