Lo spazio di lavoro basato sull'IA per i professionisti del settore legale
Prova gratis per 14 giorni (10 domande/giorno durante la prova)
title-26•Title 26 — Health and Vital Statistics
As used in this Title unless otherwise specifically indicated:
"State department," "department of health" and "department" mean the State Department of Health;
"Commissioner" or "Director" means the State Commissioner of Health, who is the chief administrative officer of the State Department of Health;
"Council" means the Public Health Council in the State Department of Health;
"Division" means one of the divisions in the State Department of Health;
"Division director" means the director of one of the divisions in the State Department of Health;
"Local board" or "local board of health" means the board of health of any municipality or the boards, body, or officers in such municipality lawfully exercising any of the powers of a local board of health under the laws governing such municipality.
As used in this act, unless otherwise specifically indicated, "State Department," "Department of Health" and "department" mean the State Department of Health;
"Commissioner" means the State Commissioner of Health who is the chief administrative officer of the State Department of Health;
"Council" means the Public Health Council in the State Department of Health;
"Division" means one of the divisions in the State Department of Health;
"Division director" means the director of one of the divisions in the State Department of Health;
"Local board" or "local board of health" means the board of health of any municipality or the boards, bodies or officers in such municipality lawfully exercising any of the powers of a local board of health under the laws governing such municipality.
There is hereby established in the Executive Branch of the State Government a principal department which shall be known as the State Department of Health.
b. Whenever the terms "Department of Health and Senior Services" and "Commissioner of Health and Senior Services" occur or any references are made thereto in any law, rule, regulation, order, contract, document, judicial or administrative proceeding, or otherwise, the same shall be deemed to mean or refer to the "Department of Health" and the "Commissioner of Health," respectively.
c. The Commissioner of Health shall have the power, not inconsistent with section 13 of P.L.1947, c.177 (C.26:1A-13) or the provisions of P.L.2012, c.17 (C.26:1A-2.1 et al.), to organize the work of the Department of Health in such organizational units as the commissioner may determine to be necessary for its efficient and effective operation.
The commissioner shall devote his entire time and attention to the duties of the office and shall receive such salary as shall be provided by law.
b. The commissioner shall delegate such of his powers as the commissioner deems appropriate for the efficient administration of the department, to be exercised under the commissioner's direction and supervision by one or more deputy commissioners, one of whom shall be the Deputy Commissioner for Public Health Services. If the commissioner is not a duly licensed physician and a graduate of a regularly chartered and legally constituted medical school or college, then the Deputy Commissioner for Public Health Services shall be a duly licensed physician and a graduate of a regularly chartered and legally constituted medical school or college, with skill in sanitary science, who, in addition to his other duties, shall advise the commissioner on medical issues. The Deputy Commissioner for Public Health Services shall fulfill the duties of the office of commissioner in the event of a vacancy in that office, until the Governor appoints a successor to the commissioner.
The deputy commissioner shall devote his entire time and attention to the duties of that office and shall receive such salary as the commissioner deems appropriate.
Any member of the Public Health Council may be removed from office by the Governor, for cause.
Any vacancy occurring in the membership of the council for any cause shall be filled in the same manner as the original appointment but for the unexpired term only.
The members of the council shall serve without compensation, but shall be reimbursed for necessary expenses incurred in the performance of their duties.
There shall be within the department such divisions as the commissioner may, subject to approval by the Public Health Council, from time to time establish. Each division shall be under the supervision of a director, who shall be a person qualified by training and experience to direct the work assigned to it; and two or more divisions may be consolidated by the commissioner. The commissioner may authorize one of the division directors to act for him and in his place, as his deputy during his absence or disability. The commissioner may delegate such of his powers, as he may deem desirable for the efficient administration of the department, to be exercised under his direction and supervision by one or more of the division directors.
Each division director shall devote his entire time and attention to the performance of his duties.
The Public Health Council shall enact and from time to time may amend rules in relation to its meetings and the transaction of its business. It shall meet in the offices of the department at Trenton in each month at such times as its rules may prescribe. It shall meet at such other times and places within the State as, in its judgment, may be necessary. Four members of the council shall constitute a quorum thereof and, except as otherwise provided in section seven of this act, all action shall be taken by a majority vote. The commissioner shall attend all meetings of the council.
The council shall elect one of its members chairman who shall hold office for one year and until his successor shall be elected.
The council shall keep complete and accurate minutes of all its meetings, hearings, and other sessions. All such minutes shall be retained in a permanent record, and shall be available for public inspection at all times during the office hours of the department.
The State Sanitary Code may cover any subject affecting public health, or the preservation and improvement of public health and the prevention of disease in the State of New Jersey, including the immunization against disease of all school children in the State of New Jersey. In addition thereto, and not in limitation thereof, said State Sanitary Code may contain sanitary regulations: (a) prohibiting nuisances hazardous to human health; (b) (deleted by amendment) (c) regulating the use of privies and cesspools; (d) regulating the disposition of excremental matter; (e) regulating the control of fly and mosquito breeding places; (f) regulating the detection, reporting, prevention and control of communicable and preventable diseases; (g) regulating the conduct of public funerals; (h) regulating the conduct of boarding homes for children; (i) regulating the conduct of maternity homes and the care of maternity and infant patients therein; (j) regulating the conduct of camps; (k) (Deleted by amendment, P.L.1987, c.302) (l) regulating the preparation, handling, transportation, burial or other disposal, disinterment and reburial of dead human bodies; (m) prescribing standards of cleanliness for public eating rooms and restaurants; (n) regulating the conduct of tattoo parlors; (o) regulating the conduct of body piercing; and (p) regulating the conduct of cosmetic tattooing.
Prior to the final adoption by the council of any sanitary regulation or amendment thereto or repealer thereof the council shall hold a public hearing thereon. The council shall cause to be published, at least once, not less than 15 days prior to such hearing, in each of the counties of the State in a newspaper published in each of said counties, or if no newspaper be published in any such county, then in a newspaper circulated in such county, a notice of such hearing, specifying the time when and the place where such hearing will be held, together with a brief summary of the proposed regulation, amendment or repealer and a statement that copies of the text thereof may be obtained from the State Commissioner of Health and Senior Services or from the board of health of any municipality in the State. The State Department of Health and Senior Services shall prepare and make available on request therefor, copies of the text of such proposed regulations and changes therein in the manner described in such public notice.
Every sanitary regulation or amendment thereto or repealer thereof adopted in accordance with the provisions of section seven of this act shall state the date on which it takes effect, and shall be published by the filing of a copy thereof, duly signed by the chairman of the council, in the office of the Secretary of State and the sending of copies thereof, by the commissioner, to each local board of health and to the clerk of each municipality within the State. Copies shall be printed in such manner as the Public Health Council may from time to time determine, the same to be made available to the public on request. The commissioner, or one of the division directors designated by him, shall, for a fee of one dollar ($1.00) each, furnish copies of the State Sanitary Code and its amendments certified by the chairman of the council and such certified copies shall be received in evidence in all court or other judicial proceedings in the State.
The provisions of the State Sanitary Code shall have the force and effect of law. Such code shall be observed throughout the State and shall be enforced by each local board of health, the local police authorities and other enforcement agencies. Nothing herein contained however shall be deemed to limit the right of any local board of health to adopt such ordinances, rules and regulations, as, in its opinion, may be necessary for the particular locality under its jurisdiction; but such ordinances, rules and regulations shall not be in conflict with the laws of this State or the provisions of the State Sanitary Code, except, however, that such ordinances, rules and regulations may be more restrictive than the provisions of the State Sanitary Code. Every person organization or board of education having control of any public or private school in this State shall insure compliance with the State Sanitary Code as it pertains to the immunization against disease of children attending or having the right to attend such school, including any provision of the code which prohibits attendance by a child who has not been immunized.
Provisions in the State Sanitary Code in implementation of this act shall provide for exemption for pupils from mandatory immunization if the parent or guardian of the pupil objects thereto in a written statement signed by the parent or guardian upon the ground that the proposed immunization interferes with the free exercise of the pupil's religious rights. This exemption may be suspended by the State Commissioner of Health during the existence of an emergency as determined by the State Commissioner of Health.
Any penalty recovered in any such action shall be paid to the plaintiff therein. When the plaintiff is the State Department of Health, the penalty recovered shall be paid by the department to the State Treasurer. When the plaintiff is a local board of health, the penalty recovered shall be paid by the local board into the treasury of the municipality within which the local board has jurisdiction.
In addition to its powers and duties otherwise provided in this act, the Public Health Council may:
a. Request from the commissioner such information, concerning the work of the department, as it may deem necessary;
b. Consider any matter relating to the preservation and improvement of public health, and may advise the commissioner thereon;
c. From time to time submit to the commissioner any recommendations which it may deem necessary for the proper conduct of the department;
d. Study and investigate the public health activities of the State and report its findings thereon to the Governor and the Legislature.
Every local board of health shall file with the commissioner a certified copy of every by-law or ordinance of such board immediately upon passage of the same.
The Public Health Council may modify or annul any order, regulation, by-law or ordinance of any local board of health if, after giving reasonable notice and affording an opportunity to be heard to the members of such local board, the council shall determine that such order, regulation, by-law or ordinance concerns a matter which affects the public health beyond the territory over which such local board has jurisdiction.
The commissioner shall, subject to approval by the Public Health Council, prescribe the organization of the department. He shall, subject to the provisions of Title 11 of the Revised Statutes relating to Civil Service, appoint the directors of the divisions and such other personnel as he may consider necessary for the efficient performance of the work of the department.
He shall prescribe the duties of all such persons thus appointed and shall, subject to approval by the Public Health Council, fix their compensation within the limits of available appropriations. All such persons thus appointed shall be in the classified service of the Civil Service of the State, unless otherwise provided by law.
Subject to approval by the Public Health Council, the commissioner may, subject to any provisions of Title 11 of the Revised Statutes relating thereto, abolish any office or position which in his judgment it may be unnecessary to retain.
The commissioner, in addition to his powers and duties otherwise provided in this act or by any other law, shall:
a. Exercise all functions and powers of the department not specifically vested in the Public Health Council by this act;
b. Adopt rules and regulations governing the internal management of the department;
c. Administer the work of the department;
d. Enforce all laws relating to the health of the people of the State, and all provisions of the State Sanitary Code;
e. Administer all laws which are by their terms included under his jurisdiction or under the jurisdiction of the department;
f. Maintain liaison with local, State and Federal officials and agencies concerned with matters of public health or otherwise related to the functions of the department;
g. Report to the Governor, the Legislature, and the Public Health Council, with respect to the work of the department, on March fifteenth of each year and at such other times as he may deem in the public interest;
h. Institute or cause to be instituted such legal proceedings or processes as may be necessary properly to enforce and give effect to any of his powers or duties as prescribed in this act;
i. Cause studies to be made to determine whether the recognized public health activities of local health departments are being conducted and whether minimum standards of performance are being met in all municipalities of the State and for the purposes of this subsection, the commissioner shall recommend and the Public Health Council shall prescribe what are to be considered as "recognized public health activities" and "minimum standards of performance" ;
j. Require local boards of health to establish and maintain a program of recognized public health activities and to meet minimum standards of performance as prescribed by the Public Health Council in accordance with the provisions of subsection "i" of this section.
The commissioner shall have full access to any premises for the purpose of examination if he has reason to believe that on the premises there exists a violation of any health law of the State or any provision of the State Sanitary Code.
The commissioner shall have the same right of inspection in regard to all matters affecting the public health as has been or may be conferred upon the local boards of health.
The commissioner shall exercise general supervision over all matters relating to sanitation and hygiene throughout the State. Whenever in the opinion of the commissioner it is necessary or advisable, a sanitary survey of the whole or of any part of the State shall be made. The commissioner may enter upon, examine and survey any source and means of water supply, sewage disposal plant, sewage system, prison, public or private place of detention, asylum, hospital, school, public building, private institution, factory, workshop, tenement, public wash room, public rest room, public toilet and toilet facility, public eating room and restaurant, and also any premises in which he has reason to believe there exists a violation of any health law of the State, any provision of the State Sanitary Code, or any law which he has the duty of administering.
The commissioner may make a sanitary inspection of any person or property in transportation through the State, and of any car, boat, or other vehicle in which such person or property may be transported, and may enforce such detention or disinfection as may be necessary for the public safety.
Every local health official shall furnish the commissioner with such information as the commissioner may demand, and shall perform such acts as the commissioner may direct, with regard to, and within, the territory under the jurisdiction of the local health official.
At least once in every year the commissioner shall call together local health officials for a general conference on the subject of the health of the people of the State, and a discussion of ways and means to promote the same and to prevent disease.
Each local board of health may appoint one or more of its members, officers, or employees as a delegate or delegates to attend the annual conference. The actual traveling and hotel expenses of each delegate shall be paid by the treasurer or other disbursing officer of the municipality within which the local board has jurisdiction, upon presentation by each delegate of a certificate of his appointment and a bill of his expenses duly verified by affidavit.
The commissioner shall call to the attention of any local board of health, by such notice as he may deem reasonable, any failure on its part to enforce the laws of the State or the provisions of the State Sanitary Code and afford such local board an opportunity to explain its failure. The determination of the commissioner as to what is a reasonable notice shall be conclusive. If, after a hearing, it is found that no good reason exists for the failure of the local board of health to enforce the law or the provisions of the State Sanitary Code, the commissioner shall issue an order directing it to do so.
If the local board fails to comply with such order within the time specified, or, if none is specified, within a reasonable time, the commissioner shall immediately take such action as may be necessary to perform the acts specified in the order.
In all legal proceedings the order of the commissioner shall be prima facie evidence of compliance with the provisions of this section, and conclusive evidence of the violation recited in the order.
Any contracts which the commissioner may make for the purpose of carrying out the power given to him in the second paragraph of section twenty-three of this act shall be binding upon the local municipality and shall have the same force and effect as if duly authorized and made by the local board of health.
Any moneys expended by the State, and the amount of all obligations incurred by the State Department, to comply with the orders mentioned in section twenty-three of this act may be recovered in an action at law, in the name of the State Department, from the municipality the local board of health of which failed to comply with the order, and when recovered shall be paid to the State Treasurer.
Whenever any nuisance or source of foulness within the territorial jurisdiction of any local board of health is of such a nature that, in the opinion of the commissioner, it is hazardous to the health of persons residing within the limits of the jurisdiction of such local board, the commissioner may cause a notice in writing, signed by him, to be sent to the local board, requiring it to cause the nuisance or source of foulness to be abated within such time as the commissioner by the notice may specify.
If no action for abatement, as provided in section twenty-six of this act shall be taken by the local board within the time specified in the notice, or if in the opinion of the commissioner the action of the local board shall not be such as the necessities of the case seem to him to require, the commissioner may institute an action in the Superior Court in the name of the State on the relation of the commissioner to enjoin the continuance of the nuisance or source of foulness.
Whenever any nuisance or foul odors injurious to the public health within the territorial jurisdiction of a local board shall have a source of origin outside such territorial jurisdiction, the State Commissioner of Health may institute an action in the Superior Court, in the name of the State, on the relation of the commissioner, to enjoin the continuance of the nuisance or source of foulness or ill health.
In every such action in which it shall be ascertained by the court that the nuisance or source of foulness or ill health existed at the time of the commencement of the action, substantially as therein set forth, the court may abate the same by an injunction or otherwise. The court may charge the costs of the action upon the property whereon the nuisance or source of foulness or ill health is found, and enforce the payment of the same by the sale of the property or any part of it; or the court may order the persons who caused the nuisance or source of foulness or ill health, or allowed the same to continue, to pay the costs.
In case no such nuisance or source of foulness or ill health shall be found to exist, costs shall not be awarded against the commissioner unless it shall appear that no probable cause existed for bringing such suit.
Whenever the approval of the Department of Health is required to any act, plan, paper, or proposed undertaking, the commissioner or one of the division directors authorized for such purpose by him, shall examine the same. If such examination is made by a division director he shall report to the commissioner the results of his examination, together with his recommendations for action. If in conducting such examination the commissioner deems it necessary, he shall conduct hearings and examine witnesses.
The commissioner may cause to be made, in the State laboratory, analyses and examinations of samples of water, food, drugs, pathological materials and similar substances, when requested to do so by any official agency in this State or by any duly licensed physician, dentist, pharmacist, or veterinarian of this State.
The commissioner shall fix the charges to be made for analyses and examinations and shall make rules governing the collection and examination of samples.
All moneys received for the analyses and examinations of such samples shall be paid by the commissioner to the State Treasurer.
Subject to approval by the Governor and the Public Health Council, the commissioner may accept and administer for the State any grant, gift or bequest to be applied, principal or income, or both, for the purpose specified in such grant, gift or bequest, to the maintenance and use of any service in, or activity of, the department.
Subject to approval by the Public Health Council, the commissioner may accept the services of any local or Federal official or agency in such manner and in such capacities as he may deem appropriate.
Subject to approval by the Governor and the Public Health Council, the commissioner may apply for and accept grants from the Federal Government or any officer or agency thereof, and may comply with the terms, conditions and limitations thereof, for any of the purposes of this act. Any moneys so received may be expended by the department, subject to any limitations imposed in the grant, to effect any of the purposes of this act, upon warrant of the Commissioner of Taxation and Finance on vouchers certified or approved by the Commissioner of Health.
This act shall be known and may be cited as the "Supplemental Nutrition Assistance Contingency Fund Act."
The Legislature finds and declares that:
a. The federal "WIC" program provides nutritious foods to low-income pregnant and lactating women and infants and children up to five years of age who are determined to be at special nutritional risk because of poor health or inadequate nutrition, or both;
b. The federal "WIC" program is essential to the well-being of all eligible persons, and these persons should receive the benefits of the program;
c. The Department of Health has limited participation in the "WIC" program and did not spend all of the federal moneys available for the program to ensure that the program did not overspend its federal allotment, because the federal government requires that any WIC program funds not spent during the federal fiscal year in which they are appropriated be returned to the federal government, and because there are currently no State funds provided to support the WIC program in New Jersey;
d. If a contingency fund was established, the State would be able to ensure that program benefits are provided to all eligible women, infants and children; and
e. It is therefore, in the interest of the State to establish a contingency fund for the "WIC" program in order to provide a stable, nutritional food program for all eligible women, infants, and children with nutritious foods.
There is established in the General Fund the "Supplemental Nutrition Assistance Contingency Fund" as a special fund. The State Treasurer shall credit the fund with all moneys appropriated thereto or otherwise made available, and all interest received from the investment of moneys in the fund. All moneys in the fund are appropriated to effectuate the purposes of this act, and any unexpended balances in the fund at the end of a fiscal year shall be appropriated to the credit of the fund. Moneys in the fund shall be available as a contingency reserve to ensure that underenrollment of persons otherwise eligible for supplemental foods under the special supplemental food program for women, infants and children (WIC) established pursuant to Pub.L. 95-267 (42 U.S.C. s. 1786) does not occur due to a concern of overspending federal funds available for that program. Moneys in the fund shall not be available to expand or augment program services and shall not be expended for the administrative costs of the program.
a. cause copies of the voter registration forms and instructions provided for under subsections e. and f. of section 16 of P.L.1974, c.30 (C.19:31-6.4) and the declination form provided for in subsection b. of section 26 of P.L.1994, c.182 (C.19:31-6.11) to be distributed at each such agency or office to each person appearing in person thereat to apply for services or assistance provided thereby or to seek a recertification, renewal or change of address relative to the assistance provided at such office. An employee of the agency or office shall inquire of every such person whether the person, if not already registered to vote from the place of his or her present residence, wishes to be so registered and shall inform the person that whether or not the applicant chooses to register will not affect the person's eligibility for those services. The employee shall subsequently review the forms to determine whether or not the person wishes to register to vote. If the person does not wish to register, the employee shall provide the person with any assistance necessary to complete the declination form and then inform the person that the form will be retained by the employee. If the person wishes to register, the employee shall provide the person with any assistance necessary in completing the voter registration form; shall inform the applicant that the applicant may leave the completed form with the employee or mail it personally to the Secretary of State; and if the applicant chooses to leave the form, shall accept the completed form, stamp or otherwise mark the lower right hand corner of the document with the date on which it was so received, and forward it to the Secretary of State. The employee shall provide to each applicant who does not decline to register to vote the same degree of assistance with regard to the completion of the voter registration form as is provided by the office with regard to the completion of its own forms, unless the applicant refuses such assistance;
b. provide for the continuous supply of the forms and instructions specified in subsection a. of this section to every agency and office which provides assistance under P.L.1987, c.261 (C.26:1A-36.1 et seq.) and Pub.L. 95-267 (42 U.S.C. s.1786);
c. provide the forms and instructions specified in subsection a. of this section in both the English and Spanish languages to the agencies and offices which are located in any county in which bilingual sample ballots must be provided pursuant to R.S.19:14-21, R.S.19:49-4 or section 2 of P.L.1965, c.29 (C.19:23-22.4);
d. provide for the collection of completed voter registration forms by any employee of the agency or office for the transmittal of the forms to the Secretary of State;
e. provide that the forms, instructions and assistance specified in subsection a. of this section shall be provided to any person with a disability who receives assistance or services at that person's home from an employee of the agency or office;
f. inform each employee of the agency or office who assists in registering a person to vote that that employee shall not:
(1) seek to influence an applicant's political preference or party registration;
(2) display any such political preference or party allegiance;
(3) make any statement to an applicant or take any action the purpose or effect of which is to discourage the applicant from registering to vote; or
(4) make any statement to an applicant or take any action the purpose or effect of which is to lead the applicant to believe that a decision to register or not to register has any bearing on the availability of services or benefits; and
g. make certain that no information relating to a declination to register to vote by an individual in connection with any type of application for service made by that individual at any agency or office is used for any purpose other than voter registration.
The WIC Services Unit shall grant the temporary authorization within 14 days of the completion of the initial review of the site by the WIC Services Unit. The temporary authorization shall be valid until the vendor's application is approved or disapproved.
The WIC Services Unit shall not issue a temporary authorization where doing so would be contrary to federal regulations or would jeopardize federal financial participation.
The WIC Services Unit shall grant the authorization immediately upon receipt of documentation that the vendor is an authorized farmers market participant in the federal Supplemental Nutrition Assistance Program and shall not require any further documentation from the farmers market.
The WIC Services Unit shall not issue the authorization where doing so would be contrary to federal regulations or would jeopardize federal financial participation.
"Food instrument" means a voucher, check, electronic benefits transfer card, coupon, or other document which is used by a participant in the WIC program to obtain supplemental foods.
"WIC" means the federal Special Supplemental Nutrition Program for Women, Infants, and Children, established pursuant to the "Child Nutrition Act of 1966," Pub.L.89-642 (42 U.S.C. s.1771 et seq.).
(1) purchase WIC-eligible foods using the online platform of an authorized New Jersey WIC vendor, including an approved vendor which operates predominantly as an online retailer; and
(2) utilize funds available through any New Jersey WIC food instrument to pay the delivery charge levied by an authorized New Jersey WIC vendor for home delivery of the individual's WIC-eligible purchase.
b. The Commissioner of Health shall apply to the Food and Nutrition Service within the United States Department of Agriculture for participation in any waivers or approvals made available by the WIC program to implement the provisions of this section.
If the Commissioner of the Department of Health determines that an allocation from the contingency fund is required as a result of overspending beyond the availability of federal funds, he shall provide written notification to the Director of the Division of Budget and Accounting in the Department of the Treasury of his determination and the reasons therefor. The Director of the Division of Budget and Accounting shall review the commissioner's determination and if the director shall agree, he shall make such sums available to the Department of Health as in his opinion are required based on his review of the commissioner's determination. Upon his approval or disapproval of an allocation from the contingency fund, the director shall notify the Joint Budget Oversight Committee or its successor, of the approval or disapproval and the reasons therefor.
a. It is in the best interests of the State to provide a comprehensive system of early intervention services to support infants and toddlers with disabilities, those at risk for disability, and their families, that is built on existing social networks, and naturally occurring supports such as community associations and extended families which promote the inclusion of the child and the family within the community;
b. Infants and toddlers with disabilities are uniquely dependent on their families for survival and nurturance, and while service systems and the personnel within those systems may fluctuate, a family is the only common thread in a child's life;
c. There is an urgent need to enhance the development of infants and toddlers with disabilities to minimize their potential for developmental delay and to enhance the capacity for families to meet the needs of these infants and toddlers;
d. There is also a need to reduce the education costs to our society, reduce costs associated with reliance on social services, minimize the likelihood of institutionalization, reduce health care costs and improve the long-term health and potential for future employability and independence of infants and toddlers with disabilities;
e. No one agency or discipline can meet the complex needs of infants with disabilities and their families, and services to infants and toddlers with disabilities must be comprehensive and multi-disciplinary and must be coordinated so as to assure access and assist families in obtaining needed information and encouraging advocacy on their behalf; and
f. Services and strategies to assist and support families must respect autonomy, interdependence and decision-making in a way which reflects the unique racial, ethnic, cultural and social-economic experiences and background of a family.
a. developing, in consultation with autism experts and advocates, including, but not limited to, the Governor's Council for Medical Research and Treatment of Autism, Autism Speaks, The New Jersey Center for Outreach and Services for the Autism Community, The Autism Center of New Jersey Medical School at Rutgers, The State University, the Statewide Parent Advocacy Network, Inc., and the New Jersey chapter of the American Academy of Pediatrics, guidelines for health care professionals to use in evaluating infants and toddlers living in the State for autism and to ensure the timely referral by health care professionals of infants and toddlers who are identified as having autism or suspected of being on the autism spectrum to the Early Intervention Program in order to provide appropriate services to those infants and toddlers as early as possible;
b. referring affected children who are identified as having autism or suspected of being on the autism spectrum and their families to schools and agencies, including community, consumer, and parent-based agencies, and organizations and other programs mandated by Part C of the "Individuals with Disabilities Education Act" (20 U.S.C. s.1431 et seq.), which offer programs specifically designed to meet the unique needs of children with autism;
c. collecting data on Statewide autism screening, diagnosis, and intervention programs and systems that can be used for applied research, program evaluation, and policy development; and
d. disseminating information on the medical care of individuals with autism to health care professionals and the general public.
a. Many citizens of this State rely upon health insurance to cover the cost of obtaining health care.
b. It is essential that the citizens' expectation that their health care costs will be paid by their insurance policies is not disappointed and that they obtain the coverage necessary and appropriate for their care within the terms of their insurance policies.
c. Currently, some insurers deny payment for drugs that have been approved by the Federal Food and Drug Administration (FDA) when the drugs are prescribed for treatments other than those stated in the labelling approved by the FDA ("off-label" use) while other insurers providing similar coverage terms do pay for "off-label" use.
d. Denial of payment for "off-label" use can interrupt or effectively deny access to necessary and appropriate treatment for a person being treated for a life-threatening illness.
e. "Off-label" use of an FDA-approved drug is legal when prescribed in a medically appropriate way and is often necessary to provide needed care. Approximately 50 percent of cancer patients receive some type of "off label" drug in their treatment. The FDA and the federal Department of Health and Human Services recognize the wide variety of effective "off-label" uses of FDA-approved drugs. Information on the appropriate "off-label" use of FDA-approved drugs is obtained from compendia published by the United States Pharmacopoeial Convention, the American Medical Association, and the American Society of Hospital Pharmacists. In addition, scientific studies of "off-label" use of drugs published in recognized peer-reviewed professional journals provide information on appropriate uses of "off-label" drugs.
f. The "Omnibus Budget Reconciliation Act of 1990," Pub. L. 101-508, requires Medicaid agencies to pay for "off-label" use of drugs prescribed for Medicaid patients if the use is stated in any of the three compendia or peer-reviewed literature; thereby providing recognition of the three compendia and peer-reviewed literature as appropriate sources for reimbursement.
g. "Off-label" use of FDA-approved drugs provides efficacious drugs at a lower cost. To require that all appropriate uses of a drug undergo approval by the FDA may substantially increase the cost of drugs and delay or even deny patients' ability to obtain medically effective treatment. FDA approval for each use would require substantial expenditure and time to undergo the clinical trials necessary to obtain FDA approval.
h. Reimbursement for "off-label" uses of FDA-approved drugs is necessary to conform to the way in which appropriate medical treatment is provided, to make needed drugs available to patients, and may help to contain health care costs.
b. The Department of Health shall require each health care professional in the State to provide new parents, including adoptive parents, with the informational literature specified in section a. of this section. The informational literature shall be distributed to the mother and any other adult family member, including adult adoptive family members where possible, during the mother's prenatal care appointments in the last trimester of pregnancy .
c. As used in this section "health care professional" means an individual who is licensed or certified pursuant to Title 45 of the Revised Statutes, and who provides prenatal health care services as a part of the individual's authorized scope of professional practice.
