2022 -- H 7616

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LC004771

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     STATE OF RHODE ISLAND

IN GENERAL ASSEMBLY

JANUARY SESSION, A.D. 2022

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A N   A C T

RELATING TO STATE AFFAIRS AND GOVERNMENT -- DEPARTMENT OF HEALTHY

AGING

     Introduced By: Representatives Carson, Donovan, Ruggiero, McLaughlin, Cortvriend,
Speakman, Ajello, and Potter

     Date Introduced: March 02, 2022

     Referred To: House Finance

     It is enacted by the General Assembly as follows:

     SECTION 1. Legislative findings.

     The general assembly finds and declares as follows:

     (1) In the United States, there are approximately fifty-two (52) million people age sixty-

five (65) or older, according to the U.S. Census Bureau. This demographic is projected to almost

double in size by the year 2060, with a result that one out of five (5) people will be senior citizens.

Older adults are also predicted to outnumber children in the next ten (10) years. This significant

increase is largely due to many medical and technological improvements that have helped older

adults live longer.

     (2) Rhode Island currently has the eleventh (11th) largest concentration of elders in its

communities. There are currently two hundred ninety-eight thousand (298,000) senior residents in

the state, making up nearly one-third (1/3) of the population and close to fifty percent (50%) of the

voting public. Rhode Island’s older adult population is growing rapidly.

     (3) Rhode Island holds a special place in the country’s services for older adults. In 1965,

the year that both Medicare and Medicaid became law, former Rhode Island Congressman John E.

Fogarty introduced and won passage of H.R. 3708, The Older Americans Act of 1965 (OAA) (Pub.

L. 89–73, 79 Stat. 218). The OAA established the Administration on Aging (AOA), provided for

state grants “To provide assistance in the development of new or improved programs to help older

persons…”, and required states to develop and submit plans on aging to the AOA approval.

     (4) Senior centers have become one of the most widely used services among America’s

older adults, recognized by the OAA as a community focal point. Today, almost ten thousand

(10,000) senior centers enable one million individuals to stay healthy and independent by providing

meals, health programs, transportation, benefits counseling, employment, and more.

     (5) During the pandemic, senior centers became lifelines for homebound older adults by

offering home-delivered meals, telephone checks, and virtual programs. As the COVID-19 vaccine

became available, senior centers again stepped up to serve as vaccination sites and hubs of trusted

information about how to stay safe.

     (6) The federal government produced, Older Americans 2020: Key Indicators of Well-

Being (Older Americans 2020). The report provides a comprehensive picture of our older

population with an accessible compendium of indicators drawn from the most reliable and recent

official statistics. It includes strong language that would support the modernization of senior centers

to fill this tremendous need.

     (7) In 2011 the Rhode Island department of elderly affairs was changed to a division within

the department of human services. In 2019, the state budget bill included an article that made an

additional change to the division of elderly affairs and renamed it to the office of healthy aging

(OHA).

      (8) With a large percentage of the population at the age of sixty-five (65) and over, the

increasing needs of services in a post-pandemic world, and acknowledging that Rhode Island’s

older adults have spent a lifetime providing financial support to the current systems of education

and public service, the time has come to update and restructure the administration and delivery of

services.

     (9) The purpose of this legislation is to accelerate efforts to shift Rhode Island's narrative

on aging and to position the state to better meet the demands of our growing and vital constituency.

This bill serves as a blueprint for action to strengthen organizational operations and program

offerings while recognizing that people's needs and desires are diverse and multi-dimensional as

they age, by re-naming the office of healthy aging and establishing the department of healthy aging.

     SECTION 2. The title of Chapter 42-66 of the General Laws entitled "Office of Healthy

Aging" is hereby amended to read as follows:

CHAPTER 42-66

Office of Healthy Aging

CHAPTER 42-66

DEPARTMENT OF HEALTHY AGING

     SECTION 3. Sections 42-66-2, 42-66-3, 42-66-4, 42-66-5, 42-66-7, and 42-66-8 of the

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General Laws in Chapter 42-66 entitled "Office of Healthy Aging" are hereby amended to read as

follows:

     42-66-2. Establishment of department -- Director.

     There is established within the executive branch of state government a department of

elderly affairs healthy aging. The director of the department shall be the director of elderly affairs

healthy aging, appointed by and reporting directly to the governor, with the advice and consent of

the senate.

     42-66-3. Transfer of functions from the department of community affairs.

     There are transferred to the director of the department of elderly affairs healthy aging:

     (1) Those duties with respect to elderly citizens persons as enacted by former §§ 42-44-9

and 42-44-10;

     (2) So much of other functions or parts of functions of the director of the department of

community affairs; provided, however, that those duties with respect to housing facilities, projects,

and programs for the elderly shall be within the jurisdiction of the governor's office of

intergovernmental relations; and

     (3) Whenever in the general laws or in any public law the words "administration of division

of aging," "division on aging," and "director and/or department of community affairs," and the

"office of healthy aging shall appear in relation to elderly affairs ", the reference shall be deemed

to mean and include the director and the department of elderly affairs healthy aging, as the case

may be.

     42-66-4. Duties of the division Duties of the department of healthy aging.

     (a) The division department of healthy aging shall be the principal agency of the state to

mobilize the human, physical, and financial resources available to plan, develop, and implement

and bring awareness to innovative programs to ensure the dignity and independence of elderly

persons, including the planning, development, and implementation of a home- and long-term-care

program for the elderly in the communities of the state.

     (b)(1) The division department shall serve as an advocate for the needs of the adult with a

disability as these needs and services overlap the needs and services of elderly persons.

     (2) The division department shall serve as the state's central agency for the administration

and coordination of a long-term-care entry system, using community-based access points, that will

provide the following services related to long-term care: information and referral; initial screening

for service and benefits eligibility; and a uniform assessment program for state-supported long-

term care.

     (3) The division department shall investigate reports of elder abuse, neglect, exploitation,

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or self-neglect and shall provide and/or coordinate protective services.

     (4) The department shall monitor and maintain a strong relationship between the various

state agencies and the actual service providers for elderly persons.

     (c) To accomplish these objectives, the director is authorized:

     (1) To provide assistance to communities in solving local problems with regard to elderly

persons including, but not limited to, problems in identifying and coordinating local resources to

serve the needs of elderly persons;

     (2) To facilitate communications and the free flow of information and expand the lines of

communication between communities, seniors service providers, and the offices, agencies, and

employees of the state;

     (3) To encourage and assist communities, agencies, and state departments to plan, develop,

and implement home- and long-term care programs;

     (4) To provide and act as a clearinghouse for information, data, and other materials relative

to elderly persons;

     (5) To initiate and carry out studies and analyses that will aid in solving local, regional,

and statewide problems concerning elderly persons;

     (6) To coordinate those programs of other state agencies designed to assist in the solution

of local, regional, and statewide problems concerning elderly persons;

     (7) To advise and inform the governor on the affairs and problems of elderly persons in the

state;

     (8) To exercise the powers and discharge the duties assigned to the director in the fields of

health care, nutrition, homemaker services, geriatric day care, economic opportunity, local and

regional planning, transportation, and education and pre-retirement programs;

     (9) To further the cooperation of local, state, federal, and private agencies and institutions

providing for services or having responsibility for elderly persons;

     (10) To represent and act on behalf of the state in connection with federal grant programs

applicable to programs for elderly persons in the functional areas described in this chapter;

     (11) To seek, accept, and otherwise take advantage of all federal aid available to the

division, and to assist other agencies of the state, local agencies, and community groups in taking

advantage of all federal grants and subventions available for elderly persons and to accept other

sources of funds with the approval of the director of administration that shall be deposited as general

revenues;

     (12) To render advice and assistance to communities and other groups in the preparation

and submission of grant applications to state and federal agencies relative to programs for elderly

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persons;

     (13) To review and coordinate those activities of agencies of the state and of any political

subdivision of the state at the request of the subdivision, that affect the full and fair utilization of

community resources for programs for elderly persons, and initiate programs that will help ensure

such utilization;

     (14) To encourage the formation of councils on aging and to assist local communities in

the development of the councils;

     (15) To promote and coordinate daycare facilities for the frail elderly who are in need of

supportive care and supervision during the daytime;

     (16) To provide and coordinate the delivery of in-home services to the elderly, as defined

under the rules and regulations adopted by the office department of healthy aging;

     (17) To advise and inform the public of the risks of accidental hypothermia;

     (18) To establish a clearinghouse for information and education of the elderly citizens

persons of the state, including, but not limited to, and subject to available funding, a web-based

caregiver support information center;

     (19) [As amended by P.L. 2019, ch. 110, § 2]. To establish and operate, in collaboration

with the departments of behavioral health, developmental disabilities and hospitals; human

services; and children youth and families regular community agencies supporting caregivers, a

statewide family-caregiver support association and a family-caregiver resource network to provide

and coordinate family-caregiver training and support services to include counseling and elder

caregiver respite services, which shall be subject to available funding, and include home

health/homemaker care, adult day services, assisted living, and nursing facility care; and

     (19) [As amended by P.L. 2019, ch. 130, § 2]. To establish and operate, in collaboration

with the department of behavioral healthcare, developmental disabilities and hospitals; the

department of human services; the department of children, youth and families, and community

agencies supporting caregivers, a statewide family-caregiver support association and a family-

caregiver resource network to provide and coordinate family-caregiver training and support

services to include counseling and caregiver respite services, which shall be subject to available

funding, and include home health/homemaker care, adult day services, assisted living, and nursing

facility care; and

     (20) To supervise the citizens' commission for the safety and care of the elderly created

pursuant to the provisions of chapter 1.4 of title 12.

     (21) To protect and enable senior persons to stay healthy and independent by providing

meals, health programs, transportation, benefits counseling, employment, and more.

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     (22) To encourage the various state agencies to employ individuals that have expertise in

the areas of transportation, housing, nutrition, health, financial and economic literacy and stability,

lifelong learning, physical and social engagement, and adult protective services,

     (23) To provide professional development to agencies and programs providing senior

services.

     (24) To act as a liaison to governmental agencies advocating for aging issues.

     (25) To provide a clearing house for partnering agencies and businesses to assist senior

centers and municipalities to better serve their senior residents.

     (26) To appoint senior centers as the community hub for emergency service delivery.

     (27) To manage and develop a multi-tiered system of transportation that joins the

department of health and human services, the department of transportation and senior centers to

work with all available modes of public transportation at the municipal level to develop municipal

plans that suit the elderly population of each municipality.

     (28) To give senior centers and municipalities the authority to bill Medicaid for

transportation services.

     (29)To develop and submit to the general assembly for approval a funding formula that

meets the requirements and furthers the purposes of this chapter. The funding formula shall include:

     (i) Input from senior residents and their caregivers, and

     (ii) An allocation of funding to the municipality with a restriction that the money be used

only for the municipality’s senior center (s) based on the population of senior residents living in

the municipality.

     (d) In order to assist in the discharge of the duties of the division, the director may request

from any agency of the state information pertinent to the affairs and problems of elderly persons.

     42-66-5. Divisions of department.

     There shall be within the department of elderly affairs healthy aging a division of program

planning, development and operations and a division of community services.

     42-66-7. Advisory commission on aging.

     (a) Within the department of elderly affairs healthy aging there shall be an advisory

commission on aging consisting of twenty-five (25) members, four (4) of whom shall be from the

general assembly as hereinafter provided, and twenty-one (21) of whom shall be appointed by the

governor, thirteen (13) of whom shall be elderly consumers representative of that segment of the

population. In the case of members of the commission appointed by the governor, they shall be

chosen and shall hold office for three (3) years, except that in the original appointments, seven (7)

members shall be designated to serve for one year, seven (7) members shall be designated to serve

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for two (2) years and seven (7) members shall be designated to serve for three (3) years,

respectively, and until their respective successors are appointed and qualified. In the month of

February in each year the governor shall appoint successors to the members of the commission

whose terms shall expire in such year to hold office until the first day of March in the third year

after their appointment and until their respective successors are appointed and qualified.

