Chapter
475
2008 -- H 7906 SUBSTITUTE A
Enacted 07/05/08
A N A C T
RELATING TO STATUTES
AND STATUTORY CONSTRUCTION
Introduced By: Representative Gordon D. Fox
Date Introduced: February 26, 2008
It is
enacted by the General Assembly as follows:
SECTION
1. Sections 11-41.1-9 and 11-41.1-14 of the General Laws in Chapter 11-41.1
entitled
"Grocery and Laundry Carts, Milk Cases, Egg Baskets, and Bakery
Containers" are
hereby
amended to read as follows:
11-41.1-9.
Unlawful removal of shopping carts, dairy cases, dispenser cases, egg
baskets,
poultry boxes, bakery containers, and plastic bulk a shopping cart or dairy
case or
dispenser
case or merchandise
containers. --It is a violation
of this chapter for any person not
in
lawful possession of a shopping cart or dairy case or dispenser case or egg
basket or poultry
box or
bakery container, or plastic bulk merchandise container to remove an egg
basket, poultry
box, or
plastic bulk merchandise container from the premises, parking area or any other
area of
any
processor, distributor, retailer, or food service establishment.
11-41.1-14.
Purchase of shopping carts, dairy cases, dispenser cases, egg baskets,
bakery
containers or plastic bulk merchandise containers for recycling, shredding, or
destruction
- Verification of seller's identity - Proof of ownership record. – (a)
Any person or
entity
purchasing shopping carts, dairy cases, dispenser cases, egg baskets, bakery
containers or
plastic bulk
merchandise containers, who is in the business of recycling, shredding, or
destruction
of
shopping carts, dairy cases, dispenser cases, egg baskets, bakery containers or
plastic bulk
merchandise
containers shall obtain a proof of ownership record from a person selling five
(5) or
more
shopping carts, dairy cases, dispenser cases, egg baskets, bakery containers or
plastic bulk
merchandise
containers that shows that the person selling the carts, cases, baskets, or
containers
has
lawful possession or ownership of the carts, cases, baskets, or containers, and
shall also verify
the
seller's identity by a driver's license or other government-issued photo
identification. The
proof of
ownership record shall include all of the following information:
(1)
The name, address, telephone number, and signature of the seller or the
seller's
authorized
representative.
(2)
The name and address of the buyer or consignee if not sold.
(3)
A description of the product including number of units.
(4)
The date of the transaction.
(b)
The information required to be collected by this section shall be kept for one
year
from the
date of purchase or delivery, whichever is later.
SECTION 2. Section 11-47-9 of the General Laws in Chapter 11-47 entitled
"Weapons"
is hereby amended to read as follows:
11-47-9.
Persons exempt from restrictions. -- The provisions of section
11-47-8 shall
not
apply to sheriffs, deputy sheriffs, the superintendent and members of the state
police,
members
of the Rhode Island airport police department, members of the Rhode Island
state
marshals,
Rhode Island state fire marshal, chief, deputy state fire marshals,
deputy state fire
marshals
assigned to the bomb squad, and those assigned to the investigation unit,
correctional
officers,
all within the department of corrections, members of the city or town police
force,
capitol
police investigators of the department of attorney general appointed pursuant
to
section 42-9-8.1, the
witness protection coordinator for the witness protection review board as set
forth in
chapter 30 of title 12 and subject to the minimum qualifications of
section 42-9-8.1, the
director,
assistant director, and other inspectors and agents at the Rhode Island state
fugitive task
force
appointed pursuant to section 12-6-7.2, railroad police while
traveling to and from official
assignments
or while on assignments, conservation officers, or other duly appointed law
enforcement
officers, nor to members of the Army, Navy, Air Force, and Marine Corps of the
United
States, the National Guard, or organized reserves, when on duty, nor to members
of
organizations
by law authorized to purchase or receive firearms from the United States or
this
state,
provided these members are at or going to or from their places of assembly or
target
practice,
nor to officers or employees of the United States authorized by law to carry a
concealed
firearm,
nor to any civilian guard or criminal investigator carrying sidearms or a
concealed
firearm in
the performance of his or her official duties under the authority of the
commanding
officer
of the military establishment in the state of Rhode Island where he or she is
employed by
the
United States, nor to any civilian guard carrying sidearms or a concealed
firearm in the
performance
of his or her official duties under the authority of the adjutant general where
he or
she is
employed guarding a national guard facility, provided, that the commanding
officer of the
military
establishment shall have on file with the attorney general of this state a list
of the names
and
addresses of all civilian guards and criminal investigators so authorized, nor
to duly
authorized
military organizations when on duty, nor to members when at or going to or from
their
customary
places of assembly, nor to any individual employed in the capacity of
warden,
associate
warden, major, captain, lieutenant, sergeant, correctional officer or
investigator at any
project owned
or operated by a municipal detention facility corporation, including the Donald
W.
Wyatt
Detention Facility, nor to the regular and/or ordinary transportation of
pistols as
merchandise,
nor to any person while carrying a pistol unloaded and securely wrapped from
the
place of
purchase to his or her home or place of business, or in moving goods from one
place of
abode or
business to another. Persons exempted by the provisions of this section from
the
provisions
of section 11-47-8 shall have the right to carry concealed firearms
everywhere within
this
state; provided, that this shall not be construed as giving the right to carry
concealed firearms
to a
person transporting firearms as merchandise or as household or business goods.
SECTION 3. Section 14-1-6 of the General Laws in Chapter 14-1 entitled
"Proceedings
in Family Court" is hereby amended to read as follows:
14-1-6.
Retention of jurisdiction. -- (a) When the court shall have
obtained jurisdiction
over any
child prior to the child having attained the age of eighteen (18) years
by the filing of a
petition
alleging that the child is wayward or delinquent pursuant to
section 14-1-5, the child
shall,
except as specifically provided in this chapter, continue under the jurisdiction
of the court
until he
or she becomes nineteen (19) years of age, unless discharged prior to turning
nineteen
(19).
When the court shall have obtained jurisdiction over any child prior to the
child's eighteenth
(18th)
birthday by the filing of a petition
alleging that the child is dependent, neglected and abused
pursuant
to sections 14-1-5 and 40-11-7, the child shall, except as
specifically provided in this
chapter,
continue under the jurisdiction of the court until he or she becomes eighteen
(18) years of
age;
provided, that prior to an order of discharge or emancipation being entered,
the court shall
require
the department of children, youth, and families to provide a description of the
transition
services
afforded the child in placement or a detailed explanation as to the reason
those services
were not
offered; provided further that any youth who comes within the jurisdiction of
the court
by the
filing of a wayward or delinquent petition based upon an offense which was
committed
prior to
July 1, 2007, including youth who are adjudicated and committed to the Rhode
Island
Training
School and who are placed in a temporary community placement as authorized by
the
family court,
may continue under the jurisdiction of the court until he or she turns twenty-one
(21)
years of age.
(b)
In any case where the court shall not have acquired jurisdiction over any
person prior
to the
person's eighteenth (18th) birthday by the filing of a petition alleging
that the person had
committed
an offense, but a petition alleging that the person had committed an offense
which
would be
punishable as a felony if committed by an adult has been filed before that
person attains
the age of
nineteen (19) years of age, that person shall, except as specifically provided
in this
chapter,
be subject to the jurisdiction of the court until he or she becomes nineteen
(19) years of
age,
unless discharged prior to turning nineteen (19).
(c)
In any case where the court shall not have acquired jurisdiction over any
person prior
to the
person attaining the age of nineteen (19) years by the filing of a petition
alleging that the
person
had committed an offense prior to the person attaining the age of eighteen (18)
years
which
would be punishable as a felony if committed by an adult, that person shall be
referred to
the
court which would have had jurisdiction over the offense if it had been
committed by an adult.
The
court shall have jurisdiction to try that person for the offense committed
prior to the person
attaining
the age of eighteen (18) years and, upon conviction, may impose a sentence not
exceeding
the maximum penalty provided for the conviction of that offense.
(d)
In any case where the court has certified and adjudicated a child in
accordance with
the
provisions of sections 14-1-7.2 and 14-1-7.3, the jurisdiction
of the court shall encompass the
power
and authority to sentence the child to a period in excess of the age of
nineteen (19) years.
However,
in no case shall the sentence be in excess of the maximum penalty provided by
statute
for the
conviction of the offense.
(e)
Nothing in this section shall be construed to affect the jurisdiction of
other courts
over
offenses committed by any person after he or she reaches the age of eighteen
(18) years.
SECTION 4. Sections 27-4-4, 27-4-24.4 and 27-4-24.5 of the General Laws in
Chapter
27-4 entitled "Life Insurance Policies and Reserves" are hereby
amended to read as
follows:
27-4-4.
Penalty for unlawful discrimination. -- Any life insurance company,
and any
officer
or agent of any life insurance company, violating any of the provisions of
sections 27-4-
1 and
27-4-3 shall be subject to penalties determined in accordance with
section 42-14-1 42-14-
16.
27-4-24.4.
Hearing on decisions of commissioner. -- Any organization or insurer
aggrieved
by any order or decision of the commissioner, or by any rule or regulation
promulgated
and
adopted by the commissioner, may, within thirty (30) days after notice of the
order or
decision
to the organization or insurer, make written request to the commissioner for a
hearing on
the
order or decision. The commissioner shall provide a hearing and issue a
decision in
accordance
with the Administrative Procedures Act, chapter 42-35-1 42-35.
27-4-24.5.
Judicial review of orders and decisions. -- Any final order or
decision of the
commissioner,
including any order made after a hearing under the provisions of
section 27-4-
24.3 or
27-4-24.4, shall be subject to review in accordance with the
Administrative Procedures
Act,
chapter 42-35-1 42-35.
SECTION 5. Section 27-5-3.7 of the General Laws in Chapter 27-5 entitled
"Fire
Insurance
Policies and Reserves" is hereby amended to read as follows:
27-5-3.7.
Hurricane deductibles, triggers and policyholder notice. -- (a)
The
provisions
of this section shall be applicable to policies issuing or renewing on or after
July 1,
2008.
(b)
In all instances where an insurance company licensed to do business in
this state
offers
or includes any deductible and/or mitigation measure related to such deductible
for any
type of
personal lines residential property insurance on dwelling houses, the insurance
company
shall
provide prominent and clear notice to insureds, that shall be included in the
policy issuance
or
renewal package and shall fully disclose all details pertaining to any such
deductible and/or
mitigation
measure.
(c)
The insurer may apply a deductible specific to windstorm coverage where:
(i)
The deductible is specifically approved by the director and shall not exceed
five
percent
(5%) of the insured value.
(ii)
The deductible shall be applicable to losses due to a hurricane during the
period
commencing
with the issuance of a hurricane warning bulletin for any part of the state by
the
National
Hurricane Center and concluding twenty-four (24) hours after the termination of
the last
hurricane
warning bulletin for any part of the state.
(iii)
The deductible, whether it is a flat dollar deductible or a percentage
deductible shall
be
presented by at least two (2) examples that illustrate the application of the
deductible to the
insured.
Nothing herein shall prohibit the insurer from providing any additional
information to the
insured
to assist in the insured's understanding of the deductible to be
applied to the insured's
policy.
(iv)
The deductible set forth above shall not be applied to any insured, if the
insured has
installed
approved mitigation measures to protect against windstorm damage and the
insurer has
either
inspected the property or the insured has submitted satisfactory proof of
installation of the
approved
mitigation measures. The insurance commissioner, in consultation with the state
building
code commissioner, shall adopt and may amend or revise a list of mitigation
measures,
based so
far as reasonably feasible on national standards for such measures and
practices in other
comparable
states. The list of mitigation measures adopted by the insurance commissioner
shall
be
considered approved mitigation measures for purposes of this subdivision.
(d)
Premium credits shall be applied to policies with deductibles as set
forth in
subsection
27-5-3.7(c).
(e)
An insurer may require mitigation measures to protect against windstorm
damage
only
after specific approval of the substance of such mitigation measures by the
director;
(i)
Mitigation measures to be taken by an insured are clearly explained, including
a
complete
illustration of the dollar impact upon the premiums to be charged to insureds
if the
requested
mitigation activities are undertaken;
(ii)
No mandatory deductible for windstorm damage shall be included in the policy;
(iii)
An insurer shall write the requested coverage at the premium rate that includes
the
premium
credit to be realized with the completion of the mitigation efforts;
(iv)
The insurer shall affirmatively state the length of time during which discount
given
for the
mitigation efforts will apply; and
(v)
No insurer shall subsequently non-renew an insured who has taken the mitigation
steps
requested by the insurer for reasons of the insurers exposure to catastrophe
loss, unless for
non-payment
of premium, fraud, breach by the insured of a provision of the policy, reversal
or a
lack of
maintenance of the mitigation steps, or insurer solvency concerns or adverse
loss history.
(f)
Penalties for failure to comply with the provisions of this section shall
be
administered
by the director in accordance with the provisions of
section 42-14-16.
(g)
The department of business regulation shall have authority to adopt such
rules,
including
emergency rules, as may be necessary or desirable to effectuate the purposes of
this
section.
SECTION 6. Section 27-10.2-2 of the General Laws in Chapter 27-10.2 entitled
"Motor
Vehicle Body Replacement Parts" is hereby amended to read as follows:
27-10.2-2.
Aftermarket parts - Time limit prohibition. [Effective January 1, 2008.] --
(a)
Whenever an insurance company, in adjusting a first party claim for motor
vehicle physical
damage,
intends to specify the use of aftermarket parts, it shall notify the insured in
writing. Any
auto
body repair shop conducting business in the state of Rhode Island shall not use
non-original
equipment
manufactured (OEM) parts, also referred to as aftermarket parts, in the repair
of any
person's
automobile, without that person giving the repairer his or her express written
consent.
(b)
No insurance company may require the use of aftermarket parts when
negotiating
repairs
with any repairer unless the repairer has written consent from the vehicle
owner to install
aftermarket
parts. The provisions of this section shall apply only to automobiles which are
less
than
thirty (30) months beyond the date of manufacture.
(c)
For any automobile which is less than thirty (30) months beyond the date
of
manufacturer manufacture, the insurer and the auto body
repairs shop must provide a written
notice
to the vehicle owner that: (i) he or she may require the insurer to pay for and
the auto body
shop to
install "original equipment manufacturer parts " or "OEM
parts" in the repair of a motor
vehicle
body replacement; or (ii) he or she may require the insurer to pay for and the
auto body
shop to
install "non-original equipment manufacturer parts" (non-"OEM
parts") in the repair of a
motor
vehicle body replacement. To comply with this provision, written notice may be
provided
on the
appraisal written on behalf of the insurer and the estimate prepared by the
auto body repair
shop.
SECTION 7. Section 31-47.3-3 of the General Laws in Chapter 31-47.3 entitled
"The
Diesel
Emissions Reduction Act" is hereby amended to read as follows:
31-47.3-3.
Reducing emissions from school buses. -- (a) Purpose. To reduce
health
risks
from diesel particulate matter (DPM) to Rhode Island school children by
significantly
reducing
tailpipe emissions from school buses, and preventing engine emissions from
entering the
passenger
cabin of the buses.
(b)
Requirements for Rhode Island school buses:
(i)
By September 1, 2010, no full-size school bus with an engine model year 1993 or
older
may be used to transport school children in Rhode Island; and,
(ii)
Providing there is sufficient federal or state monies, by September 1, 2010,
all full-
sized
school buses transporting children in Rhode Island must be retrofitted with a
closed
crankcase
ventilation system and either: (A) be equipped with a level 1, level 2, or
level 3 device
verified
by the US Environmental Protection Agency or the California Air Resources
Board; or
(B) be
equipped with an engine of model year 2007 or newer; or (C) achieve the same or
higher
diesel
PM reductions through the use of an alternative fuel such as compressed natural
gas
verified
by CARB/EPA to reduce DPM emissions at a level equivalent to or higher than
subsection
(B) above.
(c)
Financial assistance to defray costs of pollution reductions called for
in (b)(ii):
(i)
DEM shall work with the Rhode Island department of transportation or other
authorized
transit agencies to maximize the allocation of federal congestion mitigation
and air
quality
(CMAQ) money for Rhode Island for diesel emissions reductions in federal FY
2008 and
thereafter
until the retrofit goals in this act are met. The (CMAQ) program is jointly
administered
by the
federal highway administration (FHWA) and the federal transit administration
(FTA), and
was
reauthorized by congress in 2005 under the safe, accountable, flexible, and
efficient
transportation
equity act: A legacy for users (SAFETEA-LU). The (SAFETEA-LU) requires
states
and MPOs to give priority in distributing CMAQ funds to diesel engine
retrofits, and other
cost-effective
emission reduction and congestion mitigation activities that benefit air
quality.
(ii)
Drawing upon any available federal or state monies, the director shall
establish and
implement
a system of providing incentives consistent with this section to municipalities,
vendors,
or school bus owners for the purchase and installation of any CARB/EPA-verified
emission
control retrofit device together with the purchase and installation of closed
crankcase
ventilation
system (CCV) retrofit device. In 2007, the per-unit incentive shall not exceed
one
thousand
two hundred fifty dollars ($1,250) for a level 1 device plus a CCV, or two
thousand five
hundred
dollars ($2,500) for a level 2 device plus a CCV, or for model years 2003-2006
five
thousand
dollars ($5,000) for a level 3 device plus a CCV. Incentive levels may be
reevaluated
annually,
with the goal of maintaining competition in the market for retrofit devices. To
the
extent
practicable, in kind services will also be utilized to offset some of the
costs. Incentive
recipients
must also certify that newly purchased or retrofitted buses with a level
3 technology
will
operate in the state of Rhode Island for a minimum of four (4) years.
(d)
Priority community provision:
(i)
When penalty funds, state SEP funds, federal funds, or funds from other state
or non-
state
sources become available, these should first be allocated toward further
offsetting costs of
achieving
"best available" emissions control in "priority
communities";
(ii)
The "best available" standard is attained by all new buses (MY2007
and newer) and
by
diesel buses model year 2003 to 2006, inclusive that has been retrofitted with
level 3-verified
diesel
particulate filters and closed crankcase ventilation systems, by diesel buses model
year
1994 to
2002, inclusive that has been retrofitted with at least level 2-verified diesel
particulate
filters
and closed crankcase ventilation systems or could be achieved with a natural
gas bus that
achieves
the same or better standards of cleanliness as a 2007 diesel bus standard; and
(iii)
"Priority communities" (to be identified by the Rhode Island DEM) are
Rhode Island
communities
that have high levels of ambient air pollution and high incidence of childhood
respiratory
impacts.
(e)
To achieve the pressing public health and environmental goals of this act,
DEM shall
identify
opportunities to achieve maximize PM reductions from diesel powered heavy duty
vehicle
or equipment that is owned by, operated by, or on behalf of, or leased by, or
operating
under a
contact to a state agency or state or regional public authority (except
vehicles that are
specifically
equipped for emergency response) and diesel powered waste collection and
recycling
vehicles
that are owned, leased, or contracted to perform the removal or transfer
or municipal,
commercial
or residential waste, or recycling services. No later than January 1, 2008, DEM
shall
present
a report to the general assembly, governor, house committee on environment and
natural
resources,
and the senate committee on environment and agriculture on such opportunities
to
maximum
PM reductions from the aforementioned fleets including legislative changes,
regulatory
changes,
funding sources, contract requirements, procurement requirements, and other
mechanisms
that will bring about maximum PM reductions from these two priority fleets.
This
report
shall explore funding sources beyond CMAQ, including but not limited to Diesel
Reductions
Emissions Reduction Act (DERA) funds under the Federal Energy Act.
(f)
Severability. If any clause, sentence, paragraph, section or part of this
act shall be
adjudged
by any court of competent jurisdiction to be invalid and after exhaustion of
all further
judicial
review, the judgment shall not affect, impair or invalidate the remainder
thereof, but shall
be
confined in its operation to the clause, sentence, paragraph, section or part
of this act directly
involved
in the controversy in which the judgment shall have been rendered.
SECTION 8. Section 40-8-19 of the General Laws in Chapter 40-8 entitled
"Medical
Assistance"
is hereby amended to read as follows:
40-8-19.
Rates of payment to nursing facilities. -- (a) Rate reform. The
rates to be paid
by the
state to nursing facilities licensed pursuant to chapter 17 of title
23, and certified to
participate
in the Title XIX Medicaid program for services rendered to Medicaid-eligible
residents,
shall be reasonable and adequate to meet the costs which must be incurred by
efficiently
and economically operated facilities in accordance with 42 U.S.C.
1396a(a)(13). The
department
of human services shall promulgate or modify the principles of reimbursement
for
nursing
facilities currently in effect on July 1, 2003 to be consistent with the
provisions of this
section
and Title XIX, 42 U.S.C. 1396 et seq., of the Social Security Act.
(b)
Rate reform. Subject to the phase-in provisions in subsections (c) and
(d), the
department
shall, on or before October 1, 2005, modify the principles of reimbursement for
nursing
facilities to include the following elements:
(1)
Annual base years;
(2)
Four (4) cost centers: direct labor, property, other operating, and pass through
items;
(3)
Re-array of costs of all facilities in the labor and other operating cost
centers every
three
(3) years beginning with calendar year 2002;
(4)
A ceiling maximum for allowable costs in the direct labor cost center to be
established
by the department between one hundred ten percent (110%) and one hundred
twenty-
five
percent (125%) of the median for all facilities for the most recent array year.
(5)
A ceiling maximum for allowable costs in the other operating cost center to be
established
by the department between ninety percent (90%) and one hundred fifteen percent
(115%)
of the median for all facilities for the most recent array year;
(6)
Adjustment of costs and ceiling maximums by the increase in the National Nursing
Home
Price Index ("NNHPI") for the direct labor cost center and the other
operating cost center
for year
between array years; such adjustments to be applied on October 1st of each year
beginning
October 1, 2003 for the direct labor cost center and October 1, 2005 for the
other
operating
cost center, except for the fiscal year beginning July 1, 2006 for which the
price index
shall be
applied on February 1, 2007 and for the fiscal year beginning October 1, 2007
for which
the adjustment
of costs and ceiling maximums shall be one and one-tenth percent (1.1%)
percent.
(7) Application of a fair rental value system to be developed by the department
for
calculating
allowable reimbursement for the property cost center;
(8)
Such quality of care and cost containment incentives as may be established by
departmental
regulations.
(c)
Phase I Implementation. The department shall file a state plan amendment
with the
U.S.
Department of Health and Human Services on or before August 1, 2003 to modify
the
principles
of reimbursement for nursing facilities, to be effective on October 1, 2003, or
as soon
thereafter
as is authorized by an approved state plan amendment, to establish the direct
labor cost
center
and the pass through items cost center utilizing calendar year 2002 cost data,
and to apply
the
ceiling maximums in subsections (b)(4) and (b)(5). Nursing facilities whose
allowable 2002
direct
labor costs are below the median in the direct labor cost center may make application
to the
department
for a direct labor cost interim payment adjustment equal to twenty-five percent
(25%)
of the
amount such allowable 2002 direct labor costs are below the median in the
direct labor cost
center,
provided that the interim payment adjustment granted by the department on or
after
October
1, 2003 must be expended by the facility on expenses allowable within the
direct labor
cost center,
and any portion of the interim payment not expended on allowable direct labor
cost
center
expenses shall be subject to retroactive adjustment and recoupment by the
department
upon the
department's determination of a final direct labor payment adjustment after
review of the
facility's
actual direct labor expenditures. The final direct labor payment adjustment
will be
included
in the facility's October 1, 2004 rate until the facility's next base year.
(d)
Phase II Implementation. The department shall file a state plan amendment
with the
U.S.
Department of Health and Human Services to modify the principles of
reimbursement for
nursing
facilities, to be effective on September 1, 2004, or as soon thereafter as is
authorized by
an
approved state plan amendment, to establish a fair rental value system for
calculating
allowable
reimbursement for the property cost center in accordance with subsection
(b)(7);
provided,
however, that no facility shall receive a payment as of September 1, 2004 for
property-
related
expenses pursuant to the fair rental value system that is less than the
property-related
payment
they would have received for the other property-related ("OPR") cost
center system in
effect
as of June 30, 2004.
SECTION 9. Section 42-7.2-5 of the General Laws in Chapter 42-7.2 entitled
"Office
of
Health and Human Services " is hereby amended to read as follows:
42-7.2-5.
Duties of the secretary. -- The secretary shall be subject to the
direction and
supervision
of the governor for the oversight, coordination and cohesive direction of state
administered
health and human services and in ensuring the laws are faithfully executed, not
withstanding
any law to the contrary. In this capacity, the Secretary of Health and Human
Services
shall be authorized to:
(a)
(1) Coordinate the administration and financing of health care benefits,
human
services
and programs including those authorized by the Medicaid State Plan under Title
XIX of
the US
Social Security Act. However, nothing in this section shall be construed as
transferring to
the
secretary the powers, duties or functions conferred upon the departments by
Rhode Island
public
and general laws for the administration of federal/state programs financed in
whole or in
part
with Medicaid funds or the administrative responsibility for the preparation
and submission
of any
state plans, state plan amendments, or authorized federal waiver applications.
(b)
(2) Serve as the governor's chief advisor and liaison to federal
policymakers on
Medicaid
reform issues as well as the principal point of contact in the state on any
such related
matters.
(c)
(3) Review and ensure the coordination of any new departmental waiver
requests and
renewals
as well as any initiatives and proposals requiring amendments to the Medicaid
state plan
with the
potential to affect the scope, amount or duration of publicly-funded health
care services,
provider
payments or reimbursements, or access to or the availability of benefits and
services as
provided
by Rhode Island general and public laws. The secretary shall consider whether
any such
waivers
or amendments are legally and fiscally sound and consistent with the
state's policy and
budget
priorities. The secretary shall also assess whether a proposed waiver or amendment
is
capable
of obtaining the necessary approvals from federal officials and achieving the
expected
positive
consumer outcomes. Department directors shall, within the timelines specified,
provide
any information
and resources the secretary deems necessary in order to perform the reviews
authorized
in this section;
(d)
(4) Beginning in 2006, prepare and submit to the governor, the
chairpersons of the
house
and senate finance committees, the caseload estimating conference, and to the
joint
legislative
committee for health care oversight, by no later than February 1 of each year,
a
comprehensive
overview of all Medicaid expenditures outcomes, and utilization rates. The
overview
shall include, but not be limited to, the following information:
(1)
(i) Expenditures under Titles XIX and XXI of the social security act Social
Security
Act, as amended;
(2)
(ii) Expenditures, outcomes and utilization rates by population and
sub-population
served
(e.g. families with children, children with disabilities, children in foster
care, children
receiving
adoption assistance, adults with disabilities, and the elderly);
(3)
(iii) Expenditures, outcomes and utilization rates by each state department
or other
municipal
or public entity receiving federal reimbursement under Titles XIX and XXI of
the
social
security act Social Security Act,
as amended; and
(4)
(iv) Expenditures, outcomes and utilization rates by type of service
and/or service
provider.
The
directors of the departments, as well as local governments and school
departments,
shall
assist and cooperate with the secretary in fulfilling this responsibility by
providing whatever
resources,
information and support shall be necessary.
(e)
(5) Resolve administrative, jurisdictional, operational, program, or
policy conflicts
among
departments and their executive staffs and make necessary recommendations to
the
governor.
(f)
(6) Assure continued progress toward improving the quality, the economy,
the
accountability
and the efficiency of state-administered health and human services. In this
capacity,
the secretary shall:
(1)
(i) Direct implementation of reforms in the human resources practices of
the
departments
that streamline and upgrade services, achieve greater economies of scale and
establish
the coordinated system of the staff education, cross- training, and career
development
services
necessary to recruit and retain a highly-skilled, responsive, and engaged
health and
human
services workforce;
(2)
(ii) Encourage the departments to utilize consumer-centered approaches
to service
design
and delivery that expand their capacity to respond efficiently and responsibly
to the
diverse
and changing needs of the people and communities they serve;
(3)
(iii) Develop all opportunities to maximize resources by leveraging the
state's
purchasing
power, centralizing fiscal service functions related to budget, finance, and
procurement,
centralizing communication, policy analysis and planning, and information
systems
and data
management, pursuing alternative funding sources through grants, awards and
partnerships
and securing all available federal financial participation for programs and
services
provided
through the departments; and
(4)
(iv) Improve the coordination and efficiency of health and human
services legal
functions
by centralizing adjudicative and legal services and overseeing their timely and
judicious
administration.
(g)
(7) Prepare and integrate comprehensive budgets for the health and human
services
departments
and any other functions and duties assigned to the office. The budgets shall be
submitted
to the state budget office by the secretary, for consideration by the governor,
on behalf
of the
state's health and human services in accordance with the provisions set forth
in section 35-
3-4 of
the Rhode Island general laws.
(h)
(8) Utilize objective data to evaluate health and human services policy
goals, resource
use and
outcome evaluation and to perform short and long-term policy planning and
development.
(i)
(9) Establishment of an integrated approach to interdepartmental
information and data
management
that will facilitate the transition to consumer-centered system of state
administered
health
and human services.
(j)
(10) At the direction of the governor or the general assembly, conduct
independent
reviews
of state-administered health and human services programs, policies and related
agency
actions
and activities and assist the department directors in identifying strategies to
address any
issues
or areas of concern that may emerge thereof. The department directors shall provide
any
information
and assistance deemed necessary by the secretary when undertaking such
independent
reviews.
(k)
(11) Provide regular and timely reports to the governor and make
recommendations
with
respect to the state's health and human services agenda.
(l)
(12) Employ such personnel and contract for such consulting services as
may be
required
to perform the powers and duties lawfully conferred upon the secretary.
(m)
(13) Implement the provisions of any general or public law or regulation
related to
the
disclosure, confidentiality and privacy of any information or records, in the
possession or
under
the control of the executive office or the departments assigned to the
executive office, that
may be
developed or acquired for purposes directly connected with the secretary's
duties set forth
herein.
(n)
(14) Hold the director of each health and human services department
accountable for
their
administrative, fiscal and program actions in the conduct of the respective
powers and duties
of their
agencies.
SECTION 10. Section 42-14.5-3 of the General Laws in Chapter 42-14.5 entitled
"The
Rhode Island Health Care Reform Act of 2004 – Health Insurance Oversight "
is hereby
amended
to read as follows:
42-14.5-3.
Powers and duties. [Contingent effective date; see notes under
section 42-
14.5-1.]
--The health insurance
commissioner shall have the following powers and duties:
(a)
To conduct an annual public meeting or meetings, separate and distinct from
rate
hearings
pursuant to section 42-62-13, regarding the rates, services and
operations of insurers
licensed
to provide health insurance in the state the effects of such rates, services
and operations
on
consumers, medical care providers and patients, and the market environment in
which such
insurers
operate. Notice of not less than ten (10) days of said hearing(s) shall go to
the general
assembly,
the governor, the Rhode Island Medical Society, the Hospital Association of
Rhode
Island,
the director of health, and the attorney general. Public notice shall be posted
on the
department's
web site and given in the newspaper of general circulation, and to any entity
in
writing requesting
notice.
(b)
To make recommendations to the governor and the joint legislative committee on
health
care oversight regarding health care insurance and the regulations, rates,
services,
administrative
expenses, reserve requirements, and operations of insurers providing health
insurance
in the state, and to prepare or comment on, upon the request of the co-chairs
of the joint
committee
on health care oversight or upon the request of the governor, draft legislation
to
improve
the regulation of health insurance. In making such recommendations, the
commissioner
shall
recognize that it is the intent of the legislature that the maximum disclosure
be provided
regarding
the reasonableness of individual administrative expenditures as well as total
administrative
costs. The commissioner shall also make recommendations on the levels of
reserves
including consideration of: targeted reserve levels; trends in the increase or
decrease of
reserve
levels; and insurer plans for distributing excess reserves.
(c)
To establish a consumer/business/labor/medical advisory council to obtain
information
and present concerns of consumers, business and medical providers affected by
health
insurance decisions. The council shall be involved in the planning and conduct
of the
public
meeting in accordance with subsection (a) above. The advisory council shall
assist in the
design
of an insurance complaint process to ensure that small businesses that
experience
extraordinary
rate increases in a given year could request and receive a formal review by the
department.
The advisory council shall assess views of the health provider community
relative to
insurance
rates of reimbursement, billing and reimbursement procedures, and the insurers'
role in
promoting
efficient and high quality health care. The advisory council shall issue an
annual report
of
findings and recommendations to the governor and the joint legislative
committee on health
care
oversight. The advisory council is to be diverse in interests and shall include
representatives
of
community consumer organizations; small businesses, other than those involved
in the sale of
insurance
products; and hospital, medical, and other health provider organizations. Such
representatives
shall be nominated by their respective organizations. The advisory council
shall
be
co-chaired by the health insurance commissioner and a community consumer
organization or
small
business member to be elected by the full advisory council.
(d)
To establish and provide guidance and assistance to a subcommittee ("The
Professional
Provider-Health Plan Work Group") of the advisory council created pursuant
to
subsection
(c) above, composed of health care providers and Rhode Island licensed health plans.
This
subcommittee shall develop a plan to implement the following activities:
(i)
By January 1, 2006, a method whereby health plans shall disclose to contracted
providers
the fee schedules used to provide payment to those providers for services
rendered to
covered
patients;
(ii)
By April 1, 2006, a standardized provider application and credentials
verification
process,
for the purpose of verifying professional qualifications of participating
health care
providers;
(iii)
By September 1, 2006, a uniform health plan claim form to be utilized by
participating
providers;
(iv)
By March 15, 2007, a report to the legislature on proposed methods for health
maintenance
organizations as defined by section 27-41-1, and nonprofit hospital
or medical
service
corporations as defined by chapters 27-19 and 27-20, to make facility-specific
data and
other
medical service-specific data available in reasonably consistent formats to
patients
regarding
quality and costs. This information would help consumers make informed choices
regarding
the facilities and/or clinicians or physician practices at which to seek care.
Among the
items
considered would be the unique health services and other public goods provided
by
facilities
and/or clinicians or physician practices in establishing the most appropriate
cost
comparisons.
(v)
By December 1, 2006, contractual disclosure to participating providers of the
mechanisms
for resolving health plan/provider disputes; and
(vi)
By February 1, 2007, a uniform process for confirming in real time patient
insurance
enrollment
status, benefits coverage, including co-pays and deductibles.
(vii)
By December 1, 2007, a report to the legislature on the temporary credentialing
of
providers
seeking to participate in the plan's network and the impact of said activity on
health
plan
accreditation;
(viii)
By February 1, 2008, a report to the legislature on the feasibility of
occasional
contract
renegotiations between plans and the providers in their networks.
(ix)
By May 1, 2008, a report to the legislature reviewing impact of silent PPOs on
physician
practices.
A
report on the work of the subcommittee shall be submitted by the health
insurance
commissioner
to the joint legislative committee on health care oversight on March 1, 2006,
March 1,
2007, and March 1, 2008.
(e)
To enforce the provisions of Title 27 and Title 42 as set forth in
section 42-14-5(d).
(f)
There is hereby established the Rhode Island Affordable Health Plan Reinsurance
Fund.
The fund shall be used to effectuate the provisions of
sections 27-18.5-8 and 27-50-17.
(g)
To examine and study the impact of changing the rating guidelines and/or merging
the
individual
health insurance market as defined in section chapter 27-18.5
and the small employer
health
insurance market as defined in chapter 27-50 in accordance with the following:
(i)
The study shall forecast the likely rate increases required to effect the
changes
recommended
pursuant to the preceding subsection (g) in the direct pay market and small
employer
health insurance market over the next five (5) years, based on the current
rating
structure,
and current products.
(ii)
The study shall include examining the impact of merging the individual and
small
employer
markets on premiums charged to individuals and small employer groups.
(iii)
The study shall include examining the impact on rates in each of the individual
and
small
employer health insurance markets and the number of insureds in the context of
possible
changes
to the rating guidelines used for small employer groups, including: community
rating
principles;
expanding small employer rate bands bonds beyond the current
range; increasing the
employer
group size in the small group market; and/or adding rating factors for broker
and/or
tobacco
use.
(iv)
The study shall include examining the adequacy of current statutory and
regulatory
oversight
of the rating process and factors employed by the participants in the proposed
new
merged
market.
(v)
The study shall include assessment of possible reinsurance mechanisms and/or
federal
high-risk
pool structures and funding to support the health insurance market in Rhode
Island by
reducing
the risk of adverse selection and the incremental insurance premiums charged
for this
risk,
and/or by making health insurance affordable for a selected at-risk population.
(vi)
The health insurance commissioner shall establish an insurance market merger
task
force to
assist with the study. The task force shall be chaired by the health insurance
commissioner
and shall include, but not be limited to, representatives of the general
assembly, the
business
community, small employer carriers as defined in section 27-50.3 27-50-3,
carriers
offering
coverage in the individual market in Rhode Island, health insurance brokers and
members
of the general public.
(vii)
For the purposes of conducting this study, the commissioner may contract with
an
outside
organization with expertise in fiscal analysis of the private insurance market.
In
conducting
its study, the organization shall, to the extent possible, obtain and use
actual health
plan
data. Said data shall be subject to state and federal laws and regulations
governing
confidentiality
of health care and proprietary information.
(viii)
The task force shall meet no later than October 1, 2007 and the commissioner
shall
file a
report with the speaker of the house of representatives and the president of
the senate no
later
than January 1, 2008.
SECTION 11. Section 42-46-2 of the General Laws in Chapter 42-46 entitled
"Open
Meetings"
is hereby amended to read as follows:
42-46-2.
Definitions. -- As used in this chapter:
(a)
(1) "Meeting" means the convening of a public body to
discuss and/or act upon a
matter
over which the public body has supervision, control, jurisdiction, or advisory
power. As
used
herein, the term "meeting" expressly includes, without limiting the
generality of the
foregoing,
so-called "workshop," "working," or "work"
sessions.
(b)
(2) "Open call" means a public announcement by the
chairperson of the committee
that the
meeting is going to be held in executive session and the chairperson must
indicate which
exception
of section 42-46-5 is being involved.
(c)
(3) "Public body" means any department, agency,
commission, committee, board,
council,
bureau, or authority or any subdivision thereof of state or municipal
government or any
library
that funded at least twenty-five percent (25%) of its operational budget in the
prior budget
year
with public funds, and shall include all authorities defined in
section 42-35-1(b). For
purposes
of this section, any political party, organization, or unit thereof meeting or
convening is
not and
should not be considered to be a public body; provided, however, that no such
meeting
shall be
used to circumvent the requirements of this chapter.
(d)
(4) "Quorum", unless otherwise defined by applicable law,
means a simple majority
of the
membership of a public body.
(e)
(5) "Prevailing plaintiff" includes those persons and
entities deemed "prevailing
parties"
pursuant to 42 U.S.C. 1988.
(f)
(6) "Open forum" means the designated portion of an open
meeting, if any, on a
properly
posted notice reserved for citizens to address comments to a public body
relating to
matters
affecting the public business.
SECTION 12. Section 42-72-5 of the General Laws in Chapter 42-72 entitled
"Department
of Children, Youth, and Families" is hereby amended to read as follows:
42-72-5.
Powers and scope of activities. -- (a) The department is the
principal agency
of the
state to mobilize the human, physical and financial resources available to
plan, develop,
and
evaluate a comprehensive and integrated statewide program of services designed
to ensure
the
opportunity for children to reach their full potential. The services include
prevention, early
intervention,
out-reach, placement, care and treatment, and after-care programs; provided,
however,
that the department notifies the state police and cooperates with local police
departments
when it receives and/or investigates a complaint of sexual assault on a minor
and
concludes
that probable cause exists to support the allegations(s). The department also
serves as
an
advocate for the needs of children.
(b)
To accomplish the purposes and duties, as set forth in this chapter, the
director is
authorized
and empowered:
(1)
To establish those administrative and operational divisions of the department
that the
director
determines is in the best interests of fulfilling the purposes and duties of
this chapter;
(2)
To assign different tasks to staff members that the director determines best
suit the
purposes
of this chapter;
(3)
To establish plans and facilities for emergency treatment, relocation and
physical
custody
of abused or neglected children which may include, but are not limited to,
homemaker/educator
child case aides, specialized foster family programs, day care facilities,
crisis
teams, emergency parents, group homes for teenage parents, family centers
within existing
community
agencies, and counseling services;
(4)
To establish, monitor, and evaluate protective services for children including,
but not
limited
to, purchase of services from private agencies and establishment of a policy
and
procedure
manual to standardize protective services;
(5)
To plan and initiate primary and secondary treatment programs for abused and
neglected
children;
(6)
To evaluate the services of the department and to conduct periodic
comprehensive
needs
assessment;
(7)
To license, approve, monitor, and evaluate all residential and non-residential
child
care
institutions, group homes, foster homes, and programs;
(8)
To recruit and coordinate community resources, public and private;
(9)
To promulgate rules and regulations concerning the confidentiality, disclosure
and
expungement
of case records pertaining to matters under the jurisdiction of the department;
(10)
To establish a minimum mandatory level of twenty (20) hours of training per
year
and
provide ongoing staff development for all staff; provided, however, all social
workers hired
after
June 15, 1991, within the department shall have a minimum of a bachelor's
degree in social
work or
a closely related field, and must be appointed from a valid civil service list;
(11)
To establish procedures for reporting suspected child abuse and neglect
pursuant to
chapter
11 of title 40;
(12)
To promulgate all rules and regulations necessary for the execution of
departmental
powers
pursuant to the Administrative Procedures Act, chapter 35 of title
42;
(13)
To provide and act as a clearinghouse for information, data and other materials
relative
to children;
(14)
To initiate and carry out studies and analysis which will aid in solving local,
regional
and
statewide problems concerning children;
(15)
To represent and act on behalf of the state in connection with federal grant
programs
applicable
to programs for children in the functional areas described in this chapter;
(16)
To seek, accept, and otherwise take advantage of all federal aid available to
the
department,
and to assist other agencies of the state, local agencies, and community groups
in
taking
advantage of all federal grants and subventions available for children;
(17)
To review and coordinate those activities of agencies of the state and of any
political
subdivision
of the state which affect the full and fair utilization of community resources
for
programs
for children, and initiate programs that will help assure utilization;
(18)
To administer the pilot juvenile restitution program, including the overseeing
and
coordinating
of all local community based restitution programs, and the establishment of
procedures
for the processing of payments to children performing community service; and
(19)
To adopt rules and regulations which:
(i)
For the twelve (12) month period beginning on October 1, 1983, and for each
subsequent
twelve (12) month period, establish specific goals as to the maximum number of
children
who will remain in foster care for a period in excess of two (2) years; and
(ii)
Are reasonably necessary to implement the child welfare services and foster
care
programs;
(20)
May establish and conduct seminars for the purpose of educating children
regarding
sexual
abuse;
(21)
To establish fee schedules by regulations for the processing of requests from
adoption
placement agencies for adoption studies, adoption study updates, and
supervision related
to
interstate and international adoptions. The fee shall equal the actual cost of
the service(s)
rendered,
but in no event shall the fee exceed two thousand dollars ($2,000);
(22)
To be responsible for the education of all children who are placed, assigned,
or
otherwise
accommodated for residence by the department in a state operated or supported
community
residence licensed by a Rhode Island state agency. In fulfilling this
responsibility the
department
is authorized to enroll and pay for the education of students in the public
schools or,
when
necessary and appropriate, to itself provide education in accordance with the
regulations of
the
board of regents for elementary and secondary education either directly or
through contract;
(23)
To develop multidisciplinary service plans, in conjunction with the department
of
health,
at hospitals prior to the discharge of any drug-exposed babies. The plan
requires the
development
of a plan using all health care professionals.