The department shall formulate comprehensive policies for the promotion of public health and the prevention of disease within the State. It shall in addition to other powers and duties vested in it by this act or by any other law:
a. Collect, preserve and tabulate all information required by law in reference to births, marriages, deaths and all vital facts and shall obtain, collect and preserve such information relating to the health of the people of the State and to the prevention of disease as may be useful in the discharge of the functions of the department;
b. Prepare and administer or supervise a State-wide program of health education, prepare and make available to practicing physicians and local boards of health in the State technical information concerning public health, cooperate with the Commissioner of Education in the preparation and distribution of health bulletins among all the public schools of the State for the purpose of educating children in sanitation and hygiene, cooperate with the Commissioner of Education in the preparation of a program of school health services;
c. Administer or supervise a program of public health nursing, prescribe the minimum qualifications of all public health nurses engaged in official public health work, and encourage and aid in coordinating local public health nursing services;
d. Encourage, direct and aid in coordinating local programs concerning control of preventable diseases in accordance with a unified State-wide plan which shall be formulated by the department;
e. Administer or supervise a program of maternal and child health services, encourage and aid in coordinating local programs concerning maternal and infant hygiene, and encourage and aid in coordinating local programs concerning prenatal and post-natal care, and may, when requested by a local board of education, supervise the work of school nurses;
f. Administer or supervise a program of dental health, encourage and aid in coordinating local programs concerning dental health;
g. Establish and maintain adequate serological, bacteriological and chemical laboratories with such expert assistance and such facilities as are necessary for routine examinations and analyses, and for original investigations and research in matters affecting public health;
h. Administer or supervise a program of industrial hygiene, encourage the establishment of medical, dental, environmental engineering and nursing services in all industrial plants in the State, cooperate with the State Department of Labor in formulating rules and regulations concerning industrial sanitary conditions;
i. (Deleted by amendment)
j. Enforce the State food, drug, and cosmetic laws and collaborate in the enforcement of the Federal Food, Drug, and Cosmetic Act;
k. Keep complete and accurate minutes of all hearings held before the commissioner or any member of the department pursuant to the provisions of this act.
All such minutes shall be retained in a permanent record, and shall be available for public inspection at all times during the office hours of the department.
Information and data in the possession of the State Department of Health, pertaining to the health of any named person, procured in connection with research studies approved by the Public Health Council for the purpose of reducing the morbidity or mortality from any cause or condition of health shall be kept in the confidence of the department and shall not be revealed or disclosed in any manner or under any circumstances by any person connected with such research studies or by the department or any person therein except (a) to persons within the department, (b) to other persons participating in such research studies or (c) in such impersonal form that the individual to whom the information or data relates cannot be identified therefrom.
No person may be held liable for damages or otherwise prejudiced in any manner by reason of furnishing information or data pertaining to the health of any person to the State Department of Health for use in connection with research studies described in section 1 of this act.
Any person who reveals or discloses any information or data pertaining to the health of any named person in violation of this act is a disorderly person.
"Council" means the New Jersey Council on Physical Fitness and Sports.
"Physical Fitness" means good or improved life-style habits of a State resident through the utilization of recreational opportunities, consistent and medically correct exercise and leisure time management for the express purpose of decreasing stress-related maladies, thereby promoting a more healthful environment for the citizens of the State.
"Sports" means those team or individual competitive athletic activities that are participated in on an amateur, nonprofit basis by the citizens of the State for the express purposes of enjoyment, exercise and sportsmanship.
b. Each public member of the council shall serve for a term of three years, expiring on January 1 in the appropriate year; except that of the members first appointed, four shall be appointed for a term of one year, five shall be appointed for a term of two years and six shall be appointed for a term of three years, as determined by the Governor. Each member shall hold office for the term of appointment and until a successor is appointed and qualified. A public member of the council shall be eligible for reappointment. Members appointed to fill a vacancy occurring for any reason other than the expiration of the term shall serve for the unexpired term only.
c. Public members shall serve without compensation, but shall be reimbursed for necessary expenses incurred in the performance of their duties.
d. The council shall adopt rules for the transaction of its business and shall keep a record of its business, including a record of its resolutions, transactions, findings and determinations. A majority of the members of the council shall constitute a quorum, but a lesser number may hold a hearing.
e. The council shall meet at least once in each quarter of the fiscal year, and as often thereafter as shall be deemed necessary by the chairperson.
f. By a two-thirds vote of the council, a member may be dismissed from membership for such reasons as the council may establish, which reasons shall include lack of interest in council duties or repeated absences from council meetings.
g. The council shall be administrated by the Department of Health. The department shall employ necessary staff to carry out the duties and functions of the council as otherwise provided in this act or as otherwise provided by law.
a. Enlist the active support and assistance of individual citizens, civic groups, private enterprise, voluntary organizations and others in an effort to promote and improve the fitness of all the citizens of the State through regular participation in physical fitness and sports activities;
b. Initiate programs to inform the general public of the importance of exercise and the link that exists between regular physical activity and such qualities as good health, wellness and effective performance;
c. Develop, foster, and coordinate services and programs of physical fitness and sports for the people of the State;
d. Develop programs to promote personal health, wellness and physical fitness in cooperation with medical, dental and other similar professional societies;
e. Assist the Department of Education in helping schools to develop health, physical fitness and wellness programs for students;
f. Sponsor physical fitness and sports workshops, clinics, conferences and other similar activities;
g. Give recognition to outstanding developments and achievements in, and contributions to, physical fitness and sports;
h. Assist recreation agencies and State sports governing bodies at all levels in developing "sports for all" programs which emphasize the value of sports to physical, mental and emotional fitness;
i. Collect and disseminate physical fitness and sports information;
j. Encourage State agencies, local governments and communities to develop local physical fitness programs, wellness programs and amateur athletic competitions;
k. Assist business, industry, government and labor organizations in establishing sound physical fitness programs to elevate employee fitness and in reducing the financial and human costs resulting from physical inactivity; and
l. Stimulate and encourage research in the areas of sports medicine, physical fitness and sports performance.
Every such examination shall be in such public health subjects as the commissioner shall direct.
a. Health officer's license;
b. (Deleted by amendment, P.L.1997, c.416).
c. (Deleted by amendment, P.L.1997, c.416).
d. (Deleted by amendment, P.L.1997, c.416).
e. (Deleted by amendment, P.L.1997, c.416).
f. (Deleted by amendment, P.L.1997, c.416).
g. (Deleted by amendment, P.L.1997, c.416).
h. (Deleted by amendment, P.L.1997, c.416).
i. (Deleted by amendment, P.L.1997, c.416).
j. (Deleted by amendment, P.L.1997, c.416).
k. Registered environmental health specialist's license.
However, any health officer's license, sanitary inspector's license, and plumbing inspector's license issued before the effective date of P.L.1947, c.177 (C.26:1A-1 et seq.) by the Department of Health shall, unless suspended or revoked in accordance with the provisions of sections 43 and 44 of that act, remain in effect during the employment as such of the holder thereof. Upon enactment of P.L.1997, c.416 (C.26:1A-42.1 et al.) any existing Sanitary Inspector, First Grade license shall become a Registered Environmental Health Specialist license without any further action required of the licensee.
Any license eliminated by P.L.1997, c.416 (C.26:1A-42.1 et al.) shall, unless suspended or revoked in accordance with the provisions of sections 43 and 44 of P.L.1947, c.177 (C.26:1A-43 and C.26:1A-44), remain in effect until the holder thereof does not renew the license within two years from the date of its expiration, or the commissioner does not renew the license in accordance with section 42 of that act, whichever comes first.
a. Violation of any of the provisions of this act or of any law relating to public health;
b. Violation of any provision of the State Sanitary Code;
c. Violation of any applicable local health regulation or ordinance;
d. Any act or happening occurring after the making of application for such license which, if the same had occurred prior to said time, would have prevented the issuance of such license; or
e. A conviction in a court of competent jurisdiction, either within or outside this State, of a crime involving moral turpitude, except that if the conviction is reversed and the holder of the license is discharged or acquitted, or if the holder is pardoned or the civil rights of the holder are restored, the holder may obtain a license.
Notwithstanding any provision of section 10 of P.L.1968, c.410 (C.52:14B-10) to the contrary, the commissioner, before adopting, rejecting or modifying the recommended report and decision of an administrative law judge, shall consult with the Public Health Council.
The suspension or revocation of a license shall be effected by a notice in writing of the suspension or revocation, designating the effective date thereof, and in the case of a suspension, the term of the suspension, which notice may be served upon the licensee personally or by mailing the same by registered mail addressed to the licensee at the licensee's home address.
The commissioner shall file a copy of the notice of suspension or revocation of license with the local board of health.
Whenever it is necessary for the Department of Health to hold any hearing or to make any investigation, under any law or rule, the hearing may be held or the examination be made by the direction of the commissioner, in accordance with such rules as he may prescribe. The hearing or investigation may be before the commissioner or a member of the department designated by him. If before a member of the department so designated, he shall submit to the commissioner the evidence taken by him, together with his recommendations.
The commissioner and any member of the department authorized for such purpose by him, may, in any part of the State, administer oaths and examine witnesses under oath in any matter relating to the powers and duties of the department, or to the health of the people of the State, or to the prevention of disease. Any persons who, having been so sworn, willfully gives false testimony shall be guilty of perjury.
The commissioner may issue subpoenas, signed by him requiring the attendance of witnesses and the production of books and papers in any part of the State before him, or a member of the department designated by him.
Any person who, being served with a subpoena issued pursuant to the provisions of section forty-seven of this act, shall fail to attend or give testimony, unless such testimony incriminate him or subject him to a fine or punishment, shall be liable to a penalty of five hundred dollars ($500.00) for each offense, to be recovered in the name of the State; the penalty, when recovered, to be paid to the State Treasurer.
The Attorney General shall prosecute the action for the recovery of the penalty prescribed in section forty-eight of this act when requested so to do by the commissioner, and when, in his judgment, the facts and the law warrant such prosecution.
The commissioner may, subject to approval by the Public Health Council, from time to time establish such health districts as he may deem necessary. He shall, subject to the provisions of Title 11 of the Revised Statutes, relating to civil service, appoint, for each of such districts, a district State health officer who shall be a person qualified in public health administration. All such persons thus appointed shall be in the classified service of the civil service of the State, unless otherwise provided by law. The commissioner shall, subject to approval by the Public Health Council, and within the limits of available appropriations therefor, fix the compensation of each of the district State health officers thus appointed. Each district State health officer, under the direction of the commissioner and subject to the provisions of the State Sanitary Code, shall, in addition to such other duties as may be imposed upon him by the commissioner, perform the following duties:
a. Keep himself informed as to the work of each local health department within his health district;
b. Aid each local health officer within his health district in the performance of his duties, and particularly during the prevalence of any contagious disease;
c. Assist each local health officer within his health district in making an annual health survey of the territory within his jurisdiction, and in maintaining therein a continuous sanitary supervision;
d. Call together the local health officers within the district or any portion of it from time to time for conference;
e. Adjust questions of jurisdiction arising between local health officers within his district;
f. Study the causes of excessive mortality from any disease in any portion of his district;
g. Promote efficient registration of births and deaths;
h. Endeavor to enlist the co-operation of all the organizations concerned or interested in public health activities within his district, in the improvement of public health therein;
i. Disseminate information to the general public in all matters pertaining to public health; and
j. Act as the representative of the commissioner, and under his direction, in securing the enforcement within his district of the provisions of the State Sanitary Code and of the laws of this State pertaining to public health.
The offices of Perth Amboy Port health officer and deputy Perth Amboy Port health officer are hereby abolished. The terms of office of the present Perth Amboy Port health officer and deputy Perth Amboy Port health officer shall expire on the thirtieth day of June, one thousand nine hundred and forty-seven.
The functions, powers, duties, records and property of the present State Department of Health and of the Perth Amboy Port health officer are hereby transferred to and vested in the State Department of Health established under this act, to be exercised and used by it pursuant to the provisions of this act and as otherwise provided by law.
The terms of office of all the members of the present State Board of Health shall expire on the thirtieth day of June, one thousand nine hundred and forty-seven.
The term of office of the present State Director of Health shall expire on the thirtieth day of June, one thousand nine hundred and forty-seven, but he shall continue in office until a State Commissioner of Health is appointed and qualified as provided in section three of this act.
The functions, powers and duties of the State Board of Health and the functions, powers and duties of the present Director of Health are hereby transferred to and vested in the State Department of Health established under this act, to be exercised in accordance with the provisions of this act and as otherwise provided by law.
The regulations contained in the present State Sanitary Code shall continue with full force and effect until superseded pursuant to sections seven and eight of this act.
All appropriations available and to become available to the present State Department of Health and all appropriations available and to become available to the offices abolished by this act are hereby transferred to the State Department of Health established under this act.
The employees of the present State Department of Health, except as otherwise provided in this act, are hereby transferred to the State Department of Health established under this act. Persons so transferred shall be assigned to such duties as the commissioner shall determine.
Nothing in this act shall be construed to deprive any person of any right or protection provided him by Title 11 of the Revised Statutes or by any pension law or retirement system.
The department shall be provided with suitable quarters which shall be sufficient to house all of the divisions of the department within the same building.
Whenever the terms "State Board of Health," "State Department of Health" and "Department of Health" occur or any reference is made to any of said terms, in any law, they, and each of them, shall be deemed to mean or refer to the State Department of Health as described in this act. The Commissioner of Health shall, except as may be otherwise provided by this act, have all powers conferred and perform all the duties imposed by law upon the State Board of Health, or any member, committee or officer thereof, including the secretary.
Whenever the terms "State Director of Health," "Perth Amboy Port health officer" and "deputy Perth Amboy Port health officer" occur or any reference is made to any of said terms, in any law, they, and each of them, shall be deemed to mean or refer to the State Commissioner of Health as described in this act.
This act shall not affect actions or proceedings, civil or criminal, brought by or against the State Board of Health or the State Department of Health, and pending on the first day of July, one thousand nine hundred and forty-seven, and such actions or proceedings may be prosecuted or defended in the same manner and to the same effect by the State Commissioner of Health as if the foregoing provisions had not taken effect. Nor shall any of the foregoing provisions affect in any manner any order or recommendation made by, or other matters or proceedings before, such State Board of Health or State Department of Health, and all such matters and proceedings pending before such board or department on said date shall be continued before the State Commissioner of Health.
The following sections of the Revised Statutes are hereby repealed: Revised Statutes, sections 26:2-1 to 26:2-55, inclusive, 26:4-111, 26:4-114 and 26:4-115.
This act is intended to protect the public health in this State and shall be liberally construed.
This act shall not be construed to deny the right of a person, parent, guardian or custodian to treat or provide treatment for himself or an ill minor in accordance with the religious tenets of any church as is now or may hereafter be authorized by other statutes of this State, or to require any such person or any of his minor children to submit to physical examination other than as is now or may hereafter be required by other statutes of this State, or to require any such person or any of his minor children to submit to confinement in any hospital or medical institution other than as is now or may hereafter be required by other statutes of this State; provided, always, however, that the laws, rules and regulations relating to communicable diseases and sanitary matters are not violated.
The powers, duties and functions vested in the State Department of Health under the provisions of this act shall not be construed to affect in any manner the powers, duties and functions vested in the State Department of Labor or the State Commissioner of Labor under any other provisions of law.
This act shall take effect on the first day of July, one thousand nine hundred and forty-seven, except that any appointment and any confirmation of any appointment permitted by this act may be made prior to such date.
There is hereby established in the State Department of Health a Bureau of Examination and Licensing.
The State Board of Barber Examiners, the department of beauty culture control, and the board of beauty culture control, and all of their respective functions, powers, duties, records and property are hereby transferred to the Bureau of Examination and Licensing established hereunder in the State Department of Health.
Subject to the restrictions and limitations contained in this act and except as otherwise provided herein, each of the respective boards and agencies within the Bureau of Examination and Licensing established hereunder shall continue to have all the powers and shall exercise all of the functions and duties vested in, or imposed upon it by law.
This act shall not affect the terms of office of the present members of the respective boards enumerated in section four hereof. Such boards shall continue to be constituted as provided by existing law.
Any member of any of the boards enumerated in section four hereof may be removed from office by the Governor, for cause, upon notice and opportunity to be heard.
Any vacancy occurring in the membership of any of such boards shall be filled in the same manner as the original appointment but for the unexpired term only.
The authority, vested pursuant to existing law in any of the boards or agencies enumerated in section four hereof, or in any member or officer thereof, to appoint, employ or remove clerical, secretarial, recording or other personnel, except inspectors or enforcement agents, is hereby transferred to and vested in the State Commissioner of Health. The State Commissioner of Health shall fix the compensation of all persons appointed or employed by him pursuant to such authority within the limits of available appropriations therefor. Persons thus appointed or employed shall be assigned to such duties as the State Commissioner of Health shall prescribe.
The authority, vested pursuant to existing law in any of such respective boards or agencies or in any member or officer thereof, to appoint, employ or remove inspectors or enforcement agents shall continue to be exercised by such board or agency; provided, however, that the appointment, employment or removal of any person pursuant to such authority shall be subject to the approval of the State Commissioner of Health. Such board or agency shall, subject to the approval of the State Commissioner of Health, and within the limits of available appropriations therefor, fix the compensation of inspectors and enforcement agents thus appointed or employed. Persons thus appointed or employed shall be assigned to such duties as such board shall determine.
In addition to other powers and duties specifically conferred and imposed upon him by this act or by any other law, the State Commissioner of Health shall:
(a) Supervise the work of the employees engaged in any of the boards or agencies within the State Department of Health or any bureau or section in said department.
(b) Adopt uniform procedures for all secretarial, recording and clerical duties of each of the boards and agencies within the Bureau of Examination and Licensing.
(c) Maintain a public register of all persons licensed by any of the several boards and agencies within the said bureau, or by or in the name of the State Department of Health.
(d) Integrate, so far as practicable, all staff services of the State Department of Health and of each of the bureaus and sections therein.
Such clerical, secretarial, recording or other personnel, except inspectors and enforcement agents, of each of the respective boards and agencies enumerated in section four hereof, as the State Commissioner of Health may, after consultation with the members of such board or agency, determine are needed for the proper performance of the work of such board or agency, are hereby transferred to the Bureau of Examination and Licensing established hereunder. Persons so transferred shall be assigned to such duties as the State Commissioner of Health shall determine.
Such inspectors and enforcement agents of each of the respective boards and agencies enumerated in section four hereof, as such board or agency may, subject to the approval of the State Commissioner of Health, determine are needed for the proper performance of the work of such board or agency, are hereby transferred to such board or agency. Persons so transferred shall be assigned to such duties as such board or agency shall determine.
The treasurer or custodian of the funds of each of the respective boards and agencies enumerated in section four hereof shall, on the effective date hereof, through the State Commissioner of Health, transfer to the State treasury all funds and investments belonging to such board or agency.
Notwithstanding the provisions of any other law to the contrary:
(1) All license, certificate, permit, registration and renewal fees prescribed by law for any of the professions or occupations with which any of the boards or agencies enumerated in section four hereof is concerned, or payable to any such board or agency, or to any member or officer thereof, pursuant to law, shall henceforth be paid into the State treasury through the State Commissioner of Health; and
(2) All fines, penalties, and other moneys derived from the operation of, or payable pursuant to law to, any of the boards or agencies enumerated in section four hereof, or to any member or officer thereof, shall henceforth be paid into the State treasury through the State Commissioner of Health.
Such fees, fines, penalties and other moneys so paid into the State treasury shall be placed to the credit of the respective board or agency concerned therewith, and no part thereof may be disbursed or expended for any purpose except in accordance with appropriations made by law, and then only upon warrant of the State Treasurer on vouchers certified or approved by the chairman, president, or other presiding officer of the board or agency concerned therewith and the State Commissioner of Health. Expenditures from appropriations in any fiscal year shall in no event exceed the amount paid into the State treasury for or on behalf of such board or agency during such year.
On or before the fifteenth day of September in each year, each of the boards and agencies within the Bureau of Examination and Licensing established hereunder shall prepare and submit to the State Commissioner of Health a budget request for appropriations for such board or agency for the ensuing fiscal year. The respective budget requests so prepared shall, upon approval of the State Commissioner of Health, be submitted to the State Treasurer. The total annual appropriations for any of such boards or agencies shall in no event exceed the total amount of all moneys paid into the State treasury for or on behalf of such board or agency, as provided herein, during the preceding fiscal year.
Any surplus remaining in any year to the credit of any of the boards or agencies within the Bureau of Examination and Licensing established hereunder, after annual appropriations made as provided herein, shall be paid into and become part of the general fund of the State.
Limitations on appropriations to any of the boards or agencies enumerated in section four hereof, contained in any existing law, shall, notwithstanding the provisions of this act, continue in full force and effect.
Such employees of the State Crippled Children's Commission, as the State Commissioner of Health may, after consultation with such commission, determine are needed for the proper performance of the work of such commission, are hereby transferred to the State Department of Health. Persons so transferred shall be assigned to such duties as the State Commissioner of Health shall after consultation with the commission, prescribe.
All appropriations available and to become available to the State Crippled Children's Commission are hereby transferred to the State Department of Health, and shall be available for the objects and purposes for which appropriated.
All appropriations available and to become available to the State Board of Barber Examiners, and all appropriations available and to become available to the department of beauty culture control and to the board of beauty culture control are hereby transferred to the State Department of Health.
Nothing in this act shall be construed to deprive any person of any right or protection provided him by Title 11 of the Revised Statutes, Civil Service, or under any pension law or retirement system.
This act shall not affect the orders, rules and regulations heretofore made or promulgated by any of the respective boards or agencies enumerated in section four of this act but such orders, rules and regulations shall continue with full force and effect until amended or repealed by such board or agency.
This act shall not affect actions or proceedings, civil or criminal, brought by or against any of the respective boards or agencies enumerated in section four of this act and pending on the effective date hereof, and such actions or proceedings may be prosecuted or defended in the same manner and to the same effect by such board or agency as if the foregoing provisions had not taken effect; nor shall any of the foregoing provisions affect any order or recommendation made by, or other matters or proceedings before, any of such respective boards or agencies, and all such matters and proceedings pending before any such board or agency on the effective date of this act shall be continued before such board or agency.
Nothing in this act shall affect the validity of any license, certificate of registration, or other authorization, heretofore issued to any person under any prior law, to practice any profession or to engage in any occupation governed or regulated by the provisions of this act or by any board or agency enumerated in section four of this act; but all persons holding such licenses, certificates of registration, or other authorization, shall in all other respects be subject to the provisions of this act and to the respective provisions of law governing or regulating such profession or occupation.
All acts and parts of acts inconsistent with any of the provisions of this act are, to the extent of such inconsistency, hereby repealed.
This act shall be known as, and may be cited as, the "State Department of Health Act of 1948."
This act shall take effect on the first day of January, one thousand nine hundred and forty-nine, except that any appointment, and any confirmation of any appointment, permitted by this act may be made prior to such date.
This act shall be known and may be cited as "The Prevention of Chronic Illness Act."
The growing problem of prevention, detection and care of chronic illness, which is of such character as not to be exclusively medical, educational or welfare, has now reached such proportions in this State as to require the participation of the State and of the agencies administering public health, education and welfare within the State and it is hereby declared to be the public policy of this State that the responsibility therefor must be shared by the State and the counties and the several municipalities and health districts and the voluntary agencies and institutions within the State and the public at large.
There is hereby established within the Department of Health a Division of Chronic Illness Control for the prevention, early detection and control of chronic illness and rehabilitation of the chronic sick of this State.
The Division of Chronic Illness Control shall be under the immediate supervision of a director, who shall be a physician qualified in public health, and who shall be appointed by and serve at the pleasure of the State Commissioner of Health.
The division shall administer and provide for the carrying out of the programs required to perform the general functions provided by this act to be performed by the State and for the carrying out of the general policies formulated by the Advisory Council on the Chronic Sick as approved by the State Commissioner of Health and it shall perform such other duties as may be delegated to it by the State Commissioner of Health.
