HB 1204 – AS AMENDED BY THE SENATE
05/04/06 2191s
2006 SESSION
01/03
HOUSE BILL 1204
AN ACT relative to human immunodeficiency virus education, prevention, and control and relative to the powers of state government in the event of an incident or outbreak of communicable disease.
SPONSORS: Rep. MacKay, Merr 11
COMMITTEE: Health, Human Services and Elderly Affairs
This bill repeals certain provisions of the law relative to human immunodeficiency virus education, prevention, and control.
This bill also authorizes the commissioner of the department of health and human services, with the written approval of the governor, to ration and prioritize certain pharmaceutical agents in the event of a shortage during an incident or outbreak of communicable disease. Under this bill, the commissioner, with the written approval of the governor, has the power to close public places during an incident, etc. This bill establishes a committee to advise the commissioner in addressing ethical issues under RSA 141-C.
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Explanation: Matter added to current law appears in bold italics.
Matter removed from current law appears [in brackets and struckthrough.]
Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.
05/04/06 2191s
06-2390
01/03
STATE OF NEW HAMPSHIRE
In the Year of Our Lord Two Thousand Six
AN ACT relative to human immunodeficiency virus education, prevention, and control and relative to the powers of state government in the event of an incident or outbreak of communicable disease.
Be it Enacted by the Senate and House of Representatives in General Court convened:
1 Rulemaking; Reference Deletions. Amend RSA 141-F:4, VI to read as follows:
VI. Any matter deemed necessary for the administration of RSA 141-F:9-a[-RSA 141-F:9-d].
2 Repeal. The following are repealed:
I. RSA 141-F:9-b, relative to invasive procedure applications.
II. RSA 141-F:9-c, relative to an expert review panel composition.
III. RSA 141-F:9-d, relative to decisions by the expert review panel.
3 Communicable Disease; Closure and Decontamination. Amend RSA 141-C:16-a to read as follows:
141-C:16-a Closure; Decontamination.
I. The commissioner, with the written approval of the governor, may close, direct, and compel the evacuation [of or decontamination of any facility where there is reasonable cause to believe that there is a danger to the public health. The commissioner may also decontaminate, or cause to be decontaminated, or destroy any material of which there is reasonable cause to believe may present imminent danger to the public health] and decontamination of any building located within the state that is accessible to the public, such as businesses, primary and secondary schools, and universities, regardless of whether publicly or privately owned, when there is reasonable cause to believe the building may present an imminent danger to the public health due to an incident or outbreak of communicable disease. The commissioner may also cause any material located within or on the grounds of such building to be decontaminated or destroyed when there is reasonable cause to believe that the material may present imminent danger to the public health. Destruction of any material under this chapter shall be considered a taking of private property and shall be subject to the compensation provisions of RSA 4:46.
II. The closure of any buildings pursuant to this section shall be by the least restrictive means possible and the commissioner shall close only those buildings that are reasonably believed to pose a threat to the health of the public.
III. The owner of any building or portion of a building that is ordered closed in accordance with this section may request a hearing in the superior court to contest that order. The superior court shall schedule and hold a hearing and issue a decision within 5 working days of the court’s receipt of the request for a hearing. At the hearing, the burden of proof shall be on the commissioner to prove by a preponderance of the evidence that closure of the building is reasonably necessary to protect the health of the public.
4 New Section; Communicable Disease; Cancellation of Events. Amend RSA 141-C by inserting after section 16-a the following new section:
141-C:16-b Cancellation of Events. The commissioner, with the written approval of the governor, may order the cancellation of public gatherings and events within the state, or in specific geographic areas of the state, as is deemed necessary to prevent the spread of disease; provided, that under no circumstances shall the constitutional rights of assembly be abrogated in any emergency situation.
5 New Sections; Communicable Disease; Custody; Rationing; Cost of Items. Amend RSA 141-C by inserting after section 17-a the following new sections:
141-C:17-b Custody; Rationing. If there is a statewide or regional shortage or threatened shortage of any anti-toxins, serums, vaccines, immunizing agents, antibiotics, and other pharmaceutical agents, or mechanical equipment such as ventilators, the commissioner, with the written approval of the governor, may control, restrict, and ration the use, sale, dispensing, distribution, or transportation of such agents as necessary to best protect the health, safety, and welfare of the people of this state. In making rationing or other supply and distribution decisions, the commissioner may determine the preference and priority for distribution of such agents, such as giving preference to health care providers and emergency response personnel. The commissioner, with the written approval of the governor, shall have the discretion to take custody of all supplies of specific anti-toxins, serums, vaccines, immunizing agents, antibiotics, and other pharmaceutical agents, or mechanical equipment such as ventilators, existing within the state to ensure that such agents are distributed and utilized appropriately. Any person who is aggrieved by a decision made by the commissioner and approved by the governor with respect to the restriction or rationing of the use, sale, dispensing, distribution, or transportation of such agents, and mechanical equipment such as ventilators may request a hearing in the superior court to contest that order. Hearings held under this section shall conform to the provisions of RSA 141-C:16-a, III. Multiple requests for hearings under this section may be consolidated into one hearing if the underlying facts are similar, the court deems such consolidation to be appropriate, and the court determines that such consolidation will adequately satisfy the due process rights of the persons who requested a hearing.