(24)
To be responsible for the delivery of appropriate mental health services to
seriously
emotionally
disturbed children and children with functional developmental disabilities.
Appropriate
mental health services may include hospitalization, placement in a residential
treatment
facility, or treatment in a community based setting. The department is charged
with the
responsibility
for developing the public policy and programs related to the needs of seriously
emotionally
disturbed children and children with functional developmental disabilities.
In
fulfilling its responsibilities the department shall:
(i)
Plan a diversified and comprehensive network of programs and services to meet
the
needs of
seriously emotionally disturbed children and children with functional
developmental
disabilities;
(ii)
Provide the overall management and supervision of the state program for
seriously
emotionally
disturbed children and children with functional developmental disabilities;
(iii)
Promote the development of programs for preventing and controlling emotional or
behavioral
disorders in children;
(iv)
Coordinate the efforts of several state departments and agencies to meet the
needs of
seriously
emotionally disturbed children and children with functional developmental
disabilities
and to
work with private agencies serving those children;
(v)
Promote the development of new resources for program implementation in
providing
services
to seriously emotionally disturbed children and children with functional
developmental
disabilities.
The
department shall adopt rules and regulations, which are reasonably necessary to
implement
a program of mental health services for seriously emotionally disturbed
children.
Each
community, as defined in chapter 7 of title 16, shall contribute to
the department, at
least in
accordance with rules and regulations to be adopted by the department, at least
its average
per
pupil cost for special education for the year in which placement commences, as
its share of
the cost
of educational services furnished to a seriously emotionally disturbed child
pursuant to
this
section in a residential treatment program which includes the delivery of
educational services.
"Seriously emotionally disturbed child" means any person under the
age of eighteen (18)
years or
any person under the age of twenty-one (21) years who began to receive services
from
the
department prior to attaining eighteen (18) years of age and has continuously
received those
services
thereafter who has been diagnosed as having an emotional, behavioral or mental
disorder
under
the current edition of the Diagnostic and Statistical Manual and that
disability has been on-
going
for one year or more or has the potential of being ongoing for one year or
more, and the
child is
in need of multi-agency intervention, and the child is in an out-of-home
placement or is at
risk of
placement because of the disability.
A
child with a "functional developmental disability" means any person
under the age of
eighteen
(18) years or any person under the age of twenty-one (21) years who began to
receive
services
from the department prior to attaining eighteen (18) years of age and has
continuously
received
those services thereafter.
The
term "functional developmental disability" includes autism spectrum
disorders and
means a
severe, chronic disability of a person which:
(a)
Is attributable to a mental or physical impairment or combination of mental
physical
impairments;
(b)
Is manifested before the person attains age eighteen (18);
(c)
Is likely to continue indefinitely;
(d)
Results in age- appropriate substantial functional limitations in three (3) or
more of
the
following areas of major life activity.
(i)
Self-care;
(ii)
Receptive and expressive language;
(iii)
Learning;
(iv)
Mobility;
(v)
Self-direction;
(vi)
Capacity for Independent Living; and
(vii)
Economic self-sufficiency; and
(e)
Reflects the person's need for a combination and sequence of special,
interdisciplinary,
or generic care, treatment, or other services which are of life-long or
extended
duration
and are individually planned and coordinated.
(25)
To provide access to services to any person under the age of eighteen (18)
years or
any
person under the age of twenty-one (21) years who began to receive child
welfare services
from the
department prior to attaining eighteen (18) years of age, has continuously
received those
services
thereafter and elects to continue to receive such services after attaining the
age of
eighteen
(18) years.
(26)
To develop and maintain, in collaboration with other state and private
agencies, a
comprehensive
continuum of care in this state for children in the care and custody of the
department
or at risk of being in state care. This continuum of care should be
family-centered and
community-based
with the focus of maintaining children safely within their families or, when a
child
cannot live at home, within as close proximity to home as possible based on the
needs of the
child
and resource availability. The continuum should include community-based
prevention,
family
support and crisis intervention services as well as a full array of foster care
and residential
services,
including residential services designed to meet the needs of children who are
seriously
emotionally
disturbed, children who have a functional developmental disability and youth
who
have
juvenile justice issues. The director shall make reasonable efforts to provide
a
comprehensive
continuum of care for children in the care and custody of the DCYF, taking into
account
the availability of public and private resources and financial appropriations
and the
director
shall submit an annual report to the general assembly as to the status of his
or her efforts
in
accordance with the provisions of subsection 42-72-4(b)(13).
(27)
To administer funds under the John H. Chafee Foster Care Independence and
Educational
And Training Voucher (ETV) Programs of Title IV-E of the Social Security Act,
and
the
DCYF Higher Education Opportunity Grant Program as outlined in RIGL
section 42-72.8, in
accordance
with rules and regulations as promulgated by the director of the department.
(c)
In order to assist in the discharge of his or her duties, the director
may request from
any
agency of the state information pertinent to the affairs and problems of
children.
(d)
Funding for these clients shall include funds that are transferred to the
Department of
Human
Services as part of the Managed Health Care program transfer. However, the
expenditures
relating
to these clients shall not be part of the Department of Human Services'
Caseload
estimated
for the semi-annual Caseload Estimating Conference. The expenditures shall be
accounted
for separately.
(e)
The assembly has included funding in the FY 2008 Department of Children,
Youth
and
Families budget in the amount of $10.5 million from all sources of funds and
$6.0 million
from
general revenues to provide a managed system to care for children serviced
between 18 to
21 years
of age. The department shall manage this caseload to this level of funding.
(27)
To administer funds under the John H. Chafee Foster Care Independence and
Educational
And Training Voucher (ETV) Programs of Title IV-E of the Social Security Act,
and
the
DCYF Higher Education Opportunity Grant Program as outlined in RIGL
section 42-72.8, in
accordance
with rules and regulations as promulgated by the director of the department.
SECTION
13. Section 42-141-5 of the General Laws in Chapter 42-141entitled
"Affordable
Energy" is hereby amended to read as follows:
42-141-5.
Affordable energy fund. -- (a) Fund established..
(1)
A special account is hereby established in the state treasury to be called the
"affordable
energy fund."
(2)
Money remaining in the fund at the end of a fiscal year shall remain available
for
expenditure
in successive fiscal years.
(3)
The fund shall be used for only those purposes enumerated in subsection (d).
(b)
Financing of the fund. The fund shall consist of the following sources:
(1)
Sums the legislature may appropriate;
(2)
Moneys received from federal, state, private donor or other sources for the
purpose of
energy
affordability by low income households;
(3)
Fees required pursuant to subsection (c); and
(4)
Any interest earned on the moneys in the fund.
(c)
Affordable energy fees.
(1)
An affordable energy fee in an amount set forth in this subsection shall be
imposed on
gross
receipts of electricity and gas companies and gross receipts on the sale of
heating fuels not
used for
residential heating. The fee shall be remitted to the division of taxation
according to the
applicable
schedule for the remission of the gross receipts tax as provided for in chapter
44-13 or
the
sales and use as provided for in chapter 44-18. The fees shall be as follows:
(i)
Gas. Effective January 1, 2009, one-quarter of one percent (0.25%) of the gross
receipts
tax of gas companies subject to the provisions of chapter 44-13 "Public
Service
Corporation
Tax". Effective January 1, 2010, one-half of one percent (0.50%) of the
gross
receipts
of gas companies subject to the provisions of chapter 44-13 "Public
Service Corporation
Tax".
Effective January 1, 2011 three-quarters of one percent (0.75%) of the gross
receipts of gas
companies
subject to the provisions of chapter 44-13 "Public Service Corporation
Tax". Effective
January
1, 2012 and each January 1 thereafter one percent (1%) of the gross receipts of
gas
companies
subject to the provisions of chapter 44-13, "Public Service Corporation
Tax".
(ii)
Electricity. Effective January 1, 2009, one-quarter of one percent (0.25%) of
the gross
receipts
tax of electric companies subject to the provisions of chapter 44-13
"Public Service
Corporation
Tax". Effective January 1, 2010, one-half of one percent (0.50%) of the
gross
receipts
of electric companies subject to the provisions of chapter 44-13 "Public
Service
Corporation
Tax". Effective January 1, 2011, three-quarters of one percent (0.75%) of
the gross
receipts
of electric companies subject to the provisions of chapter 44-13
"Public Service
Corporation
Tax". Effective January 1, 2012 and each January 1 thereafter, one percent
(1%) of
the
gross receipts of electric companies subject to the provisions of chapter
44-13, "Public
Service
Corporation Tax".
(iii)
Heating fuel other than natural gas and electricity. Effective January 1, 2009,
one-
half
percent (.50%) of gross receipts from the sales and use of heating fuel subject
to the
provisions
of chapter 44-18 "Sales and Use Taxes - Liability and Computation".
Effective
January
1, 2010, one percent (1.0%) of gross receipts from the sales and use of heating
fuel
subject
to the provisions of chapter 44-18 "Sales and Use Taxes - Liability and
Computation".
Effective
January 1, 2011, one and one-half percent (1.5%) of gross receipts from the
sales and
use of
heating fuel subject to the provisions of chapter 44-18. Effective January 1,
2012 and each
January
1 thereafter two percent (2%) of gross receipts from the sales and use of
heating fuel
subject
to the provisions of chapter 44-18. "Sales and Use Taxes - Liability and
Computation".
(2)
Every person from whom an affordable energy fee is due shall be liable for the
fee
until it
has been paid to the state.
(d)
Purposes of the fund.
(1)
The commissioner may use money from the fund to:
(i)
Support weatherization and energy conservation educational programs and
weatherization
and energy conservation services for low-income and very low income
households;
(ii)
Compensate electric and gas distribution companies for revenues lost due to the
reductions
in distribution and customer charges, in accordance with a plan approved by the
commission,
to very low income households, and if feasible to low income households, which
shall,
as a first priority, be used to provide up to a fifty percent (50%) reduction
in the distribution
and
customer charges for a reasonable and prudent use by very low-income households
of gas
and
electricity that does not exceed average use for comparable dwelling units.
(iii)
Defray the cost of heating fuel delivered to very low income households by an
amount
not to exceed twenty-five percent (25%) of the allowable cost of heating fuel
and a total
usage by
the household, supported assistance from all sources overseen by the
commissioner, that
is
reasonable and prudent and does not exceed average use for comparable dwelling
units.
(iv)
Provide supplemental funds as may be necessary to augment the LIHEAP program in
order to
accomplish the purposes of this chapter; it is not the purpose of the fund to
reduce the
amount
of assistance a household would otherwise receive from LIHEAP and other sources
in the
absence
of the fund or to subsidize utility rates in effect as of July 1, 2006, and
provided for by
law.
(2)
If the commissioner determines it is in the public interest to allocate funds
for the
purposes
set forth in subparagraph (1)(ii) above, the commissioner shall notify the commission
of
the
amount of funds to be allocated for a specified period. The commission shall
then direct the
electric
and/or gas distribution companies to file amendments to the appropriate tariffs
to
implement
rate reductions designed to provide the rate reduction consistent with the
amount
allocated
for the period designated, which amendments are subject to the review and
approval of
the
commission. Once approval is given, the allocated funds shall be transferred to
the gas and/or
electric
distribution company. Any funds held after transfer shall accumulate interest
at the
customer
deposit rate ("interest"). If, at the end of the rate reduction
period, there are any unused
dollars
from the fund, such dollars shall be returned to the affordable energy fund
with interest.
Likewise,
if at the end of the rate reduction period, there were not enough funds
allocated to
cover
the rate reduction as designed, the shortfall will be reimbursed from the
affordable energy
fund
with interest; provided, however, if there are no additional funds available
from the fund,
such
shortfall or uncovered balance of such shortfall will be recovered with
interest from all
customers
in a manner and over the period approved by the commission.
(e)
Administration and records of the fund.
(1)
The commissioner shall administer the fund in accordance with this chapter.
(2)
The commissioner in consultation with the department shall adopt procedures
governing
the expenditure of, and accounting for, money expended from the fund.
(3)
The commissioner is responsible for insuring that there are adequate moneys
available
in the
fund to carry out the purposes of this section.
(4)
The commissioner shall maintain accounting records showing the income and
expenses
of the fund.
(f)
Expenditure of fund money. Disbursements may be made from the fund for
the
following
purposes:
(1)
Necessary administrative expenses, personnel expenses and equipment costs of
the
office
related to this section which shall not exceed ten percent (10%) of the revenue
of the fund;
(2) All costs to effectuate the purposes of the fund as set forth in subsection
(d).
(g)
Report to the legislature. The commissioner shall submit a report to the legislature
not
later than the tenth (10th) day following the convening of each regular session
of the
legislature.
The report may include information considered significant by the commissioner
but
must
include:
(1)
The amount of money expended under section 42-141-5 during the
preceding fiscal
year;
(2)
The amount and source of money received during the preceding fiscal year;
(3)
A detailed summary of activities funded by the fund during the preceding fiscal
year;
(4)
The projected cost to the fund for affordable energy programs in the next
fiscal year.
SECTION 14. Section 44-1-7.1 of the General Laws in Chapter 44-1 entitled
"State Tax
Officials"
is hereby amended to read as follows:
44-1-7.1.
Interest on overpayments. -- (a) Notwithstanding any
general or specific
statute
to the contrary, overpayments of state taxes or surcharges that are remitted to
the tax
division
in accordance with section 39-21.1-14, shall bear interest at the
rate provided in
section 44-1-7 from
the date the tax was paid, or from the date including any extensions of the
date
the tax became due, whichever of the dates occurs later.
(a)
Each January 1 the tax administrator shall compute the rate of interest to be
in effect
for
that calendar year by reference to the prime rate, which was in effect on
October 1 of the
preceding
year. The term “prime rate” shall mean the predominant prime rate quoted by
commercial
banks to large businesses as determined by the board of governors of the
Federal
Reserve
System.
(b) Notwithstanding any general or specific statute to the contrary,
overpayments of state
taxes or
surcharges that are remitted to the tax division pursuant to
section 39-21.1-14, shall bear
interest
at the prime rate as defined in section 44-1-7.1(a) from the date the
tax or the surcharge
that is
referenced in this provision was paid, or from the date including any
extensions of the date
the tax
became due, whichever of the dates occurs later.
(c)
If any overpayment of state tax is refunded within ninety (90) days after the
last date
prescribed
(or permitted by extension of time) for filing the return of the tax, or within
ninety (90)
days
after the return is in fact filed, no interest shall be allowed under this
section on the
overpayment.
(d)
For the purposes of this section, if any overpayment of state tax results from
a carry-
back of
a net operating loss, the overpayment is deemed not to have been made prior to
the close
of the taxable
year in which the net operating loss arises.
(e)
If any overpayment of a surcharge referenced in subsection (b) of this section
is
refunded
within ninety (90) days after notification of overpayment of the surcharge, no
interest
shall be
allowed under this section on the overpayment.
SECTION 15. Section 44-11-14 of the General Laws in Chapter 44-11 entitled
"Business
Corporation Tax" is hereby amended to read as follows:
44-11-14.
Allocation of income from business partially within state. -- (a)
In the case
of a
taxpayer deriving its income from sources both within and outside of this state
or engaging in
any
activities or transactions both within and outside of this state for the
purpose of profit or gain,
its net
income shall be apportioned to this state by means of an allocation fraction to
be computed
as a
simple arithmetical mean of three (3) fractions:
(1)
The first of these fractions shall represent that part held or owned within
this state of
the
average net book value of the total tangible property (real estate and tangible
personal
property)
held or owned by the taxpayer during the taxable year, without deduction on
account of
any
encumbrance thereon;
(2)
The second fraction shall represent that part of the taxpayer's total receipts
from sales
or other
sources during the taxable year which is attributable to the taxpayer's
activities or
transactions
within this state during the taxable year; meaning and including within that
part, as
being
thus attributable, receipts from:
(i)
Gross sales of its tangible personal property (inventory sold in the ordinary
course of
business)
where:
(A)
Shipments are made to points within this state; or
(B)
Shipments are made from an office, store, warehouse, factory or other place of
storage
in this state and the taxpayer is not taxable in the state of the purchase and
the taxpayer is
not
taxable in the state of the purchase.
(ii)
Gross income from services performed within the state;
(iii)
Gross income from rentals from property situated within the state;
(iv)
Net income from the sale of real and personal property, other than inventory
sold in
the
ordinary course of business as described in paragraph (i) of this subdivision,
or other capital
assets
located in the state;
(v)
Net income from the sale or other disposition of securities or financial
obligations;
and
(vi)
Gross income from all other receipts within the state;
(3)
The third fraction shall represent that part of the total wages, salaries, and
other
compensation
to officers, employees, and agents paid or incurred by the taxpayer during the
taxable
year which is attributable to services performed in connection with the
taxpayer's
activities
or transactions within this state during the taxable year.
(b)
Notwithstanding any of the provisions of this section, revenue and
expenses subject
to the
gross earnings tax pursuant to chapter 13 of this title shall not be included
in the calculation
described
in this section.
SECTION
16. Sections 5-56.1-8 and 5-56.1-9 of the General Laws in Chapter 5-56.1
entitled
"Designers of Individual Sewage Disposal Systems" are hereby amended
to read as
follows:
5-56.1-8.
Denial, suspension and revocation of licenses - Censure. -- (a) The
licensing
authority
may deny, suspend or revoke a designer's license if the person or licensed
designer fails
to
comply with the requirements prescribed in this chapter or any regulation
promulgated under
this
chapter or where the person or licensed designer:
(1)
Provided incorrect, incomplete or misleading information in obtaining a
designer's
license;
or
(2)
Demonstrated gross or repeated negligence, incompetence or misconduct in the
representation
of site conditions in an application to the department of environmental
management,
design of an ISDS, or inspection or certification of an installation of an ISDS;
or
(3)
Committed a felony involving moral turpitude; or
(4)
Failed or neglected to comply with continuing education requirements
established
by the licensing authority.
(b)
An action to suspend or revoke a designer's license pursuant to subsection (a)
of this
section
may not be taken until after the licensed designer has an opportunity to have a
hearing
before
the licensing authority. This hearing shall be held within thirty (30) days of
written notice
of
intent to suspend or revoke the license.
(c)
The licensing authority shall appoint a review panel consisting of five (5)
members
at least three (3) of whom shall be licensed designers not employed by the
licensing
authority, for the purpose of reviewing and hearing disciplinary actions
contemplated
under subsection (b) of this section. The review board shall make
recommendations
to the licensing authority to suspend or revoke licenses. All final
decisions
shall be made by the licensing authority.
(d)
Any person aggrieved by the denial of an application for a license pursuant to
§ 5-
56.1-4
or a denial, suspension or revocation of a license pursuant to this section may
request a
formal
hearing pursuant to § 42-17.1-2(u) § 42-17.1-2(21) which shall be
granted, if requested, in
writing
by the aggrieved applicant or licensee within ten (10) days of the denial,
suspension or
revocation.
(e)
The licensing authority may publicly censure any licensed designer whose
license
was suspended or revoked.
5-56.1-9. Penalties. -- The penalties for noncompliance with any
section of this chapter
shall be
the same as stated in §§ 42-17.1-2(v) § 42-17.1-2(22) and chapter
17.6 of title 42 42-
17.6.
SECTION
17. Section 16-67.1-3 of the General Laws in Chapter 16-67.1 entitled
"Rhode
Island
High School Dropout Prevention Act of 2007" is hereby amended to read as
follows:
16-67.1-3.
Defining the age and protocol for a student to leave school. -- (a)
Children
who have
completed sixteen (16) years of life and who have not yet attained eighteen
(18) years
of age
may not withdraw from school before graduation unless:
(1)
The student, the student's parent(s)/guardian and an administrator agree to the
withdrawal;
(2)
At the exit interview, the student and the student's parent(s)/guardian provide
written
acknowledgement
of the withdrawal that meets the requirements of subsection (D) paragraph
(4)(D)
of this subsection;
(3)
The school principal provides written consent for the student to withdraw from
school;
and/or
(4)
The withdrawal is due to:
(A)
Due to documented financial hardship and the need of the individual to
be employed
to
support the individual's family or a dependent;
(B)
Due to documented illness;
(C)
By order of a court that has jurisdiction over the student; and
(D)
Accompanied by a written acknowledgement of a withdrawal under subsection
(b)(2)
subdivision
(2) of this subsection which must
include a statement that the student and the
student's
parent(s)/guardian understand that withdrawal from school is likely to reduce
the
student's
future earnings and increase the student's likelihood of being unemployed in
the future;
(b)
If a child of the age described in subsection (a) is habitually absent
from school and
the
school is unable to contact the parent(s)/guardian, the school may withdraw the
child from
enrollment
provided that its attempts to contact the parent(s)/guardian by telephone,
regular and
registered
mail, and home visit are documented. If a child who has been withdrawn from
enrollment
under this subsection returns to school, or if the school mistakenly withdraws
the child
from enrollment,
the child shall promptly be re-enrolled.
SECTION
18. Section 23-81-6 of the General Laws in Chapter 23-81 entitled "Rhode
Island
Coordinated Health Planning Act of 2006" is hereby amended to read as
follows:
23-81-6.
Funding. -- The department of health may apply for and receive private
and/or
public
funds to carry out the requirements of this act chapter.
SECTION
19. Section 28-53-8 of the General Laws in Chapter 28-53 entitled "Rhode
Island
Uninsured Employers Fund" is hereby amended to read as follows:
28-53-8.
Limitations on payments to injured employees. -- (a) Where the
director
determines
by experience or other appropriate accounting and actuarial methods that the
reserves
in the
fund are insufficient to pay all claims presented or pending, the director
shall petition the
workers'
compensation court for an order to make appropriate, proportionate reductions
in the
payments
being made to injured employees by the fund or to suspend all payments to
injured
employees
until such time as the reserves maintained by the fund are sufficient to resume
the
payment
of benefits. The matter shall be heard by the chief judge. If the court
determines that the
monies
held by the fund are insufficient to fully pay all claims as they fall due, the
court shall
issue an
order directing that a proportionate reduction be made in the payments made to
those
employees
receiving benefits from the fund. In considering the fund's request for relief,
the court
shall
give due weight to the policy of the workers' compensation act that benefits
are to be paid
weekly
and that the unwarranted reduction or interruption in the employee's weekly
compensation
benefit will impose financial hardship upon the injured worker.
(b)
The chief judge shall hear the director's petition within twenty-one (21) days
of the
date the
matter is filed with the court. The petition shall set forth the names and
addresses of each
employee
who may be affected by the reduction in benefits and the court shall provide
notice to
each
employee. The attorney general shall appear on behalf of the employees
receiving benefits
from the
fund and shall take such action as he or she feels is necessary to protect the
rights of the
injured
employees.
(c)
In the event that the court determines that a reduction or suspension of
payments is
necessary
to maintain the fiscal integrity of the fund, the court shall schedule a
mandatory review
date to
determine whether the financial status of the fund warrants a continuation of
the order
reducing
such payments and shall reinstitute payments only upon finding that the
reserves
maintained
by the fund are sufficient to pay all future claims as they fall due.
SECTION
20. 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
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, 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
(1/2) 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 social 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 (public law 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
department
of elderly affairs. The public utilities commission may promulgate regulations
to
implement
this section. The department 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 subsection 39-2-1(e) 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 (10) year
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
person, firm or corporation a reduced rate, provided such 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 subsection 42-
141-5(d).
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
21. Section 39-18-9 of the General Laws in Chapter 39-18 entitled "Rhode
Island
Public Transit Authority" is hereby amended to read as follows:
39-18-9.
Revenues. -- The authority is hereby authorized and empowered to fix
and
revise
from time to time, such schedules of service and such rates of fare and charges
for service
furnished
or operated as it determines to be reasonable. The schedules of service, rates
of fare,
and
charges for service shall not be subject to supervision or regulation by any
commission,
board,
bureau, or agency of the state or of any municipality or other political
subdivision of the
state;
except as provided in § 39-18-4. Provided, however, if there are any changes in
frequency
of
services of more than fifteen percent (15%), providers of service, rates of
service, other than
system
wide changes, and charges for service shall be presented for comment at least
one public
hearing
scheduled in an accessible location in each county affected, and the hearing
shall be
scheduled
in two (2) sessions, one during daytime business hours and one during evening
hours.
The
revenues derived from the authority's operations and any other funds or
property received or
to be
received by the authority (including, without limitation, any funds or other
property
received
or to be received by the authority pursuant to § 39-18-4(10) 39-18-4(a)(10),
in whole or
in part,
at any time and from time to time, may be pledged to, and charged with, the
payment of
the
principal of and the interest on some or all of the authority's bonds as
provided for in the
resolution
authorizing the issuance of the bonds or in the trust agreement securing the
bonds. The
pledge
shall be valid and binding from the time when the pledge is made; the revenues,
funds, or
other
property so pledged, and thereafter received by the authority, shall
immediately be subject
to the
lien of the pledge without any physical delivery thereof or further act, and
the lien of any
pledge
shall be valid and binding as against all parties having claims of any kind in
tort, contract,
or
otherwise against the authority, irrespective of whether the parties have
notice thereof. Neither
the
resolution nor any trust agreement by which a pledge is created need be filed
or recorded
except in
the records of the authority.
SECTION
22. Section 42-17-1 of the General Laws in Chapter 42-17 entitled
"Department
of Agriculture and Conservation" is hereby repealed.
42-17-1.
Department established - Responsibilities. -- There shall be a
department of
agriculture
and conservation. The head of the department shall be the director of
agriculture and
conservation
who shall carry out, except as otherwise provided in this title, the provisions
of
chapters
1 to 3, inclusive, 6, 9 to 12, inclusive, 14, 15, and 17 to 19, inclusive of
title 2; chapters
2, 4,
5, 8, and 12 of title 4; chapters 1 to 6, inclusive, 9 to 13, inclusive, 18,
19, 21, 24 to 32,
inclusive,
and 34 of title 20; chapters 2, 4 to 7, inclusive, 17, 18, and 20 of title 21;
and any and
all
other general laws and public laws heretofore carried out by the existing
director of agriculture
and
conservation and department of agriculture and conservation.
SECTION
23. Section 42-17.1-2.3 of the General Laws in Chapter 42-17.1 entitled
"Department
of Environmental Management" is hereby amended to read as follows:
42-17.1-2.3.
Watershed-based management. -- (a) In order to accomplish the duties
and
responsibilities for the protection, development, planning, and utilization of
the natural
resources
of the state, the director is authorized: (1) to plan, coordinate, integrate,
manage,
exercise
and/or implement the powers set forth in this chapter on a watershed basis for
the
purposes
of preserving and/or improving ecosystem functionality, protecting public
health, safety
and
welfare, and providing for the use of natural resources, including for
recreational and
agricultural
purposes; (2) to work in conjunction with the Rhode Island rivers council and
in
cooperation
with federal, interstate, state, local and private agencies and community
organizations
and
watershed groups and associations and persons to effectuate watershed-based
management,
as
appropriate and desirable; (3) to cooperate with the coastal resources management
council in
the
preparation and adoption of a marine resources development plan as provided for
in § 46-23-
6(1)(v)(A);
and (4) to coordinate and administer the activities of the department to
achieve the
purposes
of systems level planning by the state; and within areas subject to the
jurisdiction of the
coastal
resources management council, to administer its programs and exercise its
powers and
duties
consistent with the marine resources development plan and in those areas which
are not
subject
to the jurisdiction of the coastal resources management council to administer
its programs
and
exercise its powers and duties in a manner that contributes to meeting the
purposes and goals
of the
marine resources development plan.
(b)
Cumulative effects and potential cumulative effects of regulatory actions,
including,
but not
limited to, the issuance of permits and approvals, on a geographic basis, shall
be
incorporated,
subject to the limitations set forth in subsection 42-17.1-2(n) 42-17.1-2(14),
to the
extent
practicable and reasonable by the department into watershed-based management
and
planning.
SECTION
24. Section 42-64-7.9 of the General Laws in Chapter 42-64 entitled "Rhode
Island
Economic Development Corporation" is hereby amended to read as follows:
42-64-7.9.
Orders as to pretreatment of sewage. -- (a) Without limiting the
generality
of the
foregoing, the authority vested in the Rhode Island economic development
corporation
shall
include the authority to limit, reject, or prohibit any direct or indirect
discharge of pollutants
or
combination of pollutants as defined by applicable federal or state law, into
any treatment
facility
operated by the corporation, to require that any person or class of user shall
submit any
and all
discharges into the corporation's wastewater collection and treatment system to
those
pretreatment
standards and requirements as prescribed by the corporation.
(b)
The corporation shall adopt rules, regulations and permit requirements for
pretreatment.
The corporation shall adopt rules, regulations and permit requirements
necessary to
ensure
compliance by all parties with:
(1)
Applicable federal and state laws
(2)
State and federal discharge permit limitations for the corporation's wastewater
treatment
facility
(3)
Necessary and appropriate local limitations.
(c)
The Rhode Island economic development corporation shall have the authority to
issue or
deny permits to any person for the direct or indirect discharge of any
pollutants into any
corporation
wastewater treatment facility and to require the development of a compliance
schedule
by each discharger to insure compliance with any pretreatment required by the
corporation.
No person shall discharge any pollutant into the corporation's wastewater
facility
except
as in compliance with the provisions of this section and any rules and
regulations
promulgated
under this chapter and pursuant to all terms and conditions of a permit.
(d)
The Rhode Island economic development corporation may, by regulation, order,
permit
or otherwise require any person who discharges into any wastewater treatment
facility
owned by
the corporation to:
(1)
Establish and maintain records as required by federal or state statute, or by
rule,
regulation,
compliance order, or permit terms;
(2)
Make any and all reports as required by federal or state statute or by rule,
regulation,
compliance
order or permit terms;
(3)
Install, calibrate, use and maintain any and all monitoring equipment or
testing
procedures
including, where appropriate, biological monitoring methods;
(4)
Sample any discharges and effluents in accordance with the methods and at the
locations
and at the intervals and in a manner as the corporation may prescribe, and
(5)
Provide any other information relating to discharges into the facilities of the
corporation
that the corporation may reasonably require to insure compliance with
prescribed
pretreatment.
The information shall include, but is not limited to, those records, reports
and
procedures
required by applicable federal and state laws.
(e)
Notwithstanding any other provision of this section, the Rhode Island economic
development
corporation shall have the authority, and shall accordingly prescribe the
appropriate
procedures,
to immediately and effectively halt or prevent any discharge of pollutants into
the
facilities
of the corporation which reasonably appears to present an imminent danger to
human
health
or the environment. The Rhode Island economic development corporation shall
also have
the
authority and shall prescribe the appropriate procedures, which shall include
notice to the
affected
discharger and an opportunity to respond, to hold or prevent any discharge into
the
facilities
of the corporation, which presents or may present a threat to the operation of
the
wastewater
collection and/or treatment system. Procedures prescribed under this
subsection,
which
comply in form to those provided in § 42-17.1-2(u) 42-17.1-2(21)
shall be deemed to be
appropriate.
SECTION
25. Section 42-125-6 of the General Laws in Chapter 42-125 entitled "Rhode
Island
Greenways Act of 1995" is hereby amended to read as follows:
42-125-6.
Powers and duties. -- The council has the following powers:
(1)
To be entitled to ask for and receive from any commission, board, officer or
agency of
the
state any information, cooperation, assistance, and advice as shall be
reasonable and proper in
view of
the nature of the council's functions;
(2)
To assess and evaluate the current programs and policies of the state as they
relate to
the
creation and maintenance of systems of greenways throughout the state and to make
recommendations
regarding the coordination of activities within state government to create and
maintain
systems of greenways as part of the state's twenty-first century
infrastructure;
(3)
To make any recommendations that may be necessary to the state planning
council
to maintain a greenways element of the state guide plan as described in §
42-11-
10;
(4)
To make recommendations to the executive director of the Rhode Island economic
development
corporation regarding the inclusion of greenways in programs to promote tourism
and
encourage the location and development of recreational facilities as
provided for in § 42-63-
2(a)
[repealed];
(5)
To make recommendations to the director of the department of environmental
management
regarding the inclusion of greenways in (1) the department's cooperation with
the
Rhode
Island economic development corporation in planning and promotional functions
relating
to
recreation as provided for in § 42-17.1-2(f) 42-17.1-2(6), and
(2) the department's general
functions
relating to parks and recreation, preservation of wetlands and habitat, and
planning and
development
as provided for in § 42-17.1-4;
(6)
To make recommendations to the director of the department of transportation
regarding
the inclusion of greenways in plans and implementation programs for
transportation as
provided
for in § 42-13-1;
(7)
To provide advice and assistance to political subdivisions, businesses, citizen
groups,
and
nonprofit organizations regarding the creation and maintenance of greenways;
(8)
To foster public involvement in greenways planning and development;
(9)
To apply for, contract for, and expend federal and other grants or assistance,
appropriate
to the purposes of this chapter, and
(10)
To approve and submit an annual report within ninety (90) days after the end of
the
fiscal
year to the governor, the speaker of the house of representatives, the
president of the senate,
and the
secretary of state of its activities during that fiscal year. The report shall
provide: an
operating
statement summarizing meetings or hearings held, including meeting minutes,
subjects
addressed,
decisions rendered, studies conducted, policies developed, and programs
administered
or
initiated; a consolidated financial statement of all funds received and
expended including the
source
of the funds, a listing of any staff supported by these funds, and a summary of
any clerical,
administrative
or technical support received; a summary of performance during the previous
fiscal
year including accomplishments, shortcomings and remedies; a synopsis of any
legal
matters
related to the authority of the council; a summary of any training courses held
pursuant to
subsection
42-125-6(11), a briefing on anticipated activities in the upcoming fiscal year;
and
findings
and recommendations for improvements. The report shall be posted as prescribed
in §
42-20-8.2.
The director of the department of administration shall be responsible for the
enforcement
of this provision.
(11)
To conduct a training course for newly appointed and qualified members and new
designees
of ex officio members within six (6) months of their qualification or
designation. The
course
shall be developed by the chair of the council, approved by the council, and
conducted by
the
chair of the council. The council may approve the use of any council or staff
members of
other
individuals to assist with training. The course shall include instruction in
the following
areas:
the provisions of chapter 42-125; § 42-11-10; subsections 42-17.1-2(f) 42-17.1-2(6),
and
(2); §
42-17.1-4; § 42-13-1; chapter 42-46; chapter 36-14; chapter 38-2; and the
council's
operating
procedures. The director of the department of administration shall, within ninety
(90)
days of the
effective date of this act [May 3, 2006], prepare and disseminate
training materials
relating
to the provisions of chapters 42-46, 36-14 and 38-2.
SECTION
26. Section 42-141-12 of the General Laws in Chapter 42-141 entitled
"Affordable
Energy" is hereby amended to read as follows:
42-141-12.
Transitional provision. -- Effective September 1, 2006, in order to
provide
for
transitional assistance to very low-income customers during fiscal year 2007,
notwithstanding
any law
or order to the contrary, the following provisions shall apply to eligibility
for restoration
of gas
and/or electric service to a very low-income customer who has been terminated
from
service
in calendar year 2006; the very low-income customer shall pay eighteen percent
(18%) of
the
customer's unpaid balance and shall agree to remain current with payments for
current usage
and to
pay one thirty-sixth (1/36) of one-half (1/2) of the remaining balance per
month through
June
2007; a very low income customer who complies with the provisions of this
section shall be
transitioned
to the provision of subsection 39-2-1(e)(ii) 39-2-1(d)(1)(ii) and
(iii) effective July 1,
2007,
and the monthly payments on the remaining balance that have been made pursuant
to such
agreement
shall be credited to the requirements of subdivision 39-2-1(e)(iv) 39-2-1(d)(1)(iv)
for
the
forgiveness of arrearages. A very low-income customer who elects to use the
provisions of
this
section and who fails to comply with the terms of the agreement for the
restoration of service
under
the provisions of this section shall be ineligible to apply for restoration of
service under the
provisions
of subdivision 39-2-1(e) 39-2-1(d) and shall be subject to
termination of service
effective
April 15, 2007, and any unpaid balance shall be due in full and shall be
payable in
accordance
with the rules of the commission. The provisions of this section shall be
repealed
effective
July 2, 2007.
SECTION
27. Section 45-2-50 of the General Laws in Chapter 45-2 entitled "General
Powers"
is hereby amended to read as follows:
45-2-50.
Town of Exeter -- Municipal court. -- (a) The town council of the town
of
Exeter
may establish a municipal court and confer upon that court original jurisdiction,
notwithstanding
any other provisions of the general laws, to hear and determine causes
involving
the
violation of any ordinance, including, but not limited to, municipal code
violations, animal
regulation
violations, traffic and parking violations, minimum housing ordinances of the
town and
any
violation of the provisions of chapter 24.3 of this title, entitled the
"Rhode Island Housing
Maintenance
and Occupancy Code"; provided, however, that any defendant found guilty of
any
offense,
excluding violations of the minimum housing ordinances or chapter 24.3 of this
title
within
the jurisdiction of the court, may within seven (7) days of the conviction,
file an appeal
from the
conviction to the superior court and be entitled in the latter court to a trial
de novo; and
provided
further, however, that any defendant found guilty of any violation of a minimum
housing
ordinance or of chapter 24.3 of this title, may within seven (7) days of
conviction, file an
appeal
from the conviction to the fourth division of the district court and be
entitled to a trial de
novo in
accordance with §§ 8-8-3(a)(4) and 8-8-3.2.
(b)
With respect to violations of either municipal ordinances dealing with minimum
housing
or chapter 24.3 et seq., of this title dealing with housing maintenance and
occupancy, the
town
council may also confer upon the municipal court, in furtherance of the court's
jurisdiction,
the
power to proceed according to equity:
(1)
To restrain, prevent, enjoin, abate, or correct a violation;
(2)
To order the repair, vacation, or demolition of any dwelling existing in
violation; or
(3)
To otherwise compel compliance with all of the provisions of those ordinances
and
statues statutes.
(c)
The town council of the town of Exeter is authorized and empowered to appoint a
judge of
the municipal court. The judge shall serve for a term of two (2) years, or
concurrent with
the term
of each appointing council. The town council of the town is authorized and
empowered
to enact
ordinances governing the personnel, operation, and procedure to be followed in
the court
and to
establish a schedule of fees and costs, and to otherwise provide for the
operation and
management
of the court. The municipal court may impose sentences not to exceed thirty
(30)
days in
jail and impose fines not in excess of five hundred dollars ($500), or both.
The court is
empowered
to administer oaths, compel the attendance of witnesses, and punish persons for
contempt,
and to authorize and execute search warrants to the extent the warrants could
be
authorized
and executed by a justice of the district court.
SECTION
28. Section 46-12-38 of the General Laws in Chapter 46-12 entitled "Water
Pollution"
is hereby amended to read as follows:
46-12-38.
Licensing of underground storage tank tightness testing. -- (a)
Definitions.
As used
in this section and in conjunction with this chapter these terms shall be
construed to
mean:
(1)
"Test" means a tank tightness test capable of detecting a five
hundredths (.05) gallon
per hour
leak from any portion of an underground storage tank (including but not limited
to
piping)
that routinely contains petroleum products or hazardous materials while
accounting for
effects
such as thermal expansion or contraction of the petroleum product or hazardous
materials,
vapor
pockets, tank deformation, evaporation or condensation, the location of the
water table, or
other
conditions that could affect test results and which have been approved, in
writing, by the
director
for use in the state of Rhode Island.
(2)
"Tester" means an individual who performs tightness tests on
underground storage
tanks.
(3)
"Testing business" means a person who employs or subcontracts with
testers
in the
regular course of business.
(b)
Authority of the director. The director shall promulgate rules and regulations
consistent
with this chapter and with chapter 13.1 of title 46 entitled "Groundwater
Protection"
for the
licensing of testers and testing businesses. Nothing in this section shall
limit the director's
powers
and duties as set forth in this chapter.
(c)
License requirement and fee.
(1)
No person shall test underground storage tanks or operate a testing business
without a
license
issued by the director in accordance with this section.
(2)
The director shall charge an annual fee of one hundred dollars ($100) to each
tester to
whom he
or she issues a license. No licensure shall be issued unless the tester and
testing business
have
paid the license fee. The director shall deposit the fees collected into the
water and air
protection
program account created pursuant to § 42-17.1-2(z) 42-17.1-2(26).
(3)
The results of any test performed by or on behalf of an unlicensed tester or
testing
business
shall be considered null and void. Where it is determined that test(s) have
been
performed
by an unlicensed tester or testing business, the owner or operator of the
underground
storage
tank(s) shall, within ten (10) days of discovery, either have the underground
storage
tank(s)
retested by a duly licensed tester or testing business, or have the underground
storage
tank(s)
emptied and removed from the ground as if they had failed the test(s). Any
unlicensed
tester
or testing business that conducts business in the state of Rhode Island shall
be strictly liable
for the
cost of any retesting performed in accordance with this section.
(4)
No license shall be issued unless the tester and/or testing business shall
demonstrate
that
they, jointly or severally, possess liability insurance in an amount
satisfactory to the director
for any
environmental harm, property damage and bodily injury resulting from tank
tightness
testing
activities, including, but not limited to, performance of tests; the
collection, calculation
and
analysis of test data; handling, calibration, operation and maintenance of
testing equipment;
and the
preparation of test results. The amount of liability insurance shall be
established by the
director.
(5)
The rules and regulations promulgated by the director in accordance with this
section
may,
without limitation, require that testers hold and maintain certain
certifications, and/or pass
written
or practical examinations as a prerequisite to licensure. The director may
assess a
reasonable
fee to cover the cost of any examination administered by or on behalf of the
department
of environmental management.
(d)
Revocation of license. The director shall revoke the license of any tester or
testing
business
who fails to comply with this section or with the rules and regulations
promulgated
hereunder
after the director has provided the party with notice and the opportunity to be
heard in
accordance
with chapter 35 of title 42.