The State Department of Health shall within funds appropriated and available therefor be charged with the responsibility of carrying out the obligations herein assumed by the State as its share of the task of providing for prevention, early detection and control of chronic illness and rehabilitation of the chronic sick and it shall also:
(a) Arrange for joint discussion of the general problem of the chronic sick with representatives of all State agencies and departments engaged in health, welfare and education and with representatives of the several counties, municipalities and health districts, general and special hospitals, voluntary agencies and institutions, and the medical, dental, nursing and allied professions, for the purpose of formulating an adequate program for dealing with the problem of the chronic sick and to determine a formula for the ultimate division of the governmental share of the cost thereof between municipalities, counties and the State;
(b) Plan for the provision of adequate visiting nurse and housekeeping aid services by appropriate public or private agencies throughout the State, to the end that the nursing and medical care being furnished the chronic sick in their own homes shall be improved in every manner possible;
(c) Collect and prepare all available information designed to acquaint the professions and the public with the best and most modern methods of preventing chronic sickness and its early detection and control, and caring for and rehabilitating the chronic sick, and arranging for the distribution thereof through all possible media so that the greatest number of persons may benefit therefrom;
(d) Collect, prepare and distribute information including statistics which will afford the general public greater insight into the significance, character and magnitude of the problem of prevention of chronic sickness as well as insight into the problem of the care and rehabilitation of the chronic sick in order to secure a more active interest of the general public in such problems;
(e) Perform and encourage research activities as to the best and most modern methods of prevention, discovery, treatment and cure of chronic diseases and the care and rehabilitation of persons affected and for the analysis of such data and for the dissemination of such information to the professions and agencies engaged in providing for the chronic sick, as well as to the general public;
(f) In effectuation of (e) study the problem of prevention and detection of all types of chronic disease by laboratory, statistical and community co-operative methods and by such other methods as may be deemed advisable;
(g) Assist in promoting and strengthening of child and adult health programs for the purpose of preventing or retarding the development of chronic illnesses;
(h) Maintain and expand co-operative relationships with all professional and public and private agencies responsible for and interested in, the prevention and detection of chronic illness and in the care and rehabilitation of the chronic sick.
The State Department of Health shall administer the distribution and expenditure of moneys appropriated for the purposes described in section 6 of this act in such manner and in such amounts as the State Commissioner of Health with the approval of the Director, Division of Budget and Accounting in the Department of the Treasury shall determine to be most feasible, practicable and beneficial for the recipients thereof and in accordance with the formula of participation determined upon by the State Commissioner of Health but the money shall not be paid to any physician as salary or fee for treatments administered to the chronic sick except where such treatments may be administered for research purposes approved by the State Commissioner of Health, nor shall direct assistance in cash or merchandise for the general support of needy persons be paid therefrom.
The State Department of Health shall on or before the first day of October in each year report to the Governor setting forth in detail the scope and type of activities required to implement the program authorized by this act for the ensuing fiscal year, including recommendations of methods which might be utilized to encourage greater participation in said program by the counties, municipalities, health districts and the several private and public agencies engaged in said field and it shall include therein its recommendations as to the sum or sums of money to be included in the department's annual budget for the performance of the functions set forth in this act.
The Department of Education shall assist the Department of Health in disseminating information designed to acquaint and give to the general public greater insight into the problems of chronic sickness and the prevention of chronic illness.
The State Department of Health is hereby authorized and empowered with the approval of the Governor to apply for and negotiate with the Federal Government or any officer or agency thereof for the purpose of securing an allotment of any Federal moneys that might be made available to the State for the purposes of this act. Such funds when received shall be subject to disbursement by the State Department of Health in the same manner as other funds of the State are disbursed.
Notwithstanding the provisions of this act, the Department of Institutions and Agencies shall continue to be the sole State agency for the rendering of welfare assistance to the permanently and totally disabled and to needy persons in such other categories of assistance as is now or may be authorized hereafter by law.
Three members of the commission shall be appointed for one year, three for two years and three for three years, and their successors shall be appointed for terms of three years. All members may hold over and serve on the commission after the expiration of their respective terms, until their respective successors are appointed and shall qualify. Vacancies occurring other than by expiration of term shall be filled for the unexpired term. A chairman and other officers of the commission shall be elected for a term of two years by the members from among the members appointed by the Governor.
The Commission on Aging shall meet at regular intervals and at least quarterly. The times and places for the said meetings shall be fixed by the commission and special meetings may be called by the chairman on not less than 10 days' written notice to each member. The commission may adopt bylaws for the regulation of its affairs.
The members of the Commission on Aging shall serve without compensation, but the members of the commission shall be entitled to reimbursement for their necessary expenses incurred in the performance of their duties as such members.
The director shall be deemed to be a full-time State official and he shall be paid such compensation as shall be provided by law. The director shall serve during the term of office of the Governor but he shall continue in office after the expiration of his term until his successor shall be appointed and shall qualify; provided, however, that the director in office on the effective date of this act shall complete the term to which he was appointed.
The division shall:
(1) Maintain a continuous study, analysis and interpretation of all information, data, programs and developments pertaining to the aging processes and the needs of the older residents of New Jersey;
(2) Maintain a continuous inventory of resources in any way available which can be drawn upon to carry out the program of the division in the performance of its functions and duties;
(3) Serve as the central permanent agency for the planning and co-ordination of programs and services for the older residents in the State, particularly in respect to those which multiple governmental agencies or private organizations may contribute;
(4) Provide leadership and administrative direction to such efforts from one central source so that those who need help or who may provide help on any of the aspects of aging shall have a central point of contact;
(5) Serve as a communications clearing house for information in the large and complex fields of human relationships in respect to aging;
(6) Disseminate and publicize organized information of value to the public generally and to all groups concerned in any way with the diverse subject of aging;
(7) Consult with, advise and otherwise provide professional assistance to organized efforts by communities, organizations, associations and groups who are working toward any and all forms of assistance to the aging;
(8) Hold public hearings when necessary to further the objectives consonant with the provisions of this act;
(9) Co-operate and consult with such other departments of State or Federal Government to the extent necessary to attain the objectives of this act.
(1) Furnish consultation and advice to the Division of Aging Services on programs designed to carry out the division's mandate.
(2) Provide leadership in the field of aging.
(3) Make recommendations to the Governor and Legislature regarding new legislation needed in areas related to aging.
(4) Maintain liaison with other commissions and groups whose activities relate to the broad field of aging.
The staff of the division should be qualified to provide consultative and advisory assistance to other State agencies and to local agencies or organizations which are developing or improving their particular services to the aging. In addition to the director and necessary clerical personnel, the staff should include such professionally trained persons as shall be necessary to carry out the purposes of this act.
The Legislature, from time to time, shall provide for the salaries and expenses of the division by inclusion in any general or supplemental appropriation act or by a direct appropriation.
Appointments may be made and preliminary action may be taken in advance of the going into operation of this act.
This act shall take effect immediately but shall be inoperative for 90 days following its approval.
The Legislature further recognizes that: heart disease is the leading cause of death for women, however, women with heart disease are not diagnosed or treated as early or as aggressively as men, and the classic risk profile for cardiovascular disease is based on a male model of disease; breast cancer is the leading cause of death in women between the ages of 35-50; New Jersey has higher than average rates for breast cancer and the State ranks 25th among all states for breast cancer screening; there remains a tremendous need for education and information regarding breast cancer symptoms, self-evaluation, routine mammography, prevention programs and access to services; nearly one fourth of pregnant women do not receive adequate prenatal care; women constitute the fastest growing group of people with AIDS in New Jersey; and domestic violence is a major health problem for women nationally and in this State.
Therefore, it is necessary to create a special office to focus exclusively on these crucial health concerns facing the women in New Jersey.
The office shall:
a. Provide grants to community-based organizations to conduct special research, demonstration, and evaluation projects on women's health concerns;
b. Develop and implement model public and private partnerships throughout the State for health awareness campaigns and to improve the access, acceptability, and use of public health services;
c. Serve as an information and resource center for women's health information and data;
d. Function as an advocate for the adoption and implementation of effective measures to improve women's health;
e. Convene such task forces of experienced, knowledgeable persons on specific women's health issues as the director deems appropriate; and
f. Review the programs of the Departments of Health, Human Services, Children and Families, and Education and any other department of State government, as appropriate, that concern women's health and make recommendations to the departments that will enable them to better coordinate and improve the effectiveness of their efforts.
a. Apply for and accept any grant of money from the federal government, private foundations or other sources, which may be available for programs related to women's health;
b. Serve as the designated State agency for receipt of federal funds specifically designated for women's health programs; and
c. Enter into contracts with individuals, organizations, and institutions necessary for the performance of its duties under this act.
The commission shall consist of nine members, including the Commissioner of Health or his designee, who shall serve ex officio, and eight public members who are residents of the State and who shall be appointed as follows: one member who is a health care professional shall be appointed by the President of the Senate; one member who is a health care professional shall be appointed by the Speaker of the General Assembly; and six members, at least two of whom are health care professionals, at least one of whom represents health care facilities, at least one of whom represents the health insurance industry, and at least one of whom is a woman with a disability, shall be appointed by the Governor with the advice and consent of the Senate. No less than five of the public members shall be women.
The term of office of each public member shall be three years, but of the members first appointed, two shall be appointed for a term of one year, three shall be appointed for a term of two years and three shall be appointed for a term of three years. A member shall hold office for the term of his appointment and until his successor has been appointed and qualified. All vacancies shall be filled for the balance of the unexpired term in the same manner as the original appointment. A member of the commission is eligible for reappointment.
The public members of the commission shall not receive any compensation for their services, but shall be reimbursed for the actual and necessary expenses incurred in the performance of their duties as members of the commission, within the limits of funds available to the commission.
The members of the commission shall annually elect a chairman and a vice-chairman from among the public members and may select a secretary, who need not be a member of the commission.
The Office on Women's Health in the Department of Health shall provide staff and assistance which the commission requires to carry out its work.
a. Review and make recommendations to the Office on Women's Health on any rules, regulations and policies proposed by the office;
b. Advise the office on the awarding of grants and development of programs and services required pursuant to this act;
c. Advise the office on the needs, priorities, programs and policies relating to women's health in this State; and
d. Provide any other assistance to the office, as may be requested by the director.
The commission may accept from any governmental department or agency, public or private body or any other source grants or contributions to be used in carrying out its responsibilities under this act.
a. Menstrual disorders such as endometriosis and polycystic ovarian syndrome affect many women and can have a negative effect on fertility and overall maternal health;
b. According to the United States Department of Health and Human Services' Office on Women's Health, endometriosis may affect more than 11 percent of American women between the ages of 15 and 44, which is approximately 6.5 million women in the United States alone; endometriosis may also occur in pre-menarcheal and post-menopausal individuals;
c. According to the Mayo Clinic, endometriosis is an often painful disorder in which tissue similar to the tissue that normally lines the inside of a woman's uterus, called the endometrium, grows outside the uterus;
d. In patients who have endometriosis, the endometrial-like tissue thickens, breaks down, and bleeds. However, since this tissue has no way to exit the body, it becomes trapped;
e. When endometriosis impacts the ovaries, cysts called endometriomas may form. Surrounding tissue can become irritated, eventually developing scar tissue and adhesions that can cause pelvic tissues and organs to stick to each other;
f. The primary symptom of endometriosis is pelvic pain. Although many women experience cramping during their menstrual periods, those with endometriosis typically describe menstrual pain that is much worse than normal cramping, which pain may increase over time;
g. Symptoms of endometriosis include: painful periods known as dysmenorrhea, pain with intercourse, pain with bowel movements or urination, excessive bleeding, infertility, fatigue, diarrhea, constipation, bloating, and nausea;
h. Ovarian cancer is more common in those who have endometriosis as compared with the general population;
i. Although rare, another type of cancer called endometriosis-associated adenocarcinoma can develop later in life in those who have had endometriosis;
j. According to the federal Centers for Disease Control and Prevention, polycystic ovary syndrome (PCOS) is one of the most common causes of female infertility, affecting as many as five million, or six to 12 percent, of women of reproductive age in the United States;
k. Polycystic ovary syndrome is a lifelong health condition that can affect the lives of people who have it far beyond their child-bearing years and involves other serious health complications;
l. Women with PCOS are often insulin resistant, which means that their bodies can make insulin but are unable to use it effectively, increasing their risk for Type 2 diabetes;
m. Women with PCOS also have higher levels of androgens, which are hormones that can stop eggs from being released and cause irregular periods, acne, thinning scalp hair, and excess hair growth on the face and body;
n. More than half of women with PCOS develop type 2 diabetes by age 40. Women with PCOS can also develop gestational diabetes when pregnant, which puts the pregnancy and baby at risk and can lead to type 2 diabetes later in life for both mother and child;
o. Women with PCOS are at higher risk of heart disease, which risk increases with age;
p. Women with PCOS can also experience: (1) high blood pressure, which can damage the heart, brain, and kidneys; (2) high LDL or "bad" cholesterol and low HDL or "good" cholesterol, which increases the risk for heart disease; (3) sleep apnea, which is a disorder that causes breathing to stop during sleep and raises the risk for heart disease and type 2 diabetes; and (4) stroke;
q. PCOS is also linked to depression and anxiety;
r. Menstrual toxic shock syndrome is a menstruation-related condition that can lead to serious adverse health symptoms, including death if left untreated. The symptoms of menstrual toxic shock syndrome generally begin with low fever, muscle aches, chills, fatigue, and headaches, but as the condition progresses, symptoms can include high fever, vomiting, rashes, redness of the eyes, lips, and tongue, low blood pressure, and mental confusion;
s. Menstrual toxic shock syndrome is generally treatable with antibiotics, but treatment relies on identifying the signs of the condition and seeking professional help. Anyone can contract menstrual toxic shock syndrome, but women using tampons and similar devices are at a higher risk; and
t. Given all of the increased health risks associated with menstrual disorders, such as endometriosis and PCOS, as well as the risks of menstrual toxic shock syndrome, and the number of women impacted by these conditions, it is imperative that the Department of Health establish a public awareness campaign about the effects of menstrual disorders and menstruation-related conditions on fertility and overall maternal health.
b. The public awareness campaign shall include, but not be limited to, the following:
(1) a comprehensive description of common menstrual and menstruation-related disorders, such as endometriosis and PCOS, including discussion of causes, symptoms, and treatment options;
(2) information on the causes and symptoms of menstrual toxic shock syndrome and the ways in which women may reduce the risk of developing the syndrome;
(3) information about educational resources available to women concerning menstrual disorders, menstruation-related disorders, and menstruation-related conditions; and
(4) materials encouraging women to schedule routine gynecological examinations, consult with their physicians about menstrual and menstruation-related disorders, and seek treatment if they are experiencing symptoms associated with menstrual toxic shock syndrome.
c. The department shall make available to the public, electronically on its website, information about common menstrual and menstruation-related disorders, such as endometriosis and PCOS, and their effects on maternal health, as well as informational literature concerning the signs, causes, and dangers of menstrual toxic shock syndrome.
a. It is in the public interest for New Jersey residents to have all appropriate personal health information available to them and to their treating health care professionals in a medical office, hospital emergency room, other health care facility setting, or pharmacy;
b. Natural disasters and other public health emergencies have demonstrated the need for timely, secure, and accessible health information, in particular for our most vulnerable populations, including senior citizens, persons with disabilities, and those with limited financial means;
c. Health information technology has great potential as one means of furthering progress towards achieving affordable, safe, and accessible health care for all persons by: ensuring that health information is available at the point of care for all patients, while protecting the confidentiality and privacy of the information; improving safety, reducing medical errors, and avoiding duplicative and unnecessary medical tests and procedures; improving coordination of care among hospitals, clinics, nursing homes, home health agencies, pharmacies, and health care professionals; and providing consumers with their own health information in order to encourage greater participation in decisions concerning their own health care;
d. The federal Department of Health and Human Services has estimated that health information technology, in addition to improving the quality of chronic care management and reducing medical errors, could achieve potential savings of almost 10% of total health care spending in the United States;
e. The many different and conflicting standards for collecting and reporting personal health information within the health care community currently hinder the appropriate sharing of patient health care information, and health information technology can eliminate these different standards;
f. State leadership can promote public policy, encourage coordinated efforts in the private health care sector, further public and private partnerships, and maximize federal and regional financial participation, in support of adopting an electronic health information infrastructure;
g. It is desirable to implement an electronic health information infrastructure in the context of a Statewide health information technology plan that includes standards and protocols designed to promote patient education, patient privacy, physician best practices, electronic connectivity to health care data, and generally a more efficient and less costly means of delivering quality health care in New Jersey, in order to provide for an interoperative environment among health care providers, health care payers, employers, and patients in New Jersey;
h. It is time for this State to clearly and unequivocally move its public policy in the direction of establishing an electronic health information infrastructure through a vehicle that provides for a collaborative planning and implementation strategy and includes the relevant public and private stakeholders in developing and achieving a sustainable model for an electronic health information network for New Jersey; and
i. In order to conserve and efficiently use funds for the effective delivery of quality medical care to all persons, it is the policy of the State to lessen the expenditure of resources on unnecessarily repeated medical tests, while maintaining the highest quality of medical care for our citizens.
"Health information technology" means technology that is used to electronically collect, store, retrieve, and transfer clinical, administrative, and financial health information.
"Interoperative" means that entities are able to exchange data accurately, effectively, securely, and consistently with different information technology systems, software applications, and networks in such a way that the clinical or operational purposes and meaning of the data are preserved and unaltered.
"Office for e-HIT" means the Office for the Development, Implementation, and Deployment of Electronic Health Information Technology, established in the Department of Banking and Insurance, pursuant to section 8 of this act (C.17:1D-1).
"Plan" means the Statewide health information technology plan that is developed and implemented pursuant to this act.
b. The commission shall collaborate with the Office for e-HIT established pursuant to section 8 of this act (C.17:1D-1), concerning all activities related to the development, implementation, and oversight of the plan.
The commission shall be responsible for approving the Statewide health information technology plan.
c. In providing advice on the development of the plan, the commission shall, at a minimum, consider the following:
(1) the importance of the education of the general public and health care professionals about the value of an electronic health infrastructure for improving the delivery of patient care;
(2) the means for the creation of an effective, efficient, Statewide use of electronic health information in patient care, health care policymaking, clinical research, health care financing, and continuous quality improvements;
(3) the means for the promotion of the use of national standards for the development of an interoperative system, including provisions relating to security, privacy, data content, structures and format, vocabulary, and transmission protocols;
(4) the nature of proper strategic investments in equipment and other infrastructure elements that will facilitate the ongoing development of a Statewide infrastructure;
(5) funding needs for the ongoing development of health information technology projects;
(6) actions needed to incorporate existing health care information technology initiatives into the plan in order to avoid incompatible systems and duplicative efforts;
(7) the proper means for the review and integration of the recommendations, findings, and conclusions of the New Jersey Health Information Security and Privacy Collaboration;
(8) the importance of recommending steps for the proper resolution of issues related to data ownership, governance, and confidentiality and security of patient information;
(9) the importance of promoting the deployment of health information technology in primary care provider settings; and
(10) the roles that the development and use of open-source electronic medical record software and the use of application service provider software can play in effectuating the purposes of paragraph (9) of this subsection.
d. The commission shall review the plan submitted by the Office for e-HIT and notify it of any changes needed to approve the plan.
(1) the Commissioners of Health, Banking and Insurance, Children and Families, and Human Services, and the State Treasurer, or their designees, who shall serve ex officio; and
(2) 14 public members, who shall be appointed by the Governor no later than the 60th day after the effective date of this act, as follows: three physicians engaged in private practice in this State, one of whom is a pediatrician and one a psychiatrist; two persons who represent acute care hospitals in this State, one of whom represents a teaching hospital and the other a non-teaching hospital; a registered professional nurse practicing in this State; a pharmacist practicing in this State; a person who represents a clinical laboratory operating in this State; an attorney practicing in this State with demonstrated expertise in health privacy issues; a person who represents a health insurance carrier operating in this State; a person who represents a Quality Improvement Organization located in New Jersey that contracts with the federal Centers for Medicare & Medicaid Services to improve the efficiency and effectiveness, economy, and quality of services provided to Medicare beneficiaries; and three members of the public with a demonstrated professional expertise in issues relating to the work of the commission, including one member with expertise in electronic health information technology.
(3) The Governor shall designate a public member as chair of the commission.
b. The public members shall serve for a term of three years; except that, of the public members first appointed, five shall serve for a term of three years, five for a term of two years, and four for a term of one year. Vacancies in the membership of the commission shall be filled in the same manner as the original appointments were made.
c. The commission shall organize as soon as may be practicable, but no later than the 45th day after the appointment of its members. The public members shall serve without compensation, but may be reimbursed for necessary expenses incurred in the performance of their duties.
d. A majority of the total authorized membership of the commission shall constitute a quorum at any meeting thereof. Action may be taken and motions and resolutions adopted by the commission at any meeting of the commission by the affirmative vote of a majority of the quorum of the members who are present. A vacancy in the membership of the commission shall not impair the right of a quorum of the members to exercise all the powers and perform all the duties of the commission.
e. The commission shall meet and confer with the Office for e-HIT at least quarterly and may meet at other times at the call of the commission chair. The meetings of the commission shall comply with the provisions of the "Senator Byron M. Baer Open Public Meetings Act," P.L.1975, c.231 (C.10:4-6 et seq.).
f. In addition to any other powers authorized by law, the commission shall have the authority, in accordance with State law, to:
(1) make and enter into contracts to purchase services and supplies;
(2) develop and submit a proposed budget, not to exceed $1 million annually;
(3) apply for, receive, and expend grants from governmental or private nonprofit sources;
(4) recommend to the Department of Banking and Insurance the necessary charges and assessments to be levied to collect payments from persons and entities for the provision of services or as the Office for e-HIT otherwise determines necessary to effectuate the purposes of this act;
(5) receive and expend appropriations;
(6) provide such other services and perform such other functions as the commission deems necessary to fulfill its responsibilities under this act; and
(7) appoint, retain, or employ consultants on a contract basis or otherwise, who are deemed necessary, and as may be within the limits of funds appropriated or otherwise made available to it for its purposes.
g. In collaboration with the Office for e-HIT, the commission shall, no later than 18 months after its initial meeting and annually thereafter, submit a joint report to the Governor, and to the Legislature pursuant to section 2 of P.L.1991, c.164 (C.52:14-19.1), concerning its activities and the status of, and actions taken regarding development, implementation, and oversight of the Statewide health information technology plan. The commission shall include in that report any findings and recommendations that it desires to make, along with any legislative bills that it desires to recommend for adoption by the Legislature.
h. The commission shall develop and submit a proposed budget to the Commissioner of Health to effectuate its duties as set forth in this act.
The budget shall be subject to approval by the Commissioner of Health.
i. The commission shall appoint a full-time executive director, who shall serve as secretary to the commission. The executive director shall serve at the pleasure of the commission and shall be qualified by training and experience to perform the duties of the position. The executive director shall be in the unclassified service of the Civil Service and may hire properly qualified employees, within the limits of funds appropriated or otherwise made available to the commission, who shall also be employed in the unclassified service of the Civil Service; except that employees performing stenographic or clerical duties shall be in the career service and appointed pursuant to Title 11A of the New Jersey Statutes.
"De-identified data" means information that does not identify an individual and for which there is no reasonable basis to believe that the information can be used to identify an individual, and which meets the requirements for de-identification of protected health information under the "Health Insurance Portability and Accountability Act of 1996," Pub.L.104-191, and any regulations adopted pursuant thereto by the Secretary of the United States Department of Health and Human Services.
b. For each reported diagnosis of Legionnaires' disease in the State, the Department of Health, or a local health officer pursuant to subsection f. of this section, shall conduct an epidemiological investigation to ascertain potential sources of infection consistent with the provisions of this section and the procedures and guidelines established pursuant to subsection c. of this section.
c. The Department of Health shall develop procedures and guidelines regarding suspected outbreaks of Legionnaires' disease and the case investigation of reported diagnoses of Legionnaires' disease pursuant to subsection b. of this section, including, but not limited to:
(1) documentation of any disruption of the public community water system, as defined in section 1 of P.L.2024, c.66 (C.58:12A-12.10), of the water system serving the primary residence of the individual with a confirmed case of Legionnaires' disease or other water exposure points identified pursuant to paragraph (3) of this subsection;
(2) provisions for the investigation of potential sources of exposure to Legionella bacteria from fixtures, water-using equipment, or features at the individual's residence including water exposures external to the residence such as irrigation, hoses, or water-based equipment and devices;
(3) provisions for the investigation of potential sources of exposure to Legionella bacteria from water exposure points in locations the individual visited in the 14 days preceding infection, if appropriate; and
(4) procedures for determining when sampling of water fixtures identified as potential sources of exposure in paragraphs (2) and (3) of this subsection shall be performed and procedures for performing such sampling.
d. As part of an investigation of a confirmed case of Legionnaires' disease, the Department of Health or the local health officer may require the owner or operator of a building suspected to be a source of Legionella bacteria exposure to test and mitigate the presence of Legionella bacteria consistent with the procedures and guidelines established by the department. The owner or operator shall report to the department the results of any environmental testing performed as part of the investigation. For the purposes of this subsection "building" shall not include any residential property with four or fewer dwelling units.
e. The Department of Health or the local health officer may require the owner or operator of a building suspected to be a source of Legionella bacteria exposure to provide notice in a form and manner specified by the department. If notice is required in a municipality in which the primary language of 10 percent or more of the residents is a language other than English, the owner or operator shall provide the notice in both English and the other language to potentially exposed individuals.
f. The Department of Health may delegate its responsibilities and duties pursuant to this section as deemed appropriate for conducting all or part of the case investigation required by this section to a local health officer having jurisdiction over the locality in which a patient diagnosed with Legionnaires' disease lives, frequently visits, or is employed, subject to the resources available to the local health officer.
g. The Department of Health shall establish on its Internet website a dashboard accessible to the public and healthcare providers that provides de-identified data related to all reported cases of Legionnaires' disease with the goal of providing near-real-time incidence rates in affected communities. The Department of Health shall include information concerning aggregated data of all reported cases of Legionnaires' disease with the greatest degree of specificity consistent with ensuring that no information that could compromise protected health information, or patient identity, is included in such reporting.