     (b) The four (4) members from the general assembly shall be appointed, two (2) from the

house of representatives by the speaker, one from each of the two (2) major political parties, and

two (2) from the senate by the president of the senate, one each from the two (2) major political

parties, each to serve until the thirty-first day of December in the second year of the term to which

the member has been elected. Any vacancy, which may occur in the commission, shall be filled in

like manner as the original appointment, for the remainder of the unexpired term.

     (c) The members of the commission at the first meeting shall elect a chairperson and such

other officers as they may deem necessary. The commission shall meet at the call of the governor

or the chairperson and shall make suggestions to and advise the governor or the director concerning

the policies and problems confronting the aged and aging of the state. The members of the

commission shall serve without compensation but shall be compensated for their necessary and

actual traveling expenses in the performance of their official duties.

     42-66-8. Abuse, neglect, exploitation, and self-neglect of elderly persons -- Duty to

report.

     (a) Any person who has reasonable cause to believe that any person sixty (60) years of age

or older has been abused, neglected, or exploited, or is self-neglecting, shall make an immediate

report to the director of the office department of healthy aging, or his or her designee. The office

department of healthy aging may then notify law enforcement if appropriate. This section applies

to any person sixty (60) years of age or older regardless of where he or she lives in the community.

     (b) Any physician, physician assistant, medical intern, registered nurse, licensed practical

nurse, nurse's aide, orderly, certified nursing assistant, medical examiner, dentist, optometrist,

optician, chiropractor, podiatrist, coroner, police officer, probation officer, emergency medical

technician, firefighter, speech pathologist, audiologist, social worker, pharmacist, physical or

occupational therapist, or health officer, who has reasonable cause to believe that any person sixty

(60) years of age or older has been abused, neglected, or exploited, or is self-neglecting, shall make

an immediate report to the director of the office department of healthy aging, or his or her designee.

The office department of healthy aging may then notify law enforcement if appropriate. This

section applies to any person sixty (60) years of age or older regardless of where he or she lives in

the community. Reporting requirements relating to individuals in healthcare facilities are further

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set forth in § 23-17.8-2. The report pursuant to this section shall contain:

     (1) The name, address, telephone number, occupation, and employer's address and the

phone number of the person reporting;

     (2) The name and address of the patient or resident elderly person who is believed to be

the victim of the abuse, mistreatment, or neglect;

     (3) The details, observations, and beliefs concerning the incident(s);

     (4) Any statements regarding the incident made by the patient or resident elderly person

who is believed to be the victim and to whom they were made;

     (5) The date, time, and place of the incident;

     (6) The name of any individual(s) believed to have knowledge of the incident;

     (7) The name of any individual(s) believed to have been responsible for the incident;

     (8) The name of the individual's caretaker, if known;

     (9) Any medical treatment being received if immediately required and need to coordinate

care, if known;

     (10) Any other information the reporter believes relevant to the investigation; and

     (11) The name and address of the reporter and where the reporter can be contacted. The

reporter's identity shall remain confidential unless disclosure is consented to by the reporter or by

court order.

     (c) Individuals required to report pursuant to the provisions of subsection (b) of this section

shall, whenever practical and if known, provide twenty-four hour (24) notice of discharge to the

department and shall include the address and telephone number of the individual being discharged.

     (d) In cases of abuse, neglect, or exploitation, any person who fails to make the report shall

be punished by a fine of not more than one thousand dollars ($1,000). Nothing in this section shall

require an elder who is a victim of abuse, neglect, exploitation or who is self neglecting, to make a

report regarding such abuse, neglect, exploitation, or self-neglect to the director of the office

department of healthy aging, or his or her designee. The office department of healthy aging may

then notify law enforcement if appropriate.

     (e) No person required to report pursuant to the provisions of this section shall be liable in

any civil or criminal action by reason of the report; provided, however, that such person did not

perpetrate, inflict, or cause the abuse. No employer or supervisor may discharge, demote, transfer,

reduce pay, benefits, or work privileges; prepare a negative work performance evaluation; or take

any other action detrimental to an employee or supervisee who files a report in accordance with the

provisions of this section by reason of such report.

     SECTION 4. Sections 5-37-22 and 5-37-23 of the General Laws in Chapter 5-37 entitled

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"Board of Medical Licensure and Discipline" are hereby amended to read as follows:

     5-37-22. Disclosures.

     (a)(1) Any physician who is not a participant in a medical insurance plan shall post a notice,

in a conspicuous place in his or her medical offices where it can be read by his or her patients, that

reads, in substance, as follows:

     "To my patients:

     I do not participate in a medical insurance plan. You should know that you shall be

responsible for the payment of my medical fees."

     (2) Any physician who fails to post this notice shall not be entitled to charge his or her

patients any amount for medical fees in excess of that allowed had the physician participated in a

medical insurance plan.

     (b) Every physician shall disclose to patients eligible for Medicare, in advance of treatment,

whether the physician accepts assignment under Medicare reimbursement as payment in full for

medical services and/or treatment in the physician's office. This disclosure shall be given by posting

in each physician's office, in a conspicuous place, a summary of the physician's Medicare

reimbursement policy. Any physician who fails to make the disclosure as required in this section

shall not be allowed to charge the patient in excess of the Medicare assignment amount for the

medical procedure performed.

     (c) When a patient requests, in writing, that his or her medical records be transferred to

another physician or medical practice group, the original physician or medical-practice group shall

promptly honor the request. The physician or medical-practice group shall be reimbursed for

reasonable expenses (as defined by the director pursuant to § 23-1-48) incurred in connection with

copying the medical records.

     (d) Every physician or medical-practice group shall, upon written request of any patient (or

his or her authorized representative as defined in § 5-37.3-3(1)) who has received healthcare

services from the physician or medical-practice group, at the option of the physician or medical-

practice group either permit the patient (or his or her authorized representative) to examine and

copy the patient's confidential healthcare information, or provide the patient (or his or her

authorized representative) a summary of that information. If the physician or medical-practice

group decides to provide a summary and the patient is not satisfied with a summary, then the patient

may request, and the physician or medical-practice group shall provide, a copy of the entire record.

At the time of the examination, copying, or provision of summary information, the physician or

medical-practice group shall be reimbursed for reasonable expenses (as defined by the director

pursuant to § 23-1-48) in connection with copying this information. If, in the professional judgment

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of the treating physician, it would be injurious to the mental or physical health of the patient to

disclose certain confidential healthcare information to the patient, the physician or medical-practice

group shall not be required to disclose or provide a summary of that information to the patient, but

shall upon written request of the patient (or his or her authorized representative) disclose that

information to another physician or medical-practice group designated by the patient.

     (e) Every physician who has ownership interest in health facilities or laboratories, including

any healthcare facility licensed pursuant to chapter 17 of title 23, any residential-care/assisted-

living facility licensed pursuant to chapter 17.4 of title 23, any adult day-care program licensed or

certified by the director of the office department of healthy aging, or any equipment not on the

physician's premises, shall, in writing, make full patient disclosure of his or her ownership interest

in the facility or therapy prior to utilization. The written notice shall state that the patient has free

choice either to use the physician's proprietary facility or therapy or to seek the needed medical

services elsewhere.

     (f) Every physician who makes a referral of a patient to receive physical therapy services

shall provide the notice required by this section if the services are provided by employees or

independent contractors of the physician or if the entity is one in which the physician has an

ownership interest. Any such interest referenced in this paragraph shall be in accordance with

federal and state law, specifically including, but not limited to, chapter 48.1 of this title.

     (g) Unless otherwise expressly stated in writing by the medical-practice group, all medical

records shall be the property of the medical-practice group with which a physician is associated

when that physician created all such medical records. A medical-practice group shall provide

patients with access to patients' medical records in the same manner as is required of individual

physicians under this chapter. To the extent a medical-practice group fails to provide access to

patients in accordance with the requirements of this chapter, the individual officers of the medical-

practice group (or in the absence of officers, the shareholders or owners of the medical-practice

group), in their capacities as licensees of the board, shall be subject to the disciplinary powers of

the board.

     5-37-23. Over-billing reward program.

     (a) Any person sixty-five (65) years of age or older who is billed for healthcare services

that have never been provided to that person may report the billing error to the office department

of healthy aging. The division shall investigate the report.

     (b) The healthcare provider shall repay any verified billing error, and in addition shall pay

ten percent (10%) of the billing error to this patient. The ten percent (10%) award shall not preclude

recovery by the patient under any other provision of the Rhode Island general laws. Diagnostic-

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related group billings are exempt from the ten percent (10%) penalty.

     SECTION 5. Section 5-37.3-4 of the General Laws in Chapter 5-37.3 entitled

"Confidentiality of Health Care Communications and Information Act" is hereby amended to read

as follows:

     5-37.3-4. Limitations on and permitted disclosures.

     (a)(1) Except as provided in subsection (b), or as specifically provided by the law, a

patient's confidential healthcare information shall not be released or transferred without the written

consent of the patient, or his or her authorized representative, on a consent form meeting the

requirements of subsection (d). A copy of any notice used pursuant to subsection (d) and of any

signed consent shall, upon request, be provided to the patient prior to his or her signing a consent

form. Any and all managed care entities and managed care contractors writing policies in the state

shall be prohibited from providing any information related to enrollees that is personal in nature

and could reasonably lead to identification of an individual and is not essential for the compilation

of statistical data related to enrollees, to any international, national, regional, or local medical-

information database. This provision shall not restrict or prohibit the transfer of information to the

department of health to carry out its statutory duties and responsibilities.

     (2) Any person who violates the provisions of this section may be liable for actual and

punitive damages.

     (3) The court may award a reasonable attorney's fee at its discretion to the prevailing party

in any civil action under this section.

     (4) Any person who knowingly and intentionally violates the provisions of this section

shall, upon conviction, be fined not more than five thousand ($5,000) dollars for each violation, or

imprisoned not more than six (6) months for each violation, or both.

     (5) Any contract or agreement that purports to waive the provisions of this section shall be

declared null and void as against public policy.

     (b) No consent for release or transfer of confidential healthcare information shall be

required in the following situations:

     (1) To a physician, dentist, or other medical personnel who believes, in good faith, that the

information is necessary for diagnosis or treatment of that individual in a medical or dental

emergency;

     (2) To medical and dental peer-review boards, or the board of medical licensure and

discipline, or board of examiners in dentistry;

     (3) To qualified personnel for the purpose of conducting scientific research, management

audits, financial audits, program evaluations, actuarial, insurance underwriting, or similar studies;

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provided, that personnel shall not identify, directly or indirectly, any individual patient in any report

of that research, audit, or evaluation, or otherwise disclose patient identities in any manner;

     (4)(i) By a healthcare provider to appropriate law enforcement personnel, or to a person if

the healthcare provider believes that person, or his or her family, is in danger from a patient; or to

appropriate law enforcement personnel if the patient has, or is attempting to obtain, narcotic drugs

from the healthcare provider illegally; or to appropriate law enforcement personnel, or appropriate

child-protective agencies, if the patient is a minor child or the parent or guardian of said child and/or

the healthcare provider believes, after providing healthcare services to the patient, that the child is,

or has been, physically, psychologically, or sexually abused and neglected as reportable pursuant

to § 40-11-3; or to appropriate law enforcement personnel or the office department of healthy aging

if the patient is an elder person and the healthcare provider believes, after providing healthcare

services to the patient, that the elder person is, or has been, abused, neglected, or exploited as

reportable pursuant to § 42-66-8; or to law enforcement personnel in the case of a gunshot wound

reportable under § 11-47-48, or to patient emergency contacts and certified peer recovery

specialists notified in the case of an opioid overdose reportable under § 23-17.26-3;

     (ii) A healthcare provider may disclose protected health information in response to a law

enforcement official's request for such information for the purpose of identifying or locating a

suspect, fugitive, material witness, or missing person, provided that the healthcare provider may

disclose only the following information:

     (A) Name and address;

     (B) Date and place of birth;

     (C) Social security number;

     (D) ABO blood type and RH factor;

     (E) Type of injury;

     (F) Date and time of treatment;

     (G) Date and time of death, if applicable; and

     (H) A description of distinguishing physical characteristics, including height, weight,

gender, race, hair and eye color, presence or absence of facial hair (beard or moustache), scars, and

tattoos.