SECTION
29. Section 46-12.5.1-12 of the General Laws in Chapter 46-12.5.1 entitled
"Oil
Pollution Control" is hereby amended to read as follows:
46-12.5.1-12.
Notices of violations and compliance orders. -- (a) The director shall
follow
the procedures provided in § 42-17.1-2(u) 42-17.1-2(21) in
issuing any notice of violation
or compliance
order authorized pursuant to this chapter or any rules, regulations, or permits
promulgated
thereunder.
(b)
Where an order of the director does not otherwise specify, the person against
whom an
order is entered shall, within seventy-two (72) hours of the receipt of the
order
and
before proceeding to install a system or means to contain, abate, control, and
remove
the
discharged oil, submit to the director a plan or a statement describing the
system or
means
that the person intends to implement.
SECTION
30. Sections 46-12.9-5 and 46-12.9-6 of the General Laws in Chapter 46-12.9
entitled
"Rhode Island Underground Storage Tank Financial Responsibility Act"
are hereby
amended
to read as follows:
46-12.9-5.
Purpose of fund. -- (a) The purpose of the fund shall be to facilitate
the
clean-up
of releases from leaking underground storage tanks, underground storage tank
systems,
including
those located on sites or government sites in order to protect the environment
including
drinking
water supplies and public health and to take necessary action to proactively
prevent such
releases.
(b)
The fund shall provide reimbursement to responsible parties for the eligible
costs
incurred
by them as a result of releases of certain petroleum from underground storage
tanks or
underground
storage tank systems as provided herein. Monies in the fund shall be dispensed
only
upon the
order of the review board or its designee for the following purposes.
(1)
The fund shall pay not more than one million dollars ($1,000,000) per incident
and up
to two
million dollars ($2,000,000) in the aggregate for damages of eligible costs, as
defined in
regulations
promulgated hereunder and, as further defined in § 46-12.9-3 excluding legal
costs
and
expenses, incurred by a responsible party as a result of a release of petroleum
from an
underground
storage tank or underground storage tank system; provided, however, that a
responsible
party shall be responsible for the first twenty thousand dollars ($20,000) of
said
eligible
costs;
(2)
Reimbursement for any third party claim including, but not limited to, claims
for
bodily
injury, property damage and damage to natural resources which are asserted
against a
responsible
party and which have arisen as a result of a release of petroleum from an
underground
storage
tank or underground storage tank system in an amount not to exceed one million
dollars
($1,000,000)
for each release as set forth in subsection (2) (b)(1) of this
section; provided, that
such
claims are found by the review board to be justified, reasonable, related to
the release of
petroleum
and not excessive or spurious in nature; and
(3)
Eligible costs incurred by the department in carrying out the investigative,
remedial
and
corrective action activities at sites of a petroleum release associated with an
underground
storage
tank or underground storage tank system where the responsible party fails to
comply with
an order
of the department to take such corrective action. In the event of such failure,
the
department
may access the fund to perform the ordered work and shall proceed to recover
from
the
responsible party on behalf of the fund any amount expended from the fund by
the
department.
(4)
Nothing contained in this chapter shall be construed to prevent subrogation by
the
state of
Rhode Island against any responsible party other than the owner and/or operator
for all
sums of
money which the fund shall be obligated to pay hereunder plus reasonable
attorneys' fees
and
costs of litigation and such right of subrogation is hereby created.
(5)
Eligible costs incurred by the department to support the fund, including, but
not
limited
to, all personnel support to process and review of claims in order to formulate
recommendations
for reimbursement for consideration by the review board, and providing
meeting
space for board meetings; provided, however, that no more than five hundred and
fifty
thousand
dollars ($550,000) shall be dispensed from the fund for administrative purposes
during
any
fiscal year. The department shall directly access the fund, pursuant to the
limits set forth in §
46-12.9-5(1)
above subdivision 46-12.9-5(b)(1),
to pay for such expenses.
(6)
Grants to any third party for purposes of removal of underground storage tanks
and/or
replacement
of underground storage tanks with other fuel storage and distribution systems,
including
aboveground storage tanks, when such removal and/or replacement will minimize
the
potential
future exposure of the fund to major expenses related to reimbursement of costs
incurred
in
response or remediation should a future release occur. Grants under this
section shall be limited
to fifty
thousand dollars ($50,000) per site and shall be in addition to any eligible
reimbursement
for
clean up expenses at that site.
46-12.9-6.
Eligibility. -- (a) In order to be eligible for reimbursement from the
fund for
eligible
costs a responsible party must be subject to financial responsibility as
required by the
EPA (40
CFR part 280 subpart H) and:
(1)
Have substantially complied with all state technical requirements for
underground
storage
tanks and underground storage tank systems as promulgated by the department of
environmental
management pursuant to chapter 12 of this title and chapter 17.1 of title 42,
including,
but not limited to, requirements for registration, proper installation, spill
containment,
line
leak detection, corrosion protection, leak detection, tank tightness testing,
inventory control,
closure
and leak or spill reporting;
(2)
Have incurred an eligible cost in excess of the deductible amount specified in
§ 46-
12.9-5(2) 46-12.9-5(b)(1) whether for clean-up or
related matters or for claims of third parties as
set
forth in § 46-12.9-3 resulting from a release of petroleum, subject to the
motor and special
fuels
tax from an underground storage tank or underground storage tank system. In
order to apply
for
reimbursement from the fund, it shall not be necessary that the third party and
the responsible
party
complete adjudication of any claim before submission to the review board;
provided,
however,
that all such claims shall be reasonably verified and must be demonstrated to
the
reasonable
satisfaction of the review board in order to be considered eligible for
reimbursement.
(b)
Notwithstanding the financial responsibility requirement of this section,
responsible
parties may
be eligible for reimbursement of eligible costs incurred for government sites
provided
that:
(1)
A city, town, the state or a state agency is the responsible party for a
release at the
government
site and was the owner of the site at the time of the release;
(2)
A city, town, the state or a state agency is the responsible party and owner of
the
government
site at the time of application on which a release occurred prior to the city,
town or
state
agency's ownership, provided that the government entity purchased the property
prior to
March 1,
1998; or
(3)
A city, town, the state or a state agency was the responsible party at the time
of the
release
and the government site is owned by a successor in interest at the time of
application.
(c)
Notwithstanding the requirement that the released petroleum be subject to the
motor
and
special fuels tax, underground storage tanks containing petroleum products for
which the
motor
and special fuels tax is inapplicable including, but not limited to,
underground storage
tanks
used for the distribution of No. 2 heating oil, used/waste oil, kerosene or
other materials as
deemed
appropriate by the review board may be eligible for reimbursement with the
following
exceptions:
(1)
Underground storage tanks containing heating or fuel oils used solely for
onsite
consumption
shall not be eligible.
(2)
Underground storage tanks exempted from the department's "regulations for
underground
storage facilities used for petroleum products and hazardous materials"
under
Section
5.03 and Section 9.01 (A-D) shall not be eligible.
SECTION
31. Section 46-25-25 of the General Laws in Chapter 46-25 entitled
"Narragansett
Bay Commission" is hereby amended to read as follows:
46-25-25.
Orders as to pretreatment of sewage. -- (a) Without limiting the
generality
of the
foregoing, the authority hereby vested in the commission shall include the
authority to
limit,
reject, or prohibit any direct or indirect discharge of pollutants or combination
of pollutants,
as
defined by applicable federal or state law, into the facilities of the project;
to require that any
person
or class of user shall cause pollutants from his or her property, prior to
their entry into the
facilities
of the project, to be submitted to such pretreatment standards and requirements
as the
commission
may prescribe by rule or regulation. The commission shall prescribe such rules
and
regulations
for pretreatment as in the opinion of the commission:
(1)
Are required by applicable federal or state law,
(2)
Are required under the terms of the project's federal permit(s), or
(3)
Are necessary and appropriate for the project.
(b)
The commission shall have the authority to issue or deny permits to any person
for
the
direct or indirect discharge of any pollutants into the facilities of the
project; to require the
development
of a compliance schedule by each person to insure compliance with such
pretreatment
as the commission may prescribe. No person shall discharge any pollutant into
the
facilities,
except as in compliance with the provisions of this section, and any rules and
regulations
promulgated hereunder, and pursuant to the terms and conditions of a permit.
(c)
The commission may, by regulation, order, permit, or otherwise require any
person
who
discharges into the facilities of the project to:
(1)
Establish and maintain such records;
(2)
Make such reports;
(3)
Install, calibrate, use, and maintain such monitoring equipment or methods,
including
where
appropriate, biological monitoring methods;
(4)
Sample such discharges and effluents, in accordance with such methods, at such
locations,
at such intervals, and in such manner as the commission shall prescribe; and
(5)
Provide such other information relating to discharges into the facilities of
the project
as the
commission may reasonably require to insure compliance with prescribed
pretreatment.
The
information shall include, but not be limited to, those records, reports, and
procedures
required
by applicable federal law.
(d)
Notwithstanding any other provision of this section, the commission shall have
the
authority,
and shall prescribe the appropriate procedures, after informal notice to the
discharger,
immediately
and effectively to halt or prevent any discharge of pollutants into the
facilities of the
project
which reasonably appears to present an imminent endangerment to the health or
welfare
of persons.
Halting or preventing may include, but shall not be limited to, physically
plugging
and/or
blocking the discharger's connection to the facilities of the project. The
commission shall
also
have the authority, and shall prescribe the appropriate procedures, which shall
include notice
to the
affected discharger and an opportunity to respond, to hold, or prevent any
discharge into
the
facilities of the project which presents or may present an endangerment to the
environment or
which
threatens to interfere with the operation of the project. Procedures prescribed
under this
subsection
which comply in form with those provided in § 42-17.1-2(u) 42-17.1-2(21)
shall be
deemed
to be appropriate.
SECTION
32. Section 23-1-46 of the General Laws in Chapter 23-1 entitled
"Department
of
Health" is hereby amended to read as follows:
23-1-46.
Insurers. -- (a) Beginning in the fiscal year 2007, each insurer
licensed or
regulated
pursuant to the provisions of chapters 18, 19, 20, and 41 of title 27 shall be
assessed a
child
immunization assessment and an adult immunization assessment for the purposes
set forth
in this
section. The department of health shall make available to each insurer, upon
its request,
information
regarding the department of health's immunization programs and the costs
related to
the
program. Further, the department of health shall submit to the general assembly
an annual
report
on the immunization programs and cost related to the programs, on or before
February 1 of
each year.
Annual assessments shall be based on direct premiums written in the year prior
to the
assessment
and for the child immunization program shall not include any Medicare
Supplement
Policy
(as defined in § 27-18-2.1(g) 27-18.2-1(g)), Medicaid or Medicare
premiums. Adult
influenza
immunization program annual assessments shall include contributions related to
the
program
costs from Medicare, Medicaid and Medicare Managed Care. As to accident and
sickness
insurance, the direct premium written shall include, but is not limited to,
group, blanket,
and
individual policies. Those insurers assessed greater than ten thousand dollars
($10,000) for
the year
shall be assessed four (4) quarterly payments of twenty-five percent (25%) of
their total
assessment.
Beginning July 1, 2001, the annual rate of assessment shall be determined by
the
Director director of Health health in
concurrence with the Primary Payors primary payors, those
being
insurers assessed at greater than ten thousand dollars ($10,000) for the
previous year. This
rate
shall be calculated by the projected costs for advisory committee on
immunization practices
the
Advisory Committee on Immunization Practices (ACIP) recommended and state mandated
vaccines
after the federal share has been determined by the centers for disease
control and
prevention Centers for Disease Control and Prevention.
The primary payors shall be informed of
any
recommended change in rates at least six (6) months in advance, and rates shall
be adjusted
no more
frequently than one time annually. For the childhood vaccine program the
director of the
department
of health shall deposit these amounts in the “childhood immunization account”.
These
assessments
shall be used solely for the purposes of the “childhood immunization programs”
and
no
other. For the adult immunization program the director of the department of
health shall
deposit
these amounts in the “adult immunization account”.
(b)
Any funds collected in excess of funds needed to carry-out ACIP recommendations
shall be
deducted from the subsequent year's assessments.
SECTION
33. Section 23-1.8-2.1 of the General Laws in Chapter 23-1.8 entitled
"Commission
on the Deaf and Hard-of-Hearing" is hereby amended to read as follows:
23-1.8-2.1.
Sign language interpreter referral service. -- The commission shall
administer
the sign language interpreter referral service for all certified licensee,
licensee,
grandparent
licensee, and special licensee interpreters, as provided in chapter 71 of title
5, who
hold a
valid interpreter for the deaf license issued by the state board of examiners
of interpreters
for the
deaf pursuant to § 5-71-9 or § 5-71-12 [repealed] or hold a valid
license, certificate, or
equivalent
issued with another state with reciprocity pursuant to § 5-71-10. The
commission shall
not
impose any limits on the practice of certified licensees, licensees,
grandparent licensees, or
special
licensees beyond those imposed by the state board of examiners for interpreters
for the
deaf. Prior
to January 1, 1998 the commission's sign language interpreter referral service
shall be
open to
all interpreters for the deaf who meet or exceed qualifications for license in
§ 5-71-9, 5-
71-10,
5-71-11 [repealed], or 5-71-12 [repealed]. The commission shall
refer any complaints
regarding
the conduct or performance of any interpreter utilizing their referral service
to the state
board of
examiners for interpreters for the deaf for appropriate action pursuant to §
5-71-13. The
commission
shall upon receipt of notice of revocation or suspension of a license by the
state
board of
examiners for interpreters for the deaf, immediately cease to refer customers
to that
licensee,
unless and until the license is restored.
SECTION
34. Sections 23-3-1 and 23-3-25 of the General Laws in Chapter 23-3 entitled
"Vital
Records" are hereby amended to read as follows:
23-3-1.
Definitions. -- As used in this chapter:
(1)
“Community of resident” means the city or town within the state of a person's home
address
at the time of his or her marriage or death, or of his or her mother's home
address at the
time of
his or her birth.
(2)
“Dead body” means a lifeless human body or parts of a lifeless human body or
its
bones
from the state of which it reasonably may be concluded that death recently
occurred.
(3)
“Fetal death” means death prior to the complete expulsion or extraction from
its
mother
of a product of human conception, irrespective of the duration of pregnancy;
the death is
indicated
by the fact that after the expulsion or extraction the fetus does not breathe
or show any
other
evidence of life such as beating of the heart, pulsation of the umbilical cord,
or definite
movement
of the voluntary muscles.
(4)
“Filing” means the presentation of a certificate, report, or other record
provided for in
this
chapter, of a birth, death, fetal death, adoption, marriage, or divorce for
registration by the
division
of vital records.
(5)
“Final disposition” means the burial, interment, cremation, or other
disposition of a
dead
body or fetus.
(6)
“Institution” means any establishment, public or private, which provides
in-patient
medical,
surgical, or diagnostic care or treatment, or nursing, custodial or domiciliary
care to two
(2) or
more unrelated individuals, or to which persons are committed by law.
(7)
“Live birth” means the complete expulsion or extraction from its mother of a
product
of human
conception, irrespective of the duration of pregnancy, which, after that
expulsion or
extraction,
breathes or shows any other evidences of life such as beating of the heart,
pulsation of
the
umbilical cord, or definite movement of the voluntary muscles, whether or not
the umbilical
cord has
been cut or the placenta is attached.
(8)
“Physician” means a person authorized or licensed to practice medicine pursuant
to
chapter
37 of title 5.
(9)
“Registration” means the acceptance by the division of vital records and the
incorporation
in its official records of certificates, reports, or other records provided for
in this
chapter,
or births, deaths, fetal deaths, adoptions, marriages, or divorces.
(10)
“Signing” or “Signature” means the application of either a hand signature to a
paper
record
or an electronic process approved by the state registrar of vital records.
(11)
(10) “System of vital records” means the registration, collection,
preservation,
amendment,
and certification of vital statistics records, and activities related to them
including the
tabulation,
analysis, and publication of statistical data derived from those records.
(12)
(11) “Vital records” means records of birth, death, fetal death,
marriage, divorce, and
data
related to those records.
(12)
“Signing” or “Signature” means the application of either a hand signature to a
paper
record
or an electronic process approved by the state registrar of vital records.
23-3-25.
Fees for copies and searches. -- (a) The state registrar shall charge
fees for
searches
and copies as follows:
(1)
For a search of two (2) consecutive calendar years under one name and for
issuance of
a
certified copy of a certificate of birth, fetal death, death, or marriage, or a
certification of birth,
or a
certification that the record cannot be found, the fee is twenty dollars
($20.00). For each
duplicate
copy of a certificate or certification issued at the same time, the fee is
fifteen dollars
($15.00).
(2)
For each additional calendar year search, if applied for at the same time or
within
three
(3) months of the original request and if proof of payment for the basic search
is submitted,
the fee
is two dollars ($2.00).
(3)
For providing expedited service, the additional handling fee is seven dollars
($7.00).
(4)
For processing of adoptions, legitimations, or paternity determinations as
specified in
§§
23-3-14 and 23-3-15, there shall be a fee of fifteen dollars ($15.00).
(5)
For making authorized corrections, alterations, and additions, the fee is ten
dollars
($10.00);
provided, no fee shall be collected for making authorized corrections or
alterations and
additions
on records filed before one year of the date on which the event recorded has
occurred.
(6)
For examination of documentary proof and the filing of a delayed record, a fee
of
twenty
dollars ($20.00); and in addition to that fee, the fee is twenty dollars
($20.00); for the
issuance
of a certified copy of a delayed record.
(b)
Fees collected under this section by the state registrar shall be deposited in
the
general
fund of this state, according to the procedures established by the state
treasurer.
(c)
The local registrar shall charge fees for searches and copies of records as
follows:
(1)
For a search of two (2) consecutive calendar years under one name and for
issuance of
a
certified copy of a certificate of birth, fetal death, death, delayed birth, or
marriage, or a
certification
of birth or a certification that the record cannot be found, the fee is twenty
dollars
($20.00).
For each duplicate copy of a certificate or certification issued at the same
time, the fee
is
fifteen dollars ($15.00).
(2)
For each additional calendar year search, if applied for at the same time or
within
three
(3) months of the original request and if proof of payment for the basic search
is submitted,
the fee
is two dollars ($2.00).
(d)
Fees collected under this section by the local registrar shall be deposited in
the city or
town
treasury according to the procedures established by the city or town treasurer
except that six
dollars
($6.00) of the certified copy fees shall be submitted to the state registrar
for deposit in the
general
fund of this state.
SECTION
35. Section 23-4-6 of the General Laws in Chapter 23-4 entitled "Office of
State
Medical Examiners" is hereby amended to read as follows:
23-4-6.
State medical examiners commission. -- (a) There is established the
state
medical
examiners commission. The commission shall hear and determine appeals to
decisions
by chief
medical examiners regarding the undertaking of investigations, inquests, and
autopsies,
and
shall advise the chief medical examiner on matters of public concern.
(b)
The commission shall consist of twelve (12) members, three (3) of whom shall be
ex
officio
members, viz., the director of health, the attorney general, the superintendent
of state
police,
and nine (9) citizens of the state to be appointed by the governor with the
advice and
consent
of the senate for the term of three (3) years. The governor shall give due
consideration to
any
recommendations for nominations submitted to him or her by the president of the
Rhode
Island
Medical Society, the president of the Rhode Island Society of Pathologists, the
president of
the
Rhode Island Bar Association, the vice president of Brown University Division
of Biological
and
Medical Sciences and the president of the Rhode Island Funeral Directors
Association. Each
citizen
member shall hold office for the term of his or her appointment and until his
or her
successor
is appointed. Vacancies for citizen members shall be filled by appointment for
the
unexpired
term only.
(c)
The director of health and the attorney general shall be the chairperson and
vice
chairperson,
respectively, of the commission. The chief medical examiner of the office of
state
medical
examiners shall serve as the executive secretary of the commission, and the
expenses of
the
commission shall be a responsibility of the department of health. The board may
elect from
among
its members such other officers as it deems necessary. Seven (7) members of the
board
shall
constitute a quorum and the vote of a majority of those present and voting
shall be required
for
action. The commission shall meet at the call of its chairperson and at least
four (4) times each
year,
the time and the place for each meeting to be fixed by the chairperson.
(d)
Members of the commission shall be removable by the governor pursuant to the
provisions
of § 36-1-7 of the general laws and for cause only, and removal solely for
partisan or
personal
reasons unrelated to capacity or fitness for the office shall be unlawful.
(e)
Within ninety (90) days after the end of each fiscal year, the commission shall
approve
and submit an annual report to the governor, the speaker of the house of
representatives,
the
president of the senate, and the secretary of state, of its activities during
that fiscal year. The
report
shall provide an operating statement summarizing meetings or hearings held,
including
meeting
minutes, subjects addressed, decisions rendered, appeals considered and their
disposition,
rules or
regulations promulgated, studies conducted, policies and plans developed,
approved, or
modified,
and programs administered or initiated; a consolidated financial statement of
all funds
received
and expended including the source of the funds, a listing of any staff
supported by these
funds,
and a summary of any clerical, administrative or technical support received; a
summary of
performance
during the previous fiscal year including accomplishments, shortcomings and
remedies;
a synopsis of hearing, complaints, suspensions, or other legal matters related
to the
authority
of the commission; a summary of any training courses held pursuant to this
chapter; a
briefing
on anticipated activities in the upcoming fiscal year; and findings and
recommendations
for
improvements. The report shall be posted electronically on the websites of the
general
assembly
and the secretary of state pursuant to the provisions of § 42-20-8.2. The
director of the
department
of administration shall be responsible for the enforcement of the provisions of
this
subsection.
(f)
To The commission shall conduct a training course for newly
appointed and qualified
members
within six (6) months of their qualification or designation. The course shall
be
developed
by the chair of the commission, be approved by the commission, and be conducted
by
the
chair of the commission. The commission may approve the use of any commission
and/or
staff
members and/or individuals to assist with training. The training course shall
include
instruction
in the following areas: the provisions of chapters 42-46, 36-14 and 38-2; and
the
commission's
rules and regulations. The director of the department of administration shall,
within
ninety
(90) days of the effective date of this act [June 16, 2006],
prepare and disseminate training
materials
relating to the provisions of chapters 42-46, 36-14, and 38-2.
SECTION
36. Section 23-4-14.1 of the General Laws in Chapter 23-4 entitled "Office
of
State
Medical Examiners" is hereby repealed.
23-4-14.1.
Quality Improvement — Reporting to the governor and legislature. —
The
office of the state medical examiners shall issue a status report to the
governor and the
general
assembly on or before September 15, 2005 and March 15, 2006 on efforts and
outcomes
during
the prior six (6) month period. Said report shall include, but may not be
limited to, the
following
areas of quality improvement:
·
Volume of
investigations
·
Turnaround time for
investigations
·
Organ/Tissue donation
activities
·
External reviews of the
OSME, including progress toward national accreditation
·
Budget and staffing
·
Plans for continued
quality and performance improvement.
SECTION
37. Section 23-4.8-3 of the General Laws in Chapter 23-4.8 entitled
"Spousal
Notice
for Abortion" is hereby amended to read as follows:
23-4.8-3.
Exceptions. -- The requirements of § 23-4.8-2 shall not apply if:
(1)
The woman having the abortion furnishes to the physician who is to perform the
abortion
or the physician's authorized agent prior to the abortion being performed a
written
statement
that she has given notice to her husband of the proposed abortion or a written
statement
that the
fetus was not fathered by her husband;
(2)
The woman or and her husband are living separate and apart or
either spouse has filed
a
petition or complaint for divorce in a court of competent jurisdiction;
(3)
The physician who is to perform the abortion or his or her authorized agent
receives
the
written affirmation of the husband that he has been notified of the proposed
abortion; or
(4)
There is an emergency requiring immediate action. In the case of an emergency,
the
woman's
attending physician shall certify in writing on the patient's medical record
that an
emergency
exists and the medical basis for his or her opinion.
SECTION 38. Sections 23-6-14, 23-6-20 and 23-6-24 of the General Laws in
Chapter
23-6
entitled "Prevention and Suppression of Contagious Diseases" are
hereby amended to read
as
follows:
23-6-14.
Exceptions. -- A physician or other health care provider may secure a
test
sample
for the presence of HIV without consent under the following conditions:
(1)
When the person to be tested is under one year of age;
(2)
When the person to be tested is between one and thirteen (13) years of age and
appears
to be symptomatic for HIV;
(3)
When the person to be tested is a minor under the care and authority of the
department
of children, youth, and families, and the director of that department certifies
that an
HIV test
is necessary to secure health or human services for that person;
(4)
When a person (the complainant) can document significant exposure to blood or
other
bodily
fluids of another person (the individual to be tested), during the performance
of the
complainant's
occupation, providing:
(i)
The complainant completes an incident report within forty-eight (48) hours of
the
exposure,
identifying the parties to the exposure, witnesses, time, place, and nature of
the event;
(ii)
The complainant submits to a baseline HIV test and is negative on that test for
the
presence
of HIV, within seventy-two (72) hours of the exposure;
(iii)
There has been a significant percutaneous or mucus membrane exposure, i.e.,
needlestick,
bite, splash over open wound, broken skin, or mucus membrane, by blood or
bodily
fluids
of the person to be tested of a type and in sufficient concentration to permit
transmission of
HIV if
present in those fluids; and
(iv)
If a sample of the patient's blood is not otherwise available and the patient
refuses to
grant
informed consent, then the complainant may petition the superior court for a
court order
mandating
that the test be performed.
(5)
(i) In a licensed health care facility or in the private office of a physician
in the event
that an
occupational health representative or physician, registered nurse practitioner,
physician
assistant,
or nurse-midwife not directly involved in the exposure, determines that a
health care
provider,
other than one in a supervisory position to the person making the determination
had a
significant
exposure to the blood and/or body fluids of a patient and the patient or the
patient's
guardian
refuses to grant consent for an HIV test to determine whether the patient has
HIV, then,
if a
sample of the patient's blood is available, that blood shall be tested for HIV.
(ii)
If a sample of the patient's blood is not otherwise available and the patient
refuses to
grant
informed consent, then the health care worker may petition the superior court
for a court
order
mandating that the test be performed.
(iii)
Before a patient or a sample of the patient's blood is required to undergo an
HIV test,
the
health care provider must submit to a baseline HIV test within seventy-two (72)
hours of the
exposure.
(iv)
No person who determines that a health care worker has sustained a significant
exposure
and authorizes the HIV testing of a patient, nor any person or health care
facility who
acts in
good faith and recommends the test be performed, shall have any liability as a
result of
their
actions carried out under this chapter, unless those persons are proven to have
acted in bad
faith.
(6)
In an emergency, where due to a grave medical or psychiatric condition, it is
impossible
to obtain consent from the patient or the patient's parent, guardian, or agent.
(7)
As permitted under §§ 23-18.6-12 23-18.6.1-14(c) and (d) (organ
transplant), 23-1-38
(sperm
donation), and 23-8-1.1 (person under eighteen (18) years may give consent for
testing for
communicable
diseases).
(8)
Mandatory testing for human immunodeficiency virus (HIV) conducted pursuant to
§§
42-56-37 (testing at ACI), 11-34-10 (prostitution), and 21-28-4.20 (IDU and
needles).
23-6-20.
Notification of disclosure. -- In all cases when an individual's HIV
test results
are
disclosed to a third party, other than a person involved in the care and
treatment of the
individual,
and except as permitted by subsections (a)(1), (a)(2)(i), (a)(2)(ii),
(a)(2)(iv), or (a)(4)
of §
23-6-17 (permitted disclosures re: confidentiality), and permitted by and
disclosed in
accordance
with the Federal Health Insurance Portability and Accountability Act of 1996
(Public
law
104-191) enacted on August 21, 1996 and as thereafter amended, the person so
disclosing
shall
make reasonable efforts to inform that individual in advance of:
(1)
The nature and purpose of the disclosure;
(2)
The date of disclosure;
(3)
The recipient of the disclosed information.
23-6-24.
Insurance exemption. -- (a) Sections 23-6-10 — 23-6-23 do not apply to
the
offering
or sale of life insurance in Rhode Island; provided, however, that any
insurance company
offering
or selling life insurance within Rhode Island that requires an individual to be
tested for
infection
with human immunodeficiency virus (HIV) or any other identified causative agent
of
HIV for
purposes of determining insurability shall: (1) give that individual prior
written notice of
those
requirements, and (2) proceed with that testing only upon the written
authorization of the
individual
or in the event the individual is a minor, the individual's parent or guardian.
Notwithstanding
anything in §§ 23-6-10 — 23-6-23 to the contrary, life insurance companies
offering
or selling life insurance in Rhode Island may otherwise obtain or disclose HIV
test
results
in accordance with § 23-6-17(3). Nothing in this chapter prohibits that company
from
collecting
data for statistical purposes, so long as the insured is not identified.
However, nothing
in this
section shall be construed to permit that insurance company to cancel or refuse
to renew a
life
insurance policy that by its terms has not lapsed on the basis of a positive
HIV test result.
(b)
(1) “Health benefits” include accident and sickness, including disability or
health
insurance,
health benefit plans and/or policies, hospital, health, or medical service
plans, or any
health
maintenance organization plan pursuant to title 27 or otherwise.
(2)
The provisions of §§ 23-6-10 — 23-6-23 apply to the offer or sale of health
benefits
in this
state by any company regulated under the laws of this state, including, but not
limited to,
title 27
and chapter 62 of title 42; provided, however, §§ 23-6-10 — 23-6-23 do not
apply to the
following:
(i)
Individual health benefit policies;
(ii)
Small group health benefits plans, i.e., groups having fewer than twenty-five
(25)
employees
eligible to participate in an employer sponsored plan, or, in the case of
non-employer
groups,
a group having fewer than twenty-five (25) employees;
(iii)
Late entrants into any group health benefits plan, regardless of the size of
the group.
A late
entrant shall be defined as any individual who does not enroll into a health
plan when first
eligible
under the plan, but who later seeks coverage under the group plan;
(iv)
Where an individual seeks to become eligible for an amount of group disability
income
benefit, which benefit would be in excess of the insurer's non-medical maximum
as
defined
under the group plan.
(3)
Any company offering or selling health benefits in this state and regulated
under the
laws of
this state that requires an individual to be tested for infection with HIV or
any other
identified
causative agent of HIV as permitted in paragraphs (2)(i) to (iv) for purposes
of
determining
insurability shall: (i) give that individual prior written notice of those requirements,
and (ii)
proceed with that testing only upon the written authorization of the
individual, or in the
event
the individual is a minor, the individual's parent or guardian. Notwithstanding
anything in
this
chapter to the contrary, companies offering or selling health benefits in this
state may
otherwise
obtain or disclose HIV test results in accordance with § 23-6-17(3) 23-6-17(a)(3).
Nothing
in this chapter shall prohibit that company from collecting data for
statistical purposes so
long as
the insured's name is not identified.
(4)
Nothing in this chapter shall be construed to permit any company that offers or
sells
health
benefits in this state to cancel or refuse to renew a health benefit, which has
not by its
terms
lapsed, on the basis of a positive HIV test result.
(c)
(1) There is established a commission to develop and recommend to the
legislature a
risk
pool plan under which all insurers issuing health insurance in the state shall
participate and
share a
proportion of the risk and cost of insuring people with HIV.
(2)
The commission consists of eleven (11) members; three (3) of whom shall be
members
of the house of representatives, not more than two (2) from the same political
party, to
be appointed
by the speaker of the house; two (2) of whom shall be members of the senate,
not
more
than one of whom shall be from the same political party, to be appointed by the
president of
the
senate; one of whom shall be the director of the department of health, or his
or her designee;
one of
whom shall be the director of the department of business regulation, or his or
her designee;
two (2)
of whom shall be representatives of the insurance community, to be appointed by
the
governor;
and two (2) of whom shall be representatives of AIDS project Rhode Island, to
be
appointed
by the governor.
(3)
The commission shall meet at the call of the speaker.
SECTION
39. Section 23-7-6.2 of the General Laws in Chapter 23-7 entitled
"Mosquito
Abatement"
is hereby amended to read as follows:
23-7-6.2.
Board training. -- Newly appointed and qualified members of the board
and
new
designees of ex officio members are required to complete a training course
within six (6)
months
of their qualification or designation. The course shall be developed by the
chair of the
board,
approved by the board and conducted by the chair of the board. The board may
approve
the use
of any board or staff members or other individuals to assist with training. The
course shall
include
instruction in the following areas: the provisions of chapters 23-7, 42-46,
36-14 and 38-2;
and the
board's rules and regulations. The director of the department of administration
shall,
within
ninety (90) days of the effective date of this act [April 20, 2006],
prepare and disseminate
training
materials relating to the provisions of chapters 42-46, 36-14 and 38-2.
SECTION
40. Sections 23-9-14, 23-9-15, 23-9-16, 23-9-17, 23-9-18 and 23-9-21 of the
General
Laws in Chapter 23-9 entitled "Quarantine of Vessels" are hereby
amended to read as
follows:
23-9-14.
Hoisting of quarantine colors. -- The commander of a vessel as
described in §
23-9-13
[repealed] this chapter, on
his or her arrival in any of the waters of the state, shall
immediately
hoist and keep his or her colors in the shrouds of that vessel as a signal that
he or she
has come
from some infected place or has infection or contagion on board.
23-9-15.
Unauthorized departure from infected vessel. -- If any person shall
come on
shore
from on board a vessel as described in § 23-9-13 [repealed] this
chapter without first
obtaining
a license, the city or town council may immediately send that offender back on
board
that
vessel, or confine him or her on shore in a convenient place that appears to
the city or town
council
most effectual to prevent the spreading of any infection; and the offending
person shall
satisfy
and pay all charges that shall arise on the confinement, and shall be fined
forty dollars
($40.00).
23-9-16.
Examination of vessel - Guards to prevent unauthorized communication. --
The city
or town council of the city or town where a vessel as described in § 23-9-13
[repealed]
this
chapter arrives shall send a
physician or other suitable person to examine and report to them
of the
true state of that vessel and the people on board, at the charge of the master
or owner of
that
vessel; and they shall immediately put on board that vessel some suitable
person or persons
to
secure that vessel and effectually prevent any communication with that vessel,
at the like
charge
of the master or owner of that vessel.
23-9-17.
Confinement or removal of persons on board. -- The city or town council
of
the city
or town where a vessel as described in § 23-9-13 [repealed] this
chapter arrives shall
confine
on board that vessel, or send to some hospital or other suitable place, all
persons who
came in
that vessel, for a convenient time, until those of them that have, or are
likely to have, the
smallpox
or other infectious or contagious distemper are perfectly recovered and
cleansed from
that
distemper, or have passed a suitable quarantine, and also all persons who have
gone on board
that
vessel without license, at the charge and expense of those persons
respectively.
23-9-18.
Disinfection of imported goods. -- The city or town council of a city
or town
where a
vessel as described in § 23-9-13 [repealed] this chapter arrives
shall appoint suitable
persons to
take effectual care that all goods, wares, and merchandise imported in that
vessel
which
they think may hold and communicate the infection or contagion are landed in
some
suitable
place to be appointed by the council and cleansed in the manner directed by the
council
before
they are permitted to be brought into any house, shop, or warehouse, other than
that in
which
they are cleansed.
23-9-21.
Forfeiture of unlawfully imported goods. -- All goods imported in a
vessel as
described
in § 23-9-13 [repealed] this chapter that shall be clandestinely
landed or brought into
any
house, shop, or warehouse without a certificate and allowance as provided in §
23-9-19, or
that
shall be imported by land as provided in § 23-9-20 and not cleansed or aired by
order of the
city or
town council, shall be forfeited; one-third (1/3) of those goods to the use of
the state and
two-thirds
(2/3) to the use of the person who shall sue for the goods.
SECTION
41. Section 23-11-17 of the General Laws in Chapter 23-11 entitled
"Sexually
Transmitted
Diseases" is hereby amended to read as follows:
23-11-17.
Human immunodeficiency virus (HIV) testing. -- (a)(1) The
physician or
health
care provider attending any person for a suspected sexually transmitted disease
shall offer
testing
for human immunodeficiency virus (HIV). All testing pursuant to this section
shall be
performed
in accordance with §§ 23-6-17 (confidentiality) and 23-6-18 (protection of the
medical
record)
and the informed consent standards contained in chapter 6 of title 23.
(2)
Each person tested and counseled shall first be provided with an “informed
consent
form” as
provided by subsection 23-6-11(3), and shall specifically be given the
opportunity to
decline
or opt-out of testing, which he or she shall sign and date in acknowledgment of
his/her
election
to be tested.
(b)
In the event an individual consents to anonymous testing and tests positive for
HIV,
the HIV
testing counselor shall provide the client an informed consent form as provided
by
subsection
23-6-11(3). If an individual is tested anonymously and is found positive on the
initial
screening
test or during a post-test consultation, the counselor shall discuss, with the
client,
options regarding
referrals and reporting of this positive screening, including the necessity of
accessing
a physician. The department of health shall maintain sites for providing both
anonymous
and confidential HIV testing, and HIV counseling and referral. Each site,
funded by
the
department of health, shall offer free testing, counseling and referral for
indigent parties and
other
individuals without health insurance, offer a sliding scale for payment for all
other
individuals
and, in the case of confidential testing, screen, for ability to pay through a
third-party
insurer.
In the case of nonfunded sites for HIV testing, organizations and/or
institutions
performing
the test shall offer free testing, counseling and referral for indigent parties
and other
individuals
without health insurance.
(c)
All persons tested under this section shall be counseled and tested in
accordance with
regulations
promulgated by the department of health; provided, however, that the counseling
shall
be in
accordance with acceptable medical standards, and no test results shall be
given by any
means
(e.g. phone, mail, e-mail, fax, etc.) other than in person. Counselors for HIV
counseling,
testing
and referral must undergo training given by the department of health to become
a qualified
professional
counselor.
SECTION
42. Sections 23-13-13, 23-13-17, 23-13-22, 23-13-23, and 23-13-26 of the
General
Laws in Chapter 23-13 entitled "Maternal and Child Health Services for
Children with
Special
Health Care Needs" are hereby amended to read as follows:
23-13-13.
Testing for hearing impairments. -- (a) It is declared to be the public
policy
of this
state that every newborn infant be evaluated by procedures approved by the
state
department
of health for the detection of hearing impairments, in order to prevent many of
the
consequences
of these disorders. No hearing impairment test shall be made as to any newborn
infant
if the parents of that child object to the test on the grounds that a hearing
impairment test
would
conflict with their religious tenets or practices.
(b)
The physician attending a newborn child shall cause the child to be subject to
hearing
impairment
tests as described in department of health regulations.
(c)
In addition, the department of health is authorized to establish by rules and
regulations
a reasonable fee structure for hearing impairment testing to cover program
costs not
otherwise
covered by federal grant funds specifically secured for this purpose. This
testing shall
be a
covered benefit reimbursable by all health insurers, as defined in § 27-38-6
[repealed] 27-
38.2-2(1) except for supplemental policies that only provide
coverage for specific diseases,
hospital
indemnity, Medicare supplement, or other supplemental policies. The department
of
human
services shall pay for hearing impairment testing when the patient is eligible
for medical
assistance
under the provisions of chapter 8 of title 40. In the absence of a third party
payor the
charges
for hearing impairment testing shall be paid by the hospital or other health
care facility
where
the birth occurred. Nothing in this section shall preclude the hospital or
health care facility
from
billing the patient directly. Those fees shall be deposited into the general
fund as general
revenues.
(d)
There is created a hearing impairments testing advisory committee which shall
advise
the
director of the department of health regarding the validity and cost of testing
procedures. That
advisory
committee shall:
(1)
Meet at least four (4) times per year;
(2)
Be chaired by the director or his or her designee;
(3)
Be composed of seven (7) members appointed by the director from the following
professions
or organizations:
(i)
A representative of the health insurance industry;
(ii)
A pediatrician, designated by the R.I. chapter of the American Academy of
Pediatrics;
(iii)
An audiologist, designated by the R.I. chapter of the American Speech and
Hearing
Association;
(iv)
Two (2) representatives of hospital neonatal nurseries;
(v)
A representative of special education designated by the department of
elementary and
secondary
education; and
(vi)
The director of health or his or her designee.
23-13-17.
Special supplemental food program for women, infants, and children
(WIC).
-- (a) The director of health shall administer a program
to be called the WIC program, to
provide
supplemental foods and nutrition education to pregnant, postpartum, and breastfeeding
women,
infants, and young children from families who meet financial eligibility
standards
established
by the department and who are at special risk with respect to their physical
and mental
health
by reason of inadequate nutrition, or health care, or both. The WIC program
shall be
administered
in a manner consistent with applicable federal law, 42 U.S.C. § 1786, and the
provision
of this chapter.
(b)
All applicants and participants who are eligible shall be entitled to
participate in the
WIC
program.
(c)
The cost of the program shall not exceed two hundred thousand dollars
($200,000).
(d)
Every person, party, entity, partnership, corporation, or other business,
governmental,
or
nonprofit entity which embezzles, willfully misapplies, steals, or obtains by
fraud or deception
any
funds, assets or property provided under § 7 of the Child Nutrition Act of 1986
1966, 42
U.S.C. §
1756 1776, or under this chapter, whether received directly or
indirectly from the United
States
department of agriculture or the Rhode Island department of health, or
receives, conceals,
or
retains those funds, assets, or property for his or her own interest, knowing
those funds, assets,
or
property have been embezzled, willfully misapplied, stolen, or obtained by
fraud or deception
shall,
if the amount of funds, assets, or property are of the value of five hundred
dollars ($500) or
more, be
fined not more that ten thousand dollars ($10,000), or if the amount of funds,
assets, or
property
are of a value of less than five hundred dollars ($500), shall be fined not
more than one
thousand
dollars ($1,000). The amount of funds, assets, or property provided under the
special
supplemental
food program for women, infants, and children misdirected in violation of this
chapter
shall be calculated as the aggregate from any and all incidents or acts
prohibited by this
chapter
occurring in any consecutive twelve (12) month period.
(e)
Every person, party, entity, partnership, corporation, or other business,
governmental,
or
nonprofit entity which duplicates, causes to be duplicated, creates,
manufactures, or causes to
be
created or manufactured any copy or facsimile of any article or method employed
by the
Rhode
Island department of health to identify food vendors which redeem food
instruments of the
special
supplemental food program for women, infants, and children (WIC program)
without the
express
written authorization of the Rhode Island department of health or whoever
obtains, steals,
conceals
or retains a WIC program vendor identifier knowing the identifier has been
copied or
created
without department of health authorization or obtains or retains an identifier
or copy or
facsimile
of it, without the express written authorization of the Rhode Island department
of
health,
shall, if the WIC program vendor identifier is used in the acceptance,
redemption, or
deposit
of WIC program food instruments, be fined not more than ten thousand dollars
($10,000),
or if
the unauthorized vendor identifier is not shown to have been used in the
acceptance,
redemption,
or deposit of WIC program food instruments, shall be fined not more than one
thousand
dollars ($1,000).