(1) a general or specialty hospital that provides in-patient services and is licensed pursuant to P.L.1971, c.136 (C.26:2H-1 et seq.);
(2) a nursing home, assisted living facility, comprehensive personal care home, residential health care facility, or dementia care home licensed pursuant to P.L.1971, c.136 (C.26:2H-1 et seq.);
(3) a building containing a whirlpool, spa, pool, open-circuit or closed-circuit cooling tower or evaporative condenser that provides cooling or refrigeration for a heating, ventilation, air conditioning, or refrigeration system, indoor ornamental fountain, mister, atomizer, air wash, humidifier, or other non-potable water system or device that releases water aerosols in the building or on the property upon which the building is located. A building with a device listed in this paragraph shall implement a water management program for the listed device and need not implement a water management program for the entire building unless otherwise indicated by this subsection;
(4) a federal, State, county, or privately owned or operated correctional facility with one or more centralized potable hot water systems;
(5) a residential high-rise structure with six or more floors and one or more centralized potable water-heater systems;
(6) a building with one or more centralized potable water-heater systems shared by 25 or more housing units for transient use, including, not but limited to, a hotel or motel;
(7) a residential building with a centralized potable water-heater system that is shared by 25 or more housing units, which serves as subsidized housing designated for individuals who are 62 years of age or older or who have a disability or is designated as senior housing and is subject to the provisions of P.L.1986, c.103 (C.52:27D-330 et seq.);
(8) a residential, commercial, institutional, or industrial building or facility, including a hotel or motel, not otherwise required to implement a water management program, but which has been determined by the Department of Health or a local health officer to have been associated with an outbreak of Legionnaires' disease. The Department of Health or local health officer shall determine the period during which a water management program is required pursuant to this paragraph in order to address the increased risk of Legionella contamination of the building or facility.
b. (1) A water management program for a building or facility that meets the criteria of paragraphs (1) or (2) of subsection a. of this section that has been determined by the Department of Health or a local health authority to have been associated with an outbreak of Legionnaires' disease or for which periodic water sampling for bacteria is recommended by the federal Centers for Disease Control and Prevention shall include periodic water sampling and testing for bacteria in accordance with the rules and regulations promulgated by the Department of Health pursuant to section 8 of P.L.2024, c.66 (C.26:1A-142).
(2) A water management program for a building or facility that does not meet the criteria described in paragraph (1) of this subsection may include periodic water sampling and testing for bacteria.
(3) All sampling and testing carried out pursuant to this subsection shall include, but not be limited to, testing for the presence of Legionella pneumophila and shall be conducted in a manner consistent with:
(a) rules, regulations, and best practices developed by the Department of Health; and
(b) the American Society of Heating, Refrigeration, and Air Conditioning Engineers (ASHRAE) Standard 188-2018 or subsequent versions thereof or comparable standards adopted by a nationally recognized, accepted, and appropriate organization.
(4) The owner or operator of a covered facility or building shall follow ASHRAE Standard 188-2018 and guidelines established by the federal Centers for Disease Control and Prevention in interpreting and responding to positive test results. The Department of Health shall establish procedures for the reporting of positive test results for Legionella bacteria received during testing carried out pursuant to this subsection.
c. When a person required to implement a water management program pursuant to this section has complied with the requirements of this section, the person shall post a written public notice on the premises in a location easily accessible to building occupants that such a program has been implemented.
d. No later than 12 months after the effective date of P.L.2024, c.66 (C.58:12A-12.10 et al.), the Department of Health shall develop and make available on its Internet website guidance documents for the development and implementation of water management programs pursuant to this section, including guidance documents for complying with record-keeping requirements, and best practices for periodic water sampling and testing.
e. The owner or operator of a building or facility required to implement a water management program pursuant to this section shall establish documentation concerning all procedures and shall maintain all records related to these procedures and their implementation and make them available upon request to an employee of the Department of Community Affairs, the Department of Environmental Protection, the Department of Health, or any other department or agency with license or inspection authority for the facility or building in order to confirm that a water management program was developed. The Department of Community Affairs, the Department of Environmental Protection, the Department of Health, or any other department or agency with license or inspection authority for the facility or building shall not be required to evaluate or otherwise review a water management program unless required for an investigation of a case of Legionnaires' disease in accordance with procedures developed by the Department of Health pursuant to section 5 of P.L.2024, c.66 (C.26:1A-139).
f. (1) No later than 27 months after the effective date of P.L.2024, c.66 (C.58:12A-12.10 et al.), the owner or operator of a building or facility that meets any of the criteria set forth in paragraphs (1) through (8) of subsection a. of this section shall implement the procedures outlined in their personalized water management program. Newly constructed or repurposed buildings or facilities shall confirm that the water management program mitigates the potential for human exposure to Legionella bacteria prior to commissioning.
(2) The owner or operator of a building or facility that meets any of the criteria set forth in paragraphs (1) through (8) of subsection a. of this section shall maintain on the building or facility premises for at least five years: (i) the written water management program; (ii) documentation and records concerning all procedures conducted, including the results from any water testing carried out pursuant to subsection b. of this section; and (iii) all other relevant documentation on the implementation of the water management program. Such records shall be made available to the Department of Health immediately upon request.
g. (1) The owner or operator of a building or facility who fails to implement or demonstrate compliance with a water management program required pursuant to this section, fails to report a positive Legionella water system test pursuant to the procedures set by the Department of Health, fails to test for or mitigate the presence of Legionella as required by the Department of Health or the local health officer pursuant to subsection d. of section 5 of P.L.2024, c.66 (C.26:1A-139), or fails to provide notice pursuant to subsection e. of section 5 of P.L.2024, c.66 (C.26:1A-139) shall be subject to a civil penalty of not more than $2,000 for a first violation, and not more than $5,000 for a second or subsequent violation, except that the owner or operator shall be subject to a civil penalty of not more than $10,000 for any violation which causes serious injury or death to any person. Penalties imposed pursuant to this paragraph shall be collected by the State in a civil action by a summary proceeding under the "Penalty Enforcement Law of 1999," P.L.1999, c.274 (C.2A:58-10 et seq.). The Superior Court and the municipal court shall have jurisdiction over proceedings for the enforcement of the penalties provided by this paragraph.
(2) Whenever the Department of Health determines that any person is in violation of a provision of this section or section 5 of P.L.2024, c.66 (C.26:1A-139), the department may assess a civil administrative penalty of not more than $2,000 for a first violation, and not more than $5,000 for a second or subsequent violation, except that the person shall be subject to a civil administrative penalty of not more than $10,000 for any violation which causes serious injury or death to any person. In assessing a civil administrative penalty, the commissioner shall consider the severity of the violation, the measures taken to prevent further violations, and whether the penalty will act as an appropriate deterrent. Prior to the assessment of a civil administrative penalty under this paragraph, the person committing the violation shall be notified by certified mail or personal service that the penalty is being assessed. The notice shall identify the section of the statute, rule, regulation, or order that was violated; recite the facts alleged to constitute a violation; state the basis for the amount of the civil administrative penalties to be assessed; and affirm the rights of the alleged violator to a hearing. The ordered party shall have 35 days from receipt of the notice within which to deliver to the Commissioner of Health a written request for a hearing. After the hearing and upon finding that a violation has occurred, the Commissioner of Health may issue a final order after assessing the amount of the fine specified in the notice. If no hearing is requested, the notice shall become a final order after the expiration of the 35-day period. Payment of the assessment is due when a final order is issued or the notice becomes a final order.
(3) The Department of Community Affairs, the Department of Environmental Protection, the Department of Health, or any other department or agency with license or inspection authority for the facility or building may institute a civil action for injunctive relief in the Superior Court to enforce the provisions of this section or section 5 of P.L.2024, c.66 (C.26:1A-139) and to prohibit and prevent a violation of these sections, and the court may proceed in the action in a summary manner.
h. The provisions of this section shall not apply to a residential property with four or fewer dwelling units.
b. No later than one year after the effective date of P.L.2024, c.66 (C.58:12A-12.10 et al.), and annually thereafter, the Department of Health, in consultation with the Department of Environmental Protection, shall submit a report to the Governor, and, pursuant to section 2 of P.L.1991, c.164 (C.52:14-19.1), to the Legislature, which shall include:
(1) the number of cases of Legionnaires' disease in the State reported in each of the previous 10 years;
(2) the number of reported water sampling results in public community water systems in the past year received by the Department of Environmental Protection that indicate the presence of Legionella bacteria;
(3) the number and type of violations of the provisions of P.L.2024, c.66 (C.58:12A-12.10 et al.) for which penalties were assessed;
(4) recommendations as to whether the minimum detectable disinfectant targets established pursuant to subsection a. of section 2 of P.L.2024, c.66 (C.58:12A-12.11) should be increased in order to minimize the growth and transmission of Legionella bacteria; and
(5) any recommendations for legislative action as may be necessary to further control Legionella bacteria in the public water supply and affected buildings.
The department may, for the purpose of paying the traveling expenses of its employees, the expenses in connection with the traveling exhibits operated by the department, and other current expenses requiring a prompt cash outlay, establish a petty cash expense fund.
Upon application in writing by the director, the state treasurer, upon the warrant of the state comptroller, shall, for the purpose aforesaid, pay to the director from the annual appropriation for the department, a sum not exceeding two thousand dollars.
The director shall send to the state comptroller, on or before the tenth day of each month, a detailed account of the disbursements made from the fund for the preceding month, accompanied by vouchers, when such disbursements are of a character that vouchers can be readily obtained therefor. Upon the receipt of this account the comptroller shall draw his warrant upon the treasurer for the amount thereof, and upon said warrant the treasurer shall pay to the director said sum, which sum, when received by the director, shall be used for the reimbursement of the fund. On or before October thirty-first in each year the director shall return to the state treasurer the full amount of the fund.
Any question arising with reference to the amount to be allowed to the department, the expenditure of the fund, the accounting therefor, and the repayment thereof to the state treasurer, shall be finally determined by the ruling of the state comptroller.
The Department of Health, acting for and on behalf of the State of New Jersey, is authorized and empowered, pursuant to the appropriate provisions of an Act of the Congress entitled "An act to provide for the general welfare by establishing a system of Federal old-age benefits, and by enabling the several States to make more adequate provision for aged persons, blind persons, dependent and crippled children, maternal and child welfare, public health, and the administration of their unemployment compensation laws; to establish a social security board; to raise revenue, and for other purposes" (Public Statute No. 271-74th Congress), to participate in such grants subject to the provisions of the aforesaid Federal statute, and the rules and regulations thereunder, and particularly Titles V and VI thereof covering the appropriations therefor.
The Department of Health, acting for and on behalf of the State of New Jersey, is authorized and empowered, pursuant to the appropriate provisions of an Act of the Congress entitled "An act to impose additional duties upon the United States Public Health Service in connection with the investigation and control of the venereal diseases" (Public Statute No. 540-75th Congress), to participate in such grants subject to the provisions of the aforesaid Federal statute, and the rules and regulations thereunder.
The Department of Health, acting for and on behalf of the State of New Jersey, is authorized and empowered, pursuant to the appropriate provisions of an Act of Congress entitled "An act to provide for the acquisition and equipment of public works made necessary by the defense program" (Public Statute No. 137-77th Congress, approved June 28, 1941), to participate in such grants subject to the provisions of the aforesaid Federal statute, and the rules and regulations thereunder.
The Department of Health is likewise authorized to pay from the aforesaid Federal grants, upon approval by the Civil Service Commission, compensation to administrative officers of the department for administering projects under such grants, said compensation to be in addition to the regular salary received by such officers in the performance of duties for which they are paid from funds appropriated by the State, notwithstanding any other provision of the law to the contrary.
The Department of Health is further authorized and directed to make application to the Surgeon-General of the United States and to such other officers and agencies of the Federal government in said Acts enumerated, for securing the allotments so authorized, such allotments to be paid to the State Treasurer. The State Treasurer shall maintain such sums as may be received in separate funds, to be disbursed by him on the warrant of the Comptroller, subject to the certification of the Department of Health, in furtherance of the purposes enumerated.
Within the meaning of this act a public place shall be any restaurant, lunchroom, cabin, barroom, hotel or other place where food or drink is offered for sale to the public, and any camp, trailer camp, tourist home or public recreation place or place of business where toilet facilities or water for drinking or culinary purposes may be available for use of the public.
Any toilet, toilet room or washroom maintained in or in connection with any public place shall be kept clean at all times.
Any toilet or receptacle for human excrement at or in connection with any public place shall be constructed and maintained so that flies cannot gain access to the excremental matter contained therein and such excremental matter shall at all times be prevented from flowing over or upon the surface of the ground and shall be prevented from gaining access to any of the waters of this State; provided, however, that this section shall not apply to effluent from sewage disposal plants which have been or hereafter may be approved by the State Department of Health.
Any water used or available for use for drinking or culinary purposes or for the cleansing of utensils used in preparing or serving food or drink for public consumption, shall be of a quality safe for such use and shall meet standards of quality fixed by the director of health of the State of New Jersey.
Food offered for sale or intended for public consumption at any public place shall be protected from flies, dust and dirt.
No common towel and no common drinking utensils shall be permitted at any public place except it be thoroughly cleansed after each use and before used by another person.
At any public place at which food or drink is offered for sale or public consumption, adequate washing facilities for thoroughly cleansing utensils used in preparing or serving the same shall be provided and such utensils and the counters, table tops, shelves, boxes, refrigerators and other receptacles in or upon which food or drink is stored, prepared, handled, displayed or served shall be kept clean.
Garbage, including waste vegetable and animal material, which may attract flies, shall not be permitted at or in connection with any public place unless the material is kept covered to prevent access of flies and escape of foul odors.
No dishwater, drainage from plumbing fixtures or other foul or putrescible waste liquids from or produced in connection with any public place shall be permitted to accumulate on the surface of the ground or be disposed of in a manner that will pollute any water supply or create a nuisance.
All public places so far as the same may be practicable, shall be kept free from rats, mice, roaches and other vermin.
Nothing in this act shall be construed to prohibit or limit the authority otherwise granted by statute to any local board of health to regulate or control places defined in this act.
Any person, corporation or their agents violating any of the provisions of this act, shall be liable to a penalty of not less than ten dollars ($10.00) nor more than fifty dollars ($50.00), and for the second and each subsequent offense to a penalty of not less than twenty-five dollars ($25.00) nor more than one hundred dollars ($100.00), to be recovered by and in the name of the State Commissioner of Health of the State of New Jersey, or by and in the name of the local board of health.
Any penalty recovered under the provisions of this subtitle shall be paid to the plaintiff. When the plaintiff is the State Commissioner of Health of the State of New Jersey, the penalty recovered shall be paid by the commissioner into the treasury of the State. When the plaintiff is a local board of health, the penalty recovered shall be paid by the local board into the treasury of the municipality within which the local board has jurisdiction.
Every municipal court shall have jurisdiction over proceedings to enforce and collect any penalty imposed because of a violation of any provision of this subtitle, if the violation has occurred within the territorial jurisdiction of the court. The proceedings shall be summary and in accordance with the Penalty Enforcement Law (N.J.S. 2A:58-1 et seq.). Process shall be in the nature of a summons or warrant and shall issue only at the suit of the State Commissioner of Health of the State of New Jersey, or the local board of health, as the case may be, as plaintiff.
The court shall cause a defendant who refuses or neglects to pay forthwith the amount of a judgment rendered against him and the costs and charges incident thereto, to be committed to the county jail for a period not exceeding ten days in the case of a first conviction, and in case of a conviction for a second, subsequent or continuing violation, for a period not exceeding thirty days.
a. In order to protect the health, morals and welfare of the State of New Jersey, wherever the prosecutor of any county of the State of New Jersey receives information that wild, cultivated or hidden growth of beds of alleged stramonium are located anywhere within his county, he shall immediately communicate the information to the State Department of Health, and the department, upon receipt of the information, shall immediately dispatch one of its agents to the location who shall make an examination and determination of the alleged stramonium weed so as to determine the existence or nonexistence of stramonium at the location. The department shall immediately communicate by writing its determination to the prosecutor.
b. Upon certification by the department of the existence of stramonium at the location examined by the department, the prosecutor is empowered to dispatch one of his agents to the location so certified and the agent shall destroy the stramonium. The prosecutor or his agent shall not be civilly responsible in any manner whatsoever for destruction of the stramonium.
c. As used in this section, "stramonium" means the plant Datura Stramonium Linne, including Datura Tatula Linne.
The Department of Health is authorized and empowered to maintain and operate hospitals for the detention, care, treatment and rehabilitation of persons having or suspected of having venereal diseases and to construct, purchase, lease, rent or otherwise acquire the use of property, buildings, equipment and supplies for this purpose.
Notwithstanding the provisions of section 23:4-53 of the Revised Statutes or any other law, the State Department of Health or any local board of health within its jurisdiction may order and provide for the destruction or removal of escaped domestic pigeons that have become feral from any area or place upon a finding by the department or the board, as the case may be, that the presence of such escaped domestic pigeons in such area or place is hazardous to the health of any of the inhabitants of this State.
The State Department of Health hereafter referred to as the department, shall establish a program for the care and treatment of persons suffering from chronic renal diseases. This program shall assist persons suffering from chronic renal diseases who require lifesaving care and treatment for such renal disease, but who are unable to pay for such services on a continuing basis.
The State Commissioner of Health hereafter referred to as the commissioner, shall appoint a Renal Disease Advisory Committee, hereafter referred to as the committee, to consult with the department in the administration of this act. The committee shall be composed of 11 persons representing hospitals and medical schools which establish dialysis centers, voluntary agencies interested in kidney diseases, local public health agencies, physicians licensed to practice medicine in all of its branches, and the general public. Each member shall hold office for a term of 4 years and until his successor is appointed and qualified, except that the terms of the members first taking office shall expire, as designated at the time of appointment, 2 at the end of the first year, 3 at the end of the second year, 3 at the end of the third year, and 3 at the end of the fourth year, after the date of appointment. Any person appointed to fill a vacancy occurring prior to the expiration of the term for which his predecessor was appointed shall be appointed for the remainder of such term. The committee shall meet as frequently as the secretary deems necessary, but not less than once each year. The committee members shall receive no compensation but shall be reimbursed for actual expenses incurred in carrying out their duties as members of this committee.
The department shall:
(1) With the advice of the committee, develop standards for determining eligibility for care and treatment under this program.
(2) Assist in the development and expansion of programs for the care and treatment of persons suffering from chronic renal diseases, including dialysis and other medical procedures and techniques which will have a lifesaving effect in the care and treatment of persons suffering from these diseases.
(3) Assist in the development of programs for the prevention of chronic renal diseases.
(4) Extend financial assistance to persons suffering from chronic renal diseases in obtaining the medical, nursing, pharmaceutical, and technical services necessary in caring for such diseases, including the renting of home dialysis equipment.
(5) Assist in equipping dialysis centers.
(6) Institute and carry on an educational program among physicians, hospitals, public health departments, and the public concerning chronic renal diseases, including the dissemination of information and the conducting of educational programs concerning the prevention of chronic renal diseases and the methods for the care and treatment of persons suffering from these diseases.
"Hemophilia" means a bleeding tendency resulting from a genetically determined, hereditarily determined, or acquired factor deficiency in the blood.
"Qualitative platelet disorders" means conditions resulting from genetically determined, hereditarily determined, or acquired defects or abnormalities in blood platelet functions or structures.
"Von Willebrand disease" means a bleeding tendency resulting from a genetically determined, hereditarily determined, or acquired deficiency of the von Willebrand factor in the blood.
a. Develop standards for determining eligibility for care and treatment under this program;
b. Assist in the development and expansion of programs for the care and treatment of persons suffering from hemophilia, qualitative platelet disorders, and von Willebrand disease, including self-administration, prevention, and home care and other medical and dental procedures and techniques designed to provide maximum control over bleeding episodes typical of these conditions;
c. Extend financial assistance to persons suffering from hemophilia, qualitative platelet disorders, and von Willebrand disease in obtaining blood, blood derivatives, and concentrates, and other efficacious agents for use in hospital, medical, and dental facilities, and at home, or participate in the cost of blood processing to the extent that such support will facilitate the supplying of blood, blood derivatives, and concentrates and other efficacious agents to patients at an economical cost, thus increasing the effectiveness of the moneys appropriated to carry out the provisions of P.L.1972, c.124 (C.26:2-90 et seq.);
d. Institute and carry on educational programs among patients, physicians, dentists, hospitals, public health departments, and the public concerning hemophilia, qualitative platelet disorders, and von Willebrand disease, including dissemination of information and the conducting of educational programs concerning the methods of care and treatment of persons suffering from these conditions; and
e. Promulgate all rules and regulations necessary to effectuate the purposes of P.L.1972, c.124 (C.26:2-90 et seq.).
This act shall be known and may be cited as the "Juvenile Terminal Illness Assistance Act."
It is hereby declared to be the policy of the State that no child shall be denied access to any medical assistance which may prolong his or her life because of inability to pay the cost thereof. The Legislature hereby finds that there are cases where a child's illness has been diagnosed as terminal and all remedies and finances have been exhausted, and only by continued medical and financial assistance could the child's life be prolonged. It is, therefore, declared to be the policy of the State that, in such cases, the State shall provide assistance in the case of medical expenses.
The State Department of Health shall establish a program for the care and treatment of children suffering from terminal illnesses. This program shall assist children suffering from such illnesses who require lifesaving care and treatment therefor, but whose parents or guardian are unable to pay for such services on a continuing basis.
For the purposes of this act:
a. "Child" means any person under 21 years of age.
b. "Terminal illness" means an illness for which there is no known cure and which ultimately ends in death, and which has been certified as such by two physicians licensed to practice medicine and surgery.
c. "Department" means the State Department of Health.
d. "Commissioner" means the State Commissioner of Health.
The commissioner shall appoint a Terminal Illness Advisory Committee, hereafter referred to as the committee, to consult with the department in the administration of this act. The committee shall be composed of 11 persons representing hospitals and medical schools, voluntary agencies interested in terminal illness, local public health agencies, physicians licensed to practice medicine in all of its branches, and the general public. Each member shall hold office for a term of 4 years and until his successor is appointed and qualified, except that the terms of the members first taking office shall expire, as designated at the time of appointment, two at the end of the first year, three at the end of the second year, three at the end of the third year, and three at the end of the fourth year, after the date of appointment. Any person appointed to fill a vacancy occurring prior to the expiration of the term for which his predecessor was appointed shall be appointed for the remainder of such term. The committee shall meet as frequently as the secretary deems necessary, but not less than once each year. The committee members shall receive no compensation but shall be reimbursed for actual expenses incurred in carrying out their duties as members of this committee.
The department shall:
a. With the advice of the committee, develop standards for determining eligibility for care and treatment under this program.
b. Assist in the development and expansion of programs for the care and treatment of children suffering from terminal illnesses, including medical procedures and techniques which will have a lifesaving effect in the care and treatment of persons suffering from these diseases.
c. Assist in the development of programs for the prevention of terminal illnesses.
d. Extend financial assistance to children suffering from terminal illnesses in obtaining the medical, nursing, pharmaceutical, and technical services in caring for such diseases.
e. Promulgate rules and regulations necessary to effectuate the purposes of this act.
Nothing in this act shall be construed to compel any person to undergo any medical screening, examination, diagnosis, or treatment or to accept any other health care (other than for the purpose of discovering and preventing the spread of infection or contagious disease or for the purpose of protecting environmental health), if the child or his parent or guardian objects thereto on religious grounds.
If any clause, sentence, section, provision, or part of this act shall be adjudged to be unconstitutional or invalid for any reason by any court of competent jurisdiction, such judgment shall not invalidate, impair or affect the remainder of this act, which shall remain in full force and effect.
Hearing loss occurs in newborns more frequently than any other health condition for which newborn screening is currently required. Moreover, early detection of hearing loss in a child and early intervention and treatment before six months of age has been demonstrated to be highly effective in facilitating a child's healthy development in a manner consistent with the child's age and cognitive ability. Eighty percent of a child's ability to learn speech, language and related cognitive skills is established by the time the child is 36 months of age, and hearing is vitally important to the healthy development of such language skills. Due to advances in medical technology, children of all ages can receive reliable and valid screening for hearing loss in a cost-effective manner. Appropriate screening and identification of newborns and infants with hearing loss will facilitate early intervention and treatment in the critical time period for language development, and may, therefore, serve the public purposes of promoting the healthy development of children and reducing public expenditures for health care and special education and related services.
Therefore, it is necessary for the Legislature to establish a universal newborn hearing screening program that will: a. provide early detection of hearing loss in newborn children at the hospital or birthing center or as soon after birth as possible; b. enable these children and their care givers to obtain needed multi-disciplinary evaluation, treatment, and intervention services at the earliest opportunity; and c. prevent or mitigate the developmental delays and academic failures associated with late identification of hearing loss.
"Commissioner" means the Commissioner of Health.
"Department" means the Department of Health.
"Electrophysiologic screening measures" means the electrical result of the application of physiologic agents and includes, but is not limited to, the procedures currently known as Auditory Brainstem Response testing (ABR) and Otoacoustic Emissions testing (OAE) and any other procedure adopted by regulation by the commissioner.
"Hearing loss" means a hearing loss of 30dB or greater in the frequency region important for speech recognition and comprehension in one or both ears, which is approximately 500 through 4000 Hz., except that the commissioner may adopt a standard which establishes a less severe hearing loss, as appropriate.
"Newborn" means a child up to 28 days old.
"Parent" means a biological parent, stepparent, adoptive parent, legal guardian, or other legal custodian of a child.
b. Effective January 1, 2002, the department shall issue guidelines for the periodic monitoring of all infants between the age of 29 days and 36 months for delayed onset hearing loss.
c. Notwithstanding the provisions of subsection a. of this section to the contrary, no newborn child shall be screened for hearing loss if the parent of the newborn objects to such screening on the grounds that the screening conflicts with the parents' bona fide religious tenets or practices.
a. the electrophysiologic screening measure to be performed;
b. the qualifications of the personnel designated to perform the electrophysiologic screening measure;
c. guidelines for the provision of follow-up services for newborns identified as having or being at risk of developing a hearing loss;
d. the educational services to be provided to the parents of newborns identified as having or being at risk for developing a hearing loss; and
e. the protocol to be followed to ensure the confidentiality of any patient identifying information furnished to the department for the purposes of the central registry established pursuant to this act.
b. A hospital, birthing center or health care professional who performs testing required by this act shall report the results of such testing when a hearing loss is indicated to the department in a manner and on forms prescribed by the commissioner.
Each member shall hold office for a term of two years and until each member's successor is appointed and qualified. Any person appointed to fill a vacancy occurring prior to the expiration of the term for which the person's predecessor was appointed shall be appointed for the remainder of such term.