     (I) Except as permitted by this subsection, the healthcare provider may not disclose for the

purposes of identification or location under this subsection any protected health information related

to the patient's DNA or DNA analysis, dental records, or typing, samples, or analysis of body fluids

or tissue;

     (iii) A healthcare provider may disclose protected health information in response to a law

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enforcement official's request for such information about a patient who is, or is suspected to be, a

victim of a crime, other than disclosures that are subject to subsection (b)(4)(vii), if:

     (A) The patient agrees to the disclosure; or

     (B) The healthcare provider is unable to obtain the patient's agreement because of

incapacity or other emergency circumstances provided that:

     (1) The law enforcement official represents that the information is needed to determine

whether a violation of law by a person other than the victim has occurred, and such information is

not intended to be used against the victim;

     (2) The law enforcement official represents that immediate law enforcement activity that

depends upon the disclosure would be materially and adversely affected by waiting until the patient

is able to agree to the disclosure; and

     (3) The disclosure is in the best interests of the patient as determined by the healthcare

provider in the exercise of professional judgment;

     (iv) A healthcare provider may disclose protected health information about a patient who

has died to a law enforcement official for the purpose of alerting law enforcement of the death of

the patient if the healthcare provider has a suspicion that such death may have resulted from

criminal conduct;

     (v) A healthcare provider may disclose to a law enforcement official protected health

information that the healthcare provider believes in good faith constitutes evidence of criminal

conduct that occurred on the premises of the healthcare provider;

     (vi)(A) A healthcare provider providing emergency health care in response to a medical

emergency, other than such emergency on the premises of the covered healthcare provider, may

disclose protected health information to a law enforcement official if such disclosure appears

necessary to alert law enforcement to:

     (1) The commission and nature of a crime;

     (2) The location of such crime or of the victim(s) of such crime; and

     (3) The identity, description, and location of the perpetrator of such crime.

     (B) If a healthcare provider believes that the medical emergency described in subsection

(b)(4)(vi)(A) is the result of abuse, neglect, or domestic violence of the individual in need of

emergency health care, subsection (b)(4)(vi)(A) does not apply and any disclosure to a law

enforcement official for law enforcement purposes is subject to subsection (b)(4)(vii);

     (vii)(A) Except for reports permitted by subsection (b)(4)(i), a healthcare provider may

disclose protected health information about a patient the healthcare provider reasonably believes to

be a victim of abuse, neglect, or domestic violence to law enforcement or a government authority,

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including a social-service or protective-services agency, authorized by law to receive reports of

such abuse, neglect, or domestic violence:

     (1) To the extent the disclosure is required by law and the disclosure complies with, and is

limited to, the relevant requirements of such law;

     (2) If the patient agrees to the disclosure; or

     (3) To the extent the disclosure is expressly authorized by statute or regulation and:

     (i) The healthcare provider, in the exercise of professional judgment, believes the

disclosure is necessary to prevent serious harm to the patient or other potential victims; or

     (ii) If the patient is unable to agree because of incapacity, a law enforcement or other public

official authorized to receive the report represents that the protected health information for which

disclosure is sought is not intended to be used against the patient and that an immediate enforcement

activity that depends upon the disclosure would be materially and adversely affected by waiting

until the patient is able to agree to the disclosure.

     (B) A healthcare provider that makes a disclosure permitted by subsection (b)(4)(vii)(A)

must promptly inform the patient that such a report has been, or will be, made, except if:

     (1) The healthcare facility, in the exercise of professional judgment, believes informing the

patient would place the individual at risk of serious harm; or

     (2) The healthcare provider would be informing a personal representative, and the

healthcare provider reasonably believes the personal representative is responsible for the abuse,

neglect, or other injury, and that informing such person would not be in the best interests of the

individual as determined by the covered entity in the exercise of professional judgment;

     (viii) The disclosures authorized by this subsection shall be limited to the minimum amount

of information necessary to accomplish the intended purpose of the release of information;

     (5) Between, or among, qualified personnel and healthcare providers within the healthcare

system for purposes of coordination of healthcare services given to the patient and for purposes of

education and training within the same healthcare facility;

     (6) To third-party health insurers, including to utilization review agents as provided by §

23-17.12-9(c)(4), third-party administrators licensed pursuant to chapter 20.7 of title 27, and other

entities that provide operational support to adjudicate health insurance claims or administer health

benefits;

     (7) To a malpractice insurance carrier or lawyer if the healthcare provider has reason to

anticipate a medical-liability action;

     (8)(i) To the healthcare provider's own lawyer or medical-liability insurance carrier if the

patient whose information is at issue brings a medical-liability action against a healthcare provider.

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     (ii) Disclosure by a healthcare provider of a patient's healthcare information that is relevant

to a civil action brought by the patient against any person or persons other than that healthcare

provider may occur only under the discovery methods provided by the applicable rules of civil

procedure (federal or state). This disclosure shall not be through ex parte contacts and not through

informal ex parte contacts with the provider by persons other than the patient or his or her legal

representative.

     Nothing in this section shall limit the right of a patient, or his or her attorney, to consult

with that patient's own physician and to obtain that patient's own healthcare information;

     (9) To public-health authorities in order to carry out their functions as described in this title

and titles 21 and 23 and rules promulgated under those titles. These functions include, but are not

restricted to, investigations into the causes of disease, the control of public-health hazards,

enforcement of sanitary laws, investigation of reportable diseases, certification and licensure of

health professionals and facilities, review of health care such as that required by the federal

government and other governmental agencies;

     (10) To the state medical examiner in the event of a fatality that comes under his or her

jurisdiction;

     (11) In relation to information that is directly related to a current claim for workers'

compensation benefits or to any proceeding before the workers' compensation commission or

before any court proceeding relating to workers' compensation;

     (12) To the attorneys for a healthcare provider whenever that provider considers that

release of information to be necessary in order to receive adequate legal representation;

     (13) By a healthcare provider to appropriate school authorities of disease, health screening,

and/or immunization information required by the school; or when a school-age child transfers from

one school or school district to another school or school district;

     (14) To a law enforcement authority to protect the legal interest of an insurance institution,

agent, or insurance-support organization in preventing and prosecuting the perpetration of fraud

upon them;

     (15) To a grand jury, or to a court of competent jurisdiction, pursuant to a subpoena or

subpoena duces tecum when that information is required for the investigation or prosecution of

criminal wrongdoing by a healthcare provider relating to his, her or its provisions of healthcare

services and that information is unavailable from any other source; provided, that any information

so obtained, is not admissible in any criminal proceeding against the patient to whom that

information pertains;

     (16) To the state board of elections pursuant to a subpoena or subpoena duces tecum when

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that information is required to determine the eligibility of a person to vote by mail ballot and/or the

legitimacy of a certification by a physician attesting to a voter's illness or disability;

     (17) To certify, pursuant to chapter 20 of title 17, the nature and permanency of a person's

illness or disability, the date when that person was last examined and that it would be an undue

hardship for the person to vote at the polls so that the person may obtain a mail ballot;

     (18) To the central cancer registry;

     (19) To the Medicaid fraud control unit of the attorney general's office for the investigation

or prosecution of criminal or civil wrongdoing by a healthcare provider relating to his, her, or its

provision of healthcare services to then-Medicaid-eligible recipients or patients, residents, or

former patients or residents of long-term residential-care facilities; provided, that any information

obtained shall not be admissible in any criminal proceeding against the patient to whom that

information pertains;

     (20) To the state department of children, youth and families pertaining to the disclosure of

healthcare records of children in the custody of the department;

     (21) To the foster parent, or parents, pertaining to the disclosure of healthcare records of

children in the custody of the foster parent, or parents; provided, that the foster parent or parents

receive appropriate training and have ongoing availability of supervisory assistance in the use of

sensitive information that may be the source of distress to these children;

     (22) A hospital may release the fact of a patient's admission and a general description of a

patient's condition to persons representing themselves as relatives or friends of the patient or as a

representative of the news media. The access to confidential healthcare information to persons in

accredited educational programs under appropriate provider supervision shall not be deemed

subject to release or transfer of that information under subsection (a);

     (23) To the workers' compensation fraud prevention unit for purposes of investigation

under §§ 42-16.1-12 -- 42-16.1-16. The release or transfer of confidential healthcare information

under any of the above exceptions is not the basis for any legal liability, civil or criminal, nor

considered a violation of this chapter; or

     (24) To a probate court of competent jurisdiction, petitioner, respondent, and/or their

attorneys, when the information is contained within a decision-making assessment tool that

conforms to the provisions of § 33-15-47.

     (c) Third parties receiving, and retaining, a patient's confidential healthcare information

must establish at least the following security procedures:

     (1) Limit authorized access to personally identifiable confidential healthcare information

to persons having a "need to know" that information; additional employees or agents may have

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access to that information that does not contain information from which an individual can be

identified;

     (2) Identify an individual, or individuals, who have responsibility for maintaining security

procedures for confidential healthcare information;

     (3) Provide a written statement to each employee or agent as to the necessity of maintaining

the security and confidentiality of confidential healthcare information, and of the penalties provided

for in this chapter for the unauthorized release, use, or disclosure of this information. The receipt

of that statement shall be acknowledged by the employee or agent, who signs and returns the

statement to his or her employer or principal, who retains the signed original. The employee or

agent shall be furnished with a copy of the signed statement; and

     (4) Take no disciplinary or punitive action against any employee or agent solely for

bringing evidence of violation of this chapter to the attention of any person.

     (d) Consent forms for the release or transfer of confidential healthcare information shall

contain, or in the course of an application or claim for insurance be accompanied by a notice

containing, the following information in a clear and conspicuous manner:

     (1) A statement of the need for and proposed uses of that information;

     (2) A statement that all information is to be released or clearly indicating the extent of the

information to be released; and

     (3) A statement that the consent for release or transfer of information may be withdrawn at

any future time and is subject to revocation, except where an authorization is executed in connection

with an application for a life or health insurance policy in which case the authorization expires two

(2) years from the issue date of the insurance policy, and when signed in connection with a claim

for benefits under any insurance policy, the authorization shall be valid during the pendency of that

claim. Any revocation shall be transmitted in writing.

     (e) Except as specifically provided by law, an individual's confidential healthcare

information shall not be given, sold, transferred, or in any way relayed to any other person not

specified in the consent form or notice meeting the requirements of subsection (d) without first

obtaining the individual's additional written consent on a form stating the need for the proposed

new use of this information or the need for its transfer to another person.

     (f) Nothing contained in this chapter shall be construed to limit the permitted disclosure of

confidential healthcare information and communications described in subsection (b).

     SECTION 6. Sections 7-11.2-3 and 7-11.2-6 of the General Laws in Chapter 7-11.2 entitled

"Senior Savings Protection Act" are hereby amended to read as follows:

     7-11.2-3. Notification of agencies and family members.