(f)
Every person, party, entity, firm, or corporation which misrepresents itself
as, or in
any
other manner improperly, fraudulently or deceptively holds itself out to be,
authorized by any
unit of
the federal, state, or local government or other entity to accept, redeem, or
deposit WIC
program
food instruments, such as WIC checks, or which otherwise attempts or solicits
to accept,
redeem,
or deposit WIC food instruments without the express authorization of the
department in
any
manner shall, if the action is accompanied by the unauthorized acceptance,
redemption, or
deposit
of WIC program food instruments, be fined not more than ten thousand dollars
($10,000),
or if
those actions are not shown to have been accompanied by the acceptance,
redemption, or
deposit
of WIC program food instruments, shall be fined not more than one thousand
dollars
($1,000).
(g)
The possession of any funds, assets, property, vendor identifier, or WIC food
instruments
shall be evidence of guilty knowledge by the person having possession that the
property
was embezzled, willfully misapplied, stolen, or obtained by fraud or deception
or created
or
received without authorization except the person shows that it was acquired in
the due course
of trade
and for adequate consideration.
(h)
Any penalty imposed under this chapter shall be in addition to immediate
repayment
of any
claim made under the provisions of the Rhode Island state plan of operation and
administration
of the special supplemental food program for women, infants, and children for
funds
improperly obtained or received.
(i)
Any fine imposed under this chapter does not preclude any other sanctions or
penalties
set forth in state or federal regulations, rules or the provisions of the Rhode
Island state
plan of
operation and administration for the special supplemental food program or the
provisions
of the
vendor participation agreement in force between the Rhode Island department of
health and
any WIC
program vendor.
23-13-22.
Early intervention program for developmentally disabled infants. --
(a) The director of the department of human services shall ensure that all
developmentally
disabled infants from birth to three (3) years of age shall be enrolled in the
early
intervention
program. Regulations governing the delivery of services under this program,
including
eligibility criteria, shall be promulgated by the department of human services,
with the
advice
of the interagency coordinating council; provided, however, that all
regulations
promulgated
by the department of health shall remain in full force and effect until the
time they
are
replaced by regulations promulgated by the department of human services. The
regulations
shall
stipulate, at a minimum, the following provisions that are consistent with the
intent of this
chapter:
(1)
The director shall develop and maintain a procedure for the earliest possible
identification
and efficient referral of all developmentally disabled infants;
(2)
The director shall ensure that every infant identified and referred to this
program is
enrolled
as soon as possible after birth; and further, that for infants placed on a
waiting list for
facility
based group programming, an early intervention program shall be made available
within a
thirty
(30) day period from the time a need is identified in the individual program
plan;
(3)
Unless parents refuse the service, the home visiting component of the program
shall
commence
as soon as the infant has been identified as having a possible developmental
disability;
(4)
Any parent(s) who is/are dissatisfied with decisions or termination of service
or with
practices
and procedures of a particular agency or the department of human services shall
notify
the
director of the department of human services in writing within thirty (30)
calendar days and
the
complaint shall be reviewed in accordance with department of health policy and
procedures,
as
amended, and the Administrative Procedures Act, chapter 35 of title 42.
(5)
An early intervention program for purposes of this section shall mean a
comprehensive
array of educational, developmental, health, and social services provided on a
calendar
year basis to eligible infants, children, and their families as specified in
program
regulations.
(b)
Within ninety (90) days after the effective date of this act [October 1,
2004], an
evaluation
plan describing outcome measures that document the program's successes and
shortcomings
from the previous fiscal year shall be submitted to the speaker of the house of
representatives,
the president of the senate and the house oversight committee and the governor
and the
interagency coordinating council. Development of the plan shall be made in
consultation
with the
entities with expertise in this area and the interagency coordinating council.
The plan
shall
include a memorandum of understanding between the department of health,
department of
human
services and the department of elementary and secondary education that
demonstrates
coordination
and continuity of early intervention services among these departments.
(c)
Within six (6) months after the effective date of this act [January 1,
2005] where
prescribed
outcomes documented in the evaluation plan have not been accomplished the
responsible
agencies shall submit written explanations for the shortfalls, together with
their
proposed
remedies. The report shall also include evaluation of the progress of the
coordination
efforts
between the department of health and the department of human services and the
department
of elementary and secondary education and the interagency coordinating council
and
shall
include any recommendations regarding modifications of the reimbursement
mechanisms of
this
chapter.
(d)
Within twelve (12) months after the effective date of this article [August
1, 2005] a
final
report shall include the progress of the coordination efforts between the
department of health
and the
department of human services and department of elementary and secondary
education,
interagency
coordinating council and shall include any recommendations regarding
modifications
to the
comprehensive array of educational, developmental, health and social services
provided on
a
calendar year basis to eligible infants, children and their families as
specified in an early
intervention
system.
(e)
All reports or documents required to be produced pursuant to 20 U.S.C. § 1471
et
seq.,
shall be submitted to the speaker of the house, president of the senate and the
chairpersons
of the appropriate
house of representatives and senate oversight committees and the governor and
the
interagency coordinating council. Adherence to such plans and reporting
requirements, and
budgets
and the timely achievement of goals contained therein shall be considered by
the
oversight
committees of the house of representatives and senate, among other relevant
factors, in
determining
appropriations or other systemic changes.
23-13-23.
Interagency coordinating council. -- The interagency coordinating council,
which is
composed in accordance with 20 U.S.C. § 1441, as added by Public Law 105-17
108-
446, shall monitor the multiagency operation of the early
intervention program and to provide a
forum where
problems may be addressed relating to the delivery of services in the early
intervention
program.
23-13-26.
Technology-dependent children - Definitions - Caretakers' skills. -- (a)
For
the
purposes of this section, the following definitions apply:
(1)
“Advanced skills” means familiarity and current experience with the following:
(i)
Pediatric intensive care assessments skills;
(ii)
Ventilator and respirator equipment;
(iii)
Maintenance in oxygen therapy and pulse oximeter equipment;
(iv)
Tracheostomy care — daily and emergency care;
(v)
Respiratory suctioning and maintenance of suctioning equipment;
(vi)
Administration of respiratory treatment and chest therapy;
(vii)
Gastrostomy and naso-gastric care and gavage/pump feedings;
(viii)
Administration and familiarity of multiple cardio — pulmonary medications; and
(ix)
Basic life support certification and periodic recertification.
(2)
“Medical devices or equipment” include, but are not limited to, the following:
(i)
Respirator;
(ii)
Tracheostomy;
(iii)
Oxygen;
(iv)
Naso-gastric or gastrostomy tube;
(v)
Indwelling catheter;
(vi)
Intravenous device;
(vii)
Total parenteral nutritional support; and
(viii)
Peritoneal or hemodialysis.
(3)
“Technology-dependent children” means:
(i)
Children who have severe, chronic disabilities attributable to a mental or
physical
impairment
or combination of mental and physical impairments, which disability is
manifested
before
the person attains the age of twenty-two (22), is likely to continue
indefinitely, results in
substantial
functional limitations in three (3) or more of the following areas of major life
activity:
(A)
Self-care;
(B)
Receptive and expressive language;
(C)
Learning;
(D)
Mobility;
(E)
Self-direction;
(F)
Capacity for independent living; or
(G)
Economic self-sufficiency; and
(ii)
Who requires medical devices or equipment to compensate for the chronic,
persistent
reduction
or absence of a vital body function.
(b)
Certified school nurse teachers, as defined in § 16-21-8, who provide direct
care for
technology-dependent
children shall have advanced skills which include, but are not limited to,
those
skills in subsection (a)(1) of this section.
(c)
The specific guidelines for the care of technology-dependent children in
schools shall
be
included in the rules and regulations issued jointly by the director of the
department of health
and the
board of regents for elementary and secondary education under the provisions of
U.S.
Public
Law 94-142 108-446, 20 U.S.C. § 1400 et seq., and chapter 24 of
title 16 as part of the
school
health program.
(d)
Nothing in § 16-11-2 shall be construed to prevent the board of regents from
promulgating
regulations requiring certified nurse teachers who provide direct care for
technology-dependent
children to obtain the advanced skills required under this section.
(e)
The obligation of a school district to provide the services set forth in this
section shall
be
determined in accordance with other applicable state and federal laws and
regulations.
SECTION
43. Section 23-13.2-1 of the General Laws in Chapter 23-13.2 entitled
"Nursing
Working Mothers" is hereby amended to read as follows:
23-13.2-1.
Workplace policies protecting a woman's choice to breastfeed. -- (a) An
employer
may provide reasonable unpaid break time each day to an employee who needs to
breastfeed
or express breast milk for her infant child to maintain milk supply and
comfort. The
break
time must, if possible, run concurrently with any break time already provided
to the
employee.
An employer is not required to provide break time under this section if to do
so would
create
an undue hardship on the operations of the employer.
(b)
An employer shall make a reasonable effort to provide a private, secure and sanitary
room or
other location in close proximity to the work area, other than a toilet stall,
where an
employee
can express her milk or breastfeed her child.
(c)
The department of health shall issue periodic reports on breastfeeding rates,
complaints
received and benefits reported by both working breastfeeding mothers and
employers.
(d)
As used in this section:
(1)
“Employer” means a person engaged in business who has one or more employees,
including
the state and any political subdivision of the state;
(2)
“Employee” means any person engaged in service to an employer in the business
of
the
employer;
(3)
“Reasonable efforts” means any effort that would not impose an undue hardship
on
the
operation of the employer's business; and
(4)
“Undue hardship” means any action that requires significant difficulty or
expense
when
considered in relation to factors such as the size of the business, its
financial resources and
the
nature and structure of its operation.
SECTION
44. Sections 23-13.3-1 and 23-13.3-4 of the General Laws in Chapter 23-13.3
entitled
"Birth Defects Surveillance and Information System" are hereby
amended to read as
follows:
23-13.3-1.
Preamble to birth defects surveillance and information system. --
Whereas
birth defects are a major cause of infants deaths and childhood disabilities;
and whereas
early
recognition and response to birth defects often prevents more serious effects;
and whereas
the
epidemiological patterns of specific birth defects may provide keys to improved
birth
outcomes.
An active birth defects surveillance and information system is essential to
developing
programs
and disseminating information that can reduce birth defects and infant
mortality. An
active
birth defects surveillance and information system serves to:
(a)
(1) Describe occurrence of birth defects in the newborn and children up
to five (5);
(b)
(2) Detect trends of morbidity and mortality, stimulate epidemiological
research
diminish
the impact of birth defects and infant mortality;
(c)
(3) Identify newborns and children with birth defects to intervene on a
timely basis for
treatment.
23-13.3-4.
Advisory council. -- (a) Not later than thirty (30) days after the
effective
date
of this act July 7, 2003, the
director shall appoint a council to advise the department on the
establishment
and implementation of the birth defects reporting, surveillance and information
system.
(b)
The council shall recommend to the director a list of birth defects to be
reported to
the
surveillance system.
(c)
The council shall include not more than fifteen (15) persons who collectively
bring
the
following expertise: (1) representative of the Children's Cabinet; (2) health
care services; (3)
the
Rhode Island March of Dimes and other community organizations concerned with
birth
defects;
(4) parents of children with birth defects; and (5) the public.
(d)
Members may serve for two (2) three (3) year terms. Terms for each appointee
begin
at the
initial appointment date.
(e)
Not later than thirty (30) days after the initial appointments are made the
director
shall
convene the first meeting of the council. In consultation with and with the
approval of the
council,
the director shall appoint, at the first meeting of the council, the
chairperson and vice
chairperson
of the council from among the members of the council. The chairperson may call
additional
meetings, as the chairperson considers appropriate.
(f)
The council may establish rules of procedure as necessary to facilitate the
council's
orderly
conduct of business.
(g)
Council members shall serve without compensation.
SECTION
45. Sections 23-13.4-1, 23-13.4-2, 23-13.4-3, 23-13.4-4, and 23-13.4-5 of the
General
Laws in Chapter 23-13.4 entitled "Hazardous Chemicals – Contamination of
Breast Milk
and
Environment" are hereby amended to read as follows:
23-13.4-1.
Legislative findings. -- The legislature finds and declares all of the
following:
(a)
(1) Chemicals known as brominated flame retardants (BFRs) are widely
used in
Rhode
Island. To meet stringent fire standards, manufacturers add BFRs to a multitude
of
products,
including plastic housing of electronics and computers, circuit boards, and the
foam and
textiles
used in furniture.
(b)
(2) Polybrominated diphenyl ether (PBDE), which is a subcategory of
BFRs, has
increased
fortyfold in human breast milk since the 1970s.
(c)
(3) PBDE has the potential to disrupt thyroid hormone balance and
contribute to a
variety
of developmental deficits, including low intelligence and learning
disabilities. PBDE may
also
have the potential to cause cancer.
(d)
(4) Substantial efforts to eliminate BFRs from products have been made
throughout
the
world, including private and public sectors. These efforts have made available
numerous
alternatives
safe to human health while meeting stringent fire standards. To meet market
demand,
it is in
the interest of Rhode Island manufacturers to eliminate the use of BFRs.
(e)
(5) In order to protect the public health and the environment, the
legislature believes it
is
necessary for the state to develop a precautionary approach regarding the production,
use,
storage,
and disposal of products containing brominated fire retardants.
23-13.4-2.
Definitions. -- For purposes of this chapter, the following words shall
have the
following
meanings:
(a)
(1) “DecaBDE” means decabromodiphenyl ether.
(b)
(2) “OctaBDE” means octabrominated diphenyl ether or any technical
mixture in
which
octabrominated diphenyl ether is a predominate congener.
(c)
(3) “PBDE” means polybrominated diphenyl ether.
(d)
(4) “PentaBDE” means pentabrominated diphenyl ether or any technical
mixture in
which
pentabrominated diphenyl ether is a predominate congener including, but not
limited to,
metal
furniture, machinery, major appliances, electronic products, and wood-burning stoves.
23-13.4-3.
Manufacturing, processing or distribution. -- (a) Effective January 1,
2007,
a person
may not manufacture, process, or distribute in commerce a product or a
flame-retardant
part of
a product containing more than one-tenth (1/10%) of one percent (1%) of
pentaBDE or
octaBDE.
(b)
Subsection (a) of this section does not apply to the following:
(1)
The sale by a business, charity, or private party of any used product
containing PBDE.
(2)
The distribution in commerce of original equipment manufacturer replacement
service
parts
manufactured prior to the effective date of this act July 14, 2006.
(3)
The processing of recycled material containing pentaBDE or octaBDE in
compliance
with
applicable state and federal laws.
(4)
Use of products containing small quantities of PBDEs that are produced or used
or
used for
scientific research on the health or environmental effects of PBDEs.
23-13.4-4.
“DecaBDE” Study. -- By January 2, 2007, the department of environmental
management,
shall submit to the general assembly a report that reviews the latest available
scientific
research to address the following issues:
(a)
(1) Whether decaBDE is bio-accumulating in humans and the environment,
and if so,
whether
the levels of decaBDE are increasing, decreasing, or staying the same;
(b)
(2) How are humans exposed to decaBDE;
(c)
(3) What health effects could result from exposure to decaBDE, and are
current levels
of
exposure at levels that could produce these effects;
(d)
(4) Whether decaBDE breaks down into more harmful chemicals that could
damage
public
health; and
(e)
(5) Whether effective flame retardants are available for decaBDE uses,
and whether
the use
of available alternatives reduce health risks while still maintaining an
adequate level of
flame
retardant performance.
23-13.4-5.
Review of “decaBDE” Study. -- By February 28, 2007, the department of
health,
shall submit to the general assembly a report that reviews the department of
environmental
management's
decaBDE study. In addition to a review of any public health implications the
department
of health believes would result from exposure to decaBDE, it shall also comment
on
the
following:
(a)
(1) The known exposure pathways for humans to decaBDE;
(b)
(2) What scientific evidence exists to demonstrate that decaBDE breaks
down into
other
chemicals that could pose public health concerns; and
(c)
(3) What research and analysis exists on the potential human health
effects of flame
retardants
that could be used as alternative to decaBDE.
SECTION
46. Section 23-14.1-5 of the General Laws in Chapter 23-14.1 entitled
"Health
Professional
Loan Repayment Program" is hereby amended to read as follows:
23-14.1-5.
Duties of the board. -- The board shall:
(1)
Determine which areas of the state shall be eligible to participate in the loan
repayment
program each year, based on health professional shortage area designations.
(2)
Receive and consider all applications for loan repayment made by eligible
health
professionals.
(3)
Conduct a careful and full investigation of the ability, character, financial
needs, and
qualifications
of each applicant.
(4)
Consider the intent of the applicant to practice in a health professional
shortage area
and to
adhere to all the requirements for participation in the loan repayment program.
(5)
Submit to the director a list of those individuals eligible for loan repayment
and
amount
of loan repayment to be granted.
(6)
Promulgate rules and regulations to ensure an effective implementation and
administration
of the program.
(7)
Within ninety (90) days after the end of each fiscal year, the board shall
approve and
submit
an annual report to the governor, the speaker of the house of representatives,
the president
of the
senate, and the secretary of state, of its activities during that fiscal year.
The report shall
provide:
an operating statement summarizing meetings or hearings held, including meeting
minutes,
subjects addressed, decisions rendered, applications considered and their
disposition,
rules or
regulations promulgated, studies conducted, polices and plans developed,
approved, or
modified,
and programs administered or initiated; a consolidated financial statement of
all funds
received
and expended including the source of the funds, a listing of any staff
supported by these
funds,
and a summary of any clerical, administrative or technical support received; a
summary of
performance
during the previous fiscal year including accomplishments, shortcomings and
remedies;
a synopsis of hearings, complaints, suspensions, or other legal matters related
to the
committee;
a summary of any training courses held pursuant to this chapter; a briefing on
anticipated
activities in the upcoming fiscal year, and findings and recommendations for
improvements.
The report shall be posted electronically on the websites of the general
assembly
and the
secretary of state pursuant to the provisions of § 42-20-8.2. The director of
the department
of
administration shall be responsible for the enforcement of the provisions of
this subsection.
(8)
To conduct Conduct a training course for newly appointed and
qualified members
within
six (6) months of their qualification or designation. The course shall be
developed by the
chair of
the board, be approved by the board, and be conducted by the chair of the
board. The
board may
approve the use of any board and/or staff members and/or individuals to assist
with
training.
The training course shall include instruction in the following areas: the
provisions of
chapters
42-46, 36-14 and 38-2; and the board's rules and regulations. The director of
the
department
of administration shall, within ninety (90) days of the effective date of
this act [June
16, 2006],
prepare and disseminate training materials relating to the provisions of
chapters 42-46,
36-14,
and 38-2.
SECTION
47. Section 23-16.3-8 of the General Laws in Chapter 23-16.3 entitled
"Clinical
Laboratory Science Practice" is hereby amended to read as follows:
23-16.3-8.
Standards for licensure. -- (a) Clinical laboratory scientist
(technologist).
The
department of health shall issue a clinical laboratory scientist's license to
an individual who
meets
the qualifications developed by the board, including at least one of the
following
qualifications:
(1)
A baccalaureate degree in clinical laboratory science (medical technology) from
an
accredited
college or university whose curriculum included appropriate clinical education;
(2)
A baccalaureate degree in biological, chemical, or physical science from an
accredited
college
or university, and subsequent to graduation has at least twelve (12) months of
appropriate
clinical
education in an accredited clinical laboratory science program;
(3)
A baccalaureate degree which includes a minimum of thirty-six (36) semester (or
equivalent)
hours in the biological, chemical, and physical sciences from an accredited
college or
university
plus two (2) years of full-time work experience including a minimum of four (4)
months
in each of the four (4) major disciplines of laboratory practice (clinical
chemistry, clinical
microbiology,
hematology, immunology/immunohematology); or
(4)
A baccalaureate degree consisting of ninety (90) semester (or
equivalent) hours,
thirty-six
(36) of which must be in the biological, chemical, or physical sciences, from an
accredited
university, and appropriate clinical education in an accredited clinical
laboratory
science
program.
(5)
A clinical laboratory scientist (technologist) who previously qualified under
federal
regulatory
requirements such as 493.1433 42 CFR § 493.1433 of the March 14,
1990 federal
register
or other regulations or criteria which may be established by the board.
(b)
Clinical laboratory technician. The department of health shall issue a clinical
laboratory
technician's license to an individual who meets the qualifications promulgated
by the
board,
including at least one of the following qualifications:
(1)
An associate degree or completion of sixty (60) semester (or equivalent) hours
from a
clinical
laboratory technician program (MLT or equivalent) accredited by an agency
recognized
by the
United States department Department of education Education
that included a structured
curriculum
in clinical laboratory techniques;
(2)
A high school diploma (or equivalent) and (i) completion of twelve (12) months
in a
technician
training program in an accredited school such as CLA (ASCP) clinical laboratory
assistant
(American Society of Clinical Pathologists), and MLT-C medical laboratory
technician-
certificate
programs approved by the board; or (ii) successful completion of an official
military
medical
laboratory procedure course of at least fifty (50) weeks duration and has held
the military
enlisted
occupational specialty of medical laboratory specialist (laboratory technician);
or
(3)
A clinical laboratory technician who previously qualified under federal
regulatory
requirements
such as 493.1441 42 CFR § 493.1441 of the March 14, 1990 federal
register which
meet or
exceed the requirements for licensure set forth by the board.
(c)
Clinical histologic technician. The department of health shall issue a clinical
histologic
technician license to an individual who meets the qualifications promulgated by
the
board,
including at least one of the following:
(1)
Associate degree or at least sixty (60) semester hours (or equivalent) from an
accredited
college/university to include a combination of mathematics and at least twelve
(12)
semester
hours of biology and chemistry, and successfully complete an accredited program
in
histologic
technique or one full year of training in histologic technique under the
supervision of a
certified
histotechnologist or an appropriately certified histopathology supervisor with
at least
three
(3) years experience.
(2)
High school graduation (or equivalent) and two (2) years full time acceptable
experience
under the supervision of a certified/licensed clinical histologic technician at
a licensed
clinical
laboratory in histologic technique.
(d)
Cytotechnologist. The department of health shall issue a cytotechnologist
license to
an
individual who meets the qualifications promulgated by the board including at
least one of the
following:
(1)
A baccalaureate degree from an accredited college or university with twenty
(20)
semester
hours (30 quarter hours) of biological science, eight (8) semester hours (12
quarter
hours)
of chemistry, and three (3) semester hours (4 quarter hours) of mathematics and
successful
completion
of a twelve (12) month cytotechnology program.
(2)
A baccalaureate degree from an accredited college or university with twenty
(20)
semester
hours (30 quarter hours) of biological science, eight (8) semester hours (12
quarter
hours)
of chemistry, and three (3) semester hours (4 quarter hours) of mathematics and
five (5)
years
full time acceptable clinical laboratory experience including cytopreparatory
techniques,
microscopic
analysis, and evaluation of the body systems within the last ten (10) years. At
least
two (2)
of these years must be subsequent to the completion of the academic component
and at
least
two (2) years must be under the supervision of a licensed physician who is a
pathologist,
certified,
or eligible for certification, by the American Board of Pathology in anatomic
pathology
or has
other suitable qualifications acceptable to the board.
(3)
A cytotechnologist who previously qualified under federal regulatory
requirements
such as 493.1437
42 CFR § 493.1437 of the March 14, 1990 federal register.
(e)
The board shall recommend standards for any other clinical laboratory science
practitioners
specializing in areas such as nuclear medical technology, radioimmunoassay,
electron
microscopy, forensic science, molecular biology, or similar recognized academic
and
scientific
disciplines with approval of the director of health.
SECTION
48. Sections 23-17-10.5, 23-17-12.1, 23-17-51 and 23-17-59 of the General
Laws in
Chapter 23-17 entitled "Licensing of Health Care Facilities" are hereby
amended to read
as
follows:
23-17-10.5.
Medical director and attending physician file. -- (a) Each
nursing facility
licensed
under this chapter shall designate a physician to serve as medical director.
The medical
director
shall be responsible for implementation of resident care policies and for the
coordination
of
medical care in the facility. Such responsibilities shall include, but not be
limited to: the
implementation
of facility policies and procedures related to the medical care delivered in
the
facility;
physician and advanced practice practitioner credentialing; practitioner
performance
reviews;
employee health including infection control measures; evaluation of health care
delivery,
including
oversight of medical records and participation in quality improvement;
provision of
staff
education on medical issues; participation in state survey process, including
the resolution of
deficiencies
as needed; and such other duties and responsibilities as may be stipulated in
regulations
promulgated by the department of health.
(b)
The medical director, charged with the aforementioned duties and
responsibilities for
the
delivery of medical care in the nursing facility, shall be immune from civil or
criminal
prosecution
for reporting to the board of medical licensure and discipline the
unprofessional
conduct,
incompetence or negligence of a nursing facility physician or limited
registrant;
provided,
that the report, testimony or other communication was made in good faith and
while
acting
within the scope of authority conferred by this section. Each nursing facility
shall maintain
an
active file of all current attending physicians including their phone number
and address, an
emergency
phone number, their current medical license number, and their preferred
hospital
admitting
privileges. The director of the department of health is hereby authorized to
promulgate
rules
and regulations to implement the provisions of this section.
23-17-12.1.
Scope of inspections. -- (a) Inspections and investigations shall
include
health,
sanitation, nursing care, and dietary and other conditions immediately
affecting the
patients.
(b)
The department shall assign responsibility for verifying compliance with
licensing
requirements
and issuing renewal licenses to an individual or office independent of the
inspection
process.
(c)
The department shall establish written procedures to: (i) (1)
track all deficiencies
identified
during and after the inspection and investigation processes; and (ii) (2)
clearly define
the
internal process for appealing deficiency citations.
(d)
The department shall establish procedures to verify the implementation of plans
of
correction
and remediation.
23-17-51.
Magnetic resonance imaging - Quality assurance standards. -- (a) Except
as
otherwise provided in subsection (b) of this section, a magnetic resonance
imaging
examination
eligible for reimbursement under the provisions of any individual or group
health
insurance
contract, plan or policy delivered in this state shall be reimbursed only if
the facility at
which
the examination has been conducted and processed is accredited by either the
American
College
of Radiology (ACR), the Intersoceital Intersocietal Accreditation
Commission (IAC), or
an
alternate nationally recognized accrediting organization whose accreditation
standards are
substantially
similar to and no less stringent than current or subsequent ACR or IAC
standards
and have
been reviewed and deemed adequate by the department of health. All
accreditation
standards
under this section, whether promulgated by the ACR, IAC, or an alternate
nationally
recognized
accrediting organization, shall include, but shall not be limited to,
provisions for
establishing
the qualifications of the physician, standards for quality control and routine
performance
monitoring by a medical physicist, qualifications of the technologist including
minimum
standards of supervised clinical experience, personnel and patient safety
guidelines,
and
standards for initial and ongoing quality control using clinical image review
and quantitative
testing.
(b)
Any facility conducting and processing magnetic resonance imaging examinations
which,
as of June 30, 2006, is receiving reimbursement for such services by a health
insurer,
health
maintenance organization or health plan, but is not accredited pursuant to
subsection (a),
shall
file its application for accreditation within eighteen (18) months of the
effective date of this
section
[July 14, 2006]. Such
accreditation shall be obtained not later than twelve (12) months
after
submission of its application. A facility which begins conducting and
processing of
magnetic
resonance imaging examinations after June 30, 2006 shall file its application
for
accreditation
within twelve (12) months of the date of initiation of the magnetic resonance
imaging
examinations. Such accreditation shall be obtained not later than twelve (12)
months
after
submission of its application. After such accreditation is obtained, a facility
conducting and
processing
magnetic resonance imaging examinations shall, at all times, maintain
accreditation
with the
appropriate accrediting body. Notwithstanding anything herein to the contrary,
any
facility
which has filed for accreditation pursuant to this subsection (b) and which has
not been
refused
accreditation or withdrawn its application, will be deemed provisionally
accredited for the
twelve
(12) month period dating from the application filing date. Provided, further,
that
notwithstanding
any provision of the general laws or public laws to the contrary, any facility
conducting
and processing magnetic resonance imaging examinations shall conform to the
standards
of the appropriate accrediting body at all times, including during the
accreditation
process
and shall certify said conformance to any reimbursing health insurer, health
maintenance
organization
or health plan.
23-17-59.
Safe patient handling. -- (1) (a) Definitions. As used in
this chapter:
(a)
(1) “Safe patient handling” means the use of engineering controls,
transfer aids, or
assistive
devices whenever feasible and appropriate instead of manual lifting to perform
the acts
of
lifting, transferring, and/or repositioning health care patients and residents.
(b)
(2) “Safe patient handling policy” means protocols established to
implement safe
patient
handling.
(c)
(3) “Health care facility” means a hospital or a nursing facility.
(d)
(4) “Lift team” means health care facility employees specially trained
to perform
patient
lifts, transfers, and repositioning in accordance with safe patient handling
policy.
(e)
(5) “Musculoskeletal disorders” means conditions that involve the
nerves, tendons,
muscles,
and supporting structures of the body.
(2)
(b) Licensure requirements. Each licensed health care facility shall
comply with the
following
as a condition of licensure:
(a)
(1) Each licensed health care facility shall establish a safe patient handling
committee,
which
shall be chaired by a professional nurse or other appropriate licensed health
care
professional.
A health care facility may utilize any appropriately configured committee to
perform
the responsibilities of this section. At least half of the members of the
committee shall be
hourly,
non-managerial employees who provide direct patient care.
(b)
(2) By July 1, 2007, each licensed health care facility shall develop a
written safe
patient
handling program, with input from the safe patient handling committee, to
prevent
musculoskeletal
disorders among health care workers and injuries to patients. As part of this
program,
each licensed health care facility shall:
(i)
By July 1, 2008, implement a safe patient handling policy for all shifts and
units of the
facility
that will achieve the maximum reasonable reduction of manual lifting,
transferring, and
repositioning
of all or most of a patient's weight, except in emergency, life-threatening, or
otherwise
exceptional circumstances;
(ii)
Conduct a patient handling hazard assessment. This assessment should consider
such
variables
as patient-handling tasks, types of nursing units, patient populations, and the
physical
environment
of patient care areas;
(iii)
Develop a process to identify the appropriate use of the safe patient handling
policy
based on
the patient's physical and mental condition, the patient's choice, and the
availability of
lifting
equipment or lift teams. The policy shall include a means to address
circumstances under
which it
would be medically contraindicated to use lifting or transfer aids or assistive
devices for
particular
patients;
(iv)
Designate and train a registered nurse or other appropriate licensed health
care
professional
to serve as an expert resource, and train all clinical staff on safe patient
handling
policies,
equipment, and devices before implementation, and at least annually or as
changes are
made to
the safe patient handling policies, equipment and/or devices being used;
(v)
Conduct an annual performance evaluation of the safe patient handling with the
results
of the evaluation reported to the safe patient handling committee or other
appropriately
designated
committee. The evaluation shall determine the extent to which implementation of
the
program
has resulted in a reduction in musculoskeletal disorder claims and days of lost
work
attributable
to musculoskeletal disorder caused by patient handling, and include
recommendations
to increase
the program's effectiveness; and
(vi)
Submit an annual report to the safe patient handling committee of the facility,
which
shall be
made available to the public upon request, on activities related to the
identification,
assessment,
development, and evaluation of strategies to control risk of injury to
patients, nurses
and
other health care workers associated with the lifting, transferring,
repositioning, or movement
of a
patient.
(c)
(3) Nothing in this section precludes lift team members from performing
other duties
as
assigned during their shift.
(d)
(4) An employee may, in accordance with established facility protocols,
report to the
committee,
as soon as possible, after being required to perform a patient handling
activity that
he/she
believes in good faith exposed the patient and/or employee to an unacceptable
risk of
injury.
Such employee reporting shall not be cause for discipline or be subject to
other adverse
consequences
by his/her employer. These reportable incidents shall be included in the
facility's
annual
performance evaluation.
SECTION
49. Section 23-17.7.1-17 of the General Laws in Chapter 23-17.7.1 entitled
"Licensing
of Nursing Service Agencies" is hereby amended to read as follows:
23-17.7.1-17.
Criminal records review. -- (a) Any person seeking employment in a
facility
which is or is required to be licensed or registered with the department of
health if that
employment
involves routine contact with a patient or resident without the presence of
other
employees,
shall undergo a criminal background check, which shall be initiated prior to,
or within
one week
of, employment. All employees hired prior to the enactment of this section
shall be
exempted
from the requirements of this section.
(b)
The director of the department of health may, by rule, identify those positions
requiring
criminal background checks. The employee, through the employer, shall apply to
the
bureau of
criminal identification of the state police or local police department for a
statewide
criminal
records check. Fingerprinting shall not be required. Upon the discovery of any
disqualifying
information as defined in § 23-17.7.1-19 23-17.7.1-20 and in accordance
with the
rule
promulgated by the director of the department of health, the bureau of criminal
identification
of the
state police or the local police department will inform the applicant, in
writing, of the
nature
of the disqualifying information; and, without disclosing the nature of the
disqualifying
information,
will notify the employer, in writing, that disqualifying information has been
discovered.
(c)
An employee against whom disqualifying information under § 23-17.7.1-19(b)
23-
17.7.1-20(b) has been found may request that a copy of the
criminal background report be sent to
the
employer who shall make a judgment regarding the continued employment of the
employee.
(d)
In those situations in which no disqualifying information has been found, the
bureau
of
criminal identification of the state police or the local police shall inform
the applicant and the
employer,
in writing, of this fact.
(e)
The employer shall maintain on file, subject to inspection by the department of
health,
evidence that criminal records checks have been initiated on all employees.
Failure to
maintain
that evidence would be grounds to revoke the license or registration of the
employer.
(f)
It shall be the responsibility of the bureau of criminal identification of the
state police
or the
local police department to conduct the criminal records check to the applicant
for
employment
without charge to either the employee or the employer.
SECTION
50. Sections 23-17.12-5 and 23-17.12-9 of the General Laws in Chapter 23-
17.12
entitled "Health Care Services – Utilization Review Act" are hereby
amended to read as
follows:
23-17.12-5.
General application requirements. -- An application for certification
or
recertification
shall be accompanied by documentation to evidence the following:
(a)
(1) The requirement that the review agent provide patients and providers
with a
summary
of its utilization review plan including a summary of the standards, procedures
and
methods to
be used in evaluating proposed or delivered health care services;
(b)
(2) The circumstances, if any, under which utilization review may be
delegated to any
other
utilization review program and evidence that the delegated agency is a
certified utilization
review
agency delegated to perform utilization review pursuant to all of the
requirements of this
chapter;
(c)
(3) A complaint resolution process consistent with subsection
23-17.12-2(6) and
acceptable
to the department, whereby patients, their physicians, or other health care
providers
may seek
resolution of complaints and other matters of which the review agent has
received
written
notice;
(d)
(4) The type and qualifications of personnel (employed or under
contract) authorized
to
perform utilization review, including a requirement that only a practitioner
with the same
license
status as the ordering practitioner, or a licensed physician or dentist, is
permitted to make
a
prospective or concurrent adverse determination;
(e)
(5) The requirement that a representative of the review agent is
reasonably accessible
to
patients, patient's family and providers at least five (5) days a week during
normal business in
Rhode
Island and during the hours of the agency's review operations;
(f)
(6) The policies and procedures to ensure that all applicable state and
federal laws to
protect
the confidentiality of individual medical records are followed;
(g)
(7) The policies and procedures regarding the notification and conduct of
patient
interviews
by the review agent;
(h)
(8) The requirement that no employee of, or other individual rendering
an adverse
determination
for, a review agent may receive any financial incentives based upon the number
of
denials
of certification made by that employee or individual;
(i)
(9) The requirement that the utilization review agent shall not impede
the provision of
health
care services for treatment and/or hospitalization or other use of a provider's
services or
facilities
for any patient;
(j)
(10) Evidence that the review agent has not entered into a compensation
agreement or
contract
with its employees or agents whereby the compensation of its employees or its
agents is
based upon
a reduction of services or the charges for those services, the reduction of
length of
stay, or
utilization of alternative treatment settings; provided, nothing in this
chapter shall prohibit
agreements
and similar arrangements; and
(k)
(11) An adverse determination and internal appeals process consistent
with § 23-
17.12-9
and acceptable to the department, whereby patients, their physicians, or other
health care
providers
may seek prompt reconsideration or appeal of adverse determinations by the
review
agent.
23-17.12-9.
Review agency requirement for adverse determination and internal
appeals.
-- (a) The adverse determination and appeals process of
the review agent shall conform
to the
following:
(1)
Notification of a prospective adverse determination by the review agent shall
be
mailed
or otherwise communicated to the provider of record and to the patient or other
appropriate
individual as follows:
(i)
Within fifteen (15) business days of receipt of all the information necessary
to
complete
a review of non-urgent and/or non-emergent services;
(ii)
Within seventy-two (72) hours of receipt of all the information necessary to
complete
a review
of urgent and/or emergent services; and
(iii)
Prior to the expected date of service.
(2)
Notification of a concurrent adverse determination shall be mailed or otherwise
communicated
to the patient and to the provider of record period as follows:
(i)
To the provider(s) prior to the end of the current certified period; and
(ii)
To the patient within one business day of making the adverse determination.
(3)
Notification of a retrospective adverse determination shall be mailed or
otherwise
communicated
to the patient and to the provider of record within thirty (30) business days
of
receipt
of a request for payment with all supporting documentation for the covered
benefit being
reviewed.
(4)
A utilization review agency shall not retrospectively deny authorization for
health
care
services provided to a covered person when an authorization has been obtained
for that
service
from the review agent unless the approval was based upon inaccurate information
material
to the review or the health care services were not provided consistent with the
provider's
submitted
plan of care and/or any restrictions included in the prior approval granted by
the review
agent.
(5)
Any notice of an adverse determination shall include:
(i)
The principal reasons for the adverse determination, to include explicit
documentation
of the
criteria not met and/or the clinical rationale utilized by the agency's
clinical reviewer in
making
the adverse determination. The criteria shall be in accordance with the agency
criteria
noted in
subsection 23-17.12-9(d) and shall be made available within the first level
appeal
timeframe
if requested unless otherwise provided as part of the adverse determination
notification
process;
(ii)
The procedures to initiate an appeal of the adverse determination, including
the name
and
telephone number of the person to contract with regard to an appeal;
(iii)
The necessary contact information to complete the two-way direct communication
defined
in subdivision 23-17.12-9(a)(7); and
(iv)
The information noted in subdivision 23-27.12-9(a)(5)(i)(ii)(iii) for all
verbal
notifications
followed by written notification to the patient and provider(s).
(6)
All initial retrospective adverse determinations of a health care service that
had been
ordered
by a physician, dentist or other practitioner shall be made, documented and
signed
consistent
with the regulatory requirements which shall be developed by the department
with the
input of
review agents, providers and other affected parties.
(7)
A level one appeal decision of an adverse determination shall not be made until
an
appropriately
qualified and licensed review physician, dentist or other practitioner has
spoken to,
or
otherwise provided for, an equivalent two-way direct communication with the
patient's
attending
physician, dentist, other practitioner, other designated or qualified
professional or
provider
responsible for treatment of the patient concerning the medical care, with the
exception
of the
following:
(i)
When the attending provider is not reasonably available;
(ii)
When the attending provider chooses not to speak with agency staff;
(iii)
When the attending provider has negotiated an agreement with the review agent
for
alternative
care; and/or
(iv)
When the attending provider requests a peer to peer communication prior to the
adverse
determination, the review agency shall then comply with subdivision
23-17.12-9(c)(1) in
responding
to such a request. Such requests shall be on the case specific basis unless
otherwise
arranged
for in advance by the provider.
(8)
All initial, prospective and concurrent adverse determinations of a health care
service
that had
been ordered by a physician, dentist or other practitioner shall be made,
documented and
signed
by a licensed practitioner with the same licensure status as the ordering
practitioner or a
licensed
physician or dentist. This does not prohibit appropriately qualified review
agency staff
from
engaging in discussions with the attending provider, the attending provider's
designee or
appropriate
health care facility and office personnel regarding alternative service and
treatment
options.
Such a discussion shall not constitute an adverse determination provided though
that any
change
to the provider's original order and/or any decision for an alternative level
of care must be
made
and/or appropriately consented to by the attending provider or the provider's
designee
responsible
for treating the patient.
(9)
The requirement that, upon written request made by or on behalf of a patient,
any
adverse
determination and/or appeal shall include the written evaluation and findings
of the
reviewing
physician, dentist or other practitioner. The review agent is required to
accept a verbal
request made
by or on behalf of a patient for any information where a provider or patient
can
demonstrate
that a timely response is urgent.
(b)
The review agent shall conform to the following for the appeal of an adverse
determination:
(1)
The review agent shall maintain and make available a written description of the
appeal
procedure by which either the patient or the provider of record may seek review
of
determinations
not to authorize a health care service. The process established by each review
agent
may include a reasonable period within which an appeal must be filed to be
considered and
that
period shall not be less than sixty (60) days.
(2)
The review agent shall notify, in writing, the patient and provider of record
of its
decision
on the appeal as soon as practical, but in no case later than fifteen (15) or
twenty-one
(21)
business days if verbal notice is given within fifteen (15) business days after
receiving the
required
documentation on the appeal.
(3)
The review agent shall also provide for an expedited appeals process for
emergency
or life
threatening situations. Each review agent shall complete the adjudication of
expedited
appeals
within two (2) business days of the date the appeal is filed and all
information necessary
to
complete the appeal is received by the review agent.
(4)
All first level appeals of determinations not to authorize a health care
service that had
been
ordered by a physician, dentist, or other practitioner shall be made,
documented, and signed
by a
licensed practitioner with the same licensure status as the ordering
practitioner or a licensed
physician
or a licensed dentist.
(5)
All second level appeal decisions shall be made, signed, and documented by a
licensed
practitioner in the same or a similar general specialty as typically manages
the medical
condition,
procedure, or treatment under discussion.
(6)
The review agent shall maintain records of written appeals and their
resolution, and
shall
provide reports as requested by the department.