The council shall meet as frequently as the commissioner deems necessary, but not less than once each year. Council members shall receive no compensation but shall be reimbursed for actual expenses incurred in carrying out their duties as members of this council.
The Legislature hereby finds and declares:
a. That New Jersey is currently suffering from the highest overall mortality rates for cancer in the Nation;
b. That certain forms of cancer are now believed to be attributable to environmental factors which, if controlled, can significantly reduce cancer incidence in this State;
c. That more complete and more precise statistical data are necessary to determine the correlations between cancer incidence and possible environmental factors and to evaluate cancer treatment and prevention measures that are currently in progress; and,
d. That a cancer registry would thus provide a vital foundation for a concerted State effort to reduce the incidence of environmentally related cancer in this State.
b. Pursuant to subsection a. of this section, the Commissioner of Health is hereby authorized to adopt and promulgate, in the manner prescribed by the applicable provisions of the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.) rules and regulations specifying the health care providers, individuals, and other organizations obliged to make the report and submissions required by subsection a. of this section, the related information to be included in such reports, and the methods for such reporting.
c. All abstracting work performed by a health care facility in accordance with this section shall be performed by a certified tumor registrar.
d. (1) The Department of Health shall contract out its registry services to health care facilities which lack adequate internal capabilities to report cases on a timely basis, as provided in the regulations adopted pursuant to this section. Such health care facilities shall reimburse the department for services rendered.
(2) If a health care facility fails to correct deficiencies in its reporting that are discovered on audit by the Department of Health within 30 days, the department will conduct the appropriate registrar activities and charge the facility for all costs related to its services.
e. Health insurers and other third party health care payers providing health benefits plans to residents of the State shall report to the Department of Health cases of cancer of State residents based upon selection criteria and in a format specified by the department.
f. (1) A health care facility, health care provider, or health insurer that fails to comply with the provisions of this section shall be liable to a penalty of up to $500 per unreported cancer case.
(2) A health care facility that fails to report cases of cancer electronically, as required by regulation, shall be liable to a penalty not to exceed $1,000 per business day.
(3) A penalty sued for under the provisions of this subsection shall be recovered by and in the name of the Department of Health and shall be dedicated to the cancer registry.
g. All information reported to the Department of Health for inclusion in the cancer registry pursuant to this section shall be verified for accuracy by the department within six months of receiving the information and shall be incorporated in the registry. Aggregate or summary information, to include gender distribution, age groupings of cases, and cancer types, shall be made available to the public no later than six months after verification by the department. The department shall not make public any information reported to the department which discloses the identity of any person to whom the information relates.
Nothing in this act shall be construed to compel any individual to submit to medical or health department examination or supervision.
a. Newborn screening is an essential public health activity that strives to screen every newborn infant for a variety of congenital disorders, which, if not detected and managed early, can result in significant morbidity, mortality, and disability. The State's newborn screening system shall be a coordinated and comprehensive effort to provide education, screening, follow-up, diagnosis, treatment and management, and program evaluation activities ;
b. Ongoing advances in technologies and treatment modalities make it possible to screen newborn infants for a wide array of biochemical disorders. It is imperative that the State adjust its Newborn Screening Program to incorporate these biochemical disorders to ensure that the program remains at the forefront of these advances; and
c. It is the intent of this act to protect the health and quality of life of newborn infants born in this State by enhancing the capacity to screen for congenital disorders and by providing: all newborn infants with screens for certain conditions and with appropriate referrals and early medical intervention when warranted; and newborn data collection is standardized, and conditions detected by newborn screening are tracked and monitored. Further, information on newborn screening and conditions for which a newborn can be screened should be readily accessible, current, and understandable to both health care providers and parents or guardians.
The Department of Health shall charge a reasonable fee for the screening, follow-up, treatment, and education performed pursuant to this act. The amount of the fee shall be adjusted by the commissioner as necessary to support the screening, follow-up, and treatment of newborn infants, and the education of physicians, hospital staffs, nurses, and the public as required by this act. The procedures for collecting the fee shall be determined by the commissioner. The commissioner shall apply all revenues collected from the fees to the screening, follow-up, education, and treatment procedures performed pursuant to this act. The fee shall be used to support the program, including, but not limited to, ongoing infrastructure upgrades, including providing electronic access to physicians to obtain screening results, and follow-up recommendations.
Based on the recommendations of the Newborn Screening Advisory Review Committee established pursuant to section 2 of P.L.2019, c.296 (C.26:2-110a), the commissioner may also require the screening of newborn infants for other disorders if reliable and efficient screening techniques are available. If the commissioner determines that an additional test shall be required, the commissioner, at least 60 days prior to requiring the test, shall so advise the President of the Senate and the Speaker of the General Assembly.
The commissioner shall provide laboratory services and a follow-up program on positive screen cases in order that measures may be taken to prevent death or intellectual or other permanent disabilities. The program shall provide timely information and recommendations for referral to specialist treatment centers for newborn infants who screen positive for disorders pursuant to this section.
The commissioner shall collect screening information on newborn infants in a standardized manner and develop a system for quality assurance which includes the periodic assessment of indicators that are measurable, functional, and appropriate to the conditions for which newborn infants are screened pursuant to this section. The commissioner shall have the authority to use the information collected to provide follow-up to newborn infants with screened positive diagnoses to provide information and recommendations for referral. Information on newborn infants compiled pursuant to this section shall be used by the department and agencies designated by the commissioner for the purposes of carrying out this act, but otherwise the information shall be confidential and not divulged or made public so as to disclose the identity of any person to which it relates, except as provided by law.
The department shall provide education or training on the Newborn Screening Program to physicians, hospital staffs, nurses, and the public concerning newborn screening.
The provisions of this section shall not apply if the parents of a newborn infant provide written notice to the hospital or birthing facility where the newborn infant was delivered, in a manner designated by the commissioner, that they object to the screening on the grounds that it would conflict with their religious tenets or practices.
As used in this section:
"Health care provider" means a health care professional licensed pursuant to Title 45 of the Revised Statutes or a health care facility licensed pursuant to Title 26 of the Revised Statutes that provides health care services to newborn infants.
"Qualified laboratory" means a clinical laboratory not operated by the Department of Health, which is certified by the Secretary of Health and Human Services pursuant to the federal "Clinical Laboratory Improvement Amendments of 1988," Pub.L.100-578 (42 U.S.C. s.263a) and reports its test results by using normal pediatric reference ranges.
b. (1) The Commissioner of Health shall prepare and make available electronically, on the Internet website of the Department of Health, information that explains the availability of testing performed by qualified laboratories for disorders in infants for which testing is not required pursuant to P.L.1977, c.321 (C.26:2-110 et seq.).
(2) A health care provider shall give an infant's parent or guardian a hard copy of the information prepared pursuant to paragraph (1) of this subsection and provide the parent or guardian with a reasonable opportunity to read the information when giving the parent or guardian the option of consenting to the performance of testing pursuant to subsection a. of this section.
A newborn shall not be denied testing for HIV on the basis of the newborn's economic status.
b. The commissioner shall establish a comprehensive program for the follow-up testing of newborns who test positive for HIV pursuant to subsection a. of this section or whose mother is HIV-positive, which shall include, but not be limited to, procedures for the administration of HIV testing, counseling of the newborn's mother, tracking the newborn, disclosure of HIV test results to the mother, facility compliance reviews, and educational activities related to the HIV testing.
c. The provisions of this section shall not apply to a newborn whose parents object to the test as being in conflict with their religious tenets and practices. The parents shall provide the health care facility with a written statement of the objection, and the statement shall be included in the newborn's medical record.
d. As used in this section, "birthing facility" means an inpatient or ambulatory health care facility licensed by the Department of Health that provides birthing and newborn care services.
e. The Commissioner of Health shall adopt rules and regulations, pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.), necessary to carry out the purposes of this section.
a. Congenital heart defects (CHDs) are structural abnormalities of the heart that are present at birth; CHDs range in severity from simple problems such as holes between chambers of the heart, to severe malformations, such as the complete absence of one or more chambers or valves; some critical CHDs can cause severe and life-threatening symptoms which require intervention within the first days of life;
b. According to the United States Secretary of Health and Human Services' Advisory Committee on Heritable Disorders in Newborns and Children, congenital heart disease affects approximately seven to nine of every 1,000 live births in the United States and Europe; the federal Centers for Disease Control and Prevention states that CHD is the leading cause of infant death due to birth defects;
c. Current methods for detecting CHDs generally include prenatal ultrasound screening and repeated clinical examinations; while prenatal ultrasound screenings can detect some major congenital heart defects, these screenings, alone, identify less than half of all CHD cases, and critical CHD cases are often missed during routine clinical exams performed prior to a newborn's discharge from a birthing facility;
d. Pulse oximetry is a non-invasive test that estimates the percentage of hemoglobin in blood that is saturated with oxygen; when performed on a newborn a minimum of 24 hours after birth, pulse oximetry screening is often more effective at detecting critical, life-threatening CHDs which otherwise go undetected by current screening methods; newborns with abnormal pulse oximetry results require immediate confirmatory testing and intervention; and
e. Many newborn lives could potentially be saved by earlier detection and treatment of CHDs if birthing facilities in the State were required to perform this simple, non-invasive newborn screening in conjunction with current CHD screening methods.
b. As used in this section, "birthing facility" means an inpatient or ambulatory health care facility licensed by the Department of Health that provides birthing and newborn care services.
c. The commissioner shall adopt rules and regulations, pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.), necessary to carry out the purposes of this act.
(1) the registration with the federal Food and Drug Administration of the necessary reagents;
(2) the availability of the necessary reagents from the federal Centers for Disease Control and Prevention;
(3) the availability of quality assurance testing methodology for these processes; and
(4) the acquisition by the Department of Health of the equipment necessary to implement the expanded screening tests.
b. The Department of Health may charge a reasonable fee for the tests performed pursuant to this section. The amount of the fee and the procedures for collecting the fee shall be determined by the Commissioner of Health.
(1) the development of a reliable test or series of tests for screening newborns for ALD using dried blood spots and quality assurance testing methodology for ALD testing;
(2) the availability of quality assurance materials for the ALD test from the federal Centers for Disease Control and Prevention;
(3) the inclusion of newborn screening for ALD in the Recommended Uniform Screening Panel of the United States Secretary of Health and Human Services' Advisory Committee on Heritable Disorders in Newborns and Children, after the committee's evidence review of newborn screening for ALD;
(4) the review by the Department of Health of the proposed test; and
(5) the acquisition of equipment necessary to implement the expanded screening tests by the State's Newborn Screening Laboratory.
b. The Department of Health may charge a reasonable fee and any reasonable increase in this fee as necessary, for the test performed pursuant to this section. The amount of the fee and the procedures for collecting the fee shall be determined by the Commissioner of Health.
(1) the development of a reliable test or series of tests for screening newborns for MPS I using dried blood spots and quality assurance testing methodology for Hunter syndrome testing;
(2) the availability of quality assurance materials for the MPS I test from the federal Centers for Disease Control and Prevention;
(3) the inclusion of newborn screening for MPS I in the Recommended Uniform Screening Panel of the United States Secretary of Health and Human Services' Advisory Committee on Heritable Disorders in Newborns and Children, after the committee's evidence review of newborn screening for MPS I;
(4) the review by the Department of Health of the proposed test; and
(5) the acquisition of equipment necessary to implement the expanded screening tests by the State's Newborn Screening Laboratory.
b. All infants born in this State shall be tested for mucopolysaccharidosis II (MPS II), also called Hunter syndrome, beginning six months following the occurrence of all of the following:
(1) the development of a reliable test or series of tests for screening newborns for MPS II using dried blood spots and quality assurance testing methodology for Hunter syndrome testing;
(2) the availability of quality assurance materials for the MPS II test from the federal Centers for Disease Control and Prevention;
(3) the inclusion of newborn screening for MPS II in the Recommended Uniform Screening Panel of the United States Secretary of Health and Human Services' Advisory Committee on Heritable Disorders in Newborns and Children, after the committee's evidence review of newborn screening for MPS II;
(4) the review by the Department of Health of the proposed test; and
(5) the acquisition of equipment necessary to implement the expanded screening tests by the State's Newborn Screening Laboratory.
c. The Department of Health may charge a reasonable fee and any reasonable increase in this fee as necessary, for the tests performed pursuant to this section. The amount of the fee and the procedures for collecting the fee shall be determined by the Commissioner of Health.
b. The Commissioner of Health shall develop a comprehensive program of follow-up services and procedures in the event a newborn tests positive for one or more genetic markers associated with spinal muscular atrophy, which services and procedures shall include, at a minimum:
(1) genetic counseling for the parents of the newborn concerning the risk that one or both parents is a carrier of the genetic mutation associated with spinal muscular atrophy, and the risk that other children born to the parents may carry the mutation, pass it on to their own offspring, or may be born with spinal muscular atrophy; and
(2) information concerning available treatment options for spinal muscular atrophy.
c. The Department of Health may charge a reasonable fee to administer tests performed pursuant to this section. The amount of the fee and the procedures for collecting the fee shall be determined by the Commissioner of Health.
d. The Commissioner of Health shall adopt rules and regulations, pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.), necessary to carry out the purposes of this section.
(1) the development of a reliable test or series of tests for screening newborns for cCMV using dried blood spots and quality assurance testing methodology for cCMV testing;
(2) the availability of quality assurance materials for the cCMV test from the federal Centers for Disease Control and Prevention;
(3) the inclusion of newborn screening for cCMV in the Recommended Uniform Screening Panel of the United States Secretary of Health and Human Services' Advisory Committee on Heritable Disorders in Newborns and Children, after the committee's evidence review of newborn screening for cCMV;
(4) the recommendation by the Newborn Screening Advisory Review Committee established pursuant to section 2 of P.L.2019, c.296 (C.26:2-110a) that the test be included in the State Newborn Screening Program;
(5) the Commissioner of Health's approval to include the test in the State's Newborn Screening Program, which approval shall be based on the recommendations of the Newborn Screening Advisory Review Committee; and
(6) the acquisition of equipment necessary to implement the expanded screening tests by the State's Newborn Screening Laboratory.
b. The Department of Health may charge a reasonable fee for the test performed pursuant to this section in such amount as shall be determined by the Commissioner of Health, and may periodically increase the fee by any reasonable amount as the commissioner determines to be necessary. The procedures for collecting the fee shall be determined by the commissioner.
b. The commissioner, in establishing the public awareness campaign, shall develop outreach efforts and provide information and educational materials to pregnant persons on CMV and cCMV including, but not limited to:
(1) the cause and nature of CMV and cCMV;
(2) diagnostic procedures and appropriate indications for their use;
(3) lifestyle issues relating to how a pregnant person can pass cCMV to a developing fetus; and
(4) the availability of CMV and cCMV diagnostic and treatment services in the community.
c. The commissioner shall prepare, and make available on the Department of Health's Internet website, in English and Spanish, and in a manner that is easily understandable by a pregnant person, information about the symptoms and treatment of CMV and cCMV and any other information that the commissioner deems to be necessary. This information may be revised by the department whenever new information about CMV and cCMV becomes available.
The commissioner is authorized to enter into agreements with the Federal Government and public health agencies in other states to achieve greater effectiveness or efficiency in carrying out the provisions of this act.
The Legislature finds that the effective identification, diagnosis, care and treatment of persons who have been exposed to diethylstilbestrol, commonly referred to as DES, is of paramount public importance; that DES, a synthetic estrogen-type hormone, was extensively administered between 1940 and 1970 to pregnant women threatened with miscarriage; that, subsequently, a causal relationship was found between DES and an unusual type of cervical and vaginal cancer in the daughters of persons who took the drug during pregnancy; that use of DES during pregnancy has been discontinued as a result of these findings, but that as many as 75,000 persons in New Jersey may have been exposed to the drug during its period of usage.
The Legislature further finds that the magnitude of this problem may only be realized in the next few years as the daughters of women exposed to the drug reach reproductive age, the time when such abnormalities become apparent; that the situation is compounded by the relative newness of the studies associating DES with cancer and the uncertainty over the implications of recent research; and that many physicians are not yet familiar with detection and treatment techniques because the problem has been relatively recently identified.
Therefore, the Legislature declares that it is imperative that programs be established to identify and diagnose persons who have been exposed to the drug diethylstilbestrol, to refer them to sources of care and treatment, and to provide an education program for physicians and other health care professionals so that exposed persons may benefit from the best possible diagnostic procedures and treatment.
As used in this act:
a. "Primary screening" means the initial evaluation of a person through history, physical examination and routine tests to determine the possible existence of physical changes due to diethylstilbestrol exposure; and
b. "Secondary screening" means a follow-up evaluation with specialized diagnostic measures of a person identified in a primary screening as having a high probability of being diethylstilbestrol exposed, in order to confirm the existence of changes attributed to that exposure.
The Commissioner of the Department of Health shall establish:
a. A program to educate the public and health care professionals involved in primary screening about the potential hazards and afflictions which may be related to exposure to diethylstilbestrol and the symptoms and prevention of associated malignancies. The program shall include a public information campaign on diethylstilbestrol to encourage persons exposed to the drug to seek medical care for the prevention or treatment of any malignant condition.
b. Secondary screening programs for diethylstilbestrol exposed persons through contract with licensed health care facilities. In contracting for the secondary screening programs, consideration shall be given to the location of the facility in relation to the concentration of population within the State and the capacity of the facility to properly conduct a secondary screening program. Each contract for a secondary screening program shall be upon such terms and conditions as the Commissioner of Health determines; but each facility shall charge each person receiving services a fee as determined by the commissioner. Where provided, all third party payors shall be accepted and utilized in securing payment for services.
c. Continuing education programs for health care professionals involved in the diagnosis and treatment of diethylstilbestrol exposed persons.
The Commissioner of the Department of Health shall maintain a registry of women who took diethylstilbestrol during pregnancy and their offspring who were exposed to diethylstilbestrol prenatally for the purpose of follow-up care and treatment of long-term problems associated with diethylstilbestrol exposure. Enrollment in the registry shall be upon a voluntary basis.
The Department of Health shall make an annual report to the Legislature, through the President of the Senate, Speaker of the General Assembly and Chairmen of the Senate and Assembly Institutions, Health and Welfare Committees of its findings and recommendations concerning the effectiveness, impact and benefits derived from the programs created herein, and any recommendations for legislative changes deemed necessary.
The Legislature finds that every year there are a substantial number of accidental poisonings especially among young children and that the possibility of serious injury or death which results from the ingestion of poisonous substances could be dramatically reduced by the development of a poison control and drug information program.
As used in this act:
a. "Commissioner" means the Commissioner of the Department of Health;
b. "Program" means the poison control and drug information program established by the commissioner.
The commissioner shall establish a Statewide program of poison control and drug information. Program services shall be available on a 24 hour basis to the residents of every county.
The principal activity of the program shall be answering requests by telephone for poison information and making recommendations for appropriate management and treatment of poisoning exposure and overdose victims. Services of the poison control and drug information program shall also include:
a. Evaluating whether treatment can be accomplished in the home setting or whether transport to an emergency treatment facility is required;
b. Recommending treatment measures to appropriate personnel;
c. Providing follow-up education to prevent future similar incidents;
d. Providing community education programs designed to improve public awareness of poisoning and overdose problems and to educate the public regarding prevention; and
e. Answering drug information questions from health professionals by providing current and accurate information relating to drugs and their therapeutic uses.
The program shall utilize physicians, pharmacists, nurses and other necessary personnel trained in various aspects of toxicology, poison control, and drug information retrieval and analysis.
The Legislature finds and declares that the rising incidence of heart disease, kidney disease and stroke is causing increased concern among public health officials and private practitioners who feel that it is imperative that new initiatives be developed to combat the high blood pressure which is so often associated with these life threatening conditions.
The Legislature further finds that the expansion of the comprehensive hypertension control program presently operated by the New Jersey State Department of Health with funds from federal block grants is in the best interests of the citizens of the State of New Jersey in an effort to minimize the incidence of death and disability which so often accompany uncontrolled high blood pressure.
As used in this act:
a. "Commissioner" means the Commissioner of the Department of Health;
b. "Department" means the State Department of Health;
c. "Program" means the hypertension control program established by the commissioner.
The commissioner shall expand the existing hypertension control program within the department, which shall have central authority and responsibility for the development of a system of community based high blood pressure control programs.
The commissioner shall take any action he deems necessary, including the provision of advisory and technical assistance and the development of training and educational programs, to assist qualified individuals and agencies to develop comprehensive and coordinated hypertension programs.
a. Hypertension screening;
b. Treatment referral;
c. Counseling for persons with high blood pressure as to proper diet, weight control, and appropriate care and treatment of the condition; and
d. Patient follow-up and evaluation of treatment methods.
a. Enter into necessary contracts and agreements with counties, municipalities and other units of government, colleges, universities, associations, agencies, corporations, and individuals for the development and expansion of community hypertension programs;
b. Gather data relative to the detection of high blood pressure and the incidence of heart disease, kidney disease and stroke;
c. Promote programs of professional education for physicians, dentists, nurses, pharmacists, and public health professionals relative to the prevention, detection and control of high blood pressure and the rehabilitation of persons with heart disease, stroke, and kidney disease which result from uncontrolled hypertension;
d. Conduct scientific investigation into the prevention, cause, detection, and control of high blood pressure;
e. Develop more effective methods for the screening, evaluation and control of hypertension; and
f. Apply for and accept any grant of money from the federal government or any other source available for the purposes of P.L.1985, c.5 (C.26:2-124 et seq.).
Pursuant to the "Administrative Procedure Act," P.L. 1968, c. 410 (C. 52:14B-1 et seq.), the commissioner shall promulgate any regulations necessary to effectuate the provisions of this act.
The Legislature finds and declares that:
a. Exposure to lead and lead poisoning leads to morbidity, mortality, mental retardation, and learning disability in young children, the monetary and social costs of which far exceed the costs of monitoring and preventing lead poisoning.
b. The New Jersey Department of Health estimates that 44 of every 1000 children are at risk of lead poisoning and that the rate of lead poisoning among children at risk now exceeds the rate of paralytic polio at the height of the epidemic of the 1950's; however, the department has the resources to test and follow up on only 16% of the 220,000 children it estimates are at risk of lead poisoning.
c. Very few health departments have the resources to comply fully with the minimum standards of performance for local boards of health and Chapter XIII of the State Sanitary Code concerning control of lead poisoning in children due to the costs of the required testing, follow-up and abatement.
"Child" means a person one through five years of age.
"Commissioner" means the Commissioner of Health.
"Department" means the Department of Health.
"Lead poisoning" means the poisoning of the bloodstream that results from prolonged exposure to lead or lead-based substances in water, paint, building materials, or the environment, and which causes uncorrectable developmental delay and decreased mental functioning capacity in children, and in severe cases, can lead to a child's premature death.
The department, within the limits of funds appropriated for this purpose, has the responsibility for the development, implementation and coordination of a program to control lead poisoning and abate identified lead hazards by:
a. Identifying areas where there is a high risk of the presence of lead paint in a dwelling;
b. Establishing testing procedures for the detection of the presence of lead in persons and dwellings; and
c. Stimulating professional and public education concerning the need to test, detect and control lead poisoning and to abate identified lead hazards.
Within six months of the effective date of this act, the commissioner shall prepare a comprehensive plan to control lead poisoning in the State. The commissioner shall submit the plan to the Governor and the Legislature.
This report shall be made available to local and State agencies involved with case management and lead abatement, and to interested members of the public.
The department may set aside up to 10% of the funds appropriated pursuant to this act for the purpose of providing loans to local boards of health to abate lead paint nuisances pursuant to section 9 of P.L. 1971, c. 366 (C. 24:14A-9). The department shall establish criteria for making the loans and procedures for repayment of the loans to the department.
The commissioner shall, pursuant to the provisions of the "Administrative Procedure Act," P.L. 1968, c. 410 (C. 52:14B-1 et seq.), adopt regulations necessary to effectuate the provisions of this act.
a. The lead screening requirements provided for under P.L.1995, c.316 (C.17:48E-35.10 et al.), including the age of the child when initial screening should be conducted, the time intervals between screening, when follow-up testing is required, the methods that shall be used to conduct the lead screening, and, in accordance with the latest recommendations of the federal Centers for Disease Control and Prevention and the provisions of P.L.1995, c.328 (C.26:2-137.2 et seq.), the level of lead in the bloodstream that shall necessitate the undertaking of responsive action; and
b. The childhood immunizations recommended by the Department of Health, which shall consider the recommendations of the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention in the federal Department of Health and Human Services and, as appropriate, the recommendations of the American Academy of Pediatrics, the American Academy of Family Physicians, the American College of Obstetricians and Gynecologists, and the American College of Physicians.
a. According to the New Jersey Department of Health, 630,000 children under the age of six are at risk of lead poisoning in New Jersey and should be screened for elevated blood lead levels. Of this number, the Department of Health estimates that 177,000 pre-school children are at particularly high risk of lead poisoning;
b. Approximately 70,000 pre-school children, or almost 10 percent of the population of children under age six, are currently screened for lead poisoning;
c. Screening is an essential element in the fight to reduce and eventually eliminate childhood lead poisoning, and identification of children in the early stages of lead exposure can prevent children from suffering severe cases of lead poisoning;
d. There is no safe level of lead exposure in children, and even low levels of lead in the bloodstream have been shown to affect IQ, attention span, and academic achievement, in a manner that cannot be corrected;
e. Although lead can be found in many sources, lead exposure is entirely preventable, and the federal Centers for Disease Control and Prevention recognizes that the best way to address the problem of lead poisoning is to take action to prevent children from coming into contact with lead, while providing appropriate treatment and case management to those children who are found to have elevated blood lead levels;
f. A universal lead screening program will identify which children require medical evaluation and treatment, and will alert parents about the need to identify and abate lead hazards in their homes;
g. The integration of educational and community outreach programs, as part of a universal lead screening program, will raise public consciousness about the insidious dangers of childhood lead poisoning, encourage parents to take preventive steps to make their homes lead-safe, and encourage communities to strengthen lead exposure prevention programs; and
h. Universal lead screening and universal reporting of lead test results will allow the Department of Health and local boards of health to obtain information on neighborhoods and communities that are at a high risk for lead exposure, and thereby allow for the implementation of targeted lead hazard reduction programs in the areas of greatest need.
"Commissioner" means the Commissioner of Health.
"Department" means the Department of Health.