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     If a qualified individual reasonably believes that financial exploitation of a qualified adult

has occurred, has been attempted, or is being attempted, the qualified individual shall notify the

department of business regulation as well as the office department of healthy aging and law

enforcement in accordance with § 42-66-8. Subsequent to providing this notification, an agent or

qualified individual may notify an immediate family member, legal guardian, conservator,

cotrustee, successor trustee, or agent under a power of attorney of the qualified adult of the belief.

     7-11.2-6. Website for training resources to prevent and detect financial exploitation.

     No later than July 1, 2020, the department of business regulation and the office department

of healthy aging shall develop and make available websites that include training resources to assist

broker-dealers and agents in the prevention and detection of financial exploitation of qualified

adults. The resources shall include, at a minimum, indicators of financial exploitation of qualified

adults and potential steps broker-dealers and agents may take to prevent suspected financial

exploitation of qualified adults as authorized by law.

     SECTION 7. Section 12-1.4-3 of the General Laws in Chapter 12-1.4 entitled "Citizens'

Commission for the Safety and Care of the Elderly" is hereby amended to read as follows:

     12-1.4-3. Purpose.

     The purpose of the commission shall be to act as a liaison between the legislature, public

safety officials, the office department of healthy aging, and the older population of Rhode Island in

the area of crime against the elderly, fire safety, and protective service options available to the

elderly.

     SECTION 8. Section 19-34-1 of the General Laws in Chapter 19-34 entitled "The Elder

Adult Financial Exploitation Prevention Act" is hereby amended to read as follows:

     19-34-1. Definitions.

     As used in this chapter:

     (1) "Department" means the Rhode Island office department of healthy aging.

     (2) "Elder adult" means a person who is sixty (60) years of age or older.

     (3) "Exploitation" means the fraudulent or otherwise illegal, unauthorized, or improper act

or process of an individual, including, but not limited to, a caregiver or fiduciary that uses the

resources of an elder adult for monetary or personal benefit, profit, gain, or that results in depriving

an elder adult of rightful access to or use of benefits, resources, belongings, or assets by use, undue

influence, harassment, duress, deception, false representation or false pretenses, or conduct in

violation of § 11-68-2.

     (4) "Financial exploitation" means:

     (i) The wrongful or unauthorized taking, withholding, appropriation, or use of the money,

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assets, or other property or the identifying information of a person; or

     (ii) Any act or omission taken by a person, including through the use of a power of attorney,

guardianship, or any other legal authority, regarding an elder adult to:

     (A) Obtain control through deception, intimidation, fraud, or undue influence, over the

other person's money, assets, or property to deprive the other person of the ownership, use, benefit,

or possession of the property; or

     (B) Convert the money, assets, or other property of the other person to deprive the other

person of the ownership, use, benefit, or possession of the property.

     (5) "Regulated institution" means any financial institution, credit union, or other insured

deposit-taking institution, that is authorized to do business in this state, including one authorized

by operation of an interstate banking statute that allowed it original entry.

     SECTION 9. Section 21-36-3 of the General Laws in Chapter 21-36 entitled "The Inter-

Agency Food & Nutrition Policy Advisory Council" is hereby amended to read as follows:

     21-36-3. Council composition.

     There shall be an inter-agency food and nutrition policy advisory council which shall

consist of seven (7) members: the director of health, or his or her designee; the director of

environmental management, or his or her designee; the director of administration, or his or her

designee; the director of the department of human services, or his or her designee; the director of

the office department of healthy aging, or his or her designee; the director of the department of

corrections, or his or her designee; and the commissioner of elementary and secondary education,

or his or her designee. The members of the commission shall elect a chairperson from among

themselves.

     SECTION 10. Sections 23-1.7-2 and 23-1.7-4 of the General Laws in Chapter 23-1.7

entitled "Rhode Island Program to Address Alzheimer's Disease" are hereby amended to read as

follows:

     23-1.7-2. Creation of advisory council.

     (a) There is hereby established a council to be called the "Advisory Council on Alzheimer's

Disease Research and Treatment." The advisory council shall consist of thirteen (13) members to

be composed as follows: the lieutenant governor, or designee; the director of the department of

health, or designee; the director of the office department of healthy aging, or designee; the

chairperson of the long-term care coordinating council; one member appointed by the speaker of

the house; one member appointed by the president of the senate; and seven (7) members appointed

by the governor. The members appointed by the governor shall include one member who is an

Alzheimer's disease patient advocate; one member who is an Alzheimer's disease caregiver; one

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member who is a healthcare provider; one member who is a researcher with Alzheimer's-related

expertise in basic, translational, clinical, or drug-development science; one member who is a

representative from an Alzheimer's disease organization that funds research and has demonstrated

experience in care and patient services; one member from an Alzheimer's advocacy organization

that provides services to families and professionals, including information and referrals, support

groups, care consultation, education, and safety services; and one member who is a representative

of a healthcare insurer. Advisory council members shall select their own chairperson. Seven (7)

members shall constitute a quorum.

     (b) The member appointed by the speaker of the house,, the member appointed by the

president of the senate, and three (3) members appointed by the governor shall be initially appointed

for a term to expire July 1, 2020, and four (4) members to be appointed by the governor shall be

initially appointed for a term to expire July 1, 2021. After the initial term, the appointed members

shall serve two-year (2) terms, until their successor is appointed.

     23-1.7-4. Assessment protocol.

     (a) The director of the department of health shall establish and publish an Alzheimer's

disease assessment protocol specifically focused on recognizing the signs and symptoms of

cognitive impairments, including, but not limited to, Alzheimer's disease and appropriate resource

information for effective medical screening, investigation, and service planning.

     (b) The director of the department of health shall make available upon request a copy of

the assessment protocol to protective-services caseworkers, healthcare professionals, and members

of the public.

     (c) Protective-services caseworkers assigned to or employed by the office department of

healthy aging shall be familiar with the information contained in the assessment protocol.

     SECTION 11. Section 23-17.3-2 of the General Laws in Chapter 23-17.3 entitled "Long-

Term Care Coordinating Council" is hereby amended to read as follows:

     23-17.3-2. Membership.

     The council shall be comprised of thirty-three (33) members, as follows: the lieutenant

governor or designee; the director of the department of health or designee; the secretary of the

executive office of health and human services or designee; the director of the department of

behavioral healthcare, developmental disabilities and hospitals or designee; the attorney general or

designee; the director of the office department of healthy aging or designee; the chair of the Rhode

Island advisory commission on aging or designee; the director of the Rhode Island Chapter of the

American Association of Retired Persons (AARP) or designee; the state long-term care

ombudsman or designee; the president of the Rhode Island Senior Center Directors Association or

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designee; the executive director of the Rhode Island chapter of the Alzheimer's Association or

designee; a representative of a not-for-profit long-term-care provider organization other than a

nursing home owner and a representative of a long-term-care service provider that primarily serves

persons with developmental disabilities, both to be appointed by the governor; a representative of

an assisted living residence other than a nursing home, to be appointed by the lieutenant governor;

a public member with no direct interest in long-term-care ownership representing a senior advocacy

organization, to be appointed by the speaker; a representative of the state program of all inclusive

care for the elderly, to be appointed by the lieutenant governor; a representative of senior housing,

to be appointed by the lieutenant governor; a representative of a hospice provider organization, to

be appointed by the senate president; a licensed home-care provider or a licensed home nursing

care provider, to be appointed by the speaker; a representative of a community mental health center,

to be appointed by the president of the senate; a registered nurse experienced in the care of the

elderly, to be appointed by the governor; a representative of nonmanagerial nursing home

employees, to be appointed by the president of the senate; two (2) members of the house, not more

than one (1) from the same political party, to be appointed by the speaker; a nursing home owner,

to be appointed by the speaker; two (2) members of the senate, not more than one from the same

political party, to be appointed by the president of the senate; one consumer of home- and

community-based care or a caregiver of a consumer of home- and community-based care, to be

appointed by the lieutenant governor; one consumer of behavioral health services or a caregiver of

a consumer of behavioral health services, to be appointed by the speaker; a member of the public

representing the interests of parents of children with special care needs, to be appointed by the

governor; a person with developmental disabilities or a representative of an organization that

advocates for the rights of persons with developmental disabilities, to be appointed by the lieutenant

governor; a general physician or advanced practice nurse with experience in serving persons with

long-term care and behavioral health needs, to be appointed by the president of the senate; and a

representative of a managed care health insurer providing long-term support and services, to be

appointed by the governor. The members of the council shall serve two-year (2) terms, expiring on

the second anniversary of each individual's appointment or on the date that their respective

successors are appointed and qualified, whichever is later.

     SECTION 12. Section 23-17.17-6 of the General Laws in Chapter 23-17.17 entitled

"Health Care Quality Program" is hereby amended to read as follows:

     23-17.17-6. Health care quality steering committee.

     (a) The director shall establish and serve as chairperson of a health care quality steering

committee of no more than nineteen (19) members to advise in the following matters:

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     (1) Determination of the comparable performance measures to be reported on;

     (2) Assessment of factors, including, but not limited to, factors related to incidents and

events reported to the department pursuant to § 23-17-40, contributing to the provision of quality

health care and patient safety;

     (3) Selection of the patient satisfaction survey measures and instrument;

     (4) Methods and format for data collection;

     (5) Program expansion and quality improvement initiatives;

     (6) Format for the public quality performance measurement report;

     (7) Consideration of nursing-sensitive performance measures to be reported on;

     (8) Consideration of the relationship between human resources and quality, beginning with

measurement and reporting for nursing staff;

     (9) Consideration of measures associated with hospital-acquired infections with

consultation of infections control experts and with the hospital-acquired infections and prevention

advisory committee as established herein:

     (i) Hospital-acquired infections and prevention advisory committee:

     (A) The director of the department of health as the chairperson of the steering committee

shall appoint a permanent subcommittee called the hospital-acquired infections and prevention

advisory committee. Membership shall include representatives from public and private hospitals,

infection control professionals, director care nursing staff, physicians, epidemiologists with

expertise in hospital-acquired infections, academic researchers, consumer organizations, health

insurers, health maintenance organizations, organized labor, and purchasers of health insurance,

such as employers. The advisory committee shall have a majority of members representing the

infection control community.

     (B) The director of the department of health shall conduct a national and state specific

public reporting format scan of hospital acquired infection public reporting to be completed and

transmitted to the steering committee and referred to the advisory committee by October 1, 2008.

     (C) The advisory committee shall assist and advise the steering committee and the

department in the development of all aspects of the department's methodology for collecting,

analyzing, and disclosing the information collected under this act, including collection methods,

formatting, and methods and means for release and dissemination.

     (D) In developing the methodology for collecting and analyzing the hospital infection data,

the department, steering committee and advisory committee shall consider existing methodologies

and systems for data collection, such as the centers for disease control's national healthcare safety

network, or its successor; provided, however, the department's discretion to adopt a methodology

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shall not be limited or restricted to any existing methodology or system. The data collection and

analysis methodology shall be disclosed with the public report at the time of release.

     (E) The department, steering committee and the advisory committee shall evaluate, on a

regular basis, the quality and accuracy of hospital information reported under this act chapter and

the data collection, analysis, and dissemination methodologies.

     (ii) Hospital reports:

     (A) Individual hospitals shall collect data on hospital-acquired infections for the specific

clinical procedures determined by the department by regulation, which may include the following

general categories as further defined by the advisory committee:

     (I) Surgical site infections;

     (II) Ventilator-associated pneumonia;

     (III) Central line-related bloodstream infections;

     (IV) Urinary tract infections;

     (V) Process of care measures, such as compliance with the surgical infection

prevention/surgical care improvement program (SIP/SCIP) parameters, prevention bundles for

central line-associated bloodstream infections, prevention bundles for catheter-associated urinary

tract infections, hand hygiene compliance, compliance with isolation precautions; and

     (VI) Other categories as recommended by the advisory committee.