(c)
The review agency must conform to the following requirements when making its
adverse
determination and appeal decisions:
(1)
The review agent must assure that the licensed practitioner or licensed
physician is
reasonably
available to review the case as required under subdivision 23-17.12-9(a)(7) and
shall
conform
to the following:
(i)
Each agency peer reviewer shall have access to and review all necessary
information
as
requested by the agency and/or submitted by the provider(s) and/or patients;
(ii)
Each agency shall provide accurate peer review contact information to the
provider at
the time
of service, if requested, and/or prior to such service, if requested. This
contact
information
must provide a mechanism for direct communication with the agency's peer
reviewer;
(iii)
Agency peer reviewers shall respond to the provider's request for a two-way
direct
communication
defined in subdivision 23-17.12-9(a)(7)(iv) as follows:
(a)
(A) For a prospective review of non-urgent and non-emergent health care
services, a
response
within one (1) business day of the request for a peer discussion;
(b)
(B) For concurrent and prospective reviews of urgent and emergent health
care
services,
a response within a reasonable period of time of the request for a peer
discussion; and
(c)
(C) For retrospective reviews, prior to the first level appeal decision.
(iv)
The review agency will have met the requirements of a two-way direct
communication,
when requested and/or as required prior to the first level of appeal, when it
has
made two
(2) reasonable attempts to contact the attending provider directly.
(v)
Repeated violations of this section shall be deemed to be substantial violations
pursuant
to § 23-17.12-14 and shall be cause for the imposition of penalties under that
section.
(2)
No reviewer at any level under this section shall be compensated or paid a
bonus or
incentive
based on making or upholding an adverse determination.
(3)
No reviewer under this section who has been involved in prior reviews of the
case
under
appeal or who has participated in the direct care of the patient may
participate as the sole
reviewer
in reviewing a case under appeal; provided, however, that when new information
has
been
made available at the first level of appeal, then the review may be conducted
by the same
reviewer
who made the initial adverse determination.
(4)
A review agent is only entitled to review information or data relevant to the
utilization
review
process. A review agent may not disclose or publish individual medical records
or any
confidential
medical information obtained in the performance of utilization review
activities. A
review
agent shall be considered a third party health insurer for the purposes of §
5-37.3-6(b)(6)
of this
state and shall be required to maintain the security procedures mandated in §
5-37.3-4(c).
(5)
Notwithstanding any other provision of law, the review agent, the department,
and all
other
parties privy to information which is the subject of this chapter shall comply
with all state
and
federal confidentiality laws, including, but not limited to, chapter 37.3 of
title 5
(Confidentiality
of Health Care Communications and Information Act) and specifically § 5-37.3-
4(c),
which requires limitation on the distribution of information which is the
subject of this
chapter
on a “need to know” basis, and § 40.1-5-26.
(6)
The department may, in response to a complaint that is provided in written form
to the
review
agent, review an appeal regarding any adverse determination, and may request
information
of the review agent, provider or patient regarding the status, outcome or
rationale
regarding
the decision.
(d)
The requirement that each review agent shall utilize and provide upon request,
by
Rhode
Island licensed hospitals and the Rhode Island Medical Society, in either
electronic or
paper
format, written medically acceptable screening criteria and review procedures
which are
established
and periodically evaluated and updated with appropriate consultation with Rhode
Island
licensed physicians, hospitals, including practicing physicians, and other
health care
providers
in the same specialty as would typically treat the services subject to the
criteria as
follows:
(1)
Utilization review agents shall consult with no fewer than five (5) Rhode
Island
licensed
physicians or other health care providers. Further, in instances where the
screening
criteria
and review procedures are applicable to inpatients and/or outpatients of
hospitals, the
medical
director of each licensed hospital in Rhode Island shall also be consulted.
Utilization
review
agents who utilize screening criteria and review procedures provided by another
entity
may
satisfy the requirements of this section if the utilization review agent
demonstrates to the
satisfaction
of the director that the entity furnishing the screening criteria and review
procedures
has
complied with the requirements of this section.
(2)
Utilization review agents seeking initial certification shall conduct the
consultation
for all
screening and review criteria to be utilized. Utilization review agents who
have been
certified
for one year or longer shall be required to conduct the consultation on a
periodic basis
for the
utilization review agent's highest volume services subject to utilization
review during the
prior
year; services subject to the highest volume of adverse determinations during
the prior year;
and for
any additional services identified by the director.
(3)
Utilization review agents shall not include in the consultations as required
under
paragraph
(1) of this subdivision, any physicians or other health services providers who
have
financial
relationships with the utilization review agent other than financial
relationships for
provisions
of direct patient care to utilization review agent enrollees and reasonable
compensation
for
consultation as required by paragraph (1) of this subdivision.
(4)
All documentation regarding required consultations, including comments and/or
recommendations
provided by the health care providers involved in the review of the screening
criteria,
as well as the utilization review agent's action plan or comments on any
recommendations,
shall be in writing and shall be furnished to the department on request. The
documentation
shall also be provided on request to any licensed health care provider at a
nominal
cost
that is sufficient to cover the utilization review agent's reasonable costs of
copying and
mailing.
(5)
Utilization review agents may utilize non-Rhode Island licensed physicians or
other
health
care providers to provide the consultation as required under paragraph (1) of
this
subdivision,
when the utilization review agent can demonstrate to the satisfaction of the
director
that the
related services are not currently provided in Rhode Island or that another
substantial
reason
requires such approach.
(6)
Utilization review agents whose annualized data reported to the department
demonstrate
that the utilization review agent will review fewer than five hundred (500)
such
requests
for authorization may request a variance from the requirements of this section.
SECTION
51. Section 23-17.13-3 of the General Laws in Chapter 23-17.13 entitled
"Health
Care Accessibility and Quality Assurance Act" is hereby amended to read as
follows:
23-17.13-3.
Certification of health plans. -- (a) Certification process.
(1)
Certification.
(i)
The director shall establish a process for certification of health plans
meeting the
requirements
of certification in subsection (b).
(ii)
The director shall act upon the health plan's completed application for
certification
within
ninety (90) days of receipt of such application for certification.
(2)
Review and recertification. To ensure compliance with subsection (b), the
director
shall
establish procedures for the periodic review and recertification of qualified
health plans not
less
than every five (5) years; provided, however, that the director may review the
certification of
a
qualified health plan at any time if there exists evidence that a qualified health
plan may be in
violation
of subsection (b).
(3)
Cost of certification. The total cost of obtaining and maintaining
certification under
this
title and compliance with the requirements of the applicable rules and
regulations are borne
by the entities
so certified and shall be one hundred and fifty percent (150%) of the total
salaries
paid to
the certifying personnel of the department engaged in those certifications less
any salary
reimbursements
and shall be paid to the director to and for the use of the department. That
assessment
shall be in addition to any taxes and fees otherwise payable to the state.
(4)
Standard definitions. To help ensure a patient's ability to make informed
decisions
regarding
their health care, the director shall promulgate regulation(s) to provide for
standardized
definitions
(unless defined in existing statute) of the following terms in this
subdivision,
provided,
however, that no definition shall be construed to require a health care entity
to add any
benefit,
to increase the scope of any benefit, or to increase any benefit under any
contract:
(i)
Allowable charge;
(ii)
Capitation;
(iii)
Co-payments;
(iv)
Co-insurance;
(v)
Credentialing;
(vi)
Formulary;
(vii)
Grace period;
(viii)
Indemnity insurance;
(ix)
In-patient care;
(x)
Maximum lifetime cap;
(xi)
Medical necessity;
(xii)
Out-of-network;
(xiii)
Out-patient;
(xiv)
Pre-existing conditions;
(xv)
Point of service;
(xvi)
Risk sharing;
(xvii)
Second opinion;
(xviii)
Provider network;
(xix)
Urgent care.
(b)
Requirements for certification. The director shall establish standards and
procedures
for the certification
of qualified health plans that conduct business in this state and who have
demonstrated
the ability to ensure that health care services will be provided in a manner to
assure
availability
and accessibility, adequate personnel and facilities, and continuity of
service, and has
demonstrated
arrangements for ongoing quality assurance programs regarding care processes
and
outcomes;
other standards shall consist of, but are not limited to, the following:
(1)
Prospective and current enrollees in health plans must be provided information
as to
the
terms and conditions of the plan consistent with the rules and regulations
promulgated under
chapter
12.3 of title 42 so that they can make informed decisions about accepting and
utilizing the
health
care services of the health plan. This must be standardized so that customers
can compare
the
attributes of the plans, and all information required by this paragraph shall
be updated at
intervals
determined by the director. Of those items required under this section, the
director shall
also
determine which items shall be routinely distributed to prospective and current
enrollees as
listed
in this subsection and which items may be made available upon request. The
items to be
disclosed
are:
(i)
Coverage provisions, benefits, and any restriction or limitations on health
care
services,
including but not limited to, any exclusions as follows: by category of
service, and if
applicable,
by specific service, by technology, procedure, medication, provider or
treatment
modality,
diagnosis and condition, the latter three (3) of which shall be listed by name.
(ii)
Experimental treatment modalities that are subject to change with the advent of
new
technology,
may be listed solely by the broad category “Experimental Treatments”. The
information
provided to consumers shall include the plan's telephone number and address
where
enrollees
may call or write for more information or to register a complaint regarding the
plan or
coverage
provision.
(2)
Written statement of the enrollee's right to seek a second opinion, and
reimbursement
if
applicable.
(3)
Written disclosure regarding the appeals process described in § 23-17.12-1 et
seq. and
in the rules
and regulations for the utilization review of care services, promulgated by the
department
of health, the telephone numbers and addresses for the plan's office which
handles
complaints
as well as for the office which handles the appeals process under § 23-17.12-1
et seq.
and the
rules and regulations for the utilization of health.
(4)
Written statement of prospective and current enrollees' right to
confidentiality of all
health
care record and information in the possession and/or control of the plan, its
employees, its
agents
and parties with whom a contractual agreement exists to provide utilization
review or who
in any
way have access to care information. A summary statement of the measures taken
by the
plan to
ensure confidentiality of an individual's health care records shall be
disclosed.
(5)
Written disclosure of the enrollee's right to be free from discrimination by
the health
plan and
the right to refuse treatment without jeopardizing future treatment.
(6)
Written disclosure of a plan's policy to direct enrollees to particular
providers. Any
limitations
on reimbursement should the enrollee refuse the referral must be disclosed.
(7)
A summary of prior authorization or other review requirements including
preauthorization
review, concurrent review, post-service review, post-payment review and any
procedure
that may lead the patient to be denied coverage for or not be provided a
particular
service.
(8)
Any health plan that operates a provider incentive plan shall not enter into
any
compensation
agreement with any provider of covered services or pharmaceutical manufacturer
pursuant
to which specific payment is made directly or indirectly to the provider as an
inducement
or incentive to reduce or limit services, to reduce the length of stay or the
use of
alternative
treatment settings or the use of a particular medication with respect to an
individual
patient,
provided however, that capitation agreements and similar risk sharing
arrangements are
not
prohibited.
(9)
Health plans must disclose to prospective and current enrollees the existence
of
financial
arrangements for capitated or other risk sharing arrangements that exist with
providers
in a
manner described in paragraphs (i), (ii), and (iii):
(i)
“This health plan utilizes capitated arrangements, with its participating
providers, or
contains
other similar risk sharing arrangements;
(ii)
This health plan may include a capitated reimbursement arrangement or other
similar
risk sharing
arrangement, and other financial arrangements with your provider;
(iii)
This health plan is not capitated and does not contain other risk sharing
arrangements.”
(10)
Written disclosure of criteria for accessing emergency health care services as
well as
a
statement of the plan's policies regarding payment for examinations to
determine if emergency
health
care services are necessary, the emergency care itself, and the necessary
services following
emergency
treatment or stabilization. The health plan must respond to the request of the
treating
provider
for post-stabilization treatment by approving or denying it as soon as
possible.
(11)
Explanation of how health plan limitations impact enrollees, including
information
on
enrollee financial responsibility for payment for co-insurance, co-payment, or
other non-
covered,
out-of-pocket, or out-of-plan services. This shall include information on
deductibles and
benefits
limitations including, but not limited to, annual limits and maximum lifetime
benefits.
(12)
The terms under which the health plan may be renewed by the plan enrollee,
including
any reservation by the plan of any right to increase premiums.
(13)
Summary of criteria used to authorize treatment.
(14)
A schedule of revenues and expenses, including direct service ratios and other
statistical
information which meets the requirements set forth below on a form prescribed
by the
director.
(15)
Plan costs of health care services, including but not limited to all of the
following:
(i)
Physician services;
(ii)
Hospital services, including both inpatients and outpatient services;
(iii)
Other professional services;
(iv)
Pharmacy services, excluding pharmaceutical products dispensed in a physician's
office;
(v)
Health education;
(vi)
Substance abuse services and mental health services.
(16)
Plan complaint, adverse decision, and prior authorization statistics. This
statistical
data
shall be updated annually:
(i)
The ratio of the number of complaints received to the total number of covered
persons,
reported
by category, listed in paragraphs (b)(15)(i) — (vi);
(ii)
The ratio of the number of adverse decisions issued to the number of complaints
received,
reported by category;
(iii)
The ratio of the number of prior authorizations denied to the number of prior
authorizations
requested, reported by category;
(iv)
The ratio of the number of successful enrollee appeals to the total number of
appeals
filed.
(17)
Plans must demonstrate that:
(i)
They have reasonable access to providers, so that all covered health care
services will
be
provided. This requirement cannot be waived and must be met in all areas where
the health
plan has
enrollees;
(ii)
Urgent health care services, if covered, shall be available within a time frame
that
meets
standards set by the director.
(18)
A comprehensive list of participating providers listed by office location,
specialty if
applicable,
and other information as determined by the director, updated annually.
(19)
Plans must provide to the director, at intervals determined by the director,
enrollee
satisfaction
measures. The director is authorized to specify reasonable requirements for
these
measures
consistent with industry standards to assure an acceptable degree of
statistical validity
and
comparability of satisfaction measures over time and among plans. The director
shall publish
periodic
reports for the public providing information on health plan enrollee
satisfaction.
(c)
Issuance of certification.
(1)
Upon receipt of an application for certification, the director shall notify and
afford the
public
an opportunity to comment upon the application.
(2)
A health care plan will meet the requirements of certification, subsection (b)
by
providing
information required in subsection (b) to any state or federal agency in
conformance
with any
other applicable state or federal law, or in conformity with standards adopted
by an
accrediting
organization provided that the director determines that the information is
substantially
similar
to the previously mentioned requirements and is presented in a format that
provides a
meaningful
comparison between health plans.
(3)
All health plans shall be required to establish a mechanism, under which
providers,
including
local providers participating in the plan, provide input into the plan's health
care policy,
including
technology, medications and procedures, utilization review criteria and
procedures,
quality
and credentialing criteria, and medical management procedures.
(4)
All health plans shall be required to establish a mechanism under which local
individual
subscribers to the plan provide input into the plan's procedures and processes
regarding
the
delivery of health care services.
(5)
A health plan shall not refuse to contract with or compensate for covered
services an
otherwise
eligible provider or non-participating provider solely because that provider has
in good
faith
communicated with one or more of his or her patients regarding the provisions,
terms or
requirements
of the insurer's products as they relate to the needs of that provider's
patients.
(6)
(i) All health plans shall be required to publicly notify providers within the
health
plans'
geographic service area of the opportunity to apply for credentials. This
notification
process
shall be required only when the plan contemplates adding additional providers
and may
be
specific as to geographic area and provider specialty. Any provider not
selected by the health
plan may
be placed on a waiting list.
(ii)
This credentialing process shall begin upon acceptance of an application from a
provider
to the plan for inclusion.
(iii)
Each application shall be reviewed by the plan's credentialing body.
(iv)
All health plans shall develop and maintain credentialing criteria to be
utilized in
adding
providers from the plans' network. Credentialing criteria shall be based on
input from
providers
credentialed in the plan and these standards shall be available to applicants.
When
economic
considerations are part of the decisions, the criteria must be available to
applicants.
Any
economic profiling must factor the specialty utilization and practice patterns
and general
information
comparing the applicant to his or her peers in the same speciality specialty
will be
made
available. Any economic profiling of providers must be adjusted to recognize
case mix,
severity
of illness, age of patients and other features of a provider's practice that
may account for
higher
than or lower than expected costs. Profiles must be made available to those so
profiled.
(7)
A health plan shall not exclude a provider of covered services from participation
in its
provider
network based solely on:
(i)
The provider's degree or license as applicable under state law; or
(ii)
The provider of covered services lack of affiliation with, or admitting
privileges at a
hospital,
if that lack of affiliation is due solely to the provider's type of license.
(8)
Health plans shall not discriminate against providers solely because the
provider treats
a
substantial number of patients who require expensive or uncompensated medical
care.
(9)
The applicant shall be provided with all reasons used if the application is
denied.
(10)
Plans shall not be allowed to include clauses in physician or other provider
contracts
that
allow for the plan to terminate the contract “without cause”; provided,
however, cause shall
include
lack of need due to economic considerations.
(11)
(i) There shall be due process for non-institutional providers for all adverse
decisions
resulting
in a change of privileges of a credentialed non-institutional provider. The
details of the
health
plan's due process shall be included in the plan's provider contracts.
(ii)
A health plan is deemed to have met the adequate notice and hearing requirement
of
this
section with respect to a non-institutional provider if the following
conditions are met (or are
waived
voluntarily by the non-institutional provider):
(A)
The provider shall be notified of the proposed actions and the reasons for the
proposed
action.
(B)
The provider shall be given the opportunity to contest the proposed action.
(C)
The health plan has developed an internal appeals process that has reasonable
time
limits
for the resolution of an internal appeal.
(12)
If the plan places a provider or provider group at financial risk for services
not
provided
by the provider or provider group, the plan must require that a provider or
group has met
all
appropriate standards of the department of business regulation.
(13)
A health plan shall not include a most favored rate clause in a provider
contract.
SECTION 52. Section 23-17.14-22 of the
General Laws in Chapter 23-17.14 entitled
"The
Hospital Conversions Act" is hereby amended to read as follows:
23-17.14-22.
Distribution of proceeds from acquisition - Selection and establishment
of
an independent foundation. -- (a) In the event of the approval of a hospital
conversion
involving
a not-for-profit corporation and a for-profit corporation results in a new
entity as
provided
for in § 23-17.14-7(c)(25)(i), it shall be required that the proceeds from the
sale and any
endowments,
restricted, unrestricted and specific purpose funds shall be transferred to a
charitable
foundation
operated by a board of directors.
(b)
The presiding justice of the superior court shall have the authority to:
(1)
Appoint the initial board of directors.
(2)
Approve, modify, or reject proposed bylaws and/or articles of incorporation
provided
by the
transacting parties and/or the initial board of directors.
(c)
The board of directors shall consist of at least seven (7) members and the
executive
director,
who shall serve ex officio. The board members may include one or more members
with
experience
in matters including financial, legal, business, labor, investments, community
purpose,
grant-making,
health care and members who represent diverse populations of the affected
community
and not more than three (3) members of the board may be prior board members of
the
existing
hospital.
(d)
The membership terms shall be staggered and shall be four (4) years in
duration. The
board
shall annually elect a chairperson from among its members and other officers it
deems
necessary
for the performance of its duties and board members shall not receive
compensation.
(e)
Control of the distribution of the proceeds of the fund is vested solely in the
board;
provided,
however, the investment responsibility of the proceeds shall be through the
Rhode
Island
Foundation.
(f)
Vacancies occurring on the board may be filled by a majority vote of the
remaining
board
members.
SECTION
53. Sections 23-17.17-2 and 23-17.17-8 of the General Laws in Chapter 23-
17.17
entitled "Health Care Quality Program" are hereby amended to read as
follows:
23-17.17-2.
Definitions. -- (a) “Clinical outcomes” means information about the
results
of
patient care and treatment.
(b)
“Director” means the director of the department of health or his or her duly
authorized
agent.
(c)
“Health care facility” has the same meaning as contained in the regulations
promulgated
by the director of health pursuant to chapter 17 of this title.
(d)
“Health care provider” means any physician, or other licensed practitioners
with
responsibility
for the care, treatment, and services rendered to a patient.
(e)
“Insurer” means any entity subject to the insurance laws and regulations of
this state,
that
contracts or offers to contract to provide, deliver, arrange for, pay for, or
reimburse any of the
costs
of health care services, including, without limitation, an insurance company
offering
accident
and sickness insurance, a health maintenance organization, as defined by §
27-41-1, a
nonprofit
hospital or medical service corporation, as defined by chapters 27-19 and
27-20, or any
other
entity providing a plan of health insurance or health benefits.
(d)
(f) “Patient satisfaction” means the degree to which the facility or
provider meets or
exceeds
the patients' expectations as perceived by the patient by focusing on those
aspects of care
that the
patient can judge.
(g)
“Performance measure” means a quantitative tool that provides an indication of
an
organization's
performance in relation to a specified process or outcome.
(e)
(h) “Quality of care” means the result or outcome of health care
efforts.
(i)
“Reporting program” means an objective feedback mechanism regarding individual
or
facility performance that can be used internally to support performance
improvement activities
and
externally to demonstrate accountability to the public and other purchasers,
payers, and
stakeholders.
(f)
(j) “Risk-adjusted” means the use of statistically valid techniques to
account for
patient
variables that may include, but need not to be limited to, age, chronic disease
history, and
physiologic
data.
(g)
“Performance measure” means a quantitative tool that provides an indication of
an
organization's
performance in relation to a specified process or outcome.
(h)
“Reporting program” means an objective feedback mechanism regarding individual
or
facility performance that can be used internally to support performance
improvement activities
and
externally to demonstrate accountability to the public and other purchasers,
payers, and
stakeholders.
(i)
“Health care provider” means any physician, or other licensed practitioners
with
responsibility
for the care, treatment, and services rendered to a patient.
(j)
“Insurer” means any entity subject to the insurance laws and regulations of
this state,
that
contracts or offers to contract to provide, deliver, arrange for, pay for, or
reimburse any of the
costs
of health care services, including, without limitation, an insurance company
offering
accident
and sickness insurance, a health maintenance organization, as defined by §
27-41-1, a
nonprofit
hospital or medical service corporation, as defined by chapters 27-19 and
27-20, or any
other
entity providing a plan of health insurance or health benefits.
23-17.17-8.
Annual hospital staffing report. -- (a) Annually in the month of
January,
every
licensed hospital shall submit to the Rhode Island department of health,
its core-staffing
plan.
Such plan shall specify for each patient care unit and each shift, the number
of registered
nurses,
licensed practical nurses and/or certified nursing assistants who shall
ordinarily be
assigned
to provide direct patient care and the average number of patients upon which
such
staffing
levels are based.
(b)
For the purposes of this section:
(1)
“Core-staffing plan” shall mean the projected complement of nonmanagerial
nursing
staff
that shall be assigned on each shift to a specified patient care unit.
(2)
“Nonmanagerial nursing staff” shall mean registered nurses, licensed practical
nurses
and/or
certified nursing assistants who perform nonmanagerial direct patient care
functions for
more
than fifty percent (50%) of their scheduled hours on a given patient care unit.
(3)
“Patient care unit” shall mean a designated area for assigning patients and
staff for
which discrete
budget and staffing plans exist.
SECTION
54. Section 23-17.20-2 of the General Laws in Chapter 23-17.20 entitled
"Health
Care Facilities Staffing" is hereby amended to read as follows:
23-17.20-2.
Definitions. -- As used in this chapter:
(1)
“Employee” means a nurse licensed pursuant to chapter 5-34, and a certified
nurse
assistant
registered pursuant to chapter 23-17.9, provided further, that such term shall
not include
certified
registered nurse anesthetists or resident physicians; and provided further,
that for
purposes
of this chapter, said nurse and/or nursing assistant shall be paid on the basis
of an hourly
wage. As
used in this chapter, the term “employee” shall not include a person who is
paid an
annual
salary, and shall not include employees who are working pre-scheduled “on-call
time” in
the
surgical department of a health care facility.
(2)
“Employer” means a person, partnership, association, corporation or group of
persons
acting
directly or indirectly in the interest of a health care facility;
(3)
“Health care facility” means any private, public or state hospital;
(4)
“On-call time” means time spent by an employee who is not working on the
premises
of
the place of employment but who is compensated for availability or who, as a
condition of
employment,
has agreed to be available to return to the premises of the place of employment
on
short
notice if the need arises;
(5)
“Reasonable efforts” means that the employer shall:
(i)
Seek persons who volunteer to work extra time from all available qualified
staff who
are
working at the time of the unforeseeable emergent circumstance;
(ii)
Contact all qualified employees who have made themselves available to work
extra
time;
and
(iii)
Seek the use of per diem staff;
(4)
(6) “Regular hourly wage” means the amount that an employee is regularly
paid for
each
hour of work as determined by dividing the total hours of work during the week
into the
employee's
total earnings for the week, exclusive of pay for overtime work;
(5)
(7) “Unforeseeable emergent circumstance” means an unpredictable
occurrence
relating
to health care delivery that requires immediate action, and which shall include
a major
power
outage, a public health emergency, an irregular increase in patient census, or
an irregular
increase
in the number of employees not reporting for predetermined scheduled work
shifts.
(6)
“On-call time” means time spent by an employee who is not working on the
premises
of
the place of employment but who is compensated for availability or who, as a
condition of
employment,
has agreed to be available to return to the premises of the place of employment
on
short
notice if the need arises.
(7)
“Reasonable efforts” means that the employer shall: (a) seek persons who
volunteer to
work
extra time from all available qualified staff who are working at the time of
the
unforeseeable
emergent circumstance; (b) contact all qualified employees who have made
themselves
available to work extra time; and (c) seek the use of per diem staff.
SECTION
55. Section 23-18-11.1 of the General Laws in Chapter 23-18 entitled
"Cemeteries"
is hereby amended to read as follows:
23-18-11.1.
Permit required to alter or remove historic cemetery - Powers of city or
town
council - Appeal. -- (a) Before an agency or a property owner may authorize
or commence
alteration
or removal of any historic cemetery, the agency or owner must apply to the city
or town
council
where the historic cemetery is located for a permit to alter or remove. The
city or town
council
shall prescribe by ordinance standards to regulate the alteration or removal of
any historic
cemetery
within its municipal limits, but shall at a minimum provide that:
(1)
The applicant examine all alternatives, and demonstrate that no prudent or
feasible
alternative
to the proposed alteration is possible;
(2)
The city or town provide for notification and participation in the permitting
process of
parties
which may be interested in the proposed alteration or removal by virtue of
their status as a
governmental
health or historic preservation authority, or as a private or nonprofit
historical,
geneological genealogical or civic organization, or, in the
case of American Indian cemeteries
and
burial grounds, the appropriate tribal organization; and
(3)
The city or town provide for due consideration of the rights of descendants in
any
application
to substantially alter or remove a historic cemetery.
(b)
When an application for alteration or removal of a historic cemetery has been
made
and the
boundary is unknown or in doubt, the city or town may require that the
applicant, at its
own
expense, conduct an archaeological investigation to determine the actual size
of the cemetery
prior to
final consideration by the city or town of the application to alter or remove.
(c)
After due consideration, the city or town council may grant the application to
alter or
remove
the historic cemetery in whole or in part, under the supervision of an
archaeologist and
with any
restrictions and stipulations that it deems necessary to effectuate the
purposes of this
section,
or deny the application in its entirety. Any person or persons aggrieved by a
decision of
the city
or town council shall have the right of appeal concerning the decision to the
superior
court
and from the superior court to the supreme court by writ of certiorari.
(d)
Nothing in this section shall be deemed to contravene the authority of
municipal
bodies
under § 45-5-12 to hold, manage, repair, or maintain any neglected burial
ground.
SECTION 56. Sections 23-19-6 and
23-19-35.1 of the General Laws in Chapter 23-19
entitled
"Rhode Island Resource Recovery Corporation" are hereby amended to
read as follows:
23-19-6.
Creation, membership, and terms of the Rhode Island Resource Recovery
Corporation.
-- (a) There is authorized, created, and established a
public corporation of the
state,
having a distinct legal existence from the state and not constituting a
department of the state
government,
with the politic and corporate powers set forth in this chapter, to be known as
the
Rhode
Island resource recovery corporation, (“the corporation”) to carry out the
provisions of this
chapter.
The corporation is constituted a public instrumentality and agency exercising
public and
essential
governmental functions, and the exercise by the corporation of the powers
conferred by
this
chapter shall be deemed and held to be the performance of an essential
governmental
function
of the state.
(b)
It is the intent of the general assembly by the passage of this chapter to
create and
establish
a public corporation and instrumentality and agency of the state for the
purpose of the
activities
authorized by this chapter, and to vest the corporation with all powers,
authority, rights,
privileges,
and titles that may be necessary to enable it to accomplish those purposes.
This
chapter
shall be liberally construed in conformance with the purpose expressed in this
section.
(c)
The powers of the corporation shall be vested in eight (8) commissioners,
consisting
of the
director of administration, or the director's designee, who shall be a
subordinate within the
department
of administration, who shall serve as a nonvoting ex-officio member, and seven (7)
public
members to be appointed by the governor with advice and consent of the senate,
at least
two (2)
of whom shall be a resident of the town of Johnston. In making these
appointments, the
governor
shall give due consideration to recommendations from the mayor of the town of
Johnston
and from the League of Cities and Towns. The governor shall also give due
consideration
to recommendations from representatives of the commercial waste haulers, and
environmental
advocacy organizations, and shall consider persons experienced in the field of
recycling.
Those members of the corporation as of the effective date of this act [May
4, 2006]
who were
appointed to the corporation by members of the general assembly shall cease to
be
members
of the corporation on the effective date of this act [May 4, 2006],
and the governor shall
thereupon
nominate one new member who shall serve the balance of the unexpired term of
his or
her
predecessor. Those members of the corporation as of the effective date of
this act [May 4,
2006]
who were appointed to the corporation by the governor shall continue to
serve the balance
of their
current terms. Thereafter, the appointments shall be made by the governor with
advice
and
consent of the senate as prescribed in this section.
(d)
All public members shall serve staggered three (3) year terms except as
otherwise
provided
in subsection (c) of this section. In the month of June each year thereafter,
the governor
shall
appoint the successor(s) to the commissioners the governor has appointed whose
terms
expire
that year, to serve for a term of three (3) years commencing on the day they
are qualified.
All
public members shall serve until their respective successors are appointed and
qualified. The
members
of the corporation shall be eligible to succeed themselves.
(e)
Any vacancy occurring in the office of a member by death, resignation, or
otherwise
shall be
filled by the governor with advice and consent of the senate in the same manner
as the
original
appointment for the balance of the unexpired term of the former member as
prescribed in
subsection
23-19-6(c).
(f)
Members of the corporation shall be removable by the governor pursuant to §
36-1-7
of the
Rhode Island general laws, and removal solely for partisan or personal reasons
unrelated to
capacity
or fitness for the office shall be unlawful.
(g)
The commissioners shall annually elect from among their number a chair, vice
chair
and a
treasurer, and any other officers that they may determine. Meetings shall be
held at the call
of the
chair or whenever two (2) commissioners so request. Four (4) commissioners
shall
constitute
a quorum, and any action taken by the corporation under the provisions of this
chapter
may be
authorized by resolution approved by a majority of the commissioners present
and voting
at any
regular or special meeting. No vacancy in the membership of the corporation's
board of
commissioners
shall impair the right of a quorum to exercise all the rights and perform all
the
duties
of the corporation.
(h)
Commissioners shall receive no compensation for the performance of their
duties, but
the
commissioner shall be reimbursed for his or her reasonable expenses incurred in
carrying out
the
duties under this chapter.
(i)
The commissioners of the corporation shall at regular intervals at least eight
(8) times
a year
conduct business meetings for the purpose of carrying out its general business.
The
meetings
shall be open to the public and all records and minutes will be a matter of
public record.
The
corporation shall be considered a “public body” and shall be subject to the
provisions of the
Open
Meetings Law, chapter 42-46 and to the provisions of title 38 concerning public
records.
(j)
The corporation shall continue until its existence is terminated by law. At
that time its
holdings
and assets shall pass to and become vested in the state.
(k)
The state shall indemnify and hold harmless every past, present, or future
commissioner,
officer, or employee of the corporation who is made a party to or is required
to
testify
in any action, investigation, or other proceeding in connection with or arising
out of the
performance
or alleged lack of performance of that person's duties on behalf of the corporation.
These
persons shall be indemnified and held harmless, whether they are sued
individually or in
their
capacities as commissioners, officers, or employees of the corporation, for all
expenses,
legal fees
and/or costs incurred by them during or resulting from the proceedings, and for
any
award or
judgment arising out of their service to the corporation that is not paid by
the
corporation
and is sought to be enforced against a person individually, as expenses, legal
fees,
costs,
awards or judgments occur. Provided, however, that neither the state nor the
corporation
shall
indemnify any commissioner, officer, or employee:
(1)
For acts or omissions not in good faith or which involve intentional misconduct
or a
knowing
violation of law;
(2)
For any transaction from which the member derived an improper personal benefit;
or
(3)
For any malicious act.
(l)
No one shall be eligible for appointment unless he or she is a resident of the
state.
23-19-35.1.
Use of acquired property. -- (a) In addition to any other permitted
use, the
houses
and structures acquired per §§ 23-19-34 and 23-19-35 may, in accordance with
procedures
set
forth in regulation(s) adopted by the corporation, be:
(i)
Sold by the corporation in order to be salvaged or moved to another location;
(ii)
Razed or salvaged by the corporation; or
(iii)
Moved by the corporation to a location greater than one thousand feet (1000')
from
the
entire operational area of the central landfill.
(b)
Notwithstanding any law or regulation to the contrary, in order to return some
of the
property
purchased pursuant to § 23-19-34 or § 23-19-35 to the tax rolls, the
corporation may sell,
for any
use permitted by local zoning, any property acquired pursuant to § 23-19-34 or
§ 23-19-
35 that
is located north of Central Avenue in Johnston, and greater than one thousand
feet (1000')
from the
entire operational boundary of the central landfill. In addition, a convenant
covenant
shall be
placed in the deed of any real property so sold notifying the purchaser of the
presence of
the
landfill and protecting the corporation from any legal action by the purchaser
with respect to
the
environmental impact of it.
(c)
(1) Notwithstanding any law or regulation to the contrary, in order to return
some of
the
property purchased pursuant to §§ 23-19-34 and 23-19-35 to the tax rolls, the
corporation
shall in
addition to any other permitted use have the right to sell, rent, lease,
transfer or otherwise
convey
or encumber, any and all land acquired per § 23-19-34 or per § 23-19-35,
provided the
land is
used solely for industrial/business uses in conformance with the dimensional
requirements
of the
local zoning ordinance. In addition, a covenant shall be placed in the deed of
any real
property
so sold notifying the purchaser of the presence of the landfill and protecting
the
corporation
from any legal action by the purchaser with respect to the environmental impact
of it.
(2) The
corporation's development of an industrial/business park pursuant to this
chapter shall be
in
accordance with the following:
(i)
The corporation may utilize any and all property acquired pursuant to §§
23-19-34 and
23-19-35
and/or any property owned by the corporation located south of Central Pike,
west of
Old
Pocasset Road, to the intersection of Old Pocasset Road and Scituate Avenue,
then west of
Route
295, bounded to the south by the northern shore (mean high water line) of the
Upper
Simmons
Reservoir and the Lower Simmons Reservoir, for the development of the
industrial/business
park.
(ii)
The corporation may retain ownership of the land that comprises the
industrial/business
park and/or may sell or lease portions of the industrial/business park to other
public
or private entities.
(iii)
The industrial/business park may be utilized for any and all permitted
business,
manufacturing
and/or industrial uses authorized by the town of Johnston zoning ordinance in
any
zoning
district for all zoning districts notwithstanding the underlining zoning
district designation
of the
subject land.
(iv)
The corporation may not extend the operational portion of the central landfill
into
any
portion of the industrial/business park.
(v)
The corporation's development of the industrial/business park shall be in
compliance
with the
dimensional requirements of the town of Johnston zoning ordinance.
(vi)
The corporation shall maintain a one hundred (100) foot wide vegetated buffer
between
any portion of the industrial/business park and any adjacent property being
used for
residential
purposes.
(vii)
The corporation's development of the industrial/business park shall not be
effected
by any
change in the town of Johnston's zoning or subdivision ordinances enacted after
December
31,
2000.
(d)
Notwithstanding any law or regulation to the contrary, in order to return some
of the
property
purchased pursuant to § 23-19-35 to the tax rolls, the corporation may sell,
for any use
permitted
by local zoning, any property acquired to § 23-19-35 in which the primary
structure on
the
property is located greater than two thousand feet (2000') from the entire
operational portion
of the
central landfill. The corporation may sell all of these parcels and all
structures thereon for
any use
permitted by local zoning. In addition, a convenant covenant
shall be placed in the deed
of any
real property so sold notifying the purchaser of the presence of the landfill
and protecting
the
corporation from any legal action by the purchaser with respect to the
environmental impact
of it.
SECTION
57. Section 23-19.1-21 of the General Laws in Chapter 23-19.1 entitled
"Hazardous
Waste Management" is hereby amended to read as follows:
23-19.1-21.
Applicability of chapter - No effect on public utilities and carriers. --
Nothing
in this chapter shall be construed as affecting or in any way invalidating any
existing
regulatory
jurisdiction and authority pursuant to title 39, as amended, of the public
utilities
commission
and the division of public utilities and carriers over motor vehicles,
railroads, or
other
modes of transportation, or over the use, storage, and transportation of liquified
liquefied
natural
gas, as the term is defined in § 39-1-2, or any other existing regulatory
jurisdiction and
authority
as set forth in any other statute of the general laws of the state.
SECTION
58. Section 23-19.3.1-5 of the General Laws in Chapter 23-19.3.1 entitled
"Residential
Sanitary Sewer Connections" is hereby amended to read as follows:
23-19.3.1-5.
Rules and regulations. -- The state building code standards committee
shall
adopt rules
and regulations that will incorporate the standards in §§ 23-19.3.1-3 and
23-19.3.1-4
into the
state building code as established in section chapter 23-27.3 of
the Rhode Island general
laws.
SECTION
59. Sections 23-19.6-5 and 23-19.6-8 of the General Laws in Chapter 23-19.6
entitled
"Used Oil Recycling" are hereby amended to read as follows:
23-19.6-5.
Prohibited conduct. -- No person shall collect, transport, transfer,
store,
recycle,
use, or dispose of used oil by discharge to sewers, drainage systems, surface
or ground
water,
watercourses, or marine waters, or by incineration or deposit on land, unless
in accordance
with the
Hazardous Waste Management Act, chapter 19.7 19.1 of this title, the
Water Pollution
Law,
chapter 12 of title 46, and the Air Pollution Law Clean Air Act,
chapter 23 of this title, and
any
regulation promulgated pursuant to them.
23-19.6-8.
Sale of recycled oil products. -- A person may represent any product made
in
whole or
in part from used oil to be substantially equivalent to a product made from new
oil for a
particular
end use, if substantial equivalency has been determined in accordance with
rules
prescribed
by the federal trade commission under the federal Energy Policy and
Conservation
Act, 42
U.S.C. § 6201 et seq., or if the product conforms fully with the specifications
applicable
to that
product made from new oil.
SECTION
60. Section 23-19.14-5.2 of the General Laws in Chapter 23-19.14 entitled
"Industrial
Property Remediation and Reuse Act" is hereby amended to read as follows:
23-19.14-5.2.
Entry of registered professional engineers onto certain property. --
Any
registered professional engineer who is employed, retained and/or otherwise
acting on behalf
of a
municipality of this state may enter, examine or survey, at any reasonable
time, such places
and real
property which is either owned by a municipality or real property in which the
municipality
has a legal interest arising from a real property tax lien, on which property
owner
has made
no payments for a period of at least two (2) years, for the purpose of
performing an
environmental
site assessment or investigation. An environmental site assessment or
investigation
under this
section shall be conducted in accordance with and shall be subject to the same
guidelines
and limitations provided for an administrative inspection or, where
appropriate, a
criminal
investigation, pursuant to the provisions of § 42-17.1-2(t) 42-17.1-2(20).
SECTION
61. Sections 23-19.15-5, 23-19.15-8 and 23-19.15-9 of the General Laws in
Chapter
23-19.15 entitled "The Rhode Island Cesspool Act of 2007" are hereby
amended to read
as
follows:
23-19.15-5.
Inspection. -- (a) Unless exempted under subsection 23-19.15-8(a), the
owner of
property served by a cesspool in the following areas shall cause an inspection
to be
performed
on said cesspool by a system inspector in accordance with a schedule
established by
the
department, but no later than January 1, 2012:
(i)
(1) Which cesspool is within two hundred feet (200') of the inland edge
of a shoreline
feature
bordering a tidal water area [corresponding to the jurisdiction of the RI
Coastal Resources
Management
Council];
(ii)
(2) Which cesspool is within two hundred feet (200') of a public
drinking water well;
and
(iii)
(3) Which cesspool is within two hundred feet (200') of a surface
drinking water
supply,
specifically the impoundment from which water is drawn via the intake.
The
inspection shall be conducted and reported in accordance with procedures
required
by the
department, and the results shall be recorded on forms prescribed by the
department.
(b)
Pursuant to § 5-20.8-13, every contract for the purchase and sale of real
estate which
is or
may be served by a private cesspool, shall provide that potential purchasers be
permitted a
ten (10)
day period, unless the parties mutually agree upon a different period of time,
to conduct
an
inspection of the property's on-site sewage system in accordance with
procedures required by
the
department in subsection 23-19.15-5(a), before becoming obligated under the
contract to
purchase.
23-19.15-8.
Exemption. -- (a) The provisions of § 23-19.15-5 and subsection
23-19.15-
6(a)
shall not apply to any cesspool located in an area of a community covered by
municipal on-
site
wastewater management ordinance that requires the risk-based phase-out of
cesspools on an
alternative
schedule that meets the purposes of this act.
(b)
The provisions of subsection 23-19.15-6(a) shall not apply to any cesspool
located on
a
property that is properly designated to be sewered no later than five (5) years
after the
applicable
deadlines provided in subsection 23-19.15-6(a) provided: (i) (1)
it is not a failed
cesspool
as defined herein; (ii) (2) the owner does not increase the
design sewage flow into the
cesspool
or add bedrooms to the building served by the cesspool; (iii) (3)
the municipality holds
bonding
authorization or some other dedicated financial surety for expansion of sewers
to the area
of the
building served by the cesspool; and (iv) (4) the property owner
certifies, in writing, that
the
dwelling/building will be connected to the sewer system within six (6) months
of receipt of
the
notification to connect to the sewer system.
23-19.15-9.
Notice to remove and replace cesspools.-- (a) The owner of any cesspool
who has
not complied with the requirements pursuant to this chapter shall be in
violation of this
chapter
and subject to enforcement action by the department in accordance with chapters
17.1-2
17.1 and 17.6 of title 42 of the general laws.
(b)
Notwithstanding the above provisions, the director may require the abandonment
and
replacement
of any cesspool with an approved ISDS prior to the dates specified in
subsection 23-
19.15-6(a)
if the cesspool is a large capacity cesspool as defined pursuant to applicable
federal
regulations
governing underground injection control (UIC) facilities.