"Elevated blood lead level" means a level of lead in the bloodstream that equals or exceeds five micrograms per deciliter or other such amount as may be identified in the most recent recommendations from the federal Centers for Disease Control and Prevention, and that necessitates the undertaking of responsive action.
"Lead poisoning" means the poisoning of the bloodstream that results from prolonged exposure to lead or lead-based substances in water, paint, building materials, or the environment, and which causes uncorrectable developmental delay and decreased mental functioning capacity in children, and in severe cases, can lead to a child's premature death.
"Lead screening" means the application of a detection technique to measure a child's blood lead level and determine the extent of a child's recent exposure to lead.
b. A health care facility that serves children and is licensed pursuant to P.L.1971, c.136 (C.26:2H-1 et seq.), and any other agency or program that serves children and is designated by the commissioner to perform lead screening, shall perform lead screening on each child under six years of age that the facility, agency, or program serves, unless the facility, agency, or program has knowledge that the child has already undergone lead screening in accordance with the requirements of this act. If the health care facility, agency, or program cannot perform the required lead screening, the facility, agency, or program may refer the patient, in writing, to another health care facility, physician, registered professional nurse, or other designated agency or program which is able to perform the lead screening.
c. If a physician, registered professional nurse, or health care facility, agency, or program receives laboratory test results indicating that a child has an elevated blood lead level, the physician, registered professional nurse, or health care facility, agency, or program shall notify the parent or guardian of the child, in writing, about the test results, and shall additionally provide the parent or guardian with an explanation, in plain language, of the significance of lead poisoning. The physician, registered professional nurse, or health care facility, agency, or program shall also take appropriate measures to ensure that any of the child's siblings or other members of the household who are under the age of six either are, or have been, screened for lead exposure.
d. A physician, registered professional nurse, or health care facility, agency, or program shall not be required to conduct lead screening under this act if the parent or guardian of the child objects to the testing in writing.
e. (1) The department shall specify, by regulation, the parameters for lead screening required under this act, including the age of the child when initial screening shall be conducted, the time intervals between screening, when follow-up testing is required, and the methods that shall be used to conduct the lead screening.
(2) (a) The department shall additionally specify, by regulation, in accordance with the most recent recommendations of the federal Centers for Disease Control and Prevention, the elevated blood lead levels that require responsive action under this act, and the types of responsive action, including environmental follow-up, notice to the family, additional screening of family members, the provision of case management services, and the provision of medical treatment such as chelation therapy, that shall be undertaken when a screening test reveals an elevated blood lead level. The levels of responsive action required by the department pursuant to this paragraph may vary, consistent with the latest recommendations of the federal Centers for Disease Control and Prevention, based on the severity of the elevated blood lead level.
(b) Within 30 days after the enactment of P.L.2017, c.7, and on a biennial basis thereafter, the department shall review and appropriately revise its rules and regulations pertaining to elevated blood lead levels, in order to ensure that they appropriately reflect, and are consistent with, the latest guidance from the federal Centers for Disease Control and Prevention.
f. The department shall develop a mechanism, such as distribution of lead screening record cards or other appropriate means, by which children who have undergone lead screening can be identified by physicians, registered professional nurses, and health care facilities, agencies, and programs that perform lead screening, so as to avoid duplicate lead screening of children.
g. The department shall continuously engage in a public information campaign to inform the parents of young children, as well as physicians, registered professional nurses, and other health care providers, of the lead screening requirements of this act. At a minimum, the public information campaign shall: (1) highlight the importance of lead screening, and encourage parents, especially those who have not yet complied with the lead screening provisions of this act, to have their children screened for lead poisoning at regular intervals, in accordance with the age-based timeframes established by department regulation; and (2) provide for the widespread dissemination of information to parents and health care providers on the dangers of lead poisoning, the factors that contribute to lead poisoning, the recommended ages at which children should be tested for lead poisoning, and the elevated blood lead levels that require responsive action under this act. If the department changes the elevated blood lead levels that require responsive action under this act, as may be necessary to conform its regulations to federal guidance, the information disseminated through the public information campaign shall be appropriately revised to reflect the new action levels, and shall be reissued to parents and health care providers, within 30 days after the change is implemented.
h. The department, to the greatest extent possible, shall coordinate payment for lead screening required pursuant to this act with the State Medicaid program established pursuant to P.L.1968, c.413 (C.30:4D-1 et seq.) and other federal children's health programs, so as to ensure that the State receives the maximum amount of federal financial participation available for the lead screening services provided pursuant to this act.
b. A laboratory which performs a lead screening test pursuant to this act shall report the test results to the department, the local health department in the municipality in which the child who is the subject of the test resides, and the physician, registered professional nurse or health care facility, agency or program that submitted the specimen, within five business days of obtaining the test result.
b. The information reported to and compiled by the department pursuant to this act is to be used only by the department and such other agencies as may be designated by the commissioner and shall not otherwise be divulged or made public so as to disclose the identity of any child to whom it relates without written parental consent; and to that end, the information shall not be included under materials available to public inspection pursuant to P.L.1963, c.73 (C.47:1A-1 et seq.). The department may, however, make such statistical reports available using information compiled from the database if the name or other identifying information of the child screened is not revealed and in accordance with all other federal and State laws regarding the protection of medical information.
“Department” means the Department of Health.
“Lead screening” means the application of a detection technique to measure a person’s blood lead level and determine the extent of the person’s recent exposure to lead.
b. If the health care professional cannot perform a required lead screening, the health care professional may refer the patient, in writing, to another health care professional who is able to perform the lead screening.
c. If the health care professional receives laboratory test results indicating that the pregnant person has an elevated blood lead level, the health care professional shall notify the patient, in writing, about the test results and shall additionally provide the patient with an explanation, in plain language, of the significance of lead poisoning. The health care professional shall also take appropriate measures to ensure that any of the patient’s children or other members of the patient’s household who are under the age of six are, or have been, screened for lead exposure.
d. The health care professional shall not be required to conduct lead screening under this act if the patient objects to the testing in writing or if the health care professional determines that another health care provider has already conducted the lead screening required under this act.
e. The health care professional shall comply with the blood sample collection requirements specified in section 4 of P.L.1995, c.328 (C.26:2-137.5).
b. The information reported to and compiled by the department pursuant to this act shall be confidential, except that the department may make such statistical reports available using information compiled from the database. The information included in the statistical reports shall exclude the name or other personal identifying information of the pregnant person screened in accordance with all other federal and State laws regarding the confidentiality of medical information.
The Legislature finds and declares that the rising incidence of diabetes mellitus and its associated complications involving the eyes, kidneys, heart, blood vessels and nerves is causing concern among public health officials and private practitioners who feel that it is imperative that new initiatives be developed to combat this disease which is so costly in human, social, and economic terms.
The Legislature further finds that the authorization to make permanent the existing comprehensive Diabetes Control Program within the New Jersey State Department of Health is in the best interests of the citizens of the State of New Jersey in an effort to minimize the incidence of death and disability so often attributed to diabetes.
As used in this act:
a. "Commissioner" means the Commissioner of the State Department of Health;
b. "Department" means the State Department of Health;
c. "Program" means the Diabetes Control Program established by the commissioner.
The commissioner shall continue within the department the existing Diabetes Control Program which shall have central authority and responsibility for the development of diabetes control strategies based on sound scientific principles and protocols.
a. Gather data relative to the occurrence of diabetes and its associated complications;
b. Enter into necessary contracts and agreements with counties, municipalities, and other units of government, colleges, universities, associations, and agencies;
c. Conduct a scientific investigation into the prevention, cause, and control of diabetes and its associated morbidity;
d. Develop more effective methods for evaluating diabetes control strategies;
e. Promote programs of education for persons with diabetes in order to improve their quality of life and reduce the burdens of the disease and its complications;
f. Promote programs of professional education for physicians, nurses, dietitians, podiatrists, dentists, physical therapists, pharmacists, and public health professionals relative to the prevention and control of diabetes and the rehabilitation of persons with the complications of diabetes; and
g. Apply for and accept any grant of money from the federal government or any other source available for the purposes of P.L.1987, c.10 (C.26:2-138 et seq.).
Pursuant to the "Administrative Procedure Act," P.L. 1968, c. 410 (C. 52:14B-1 et seq.), the commissioner shall promulgate rules and regulations necessary to effectuate the provisions of this act.
b. The Department of Health, in consultation with the Department of Human Services and the Department of Children and Families, shall, no later than 24 months after the effective date of this act and biannually thereafter, present a report to the Governor, and to the Legislature pursuant to section 2 of P.L.1991, c.164 (C.52:14-19.1), on the following:
(1) The financial impact and reach of diabetes of all types on the Department of Health, the Department of Human Services, and the Department of Children and Families, as well as the population Statewide and in specific areas of the State. The report shall include: (a) the number of people with diabetes receiving services provided by each department; (b) the number of people with diabetes and family members impacted by diabetes prevention and control programs implemented by each department; (c) the financial impact of diabetes and its complications on each department; and (d) the financial impact of diabetes and its complications on each department in comparison to other chronic diseases and conditions;
(2) The benefits of implemented programs and activities aimed at preventing or controlling diabetes. This assessment shall document the amount and source of any funding directed to each department for programs and activities aimed at reaching those with diabetes;
(3) The level of coordination among the three departments and the divisions and agencies thereof on activities, programmatic activities, and messaging related to the management, treatment, or prevention of all forms of diabetes and its complications;
(4) The development or revision of a detailed action plan for preventing and controlling diabetes with a range of actionable items for consideration by the Legislature. The plan shall identify proposed actions to reduce the impact of all forms of diabetes, pre-diabetes, and complications related to diabetes; identify expected outcomes of the proposed actions in the following biennium; and establish benchmarks for preventing and controlling relevant forms of diabetes, reducing the incidence of diabetes, improving diabetes care, and controlling complications associated with diabetes; and
(5) The development of a detailed budget blueprint identifying needs, costs, and resources required to implement the plan pursuant to paragraph (4) of this subsection. This blueprint shall include a budget range for each proposed action presented in the plan pursuant to paragraph (4) of this subsection for consideration by the Legislature.
Every licensed physician or other licensed health professional engaged in the prenatal care of a pregnant woman or attending the woman at the time of delivery, miscarriage or abortion shall obtain or cause to be obtained a blood specimen of the woman prior to delivery or abortion or within 24 hours after delivery, miscarriage or abortion.
The physician or licensed health professional shall submit the blood specimen to a licensed clinical laboratory or a laboratory approved by the State Department of Health for a determination of rhesus (Rh) blood type. The laboratory shall report the results to the physician or other person engaged in the prenatal care of the woman at the time of delivery, miscarriage or abortion.
If the test results indicate the woman is Rh negative, within 48 hours of delivery, miscarriage or abortion and no more than 24 hours of receipt of the results the physician or licensed health professional who was engaged in the prenatal care of the woman shall advise the woman of the significance of the results and the availability of preventative treatment.
The provisions of this act shall not apply if the physician or other licensed health professional engaged in the prenatal care of a pregnant woman or attending the woman at time of delivery, miscarriage or abortion knows the pregnant woman's rhesus blood type and accepts responsibility for the accuracy of the information.
The provisions of this act shall not apply if the pregnant woman objects to the test.
The Legislature finds and declares that:
a. Although the majority of Americans are covered by some form of health insurance, families nevertheless lack protection against the high cost of chronic or single episodes of serious illness that may destroy their resources. An illness resulting in this potentially devastating financial consequence is referred to as a catastrophic illness.
b. Catastrophic illnesses often threaten to push some families into bankruptcy and others toward seeking inferior medical care and present a major problem for this nation's health care system in that catastrophic illnesses account for over 20% of this nation's health expenditures.
c. The impact of catastrophic illnesses on the family is especially acute in that children have the highest average medical costs among the population as a whole.
d. It is the public policy of this State that each child of this State should have access to quality health care and adequate protection against the extraordinarily high costs of health care services which are determined to be catastrophic and severely impact upon a child and his family.
e. To this end, it is incumbent upon the State to provide assistance to children and their families whose medical expenses extend beyond the families' available resources.
a. "Catastrophic illness" means any illness or condition the medical expenses of which are not covered by any other State or federal program or any insurance contract and exceed 10% of the first $100,000 of annual income of a family plus 15% of the excess income over $100,000.
b. "Child" means a person 21 years of age and under.
c. "Commission" means the Catastrophic Illness in Children Relief Fund Commission.
d. "Family" means a child and the child's parent, parents or legal guardian, as the case may be, who is legally responsible for the child's medical expenses.
e. "Fund" means the Catastrophic Illness in Children Relief Fund.
f. "Income" means all income, from whatever source derived, actually received by a family.
g. "Resident" means a person legally domiciled within the State for a period of three months immediately preceding the date of application for inclusion in the program. Mere seasonal or temporary residence within the State, of whatever duration, does not constitute domicile. Absence from this State for a period of 12 months or more is prima facie evidence of abandonment of domicile. The burden of establishing legal domicile within the State is upon the parent or legal guardian of a child.
The "Catastrophic Illness in Children Relief Fund" is established as a nonlapsing, revolving fund. The fund shall be administered by the commission, and shall be credited with monies received pursuant to section 10 of this act.
The State Treasurer is the custodian of the fund and all disbursements from the fund shall be made by the treasurer upon vouchers signed by the chairman of the commission. The monies in the fund shall be invested and reinvested by the Director of the Division of Investment in the Department of the Treasury as are other trust funds in the custody of the State Treasurer in the manner provided by law. Interest received on the monies in the fund shall be credited to the fund.
The commission shall consist of the Commissioner of Health, the Commissioner of Human Services, the Commissioner of Children and Families, the Commissioner of Banking and Insurance, and the State Treasurer, who shall be members ex officio, and seven public members who are residents of this State, appointed by the Governor with the advice and consent of the Senate for terms of five years, two of whom are appointed upon the recommendation of the President of the Senate, one of whom is a provider of health care services to children in this State and two of whom are appointed upon the recommendation of the Speaker of the General Assembly, one of whom is a provider of health care services to children in this State. The five public members first appointed by the Governor shall serve for terms of one, two, three, four and five years, respectively.
Each member shall hold office for the term of his appointment and until his successor has been appointed and qualified. A member of the commission is eligible for reappointment.
Each ex officio member of the commission may designate an officer or employee of the ex officio member's department to represent the member at meetings of the commission, and each designee may lawfully vote and otherwise act on behalf of the member for whom he constitutes the designee. Any designation shall be in writing delivered to the commission and filed with the office of the Secretary of State and shall continue in effect until revoked or amended in the same manner as provided for designation.
Each member of the commission may be removed from office by the Governor, for cause, after a public hearing and may be suspended by the Governor pending the completion of the hearing. Each member of the commission before entering upon his duties shall take and subscribe an oath to perform the duties of his office faithfully, impartially and justly to the best of his ability. A record of the oaths shall be filed in the office of the Secretary of State.
Any vacancies in the membership of the commission occurring other than by the expiration of a term shall be filled in the same manner as the original appointment, but for the unexpired term only.
The powers of the commission are vested in the members thereof in office from time to time and six members of the commission shall constitute a quorum at any meeting thereof. Action may be taken and motions and resolutions adopted by the commission at any meeting thereof by the affirmative vote of at least six members of the commission. A vacancy in the membership of the commission shall not impair the right of a quorum to exercise all the powers and perform all the duties of the commission.
The members of the commission shall serve without compensation, but the commission shall reimburse its members for the reasonable expenses incurred in the performance of their duties based upon the monies available in the fund.
The commission shall be appointed within three months after the effective date of this act and shall organize as soon as may be practicable after the appointment of its members.
a. Establish in conjunction with the Special Child Health Services program established pursuant to P.L.1948, c.444 (C.26:1A-2 et seq.) a program for the purposes of this act, administer the fund and authorize the payment or reimbursement of the medical expenses of children with catastrophic illnesses;
b. Establish procedures for application to the program, determining the eligibility for the payment or reimbursement of medical expenses for each child, and processing fund awards and appeals. The commission shall also establish procedures to provide that, in the case of an illness or condition for which the family, after receiving assistance pursuant to this act, recovers damages for the child's medical expenses pursuant to a settlement or judgment in a legal action, the family shall reimburse the fund for the amount of assistance received, or that portion thereof covered by the amount of the damages less the expense of recovery;
c. Establish the amount of reimbursement for the medical expenses of each child using a sliding fee scale based on a family's ability to pay for medical expenses which takes into account family size, family income and assets and family medical expenses and adjust the financial eligibility criteria established pursuant to subsection a. of section 2 of this act based upon the moneys available in the fund;
d. Disseminate information on the fund and the program to the public;
e. Adopt bylaws for the regulation of its affairs and the conduct of its business, adopt an official seal and alter the same at pleasure, maintain an office at the place within the State as it may designate, and sue and be sued in its own name;
f. Appoint, retain or employ staff, experts or consultants on a contract basis or otherwise, who are deemed necessary, and employ investigators or other professionally qualified personnel who may be in the noncompetitive division of the career service of the Civil Service, and as may be within the limits of funds appropriated or otherwise made available to it for its purposes;
g. Maintain confidential records on each child who applies for assistance under the fund;
h. Do all other acts and things necessary or convenient to carry out the purposes of this act; and
i. Adopt rules and regulations in accordance with the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.) necessary to effectuate the purposes of this act.
b. In the event a family has more than one child with a catastrophic illness, as defined pursuant to section 2 of P.L.1987, c.370 (C.26:2-149), the commission shall waive the family responsibility, as established by regulation, for the other child if the family has met the family responsibility for the first child in a State fiscal year.
The State Treasurer shall adopt rules and regulations in accordance with the "Administrative Procedure Act," P.L.1968, c. 410 (C. 52:14B-1 et seq.) establishing procedures for the collection of the surcharge.
a. There are dramatic differences in death, disease and injury rates between White and racial and ethnic minority populations in the State, with especially wide and persistent disparities in the incidence of cancer, cardiovascular disease and stroke, chemical dependency, diabetes, asthma, homicide, suicide, accidental injury, infant mortality, child immunization rates and HIV/AIDS;
b. There is a clear need for a collaborative State effort to address the wide disparity in death, disease and injury rates through a New Jersey Office on Minority and Multicultural Health, renamed from the New Jersey Office on Minority Health established pursuant to P.L.1991, c.401 (C.26:2-160 et seq.); and
c. The New Jersey Office on Minority and Multicultural Health shall seek to identify and develop innovative projects which will eliminate the gap between the health status of White and racial and ethnic minority populations in this State, and to coordinate current State programs which seek to address minority racial and ethnic health concerns, with the ultimate goal of enabling all members of racial and ethnic minority populations in this State to have access to high-quality health care.
b. Whenever the term "New Jersey Office on Minority Health" occurs or any reference is made thereto in any law, contract, or document, the same shall be deemed to mean or refer to the "New Jersey Office on Minority and Multicultural Health."
a. Provide grants to community-based organizations to conduct special research, demonstration, and evaluation projects for targeted at-risk racial and ethnic minority populations and to support ongoing community-based programs that are designed to reduce or eliminate racial and ethnic health disparities in the State;
b. Develop and implement model public and private partnerships in racial and ethnic minority communities for health awareness campaigns and to improve the access, acceptability, and use of public health services;
c. Serve as an information and resource center for racial and ethnic minority specific health information and data and develop a clearinghouse to collate and organize data on a county-by-county basis and disseminate it upon request to interested parties;
d. Review, recommend, and develop culturally appropriate health education materials;
e. Provide assistance to local school districts to develop programs in elementary and secondary schools which stress good nutrition and healthy lifestyles;
f. Function as an advocate for the adoption and implementation of effective measures to improve the health of racial and ethnic minority populations in this State, which measures should lead to the elimination of disparities among the various racial and ethnic populations of this State with respect to access to high-quality health care, utilization of health care services, and health status;
g. Improve existing data systems to ensure that the health information that is collected includes specific race and ethnicity identifiers;
h. Review the programs of the Departments of Health, Human Services, Community Affairs, and Education and any other department of State government, as appropriate, that concern multicultural or minority health and make recommendations to the departments that will enable them to better coordinate and improve the effectiveness of their efforts;
i. Develop a Statewide plan for increasing the number of racial and ethnic minority health care professionals which includes recommendations for the financing mechanisms and recruitment strategies necessary to carry out the plan;
j. Work collaboratively with colleges of medicine and dentistry in this State and other health care professional training programs to develop cultural and language competency courses that are designed to address the problem of racial and ethnicity disparities in health care access, utilization, treatment decisions, quality, and outcomes;
k. Develop recommendations for the most effective means of providing outreach to racial and ethnic minority communities throughout the State to ensure their maximum participation in publicly funded health benefits programs;
l. Seek to establish a Statewide alliance with community-based agencies and organizations, health care facilities, health care provider organizations, managed care organizations, and pharmaceutical manufacturers to promote the objectives of the office; and
m. Evaluate multicultural or racial and ethnic minority health programs in other states to assess their efficacy and potential for replication in this State and make recommendations regarding the adoption of such programs, as appropriate.
The purpose of the study shall be to:
(1) identify Statewide and regional trends, patterns, and racial and ethnic disparities in adverse health outcomes, and medical, non-medical, and system-related factors that may affect the sexual and reproductive health of African-American women;
(2) review the extent to which the effects of racial and ethnic disparities on the sexual and reproductive health of African-American women in a geographic area indicate the need to increase access to health care services among racial and ethnic populations in that area; and
(3) identify ways to reduce or eliminate racial and ethnic disparities that affect the sexual and reproductive health of African-American women.
b. In conducting the study, the office may seek the advice of persons specializing in the fields of women's health, minority health advocacy, or other related fields.
c. Within one year after the date of enactment of this act, the office shall prepare and submit to the Governor and, pursuant to section 2 of P.L.1991, c.164 (C.52:14-19.1), to the Legislature, a report containing the study's findings concerning the effects of racial and ethnic disparities on the sexual and reproductive health of African-American women and recommendations for legislative or other actions that can be undertaken to:
(1) improve the sexual and reproductive health of African-American women in this State;
(2) reduce or eliminate racial and ethnic disparities that affect the sexual and reproductive health of African-American women; and
(3) increase access to high quality health care services among African-American women in the following priority areas: childbirth; breast, cervical, and ovarian cancer screening; HIV/AIDS; hepatitis C; and other sexually transmitted diseases.
d. The office may prepare and submit additional reports when the office deems it appropriate, and each report, with the exception of the first report prepared under this section, shall additionally identify the extent to which the office's prior recommendations have been successfully implemented in practice and the apparent impact that the implementation of such recommended changes has had on the sexual and reproductive health of African-American women in the preceding years.
a. Adopt rules and regulations pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.), concerning the operation of the office and other matters that may be necessary to carry out the purposes of this act;
b. Maintain offices at such places within the State as it may designate;
c. Employ a director and other personnel as may be necessary. The director shall be appointed by the Commissioner of Health and shall serve at the pleasure of the commissioner during the commissioner's term of office and until the appointment and qualification of the director's successor. The director shall devote his entire time to the duties of the position and shall receive a salary as provided by law;
d. Apply for and accept any grant of money from the federal government, private foundations or other sources, which may be available for programs related to multicultural or minority health;
e. Serve as the designated State agency for receipt of federal funds specifically designated for multicultural or racial and ethnic minority health programs; and
f. Enter into contracts with individuals, organizations, and institutions necessary for the performance of its duties under this act.
The commission shall consist of nine members, including the Commissioner of Health or his designee, who shall serve ex officio, and eight public members who are residents of the State and who shall be appointed as follows: one member who is a health care professional shall be appointed by the President of the Senate; one member who is a health care professional shall be appointed by the Speaker of the General Assembly; and six members, at least two of whom are health care professionals, at least one of whom represents health care facilities and at least one of whom represents the health insurance industry, shall be appointed by the Governor with the advice and consent of the Senate.
The term of office of each public member shall be three years, but of the members first appointed, two shall be appointed for a term of one year, three shall be appointed for a term of two years and three shall be appointed for a term of three years. A member shall hold office for the term of his appointment and until his successor has been appointed and qualified. All vacancies shall be filled for the balance of the unexpired term in the same manner as the original appointment. A member of the commission is eligible for reappointment.
The public members of the commission shall not receive any compensation for their services, but shall be reimbursed for the actual and necessary expenses incurred in the performance of their duties as members of the commission, within the limits of funds available to the commission.
The members of the commission shall annually elect a chairman and a vice-chairman from among the public members and may select a secretary, who need not be a member of the commission.
The New Jersey Office on Minority and Multicultural Health shall provide such staff and assistance as the commission requires to carry out its work.
a. Review and make recommendations to the New Jersey Office on Minority and Multicultural Health on any rules, regulations and policies proposed by the office;
b. Advise the office on the awarding of grants and development of programs and services required pursuant to this act;
c. Advise the office on the needs, priorities, programs and policies relating to multicultural or racial and ethnic minority health in this State; and
d. Provide any other assistance to the office, as may be requested by the director.
The commission may accept from any governmental department or agency, public or private body or any other source grants or contributions to be used in carrying out its responsibilities under this act.
a. Establish measurable outcomes to achieve the goal of reducing health disparities in the areas provided in section 1 of this act.
b. Enhance current data tools to ensure a Statewide assessment of the risk behaviors associated with the health disparity priority areas provided in section 1 of this act. To the extent feasible, the office shall conduct the assessment so that the results may be compared to national data.