     (B) Beginning on or before April 1, 2009, hospitals shall submit quarterly reports on their

hospital-acquired infection rates to the department. Quarterly reports shall be submitted, in a format

set forth in regulations adopted by the department. Data in quarterly reports must cover a period

ending not earlier than one month prior to submission of the report. Annual reports shall be made

available to the public at each hospital and through the department. The first annual report shall be

due no later than October 2010.

     (C) The advisory committee shall recommend standardized criteria for reporting surgical

site infection outcome data for quality improvement recommendations. This will include standards

for post discharge surveillance. The information shall be included in hospital's quality improvement

and safety plan to reduce surgical site infection. The advisory committee shall recommend written

guidelines to be given to every individual before and if necessary during their hospitalization for

the purpose of preventing hospital-acquired infections. In emergency hospitalizations, written

guidelines shall be given within a reasonable period of time.

     (D) If the hospital is a division or subsidiary of another entity that owns or operates other

hospitals or related organizations, the quarterly report shall be for the specific division or subsidiary

and not the other entity.

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     (iii) Department reports:

     (A) The department shall annually submit to the legislature a report summarizing the

hospital quarterly reports and shall publish the annual report on its website. The first annual report

shall be submitted and published no later than December 2010. Following the initial report, the

department shall update the public information on a yearly basis after it has been reviewed by the

steering committee with advice from the hospital-acquired infections and prevention advisory

committee.

     (B) All reports of outcome measures issued by the department may be risk-adjusted using

NHSN methodology or other nationally accepted methodology, to adjust for the differences among

hospitals as reviewed and recommended by the hospital-acquired infections and prevention

advisory committee.

     (C) The annual report shall compare hospital-acquired infection data as recommended by

the advisory committee, collected under subsection (9)(B), for each individual hospital in the state.

The department, in consultation with the advisory committee, shall make this comparison as easy

to comprehend as possible. The report shall also include an executive summary, written in plain

language that shall include, but not be limited to, a discussion of findings, conclusions, and trends

concerning the overall state of hospital-acquired infections in the state, including a comparison to

prior years. The report may include policy recommendations, as appropriate.

     (D) The department shall publicize the report and its availability as widely as practical to

interested parties, including, but not limited to, hospitals, providers, media organizations, health

insurers, health maintenance organizations, purchasers of health insurance, organized labor,

consumer or patient advocacy groups, and individual consumers. The annual report shall be made

available to any person upon request.

     (E) No hospital report of department disclosure may contain information identifying a

patient, employee, or licensed healthcare professional in connection with a specific infection

incident.

     (10) Consideration of pressure ulcer occurrence; and

     (11) Other related issues as requested by the director.

     (b) The members of the health care quality performance steering committee shall include

one member of the house of representatives, to be appointed by the speaker; one member of the

senate, to be appointed by the president of the senate; the director or director's designee of the

department of human services; the director or the director's designee of the department of

behavioral healthcare, developmental disabilities and hospitals; the director or the director's

designee of the office department of healthy aging; and thirteen (13) members to be appointed by

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the director of the department of health to include persons representing Rhode Island licensed

hospitals and other licensed facilities/providers, the medical and nursing professions, the business

community, organized labor, consumers, and health insurers and health plans and other parties

committed to healthcare quality.

     SECTION 13. Sections 30-17.1-9 and 30-17.1-10 of the General Laws in Chapter 30-17.1

entitled "Veterans' Affairs" are hereby amended to read as follows:

     30-17.1-9. Definitions.

     When used in this chapter, the following terms shall have the following meanings:

     (1) "Advisory committee" means the veterans' services strategic plan advisory committee

as established in § 30-17.1-10.

     (2) "Committee" means the veterans' committee pursuant to the provisions of § 30-17.1-

11(c).

     (3) "State agencies" means state entities responsible for the implementation of services for

Rhode Island veterans and their families including:

     (i) The office of veterans services;

     (ii) The Rhode Island public transit authority;

     (iii) The department of human services;

     (iv) The office of postsecondary education;

     (v) The department of behavioral healthcare, developmental disabilities and hospitals;

     (vi) The department of health;

     (vii) The office department of healthy aging;

     (viii) The department of business regulation;

     (ix) The Rhode Island veteran's court;

     (x) The department of labor and training;

     (xi) The Rhode Island commerce corporation;

     (xii) The office of the secretary of state; and

     (xiii) The Rhode Island national guard.

     (4) "Veterans' services strategic plan ('VSSP')" means the strategic plan as established in §

30-17.1-11.

     30-17.1-10. Veterans' services strategic plan advisory committee established.

     (a) There is hereby created a veterans' services strategic plan advisory committee known

as "the Rhode Island veterans' services strategic plan advisory committee" consisting of fourteen

(14) members as follows:

     (1) One of whom shall be the director of the office of veterans services, or his or her

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designee, who shall serve as chairperson;

     (2) One of whom shall be the director of the department of human services, or his or her

designee;

     (3) One of whom shall be the executive director of the public transit authority, or his or her

designee;

     (4) One of whom shall be the postsecondary education commissioner, or his or her

designee;

     (5) One of whom shall be the director of the department of behavioral healthcare,

developmental disabilities and hospitals, or his or her designee;

     (6) One of whom shall be the director of the department of health, or his or her designee;

     (7) One of whom shall be the director of the office department of healthy aging, or his or

her designee;

     (8) One of whom shall be the director of the department of business regulation, or his or

her designee;

     (9) One of whom shall be the chief judge of the district court, or his or her designee;

     (10) One of whom shall be the director of the department of labor and training, or his or

her designee;

     (11) One of whom shall be the director of the Rhode Island commerce corporation, or his

or her designee;

     (12) One of whom shall be the secretary of state, or his or her designee;

     (13) One of whom shall be the adjutant general of the Rhode Island national guard, or his

or her designee; and

     (14) One of whom shall be a representative for Rhode Island municipal governments.

     (b) Forthwith upon the passage of this chapter, the members of the advisory committee

shall meet at the call of the chairperson and organize. Thereafter, the committee shall meet at the

call of the chairperson or three (3) members of the advisory committee.

     (c) All departments and agencies of the state shall furnish such advice and information,

documentation, and otherwise to the committee and its agents as is deemed necessary or desirable

by the advisory committee to facilitate the purposes of this chapter.

     (d) The office of veterans services is hereby directed to provide suitable quarters and staff

for the advisory committee.

     (e) [Deleted by P.L. 2017, ch. 131, § 1 and P.L. 2017, ch. 152, § 1].

     (f) The members of the advisory committee shall receive no compensation for their

services.

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     SECTION 14. Section 23-17.8-2 of the General Laws in Chapter 23-17.8 entitled "Abuse

in Healthcare Facilities" is hereby amended to read as follows:

     23-17.8-2. Duty to report.

     (a) Any physician, physician assistant, medical intern, registered nurse, licensed practical

nurse, nurse's aide, orderly, certified nursing assistant, medical examiner, dentist, optometrist,

optician, chiropractor, podiatrist, coroner, police officer, probation officer, emergency medical

technician, firefighter, speech pathologist, audiologist, social worker, pharmacist, physical or

occupational therapist, or health officer, or any person, within the scope of their employment at a

facility or in their professional capacity, who has knowledge of or reasonable cause to believe that

a patient or resident in a facility has been abused, mistreated, or neglected, either while in the

facility or prior to being admitted, shall make, within twenty-four (24) hours or by the end of the

next business day, a telephone report to the director of the department of health, or his or her

designee, for those incidents involving healthcare facilities, and in addition to the office department

of the state long-term care ombudsperson for those incidents involving nursing facilities, assisted

living residences, home-care and home nursing-care providers, veterans' homes and long-term care

units in Eleanor Slater hospital, or to the director of the department of behavioral healthcare,

developmental disabilities and hospitals, or his or her designee, for those incidents involving

community residences for people with developmental disabilities or the director of the office

department of healthy aging for individuals aged sixty (60) years or older. The report shall contain:

     (1) The name, address, telephone number, occupation, and employer's address and the

phone number of the person reporting;

     (2) The name and address of the patient or resident who is believed to be the victim of the

abuse, mistreatment, or neglect;

     (3) The details, observations, and beliefs concerning the incident(s);

     (4) Any statements regarding the incident made by the patient or resident and to whom they

were made;

     (5) The date, time, and place of the incident;

     (6) The name of any individual(s) believed to have knowledge of the incident;

     (7) The name of any individual(s) believed to have been responsible for the incident;

     (8) The name of the individual's caregiver, if known;

     (9) Any medical treatment being received if immediately required and need to coordinate

care, if known;

     (10) Any other information the reporter believes relevant to the investigation; and

     (11) The name and address of the reporter and where the reporter can be contacted. The

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reporter's identity shall remain confidential unless disclosure is consented to by the reporter or by

court order.

     (b) In addition to those persons required to report pursuant to this section, any other person

may make a report if that person has reasonable cause to believe that a patient or resident of a

facility has been abused, mistreated, or neglected. Additional provisions for the reporting of abuse

of individuals regardless of where they reside in the community are set forth in § 42-66-8.

     (c) Any person required to make a report pursuant to this section shall be deemed to have

complied with these requirements if a report is made to a high managerial agent of the facility in

which the alleged incident occurred. Once notified, the high managerial agent shall be required to

meet all reporting requirements of this section within the time frames specified by this chapter.

     (d) Telephone reports made pursuant to this section shall be followed-up within three (3)

business days with a written report.

     (e) Individuals required to report pursuant to this section shall, whenever practical and if

known, provide the office department of healthy aging twenty-four hour (24) notice of the discharge

from a facility, of any person subject to abuse or neglect and shall include any relevant address and

telephone number(s).

     (f) No person required to report pursuant to this section shall be liable in any civil or

criminal action by reason of the report; provided, however, that the person did not perpetrate, inflict,

or cause the abuse. No employer or supervisor may discharge, demote, transfer, reduce pay,

benefits, or work privileges; prepare a negative work performance evaluation; or take any other

action detrimental to an employee or supervisee who files a report in accordance with the provisions

of this section by reason of the report.

     SECTION 15. Section 34-25.1-9 of the General Laws in Chapter 34-25.1 entitled "Reverse

Mortgages" is hereby amended to read as follows:

     34-25.1-9. Required counseling.

     (a) All lenders shall deliver to all reverse mortgage loan applicants a statement, if available,

prepared by the office department of healthy aging on the advisability and availability of

independent counseling and information services. With respect to every reverse mortgage loan, the

prospective mortgagor(s) shall complete a reverse mortgage counseling program. An original

certificate, dated and signed by both the counselor and the mortgagor(s), certifying that the

counseling required by this section has taken place, shall be delivered to the mortgagee at least

three (3) business days prior to the closing of the loan. The lender shall not process a reverse

mortgage loan application, other than ordering an automated valuation model, ordering a credit

report, obtaining information required for inclusion in a loan application, including documenting

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and verifying credit, income, assets and property charges, evaluating extenuating circumstances

and compensating factors, evaluating the results of the financial assessment in determining

eligibility for a home equity conversion mortgage, determining whether a life expectancy set-aside

will be required and whether the set-aside must be fully or partially funded, and completing a home

equity conversion mortgage financial assessment worksheet; and ordering a preliminary title

search, until the counseling required by this section has been completed and the certificate of

counseling is delivered to the mortgagee.

     (b) The reverse mortgage counseling program shall include, but is not limited to, all matters

enumerated in subsections (e)(1) through (e)(6) of this section. The office department of healthy

aging shall maintain a list of counseling programs and agencies approved by the United States

Department of Housing and Urban Development and the Federal Housing Administration to satisfy

the requirements of this section and shall make such list available to all lenders and to the public,

provided that: (1) the counseling agency is not affiliated with the reverse mortgage lender; and (2)

the counseling agency complies with the counseling requirements of this section. The director of

the office department of healthy aging shall have the right to prescribe the form of counseling

certificate that will meet the requirements of subsection (a) of this section.