SECTION
62. Sections 23-20.10-6 and 23-20.10-9 of the General Laws in Chapter 23-
20.10
entitled "Public Health and Workplace Safety Act" are hereby amended
to read as follows:
23-20.10-6.
Where smoking not regulated. -- (a) Notwithstanding any other provision
of this
chapter to the contrary, the following areas shall be exempt from the
provisions of this
chapter. chapter:
(1)
Private residences, except when used as a licensed child care, adult day care
or health
care
facility;
(2)
Hotel and motel rooms that are rented to guests and are designated as smoking
rooms;
provided,
however, that not more than fifty percent (50%) of rooms rented to guests in a
hotel or
motel
may be so designated;
(3)
Retail tobacco stores; provided that smoke from these places does not
infiltrate into
areas
where smoking is prohibited under the provisions of this chapter;
(4)
Private and semi-private rooms or designated areas in assisted living
residences and
nursing
facilities as allowed by regulation of the department of health under chapters
17.4 and 17
of this
title;
(5)
Outdoor areas of places of employment, except those covered by the provisions
of §
23-20.10-5;
(6)
Any smoking bar as defined in § 23-20.10-2(15);
(7)
[Deleted by P.L. 2005, ch. 22, § 1 and P.L. 2005, ch. 23, § 1].
(8)
[Deleted by P.L. 2005, ch. 22, § 1 and P.L. 2005, ch. 23, § 1].
(b)
The provisions of this chapter shall not apply to any stage performance
provided that
smoking
is part of a theatrical production.
23-20.10-9.
Enforcement. -- (a) The director of health shall promulgate such rules
and
regulations
including the complaint forms, as are necessary to carry out the mandates of
this
chapter
within one hundred eighty (180) days of passage [June 29, 2004].
(b)
Notice of the provisions of this chapter shall be given to all applicants for a
business
license
in the state of Rhode Island, to all law enforcement agencies, and to any
business required
to be
registered with the secretary of state's office.
(c)
Any citizen who desires to register a complaint under this chapter may initiate
such a
complaint
with the department of health.
(d)
The department of health, having received a written and signed letter of
complaint
citing a
violation of this chapter, shall enforce this entire chapter against violations
by either of
the
following actions:
(1)
Serving written notice to comply to an employer, with a copy of the notice to
the
complaining
individual, requiring the employer to correct immediately any violation or
section of
this
chapter.
(2)
Upon receiving a second complaint at the department of health for the same or
continued
violation by the same employer, the complaint shall be resolved by notifying
the city or
town
solicitor, having jurisdiction over the licensed holder, to initiate, without
delay, an action for
injunction
to enforce the provisions of this chapter, to cause the correction of such
violation or
section,
and for assessment and recovery of a civil penalty for such violation.
(e)
The department of health, local fire department, or their designees shall,
while an
establishment
is undergoing otherwise mandated inspections, inspect for compliance with this
chapter.
(f)
An owner, manager, operator, or employee of an establishment regulated by this
chapter
shall inform persons violating this chapter of the appropriate provisions
thereof.
(g)
In addition to the remedies provided by the provisions of this section, the
department
of
health, aggrieved by the failure of the owner, operator, manager or other
person in control of a
public
place or place of employment to comply with the provisions of this chapter, may
apply for
injunctive
relief to enforce those provisions in any court of competent jurisdiction.
SECTION
63. Section 23-20.10-15 of the General Laws in Chapter 23-20.10 entitled
"Public
Health and Workplace Safety Act" is hereby repealed.
23-20.10-15.
Statewide uniformity. [Effective until October 1, 2006.] — It is
the
declared
policy of this state that there be uniformity in the application and
enforcement of
smoking
prohibitions as defined in this chapter. Any enactment relating to prohibitions
in an area
defined
in this chapter shall be by statute as enacted by the general assembly;
provided, however,
that the
general assembly may by statute delegate such authority to the cities and
towns.
SECTION 64. Sections 23-20.11-2 and
23-20.11-3 of the General Laws in Chapter 23-
20.11
entitled "Reduced Cigarette Ignition Propensity and Firefighter
Protection" are hereby
amended
to read as follows:
23-20.11-2.
Legislative findings. -- It is hereby found and declared as follows:
(a)
(1) The general assembly finds that cigarettes are one of the leading
causes of fire
deaths
in this state and in the nation. Each year 700-900 people are killed in the
United States due
to
cigarette fires; 3,000 are injured in fires ignited by cigarettes. A high
proportion of the victims
of
cigarette fires are nonsmokers, including senior citizens and young children.
Cigarette-caused
fires
result in billions of dollars of property losses and damage in the United
States and millions
of
dollars in this state. Cigarette fires unnecessarily jeopardize firefighters
and result in avoidable
emergency
response costs for municipalities.
(b)
(2) The general assembly further finds that the state of New York has
enacted a
cigarette
fire safety regulation effective June 28, 2004 that requires that cigarettes
sold in that
state
meet the fire safety performance standards. In 2005, the states of Vermont and
California
signed
into law cigarette fire safety acts that directly incorporate New York's
regulation into
statute;
and in 2006, the states of Illinois, New Hampshire, and Massachusetts did the
same.
Canada
implemented the New York State fire safety standard as of October 2005,
becoming the
first
nation to have a cigarette fire safety standard.
(c)
(3) The general assembly finds that New York State's cigarette fire
safety standard is
based
upon decades of research by the National Institute of Standards and Technology,
Congressional
research groups and private industry.
(d)
(4) It is the general assembly's intent that the state of Rhode Island
adopt the cigarette
fire
safety standard that is in effect in New York State, and the other states
listed above, to reduce
the
likelihood that cigarettes will cause fires and result in deaths, injuries and
property damage. It
is
further the legislature's intent to adopt such a cigarette fire safety standard
with a minimum of
cost to
the state and with minimum burden to cigarette manufacturers, distributors and
retail
sellers
as set forth herein.
23-20.11-3.
Definitions. -- The following terms shall have the following meanings
as
used in
this chapter:
(a)
(1) “Agent” shall mean any person authorized by the state to purchase
and affix tax
stamps
on packages of cigarettes.
(b)
(2) “Cigarette” shall mean any roll for smoking whether made wholly or
in part of
tobacco
or any other substance, irrespective of size or shape and whether or not such
tobacco or
substance
is flavored, adulterated or mixed with any other ingredient, the wrapper or
cover of
which is
made of paper or any other substance or material except tobacco, and that
because of its
size, appearance,
the type of tobacco used in its filler, or its packaging or labeling, is likely
to be
offered
to, or purchased by, consumers as a cigarette or cigarette equivalent.
(c)
(3) “Director” shall mean the director of the Rhode Island department of
health.
(d)
(4) “Manufacturer” shall mean:
(1)
(i) Any entity which manufacturers or otherwise produces cigarettes or
causes
cigarettes
to be manufactured or produced anywhere that such manufacturer intends to be
sold in
this
state, including cigarettes intended to be sold in the United States through an
importer; or
(2)
(ii) The first purchaser anywhere that intends to resell in the United
States cigarettes
manufactured
anywhere that the original manufacturer or maker does not intend to be sold in
the
United
States; or
(3)
(iii) Any entity that becomes a successor of an entity described in
paragraph (a) or (b)
of this
subdivision.
(e)
(5) “Repeatability” shall mean the range of values within which the
repeat results of
cigarette
test trails from a single laboratory will fall ninety-five percent (95%) of the
time.
(f)
(6) “Retail dealer” shall mean any person other than a manufacturer or
wholesale
dealer
engaged in selling cigarettes or tobacco products.
(g)
(7) “Sale” shall mean any transfer of title or possession or both,
exchange or barter,
conditional
or otherwise, in any manner or by any means whatever or any agreement therefor.
In
addition
to cash and credit sales, the giving of cigarettes as samples, prizes or gifts,
and the
exchanging
of cigarettes for any consideration other than money are considered sales.
(h)
(8) “Sell” shall mean to sell, or to offer or agree to do the same.
(i)
(9) “Quality control and quality assurance program” shall mean the
laboratory
procedures
implemented to ensure that operator bias, systematic and nonsystematic
methodological
errors, and equipment-related problems do not affect the results of the testing.
This
program ensures that the testing repeatability remains within the required
repeatability
values
stated in subsection 23-20.11-4(a) of this act for all test trials used to
certify cigarettes in
accordance
with this law.
(j)
(10) “Wholesale dealer” shall mean any person who sells cigarettes or
tobacco
products
to retail dealers or other persons for purposes of resale, and any person who
owns,
operates
or maintains one or more cigarette or tobacco product vending machines in, at
or upon
premises
owned or occupied by any other person.
SECTION
65. Section 23-21.1-1 of the General Laws in Chapter 23-21.1 entitled
"Sanitation
Standards for Bathing Beaches" is hereby amended to read as follows:
23-21.1-1.
Definitions. -- For the purposes of this chapter, the following
definitions
apply:
(1)
“Bathing beach” shall mean any area or tract of land, which is used in
connection
with
swimming and/or bathing in any waters of the state except that land contiguous
to the
Atlantic
Ocean provided:
(a)
(i) It is open to the public with or without permit and/or payment of a
fee;
(b)
(ii) It is maintained as a private club or association requiring
membership fees or
dues; or
(c)
(iii) It is maintained with or without charge for the recreation of
groups of ten (10) or
more
children.
(2)
“Bathing water” shall mean fresh, salt, or estuarine water adjacent to any
bathing
beach
within the state, except the Atlantic Ocean.
(3)
“Department” shall mean the Rhode Island Department of Health.
(4)
“Director” shall mean the director of health or his or her duly appointed
agents.
SECTION 66. Section 23-22-1 of the
General Laws in Chapter 23-22 entitled "Licensing
of Swimming
Pools" is hereby amended to read as follows:
23-22-1.
Definitions. -- (1) (a) “Person” as used in this chapter
includes any partnership,
association,
corporation, city, or town.
(2)
(b) “Swimming pool,” as used in this chapter, includes all swimming
pools, wading
pools,
and therapeutic pools owned or maintained by any person, partnership,
association,
corporation,
city, or town, or the state, except swimming pools maintained by an individual
for
the sole
use of the individual's household and guests without charge for admission and
not for the
purpose
of profit or in connection with any business operated for the purpose of
profit, and except
also
swimming pools owned or maintained by the United States. The term “swimming
pools”
wherever
the context requires shall be construed to include the apparatus, structure,
and
equipment
pertaining to the swimming pool, the premises on which the swimming pool is
located,
and the
premises appurtenant to this.
SECTION
67. Section 23-23-29.1 of the General Laws in Chapter 23-23 entitled "Air
Pollution"
is hereby amended to read as follows:
23-23-29.1.
Findings of fact. -- The general assembly hereby finds as follows:
(a)
(1) Motor vehicle exhaust is the largest source of air pollution in
Rhode Island, and
idling
vehicles emit higher concentrations of harmful pollutants than moving vehicles;
(b)
(2) Vehicle exhaust is hazardous to human health. Studies have linked
pollution from
vehicles
to increased rates of cancer, lung and heart disease, asthma and allergies,
urban smog
and
climate change;
(c)
(3) Fine particulate matter in diesel exhaust is particularly harmful to
children and
seniors.
Tiny particles can lodge deep within human lungs, where they can trigger asthma
attacks
and
stunt lung growth in children, and contribute to chronic obstructive pulmonary
disorder and
heart
attacks in seniors;
(d)
(4) Asthma is reaching epidemic proportions in Rhode Island. More than
one hundred
thousand
(100,000) people in Rhode Island have been diagnosed with asthma, including one
out
of every
ten (10) children. Asthma is the most common chronic disease in children and
responsible
for the most school absences in Rhode Island;
(e)
(5) Vehicle idling waste money. On average, an idling truck burns one
gallon of fuel
per
hour. A locomotive or other heavy duty engine may burn anywhere from three (3)
to eleven
(11)
gallons per hour;
(f)
(6) Excessive idling creates the need for more frequent oil and oil
filter changes, and
speeds
engine wear, reducing the amount of time before an engine needs to be rebuilt;
(g)
(7) Even on the coldest winter days, modern engines need no more than
five (5)
minutes
to warm up; and
(h)
(8) To date, other states including Connecticut and Massachusetts have
passed laws
that
limit the amount of time vehicles are permitted to idle.
SECTION
68. Section 23-24.10-5 of the General Laws in Chapter 23-24.10 entitled
"Electronic
Waste Prevention, Refuse and Recycling Act" is hereby amended to read as
follows:
23-24.10-5.
Disposal ban. -- (1) After July 1, 2008, no person shall dispose of any
of the
covered
electronic products in a manner other than by recycling or disposal as
hazardous waste.
(2)
This ban on disposal shall apply to whole units of covered electronic products,
as
well as
to the constituent subunits and materials from which the units are made.
(3)
No solid waste landfill or transfer station regulated pursuant to section
chapter 23-
18.9
shall accept any covered electronic products for the purposes of disposal after
July 1, 2008.
All
solid waste landfills and transfer stations regulated pursuant to section
chapter 23-18.9 shall
establish
procedures to promote segregation of covered electronic products from the waste
stream,
shall document those procedures in the facility operating plan, and shall
implement those
procedures
as part of the operation of the facility.
SECTION
69. Section 23-25-37 of the General Laws in Chapter 23-25 entitled
"Pesticide
Control"
is hereby amended to read as follows:
23-25-37.
Pesticide applications and notification of pesticide applications at schools.
-- (a) The
department of environmental management and the department of health shall
develop
regulations
as follows: (1) to restrict the use of hazardous pesticides in schools,
pre-schools and
child
care centers in Rhode Island; (2) for the promotion and implementation of
integrated pest
management
(IPM) as defined in § 23-25.2-2; (3) to cover situations where an emergency
application
of pesticide must be conducted to eliminate an immediate threat to human
health, and
establish
reporting requirements for these emergency applications.
(b)
On and after July 1, 2001, no person other than a licensed or certified
commercial
applicator
as defined in § 23-25-4, shall apply pesticide within any building or on the
grounds of
any
school. This section shall not apply in the case of an emergency application of
pesticide to
eliminate
an immediate threat to human health, where it is impractical to obtain the
services of
any such
applicator; provided the emergency application does not involve a restricted
use or state
limited
use pesticide. For purposes of this section, “emergency” means a sudden need to
mitigate
or
eliminate a pest which threatens the health or safety of a student or staff
member.
(c)
(1) On and after July 1, 2002, at the beginning of each school year, each local
school
authority
shall provide the staff of each school and the parents or guardians of each
child enrolled
in each
school with a written statement of the committee's policy on pesticide
application on
school
property and a description of any pesticide applications made at the school
during the
previous
school year.
(2)
The statement and description shall be provided to the parents or guardians of
any
child
who transfers to a school during the school year. The statement shall: (i)
indicate that the
staff, parents,
or guardians may register for prior notice of pesticide applications at the
school;
and (ii)
describe the emergency notification procedures provided for in this section.
Notice of any
modification
to the pesticide application policy shall be sent to any person who registers
for
notice
under this section.
(d)
On and after July 1, 2002, parents or guardians of children in any school and
school
staff
may register for prior notice of pesticide application at their school. Each
school shall
maintain
a registry of persons requesting the notice. Prior to providing for any
application of
pesticide
within any building or on the grounds of any school, the local school authority
shall
provide
for the distribution of notice to parents and guardians who have registered for
prior notice
under
this section, such that the notice is received no later than twenty-four (24)
hours prior to the
application.
Notice shall be given by any means practicable to school staff who have
registered
for the
notice. Notice under this subsection shall include: (1) the common or trade
name and the
name of
the active ingredient; (2) the EPA registration number as listed on the
pesticide label; (3)
the
target pest; (4) the exact location of the application on the school property;
(5) the date of the
application;
and (6) the name of the school administrator, or a designee, who may be
contacted
for
further information.
(e)
On and after July 1, 2003, no application of pesticide may be made in any
building or
on the
grounds of any school during regular school hours or during planned activities
at any
school.
No child shall enter an area where the application has been made until it is
safe to do so
according
to the provisions on the pesticide label. This section shall not apply to the
use of
germicides,
disinfectants, sanitizers, deodorizers, antimicrobal agents, insecticidal gels,
non-
volatile
insect or rodent bait in a tamper resistant container, insect repellants or the
application of
a
pesticide classified by the United States Environmental Protection Agency as an
exempt
material
under 40 CFR part 152.25 40 CFR 152.25.
(f)
On and after July 1, 2002, a local school authority may make an emergency
application
of pesticide without prior notice under this section in the event of an
immediate threat
to human
health, provided the board provides for notice, by any means practicable, on or
before
the day
that the application is to take place, to any person who has requested prior
notice under
this
section.
(g)
On and after July 1, 2002, notice of any pesticide application at a school
shall be
given,
by any means practicable, to the parents or guardians of any child enrolled at
the school
and to
the staff of the school not later than one week after the application. The
notice shall
include:
(1) the common or trade name and the name of the active ingredient; (2) the EPA
registration
number as listed on the pesticide label; (3) the target pest; (4) the exact
location of the
application
on the school property; (5) the date of the application; and (6) the name of
the school
administrator,
or a designee, who may be contacted for further information. A copy of the
record
of each
pesticide application at a school shall be maintained at the school for a period
of five (5)
years.
(h)
Not later than July 1, 2002, the department of environmental management and the
department
of health shall jointly establish a task force which shall specifically address
methods
to
promote public education and professional training about pesticides, their
potential health
effects
and IPM least toxic alternatives, and for evaluation and analysis of current
pest control
practices
at school and child care facilities.
SECTION
70. Sections 23-25.4-3 and 23-25.4-5 of the General Laws in Chapter 23-25.4
entitled
"Utilization of Unused Prescription Drugs Act" are hereby amended to
read as follows:
23-25.4-3.
Definitions. -- For the purposes of this chapter:
(a)
(1) “Assisted living residence” has the same meaning as such term is
defined in § 23-
17.4-2
and the regulations promulgated thereunder.
(b)
(2) “Blister packages” means multi-dose containers of a specific
medication
repackaged
by the pharmacy in accordance with section 13.7 of the regulations promulgated
under
chapter 19.1 of title 5 and intended for a specific patient.
(c)
(3) “Cancer drugs” means any of several drugs that control or kill
neoplastic cells,
commonly
referred to as “cancer-fighting chemotherapy” to destroy cancer cells.
(4)
“Charitable clinic” means an organized ambulatory care facility licensed
pursuant to
chapter
17 of title 23 organized as a nonprofit corporation pursuant to § 7-6-2 that:
(i)
Holds a valid exemption from federal income taxation issued pursuant to Section
501(a)
of the Internal Revenue Code, 26 U.S.C. § 501(1);
(ii)
Has a licensed outpatient pharmacy located at the organized ambulatory care
facility
or a
contract with a retail pharmacy to participate in the program established under
this chapter.
(d)
(5) “Health care prescriber” means any of the following persons licensed
and
authorized
to prescribe drugs or to provide medical, dental, or other health-related diagnoses,
care
or
treatment within the scope of their professional license:
(i)
A physician holding a current license to practice medicine pursuant to chapter
37 of
title 5;
(ii)
A certified registered nurse practitioner licensed pursuant to chapter 34 of
title 5;
(iii)
A physician assistant licensed pursuant to chapter 54 of title 5;
(iv)
A dentist licensed pursuant to chapter 31.1 of title 5;
(v)
An optometrist licensed pursuant to chapter 35 of title 5; and
(vi)
A pharmacist licensed pursuant to chapter 19.1 of title 5.
(vii)
A nurse — midwife licensed pursuant to chapter 13 of title 23; and
(viii)
A psychiatric and mental health clinical nurse specialist licensed pursuant to
chapter
34 of
title 5.
(e)
(6) “Medically indigent” means a person eligible to receive Medicaid or
Medicare or
a person
who has no health insurance and who otherwise lacks reasonable means to
purchase
prescribed
drugs.
(f)
“Charitable clinic” means an organized ambulatory care facility licensed
pursuant to
chapter
17 of title 23 organized as a nonprofit corporation pursuant to § 7-6-2 that:
(1)
Holds a valid exemption from federal income taxation issued pursuant to Section
501(a)
of the Internal Revenue Code (26 U.S.C., Section 501(1);
(2)
Has a licensed outpatient pharmacy located at the organized ambulatory care
facility
or a
contract with a retail pharmacy to participate in the program established under
this chapter.
(g)
(7) “Prescription drug” means a drug that may be dispensed only upon
prescription
by a
health care prescriber authorized by his or her licensing authority and as
defined in chapter
5-19.1.
(h)
(8) “Unit-dose container” is one that is designed to hold a quantity of a
drug intended
for use
as a single dose and used promptly after the container is opened. The immediate
container,
and/or
the outer container or protective packaging shall be designed to show evidence
of any
tampering
with the contents. Each individual container shall be fully identifiable
containing a
single
dose of a single entity and shall protect the integrity of the dosage form.
Labeling shall be
in
accordance with USP standards compendia and federal and state law and shall
include the
identity,
quantity, and strength of the product, name of the manufacturer, and lot number
and
expiration
date of the article.
23-25.4-5.
Criteria. -- The following criteria shall be used in soliciting and
accepting
unused
prescription drugs for use pursuant to this chapter:
(a)
(1) Nursing facilities and assisted living residences that have entered
into an
agreement
to participate with a charitable clinic shall document residents' participation
in the
program
with a written statement that their excess and otherwise eligible unused
prescription
drugs
shall be donated to a charitable clinic for the purpose of re-dispensing to
medically indigent
persons.
Participation in this program by residents of participating nursing facilities
and assisted
living
residences shall be strictly voluntary.
(b)
(2) Only prescription drugs in their original sealed multi-dose blister
packages, unit
dose
containers or perforated blister packages shall be accepted and re-dispensed;
(c)
(3) Expired or beyond use date prescription drugs shall not be accepted;
(d)
(4) A prescription drug shall not be accepted or re-dispensed if the
pharmacist
accepting
or re-dispensing the drug, in his or her judgment has reason to believe that
the drug is
adulterated,
mislabeled, or has been improperly stored;
(e)
(5) No controlled substances shall be accepted; and
(f)
(6) Subject to the limitation specified in this section, unused
prescription drugs
dispensed
for purposes of a medical assistance program may be accepted and re-dispensed
pursuant
to this chapter.
SECTION
71. Section 23-27.3-114.1 of the General Laws in Chapter 23-27.3 entitled
"State
Building Code" is hereby amended to read as follows:
23-27.3-114.1.
Action on application. -- (a) The building official shall examine or
cause
to be
examined all applications for permits and amendments thereto within fifteen
(15) days after
filing.
Before a permit is granted for the excavation or for the erection of any
building or
structure,
a written statement shall be furnished by the owner from a town or city
engineer as to
the
established grades. If the application or plans do not conform to the
requirements of this code
or of
all applicable laws, the building official shall reject the application citing
the specific
sections
of this code or applicable law upon which the rejection is based. If the
building official is
satisfied
that the proposed work conforms to the requirements of this code and all laws
applicable
thereto,
he or she shall issue a permit.
(b)
In cases where the permit application is for the construction or rehabilitation
of a
residential
dwelling occupied by one, two (2), and/or three (3) families, the building
official shall
reject
the application or issue the permit within sixty (60) calendar days after the
filing of the
application.
If after sixty (60) calendar days the application has not been either rejected
or a
permit
issued, the permit fee shall be reduced by fifty percent (50%). The review
period shall
begin on
the date when the application is filed with the building official and shall
include any
actions
on the application required by subsection (a) herein, subsection 23-28.1-2(2)
23-28.1-
2(b)(2) and 23-28.1-6 and actions by any other departments
with authority over the issuance of
the
permit.
(c)
If an application requires access by driveway to a state highway or state
highway
right of
way, or the placement or alteration of curbs, or the connecting to, pumping or
draining
water
to, the state highway drainage system, or making any alteration to the state
highway
system,
a physical alteration permit shall first be obtained from the director of the
department of
transportation
pursuant to rules and regulations promulgated under §§ 24-8-9, 24-8-33 and
24-8-
34. The
director shall render a decision within ninety (90) days of receipt of request
for access.
SECTION
72. Section 27-1-2.1 of the General Laws in Chapter 27-1 entitled
"Domestic
Insurance
Companies" is hereby amended to read as follows:
27-1-2.1.
Corporate governance standards [Effective July 1, 2008].-- (a) The
importance
of good corporate governance is crucial in promoting integrity in an insurance
company's
business practices and in maintaining public confidence and policyholder trust.
The
size and
ownership structure of a company often determines the corporate governance
standards
employed
by the company. All Rhode Island domestic insurers, regardless of their size or
ownership
structure, shall establish the following minimum corporate governance
standards:
(1)
The board of directors must be comprised of a minimum of five (5) and a maximum
of
twenty-one (21) members.
(2)
The board must meet at least two (2) times per year, however, four (4) times
per year
is
encouraged.
(3)
The board must establish a written attendance policy.
(4)
The board shall have authority to meet in executive session.
(5)
There must be an audit committee established by and amongst the board of
directors
for the
purpose of overseeing the accounting and financial reporting processes of the
insurer and
audits
of the financial statement of the insurer. If no such committee exists, the
entire board of
directors
shall act as the audit committee.
(6)
The board must review the minutes of the audit committee.
(7)
The audit committee must meet at least two (2) times per year.
(8)
There must be a written audit committee charter.
(9)
At least one member of the audit committee must have knowledge of statutory
accounting
principles or generally accepted accounting principles.
(10)
The internal audit function should have a direct reporting relationship to the
audit
committee
for critical matters such as the audit plan, resources and budgets.
(11)
The audit committee must approve the selection of the independent auditor that
performs
any audit required by the Rhode Island regulation governing annual audited
financial
reports.
(12)
The audit committee shall require the independent accountant that performs any
audit
required by Rhode Island regulation governing annual audited financial reports,
to timely
report
to the audit committee in accordance with the requirements of Statement of
Auditing
Standards
No. 61, communications with audit committee, or its replacement, including:
(i)
All significant accounting policies and material permitted practices;
(ii)
All material alternative treatments of financial information within statutory
accounting
principles that have been discussed with management officials of the insurer,
ramifications
of the use of the alternative disclosures and treatments, and the treatment
preferred
by the
accountant; and
(iii)
Other material written communications between the accountant and the management
of the
insurer, such as any management letter or schedule of unadjusted differences.
(13)
There must be a written code of ethics covering directors and officers that
includes
the
insurer's conflict of interest policy.
(14)
There should be a written policy encouraging employees to come forward with
observations
of improprieties or other malfeasance.
(15)
On or after the effective date of this act July 1, 2008 no domestic
insurer or any
affiliate
member of its holding company system (as defined in § 27-35-1 et seq.) may
extend or
maintain
credit, arrange for the extension of credit, or renew an extension of credit in
the form of
a
personal loan to or for any director or officer of a domestic insurer. The
terms and purpose of
any such
existing extensions of credit made to any director or officer of a domestic
insurer must
be
disclosed to the director. For purposes of this subsection, benefits that are
offered to directors
or
officers as policyholders of a domestic insurer, or benefits that are offered
to the general public
in the
insurer's normal course of business, shall not be considered a violation of
this subsection.
(b)
In addition to the standards enumerated in subsection (a) of this section, the
following
corporate governance standards must be employed by all Rhode Island domestic
mutual
insurance companies and all domestic insurance companies writing more than one
hundred
million dollars ($100,000,000) in premium, in any jurisdiction, on a direct
and/or
assumed
basis, as determined at the end of the previous calendar year:
(1)
The board must have an independent majority of members.
(2)
The audit committee must have an independent majority of members.
(3)
The audit committee must approve all related party transactions, which include,
include transaction between the company and its affiliates
and those between the company and its
officers
and directors. The company may establish materiality thresholds, however, they
must be
clearly
stated in its audit committee charter as required by subdivision (a)(8), but in
no event shall
the
materiality thresholds exceed those established in chapter 35 of title 27.
(c)
For purposes of this section, an independent board or audit committee member is
defined
as an individual: (1) who is not being compensated by the domestic insurer or
any
company
within its holding company system (“organization”), other than any reasonable
compensation
and benefits for services as a director, and has not been compensated within
the
past
twelve (12) months including full-time and part-time compensation as an
employee or an
independent
contractor, except for reasonable compensation as a director; (2) whose own
compensation
is not determined by individuals who are compensated by the organization,
except
for
reasonable compensation paid to the director; (3) who does not receive material
financial
benefits;
(i.e. service contracts, grants or other payments) from the organization; or
(4) who is not
related
to (as a spouse, sibling, parent, or child) or the domestic partner of an
individual
compensated
by or who receives material financial benefits from the organization.
Policyholders
of a
domestic insurer may be considered independent providing they meet the
requirements as
defined
in this subsection.
(d)
Any Rhode Island domestic insurer that does not currently employ one or more of
the
standards
enumerated in subsections (a) and (b) of this section, must submit a plan of
corrective
action
to the director for his or her approval. The director, at his or her
discretion, may waive any
of the
requirements in this section for a period not exceeding thirty-six (36) months.
The
director's
refusal to approve a plan of corrective action after reviewing such plan of
corrective
action
for a period of sixty (60) days shall, constitute a final order for purposes of
the Rhode
Island
Administrative Procedures Act allowing the party to appeal to the superior
court.
(e)
Nothing contained in the company's by-laws shall conflict with the corporate
governance
standards set forth in this act. Any amendments to a domestic insurance
company's
by-laws
shall be submitted in writing to the department.
(f)
A domestic insurer that is a member of an insurance holding company system as
defined
in chapter 35 of title 27, is exempt from this section if it can demonstrate
that it is
controlled
by an entity that either is required to be compliant with, or voluntarily is
compliant
with,
all of the following provisions of the Sarbanes-Oxley Act of 2002; 2002:
(i) the preapproval
requirements
of § 201 (§ 10A(i) of the Securities Exchange Act of 1934); (ii) the audit
committee
independence requirements of § 301 (§ 10A(m)(3) of the Securities Exchange Act
of
1934);
and (iii) the internal control over financial reporting requirements of § 404
(Item 308 of
SEC
regulation S-K) — (“SOX Compliant Entity”). If the department makes a
determination, as a
result
of its statutory examination or financial analysis, that the domestic insurer
is not controlled
by a SOX
Compliant Entity or that the insurer's interests and affairs are not adequately
considered
and
evaluated by the SOX Compliant Entity, the domestic insurer must take steps to
comply with
this
act.
(g)
A Rhode Island domestic insurer that is a wholly-owned subsidiary of another
Rhode
Island
domestic insurer that is compliant with the provisions of subsection A (a),
and if applicable
the
requirements of subsection B (b), shall be exempt from compliance
with any other
requirements
of this act.
(h)
The requirements of this section, 27-1-2.1, shall not apply to entities
regulated
pursuant
to chapters 19, 20, 20.1, 20.2, 20.3 and 41 of title 27 and shall not supercede
supersede
or
replace any specific statutory corporate governance standards otherwise
applicable to domestic
insurance
companies.
SECTION
73. Section 27-2.4-2 of the General Laws in Chapter 27-2.4 entitled
"Producer
Licensing
Act" is hereby amended to read as follows:
27-2.4-2.
Definitions. -- The following definitions apply to this chapter:
(1)
“Insurance commissioner” means the director of the department of business
regulation
or his or her designee;
(2)
(1) “Department” means the department of business regulation;
(3)
(2) “Home state” means any state or territory of the United States, or
the District of
Columbia,
in which an insurance producer maintains his or her principal place of
residence or
principal
place of business and is licensed to act as an insurance producer;
(4)
(3) “Insurance” means any of the lines of authority set forth in this
title;
(4)
“Insurance commissioner” means the director of the department of business
regulation
or his or her designee;
(5)
“Insurance producer” means a person required to be licensed under the laws of
this
state to
sell, solicit or negotiate insurance;
(6)
“Insurer” means: (i) any person, reciprocal exchange, interinsurer, Lloyds
insurer,
fraternal
benefit society, and any other legal entity engaged in the business of
insurance,
including
insurance producers; (ii) notwithstanding §§ 27-19-2, 27-20-2, 27-20.1-2,
27-20.2-2,
27-20.3-2,
and 27-41-22, all of whom shall be engaged in the business of insurance for the
purpose
of this chapter, nonprofit hospital and/or medical service corporation, a
nonprofit dental
service
corporation, a nonprofit optometric service corporation, a nonprofit legal
service
corporation,
a health maintenance organization as defined in chapter 41 of this title or as
defined
in
chapter 62 of title 42, or any other entity providing a plan of health benefits
subject to state
insurance
regulation; and (iii) an organization that for consideration assumes certain
risks for an
insured.
Insurer organizations may include corporations, stock companies, mutual
companies, risk
retention
groups, reciprocals, captives, Lloyds associations, and government residual
plans.
(7)
“License” means a document issued by this state's insurance commissioner
authorizing
a person to act as an insurance producer for the lines of authority specified
in the
document.
The license itself does not create any authority, actual, apparent or inherent,
in the
holder
to represent or commit an insurance carrier;
(8)
“Limited line credit insurance” includes credit life, credit disability, credit
property,
credit
unemployment, involuntary unemployment, mortgage life, mortgage guaranty,
mortgage
disability,
guaranteed automobile protection (gap) insurance, and any other form of
insurance
offered
in connection with an extension of credit that is limited to partially or
wholly
extinguishing
that credit obligation that the insurance commissioner determines should be
designated
a form of limited line credit insurance;
(9)
“Limited line credit insurance producer” means a person who sells, solicits or
negotiates
one or more forms of limited line credit insurance coverage to individuals
through a
master,
corporate, group or individual policy;
(10)
“Limited lines insurance” means those lines of insurance that the insurance
commissioner
deems necessary to recognize for purposes of complying with § 27-2.4-10(e);
(11)
“Limited lines producer” means a person authorized by the insurance
commissioner
to sell,
solicit or negotiate limited lines insurance;
(12)
“NAIC” means National Association of Insurance Commissioners;
(13)
“Negotiate” means the act of conferring directly with or offering advice
directly to a
purchaser
or prospective purchaser of a particular contract of insurance concerning any
of the
substantive
benefits, terms or conditions of the contract, provided that the person engaged
in that
act
either sells insurance or obtains insurance from insurers for purchasers;
(14)
“Person” means an individual;
(15)
“Resident” means a person who either resides in Rhode Island or maintains an
office
in Rhode
Island where the business of producing insurance is transacted and designates
Rhode
Island
as the residence for purposes of licensure;
(16)
“Sell” means to exchange a contract of insurance by any means, for money or its
equivalent,
on behalf of an insurance company;
(17)
“Solicit” means attempting to sell insurance or asking or urging a person to
apply for
a
particular kind of insurance from a particular company;
(18)
“Terminate” means the cancellation of the relationship between an insurance
producer
and the insurer or the termination of an insurance producer's authority to
transact
insurance;
(19)
“Uniform application” means the current version of the NAIC uniform application
for
resident and nonresident insurance producer licensing.
SECTION
74. Section 27-4.4-3 of the General Laws in Chapter 27-4.4 entitled "The
Standard
Nonforfeiture Law for Individual Deferred Annuities" is hereby amended to
read as
follows:
27-4.4-3.
Nonforfeiture requirements. -- (a) In the case of contracts issued on
or after
the
effective date of this act [July 7,
2004], no contract of annuity, except as stated in § 27-4.4-2,
shall be
delivered or issued for delivery in this state unless it contains in substance
the following
provisions,
or corresponding provisions which in the opinion of the commissioner of
insurance
are at
least as favorable to the contract holder, upon cessation of payment of
considerations under
the
contract:
(1)
That upon cessation of payment of considerations under contract, or upon
written
request
of the contract owner, the company shall grant a paid-up annuity benefit on a
plan
stipulated
in the contract of such value as is specified in §§ 27-4.4-5 — 27-4.4-8 and 27-4.4-10;
(2)
If a contract provides for a lump sum settlement at maturity, or at any other
time, that
upon
surrender of the contract at or prior to the commencement of any annuity
payments, the
company
shall pay in lieu of any paid up annuity benefit a cash surrender benefit of
such amount
as is
specified in §§ 27-4.4-5, 27-4.4-6, 27-4.4-8 and 27-4.4-10. The company may
reserve the
right to
defer the payment of the cash surrender benefit for a period not to exceed six
(6) months
after
demand therefore with surrender of the contract after making a written request
and receiving
written
approval of the commissioner. The request shall address the necessity and
equitability to
all
policyholders of the deferral;
(3)
A statement of the mortality table, if any, and interest rates used in
calculating any
minimum
paid up annuity, cash surrender, or death benefits that are guaranteed under
the
contract,
together with sufficient information to determine the amounts of the benefits;
and
(4)
A statement that any paid-up annuity, cash surrender, or death benefits that
may be
available
under the contract are not less than the minimum benefits required by any
statute of the
state in
which the contract is delivered and an explanation of the manner in which the
benefits are
altered
by the existence of any additional amounts credited by the company to the
contract, any
indebtedness
to the company on the contract, or any prior withdrawals from or partial
surrenders
of the
contract.
(b)
Notwithstanding the requirements of this section, any deferred annuity contract
may
provide
that if no considerations have been received under a contract for a period of
two (2) full
years
and the portion of the paid-up annuity benefit at maturity on the plan
stipulated in the
contract
arising from considerations paid prior to the period would be less than twenty
dollars
($20.00)
monthly, the company may at its option terminate the contract by payment in
cash of the
then
present value of the portion of the paid up annuity benefit, calculated on the
basis on the
mortality
table, if any, and interest rate specified in the contract for determining the
paid-up
annuity
benefit, and by the payment shall be relieved of any further obligation under
the contract.
SECTION 75. Sections 27-4.7-10 and
27-4.7-11 of the General Laws in Chapter 27-4.7
entitled
"Risk-Based Capital (RBC) for Health Organizations Act" are hereby
amended to read as
follows:
27-4.7-10.
Supplemental provisions - Rules -Exemption. -- (a) The provisions of
this
chapter
are supplemental to any other provisions of the laws of this state, and shall
not preclude
or limit
any other powers or duties of the commissioner under those laws, including, but
not
limited
to, chapters 41, 19, 20, 20.1, 20.2, 20.3, 14.1, 14.2, and 14.3 of this title.
The provisions
of this
chapter shall supercede supersede any provisions of this title in
conflict with this chapter.
(b)
The commissioner may adopt reasonable rules necessary for the implementation of
this
chapter.
(c)
The commissioner may exempt from the application of this chapter or modify the
requirements
of this chapter for:
(1)
A domestic health organization that:
(i)
Writes direct business only in this state;
(ii)
Assumes no reinsurance in excess of five percent (5%) of direct premium
written; and
(iii)
Writes direct annual premiums for comprehensive medical business of two million
dollars
($2,000,000) or less; or
(iv)
Is a limited health service organization that covers less than two thousand
(2,000)
lives;
or
(2)
A domestic health organization that provides a plan of health insurance, health
benefits,
or health services to members, eighty-five percent (85%) or greater of which
are
participants
in the RIte Care program administered by the State of Rhode Island, if the
health
organization
has contracts with insurers, hospital or medical service corporations,
governments,
or other
organizations that are sufficient to reasonably assure the performance of its
obligations;
provided,
that in no event shall the net worth or total adjusted capital requirement be
less than one
hundred
thousand dollars ($100,000).
27-4.7-11.
Foreign health organizations. -- (a)(1) A foreign health organization
shall,
upon the
written request of the commissioner, submit to the commissioner an RBC report
as of
the end
of the calendar year just ended the later of:
(i)
The date an RBC report would be required to be filed by a domestic health
organization
under this chapter;
(ii)
Fifteen (15) days after the request is received by the foreign health
organization.
(2)
A foreign health organization shall, at the written request of the
commissioner,
promptly
submit to the commissioner a copy of any RBC plan that is filed with the
insurance
commissioner
of any other state.
(b)
In the event of a company action level event, regulatory action level event, or
authorized
control level event with respect to a foreign health organization as determined
under
the RBC
statute applicable in the state of domicile of the health organization (or, if
no RBC
statute
is in force in that state, under the provisions of this chapter), if the
insurance commissioner
of the
state of domicile of the foreign health organization fails to require the
foreign health
organization
to file an RBC plan in the manner specified under that state's RBC statute (or,
if no
RBC
statute is in force in that state, under § 27-4.7-4), the commissioner may
require the foreign
health
organization to file an RBC plan with the commissioner. In that event, the
failure of the
foreign
health organization to file an RBC plan with the commissioner is grounds to
order the
health
organization to cease and desist from writing new insurance business in this
state.
(c)
In the event of a mandatory control level event with respect to a foreign
health
organization,
if no domiciliary receiver has been appointed with respect to the foreign
health
organization
under the rehabilitation and liquidation statue statute
applicable in the state of
domicile
of the foreign health organization, the commissioner may make application to
the
superior
court of the county of Providence permitted under chapter 14.3 of this title
with respect
to the
liquidation of property of foreign health organizations found in this state,
and the
occurrence
of the mandatory control level event shall be considered adequate grounds for
the
application.
SECTION
76. Sections 27-5-3.7 and 27-5-3.8 of the General Laws in Chapter 27-5
entitled
"Fire Insurance Policies and Reserves" are hereby amended to read as
follows:
27-5-3.7.
Hurricane deductibles, triggers and policyholder notice. -- (a) The
provisions
of this section shall be applicable to policies issuing or renewing on or after
July 1,
2008.
(b)
In all instances where an insurance company licensed to do business in this
state
offers
or includes any deductible and/or mitigation measure related to such deductible
for any
type of
personal lines residential property insurance on dwelling houses, the insurance
company
shall
provide prominent and clear notice to insureds, that shall be included in the
policy issuance
or
renewal package and shall fully disclose all details pertaining to any such
deductible and/or
mitigation
measure.
(c)
The insurer may apply a deductible specific to windstorm coverage where:
(i)
(1) The deductible is specifically approved by the director and shall
not exceed five
percent
(5%) of the insured value.
(ii)
(2) The deductible shall be applicable to losses due to a hurricane
during the period
commencing
with the issuance of a hurricane warning bulletin for any part of the state by
the
National
Hurricane Center and concluding twenty-four (24) hours after the termination of
the last
hurricane
warning bulletin for any part of the state.
(iii)
(3) The deductible, whether it is a flat dollar deductible or a
percentage deductible
shall be
presented by at least two (2) examples that illustrate the application of the
deductible to
the
insured. Nothing herein shall prohibit the insurer from providing any
additional information to
the
insured to assist in the insured's understanding the deductible to applied to
the insured's
policy.