The department shall submit a report to the Senate Budget and Appropriations Committee and the Assembly Appropriations Committee, or their successors, describing the criteria developed pursuant to this section and detailing the amount of grants distributed and the names of the programs receiving grants. The department shall submit the report annually to both committees.
a. Out-of-wedlock adolescent births are a serious problem facing the State of New Jersey and the nation;
b. A large number of adolescents ages 10-19 are having children with approximately one million adolescents in the United States becoming pregnant each year;
c. Adolescent pregnancy has serious medical consequences, including the following: adolescents are less likely than older mothers to obtain prenatal care as only half of the pregnant adolescents in New Jersey receive early prenatal care; pregnant teenagers are at excess risk for anemia, cervical trauma, premature delivery, prolonged or abrupt labor and maternal mortality; and children of adolescent mothers are more likely to have low birth weight, require further hospitalization and die in infancy;
d. Out-of-wedlock adolescent pregnancy has serious social consequences, including the following: adolescent mothers are more likely to live in poverty, receive public assistance, be a high school dropout and be unemployed as nearly 75% of all single mothers under age 25 live in poverty, approximately half of all women receiving AFDC from 1976-1992 were or had been teenage mothers, only slightly more than half of adolescents who become mothers finish high school and children of adolescent mothers experience excess rates of dropping out of school, incarceration, depression, premature sexual activity and out-of-wedlock births. As of 1992, 84% of all births to mothers under the age of 20 in New Jersey were out-of-wedlock, the sixth highest rate in the country;
e. Out-of-wedlock adolescent pregnancy imposes large economic costs to federal, state and local governments;
f. There is a need for a permanent body to confront the issue of out-of-wedlock adolescent pregnancy and to review policy proposals, such as the findings and recommendations presented in the 1988 report of the New Jersey Task Force on Adolescent Pregnancy; and
g. It is therefore necessary to establish an advisory council to determine the best methods of coordination and improvement of the services of State and local governmental, private and voluntary agencies, community organizations, and schools which seek to serve adolescents at high risk of pregnancy, pregnant adolescents, adolescent parents, and their families.
b. The advisory council shall consist of 24 members as follows: the Commissioners of the Departments of Health, Human Services, Children and Families, Education, Community Affairs, and Labor and Workforce Development, who shall serve as ex officio members, and 18 public members, four of whom shall be teenagers, including two teenage parents and two teenagers who are not parents, and fourteen of whom shall be representatives of community based religious, health, and social service organizations which serve adolescents and health professionals and educators with recognized expertise in the field of adolescent pregnancy. Of the public members, three shall be appointed by the President of the Senate, no more than two of whom shall be of the same political party; three shall be appointed by the Speaker of the General Assembly, no more than two of whom shall be of the same political party; and 12 shall be appointed by the Governor. Eight of the persons appointed by the Governor shall be appointed with the advice and consent of the Senate, no more than four of whom shall be of the same political party; and four of the persons appointed by the Governor shall be teenagers. The advisory council shall organize within 30 days after the appointment of its members. The members shall select one person from among them to serve as the chairperson and the members shall select a secretary, who need not be a member of the advisory council.
c. Each ex officio member may designate an employee of the member's department to represent the member at hearings of the advisory council. All designees may lawfully vote and otherwise act on behalf of the member for whom they constitute the designee.
d. Each public member shall be appointed for a term of three years, but of the members first appointed, six shall serve for a term of one year, six for a term of two years, and six for a term of three years. Members shall serve until their successors are appointed and qualified. Vacancies shall be filled in the same manner as the original appointments were made.
e. Members of the advisory council shall serve without compensation but, within the limits of funds appropriated or otherwise made available to it, shall be eligible for reimbursement of necessary expenses incurred in the performance of their duties.
f. The Department of Health shall provide such staff as the advisory council requests to carry out the purposes of this act.
a. Review past policy proposals, including those contained in the 1988 report of the New Jersey Task Force on Adolescent Pregnancy;
b. Develop policy proposals for the State to prevent adolescent pregnancy, reduce out-of-wedlock births among adolescents and improve services to at-risk, pregnant, and parenting adolescents;
c. Assist with and promote a coordinated and comprehensive approach to the social, economic, and health problems of adolescent pregnancy and parenthood among public and private groups;
d. Collect information on ongoing and new efforts aimed at preventing adolescent pregnancy and improving services to at-risk, pregnant, and parenting adolescents;
e. Promote and encourage broad community input, communication and education regarding adolescent pregnancy;
f. Provide advice to local public and private agencies and schools seeking to mobilize local efforts designed to prevent adolescent pregnancies and assist adolescent parents; and
g. Coordinate activities generated by the National Campaign to Prevent Teen Pregnancy and the Family Planning Program in the State Department of Health and Senior Services.
a. Postpartum depression is the name given to a wide range of emotional, psychological and physiological reactions to childbirth, including loneliness, sadness, fatigue, low self-esteem, loss of identity, increased vulnerability, irritability, confusion, disorientation, memory impairment, agitation and anxiety, which challenge the stamina of the new mother and impair her ability to function and nurture her newborn child;
b. Postpartum depression is the result of a chemical imbalance triggered by a sudden dramatic drop in hormonal production after the birth of a baby, and women at highest risk for postpartum depression are those with a previous psychiatric difficulty, such as depression, anxiety or panic disorder and those with a family member suffering from such a psychiatric difficulty, but postpartum depression frequently strikes without warning in women without any past emotional problems or psychiatric difficulties and without any complications in pregnancy. Symptoms may appear at any time after delivery;
c. Women are more likely to suffer from mood and anxiety disorders during pregnancy and following childbirth than at any other time in their lives; 70 to 80% of all new mothers suffer some degree of postpartum mood disorder lasting anywhere from a week to as much as a year or more, and approximately 10 to 20% of new mothers experience a paralyzing, diagnosable clinical depression;
d. Many new mothers suffering from postpartum depression require counseling and treatment, yet many do not realize that they need help. Those whose illness is severe may require medication to correct the underlying brain chemistry that is disturbed;
e. Postpartum depression dramatically distorts the image of perfect new motherhood and is often dismissed by the woman suffering from this illness and those around her. Sometimes it is thought to be a weakness on the part of the sufferer that is self-induced and self-controllable;
f. Currently, the United States lacks any organized treatment protocol for postpartum depression and lags behind most other developed countries in providing information, support and treatment for postpartum depression;
g. If early recognition and treatment are to occur, postpartum depression must be discussed in childbirth classes and obstetrical office visits and public education about this illness must be enhanced to lift the social stigma associated with the illness. Such discussion and education will increase the chance that a woman will inform others of her symptoms as she would for physical complications;
h. It is imperative that health care providers who provide prenatal and postnatal care to women have a thorough understanding of postpartum depression so that they can detect and diagnose this illness in its earliest stages and thus prevent the most severe cases;
i. In addition to the mother, the effects of postpartum depression can also impact the child and the father significantly. Maternal depression can affect the mother's ability to respond sensitively to her infant's needs, and can strain the parent's relationship as the father feels anxious and helpless because he does not understand what is going wrong or what is the source of the depression; and
j. Postpartum depression is one of the most treatable and curable of all forms of mental illness, and education about this illness can be very beneficial to new parents coping with these emotional and hormonal changes by helping them decide if and when they need outside help.
a. Physicians, nurse midwives, and other licensed health care professionals providing prenatal care to women shall provide education to women and their families about postpartum depression in order to lower the likelihood that new mothers will continue to suffer from this illness in silence;
b. All birthing facilities in the State shall provide departing new mothers and fathers and other family members, as appropriate, with complete information about postpartum depression, including its symptoms, methods of coping with the illness, and treatment resources;
c. Physicians, nurse midwives, and other licensed health care professionals providing postnatal care to women shall screen new mothers for postpartum depression symptoms prior to discharge from the birthing facility and at the first few postnatal check-up visits; and
d. Physicians, nurse midwives, and other licensed health care professionals providing prenatal and postnatal care to women shall include fathers and other family members, as appropriate, in both the education and treatment processes to help them better understand the nature and causes of postpartum depression so that they too can overcome the spillover effects of the illness and improve their ability to be supportive of the new mother.
b. The plan shall provide strategies to:
(1) increase awareness among mental health care service providers who treat women experiencing perinatal mood and anxiety disorders with regard to the prevalence and effects of perinatal mood and anxiety disorders on women and children;
(2) establish a referral network of mental health care providers and support services for women who are in need of perinatal mood and anxiety disorder treatment;
(3) increase women's access to formal and informal peer support services, including access to certified peer specialists who have received training related to perinatal mood and anxiety disorders;
(4) raise public awareness for, and reduce the stigma related to, perinatal mood and anxiety disorders; and
(5) provide available funds to perinatal mood and anxiety disorder screening, referral, treatment, and support services.
The department shall distribute the notice, at no charge, to all professional medical offices that provide gynecological, obstetrical, or pediatric care and to all publicly funded maternal and child health and nutrition programs in the State. The department shall update the notice as necessary, and shall make additional copies of the notice available to health care providers upon request.
a. There are estimated to be 1.63 million American polio survivors, 50,000 in New Jersey alone;
b. At least 70% of paralytic and 40% of non-paralytic polio survivors are developing post-polio sequelae, which consist of unexpected and often disabling symptoms, including overwhelming fatigue, muscle weakness, muscle and joint pain, sleep disorders, heightened sensitivity to anesthesia, cold and pain, and difficulty swallowing and breathing, and which occur 35 years after the initial poliovirus attack;
c. Post-polio sequelae can be treated and even prevented if polio survivors are taught to conserve energy and stop abusing poliovirus-damaged neurons, muscles and joints and are prescribed needed assistive devices;
d. Polio survivors have unique health problems, including sleep disorders, heightened sensitivity to anesthesia, cold and pain, and difficulty swallowing and breathing, which require special attention from medical professionals; and
e. It is in the public interest to make information about post-polio sequelae available to the general public through health care providers, so that polio survivors and their family members can learn about the various aspects of this condition.
b. The task force shall be comprised of the following members:
(1) the Commissioner of Health, or his designee, who shall serve ex officio; and
(2) no more than 20 public members to be appointed by the Governor, who shall include representatives from: the Public Health Council; the New Jersey State Commission on Cancer Research; the New Jersey Office on Minority and Multicultural Health; the Medical Society of New Jersey; academic medical centers and universities engaged in cancer education, research, and treatment; providers of cancer treatment and support services; pharmaceutical companies engaged in cancer research; community-based organizations and coalitions engaged in cancer outreach, education, and screening; and cancer survivors.
c. The public members shall serve for a term of one year. Vacancies in the membership of the task force shall be filled in the same manner as the original appointments were made.
d. The task force shall organize as soon as may be practicable, but no later than the 30th day after the appointment of its members, and shall select a chairperson from among the public members. The chairperson shall appoint a secretary who need not be a member of the task force. The public members shall serve without compensation, but may be reimbursed for necessary expenses incurred in the performance of their duties.
e. The Department of Health shall supply such staff and resources, including a person to serve as executive director of the task force, as the task force requires to carry out its duties.
f. The task force is entitled to the assistance and services of the employees of any State department, board, bureau, commission, or agency as it may require and as may be available to its for its purposes, and to incur traveling and other miscellaneous expenses necessary to perform its duties, within the limits of funds appropriated or otherwise made available to it for its purpose.
(1) evaluate current trends in cancer incidence, morbidity and mortality, screening, diagnosis, and behaviors that increase risk;
(2) evaluate historic, current, and emerging cancer control strategies;
(3) establish cancer reduction goals, which shall seek to reduce mortality rates for breast, cervical, prostate, lung, and colorectal cancer;
(4) establish specific goals for:
(a) reducing behavior that increases the risk of cancer, including behavior related to smoking and diet;
(b) reversing the present trend of annual increases in the rate of invasive melanoma;
(c) closing the gap in cancer mortality rates between the total population and minorities;
(d) increasing the use of screening tests for cancer, especially among elderly and minority populations; and
(e) increasing the percentage of cancers diagnosed at early stages;
(5) develop an integrated set of priority strategies that are necessary to achieve the goals established pursuant to this act; and
(6) delineate the respective roles and responsibilities for the State and other entities in implementing the priority strategies identified pursuant to this act.
b. (1) The task force shall report to the Governor, the Commissioner of Health, and the Legislature on its findings, recommendations, and activities at least biennially.
(2) In addition, the cervical cancer workgroup, which the task force shall establish in addition to such other workgroups as it deems appropriate, shall report to the Governor, the Commissioner of Health, and the Legislature at least biennially on its findings and recommendations regarding strategies and actions to reduce the occurrence of, and burdens suffered from, cervical cancer, along with any legislative bills that it desires to recommend for adoption by the Legislature.
a. Ovarian cancer causes more deaths than any other cancer of the female reproductive system; it ranks fourth as a cause of cancer deaths among women in the United States;
b. In the United States, from 1993 to 1997, the rate of new cases of ovarian cancer was 14.6 and the rate of mortality from ovarian cancer was 7.3 for every 100,000 women; in New Jersey, during the same period, the rate of new cases of ovarian cancer was 16.1 and the rate of mortality was 8.6 for every 100,000 women;
c. When ovarian cancer is found and treated in its earliest stages, the five-year survival rate is 95%; however, most women who suffer from ovarian cancer are not diagnosed until the later stages of the cancer when the disease has spread and the five-year survival rate decreases to 30%;
d. More than half of the deaths from ovarian cancer occur in women between the ages of 55 and 74 years of age and approximately one quarter of ovarian cancer deaths occur in women between 35 and 54 years of age;
e. Because early detection and treatment often mean the difference between life and death, it is important to increase awareness of the factors that put certain women at a higher risk for the disease: increased age; having a personal history of breast cancer or a family history of breast, ovarian, uterine, colon or other gastrointestinal cancers; and bearing no children;
f. The symptoms of ovarian cancer include: general abdominal discomfort or pain, such as gas, indigestion, pressure, swelling, bloating or cramps; nausea, diarrhea, constipation or frequent urination; loss of appetite; feeling of fullness after a light meal; weight gain or loss with no known reason; and abnormal bleeding from the vagina;
g. Because these symptoms are vague and non-specific, women and their physicians often attribute them to more common conditions so that by the time the cancer is diagnosed the tumor has often spread beyond the ovaries; and
h. Although development of a screening test to detect ovarian cancer remains a very active area of research, currently there is no definitive prevention strategy, but having regular pelvic examinations may decrease the overall risk of dying from ovarian cancer.
b. The commissioner shall, at a minimum:
(1) provide for the development of printed educational materials and public service announcements in English and Spanish; and
(2) disseminate information for distribution to the public, through a variety of entities, including, but not limited to, local health agencies and clinics, physicians, health care facilities, county offices on aging, pharmacies, libraries, senior citizen centers, other community-based outreach programs and organizations, and the Department of Health's official website.
a. An autism spectrum disorder is a developmental disorder of brain function which is typically manifested in impaired social interaction, problems with verbal and nonverbal communication and imagination, and unusual or severely limited activities and interests. These symptoms generally appear during the first three years of childhood and continue throughout life, often taking devastating emotional and financial tolls on the family of the child or adult with an autism spectrum disorder;
b. According to the federal Centers for Disease Control and Prevention, or CDC, one of every 94 children in this State has an autism spectrum disorder, which is the highest rate among the states examined by the CDC in the most comprehensive study of the prevalence of autism spectrum disorders to date;
c. There is a clear need for greater accuracy in reporting as well as for information on the epidemiologic data on the incidence and prevalence of autism spectrum disorders in this State; and
d. The State currently requires that a number of other conditions, including cancer and certain birth defects, be reported and maintained in a central registry. A similar requirement for reporting diagnoses of autism spectrum disorder, as well as providing for the inclusion on a voluntary basis of information about adults with an autism spectrum disorder who opt to be included in a registry of that information, and maintaining such a registry is needed to improve current knowledge and understanding of autism spectrum disorders, to conduct thorough and complete epidemiologic surveys of these disorders, to enable analysis of this problem, and to plan for and provide services to children and adults with an autism spectrum disorder and their families.
b. The report shall be in writing and shall include the name and address of the person submitting the report, the name, age, place of birth, and address of the child diagnosed as having an autism spectrum disorder, and other pertinent information as may be required by the commissioner; except that, if the child's parent or guardian objects to the reporting of the child's diagnosis for any reason, the report shall not include any information that could be used to identify the child.
c. The commissioner shall specify procedures for the health care professional to inform the child's parent or guardian of the requirements of subsections a. and b. of this section and the purpose served by including this information in the registry established pursuant to section 3 of P.L.2007, c.170 (C.26:2-187), as well as the parent's or guardian's right to refuse to permit the reporting of any information that could be used to identify the child.
b. The report shall be in writing and shall include the name and address of the person submitting the report, the name, age, place of birth, and address of the adult diagnosed as having an autism spectrum disorder, and other pertinent information as may be required by the commissioner.
c. The commissioner shall specify procedures for the health care professional to inform the adult of the provisions of subsections a. and b. of this section and the purpose served by including this information in the registry established pursuant to section 3 of P.L.2007, c.170 (C.26:2-187).
b. A physician, psychologist, or health care professional providing information to the department in accordance with P.L.2007, c.170 (C.26:2-185 et seq.) or section 4 of P.L.2009, c.204 (C.26:2-186.1) shall not be deemed to be, or held liable for, divulging confidential information.
c. Nothing in P.L.2007, c.170 (C.26:2-185 et seq.) or section 4 of P.L.2009, c.204 (C.26:2-186.1) shall be construed to compel a child or adult who has been reported as having an autism spectrum disorder to submit to medical or health examination or supervision by the department.
a. Autism is a developmental disorder of brain function which is typically manifested in impaired social interaction, problems with verbal and nonverbal communication and imagination, and unusual or severely limited activities and interests. These symptoms generally appear during the first three years of childhood and continue throughout life;
According to the federal Centers for Disease Control and Prevention, or CDC, one of every 94 children in this State has autism, which is the highest rate among the states examined by the CDC in the most comprehensive study of the prevalence of autism to date.
b. In addition to those diagnosed with autism every year, there are an estimated 4.5 million individuals with intellectual and other developmental disabilities living in the United States, including approximately 200,000 individuals in New Jersey.
Developmental disabilities are a diverse group of severe chronic conditions that are due to mental or physical impairments which are manifested in problems with major life activities such as language, mobility, learning, self-help, and independent living. Developmental disabilities begin anytime during development up to 22 years of age and usually last throughout a person's lifetime.
Intellectual disability is characterized both by a significantly below-average score on a test of mental ability or intelligence and by limitations in the ability to function in areas of daily life, such as communication, self-care, and getting along in social situations and school activities. Intellectual disability is sometimes referred to as a cognitive disability or mental retardation. Intellectual disabilities include, but are not limited to, Down syndrome, fetal alcohol syndrome, fragile X syndrome, Cri-du-chat syndrome, Prader-Willi syndrome, as well as infections such as congenital cytomegalovirus or birth defects that affect the brain such as hydrocephalus or cortical atrophy. Other causes of intellectual disability include serious head injury, stroke or certain infections such as meningitis; and
c. Firefighters, emergency medical technicians, and police officers may unexpectedly encounter or be asked to locate a person diagnosed with autism or an intellectual or other developmental disability. Given the high number of individuals affected by these disabilities, it is altogether fitting and proper to ensure that emergency responders are uniformly trained in recognizing the behavioral symptoms and characteristics of a child or adult with one or more of these disabilities, and are educated in the high risks associated with these disabilities as well as basic response techniques.
b. Prior to certification by the Department of Health, each emergency medical technician trained in basic life support services as defined in section 1 of P.L.1985, c.351 (C.26:2K-21) shall be required to satisfactorily complete the training developed under subsection a. of this section. Every emergency medical technician certified prior to the effective date of this act shall, within 36 months of the effective date of this act, satisfactorily complete the training in recognition and response techniques concerning these disabilities, through existing continuing education requirements.
c. The Commissioner of Health shall adopt rules and regulations, pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.), to effectuate the purposes of this act.
b. Upon the first renewal of a certification, biennial registration, or renewal of a license by a physician, advanced practice nurse, or physician assistant after completing the Student-Athlete Cardiac Screening professional development module as required pursuant to subsection a. of this section, a physician, advanced practice nurse, or physician assistant who performs annual physical examinations of children 19 years of age or younger shall attest to the completion of the module to the Board of Medical Examiners or the Board of Nursing, as appropriate. An application for renewal of a certification, biennial registration, or renewal of a license shall include a check box for attestation regarding compliance with subsection a. of this section for a physician, advanced practice nurse, or physician assistant who performs annual physical examinations of children 19 years of age or younger.
c. A physician, advanced practice nurse, or physician assistant who completes the Student-Athlete Cardiac Screening professional development module as required pursuant to subsection a. of this section shall retain on file at that person's professional office a hard copy of the certificate of completion of the module. The hard copy of the certificate of completion of the module shall be made available upon request.
b. Information provided under this section shall be in English and Spanish, and in a manner that is easily understandable for women receiving a positive prenatal diagnosis or for the family of a child receiving a postnatal diagnosis of Down syndrome.
b. The SIDS Center of New Jersey and the New Jersey branch of Keeping Babies Safe shall also post the informational literature made available by the department pursuant to subsection a. of this section on their Internet websites.
"Violence prevention services" means evidence-based, trauma-informed, supportive, and non-psychotherapeutic services provided by prevention professionals, as defined by the National Uniform Claim Committee, for the purpose of promoting improved health outcomes and positive behavioral change, preventing injury recidivism, and reducing the likelihood that violently injured individuals will perpetrate or promote violence themselves. Such services may be provided within or outside of a clinical setting, and may include the provision of peer support and counseling, mentorship, conflict mediation, crisis intervention, targeted case management, referrals, patient education, or screening services to victims of interpersonal violence.
The Commissioner of Health shall establish the "Hospital-Based Violence Intervention Program Initiative" in the department. The commissioner shall develop and provide guidelines for a comprehensive, coordinated plan to create hospital-based violence intervention programs, which provide targeted violence prevention services to individuals who have been the victim of a firearm or stabbing injury and who are at elevated risk of violent reinjury or involvement in retaliatory violence. The Commissioner shall promote coordination of hospital-based violence intervention programs with other evidence-based violence reduction initiatives, including those implemented under the State's Violence Intervention Program, in order to minimize duplication of services and achieve maximum impact. The Commissioner shall compile a list of violence prevention best practices for hospitals to employ. The Commissioner, in consultation with the Department of Law and Public Safety, shall collect data and monitor the effectiveness of the "Hospital-Based Violence Intervention Program Initiative" in reducing violence and share this information with hospitals.
(1) access to well-woman preventative services, including eligibility for and enrollment in the NJ FamilyCare Program, established pursuant to sections 3 through 5 of P.L.2005, c.156 (C.30:4J-10 through C.30:4J-12);
(2) healthy relationships and domestic violence;
(3) long-term family planning and contraception options;
(4) educational resources concerning the causes of and treatments for infertility;
(5) healthy environments and mitigating exposure to environmental risk factors;
(6) financial health; and
(7) child care assistance, referral services, the New Jersey Child Care Subsidy Program, and other social service programs with a child care component.
b. The commissioner shall develop programs and resources to encourage health care providers, community health workers, and healthcare facilities to encourage and support women in the development of a reproductive life plan, to encourage the integration of reproductive life plans into patient medical records, and to ensure that consultations, treatment, and other services provided to each woman are consistent with her reproductive life plan.
c. The commissioner may consult with or enter into partnerships with appropriate public and private entities for the purposes of developing and maintaining the "My Life, My Plan" program.
b. No later than 180 days after the effective date of this act, the Commissioner of Health, in consultation with the Attorney General, the Commissioner of Banking and Insurance, the Commissioner of Human Services, and the State Treasurer, shall provide on the Department of Health's Internet website comprehensive information on reproductive rights under State law, as well as information concerning health benefits coverage for reproductive health care services, which information shall include, but shall not be limited to, information concerning:
(1) the right under State law to access and receive emergency reproductive health care services;
(2) the right under State law to access and use contraception, including, but not limited to, condoms, diaphragms, spermicides, contraceptive vaginal rings, transdermal contraceptive patches, contraceptive hormonal injections, hormonal contraceptive pills, uterine implants, intrauterine devices, and surgical and non-surgical sterilization;
(3) the right under State law to self-determination regarding the use of contraception and the right under State law to refuse sterilization;
(4) the right under State law to access and use prescription and non-prescription medications for reproductive health care;
(5) the right under State law to carry a pregnancy to term and the right under State law to terminate a pregnancy, as well as the right to access services necessary for childbirth and abortion care;
(6) the right under State law to access preventative reproductive health care services;
(7) the right under State law to receive reproductive health care services regardless of insurance status, which information shall include links to appropriate Internet websites and other resources that can provide assistance in enrolling individuals without insurance or who are underinsured in a health benefits plan or to apply for medical assistance under the Medicaid or NJ FamilyCare programs;
(8) a resource page, or a link to a resource website, where patients can locate current, verified reproductive health care providers, including abortion care providers; and
(9) information on where and how to file a complaint in the event that an individual's reproductive rights are violated.
c. The information provided on or through the Internet website established pursuant to subsection b. of this section may be made available in such additional languages as deemed appropriate by the Commissioner of Health.
"Seizure first aid" means non-medical procedures to respond, attend, and provide comfort and safety to a person suffering from a primary generalized tonic-clonic seizure or complex partial seizure.
b. The Department of Health shall create an informational pamphlet or poster for employers on rendering seizure first aid to an individual who has suffered a seizure in the workplace. The informational pamphlet or poster may incorporate any available federal guidance, or guidance from non-profit organizations that support the welfare of individuals with epilepsy and seizure disorders, concerning seizure first aid. The Department of Labor and Workforce Development shall make the informational pamphlet or poster available on its Internet website and shall additionally disseminate such information to employers in a manner to be determined by the Commissioner of Labor and Workforce Development.
c. An employer in this State may provide the information disseminated by the department, pursuant to subsection b. of this section, to employees and post the information in a prominent place within the employer's workplace.
The Department of Health is hereby authorized to establish, equip, maintain and conduct a suitable program to collect, process, store and distribute human blood, and the various human blood derivatives including special therapeutic and diagnostic serums, which are deemed of value in the treatment of sick and injured persons, and the prevention of certain diseases; to carry out such educational and research activities as it may deem necessary in connection with said program; and to establish necessary rules and regulations to effect the purpose of this act.
The Department of Health may conduct such program solely as a State activity, or in co-operation with such private institutions, hospitals or municipal or county corporations as the department may select, on such terms as may be agreed upon.
The public policy of this State is to safeguard the health and well-being of the citizens of this State with reference to the use of blood in the treatment of many human diseases, as well as its use in treatment of injuries as a result of casualties or disasters. Use of blood in this manner has increased to such proportions that, in the public interest there is need for establishing minimum standards for the control and licensing of the activities of "blood banks."
For the purposes of this act, unless otherwise required by the context:
(a) "Act" means this act and any rule or regulation adopted hereunder:
(b) "Person" means a natural person, partnership, association, corporation, institution, agency, or other similar type entity;
(c) "Blood" means human blood or human plasma.
(d) "Blood bank" means any commercial or noncommercial activity involving the handling of blood or plasma, intended to be used for therapeutic or prophylactic purposes, which participates in any of the following operations: collection, processing, storage or distribution of blood;
(e) "Collection" means the obtaining of blood by the bleeding of donors;
(f) "Processing" means the technical stages required to prepare and identify the blood as to its suitability.