141-C:17-c Certain Cost Required. In the event of an outbreak of communicable disease, the commissioner shall pay to the retailer the Medicaid rate of any items to be acquired by the department, the rate as it was the day prior to the outbreak of the communicable disease.
6 New Sections; Communicable Disease; Ethics Committee Established. Amend RSA 141-C by inserting after section 23 the following new sections:
141-C:24 Ethics Committee.
I. There is hereby established an ethics committee to offer advice to the commissioner relative to the ethical issues that may be identified in the course of planning for, and responding to, outbreaks of communicable disease.
II. The committee shall consider the ethical implications of any of the powers that may be exercised by the commissioner under the provisions of this chapter including, but not limited to, the confiscation, distribution, and rationing of anti-toxins, serums, vaccines, immunizing agents, antibiotics, and other pharmaceutical agents, and mechanical equipment such as ventilators; the issuance and enforcement of orders of isolation, quarantine, medical examination, and medical treatment; and issues relative to information sharing and confidentiality.
III. The members of the committee shall be as follows:
(a) The director of the division of public health services.
(b) The state epidemiologist.
(c) The attorney general, or designee.
(d) A representative of a municipal department of public health, appointed by the commissioner.
(e) A representative from a college or university public health program, appointed by the commissioner.
(f) A chief of police or a police officer of a local police department, appointed by the New Hampshire Association of Chiefs of Police.
(g) A chief of a local fire department, appointed by the New Hampshire Association of Fire Chiefs.
(h) A physician, licensed under RSA 329, appointed by the New Hampshire Medical Society.
(i) The commissioner of the department of safety, or designee.
(j) A member of a fire department, appointed by The New Hampshire Professional Firefighters Association.
(k) A representative of a hospital, appointed by the New Hampshire Hospital Association.
(l) A county representative, appointed by the New Hampshire Association of Counties.
IV. The commissioner shall appoint a member of the committee to act as chairperson. The committee shall meet initially within 30 days of the effective date of this section and then as regularly as the chairperson shall direct.
V. The commissioner may at any time direct questions to the committee or request guidance on ethical issues. In addition, the committee shall develop proposed guidelines and protocols relative to any ethical issues that it identifies.
VI. The committee shall be solely advisory in nature and any guidance, guidelines, or protocols issued by the committee shall not be binding on the commissioner.
141:25 No Conflict With Emergency Management Powers. Nothing in this chapter shall be construed to limit or restrict the exercise of the governor’s emergency management powers under RSA 4:45 – RSA 4:47.
7 Effective Date.
I. Sections 1 and 2 of this act shall take effect 60 days after its passage.
II. The remainder of this act shall take effect upon its passage.
LBAO
06-2390
5/24/06
HB 1204 FISCAL NOTE
AN ACT relative to human immunodeficiency virus education, prevention, and control and relative to the powers of state government in the event of an incident or outbreak of communicable disease.
FISCAL IMPACT:
The Department of Health and Human Services states this bill, as amended by the Senate, (Amendment #2006-2191s), will increase state revenue and expenditures by an indeterminable amount in FY 2007 and each year thereafter. This bill will have no fiscal impact on county and local revenue or expenditures.
METHODOLOGY:
The Department of Health and Human Services (DHHS) states sections 1 and 2 of this bill pertaining to health care workers in RSA 141-F human immunodeficiency virus (HIV) education, prevention, and control procedure would have no fiscal impact on the Department. The Department states sections 3 through 6 of this bill regarding the powers of state government in the event of an incident or outbreak of communicable disease would have a fiscal impact on the Department. The Department of Health and Human Services (DHHS), Division of Public Health Services states this bill authorizes the Commissioner of DHHS to ration and prioritize certain pharmaceutical agents in the event of shortage during a pandemic, and the power to close public buildings during a pandemic. The Division assumes that rationing and custody of certain pharmaceutical agents will necessitate staff resources beyond a standard work day due to urgent response time and the need to identify the State’s supply and preparation of a distribution plan of such agents in the event of a shortage or other situation that may pose a threat to the public’s health and welfare. However, it is expected that additional state and local preparedness agencies, such as the Bureau of Emergency Management and the Strategic National Stockpile, would be activated and thus provide additional resources. The Division is unable to estimate overtime costs at this time since they are dependent on factors unique to each situation. The Division further assumes that any situation involving closure of a public building and decontamination to protect the public’s health would be coordinated in consultation with other state agencies which include the Departments of Safety and Environmental Services in accordance with the State’s existing readiness activities. It is expected these costs associated with emergency response would be reimbursed under the Federal Emergency Management Agency (FEMA). The Division is unable to determine the exact fiscal impact at this time. This bill also establishes a committee to address ethical issues that may arise during the event of a pandemic, but this will have no fiscal impact on the Department.