(iv)
(4) The deductible set forth above shall not be applied to any insured,
if the insured
has
installed approved mitigation measures to protect against windstorm damage and
the insurer
has
either inspected the property or the insured has submitted satisfactory proof
of installation of
the
approved mitigation measures. The insurance commissioner, in consultation with
the state
building
code commissioner, shall adopt and may amend or revise a list of mitigation
measures,
based so
far as reasonably feasible on national standards for such measures and
practices in other
comparable
states. The list of mitigation measures adopted by the insurance commissioner
shall
be
considered approved mitigation measures for purposes of this subdivision.
(d)
Premium credits shall be applied to policies with deductibles as set forth in
subsection
27-5-3.7(c).
(e)(1)
An insurer may require mitigation measures to protect against windstorm damage
only after
specific approval of the substance of such mitigation measures by the director;
(i)
(2) Mitigation measures to be taken by an insured are clearly explained,
including a
complete
illustration of the dollar impact upon the premiums to be charged to insureds
if the
requested
mitigation activities are undertaken;
(ii)
(3) No mandatory deductible for windstorm damage shall be included in
the policy;
(iii)
(4) An insurer shall write the requested coverage at the premium rate
that includes
the
premium credit to be realized with the completion of the mitigation efforts;
(iv)
(5) The insurer shall affirmatively state the length of time during
which discount
given
for the mitigation efforts will apply; and
(v)
(6) No insurer shall subsequently non-renew an insured who has taken the
mitigation
steps
requested by the insurer for reasons of the insurers exposure to catastrophe
loss, unless for
non-payment
of premium, fraud, breach by the insured of a provision of the policy, reversal
or a
lack of
maintenance of the mitigation steps, or insurer solvency concerns or adverse
loss history.
(f)
Penalties for failure to comply with the provisions of this section shall be
administered
by the
director in accordance with the provisions of § 42-14-16.
(g)
The department of business regulation shall have authority to adopt such rules,
including
emergency rules, as may be necessary or desirable to effectuate the purposes of
this
section.
27-5-3.8.
Rhode Island commission on hurricane loss projection methodology. –
(1)
(a) Legislative findings and intent. (a) (1) Reliable
projections of hurricane losses are
necessary
in order to assure that rates for residential property insurance meet the statutory
requirement
that rates be neither excessive nor inadequate.
(b)
(2) The general assembly recognizes the need for expert evaluation of
computer
models
and other recently developed or improved actuarial methodologies for projecting
hurricane
losses, in order to resolve conflicts among actuarial professionals, and in
order to
provide
both immediate and continuing improvement in the sophistication of actuarial
methods
used to
set rates charged to consumers.
(c)
(3) It is the intent of the general assembly to create the Rhode Island
commission on
hurricane
loss projection methodology as a panel of experts to provide the most
actuarially
sophisticated
guidelines and standards for projection of hurricane losses possible, given the
current
state of actuarial science.
(2)
(b) Commission created. (a) (1) There is created the Rhode
Island commission on
hurricane
loss projection methodology. For the purposes of this section, the term
“commission”
means
the Rhode Island commission on hurricane loss projection methodology. The
commission
shall be
administratively housed within the department of administration, but it shall
independently
exercise the powers and duties specified in this section.
(b)
(2) The commission shall consist of the following eight (8) members:
(1)
(i) The director of business regulation, acting as the administrator of
insurance, or
designee;
(2)
(ii) The adjutant general of the Rhode Island emergency management
agency;
(3)
(iii) A member of the board of directors of the Rhode Island Joint
reinsurance
Association
appointed by the governor;
(4)
(iv) Five (5) members directly appointed by the governor, as follows:
(A)
An actuary who is employed full-time by a property and casualty insurer which
was
responsible
for at least one percent of the aggregate statewide direct written premium for
homeowner's
insurance in the calendar year preceding the member's appointment to the
commission;
(B)
An expert in insurance finance who has a background in actuarial science;
(C)
An expert in statistics who has a background in insurance;
(D)
An expert in computer system design.
(E)
An expert in meteorology who specializes in hurricanes.
(c)
(3) Members designated under subparagraphs (b)(1)-(4) (b)(2)(i)-(iii)
shall serve on
the
commission as long as they maintain the respective offices designated in
subparagraphs
(b)(1)-(4) (b)(2)(i)-(iii). Members under subparagraph (b)(5)(A)-(E)
(b)(2)(iv)(A)-(E) shall serve
for a
term of three (3) years, and may be reappointed to the commission. All members
may be
removed
by the governor prior to the expiration of their term, for cause. Vacancies on
the
commission
shall be filled in the same manner as the original appointment.
(d)
(4) The governor shall annually appoint one of the members of the
commission to
serve as
chair.
(e)
(5) Members of the commission shall serve without compensation, but
shall be
reimbursed
for per diem and travel expenses.
(f)
(6) There shall be no liability on the part of, and no cause of action
of any nature shall
arise
against, any member of the commission for any action taken in the performance
of their
duties
under this section. In addition, the commission may, in writing, waive any
potential cause
of
action for negligence of a consultant, contractor, or contract employee engaged
to assist the
commission.
(3)
(c) Adoption and effect of standards and guidelines. (a) (1)
The commission shall
consider
any actuarial methods, principles, standards, models, or output ranges that
have the
potential
for improving the accuracy of or reliability of the hurricane loss projections
used in
residential
property insurance rate filings. The commission shall, from time to time, adopt
findings
as to the accuracy or reliability of particular methods, principles, standards,
models, or
output
ranges.
(b)
(2) The commission shall adopt revisions to previously adopted actuarial
methods,
principles,
standards, models, or output ranges at least annually.
(c)
(3)(i) A trade secret that is used in designing and constructing a
hurricane loss model
and that
is provided pursuant to this section, by a private company, to the commission,
is
confidential
and shall not be deemed a public record pursuant to the provisions of chapter 2
of
title
38.
(2)
(ii) That portion of a meeting of the commission or of a rate proceeding
on an
insurer's
rate filing at which a trade secret made confidential and exempt by this
paragraph is
discussed
shall be deemed confidential and not open to disclosure pursuant to the open
meetings
act, but
may be discussed at a closed meeting as provided for in chapter 46 of title 42.
(3)
(d) The Rhode Island commission is hereby authorized to form a
multi-state
commission
with the states of Massachusetts, Connecticut and any other interested state in
furtherance
of the goals of this act.
SECTION
77. Section 27-7.1-12.1 of the General Laws in Chapter 27-7.1 entitled
"Workers’
Compensation Insurance" is hereby amended to read as follows:
27-7.1-12.1.
Acts reducing competition prohibited. -- (a) In this section, “insurer”
includes
two (2) or more affiliated insurers: (1) under common management; or (2) under
common
controlling ownership or under common effective legal control and in fact
engaged in
joint or
cooperative underwriting, investment management, marketing, servicing, or
administration
of their business and affairs as insurers.
(b)
Neither the advisory organization nor any insurer may:
(1)
Monopolize, attempt to monopolize, or combine or conspire with any other person
or
persons
to monopolize the business of insurance of any kind, subdivision, or class;
(2)
Agree with any other insurer or the advisory organization to charge or adhere
to any
rate or
rating plan other than the uniform experience rating plan or rating rule except
as needed to
comply
with the requirements of § 27-7.1-10 [Repealed];
(3)
Make an agreement with any other insurer, the advisory organization, or other
person
to
unreasonably restrain trade or substantially lessen competition in the business
of insurance of
any
kind, subdivision, or class; or
(4)
Make any agreement with any other insurer or the advisory organization to
refuse to
deal
with any person in connection with the sale of insurance.
(c)
The fact that two (2) or more insurers, whether or not members or subscribers
to the
advisory
organization, use consistently or intermittently the same rules rating plans,
rating
schedules,
rating rules, policy forms, rate classification, underwriting rules, surveys,
inspections,
or
similar materials is not sufficient in itself to support a finding that an
agreement exists.
(d)
The advisory organization and any member or subscriber of it may not interfere
with
the
right of any insurer to make its rates independently of the advisory
organization.
(e)
Except as required by § 27-7.1-10 [Repealed], the advisory organization
may not
have or
adopt any rule or exact any agreement or formulate or engage in any program
which
would
require any member, subscriber, or other insurer to:
(1)
Utilize some or all of its service;
(2)
Adhere to its rates, rating plan, rating systems, or underwriting rules; or
(3)
Prevent any insurer from acting independently.
SECTION
78. Section 27-8-11 of the General Laws in Chapter 27-8 entitled "Casualty
Insurance
Generally" is hereby amended to read as follows:
27-8-11.
Regulations on cancellation and renewal. -- (a) In addition to and not
in lieu
of any
other power the commissioner has to issue rules and regulations, the
commissioner of
insurance
may promulgate, in accordance with the procedure established in chapter 35 of
title 42,
reasonable
rules and regulations concerning cancellation and renewal of liability and
property
damage
insurance for automobiles rated as private passenger automobiles. Those
regulations may
require
that the insurer shall furnish to the named insured the reason or reasons for
cancellation or
nonrenewal.
Those regulations shall also require that the insurer furnish, at least thirty
(30) days
prior to
renewal, written notice of material coverage modifications approved by the
insurance
division
with respect to those types of insurance defined in § 27-8-1(1) — (9) 27-8-1(1)-(8),
issued
to non-business insured and bodily injury and property damage liability
coverage issued to
non-business
insured. There shall be no liability on the part of, and no cause of action of
any
nature
shall arise against, the commissioner of insurance or any insurer, their
authorized
representatives,
agents, or employees, or any firm, person, or corporation furnishing to the
insurer
or
commissioner information as to the reasons for cancellation or nonrenewal, for
any statement
made by
any of them in any written notice of cancellation or nonrenewal, or in any
other
communication
oral or written specifying the reasons for cancellation or nonrenewal, or for
the
providing
of information pertaining to the cancellation or nonrenewal, or for statements
made or
evidence
submitted at any hearing conducted in connection with the cancellation or
nonrenewal.
(b)
The commissioner shall promulgate regulations with respect to personal motor
vehicle
insurance, homeowners insurance, and residential fire insurance, or any
components of
that
insurance requiring notification to policyholders upon renewal of any material
changes in
policy
deductibles, limits, coverage, conditions or definitions, unless the change was
requested by
the
policyholder.
SECTION
79. Section 27-10-1 of the General Laws in Chapter 27-10 entitled "Claim
Adjusters"
is hereby amended to read as follows:
27-10-1.
Applicability. -- The provisions of this chapter shall apply to
insurance claim
adjusters.
For the purposes of this chapter “insurance claim adjusters” means any person,
who or
which:
(1)
Engages for compensation in negotiating adjustments of insurance claims on
behalf of
an
insurance company, other than life and accident and health insurance claims,
under any
policies
of insurance or who advertises or holds himself or herself out as engaging in
that activity
or who
solicits that activity;
(2)
Is known or holds himself, herself, or itself out as a “public adjuster”. A
public
adjuster
is any person who, for compensation or any other thing of value on behalf of
the insured:
(a)
(i) Acts or aids, solely in relation to first party claims arising under
insurance
contracts,
other than automobile, life, accident and health, that insure the real or
personal property
of the
insured, on behalf of an insured in negotiating for, or effecting the
settlement of, a claim
for loss
or damage covered by an insurance contract;
(b)
(ii) Advertises for employment as a public adjuster of insurance claims
or solicits
business
or represents himself or herself to the public as a public adjuster of first
party insurance
claims
for losses or damages arising out of policies of insurance that insure real or
personal
property;
(c)
(iii) Directly or indirectly solicits business, investigates or adjusts
losses, or advises an
insured
about first party claims for losses or damages arising out of policies of
insurance that
insure
real or personal property for another person engaged in the business of
adjusting losses or
damages
covered by an insurance policy, for the insured; or
(3)
Advertises or solicits business as an adjuster, or holds himself or herself out
to the
public
as engaging in adjusting as a business.
SECTION
80. Sections 27-14.3-25, 27-14.3-46 and 27-14.3-63 of the General Laws in
Chapter
27-14.3 entitled "Insurers’ Rehabilitation and Liquidation Act" are
hereby amended to
read as
follows:
27-14.3-25.
Powers of liquidator. -- (a) The liquidator shall have the power:
(1)
To appoint a special deputy or deputies to act for him or her under this
chapter, and to
determine
his or her reasonable compensation. The special deputy shall have all of the
powers of
the
liquidator granted by this section. The special deputy shall serve at the
pleasure of the
liquidator;
(2)
To employ employees and agents, legal counsel, actuaries, accountants,
appraisers,
consultants,
and any other personnel as he or she may deem necessary to assist in the
liquidation;
(3)
To appoint, with the approval of the court, an advisory committee of
policyholders,
claimants,
or other creditors including guaranty associations should a committee be deemed
necessary;
provided, that if a nonprofit hospital service corporation, nonprofit medical
service
corporation,
or nonprofit dental service corporation is subject to an order of liquidation,
the
commissioner
shall appoint an advisory committee of creditors to include Rhode Island
nonprofit
hospitals.
The committee shall serve at the pleasure of the commissioner and shall serve
without
compensation
other than reimbursement for reasonable travel and per diem living expenses. No
other
committee of any nature shall be appointed by the commissioner or the court in
liquidation
proceedings
conducted under this chapter;
(4)
To fix the reasonable compensation of employees and agents, legal counsel,
actuaries,
accountants,
appraisers, and consultants with the approval of the court and may reimburse
from
the
assets of the insurer the division of insurance and its agents and consultants
at the statutory
examination
rate and/or reasonable agents' or consultants' rates for reasonable costs
incurred in
the
examination and investigation in anticipation of liquidation, and in the
liquidation of the
insurer,
those fees are to be Class 1 expenses of administration pursuant to § 27-14.3-46;
(5)
To pay reasonable compensation to persons appointed and to defray from the
funds or
assets
of the insurer all of the expenses of taking possession of, conserving,
conducting,
liquidating,
disposing of, or dealing with the business and property of the insurer. In the
event
that the
property of the insurer does not contain sufficient cash or liquid assets to
defray the
incurred
costs, the commissioner may advance the incurred costs out of any appropriation
for the
maintenance
of the insurance department. Any advanced amounts for the expenses of
administration
shall be repaid to the commissioner for the use of the insurance department out
of
the
first available moneys of the insurer;
(6)
To hold hearings, to subpoena witnesses to compel their attendance, to
administer
oaths,
to examine any person under oath, and to compel any person to subscribe to his
or her
testimony
after it has been correctly reduced to writing, and in connection with this to
require the
production
of any books, papers, records or other documents which he or she deems relevant
to
the
inquiry;
(7)
To audit the books and records of all agents or insurance producers of the
insurer
insofar
as those records relate to the business activities of the insurer;
(8)
To collect all debts and moneys due and claims belonging to the insurer,
wherever
located,
and for this purpose:
(i)
To institute timely action in other jurisdictions in order to forestall
garnishment and
attachment
proceedings against the debts;
(ii)
To do any other acts as are necessary or expedient to collect, conserve, or
protect its
assets
or property, including the power to sell, compound, compromise, or assign debts
for the
purposes
of collection upon any terms and conditions as he or she deems best; and
(iii)
To pursue any creditor's remedies available to enforce his or her claims;
(9)
To conduct public and private sales of the property of the insurer;
(10)
To use assets of the estate of an insurer under a liquidation order to transfer
policy
obligations
to a solvent assuming insurer, if the transfer can be arranged without
prejudice to
applicable
priorities under § 27-14.3-46;
(11)
To acquire, hypothecate, encumber, lease, improve, sell, transfer, abandon, or
dispose
of or deal with any property of the insurer at its market value or upon terms
and
conditions
as are fair and reasonable. He or she shall also have the power to execute,
acknowledge,
and deliver any and all deeds, assignments, releases, and other instruments
necessary
or proper to effectuate any sale of property or other transaction in connection
with the
liquidation;
(12)
To borrow money on the security of the insurer's assets or without security and
to
execute
and deliver all documents necessary to that transaction for the purpose of
facilitating the
liquidation.
Any funds borrowed may be repaid as an administrative expense and have priority
over any
other claims in § 27-14.3-46(1) 27-14.3-46(a)(1), Class 1, under
the priority of
distribution;
(13)
To enter into any contracts as are necessary to carry out the order to
liquidate, and to
affirm
or disavow any contracts to which the insurer is a party;
(14)
To continue to prosecute and to institute in the name of the insurer or in his
or her
own name
any and all suits and other legal proceedings, in this state or another place,
and to
abandon
the prosecution of claims he or she deems unprofitable to pursue further. If
the insurer is
dissolved
under § 27-14.3-24, he or she shall have the power to apply to any court in
this state or
another
place for leave to substitute himself for the insurer as plaintiff;
(15)
To prosecute any action which may exist in behalf of the creditors, members,
policyholders,
or shareholders of the insurer against any officer or director of the insurer,
or any
other
person;
(16)
To remove any or all records and property of the insurer to the offices of the
commissioner
or to any other place as may be convenient for the purposes of efficient and
orderly
execution
of the liquidation. Guaranty associations and foreign guaranty associations
shall have
reasonable
access to the records of the insurer as is necessary for them to carry out
their statutory
obligations;
(17)
To deposit in one or more banks in this state those sums as are required for
meeting
current
administration expenses and dividend distributions;
(18)
To invest all sums not currently needed, unless the court orders otherwise;
(19)
To file any necessary documents for record in the office of any recorder of
deeds or
record
office in this state or another place where property of the insurer is located;
(20)
To assert all defenses available to the insurer as against third persons,
including
statutes
of limitations, statutes of frauds, and the defense of usury. A waiver of any
defense by the
insurer
after a petition in liquidation has been filed shall not bind the liquidator.
Whenever a
guaranty
association or foreign guaranty association has an obligation to defend any
suit, the
liquidator
shall give precedence to that obligation and may defend only in the absence of
a
defense
by the guaranty associations;
(21)
To exercise and enforce all of the rights, remedies, and powers of any
creditor,
shareholder,
policyholder, or member including any power to avoid any transfer or lien that
may
be given
by the general laws and that is not included with §§ 27-14.3-30 — 27-14.3-32;
(22)
To intervene in any proceeding wherever instituted that might lead to the
appointment
of a receiver or trustee, and to act as the receiver or trustee whenever the
appointment
is offered;
(23)
To enter into agreements with any receiver or commissioner of any other state
relating
to the rehabilitation, liquidation, conservation, or dissolution of an insurer
doing business
in both
states; and
(24)
To exercise all of the powers now held or after this conferred upon receivers
by the
laws of this
state not inconsistent with the provisions of this chapter.
(b)
The enumeration in this section of the powers and authority of the liquidator
shall not
be
construed as a limitation upon him or her, nor shall it exclude in any manner
his or her right to
do any
other acts not specifically enumerated or provided for in this section as may
be necessary
or
appropriate for the accomplishment of or in aid of the purpose of liquidation.
(c)
Notwithstanding the powers of the liquidator as stated in subsections (a) and
(b) of
this
section, the liquidator shall have no obligation to defend claims or to
continue to defend
claims
subsequent to the entry of a liquidation order.
27-14.3-46.
Priority of distribution. -- (a) The priority of distribution of
claims from the
insurer's
estate shall be in accordance with the order in which each class of claims is
set forth in
this
section. Every claim in each class shall be paid in full or adequate funds
retained for such
payment
before the members of the next class receive any payment. Once such funds are
retained
by the
liquidator and approved by the court, the insurer's estate shall have no
further liability to
members
of that class except to the extent of the retained funds and any other undistributed
funds.
No
subclasses shall be established within any class except as provided in § 27-14.3-25(12)
27-
14.3-25(a)(12). No claim by a shareholder, policyholder, or other
creditor shall be permitted to
circumvent
the priority classes through the use of equitable remedies. The order of
distribution of
claims
shall be:
(1)
Class 1. The costs and expenses of administration expressly approved by the
receiver,
including,
but not limited to, the following:
(i)
The actual and necessary costs of preserving or recovering the assets of the
insurer;
(ii)
Compensation for all authorized services rendered in the conservation,
rehabilitation
or
liquidation;
(iii)
Any necessary filing fees;
(iv)
The fees and mileage payable to witnesses; and
(v)
Authorized reasonable attorney's fees and other professional services rendered
in the
conservation,
rehabilitation or liquidation.
(2)
Class 2. The administrative expenses of guaranty associations. For purposes of
this
section these
expenses shall be the reasonable expenses incurred by guaranty associations
where
the
expenses are not payments or expenses which are required to be incurred as
direct policy
benefits
in fulfillment of the terms of the insurance contract or policy, and that are
of the type and
nature
that, but for the activities of the guaranty association otherwise would have
been incurred
by the
receiver, including, but not limited to, evaluations of policy coverage,
activities involved in
the
adjustment and settlement of claims under policies, including those of in-house
or outside
adjusters,
and the reasonable expenses incurred in connection with the arrangements for
ongoing
coverage
through transfer to other insurers, policy exchanges or maintaining policies in
force.
The
receiver may in his or her sole discretion approve as an administrative expense
under this
section
any other reasonable expenses of the guaranty association if the receiver
finds:
(i)
The expenses are not expenses required to be paid or incurred as direct policy
benefits
by the
terms of the policy; and
(ii)
The expenses were incurred in furtherance of activities that provided a
material
economic
benefit to the estate as a whole, irrespective of whether the activities
resulted in
additional
benefits to covered claimants. The court shall approve such expenses unless it
finds the
receiver
abused his or her discretion in approving the expenses.
If
the receiver determines that the assets of the estate will be sufficient to pay
all Class 1
claims
in full, Class 2 claims shall be paid currently, provided that the liquidator
shall secure from
each of
the associations receiving disbursements pursuant to this section and agreement
to return
to the
liquidator such disbursements, together with investment income actually earned
on such
disbursements,
as may be required to pay Class 1 claims. No bond shall be required of any such
association.
(3)
Class 3. (i) All claims under policies including claims of the federal
or any state or
local
government for losses incurred, (“loss claims”) including third party claims,
claims for
unearned
premiums, and all claims of guaranty association for reasonable expenses other
than
those
included in Class 2. All claims under life and health insurance and annuity
policies, whether
for
death proceeds, health benefits, annuity proceeds, or investment values shall
be treated as loss
claims.
That portion of any loss, indemnification for which is provided by other
benefits or
advantages
recovered by the claimant, shall not be included in this class, other than
benefits or
advantages
recovered or recoverable in discharge of familial obligation of support or by
way of
succession
at death or as proceeds of life insurance, or as gratuities. No payment by an
employer
to his
or her employee shall be treated as a gratuity;
(ii)
Notwithstanding the foregoing, the following claims shall be excluded from
Class 3
priority:
(i)
(A) Obligations of the insolvent insurer arising out of reinsurance
contracts;
(ii)
(B) Obligations incurred after the expiration date of the insurance
policy or after the
policy
has been replaced by the insured or canceled at the insured's request or after
the policy has
been canceled
as provided in this chapter;
(iii)
(C) Obligations to insurers, insurance pools or underwriting
associations and their
claims
for contribution, indemnity or subrogation, equitable or otherwise;
(iv)
(D) Any claim which is in excess of any applicable limits provided in
the insurance
policy
issued by the insolvent insurer;
(v)
(E) Any amount accrued as punitive or exemplary damages unless expressly
covered
under
the terms of the policy; and
(vi)
(F) Tort claims of any kind against the insurer, and claims against the
insurer for bad
faith or
wrongful settlement practices.
(4)
Class 4. Claims of the federal government other than those claims included in
Class 3.
(5)
Class 5. Debts due to employees for services, benefits, contractual or
otherwise due
arising
out of such reasonable compensation to employees for services performed to the
extent
that
they do not exceed two (2) months of monetary compensation and represent
payment for
services
performed within six (6) months before the filing of the petition for
liquidation or, if
rehabilitation
preceded liquidation within one year before the filing of the petition for
rehabilitation.
Principal officers and directors shall not be entitled to the benefit of this
priority
except
as otherwise approved by the liquidator and the court. This priority shall be
in lieu of any
other
similar priority which may be authorized by law as to wages or compensation of
employees.
(6)
Class 6. Claims of any person, including claims of state or local governments,
except
those
specifically classified elsewhere in this section. Claims of attorneys for fees
and expenses
owed
them by a person for services rendered in opposing a formal delinquency
proceeding. In
order to
prove the claim, the claimant must show that the insurer which is the subject
of the
delinquency
proceeding incurred such fees and expenses based on its best knowledge,
information
and belief, formed after reasonable inquiry indicating opposition was in the
best
interests
of the person, was well grounded in fact and was warranted by existing law or a
good
faith
argument for the extension, modification or reversal of existing law, and that
opposition was
not
pursued for any improper purpose, such as to harass or to cause unnecessary
delay or needless
increase
in the cost of the litigation.
(7)
Class 7. Surplus claims of any state or local government for a penalty or
forfeiture,
but only
to the extent of the pecuniary loss sustained from the act, transaction or
proceeding out
of which
the penalty or forfeiture arose with reasonable and actual costs occasioned
thereby. The
remainder
of such claims shall be postponed to the class of claims under subdivision 8.
(8)
Class 8. Surplus or contribution notes or similar obligations, premium refunds
on
assessable
policies, interest on claims of Classes 1 through 7 and any other claims
specifically
subordinated
to this class.
(9)
Class 9. Claims of shareholders or other owners arising out of their capacity
as
shareholders
or other owners, or any other capacity except as they may be qualified in Class
3 or
6 above.
(b)
If any claimant of this state, another state or foreign country shall be
entitled to or
shall
receive a dividend upon his or her claim out of a statutory deposit or the
proceeds of any
bond or
other asset located in another state or foreign country, unless such deposit or
proceeds
shall
have been delivered to the domiciliary liquidator, then the claimants shall not
be entitled to
any
further dividend from the receiver until and unless all other claimants of the
same class,
irrespective
of residence or place of the acts or contracts upon which their claims are
based, shall
have
received an equal dividend upon their claims, and after such equalization, such
claimants
shall be
entitled to share in the distribution of further dividends by the receiver,
along with and
like all
other creditors of the same class, wheresoever residing.
(c)
Upon the declaration of a dividend, the receiver shall apply the amount of the
dividend
against any indebtedness owed to the insurer by the person entitled to the
dividend.
There
shall be no claim allowed for any deductible charged by a guaranty association
or entity
performing
a similar function.
27-14.3-63.
Subordination of claims for noncooperation. -- If an ancillary receiver
in
another
state or foreign country, whether called by that name or not, fails to transfer
to the
domiciliary
liquidator in this state any assets within his or her control other than
special deposits,
diminished
only by the expenses of the ancillary receivership, if any, the claims filed in
the
ancillary
receivership other than special deposit claims or secured claims shall be
placed in the
class of
claims under § 27-14.3-46(8) 27-14.3-46(a)(8).
SECTION
81. Sections 27-18-64 and 27-18-66 of the General Laws in Chapter 27-18
entitled
"Accident and Sickness Insurance Policies" are hereby amended to read
as follows:
27-18-64.
Coverage for early intervention services. -- (a) Every individual or
group
hospital
or medical expense insurance policy or contract providing coverage for
dependent
children,
delivered or renewed in this state on or after the effective date of this
act [July 1, 2004],
shall
include coverage of early intervention services which coverage shall take
effect no later than
January
1, 2005. Such coverage shall be limited to a benefit of five thousand dollars
($5,000) per
dependent
child per policy or calendar year and shall not be subject to deductibles and
coinsurance
factors. Any amount paid by an insurer under this section for a dependent child
shall
not be
applied to any annual or lifetime maximum benefit contained in the policy or
contract. For
the
purpose of this section, “early intervention services” means, but is not
limited to, speech and
language
therapy, occupational therapy, physical therapy, evaluation, case management,
nutrition,
service
plan development and review, nursing services, and assistive technology
services and
devices
for dependents from birth to age three (3) who are certified by the department
of human
services
as eligible for services under part C of the Individuals with Disabilities
Education Act
(20
U.S.C. § 1471 et seq.).
(b)
Subject to the annual limits provided in this section, insurers shall reimburse
certified
early
intervention providers, who are designated as such by the Department of Human
Services,
for early
intervention services as defined in this section at rates of reimbursement
equal to or
greater
than the prevailing integrated state/Medicaid rate for early intervention
services as
established
by the Department of Human Services.
(c)
This section shall not apply to insurance coverage providing benefits for: (1)
hospital
confinement
indemnity; (2) disability income; (3) accident only; (4) long-term care; (5)
Medicare
supplement;
(6) limited benefit health; (7) specified disease indemnity; (8) sickness or
bodily
injury
or death by accident or both; and (9) other limited benefit policies.
27-18-66.
Tobacco cessation programs. -- (1) (a) Every individual
or group health
insurance
contract, plan or policy delivered, issued for delivery or renewed in this
state on or after
January
1, 2007, which provides medical coverage that includes coverage for physician
services
in a
physician's office, and every policy which provides major medical or similar
comprehensive-
type
coverage, shall include coverage for smoking cessation treatment, provided that
if such
medical
coverage does not include prescription drug coverage, such contract, plan or
policy shall
not be
required to include coverage for prescription nicotine replacement therapy.
(2)
(b) As used in this section, smoking cessation treatment includes the
use of an over-
the-counter
(OTC) or prescription US Food and Drug Administration (FDA) approved nicotine
replacement
therapy, when recommended and prescribed by a prescriber who holds prescriptive
privileges
in the state in which they are licensed, and used in combination with an annual
outpatient
benefit of eight (8) one-half (1/2) hour smoking cessation counseling sessions
provided
by a
qualified practitioner for each covered individual. Smoking cessation treatment
may be
further
defined through regulation promulgated by the health insurance commissioner.
(3)
(c) Health insurance contracts, plans, or policies to which this section
applies, may
impose
copayments and/or deductibles for the benefits mandated by this section
consistent with
the
contracts', plans' or policies' copayments and/or deductibles for physician
services and
medications.
Nothing contained in this section shall impact the reimbursement, medical
necessity
or
utilization review, managed care, or case management practices of these health
insurance
contracts,
plans or policies.
(4)
(d) This section shall not apply to insurance coverage providing
benefits for:
(a)
(1) Hospital confinement indemnity;
(b)
(2) Disability income;
(c)
(3) Accident only;
(d)
(4) Long-term care;
(e)
(5) Medicare supplement;
(f)
(6) Limited benefit health;
(g)
(7) Specified disease indemnity;
(h)
(8) Sickness or bodily injury or death by accident or both; and
(i) (9)
Other limited benefit policies.
SECTION
82. Section 27-18.5-8 of the General Laws in Chapter 27-18.5 entitled
"Individual
Health Insurance Coverage" is hereby amended to read as follows:
27-18.5-8.
Wellness health benefit plan. -- All carriers that offer health
insurance in the
individual
market shall actively market and offer the wellness health direct benefit plan
to eligible
individuals.
The wellness health direct benefit plan shall be determined by regulation
promulgated
by the office of the health insurance commissioner (OHIC). The OHIC shall
develop
the
criteria for the direct wellness health benefit plan, including, but not
limited to, benefit levels,
cost
sharing levels, exclusions and limitations in accordance with the following:
(a)
(1) Form and utilize an advisory committee in accordance with subsection
27-50-
10(5).
(b)
(2) Set a target for the average annualized individual premium rate for
the direct
wellness
health benefit plan to be less than ten percent (10%) of the average annual
statewide
wage,
dependent upon the availability of reinsurance funds, as reported by the Rhode
Island
department
of labor and training, in their report entitled “Quarterly Census of Rhode
Island
Employment
and Wages.” In the event that this report is no longer available, or the OHIC
determines
that it is no longer appropriate for the determination of maximum annualized
premium,
an alternative method shall be adopted in regulation by the OHIC. The maximum
annualized
individual premium rate shall be determined no later than August 1st of each
year, to
be
applied to the subsequent calendar year premiums rates.
(c)
(3) Ensure that the direct wellness health benefit plan creates
appropriate incentives
for
employers, providers, health plans and consumers to, among other things:
(1)
(i) Focus on primary care, prevention and wellness;
(2)
(ii) Actively manage the chronically ill population;
(3)
(iii) Use the least cost, most appropriate setting; and
(4)
(iv) Use evidence based, quality care.
(d)
(4) The plan shall be made available in accordance with title 27,
chapter 18.5 as
required
by regulation on or before May 1, 2007.
SECTION
83. Sections 27-19-46, 27-19-55 and 27-19-57 of the General Laws in Chapter
27-19
entitled "Nonprofit Hospital Service Corporations" are hereby amended
to read as follows:
27-19-46.
Magnetic resonance imaging - Quality assurance standards. -- (a) Except
as
otherwise provided in subsection (b) of this section, a magnetic resonance
imaging
examination
eligible for reimbursement under the provisions of any individual or group
health
insurance
contract, plan or policy delivered in this state shall be reimbursed only if
the facility at
which
the examination has been conducted and processed is accredited by either the
American
College
of Radiology (ACR), the Intersocietal Accreditation Commission (IAC) or an alternate
nationally
recognized accrediting organization whose accreditation standards are
substantially
similar
to and no less stringent than current or subsequent ACR or IAC standards and
have been
reviewed
and deemed adequate by the department of health. All accreditation standards
under this
section,
whether promulgated by the ACR, IAC, or an alternate nationally recognized
accrediting
organization,
shall include, but shall not be limited to, provisions for establishing the
qualifications
of the physician, standards for quality control and routine performance
monitoring
by a
medical physicist, qualifications of the technologist including minimum
standards of
supervised
clinical experience, personnel and patient safety guidelines, and standards for
initial
and
ongoing quality control using clinical image review and quantitative testing.
(b)
Any facility conducting and processing magnetic resonance imaging examinations
which,
as of June 30, 2006 is receiving reimbursement for such services by a health
insurer,
health
maintenance organization or health plan, but is not accredited pursuant to
subsection (a),
shall
file its application for accreditation within eighteen (18) months of the
effective date of this
section
[June 28, 2007]. Such
accreditation shall be obtained not later than twelve (12) months
after
submission of its application. A facility which begins conducting and
processing, of
magnetic
resonance imaging examinations after June 30, 2006 shall file its application
for
accreditation
within twelve (12) months of the date of initiation of the magnetic resonance
imaging
examinations. Such accreditation shall be obtained not later than twelve (12)
months
after
submission of its application. After such accreditation is obtained, a facility
conducting and
processing,
of magnetic resonance imaging examinations shall, at all times, maintain
accreditation
with the appropriate accrediting body. Notwithstanding anything herein to the
contrary,
any facility which has filed for accreditation pursuant to this subsection (b)
and which
has not
been refused accreditation or withdrawn its application, will be deemed
provisionally
accredited
for the twelve (12) month period dating from the application filing date.
Provided,
further,
that notwithstanding any provisions of the general or public laws to the
contrary, any
facility
conducting and processing magnetic resonance imaging examinations shall conform
to
the
standards of the appropriate accrediting body at all times, including during
the accreditation
process
and shall certify said conformance to any reimbursing health insurer, health
maintenance
organization
or health plan.
27-19-55.
Coverage for early intervention services. -- (a) Every individual or
group
hospital
or medical expense insurance policy or contract providing coverage for
dependent
children,
delivered or renewed in this state on or after the effective date of this
act [July 1, 2004],
shall
include coverage of early intervention services which coverage shall take
effect no later than
January
1, 2005. Such coverage shall be limited to a benefit of five thousand dollars
($5,000) per
dependent
child per policy or calendar year and shall not be subject to deductibles and
coinsurance
factors. Any amount paid by an insurer under this section for a dependent child
shall
not be
applied to any annual or lifetime maximum benefit contained in the policy or
contract. For
the
purpose of this section, “early intervention services” means, but is not
limited to, speech and
language
therapy, occupational therapy, physical therapy, evaluation, case management,
nutrition,
service
plan development and review, nursing services, and assistive technology
services and
devices
for dependents from birth to age three (3) who are certified by the department
of human
services
as eligible for services under part C of the Individuals with Disabilities
Education Act
(20
U.S.C. § 1471 et seq.).
(b)
Subject to the annual limits provided in this section, insurers shall reimburse
certified
early
intervention providers, who are designated as such by the Department of Human
Services,
for
early intervention services as defined in this section at rates of
reimbursement equal to or
greater
than the prevailing integrated state/Medicaid rate for early intervention
services as
established
by the Department of Human Services.
(c)
This section shall not apply to insurance coverage providing benefits for: (1)
hospital
confinement
indemnity; (2) disability income; (3) accident only; (4) long-term care; (5)
Medicare
supplement;
(6) limited benefit health; (7) specified disease indemnity; (8) sickness or
bodily
injury
or death by accident or both; and (9) other limited benefit policies.
27-19-57.
Tobacco cessation programs. -- (1) (a) Every individual
or group health
insurance
contract, plan or policy delivered, issued for delivery or renewed in this
state on or after
January
1, 2007, which provides medical coverage that includes coverage for physician
services
in a
physician's office, and every policy which provides major medical or similar
comprehensive-
type
coverage, shall include coverage for smoking cessation treatment, provided that
if such
medical
coverage does not include prescription drug coverage, such contract, plan or
policy shall
not be
required to include coverage for prescription nicotine replacement therapy.
(2)
(b) As used in this section, smoking cessation treatment includes the
use of an over-
the-counter
(OTC) or prescription US Food and Drug Administration (FDA) approved nicotine
replacement
therapy, when recommended and prescribed by a prescriber who holds prescriptive
privileges
in the state in which they are licensed, and used in combination with an annual
outpatient
benefit of eight (8) one-half (1/2) hour smoking cessation counseling sessions
provided
by a
qualified practitioner for each covered individual. Smoking cessation treatment
may be
further
defined through regulation promulgated by the health insurance commissioner.
(3)
(c) Health insurance contracts, plans, or policies to which this section
applies, may
impose
copayments and/or deductibles for the benefits mandated by this section
consistent with
the
contracts', plans' or policies' copayments and/or deductibles for physician
services and
medications.
Nothing contained in this section shall impact the reimbursement, medical
necessity
or
utilization review, managed care, or case management practices of these health
insurance
contracts,
plans or policies.
(4)
(d) This section shall not apply to insurance coverage providing
benefits for:
(a)
(1) Hospital confinement indemnity;
(b)
(2) Disability income;
(c)
(3) Accident only;
(d)
(4) Long-term care;
(e)
(5) Medicare supplement;
(f)
(6) Limited benefit health;
(g)
(7) Specified disease indemnity;
(h)
(8) Sickness or bodily injury or death by accident or both; and
(i) (9)
Other limited benefit policies.
SECTION
84. Section 27-19.2-6 of the General Laws in Chapter 27-19.2 entitled
"Nonprofit
Hospital and Medical Service Corporations" is hereby amended to read as
follows:
27-19.2-6.
Actions requiring supermajority board approval. -- Neither a nonprofit
hospital
service corporation, nor an affiliate (as defined in § 42-14.5-1 27-19.2-2(a))
that is an
insurer
(as defined in § 27-20.6-1(1)), may take any of the following actions without
the prior
approval
of at least two-thirds percent (66.67%) of the corporations corporation’s
entire board of
directors:
(1)
Authorize a conversion as defined in § 27-66-4(3);
(2)
Withdraw a health insurance product previously offered in the individual
market; or
(3)
Result in the withdrawal from a geographic region.
SECTION
85. Sections 27-20-41, 27-20-50 and 27-20-53 of the General Laws in Chapter
27-19.2
entitled "Nonprofit Medical Service Corporations" are hereby amended
to read as
follows:
27-20-41.
Magnetic resonance imaging - Quality assurance standards. -- (a) Except
as
otherwise provided in subsection (b) of this section, a magnetic resonance
imaging
examination
eligible for reimbursement under the provisions of any individual or group
health
insurance
contract, plan or policy delivered in this state shall be reimbursed only if
the facility at
which
the examination has been conducted and processed is accredited by either the
American
College
of Radiology (ACR), the Intersocietal Accreditation Commission (IAC) or an
alternate
nationally
recognized accrediting organization whose accreditation standards are
substantially
similar
to and no less stringent than current or subsequent ACR or IAC standards and
have been
reviewed
and deemed adequate by the department of health. All accreditation standards
under this
section,
whether promulgated by the ACR, IAC, or an alternate nationally recognized
accrediting
organization,
shall include, but shall not be limited to, provisions for establishing the
qualifications
of the physician, standards for quality control and routine performance
monitoring
by a
medical physicist, qualifications of the technologist including minimum
standards of
supervised
clinical experience, personnel and patient safety guidelines, and standards for
initial
and
ongoing quality control using clinical image review and quantitative testing.
(b)
Any facility conducting and processing magnetic resonance imaging examinations
which,
as of June 30, 2006 is receiving reimbursement for such services by a health
insurer,
health
maintenance organization or health plan, but is not accredited pursuant to
subsection (a),
shall
file its application for accreditation within eighteen (18) months of the
effective date of this
section
[June 28, 2007]. Such
accreditation shall be obtained not later than twelve (12) months
after
submission of its application. A facility which begins conducting and
processing, of
magnetic
resonance imaging examinations after June 30, 2006 shall file its application
for
accreditation
within twelve (12) months of the date of initiation of the magnetic resonance
imaging
examinations. Such accreditation shall be obtained not later than twelve (12)
months
after
submission of its application. After such accreditation is obtained, a facility
conducting and
processing,
magnetic resonance imaging examinations shall, at all times, maintain
accreditation
with the
appropriate accrediting body. Notwithstanding anything herein to the contrary,
any
facility
which has filed for accreditation pursuant to this subsection (b) and which has
not been
refused
accreditation or withdrawn its application, will be deemed provisionally
accredited for the
twelve
(12) month period dating from the application filing date. Provided, further,
that
notwithstanding
any provisions of the general or public laws to the contrary, any facility
conducting
and processing magnetic resonance imaging examinations shall conform to the
standards
of the appropriate accrediting body at all times, including during the
accreditation
process
and shall certify said conformance to any reimbursing health insurer, health
maintenance
organization
or health plan.
27-20-50.
Coverage for early intervention services. -- (a) Every individual or
group
hospital
or medical expense insurance policy or contract providing coverage for
dependent
children,
delivered or renewed in this state on or after the effective date of this
act [July 1, 2004],
shall
include coverage of early intervention services which coverage shall take
effect no later than
January
1, 2005. Such coverage shall be limited to a benefit of five thousand dollars
($5,000) per
dependent
child per policy or calendar year and shall not be subject to deductibles and
coinsurance
factors. Any amount paid by an insurer under this section for a dependent child
shall
not be
applied to any annual or lifetime maximum benefit contained in the policy or
contract. For
the
purpose of this section, “early intervention services” means, but is not
limited to, speech and
language
therapy, occupational therapy, physical therapy, evaluation, case management,
nutrition,
service
plan development and review, nursing services, and assistive technology
services and
devices
for dependents from birth to age three (3) who are certified by the department
of human
services
as eligible for services under part C of the Individuals with Disabilities
Education Act
(20
U.S.C. § 1471 et seq.).