     (c) Counseling shall comply with the following requirements: (1) It shall be conducted in

person; however, if the prospective mortgagor(s) cannot or choose(s) not to travel to a housing

counseling agency and cannot be visited by a counselor in their home, telephone counseling shall

be permitted by counseling agencies that are authorized by the United States Department of

Housing and Urban Development or the Federal Housing Administration to conduct telephone

counseling. (2) The reverse mortgage loan shall close within one hundred eighty (180) days after

the prospective mortgagor(s) sign(s) the counseling certificate. If the reverse mortgage loan does

not close within such one hundred eighty (180) day period, the parties shall be required to again

comply with the counseling requirements of this section. (3) Mortgagees shall provide prospective

mortgagors with the name of at least three (3) independent, authorized counseling agencies

approved by the United States Department of Housing and Urban Development or the Federal

Housing Administration. The mortgagee shall not recommend a counseling agency that is an

affiliate of the mortgagee.

     (d) In the event that counseling shall not be available free of charge, the mortgagee shall

be responsible for the cost of the counseling to the extent that all other legitimate sources of funding

the counseling including, without limitation, nonprofit organizations and grants have not been

obtained. In the event that 12 U.S.C. § 1715z-20 or the federal regulations promulgated with respect

thereto shall, at the time such counseling fee is due and payable by the mortgagee, expressly

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prohibit a mortgagee from being responsible for the cost of counseling, then subsection (d) of this

section shall not apply to a reverse mortgage loan that is subject to 12 U.S.C. § 1715z-20 and the

federal regulations promulgated with respect thereto.

     (e) Counseling shall include, without limitation, discussion of the following with the

prospective mortgagor(s):

     (1) Options other than a reverse mortgage that are available to the mortgagor(s), including

other housing, social service, health, and financial options;

     (2) Other home equity conversion options that are or may become available to the

mortgagor(s), such as other reverse mortgages, sale-leaseback financing, deferred payment loan,

and property tax deferral;

     (3) The financial implications of entering into a reverse mortgage;

     (4) A disclosure that a reverse mortgage may have tax consequences, affect eligibility for

assistance under federal and state programs, and have an impact on the estate and heirs of the

homeowner(s), as well as an explanation of how the reverse mortgage may affect the estate and

public benefits of the mortgagor(s);

     (5) Such other topics as shall be required to be addressed during counseling with respect to

a reverse mortgage pursuant to 12 U.S.C. § 1715z-20, and/or any regulations promulgated pursuant

thereto; and

     (6) Such other topics as shall be required to be addressed by the director of the office

department of healthy aging.

     (f) Subsections (b), (c), (e) of this section shall not apply to any reverse mortgage loan that

is subject to 12 U.S.C. § 1715z-20 and the federal regulations promulgated with respect thereto;

provided that such loan complies with the counseling requirements set forth in 12 U.S.C. § 1715z-

20 and the federal regulations promulgated with respect thereto (including without limitation 24

C.F.R. Part 206).

     SECTION 16. Section 36-4-2 of the General Laws in Chapter 36-4 entitled "Merit System"

is hereby amended to read as follows:

     36-4-2. Positions in unclassified service.

     (a) The classified service shall comprise all positions in the state service, now existing or

hereinafter established, except the following specific positions which, with other positions

heretofore or hereinafter specifically exempted by legislative act, shall constitute the unclassified

service:

     (1) Officers and legislators elected by popular vote and persons appointed to fill vacancies

in elective offices.

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     (2) Employees of both houses of the general assembly.

     (3) Officers, secretaries, and employees of the office of the governor, office of the

lieutenant governor, department of state, department of the attorney general, and the treasury

department.

     (4) Members of boards and commissions appointed by the governor, members of the state

board of elections and the appointees of the board, members of the commission for human rights

and the employees of the commission, and directors of departments.

     (5) The following specific offices:

     (i) In the department of administration: director, chief information officer, cybersecurity

officer, director of office of management and budget, director of performance management, deputy

director, chief of staff, public information officer and legislative/policy director, and within the

health benefits exchange: director, deputy director, administrative assistant, senior policy analyst,

and chief strategic planning monitoring and evaluation;

     (ii) In the department of business regulation: director;

     (iii) In the department of elementary and secondary education: commissioner of elementary

and secondary education;

     (iv) In the department of higher education: commissioner of postsecondary education;

     (v) In the department of health: director, executive director, and deputy director;

     (vi) In the department of labor and training: director, administrative assistant, administrator

of the labor board and legal counsel to the labor board, executive director, and communications

director;

     (vii) In the department of environmental management: director;

     (viii) In the department of transportation: director, chief operating officer,

administrator/division of project management, administrator/division of planning, chief of staff,

communications director, legislative director, and policy director;

     (ix) In the department of human services: director and director of veterans' affairs;

     (x) In the state properties committee: secretary;

     (xi) In the workers' compensation court: judges, administrator, deputy administrator, clerk,

assistant clerk, clerk secretary;

     (xii) In the office department of healthy aging: director;

     (xiii) In the department of behavioral healthcare, developmental disabilities and hospitals:

director;

     (xiv) In the department of corrections: director, assistant director (institutions/operations),

assistant director (rehabilitative services), assistant director (administration), and wardens;

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     (xv) In the department of children, youth and families: director, one assistant director, one

associate director, one executive director, and a chief of staff;

     (xvi) In the public utilities commission: public utilities administrator;

     (xvii) In the water resources board: general manager;

     (xviii) In the human resources investment council: executive director;

     (xix) In the office of health and human services: secretary of health and human services;

     (xx) In the office of commerce: secretary, deputy secretary, chief of staff, communications

director, legislative director, and policy director.

     (6) Chief of the hoisting engineers, licensing division, and his or her employees; executive

director of the veterans memorial building and his or her clerical employees.

     (7) One confidential stenographic secretary for each director of a department and each

board and commission appointed by the governor.

     (8) Special counsel, special prosecutors, regular and special assistants appointed by the

attorney general, the public defender and employees of his or her office, and members of the Rhode

Island bar occupying a position in the state service as legal counsel to any appointing authority.

     (9) The academic and/or commercial teaching staffs of all state institution schools, with

the exception of those institutions under the jurisdiction of the council on elementary and secondary

education and the council on postsecondary education.

     (10) Members of the military or naval forces, when entering or while engaged in the

military or naval service.

     (11) Judges, referees, receivers, clerks, assistant clerks, and clerical assistants of the

supreme, superior, family, and district courts, the traffic tribunal, security officers of the traffic

tribunal, jurors, and any persons appointed by any court.

     (12) Election officials and employees.

     (13) Deputy sheriffs and other employees of the sheriffs division within the department of

public safety.

     (14) Patient or inmate help in state charitable, penal, and correctional institutions and

religious instructors of these institutions and student nurses in training, residents in psychiatry in

training, and clinical clerks in temporary training at the institute of mental health within the state

of Rhode Island medical center.

     (15)(i) Persons employed to make or conduct a temporary and special inquiry,

investigation, project, or examination on behalf of the legislature, or a committee therefor, or on

behalf of any other agency of the state if the inclusion of these persons in the unclassified service

is approved by the personnel administrator. The personnel administrator shall notify the house

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fiscal advisor and the senate fiscal advisor whenever he or she approves the inclusion of a person

in the unclassified service.

     (ii) The duration of the appointment of a person, other than the persons enumerated in this

section, shall not exceed ninety (90) days or until presented to the department of administration.

The department of administration may extend the appointment another ninety (90) days. In no event

shall the appointment extend beyond one hundred eighty (180) days.

     (16) Members of the division of state police within the department of public safety.

     (17) Executive secretary of the Blackstone Valley district commission.

     (18) Artist and curator of state-owned art objects.

     (19) Mental health advocate.

     (20) Child advocate.

     (21) The position of aquaculture coordinator and marine infrastructure specialist within the

coastal resources management council.

     (22) Employees of the office of the health insurance commissioner.

     (23) In the department of revenue: the director, secretary, attorney.

     (24) In the department of public safety: the director.

     (b) Provided, however, that, if any position added to the unclassified service by legislative

act after January 1, 2015, is occupied by a classified employee on June 30, 2015, such position

shall remain in the classified service until such position becomes vacant.

     SECTION 17. Section 39-2-5 of the General Laws in Chapter 39-2 entitled "Duties of

Utilities and Carriers" is hereby amended to read as follows:

     39-2-5. Exceptions to anti-discrimination provisions.

     The provisions of §§ 39-2-2 -- 39-2-4 shall be subject to the following exceptions:

     (1) A public utility may issue or give free transportation or service to its employees and

their families, its officers, agents, surgeons, physicians, and attorneys at law, and to the officers,

agents, and employees, and their families of any other public utility.

     (2) With the approval of the division, any public utility may give free transportation or

service, upon such conditions as the public utility may impose, or grant special rates therefor to the

state, to any town or city, or to any water or fire district, and to the officers thereof, for public

purposes, and also to any special class or classes of persons, not otherwise referred to in this section,

in cases where the same shall seem to the division just and reasonable, or required in the interests

of the public, and not unjustly discriminatory.

     (3) With the approval of the division, any public utility operating a railroad or street railway

may furnish to the publishers of newspapers and magazines, and to their employees, passenger

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transportation in return for advertising in the newspapers or magazines at full rates.

     (4) With the approval of the division, any public utility may exchange its service for the

service of any other public utility furnishing a different class of service.

     (5) Nothing in this section or any other provision of the law shall be construed to prohibit

the giving by any public utility, of free or reduced-rate service to an elderly person as defined by

the division.

     (6) Any motor carrier of persons, as defined in chapter 13 of this title, may elect to file a

tariff providing for a rate reduction of twenty-five percent (25%) below its one-way-fare tariff

applying to any person who is sixty-five (65) years of age or older and any person assisting and

traveling with a blind passenger who is not required to pay any fare pursuant to the provisions of §

39-2-13 for bus rides between the hours of ten o'clock (10:00) a.m. and three o'clock (3:00) p.m. of

each day. In such event, the reduced fare shall be paid in part by the passenger and in part by the

state. That part of the reduced fare payable by the state shall be one-half (½) of the reduced fare

adjusted upward to end in the nearest zero (0) or five cents (.05), and that part payable by the

passenger shall be the balance of the reduced fare. Payments by the state under this section shall be

paid monthly under procedures agreed upon by the department of transportation and the carrier.

     (7) [Deleted by P.L. 2004, ch. 378, § 4, and by P.L. 2004, ch. 504, § 4.]

     (8) Any person, firm, or corporation or any officer, agent, servant, or employee thereof

who shall violate the provisions of subsection (7) of this section by fraudulently obtaining a

telecommunications device shall, upon conviction, be fined not exceeding five hundred dollars

($500) or be imprisoned for a term not exceeding one year.

     (9)(i) Nothing in this section or any other provision of the general laws shall be construed

to prohibit the commission from taking actions to enable the state to participate in a Federal

Communications Commission telephone lifeline program. The commission may set a subscriber-

funded, monthly residence basic exchange lifeline telephone service credit in an amount not to

exceed the federal subscriber line access charge or the monthly basic-service charge, whichever is

less, for those persons who receive Supplemental Security Income (SSI), Aid to Families With

Dependent Children (AFDC), general public assistance (GPA), aid from the Rhode Island medical

assistance program, or food stamps issued pursuant to the Food Stamp Act of 1964 as amended

(Pub. L. No. 88-525 and amendments made thereto, 7 U.S.C. § 2011 et seq.), assistance from the

Low Income Home Energy Assistance Program (LIHEAP) as administered by the department of

administration, division of planning, and effective April 1, 1993, assistance from the Rhode Island

pharmaceutical assistance program administered by the office department of healthy aging. The

public utilities commission may promulgate regulations to implement this section. The department

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of human services and the department of administration, division of planning, shall certify

subscriber eligibility for the programs in accordance with public utilities commission and Federal

Communications Commission guidelines.

     (ii) The department of human services shall report monthly to the governor and to the house

of representatives fiscal advisor the number of persons newly eligible for the lifeline telephone

service credit hereunder solely by virtue of their eligibility to receive food stamp assistance and the

department of administration, division of planning, shall, also, report monthly to the governor and

to the house of representatives fiscal advisor the number of persons newly eligible for the lifeline

telephone service credit hereunder solely by virtue of their participation in the Low Income Home

Energy Assistance Program (LIHEAP).

     (10) Nothing in this section or any other provision of the general laws shall be construed

to prohibit any public utility with the approval of the commission, from forgiving arrearages of any

person in accordance with the provisions of § 39-2-1(d).

     (11) Nothing in this section or any other provision of the law shall be construed to prohibit

any utility company from cutting, disconnecting, or removing mains, poles, wires, conduits, or

fixtures free of charge to nonprofit housing development corporations prior to moving a building

to be used as affordable housing for at least a ten-year (10) period.

     (12) Nothing in this section or any other provision of the general laws shall be construed

to prohibit any telecommunications provider, with the approval of the commission, from offering

any residential customer a reduced rate, provided such rate covers all costs. A telecommunications

provider may offer a business customer a reduced rate without commission approval; provided that

the rate covers all costs.

     (13) A gas or electric distribution company may provide discounts to low-income

customers in accordance with the affordable energy plan provisions of § 42-141-5(d) [repealed].

Nothing contained herein shall prohibit the continuation of any low-income discounts approved by

the commission prior to January 1, 2006, and in effect as of that date.

     SECTION 18. Section 39-18-4 of the General Laws in Chapter 39-18 entitled "Rhode

Island Public Transit Authority" is hereby amended to read as follows:

     39-18-4. Powers and duties of the authority.

     (a) The authority is hereby authorized and empowered:

     (1) To adopt bylaws for the regulation of its affairs and the conduct of its business;

     (2) To adopt an official seal and alter the seal at pleasure;

     (3) To maintain an office at such place or places within the state as it may designate;

     (4) To sue and be sued in its own name, plead, and be impleaded; provided, however, that

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any and all actions against the authority shall be brought only in the county in which the principal

office of the authority shall be located;

     (5) To acquire, purchase, hold, use, and dispose of any property, real, personal, or mixed,

tangible or intangible, or any interest therein, necessary or desirable for carrying out the purposes

of the authority, and to lease as lessee or lessor any property, real, personal, or mixed, or any interest

therein, for such term and at such rental as the authority may deem fair and reasonable, and to sell,

transfer, convey, mortgage, or give a security interest in any property, real, personal, or mixed,

tangible or intangible, or any interest therein, at any time acquired by the authority;

     (6) To employ, in its discretion, planning, architectural, and engineering consultants,

attorneys, accountants, construction, financial, transportation, and traffic experts and consultants,

superintendents, managers, and such other officers, employees, and agents as may be necessary in

its judgment, and to fix their compensation;

     (7)(i) To fix, from time to time, subject to the provisions of this chapter, schedules and

such rates of fare and charges for service furnished or operated as in its judgment are best adopted

to ensure sufficient income to meet the cost of service; provided, however, the authority is not

empowered to operate a passenger vehicle under its control in competition with passenger vehicles

of a private carrier over routes that the private carrier operates pursuant to a certificate of public

convenience and necessity issued to the private carrier by the division of public utilities and

carriers; and provided further that the authority shall not require any person who meets the means-

test criteria as defined by the Rhode Island office department of healthy aging and who is either

sixty-five (65) years of age, or over, or who is a person with a disability to pay more than one-half

(½) of any fare for bus rides; provided, however, that under no circumstances shall fares or charges

for special service routes be discounted. Any person who is either sixty-five (65) years of age, or

over, or who is a person with a disability, who does not satisfy the means-test criteria as heretofore

provided, shall only be required to pay one-half (½) of the fare or charge for bus rides during off-

peak hours, but shall not be eligible for a reduction during peak hours. For the purposes of this

chapter, "peak hours," "off-peak hours," and "special service routes" shall be determined annually

by the authority. The authority, in conjunction with the department of human services, shall

establish an advisory committee comprised of seniors/persons with disabilities who are constituent

users of the authority's services to assist in the implementation of this section;

     (ii) Any person who accompanies and is assisting a person with a disability when the person

with a disability uses a wheelchair shall be eligible for the same price exemptions extended to a

person with a disability by subsection (a)(7)(i). The cost to the authority for providing the service

to the elderly shall be paid by the state;

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     (iii) Any person who accompanies and is assisting a passenger who is blind or visually

impaired shall be eligible for the same price exemptions extended to the passenger who is blind or

visually impaired by subsection (a)(7)(i). The cost to the authority for providing the service to the

elderly shall be paid by the state;

     (iv) The authority shall be authorized and empowered to charge a fare for any paratransit

services required by the Americans with Disabilities Act, 42 U.S.C. § 12101 et seq., in accordance

with 49 C.F.R. Part 37;

(8) To borrow money and to issue bonds of the authority for any of its purposes including, without

limitation, the borrowing of money in anticipation of the issuance of bonds or the receipt of any

operating revenues or other funds or property to be received by the authority, and the financing of

property to be owned by others and used, in whole or substantial part, by the authority for any of

its purposes, all as may, from time to time, be authorized by resolution of the authority; the bonds

to contain on their face a statement to the effect that neither the state nor any municipality or other

political subdivision of the state shall be obligated to pay the same or the interest thereon;

     (9) To enter into management contracts for the operation, management, and supervision of

any or all transit properties under the jurisdiction of the authority, and to make and enter into all

contracts and agreements necessary or incidental to the performance of its duties and the execution

of its powers under this chapter;

     (10) Without limitation of the foregoing, to borrow money from, to receive and accept

grants for or in aid of the purchase, leasing, improving, equipping, furnishing, maintaining,

repairing, constructing, and operating of transit property, and to enter into contracts, leases, or other

transactions with any federal agency; and to receive and accept from the state, from any

municipality, or other political subdivision thereof, and from any other source, aid or contributions

of either money, property, labor, or other things of value, to be held, used, and applied only for the

purposes for which the grants and contributions may be made;

     (11) To acquire in the name of the authority, by negotiated purchase or otherwise, on such

terms and conditions and in such manner as it may deem proper, or by the exercise of the power of

condemnation to the extent only and in the manner as provided in this chapter, public and private

lands, including public parks, playgrounds or reservations, or parts thereof, or rights therein, rights-

of-way, property rights, easements, and interests as it may deem necessary for carrying out the

provisions of this chapter; provided, however, that all public property damaged in carrying out the

powers granted by this chapter shall be restored or repaired and placed in its original condition as

nearly as practicable;

     (12) To contract with any municipality, public or private company or organization,

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whereby the authority will receive a subsidy to avoid discontinuance of service, and each

municipality within the state is hereby authorized to make and enter into such contracts and to

make, grant, or give to the authority a subsidy in such amount and for such period of time as it may

deem advisable;

     (13) To operate open-door service from Rhode Island to and from locations in

Massachusetts and Connecticut that are within five (5) miles of the Rhode Island border; and

     (14) To do all things necessary, convenient, or desirable to carry out the purposes of this

chapter.

     (b) To effectuate the purposes of this chapter the authority shall have the following duties:

     (1) To participate in and contribute to transportation planning initiatives that are relevant

to the purposes of the authority;

     (2) To plan, coordinate, develop, operate, maintain, and manage a statewide public transit

system consistent with the purposes of the authority, including plans to meet demands for public

transit where such demand, current or prospective, exceeds supply and/or availability of public

transit services;

     (3) To work with departments, agencies, authorities, and corporations of federal, state, and

local government, public and private institutions, businesses, nonprofit organizations, users of the

system, and other entities and persons to coordinate public transit services and provide a seamless

network of mobility options.

     SECTION 19. Section 40-6-5.2 of the General Laws in Chapter 40-6 entitled "Public

Assistance Act" is hereby amended to read as follows:

     40-6-5.2. Cashing of AFDC, GPA checks.

     (a) For the purposes of this section, the term "banking institution" shall mean: (1) Any state

or federally chartered bank, savings bank, loan and investment bank, or credit union located within

this state; and (2) Any currency-exchange specialist located within this state and enrolled with the

department of human services pursuant to regulations to be adopted by the department.

     (b) Each banking institution shall cash, at its main office or any of its branch offices within

the state, any check drawn by the state and payable within the state to a recipient of aid to families

with dependent children (AFDC) or general public assistance (GPA), if the check is negotiated to

the banking institution by the original payee of the check, and if the payee produces reasonable

identification required by this section and as provided for in regulations adopted pursuant to

subsection (d) hereof.

     (c) Nothing in this section shall be interpreted as limiting any rights the banking institution

may have against the payee by contract or at law, with regard to items that are negotiated to it as

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provided for in this section, that are not paid upon presentment, or where the payee breaches a

warranty made under § 6A-3-417. This section shall not apply to any check negotiated to a banking

institution if the institution has reason to believe that the check will not be paid on presentment or

that the tendering party may be in breach of one or more of the warranties contained in § 6A-3-417.

     (d) Provided that a banking institution properly employed the identification procedures

prescribed in regulations adopted pursuant to this subsection at the time an AFDC or GPA check

was cashed by such institution, the state shall honor and make payment on the AFDC or GPA

check, and the banking institution shall not be liable to reimburse the state for a loss incurred as a

result of the wrongful payment of a check by the banking institution. The director of the department

of human services shall adopt regulations specifying: (1) The forms of reasonable identification

that a banking institution shall accept when cashing an AFDC or GPA check pursuant to subsection

(b); and (2) The identification procedures the institution must employ to receive payment thereon

and to avoid liability for the wrongful payment of any such check. The regulations shall provide

that the forms of reasonable identification shall include, but need not be limited to: (i) An AFDC

or GPA photo-identification card issued by the department of human services; (ii) A valid

identification card issued by the administrator of the division of motor vehicles pursuant to § 3-8-

6; (iii) A valid driver's license; (iv) An identification card issued by the office department of healthy

aging; and (v) A valid identification card issued by the United States Immigration and

Naturalization Service.

     (e) The department of human services shall issue a stop-payment order with respect to any

AFDC or GPA check reported as lost, stolen, or undelivered. The department of human services

shall not issue a replacement AFDC or GPA check for a period of three (3) business days from the

date of the report of such loss, theft, or nondelivery.

     SECTION 20. Sections 40-6-5.2 and 40-6-27 of the General Laws in Chapter 40-6 entitled

"Public Assistance Act" are hereby amended to read as follows:

     40-6-5.2. Cashing of AFDC, GPA checks.

     (a) For the purposes of this section, the term "banking institution" shall mean: (1) Any state

or federally chartered bank, savings bank, loan and investment bank, or credit union located within

this state; and (2) Any currency-exchange specialist located within this state and enrolled with the

department of human services pursuant to regulations to be adopted by the department.

     (b) Each banking institution shall cash, at its main office or any of its branch offices within

the state, any check drawn by the state and payable within the state to a recipient of aid to families

with dependent children (AFDC) or general public assistance (GPA), if the check is negotiated to

the banking institution by the original payee of the check, and if the payee produces reasonable

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identification required by this section and as provided for in regulations adopted pursuant to

subsection (d) hereof.