(b)
Subject to the annual limits provided in this section, insurers shall reimburse
certified
early
intervention providers, who are designated as such by the Department of Human
Services,
for
early intervention services as defined in this section at rates of
reimbursement equal to or
greater
than the prevailing integrated state/Medicaid rate for early intervention
services as
established
by the Department of Human Services.
(c)
This section shall not apply to insurance coverage providing benefits for: (1)
hospital
confinement
indemnity; (2) disability income; (3) accident only; (4) long-term care; (5)
Medicare
supplement;
(6) limited benefit health; (7) specified disease indemnity; (8) sickness or
bodily
injury
or death by accident or both; and (9) other limited benefit policies.
27-20-53.
Tobacco cessation programs. -- (1) (a) Every individual
or group health
insurance
contract, plan or policy delivered, issued for delivery or renewed in this
state on or after
January
1, 2007, which provides medical coverage that includes coverage for physician
services
in a
physician's office, and every policy which provides major medical or similar
comprehensive-
type
coverage, shall include coverage for smoking cessation treatment, provided that
if such
medical
coverage does not include prescription drug coverage, such contract, plan or
policy shall
not be
required to include coverage for prescription nicotine replacement therapy.
(2)
(b) As used in this section, smoking cessation treatment includes the
use of an over-
the-counter
(OTC) or prescription US Food and Drug Administration (FDA) approved nicotine
replacement
therapy, when recommended and prescribed by a prescriber who holds prescriptive
privileges
in the state in which they are licensed, and used in combination with an annual
outpatient
benefit of eight (8) one-half (1/2) hour smoking cessation counseling sessions
provided
by a
qualified practitioner for each covered individual. Smoking cessation treatment
may be
further
defined through regulation promulgated by the health insurance commissioner.
(3)
(c) Health insurance contracts, plans, or policies to which this section
applies, may
impose
copayments and/or deductibles for the benefits mandated by this section
consistent with
the
contracts', plans' or policies' copayments and/or deductibles for physician
services and
medications.
Nothing contained in this section shall impact the reimbursement, medical
necessity
or
utilization review, managed care, or case management practices of these health
insurance
contracts,
plans or policies.
(4)
(d) This section shall not apply to insurance coverage providing
benefits for:
(a)
(1) Hospital confinement indemnity;
(b)
(2) Disability income;
(c)
(3) Accident only;
(d)
(4) Long-term care;
(e)
(5) Medicare supplement;
(f)
(6) Limited benefit health;
(g)
(7) Specified disease indemnity;
(h)
(8) Sickness or bodily injury or death by accident or both; and
(i) (9)
Other limited benefit policies.
SECTION
86. Section 27-20.8-1 of the General Laws in Chapter 27-20.8 entitled
"Prescription
Drug Benefits" is hereby amended to read as follows:
27-20.8-1.
Definitions. -- For the purposes of this chapter, the following terms
shall
mean:
(a)
(1) “Director” shall mean the director of the department of business
regulation.
(b)
(2) “Health plan” shall mean an insurance carrier as defined in chapters
18, 19, 20 and
41 of
this title.
(c)
(3) “Insured” shall mean any person who is entitled to have pharmacy
services paid
by a
health plan pursuant to a policy, certificate, contract or agreement of
insurance or coverage
including
those administered for the health plan under a contract with a third-party
administrator
that
manages pharmacy benefits or pharmacy network contracts.
SECTION
87. Section 27-20.9-1 of the General Laws in Chapter 27-20.9 entitled
"Contract
with Health Care Providers" is hereby amended to read as follows:
27-20.9-1.
Health care contracts - Required provisions - Definitions. -- (a) On
and
after
January 1, 2008, a health insurer that contracts with a health care provider
shall comply with
the
provisions of this chapter and shall include the provisions required by this
chapter in the
health
care contract. A contract in existence prior to January 1, 2008, that is
renewed or renews
by its
terms shall comply with the provisions of this chapter no later than December
31, 2008.
(b)
As used in this chapter, unless the context otherwise requires:
(i)
(1) “Health care contract” means a contract entered into or renewed
between a health
insurer
and a health care provider for the delivery of health care services to others.
(ii)
(2) “Health care provider” means a person licensed or certified in this
state to practice
medicine,
pharmacy, chiropractic, nursing, physical therapy, podiatry, dentistry,
optometry,
occupational
therapy, or other healing arts.
(iii)
(3) “Health insurer” means every nonprofit medical service corporation,
hospital
service
corporation, health maintenance organization, or other insurer offering and/or
insuring
health
services; the term shall in addition include any entity defined as an insurer
under § 42-62-4
and any
third-party administrator when interacting with health care providers and
enrollees on
behalf
of such an insurer.
SECTION
88. Section 27-29-17.1 of the General Laws in Chapter 27-29 entitled
"Unfair
Competition
and Practices" is hereby amended to read as follows:
27-29-17.1.
Definitions. -- For the purpose of §§ 27-29-17 — 27-29-17.4:
(1)
“Commissioner” means the commissioner of insurance.
(2)
“Expiration date” means the date upon which coverage under a policy ends. It
also
means,
for a policy written for a term longer than one year or with no fixed
expiration date, each
annual
anniversary date of such policy.
(3)
“Nonrenewal” means termination of a policy at its expiration date.
(a)
(4) “Renewal” or “to renew” means the issuance of or the offer by an
insurer to issue
a policy
succeeding a policy previously issued and delivered by the same insurer or an
insurer
within
the same group of insurers, or the issuance of a certificate or notice
extending the term of
an existing
policy for a specified period beyond its expiration date.
(b)
“Expiration date” means the date upon which coverage under a policy ends. It
also
means,
for a policy written for a term longer than one year or with no fixed
expiration date, each
annual
anniversary date of such policy.
(c)
“Nonrenewal” means termination of a policy at its expiration date.
(d)
“Commissioner” means the commissioner of insurance.
SECTION
89. Sections 27-29.1-1 and 27-29.1-5 of the General Laws in Chapter 27-29.1
entitled
"Pharmacy Freedom of Choice – Fair Competition and Practices" are
hereby amended to
read as
follows:
27-29.1-1.
Definitions. -- For purposes of this chapter, the following terms shall
mean:
(a)
(1) “Director” shall mean the director of the department of business
regulation.
(b)
(2) “Eligible bidder” shall mean a retail pharmacy, community pharmacy
or pharmacy
department
registered pursuant to chapter 19 of title 5, irrespective of corporate
structure or
number
of locations at which it conducts business, located within the geographical
service area of
a
carrier and willing to bid for participation in a restricted pharmacy network
contract.
(c)
(3) “Insurer” shall mean an insurance carrier as defined in chapters 18,
19, 20 and 41
of title
27.
(d)
(4) “Insured” shall mean any person who is entitled to have pharmacy
services paid
by an
insurer pursuant to a policy, certificate, contract or agreement of insurance
or coverage.
(e)
(5) “Non-restricted pharmacy network” shall mean a network that permits
any
pharmacy
to participate on substantially uniform terms and conditions established by an
insurer
or
pharmacy benefits manager.
(f)
(6) “Pharmacy benefits manager” shall mean any person or entity that is
not licensed
in Rhode
Island as an insurer and that develops or manages pharmacy benefits, pharmacy
network
contracts, or the pharmacy benefit bid process.
(g)
(7) “Restricted pharmacy network” shall mean an arrangement for the
provision of
pharmaceutical
drug services to insureds which under the terms of an insurer's policy,
certificate,
contract
or agreement of insurance or coverage requires an insured or creates a
financial incentive
for an
insured to obtain prescription drug services from one or more participating
pharmacies that
have
entered into a specific contractual relationship with the carrier.
27-29.1-5.
Participation of independent community pharmacies. -- (a) Any
pharmacies
licensed in the state of Rhode Island that are not owned or controlled,
directly or
indirectly
by an entity that owns pharmacies licensed in two (2) or more jurisdictions
other than
Rhode
Island, which are not participating in an insurer's restricted pharmacy network
contract
shall
nevertheless have the right to provide prescription drug services to the
insurer's insureds and
be paid
by the insurer as if the pharmacy were participating in the insurer's
restricted pharmacy
network,
provided that such non-network independent pharmacies agree:
(1)
To accept as the insurer's payments in full the price required of pharmacies in
the
insurer's
restricted pharmacy network;
(2)
To bill to the insured up to and not in excess of any copayment, coinsurance,
deductible,
other amount required of an insured by the insurer, or for other uncovered
services;
(3)
To be reimbursed on the same methodological basis, including, but not limited
to,
capitation
or other risk-sharing methodology, as required of pharmacies, in the insurer's
restricted
pharmacy
network;
(4)
To participate in the insurer's utilization review and quality assurance
programs,
including
utilization and drug management reports as required of pharmacies in the
carrier's
restricted
pharmacy network;
(5)
To provide computerized online eligibility determinations and claims
submissions as
required
of pharmacies in the insurer's restricted pharmacy network;
(6)
To participate in the insurer's satisfaction surveys and complaint resolution
programs
for its
insureds;
(7)
To protect the insurer's proprietary information and an insured's
confidentiality and
privacy;
(8)
To abide by the insurer's performance standards with respect to waiting times,
fill
rates
and inventory management, including formulary restrictions;
(9)
To comply with the insurer's claims audit provisions; and
(10)
To certify, using audit results or accountant statements, the fiscal soundness
of the
non-network
pharmacy.
(b)
An insurer may waive any of the aforementioned agreements in arranging for the
provision
of pharmaceutical drug benefits to insureds through a non-network pharmacy. An
insurer
shall not impose any agreements, terms or conditions on any non-network
independent
community
pharmacy, or on any association of pharmacies, which are more restrictive than
those
required
of pharmacies in the insurer's restricted pharmacy network. The failure of a
non-network
pharmacy
to abide by the aforementioned agreements may, at the option of the insurer,
serve as
the
basis for cancellation of the non-network pharmacy's participation.
SECTION
90. Section 27-29.2-2 of the General Laws in Chapter 27-29.2 entitled
"Freedom
of Choice for Orthotic or Prosthetic Services" is hereby amended to read as
follows:
27-29.2-2.
Definitions. -- As used in this chapter:
(a)
(1) “Orthosis” means a custom fabricated brace or support that is
designed based on
medical
necessity. “Orthosis” does not include prefabricated or direct-formed orthotic
devices, or
any of
the following assistive technology devices: Commercially available knee
orthoses used
following
injury or surgery; spastic muscle-tone inhibiting orthoses; upper extremity
adaptive
equipment;
finger splints; hand splints; wrists gauntlets; face masks used following
burns;
wheelchair
seating that is an integral part of the wheelchair and not worn by the patient
independent
of the wheelchair; fabric or elastic supports; corsets; low-temperature formed
plastic
splints;
trusses; elastic hose; canes; crutches; cervical collars; dental appliances;
and other similar
devises
as determined by the director of the department of business regulation such as
those
commonly
carried in stock by a pharmacy, department store, corset shop, or surgical
supply
facility.
(b)
(2) “Orthotics” means the science and practice of evaluating, measuring,
designing,
fabricating,
assembling, fitting, adjusting or servicing, as well as providing the initial
training
necessary
to accomplish the fitting of an orthosis for the support, correction, or
alleviation of
neuromuscular
or musculoskeletal dysfunction, disease, injury or deformity. The practice of
orthotics
encompasses evaluation, treatment and consultation with basic observational
gait and
postural
analysis. Orthotists assess and design orthoses to maximize function and
provide not
only the
support but the alignment necessary to either prevent or correct deformity or
to improve
the
safety and efficiency of mobility or locomotion, or both. Orthotic practice
includes, providing
continuing
patient care in order to assess its effect on the patient's tissues and to
assure proper fit
and
function of the orthotic device by periodic evaluation.
(c)
(3) “Prosthesis” means an artificial limb that is alignable or, in lower
extremity
applications,
capable of weight bearing. Prosthesis means an artificial medical device that
is not
surgically
implanted and that is used to replace a missing limb, appendage, or other
external
human
body part including an artificial limb, hand, or foot. The term does not
include artificial
eyes,
ears, noses, dental appliances, osotmy products, or devices such as eyelashes
or wigs.
(d)
(4) “Prosthetics” means the science and practice of evaluating,
measuring, designing,
fabricating,
assembling, fitting, aligning, adjusting or servicing, as well as providing the
initial
training
necessary to accomplish the fitting of a prosthesis through the replacement of
external
parts of
a human body lost due to amputation or congenital deformities or absences. The
practice
of
prosthetics also includes the generation of an image, form, or mold that
replicates the patient's
body or
body segment and that requires rectification of dimensions, contours and
volumes for use
in the
design and fabrication of a socket to accept a residual anatomic limb to, in
turn, create an
artificial
appendage that is designed either to support body weight or to improve or
restore
function
or cosmesis, or both. Involved in the practice of prosthetics is observational
gait analysis
and
clinical assessment of the requirements necessary to refine and mechanically
fix the relative
position
of various parts of the prosthesis to maximize function, stability, and safety
of the
patient.
The practice of prosthetics includes providing and continuing patient care in
order to
assess
the prosthetic device's effect on the patient's tissues and to assure proper
fit and function of
the
prosthetic device by periodic evaluation.
SECTION
91. Section 27-34.2-21 of the General Laws in Chapter 27-34.2 entitled
"Long
Term
Care Insurance" is hereby amended to read as follows:
27-34.2-21.
Producer training requirements. -- (a) On or after January 1, 2008, an
individual
may not sell, solicit or negotiate long-term care insurance unless the
individual is
licensed
as an insurance producer for accident and health or sickness or life and has
completed a
one-time
training course. The training shall meet the requirements set forth in this
section.
(b)
An individual already licensed and selling, soliciting or negotiating long-term
care
insurance
on the effective date of this act [July 3, 2007] may not continue
to sell, solicit or
negotiate
long-term care insurance unless the individual has completed a one-time
training course
as set
forth in the section, within one year from the effective date of this act [July
3, 2007].
(c)
In addition to the one-time training course required in this section, an
individual who
sells,
solicits or negotiates long-term care insurance shall complete ongoing training
as set forth
in this
section.
(d)
The training requirements of this section may be approved as continuing
education
courses.
(e)
The one-time training required by this section shall be no less than eight (8)
hours
and the
ongoing training required by this section shall be no less than four (4) hours
every
twenty-four
(24) months.
(f)
The training required under paragraph (a) shall consist of topics related to
long-term
care
insurance, long-term care services and, if applicable, qualified state
long-term care
insurance.
Partnership programs, including, but not limited to:
(1)
State and federal regulations and requirements and the relationship between
qualified
state
long-term care insurance partnership programs and other public and private
coverage of
long-term
services, including Medicaid;
(2)
Available long-term care services and providers;
(3)
Changes or improvements in long-term care services or providers;
(4)
Alternatives to the purchase of private long-term care insurance;
(5)
The effect of inflation on benefits and the importance of inflation protection;
and
(6)
Consumer suitability standards and guidelines.
(g)
The training required by this section shall not include training that is
insurer or
company
product specific or that includes any sales or marketing information,
materials, or
training,
other than those required by state or federal law.
(h)
Insurers subject to this act shall obtain verification that a producer receives
training
required
by this section before a producer is permitted to sell, solicit or negotiate
the insurer's
long-term
care insurance products, maintain records subject to the state's record
retention
requirements,
and make that verification available to the commissioner upon request.
(i)
Insurers subject to this act shall maintain records with respect to the
training of its
producers
concerning the distribution of its partnership policies that will allow the
state insurance
department
to provide assurance to the state Medicaid agency that producers have received
the
training
contained in this section and that producers have demonstrated an understanding
of the
partnership
policies and their relationship to public and private coverage of long-term
care,
including
Medicaid, in this state. These records shall be maintained in accordance with
the state's
record
retention requirements and shall be made available to the commissioner upon
request.
(j)
The satisfaction of these training requirements in any state shall be deemed to
satisfy
the
training requirements in this state.
SECTION
92. Sections 27-34.3-6 and 27-34.3-7 of the General Laws in Chapter 27-34.3
entitled
"Rhode Island Life and Health Insurance Guaranty Association Act" are
hereby amended
to read
as follows:
27-34.3-6.
Creation of the association. -- (a) There is created a nonprofit legal
entity to
be known
as the Rhode Island life and health insurance guaranty association. All member
insurers
shall be
and remain members of the association as a condition of their authority to
transact
insurance
in this state. The association shall perform its functions under the plan of
operation
established
and approved under § 27-34.3-10, or as previously established and approved
under §
27-34.1-11
[Repealed.] and shall exercise its powers through a board of directors
established
under §
27-34.3-7 or as previously established under § 27-34.1-8 [Repealed.].
For purposes of
administration
and assessment, the association shall maintain two (2) accounts:
(1)
The life insurance and annuity account which includes the following
subaccounts:
(i)
Life insurance account;
(ii)
Annuity account; which shall include annuity contracts owned by a governmental
retirement
plan (or its trustee) established under section 401, 403(b) or 457 of the
United States
Internal
Revenue Code, 26 U.S.C. section 401, 403(b) or 457, but shall otherwise exclude
unallocated
annuities; and
(iii)
Unallocated annuity account which shall exclude contracts owned by a
governmental
retirement
benefit plan (or its trustee) established under § 401, 403(b) or 457 of the
United States
Internal
Revenue Code, 26 U.S.C. § 401, 403(b) or 457.
(2)
The health insurance account.
(b)
The association shall come under the immediate supervision of the commissioner
and
shall be
subject to the applicable provisions of the insurance laws of this state.
Meetings or
records
of the association may be open to the public upon majority vote of the board of
directors.
27-34.3-7.
Board of directors. -- (a) The board of directors of the association
shall
consist
of not less than five (5) nor more than nine (9) member insurers serving terms
as
established
in the plan of operation. The insurer members of the board shall be selected by
member insurers
subject to the approval of the commissioner. The board of directors, previously
established
under § 27-34.1-8 [Repealed.], shall continue to operate in accordance
with the
provision
of this section. Vacancies on the board shall be filled for the remaining
period of the
term by
a majority vote of the remaining board members, subject to the approval of the
commissioner.
(b)
In approving selections to the board, the commissioner shall consider, among
other
things,
whether all member insurers are fairly represented.
(c)
Members of the board may be reimbursed from the assets of the association for
expenses
incurred by them as members of the board of directors but members of the board
shall
not be
compensated by the association for their services.
SECTION
93. Section 27-38.2-3 of the General Laws in Chapter 27-38.2 entitled
"Insurance
Coverage for Mental Illness and Substance Abuse" is hereby amended to read
as
follows:
27-38.2-3.
Medical necessity and appropriateness of treatment. -- (a) Upon request
of
the
reimbursing health insurers, all providers of treatment of mental illness shall
furnish medical
records
or other necessary data which substantiates that initial or continued treatment
is at all
times
medically necessary and appropriate. When the provider cannot establish the
medical
necessity
and/or appropriateness of the treatment modality being provided, neither the
health
insurer
nor the patient shall be obligated to reimburse for that period or type of care
that was not
established.
The exception to the preceding can only be made if the patient has been
informed of
the
provisions of this subsection and has agreed in writing to continue to receive
treatment at his
or her
own expense.
(b)
The health insurers, when making the determination of medically necessary and
appropriate
treatment, must do so in a manner consistent with that used to make the
determination
for the
treatment of other diseases or injuries covered under the health insurance
policy or
agreement.
(b)
(c) Any subscriber who is aggrieved by a denial of benefits provided
under this
chapter
may appeal a denial in accordance with the rules and regulations promulgated by
the
department
of health pursuant to chapter 17.12 of title 23.
SECTION
94. Sections 27-41-56, 27-41-68 and 27-41-70 of the General Laws in Chapter
27-41
entitled "Health Maintenance Organizations" are hereby amended to
read as follows:
27-41-56.
Magnetic resonance imaging - Quality assurance standards. -- (a) Except
as
otherwise provided in subsection (b) of this section, a magnetic resonance
imaging
examination
eligible for reimbursement under the provisions of any individual or group
health
insurance
contract, plan or policy delivered in this state shall be reimbursed only if
the facility at
which
the examination has been conducted and processed is accredited by either the
American
College
of Radiology (ACR), the Intersocietal Accreditation Commission (IAC) or an
alternate
nationally
recognized accrediting organization whose accreditation standards are
substantially
similar
to and no less stringent than current or subsequent ACR or IAC standards and
have been
reviewed
and deemed adequate by the department of health. All accreditation standards
under this
section,
whether promulgated by the ACR, IAC, or an alternate nationally recognized
accrediting
organization,
shall include, but shall not be limited to, provisions for establishing the
qualifications
of the physician, standards for quality control and routine performance
monitoring
by a
medical physicist, qualifications of the technologist including minimum
standards of
supervised
clinical experience, personnel and patient safety guidelines, and standards for
initial
and
ongoing quality control using clinical image review and quantitative testing.
(b)
Any facility conducting and processing magnetic resonance imaging examinations
which,
as of June 30, 2006 is receiving reimbursement for such services by a health
insurer,
health
maintenance organization or health plan, but is not accredited pursuant to
subsection (a),
shall
file its application for accreditation within eighteen (18) months of the effective
date of this
section
[June 28, 2007]. Such
accreditation shall be obtained not later than twelve (12) months
after
submission of its application. A facility which begins conducting and
processing, of
magnetic
resonance imaging examinations after June 30, 2006 shall file its application
for
accreditation
within twelve (12) months of the date of initiation of the magnetic resonance
imaging
examinations. Such accreditation shall be obtained not later than twelve (12)
months
after
submission of its application. After such accreditation is obtained, a facility
conducting and
processing,
magnetic resonance imaging examinations shall, at all times, maintain
accreditation
with the
appropriate accrediting body. Notwithstanding anything herein to the contrary,
any
facility
which has filed for accreditation pursuant to this subsection (b) and which has
not been
refused
accreditation or withdrawn its application, will be deemed provisionally
accredited for the
twelve
(12) month period dating from the application filing date. Provided, further,
that
notwithstanding
any provisions of the general or public laws to the contrary, any facility
conducting
and processing magnetic resonance imaging examinations shall conform to the
standards
of the appropriate accrediting body at all times, including during the accreditation
process
and shall certify said conformance to any reimbursing health insurer, health
maintenance
organization
or health plan.
27-41-68.
Coverage for early intervention services. -- (a) Every individual or
group
hospital
or medical expense insurance policy or contract providing coverage for
dependent
children,
delivered or renewed in this state on or after the effective date of this
act [July 1, 2004],
shall
include coverage of early intervention services which coverage shall take
effect no later than
January
1, 2005. Such coverage shall be limited to a benefit of five thousand dollars
($5,000) per
dependent
child per policy or calendar year and shall not be subject to deductibles and
coinsurance
factors. Any amount paid by an insurer under this section for a dependent child
shall
not be
applied to any annual or lifetime maximum benefit contained in the policy or
contract. For
the
purpose of this section, “early intervention services” means, but is not
limited to, speech and
language
therapy, occupational therapy, physical therapy, evaluation, case management,
nutrition,
service
plan development and review, nursing services, and assistive technology
services and
devices
for dependents from birth to age three (3) who are certified by the department
of human
services
as eligible for services under part C of the Individuals with Disabilities
Education Act
(20
U.S.C. § 1471 et seq.).
(b)
Subject to the annual limits provided in this section, insurers shall reimburse
certified
early
intervention providers, who are designated as such by the Department of Human
Services,
for
early intervention services as defined in this section at rates of
reimbursement equal to or
greater
than the prevailing integrated state/Medicaid rate for early intervention
services as
established
by the Department of Human Services.
(c)
This section shall not apply to insurance coverage providing benefits for: (1)
hospital
confinement
indemnity; (2) disability income; (3) accident only; (4) long-term care; (5)
Medicare
supplement;
(6) limited benefit health; (7) specified disease indemnity; (8) sickness or
bodily
injury
or death by accident or both; and (9) other limited benefit policies.
27-41-70.
Tobacco cessation programs. -- (1) (a) Every individual
or group health
insurance
contract, plan or policy delivered, issued for delivery or renewed in this
state on or after
January
1, 2007, which provides medical coverage that includes coverage for physician
services
in a
physician's office, and every policy which provides major medical or similar
comprehensive-
type
coverage, shall include coverage for smoking cessation treatment, provided that
if such
medical
coverage does not include prescription drug coverage, such contract, plan or
policy shall
not be
required to include coverage for prescription nicotine replacement therapy.
(2)
(b) As used in this section, smoking cessation treatment includes the
use of an over-
the-counter
(OTC) or prescription US Food and Drug Administration (FDA) approved nicotine
replacement
therapy, when recommended and prescribed by a prescriber who holds prescriptive
privileges
in the state in which they are licensed, and used in combination with an annual
outpatient
benefit of eight (8) one-half (1/2) hour smoking cessation counseling sessions
provided
by a
qualified practitioner for each covered individual. Smoking cessation treatment
may be
further
defined through regulation promulgated by the health insurance commissioner.
(3)
(c) Health insurance contracts, plans, or policies to which this section
applies, may
impose
copayments and/or deductibles for the benefits mandated by this section
consistent with
the
contracts', plans' or policies' copayments and/or deductibles for physician
services and
medications.
Nothing contained in this section shall impact the reimbursement, medical
necessity
or
utilization review, managed care, or case management practices of these health
insurance
contracts,
plans or policies.
(4)
(d) This section shall not apply to insurance coverage providing
benefits for:
(a)
(1) Hospital confinement indemnity;
(b)
(2) Disability income;
(c)
(3) Accident only;
(d)
(4) Long-term care;
(e)
(5) Medicare supplement;
(f)
(6) Limited benefit health;
(g)
(7) Specified disease indemnity;
(h)
(8) Sickness or bodily injury or death by accident or both; and
(i)
(9) Other limited benefit policies.
SECTION
95. Section 27-49-3.1 of the General Laws in Chapter 27-49 entitled "Motor
Vehicle
Theft and Motor Vehicle Insurance Fraud Reporting – Immunity Act" is
hereby amended
to read
as follows:
27-49-3.1.
Disclosure of personal information obtained in connection with motor
vehicle
records. -- (a) Purpose. The purpose of this section is to
implement the federal Driver's
Privacy
Protection Act of 1994 (“DPPA”), 18 U.S.C. § 2721 et seq..
(b)
Definitions. As defined in 18 U.S.C. § 2725, the following definitions apply to
this
section:
(1)
“Motor vehicle record” means any record that pertains to a motor vehicle
operator's
permit,
motor vehicle title, motor vehicle registration, or identification card issued
by the
department
of motor vehicles;
(2)
“Person” means an individual, organization, or entity, but does not include a
state or
agency
of a state; and
(3)
“Personal information” means information that identifies an individual,
including an
individual's
photograph, social security number, driver identification number, name, address
(but
not the
5 digit zip code), telephone number, and medical or disability information, but
does not
include
information on vehicular accidents, driving violations, and driver's status.
(c)
Prohibition on release and use of certain personal information from state motor
vehicle
records.
(1)
In general. Except as provided in subdivision (2) of this section, the division
of motor
vehicles,
and any officer, employee, or contractor of the division, shall not knowingly
disclose or
make
available to any person or entity personal information about any individual
obtained by the
division
in connection with a motor vehicle record.
(2)
Permissible uses. Personal information referred to in subdivision (1) of this
section
shall be
disclosed for use in connection with matters of motor vehicle or driver safety
and theft,
motor
vehicle emissions, motor vehicle product alterations, recalls, or advisories,
performance
monitoring
of motor vehicles and dealers by motor vehicle manufacturers, and removal of
nonowner
records from the original owner records of motor vehicles manufacturers to
carry out
the
purposes of the Automobile Information Disclosure Act, 15 U.S.C. § 1231 et
seq., the Motor
Vehicle
Information and Cost Saving Act (see now 49 U.S.C. § 32101 et seq.), the
National
Traffic
and Motor Vehicle Safety Act of 1966 (see now 49 U.S.C. § 30101 et seq.), and
Anti-Car
Theft
Act of 1992 (see now 49 U.S.C. § 32101 et seq.), and the Clean Air Act, 42
U.S.C. § 7401
et seq.,
and may be disclosed as follows:
(i)
For use by any government agency, including any court or law enforcement
agency, in
carrying
out its functions, or any private person or entity acting on behalf of a
federal, state, or
local
agency in carrying out its functions.
(ii)
use in connection with matters of motor vehicle or driver safety and theft;
motor
vehicle
emissions; motor vehicle product alterations, recalls or advisories;
performance
monitoring
of motor vehicles, motor vehicle parts and dealers; motor vehicle market
research
activities,
including survey research; and removal of nonowner records from the original
owner
records
of motor vehicle manufacturers.
(iii)
For use in the normal course of business by a legitimate business or its
agents,
employees,
or contractors, but only:
(A)
To verify the accuracy of personal information submitted by the individual to
the
business
of its agents, employees, or contractors, and
(B)
If the information as submitted is not correct or is no longer correct, to
obtain the
correct
information, but only for the purposes of preventing fraud by pursuing legal
remedies
against,
or recovering on a debt or security interest against, the individual.
(iv)
For use in connection with any civil, criminal, administrative, or arbitral
proceeding
in any
federal, state, or local agency or before any self-regulatory body, including
the service of
process,
investigation in anticipation of litigation, and the execution or enforcement
of judgments
and
orders, or pursuant to an order of a federal, state, or local court.
(v)
For use in research activities, and for use in producing statistical reports,
so long as
the
personal information is not published, redisclosed, or used to contact the
individuals.
(vi)
For use by any insurer or insurance support organization, or by a self-insured
entity,
or its
agents, employees, or contractors in connection with claims investigation
activities, anti-
fraud
activities, rating or underwriting.
(vii)
For use in providing notice to the owners of towed or impounded vehicles.
(viii)
For use by any licensed private investigative agency or licensed security
service for
any
purpose permitted under this subsection.
(ix)
For use by an employer or its agent or insurer to obtain or verify information
relating
to a
holder of a commercial driver's license that is required under the Commercial
Motor Vehicle
Safety
Act of 1986 (see now 49 U.S.C. § 31301 et seq.).
(x)
For use in connection with the operation of private toll transportation
facilities.
(xi)
For any other use in response to a request for individual motor vehicle
records, unless
that use
is prohibited by the individual.
(xii)
For bulk distribution for surveys, marketing or solicitations, provided that
the
information
will be used, rented or sold solely for bulk distribution for surveys,
marketing, and
solicitations
and that surveys, marketing, and solicitations will not be directed at those
individuals
who have
requested in a timely fashion that they not be directed at them.
(3)
Notice. The division of motor vehicles shall provide in a clear and conspicuous
manner
on forms for issuance or renewal of operators permits, titles, registrations or
identification
cards,
notice that personal information collected by the division may be disclosed to
any business
or
person and provide in a clear and conspicuous manner on the forms an
opportunity to prohibit
the disclosures;
provided, that social security numbers and medical or disability information
shall
not be
subject to disclosure under this chapter.
SECTION
96. Sections 27-50-5 and 27-50-17 of the General Laws in Chapter 27-50
entitled
"Small Employer Health Insurance Availability Act" are hereby amended
to read as
follows:
27-50-5.
Restrictions relating to premium rates. -- (a) Premium rates for health
benefit
plans
subject to this chapter are subject to the following provisions:
(1)
Subject to subdivision (2) of this subsection, a small employer carrier shall
develop its
rates
based on an adjusted community rate and may only vary the adjusted community
rate for:
(i)
Age;
(ii)
Gender; and
(iii)
Family composition.
(2)
A small employer carrier who as of June 1, 2000, varied rates by health status
may
vary the
adjusted community rates for health status by ten percent (10%), provided that
the
resulting
rates comply with the other requirements of this section, including subdivision
(5) of
this
subsection.
(3)
The adjustment for age in paragraph (1)(i) of this subsection may not use age
brackets
smaller
than five (5) year increments and these shall begin with age thirty (30) and
end with age
sixty-five
(65).
(4)
The small employer carriers are permitted to develop separate rates for
individuals
age
sixty-five (65) or older for coverage for which Medicare is the primary payer
and coverage
for
which Medicare is not the primary payer. Both rates are subject to the
requirements of this
subsection.
(5)
For each health benefit plan offered by a carrier, the highest premium rate for
each
family
composition type shall not exceed four (4) times the premium rate that could be
charged to
a small employer
with the lowest premium rate for that family composition.
(6)
Premium rates for bona fide associations except for the Rhode Island Builders'
Association
whose membership is limited to those who are actively involved in supporting
the
construction
industry in Rhode Island shall comply with the requirements of § 27-50-5.
(b)
The premium charged for a health benefit plan may not be adjusted more
frequently
than
annually except that the rates may be changed to reflect:
(1)
Changes to the enrollment of the small employer;
(2)
Changes to the family composition of the employee; or
(3)
Changes to the health benefit plan requested by the small employer.
(c)
Premium rates for health benefit plans shall comply with the requirements of
this
section.
(d)
Small employer carriers shall apply rating factors consistently with respect to
all
small
employers. Rating factors shall produce premiums for identical groups that
differ only by
the
amounts attributable to plan design and do not reflect differences due to the
nature of the
groups
assumed to select particular health benefit plans. Nothing in this section
shall be construed
to
prevent a group health plan and a health insurance carrier offering health
insurance coverage
from
establishing premium discounts or rebates or modifying otherwise applicable
copayments or
deductibles
in return for adherence to programs of health promotion and disease prevention,
including
those included in affordable health benefit plans, provided that the resulting
rates
comply
with the other requirements of this section, including subdivision (a)(5) of
this section.
The
calculation of premium discounts, rebates, or modifications to otherwise
applicable
copayments
or deductibles for affordable health benefit plans shall be made in a manner
consistent
with accepted actuarial standards and based on actual or reasonably anticipated
small
employer
claims experience. As used in the preceding sentence, “accepted actuarial
standards”
includes
actuarially appropriate use of relevant data from outside the claims experience
of small
employers
covered by affordable health plans, including, but not limited to, experience
derived
from the
large group market, as this term is defined in § 27-18.6-2(20) 27-18.6-2(19).
(e)
For the purposes of this section, a health benefit plan that contains a
restricted
network
provision shall not be considered similar coverage to a health benefit plan
that does not
contain such
a provision, provided that the restriction of benefits to network providers
results in
substantial
differences in claim costs.
(f)
The director may establish regulations to implement the provisions of this
section and
to
assure that rating practices used by small employer carriers are consistent
with the purposes of
this
chapter, including regulations that assure that differences in rates charged
for health benefit
plans by
small employer carriers are reasonable and reflect objective differences in
plan design or
coverage
(not including differences due to the nature of the groups assumed to select
particular
health
benefit plans or separate claim experience for individual health benefit
plans).
(g)
In connection with the offering for sale of any health benefit plan to a small
employer,
a small
employer carrier shall make a reasonable disclosure, as part of its
solicitation and sales
materials,
of all of the following:
(1)
The provisions of the health benefit plan concerning the small employer
carrier's right
to
change premium rates and the factors, other than claim experience, that affect
changes in
premium
rates;
(2)
The provisions relating to renewability of policies and contracts;
(3)
The provisions relating to any preexisting condition provision; and
(4)
A listing of and descriptive information, including benefits and premiums,
about all
benefit
plans for which the small employer is qualified.
(h)
(1) Each small employer carrier shall maintain at its principal place of
business a
complete
and detailed description of its rating practices and renewal underwriting
practices,
including
information and documentation that demonstrate that its rating methods and
practices
are
based upon commonly accepted actuarial assumptions and are in accordance with
sound
actuarial
principles.
(2)
Each small employer carrier shall file with the director annually on or before
March
15 an
actuarial certification certifying that the carrier is in compliance with this
chapter and that
the
rating methods of the small employer carrier are actuarially sound. The
certification shall be
in a
form and manner, and shall contain the information, specified by the director.
A copy of the
certification
shall be retained by the small employer carrier at its principal place of
business.
(3)
A small employer carrier shall make the information and documentation described
in
subdivision
(1) of this subsection available to the director upon request. Except in cases
of
violations
of this chapter, the information shall be considered proprietary and trade
secret
information
and shall not be subject to disclosure by the director to persons outside of
the
department
except as agreed to by the small employer carrier or as ordered by a court of
competent
jurisdiction.
(4)
For the wellness health benefit plan described in § 27-50-10, the rates
proposed to be
charged
and the plan design to be offered by any carrier shall be filed by the carrier
at the office
of the
health insurance commissioner no less than thirty (30) days prior to their
proposed date of
use. The
carrier shall be required to establish that the rates proposed to be charged
and the plan
design
to be offered are consistent with the proper conduct of its business and with
the interest of
the
public. The health insurance commissioner may approve, disapprove, or modify
the rates
and/or
approve or disapprove the plan design proposed to be offered by the carrier.
Any
disapproval
by the health insurance commissioner of a plan design proposed to be offered
shall be
based
upon a determination that the plan design is not consistent with the criteria
established
pursuant
to subsection 27-50-10(b).
(i)
The requirements of this section apply to all health benefit plans issued or
renewed on
or after
October 1, 2000.
27-50-17.
Affordable health plan reinsurance program for small businesses. -- (a)
The
commissioner shall allocate funds from the affordable health plan reinsurance
fund for the
affordable
health reinsurance program.
(b)
The affordable health reinsurance program for small businesses shall only be
available
to low wage firms, as defined in § 27-50-3, who pay a minimum of fifty percent
(50%),
as
defined in § 27-50-3, of single coverage premiums for their eligible employees,
and who
purchase
the wellness health benefit plan pursuant to § 27-50-10. Eligibility shall be
determined
based on
state and federal corporate tax filings. All eligible employees, as defined in
§ 27-50-3,
employed
by low wage forms firms as defined in § 27-50-3-(oo) shall
be eligible for the
reinsurance
program if at least one low wage eligible employee as defined in regulation is
enrolled
in the employer's wellness health benefit plan.
(c)
The affordable health plan reinsurance shall be in the firms of a carrier
cost-sharing
arrangement,
which encourages carriers to offer a discounted premium rate to participating
individuals,
and whereby the reinsurance fund subsidizes the carriers' losses within a
prescribed
corridor
of risk as determined by regulation.
(d)
The specific structure of the reinsurance arrangement shall be defined by
regulations
promulgated
by the commissioner.
(e)
All carriers who participate in the Rhode Island RIte Care program as defined
in § 42-
12.3-4
and the procurement process for the Rhode Island state employee account, as
described in
chapter
36-12, must participate in the affordable health plan reinsurance program.
(f)
The commissioner shall determine total eligible enrollment under qualifying
small
group
health insurance contracts by dividing the funds available for distribution
from the
reinsurance
fund by the estimated per member annual cost of claims reimbursement from the
reinsurance
fund.
(g)
The commissioner shall suspend the enrollment of new employers under qualifying
small
group health insurance contracts if the director determines that the total
enrollment reported
under
such contracts is projected to exceed the total eligible enrollment, thereby
resulting in
anticipated
annual expenditures from the reinsurance fund in excess of ninety-five percent
(95%)
of the
total funds available for distribution from the fund.
(h)
In the event the available funds in the affordable health reinsurance fund as
created in
§
42-14.5-3 are insufficient to satisfy all claims submitted to the fund in any
calendar year, those
claims
in excess of the available funds shall be due and payable in the succeeding
calendar year,
or when
sufficient funds become available whichever shall first occur. Unpaid claims
from any
prior
year shall take precedence over new claims submitted in any one year.
(i)
The commissioner shall provide the health maintenance organization, health
insurers
and health
plans with notification of any enrollment suspensions as soon as practicable
after
receipt
of all enrollment data. However, the suspension of issuance of qualifying small
group
health
insurance contracts shall not preclude the addition of new employees of an
employer
already
covered under such a contract or new dependents of employees already covered
under
such
contracts.
(j)
The premiums of qualifying small group health insurance contracts must be no
more
than ninety
percent (90%) of the actuarially-determined and commissioner approved premium
for
this
health plan without the reinsurance program assistance.
(k)
The commissioner shall prepare periodic public reports in order to facilitate
evaluation
and ensure orderly operation of the funds, including, but not limited to, an
annual
report
of the affairs and operations of the fund, containing an accounting of the
administrative
expenses
charged to the fund. Such reports shall be delivered to the co-chairs of the
joint
legislative
committee on health care oversight by March 1st of each year.
SECTION
97. Section 27-64-6 of the General Laws in Chapter 27-64 entitled "The
Protected
Cell Companies Act" is hereby amended to read as follows:
27-64-6.
Reach of creditors and other claimants. -- (a) (1) Protected cell
assets shall
only be
available to the creditors of the protected cell company that are creditors in
respect to that
protected
cell and shall be entitled, in conformity with the provisions of this Act
chapter, to have
recourse
to the protected cell assets attributable to that protected cell, and shall be
absolutely
protected
from the creditors of the protected cell company that are not creditors in
respect of that
protected
cell and, who accordingly, shall not be entitled to have recourse to the
protected cell
assets
attributable to that protected cell. Creditors with respect to a protected cell
shall not be
entitled
to have recourse against the protected cell assets of other protected cells or
the assets of
the
protected cell company's general account.
(2)
Protected cell assets shall only be available to creditors of a protected cell
company
after
all protected cell liabilities have been extinguished or provided for in
accordance with the
plan of
operation relating to that protected cell.
(b)
When an obligation of a protected cell company to a person arises from a
transaction,
or is
imposed, in respect of a protected cell: (1) that obligation of the protected
cell company shall
extend
only to the protected cell assets attributable to that protected cell, and the
person shall,
with
respect to that obligation, be entitled to have recourse only to the protected
cell assets
attributable
to that protected cell, and (2) that obligation of the company shall not extend
to the
protected
cell assets of any other protected cell or the assets of the protected cell
company's
general
account, and that person shall not, with respect to that obligation, be
entitled to have
recourse
to the protected cell assets of any other protected cell or the assets of the
protected cell
company's
general account.
(c)
When an obligation of a protected cell company relates solely to the general
account,
the
obligation of the protected cell company shall extend only to, and that
creditor shall, with
respect
to that obligation, be entitled to have recourse only to the assets of the
protected cell
company's
general account.
(d)
The activities, assets, and obligations relating to a protected cell are not
subject to the
provisions
of chapters 34, 34.1 and 34.3 of this title and neither a protected cell nor a
protected
cell
company shall be assessed by or be required to contribute to any guaranty fund
or guaranty
association
in this state with respect to the activities, assets or obligations of a
protected cell.
Nothing
in this section shall affect the activities or obligations of an insurer's
general account.
(e)
In no event shall the establishment of one or more protected cells alone
constitute or
be
deemed to be a fraudulent conveyance, an intent by the protected cell company
to defraud
creditors
or the carrying out of business by the protected cell company for any other
fraudulent
purpose.
SECTION 98. This act shall take effect upon passage.
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LC01091/SUB A
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