     (c) Nothing in this section shall be interpreted as limiting any rights the banking institution

may have against the payee by contract or at law, with regard to items that are negotiated to it as

provided for in this section, that are not paid upon presentment, or where the payee breaches a

warranty made under § 6A-3-417. This section shall not apply to any check negotiated to a banking

institution if the institution has reason to believe that the check will not be paid on presentment or

that the tendering party may be in breach of one or more of the warranties contained in § 6A-3-417.

     (d) Provided that a banking institution properly employed the identification procedures

prescribed in regulations adopted pursuant to this subsection at the time an AFDC or GPA check

was cashed by such institution, the state shall honor and make payment on the AFDC or GPA

check, and the banking institution shall not be liable to reimburse the state for a loss incurred as a

result of the wrongful payment of a check by the banking institution. The director of the department

of human services shall adopt regulations specifying: (1) The forms of reasonable identification

that a banking institution shall accept when cashing an AFDC or GPA check pursuant to subsection

(b); and (2) The identification procedures the institution must employ to receive payment thereon

and to avoid liability for the wrongful payment of any such check. The regulations shall provide

that the forms of reasonable identification shall include, but need not be limited to: (i) An AFDC

or GPA photo-identification card issued by the department of human services; (ii) A valid

identification card issued by the administrator of the division of motor vehicles pursuant to § 3-8-

6; (iii) A valid driver's license; (iv) An identification card issued by the office department of healthy

aging; and (v) A valid identification card issued by the United States Immigration and

Naturalization Service.

     (e) The department of human services shall issue a stop-payment order with respect to any

AFDC or GPA check reported as lost, stolen, or undelivered. The department of human services

shall not issue a replacement AFDC or GPA check for a period of three (3) business days from the

date of the report of such loss, theft, or nondelivery.

     40-6-27. Supplemental Security Income.

     (a)(1) The director of the department is hereby authorized to enter into agreements on

behalf of the state with the Secretary of the Department of Health and Human Services or other

appropriate federal officials, under the Supplemental Security Income (SSI) program established

by Title XVI of the Social Security Act, 42 U.S.C. § 1381 et seq., concerning the administration

and determination of eligibility for SSI benefits for residents of this state, except as otherwise

provided in this section. The state's monthly share of supplementary assistance to the Supplemental

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Security Income program shall be as follows:

     (i) Individual living alone: $39.92

     (ii) Individual living with others: $51.92

     (iii) Couple living alone: $79.38

     (iv) Couple living with others: $97.30

     (v) Individual living in state-licensed assisted-living residence: $332.00

     (vi) [Deleted by P.L. 2021, ch. 162, art. 12, § 1.]

     (vii) Individual living in state-licensed, supportive residential-care settings that, depending

on the population served, meet the standards set by the department of human services in conjunction

with the department of children, youth and families, the office department of healthy aging, and/or

the department of behavioral healthcare, developmental disabilities and hospitals: $300.00

     Provided, however, that the department of human services shall, by regulation, reduce,

effective January 1, 2009, the state's monthly share of supplementary assistance to the

Supplemental Security Income (SSI) program for each of the above-listed payment levels, by the

same value as the annual federal cost of living adjustment to be published by the federal Social

Security Administration in October 2008 and becoming effective on January 1, 2009, as determined

under the provisions of Title XVI of the federal Social Security Act, 42 U.S.C. § 1381 et seq.; and

provided further, that it is the intent of the general assembly that the January 1, 2009, reduction in

the state's monthly share shall not cause a reduction in the combined federal and state payment

level for each category of recipients in effect in the month of December 2008; provided further,

that the department of human services is authorized and directed to provide for payments to

recipients in accordance with the above directives.

     (2) As of July 1, 2010, state supplement payments shall not be federally administered and

shall be paid directly by the department of human services to the recipient.

     (3) Individuals living in institutions shall receive a twenty-dollar ($20.00) per-month

personal needs allowance from the state that shall be in addition to the personal needs allowance

allowed by the Social Security Act, 42 U.S.C. § 301 et seq.

     (4) Individuals living in state-licensed supportive residential-care settings and assisted-

living residences who are receiving SSI supplemental payments under this section shall be allowed

to retain a minimum personal needs allowance of fifty-five dollars ($55.00) per month from their

SSI monthly benefit prior to payment of any monthly fees in addition to any amounts established

in an administrative rule promulgated by the secretary of the executive office of health and human

services for persons eligible to receive Medicaid-funded long-term services and supports in the

settings identified in subsection (a)(1)(v).

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     (5) The department is authorized and directed to make a determination of the medical need

and whether a setting provides the appropriate services for those persons who:

     (i) Have applied for or are receiving SSI, and who apply for admission to supportive

residential-care settings and assisted-living residences on or after October 1, 1998; or

     (ii) Who are residing in supportive residential-care settings and assisted-living residences,

and who apply for or begin to receive SSI on or after October 1, 1998.

     (6) The process for determining medical need required by subsection (a)(5) of this section

shall be developed by the executive office of health and human services in collaboration with the

departments of that office and shall be implemented in a manner that furthers the goals of

establishing a statewide coordinated long-term-care entry system as required pursuant to the

Medicaid section 1115 waiver demonstration.

     (7) To assure access to high-quality, coordinated services, the executive office of health

and human services is further authorized and directed to establish certification or contract standards

that must be met by those state-licensed supportive residential-care settings, including adult

supportive-care homes and assisted-living residences admitting or serving any persons eligible for

state-funded supplementary assistance under this section. The certification or contract standards

shall define:

     (i) The scope and frequency of resident assessments, the development and implementation

of individualized service plans, staffing levels and qualifications, resident monitoring, service

coordination, safety risk management and disclosure, and any other related areas;

     (ii) The procedures for determining whether the certifications or contract standards have

been met; and

     (iii) The criteria and process for granting a one-time, short-term good-cause exemption

from the certification or contract standards to a licensed supportive residential-care setting or

assisted-living residence that provides documented evidence indicating that meeting, or failing to

meet, the standards poses an undue hardship on any person eligible under this section who is a

prospective or current resident.

     (8) The certification or contract standards required by this section shall be developed in

collaboration by the departments, under the direction of the executive office of health and human

services, so as to ensure that they comply with applicable licensure regulations either in effect or

in development.

     (b) The department is authorized and directed to provide additional assistance to

individuals eligible for SSI benefits for:

     (1) Moving costs or other expenses as a result of an emergency of a catastrophic nature,

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which is defined as a fire or natural disaster; and

     (2) Lost or stolen SSI benefit checks or proceeds of them; and

     (3) Assistance payments to SSI-eligible individuals in need because of the application of

federal SSI regulations regarding estranged spouses; and the department shall provide the

assistance in a form and amount that the department shall by regulation determine.

     SECTION 21. Section 40-8.4-14 of the General Laws in Chapter 40-8.4 entitled "Health

Care for Families" is hereby amended to read as follows:

     40-8.4-14. Permanent joint committee on health care oversight.

     (a) The legislature hereby finds and declares that: (1) Access to affordable, quality health

and long-term care is of concern for all Rhode Islanders; (2) The complexities of the health-

insurance and healthcare-delivery systems result in inefficiencies, confusion, and additional costs

for consumers and other participants in the healthcare system; (3) Reform to the health-insurance

and healthcare-delivery systems is achievable only through an ongoing, focused, directed, and

informed effort; and (4) Steps taken to reduce the numbers of uninsured Rhode Islanders, enhance

the quality of care, contain costs, ensure accessibility to services, and promote healthy lifestyles

should be monitored, adjusted or expanded as needed. Therefore, there is hereby created a

permanent legislative committee to monitor, study, report, and make recommendations on all areas

of healthcare provision, insurance, liability, licensing, cost, and delivery of services, and the

adequacy, efficacy and efficiency of statutes, rules, regulations, guidelines, practices, and programs

related to health care, long-term care, or health insurance coverage in Rhode Island.

     (b) The committee consists of twelve (12) members of the general assembly: six (6) of

whom shall be members of the house of representatives, to include the chair or deputy chair of the

committee on finance, the chair or vice chair of the committee on corporations, the chair or vice

chair of the committee on health, education and welfare; and one of whom shall be from the

minority party, to be appointed by, and to serve at the discretion of, the speaker of the house of

representatives; and six (6) of whom shall be from the senate, to include the chair or vice chair of

the committee on finance, the chair or vice chair of the committee on commerce, housing and

municipal government, the chair or vice chair of the committee on health and human services; and

one of whom from the minority party, to be appointed by, and to serve at the discretion of, the

president of the senate.

     (c) The committee shall have co-chairpersons, one appointed by the speaker of the house

of representatives and one by the president of the senate.

     (d) The committee may review or study any matter related to the provision of healthcare

services and long-term care that it considers of significance to the citizens of Rhode Island,

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including the availability of health care, the quality of health care, the effectiveness and efficiency

of managed care systems, the efficiency and the operation of state healthcare programs, and the

availability of improved processes or new technologies to achieve more effective and timely

resolution of disputes, better communication, speedier, more reliable and less costly administrative

processes, claims, payments, and other matters involving the interaction among any or all of

government, employers, consumers of health care, providers, healthcare facilities, insurers and

others. The committee may request information from any healthcare provider, healthcare facility,

insurer or others. The committee may request and shall receive from any instrumentality of the

state, including the department of human services, the department of business regulation, the

department of health, the department of behavioral healthcare, developmental disabilities and

hospitals, the office department of healthy aging, and the long-term care coordinating council, or

any other governmental advisory body or commission, including, but not limited to, the governor's

advisory council on health, information and assistance as it deems necessary for the proper

execution of its powers and duties under this section, including the annual report of the governor's

advisory council on health. The committee will undertake a comprehensive study of the state's

regulatory structure for health insurance, including the roles, relevance, impact, and coordination

of current state laws and agencies involved in insurance oversight. This study will include any

necessary recommendations for the restructuring of the state's laws and regulatory bodies. The

recommendations will be made to the speaker of the house and the president of the senate on or

before March 1, 2005.

     (e) In addition to the notification regarding regulations required under § 40-8.4-10(b), the

department of human services shall file with the permanent joint committee on health care oversight

a detailed plan for the implementation of the programs created under this chapter by August 1,

2000.

     (f) The committee shall have the power to hold hearings, shall meet at least quarterly, may

make recommendations to the general assembly, state agencies, private industry, or any other

entity, and shall report to the general assembly on its findings and recommendations as it

determines appropriate.

     (g) The office of the health insurance commissioner and the executive office of health and

human services shall issue a series of reports to the joint committee on or before October 1 of 2012,

on state implementation options related to the U.S. Patient Protection and Affordable Care Act of

2010, as amended by the Health Care and Education Reconciliation Act of 2010, and any further

amendments to or regulations or guidance issued thereunder ("ACA"). These reports shall analyze

the state options and make recommendations to the committee for legislative action regarding the

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following topics:

     (i) The feasibility of instituting a basic health program pursuant to Section 131 of the ACA,

including a proposed plan for implementation;

     (ii) The impact of eliminating gender as a rating factor, limiting variation in community

rates based on age, and limiting waiting periods for coverage, as required under the Act;

     (iii) The impact of merging the individual and small group-insurance markets on rates and

coverage, including a proposed plan for implementation;

     (iv) The feasibility of requiring insurance product consistency inside and outside of a state

health insurance exchange, including an assessment of coverage and rate impacts; and

     (v) The substantially equivalent utilization coverage limits that the legislature may

substitute for the current dollar coverage limits on numerous state health insurance mandates, to

conform with the Act.

     SECTION 22. Sections 40-8.9-4 and 40-8.9-6 of the General Laws in Chapter 40-8.9

entitled "Medical Assistance - Long-Term Care Service and Finance Reform" are hereby amended

to read as follows:

     40-8.9-4. Unified long-term care budget.