(g) "Storage" means the holding of blood in connection with collection or processing prior to distribution or transfusion;
(h) "Distribution" means the removal of blood from a blood bank to any other location for processing or storage or for the purpose of providing the blood for therapeutic or prophylactic purposes.
(i) "Licensee" means a person holding a license under the provisions of this act.
(j) "Commissioner" means the Commissioner of the State Department of Health or his duly authorized agent.
(k) "Department" means the State Department of Health.
All such licenses shall expire on December 31 in each calendar year and application for renewal therefor shall be made on or before November 10 on forms provided by the department. A fee necessary to conduct blood bank licensure operations, as provided in subsection b. of this section, shall accompany the original application for a license and each renewal thereof. The original or a certified copy of the license shall be conspicuously displayed by the licensee at the premises occupied as a blood bank.
b. (1) The fee for transfusion services shall be based on the number of transfusions performed at a facility and shall range from a minimum fee of $200 for a facility which performs up to 1,000 transfusions to a maximum fee of $700 for a facility which performs more than 5,000 transfusions a year;
(2) The fee for collection centers shall be based on the number of collections made by a facility and shall range from a minimum fee of $250 for a facility which makes up to 200 collections to a maximum fee of $1,900 for a facility which makes more than 50,000 collections a year;
(3) The fee for other blood bank services shall be as follows:
Collection Site - $100
Broker - $200
Industrial Blood Bank - $200
Home Transfusion Service - $200.
The commissioner may, pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.), periodically increase the fees to reflect increased State costs in blood bank licensure operations.
c. The income received from licensure and renewal fees pursuant to this section shall be appropriated to the department to effectuate the purposes of P.L.1963, c.33 (C.26:2A-2 et seq.).
A license shall be issued to any person who has been conducting a blood bank prior to the effective date of this act upon submission of a properly completed application form and payment of an application fee of $25.00. Said license shall be renewable as provided in this act and shall be subject to all the provisions of this act.
No licensee shall collect blood hereafter unless he has first obtained from the prospective donor a completed registration statement which shall set forth the name and address of the donor and shall contain such other information as the rules and regulations adopted hereunder shall require.
(a) The standards of operation for blood banks, including standards for the collection, processing, storage, and distribution of blood for therapeutic or prophylactic purposes shall be established by rules and regulations adopted and promulgated by the Public Health Council of the department. Such rules and regulations shall be incorporated in and made a part of the State Sanitary Code.
(b) The rules and regulations so promulgated shall include but not be limited to provision for:
(1) Qualifications for personnel employed in a blood bank.
(2) Restrictions upon the use of blood donors.
(3) Standards for collection, processing, storage, and distribution of blood.
(4) Evaluation of performance of blood banks.
Any license issued in accordance with the provisions of this act may be suspended or revoked by the commissioner for a violation of any of the provisions of this act.
The commissioner, before refusing to grant a license, or before suspending or revoking a license previously granted, except as hereinafter provided in section 10 of this act, shall give notice to the applicant or licensee personally, or by mail addressed to him at his last known address, and afford him an opportunity to be heard with respect thereto at a time and place specified in such notice. Such applicant or licensee shall have the right to be heard in person or by attorney, and to offer evidence pertinent to the subject of the hearing. A duly certified copy of the order of the commissioner issued as a result of such hearing shall be served on the applicant or the licensee by mail personally addressed to him at his last known address, except if such applicant or licensee be a corporation then the order shall be served in the same manner upon any officer or registered agent of the corporation.
The commissioner shall enforce the provisions of this act and may make complaints against persons violating its provisions or the rules or regulations issued thereunder and prosecute violations of same.
The commissioner shall have the power and authority to enter and inspect any blood bank and to make such investigation of the premises and the books and records as is reasonably necessary to carry out the provisions of this act.
It shall be a violation of this act for any person to obstruct, hinder, delay or interfere, by force or otherwise, with the performance by the commissioner of any duty under the provisions of this act.
If the commissioner shall have reason to believe that a condition exists or has occurred at a blood bank, in violation of the provisions of this act, which is dangerous to the public health, he may order such blood bank to correct such violation and may suspend the license of the blood bank until such correction is completed. If a licensee shall deny that a violation exists or has occurred, he shall have the right to apply to the commissioner for a hearing. Such hearing shall be held and a decision rendered within 48 hours of the receipt of said request. If the commissioner shall rule against the licensee, the licensee shall have the right to apply for injunctive relief against the commissioner's order. Jurisdiction for such injunctive relief shall be in the Superior Court of New Jersey.
Any person who violates the provisions of this act or an order of the commissioner shall be liable for the first offense to a penalty, to be established by the commissioner, of not less than $100.00 nor more than $1,000.00 and for the second and each succeeding offense for a penalty of not less than $500.00 nor more than $5,000.00. The penalties herein provided shall be enforced by the department as plaintiff in a summary proceeding in accordance with the penalty enforcement law (N.J.S. 2A:58-1, et seq.).
This act shall be known and may be cited as the "Blood Safety Act of 1991."
a. Whenever a blood transfusion may be necessary during a surgical procedure, a physician or surgeon shall inform the surgery patient, prior to performing the surgical procedure, of the options of receiving autologous blood transfusions, designated blood transfusions or homologous blood transfusions.
b. The physician or surgeon who will perform the surgery shall note on the patient's medical record that the patient was advised of the opportunity to receive an autologous, designated or homologous blood transfusion, if a transfusion becomes necessary.
c. The physician or surgeon who will perform the surgery shall not be required to provide his patient with an explanation of the transfusion options pursuant to this section, if medical contraindications exist or the surgery is performed on an emergency basis.
d. If there are no medical contraindications or the surgery is not performed on an emergency basis, the physician or surgeon shall allow adequate time, prior to surgery, for predonation to occur. If the patient waives the option to predonate blood, the physician or surgeon shall not incur any liability for his failure to allow the predonation to occur.
a. A health care facility which performs a transfusion shall be required to accept autologous or designated blood for a potential transfusion to a patient, if the blood is received from a blood bank licensed by the Department of Health, and has been tested and prepared in accordance with standards approved by the department.
b. A health care facility which accepts autologous or designated blood and similar blood components shall pay a service fee to the blood bank which provides the blood or blood components, equal to the price it is charged for homologous blood or blood components.
A blood bank which collects autologous or designated blood shall inform the donor of the blood or the intended recipient of the blood, in the case of a designated blood transfusion, of all fees that the blood bank charges to process, store, transport or otherwise prepare the blood for transfusion.
"Collection" means the obtaining of donated human breast milk.
"Commissioner" means the Commissioner of Health.
"Department" means the Department of Health.
"Distribution" means the removal of donated human breast milk from a human milk bank to any other location for processing or storage or for the purpose of providing breast milk to a hospital or selling breast milk to a parent.
"Human milk bank" means an organized service that provides for the selection of a donor of human breast milk, the collection, processing, storage, and marketing of donated human breast milk, and the distribution of donated human breast milk to a hospital for use by low birth weight babies or new mothers with delayed lactation, or directly to a parent, with a physician's prescription order, who is unable to nurse, or is in need of additional breast milk to feed, the parent's child.
"Marketing" means the use of suitable media to advertise the availability of, promote the appropriate use of, and provide information on how to safely procure, donated human breast milk.
"Person" means a person, partnership, association, agency, organization, or other similar entity.
"Processing" means the technical stages required to prepare and identify donated human breast milk as to its suitability.
"Storage" means the holding of donated human breast milk in connection with collection or processing prior to its distribution.
b. Any person desiring to operate a human milk bank shall:
(1) adhere to the guidelines for the establishment and operation of a donor human milk bank as required by the department;
(2) adhere to the best practices for expressing, storing, and handling human milk in hospitals, homes, and child care settings as required by the department;
(3) undergo a yearly assessment by the department, to provide evidence of adherence to the most recent edition of guidelines for the establishment and operation of a human milk bank;
(4) comply with any other provisions required by the department;
(5) register with the department in a form and manner prescribed by the department; and
(6) pay to the department an annual registration fee established by the department in order to offset the department's administrative costs incurred in executing its responsibilities under this act.
(1) a condition exists or has occurred at the human milk bank that is dangerous to the public health;
(2) the human milk bank has repeatedly violated the provisions of this act; or
(3) a human milk bank has opened or is operating without complying with the provisions of this act.
b. The commissioner may, in addition, request such other relief as is deemed necessary. In any such action the court may proceed in a summary manner.
c. Any person aggrieved by a final decision of the commissioner shall be entitled to seek judicial review in the Appellate Division of the Superior Court. All petitions for review shall be filed in accordance with the Rules of the Court.
b. The department shall have the jurisdiction to enforce and collect any penalty imposed because of a violation of this act in a summary proceeding in accordance with the "Penalty Enforcement Law of 1999," P.L.1999, c.274 (C.2A:58-10 et seq.). Process shall be in the nature of a summons or warrant and shall issue only at the suit of the commissioner as plaintiff.
c. A penalty recovered pursuant to the provisions of this section shall be recovered by the commissioner and paid into the State treasury.
a. In vitro fertilization, commonly known as IVF, is an accepted and widely used method of assisted reproductive technology (ART). ART has helped an estimated six million couples in the United States who have trouble getting or maintaining a pregnancy start families.
b. In 2016, the federal Centers for Disease Control and Prevention reported that there were approximately 267,000 IVF cycles performed in the United States, with more than five percent of those cycles occurring in New Jersey. By the end of the century, more than a million American patients who suffer from infertility will undergo IVF procedures.
c. The use of ART in the United States is not as prevalent as its use in other developed countries. In Japan, one in 20 children are born as a result of ART. In Norway the number is one in 10. As more women rise to executive positions in America's board rooms, and IVF becomes a more financially viable option because of increased health insurance coverage, ART will provide more of an opportunity for couples to preserve their fertility until they are ready to start a family.
d. IVF provides a pathway to motherhood for women who have experienced life threatening diseases, such as cancer, and the reproductive damage that is often a consequence of the treatments associated with these illnesses.
e. While technological advances in, and success rates of, IVF have increased since its inception 40 years ago, there is currently little state or federal regulation concerning the storage of embryos in embryo storage facilities .
f. In March of 2018, the failure of a storage tank at an Ohio fertility clinic caused the apparent loss of more than 4,000 frozen embryos and eggs, affecting 950 patients. Days after the storage tank failure in Ohio, a liquid nitrogen tank at an unrelated fertility clinic in California, containing thousands of eggs and embryos, malfunctioned, affecting another 400 patients.
g. It is in the best interest of the State to require that the Department of Health promulgate regulations governing the storage of human eggs, pre-embryos, and embryos in embryo storage facilities to guard against catastrophic storage system failure, such as those that occurred in California and Ohio, and the potential loss of such specimens that may result from long-term power outages during storms and other natural disasters.
"Commissioner" means the Commissioner of Health.
"Department" means the Department of Health.
"Embryo storage facility" means a facility which cryopreserves and stores human eggs, pre-embryos, and embryos for later use in in vitro fertilization, embryo transfer, gamete transfer, pronuclear stage transfer and zygote transfer, and other procedures performed to achieve a pregnancy or pregnancies. Embryo storage facility shall also include the office of a licensed health care provider which stores human eggs, pre-embryos, or embryos.
"Person" means any individual, corporation, company, association, organization, society, firm, partnership, joint stock company, or the State or any political subdivision thereof.
b. The department shall not license a person to conduct, maintain, or operate an embryo storage facility pursuant to this act unless the department is satisfied that the person has demonstrated good character, competency, and integrity, and has furnished such information to the commissioner as the commissioner may require for this purpose.
c. Within 90 days after the effective date of P.L.2022, c.106 (C.26:2A-25), as a condition of continued or new licensure, an embryo storage facility that is required to record or report the health information of a patient, shall record and report the patient's health information using a program that is compliant with the "Health Insurance Portability and Accountability Act of 1996," Pub.L.104-191 and requirements adopted by the U.S. Department of Health and Human Services regarding functions, technological capabilities, and security features within the program.
(1) Standards ISO 9001 and ISO 20387 of the International Organization for Standardization;
(2) standards for biorepositories established by the College of American Pathologists Biorepository Accreditation Program; and
(3) the U.S. Food and Drug Administration guidance on Current Good Tissue Practices.
b. The rules and regulations promulgated pursuant to this section shall promote safety and best practices among embryo storage facilities and, at a minimum: prescribe standards governing the operation, maintenance, and administration of embryo storage facilities; the safety and adequacy of the physical plant or the facilities; compliance with State and local fire safety codes; the number of staff and the qualifications of each staff member; the protection and safety of the equipment used by embryo storage facilities to process and store human eggs, pre-embryos, and embryos; the maintenance and confidentiality of records and furnishing of required information; the maintenance of all appropriate accreditations and certifications; the establishment of a quality management program; and the review of the scope of internal audits.
c. The department shall conduct an on-site facility inspection and shall evaluate the embryo storage facility to determine whether the facility complies with the provisions of this act.
d. The department shall have the authority to inspect and examine the physical plant or facilities of an embryo storage facility and to inspect all documents, records, files, or other data maintained pursuant to this act during normal operating hours and without prior notice.
e. The department shall request the appropriate State and local fire, health, and building officials to conduct examinations and inspections to determine compliance with State and local ordinances, codes, and regulations by an embryo storage facility. The inspections shall be conducted and the results reported to the department within 60 days after the request.
f. If an embryo storage facility meets the requirements of this act and the rules and regulations promulgated hereunder, the department shall issue a license to the facility. A license shall be valid for a period of one year and may be renewed at the end of that period, subject to continued compliance with the provisions of this act.
g. Nothing in this section shall be interpreted to permit the adoption of any code or standard which exceeds the standards established pursuant to the "State Uniform Construction Code Act," P.L.1975, c.217 (C.52:27D-119 et seq.).
a. the name and address of the embryo storage facility
b. a description of the facility's premises and facilities and the hours of its operation; and
c. any other information the commissioner deems necessary to include on the license application form.
b. The income received from licensure and renewal fees pursuant to this section shall be appropriated to the department to effectuate the purposes of this act.
a. Failure of an embryo storage facility or its operator to comply with the provisions of this act;
b. Violation of the terms and conditions of a license by an embryo storage facility or its operator;
c. Use of fraud or misrepresentation by an embryo storage facility or its operator in obtaining a license or in the subsequent operation of the facility;
d. Refusal by an embryo storage facility or its operator to furnish the department with required files, reports, or records; or
e. Refusal by an embryo storage facility or its operator to permit an inspection by an authorized representative of the department during normal operating hours.
b. The hearing shall take place within 60 days from the issuance or mailing of the notice and shall be conducted in accordance with the "Administrative Procedure Act," P.L. 1968, c.410 (C.52:14B-1 et seq.).
a. Reflex sympathetic dystrophy syndrome (RSDS), also known as complex regional pain syndrome, is a debilitating and progressively chronic condition characterized by severe burning pain, pathological changes in bone and skin, excessive sweating, tissue swelling and extreme sensitivity to touch;
b. More specifically, RSDS is thought to be a nerve disorder that generally occurs at the site of a minor or major trauma injury, but may also occur without an apparent injury to the afflicted person;
c. While the causes of RSDS are unknown, the syndrome is thought to be the result of damaged nerves of the sympathetic nervous system;
d. The disorder is unique in that it simultaneously affects the nerves, skin, muscles, blood vessels and bones, and if untreated, can result in permanent deformity and chronic pain;
e. RSDS is often misdiagnosed because this condition is either unknown or is poorly understood; the prognosis for patients suffering from RSDS is generally much better when the condition is identified and treated as early as possible, ideally within three months of identifying the first symptoms;
f. If treatment is delayed, the disorder can quickly spread to the entire limb, and changes in bone and muscle may become irreversible, resulting in limited mobility, atrophy of the muscles and eventual permanent disability of patients; and
g. Since a delay in diagnosis or treatment for this syndrome can result in severe physical and physiological problems, and early recognition and prompt treatment of RSDS provides the greatest opportunity for recovery, it is in the best interest of the public to establish a program to educate both individuals and medical professionals regarding this debilitative condition and to promote research to accurately identify, diagnose and treat RSDS.
"Commissioner" means the Commissioner of Health; and
"Reflex sympathetic dystrophy syndrome" or "RSDS" means a debilitating and progressively chronic condition characterized by severe burning pain, pathological changes in bone and skin, excessive sweating, tissue swelling, and extreme sensitivity to touch.
a. establish a public education program through the department's website, to promote RSDS education, which will enable individuals to make informed decisions about their health, including, but not limited to the following elements:
(1) the cause and nature of RSDS;
(2) the risk factors that contribute to the manifestation of RSDS;
(3) available treatment options, including risks and benefits of those options;
(4) environmental safety and injury prevention;
(5) rest and use of appropriate body mechanics;
(6) the availability of RSDS diagnostic, treatment, and outreach services in the community; and
(7) any other factors or elements that might mitigate the effects of RSDS;
b. notify local health departments, hospitals, clinics, and other health care providers about the availability of information concerning RSDS on the department's website;
c. within the limits of funds available to the department for this purpose, coordinate, promote, and offer professional education programs, through institutions of higher education, for health care providers and health-related community-based organizations, which may include, but are not limited to the following elements:
(1) research findings;
(2) the cause and nature of RSDS;
(3) the risk factors, including, but not limited to, lifestyle, heredity, and drug interactions;
(4) the diagnostic procedures and appropriate indications for their use;
(5) medical and surgical treatment options, including experimental and established drug therapies and the risks and benefits of each option;
(6) environmental safety and injury prevention; and
(7) the availability of RSDS diagnosis and treatment and support services in the community; and
d. promote research, through both private and public funding sources, to accurately identify, diagnose, and treat RSDS.
The commissioner may accept and expend any grants, awards or other funds or appropriations as may be made available for the purposes of this act.
a. A rare disease is defined as a disease that affects fewer than 20,000 people. Rare diseases are sometimes called orphan diseases. There are 7,000 rare diseases affecting approximately 25 to 30 million Americans;
b. The exact cause for many rare diseases remains unknown. However, 80 percent of rare diseases are genetic in origin and can be linked to mutations in a single gene or in multiple genes which can be passed down from generation to generation;
c. A person suffering with a rare disease faces a wide range of challenges, including delays in obtaining a diagnosis; being misdiagnosed; shortages of medical specialists who can provide treatment for rare diseases; and the lack of therapies and medication that are used by doctors to treat rare diseases;
d. There is a significant link between rare disease and the coronavirus 2019 (COVID-19) pandemic which heightens the importance of the establishment of an advisory council to examine the issues that affect persons with rare diseases in the State. Many people who live with rare diseases are immunosuppressed and have respiratory and neurologic issues that make the consequences of the virus much more severe for them;
e. Additionally, those with rare diseases rely on the health care system much more than those who do not have chronic and rare conditions. In as much as they go to their physicians' offices, medical testing sites, and hospitals more often than most, their risk of exposure to the COVID-19 virus is much greater;
f. People who live with rare diseases are impacted by potential shortages of life-saving medications and supplies due to changes in supply chain resulting from the COVID-19 pandemic. People with rare diseases also rely on the support of their families and home health aides, and because of the social distancing and quarantining, the pandemic puts them at risk of not having the support they need in accessing services and treatment;
g. Researchers have made considerable progress in developing diagnostic tools and treatment protocols for rare diseases and discovering methods of prevention. However, much more remains to be done in the search for new therapeutics and in understanding the link between rare disease and pandemics, and
h. It is therefore an appropriate public policy for the State of New Jersey to establish an advisory body, whose membership would be comprised of qualified professionals and persons living with rare diseases, that would be tasked to educate medical professionals, government agencies, and the public about the importance of rare diseases as an important public health issue, and to encourage research in the development of new treatments for rare diseases.
a. The advisory council shall consist of 20 members as follows:
(1) the Commissioners of Banking and Insurance, Health, Human Services, and the Executive Director of the New Jersey Office on Minority and Multicultural Health, or their designees, as ex officio members;
(2) two members of the public, one of whom shall be appointed by the Governor upon recommendation of the President of the Senate, and one of whom shall be appointed by the Minority Leader of the Senate which public members shall be any of the following: an epidemiologist, a registered nurse or nurse practitioner licensed to practice in this State with experience in providing care to patients with rare diseases, or a pediatrician or other physician licensed to practice in this State with expertise in providing care to patients with rare diseases;
(3) two members of the public, one of whom shall be appointed by the Governor upon recommendation of the Speaker of the General Assembly, and one of whom shall be appointed by the Minority Leader of the General Assembly which public members shall be any of the following: an epidemiologist, a registered nurse or nurse practitioner licensed to practice in this State with experience in providing care to patients with rare diseases, or a pediatrician or other physician licensed to practice in this State with expertise in providing care to patients with rare diseases; and
(4) 12 public members to be appointed by the Governor, who shall include: one physician licensed to practice in this State who has expertise in treating patients with rare diseases, and is associated with the research department of an academic institution in this State; a representative of general hospital or hospital system in this State recommended by the New Jersey Hospital Association; a representative of federally qualified health center in this State recommended by the New Jersey Primary Care Association; a geneticist licensed to practice in this State; a genetic counselor who has experience in providing services to persons diagnosed with a rare disease, their families, or their caregivers or care partners; a representative of the health insurance industry recommended by the New Jersey Association of Health Plans; a representative of the biotechnology industry or pharmaceutical industry who has expertise in rare diseases recommended by BIO NJ; a pharmacist licensed in this State who has expertise in rare diseases; a representative of the medical technology industry who has expertise in rare diseases and is recommended by the HealthCare Institute of New Jersey; one representative of a rare disease patient advocacy organization; one person, age 18 years or older, who has a rare disease; and one caregiver or care partner for a patient or partner with a rare disease.
b. Public members of the advisory council shall serve for a term of three years, except that of the initial appointments, five public members shall serve for one year, five public members shall serve for two years, and six public members shall serve for three years. Vacancies in the membership of the council shall be filled in the same manner as the original appointments were made. The public members of the council shall serve without compensation but may be reimbursed for traveling and other miscellaneous expenses necessary to perform their duties within the limits of funds made available to the council for its purposes.
c. The advisory council shall organize as soon as practicable after the appointment of a majority of its public members, and the Governor shall select a chairperson and vice-chairperson from among its members. The chairperson shall appoint a secretary who need not be a member of the council.
d. The advisory council shall meet a minimum of three times a year but may meet more often at the call of its chair. The council may hold hearings at the times and in the places it deems appropriate and necessary to fulfill its charge. The council shall be entitled to call to its assistance, and avail itself of the services of the employees of, any State, county, or municipal department, board, bureau, commission, or agency as it may require and as may be available to it for its purposes.
e. The Department of Health shall maintain oversight of the advisory council and may delegate the administration thereof to a State research university or institution with expertise in either the clinical treatment of rare disease patients, research of rare diseases, or health care policy pertaining to rare disease patients. The Department of Health may issue a request, within 180 days after the effective date of this act, for proposals for a location for the advisory council to operate and for staff and resources to support the operations of the council. The Department of Health shall provide staff services to the advisory council if the proposals submitted to the department are not sufficient to meet the needs of the council.
a. act as the advisory body on rare diseases to the Legislature and State departments, agencies, commissions, authorities, and private agencies that provide services to, or are charged with the care of, persons with rare diseases;
b. conduct a thorough and comprehensive study of all issues relating to the quality of and access to treatment and services provided to persons with rare diseases in this State, including the link between rare diseases and the COVID-19 pandemic, and to develop policy recommendations on those issues;
c. develop recommendations for best practice standards encompassing the most effective strategies for recognizing and treating rare diseases in New Jersey;
d. identify effective research-based strategies that have been developed to help diagnose, treat, and prevent rare diseases;
e. develop effective strategies to raise public awareness of rare diseases in this State;
f. evaluate and make recommendations to improve:
(1) the State's Newborn Screening Program in the Department of Health; and
(2) State Medicaid coverage for approved treatments and medications for patients with a rare disease;
g. research and make policy recommendations to the Legislature on access to health insurance specialists and other needed services for patients with a rare disease; and
h. identify, with assistance from the public, additional research topics on rare disease to inform future studies the council may conduct.
The Commission on Alcoholism and Promotion of Temperance established by "An act concerning the preparation and administration of a program for the rehabilitation of alcoholics and the promotion of temperance education by the Commissioner of Alcoholic Beverage Control, the Commissioner of Institutions and Agencies, the Commissioner of Education and the Director of Health constituted the Commission on Alcoholism and Promotion of Temperance," approved April fourth, one thousand nine hundred and forty-five (P.L.1945, c. 94), is abolished.
"Administrator" means the person in charge of the operation of a facility, or his designee.
"Admitted" means accepted for treatment at a facility.
"Assistant commissioner" means the Assistant Commissioner of the Division of Mental Health and Addiction Services in the Department of Human Services.
"Authorized persons" means persons who serve as volunteer first aid or ambulance squad members, para-professional medical personnel, and rehabilitated persons with alcohol use disorder.
"Commissioner" means the Commissioner of Human Services.
"Department" means the Department of Human Services.
"Division" means the Division of Mental Health and Addiction Services in the Department of Human Services.
"Facility" means any public, private place, or portion thereof providing services especially designed for the treatment of intoxicated persons or persons with alcohol use disorder; including, but not limited to intoxication treatment centers, inpatient treatment facilities, outpatient facilities, and residential aftercare facilities.
"Incapacitated" means the condition of a person who is: a. as a result of the use of alcohol, unconscious or has judgment so impaired that the person is incapable of realizing and making a rational decision with respect to the person's need for treatment, b. in need of substantial medical attention, or c. likely to suffer substantial physical harm.
"Independent physician" means a physician other than one holding an office or appointment in any department, board or agency of the State or in any public facility.
"Intoxicated person" means a person whose mental or physical functioning is substantially impaired as a result of the use of alcoholic beverages.
"Patient" means any person admitted to a facility.
"Person with alcohol use disorder" means any person who chronically, habitually, or periodically consumes alcoholic beverages to the extent that: a. such use substantially injures the person's health or substantially interferes with the person's social or economic functioning in the community on a continuing basis, or b. the person has lost the power of self-control with respect to the use of such beverages.
"Private facility" means a facility other than one operated by the federal government, the State of New Jersey, or any political subdivision thereof.
"Public facility" means a facility operated by the State of New Jersey or any political subdivision thereof.
"Treatment" means services and programs for the care or rehabilitation of intoxicated persons and persons with alcohol use disorder, including, but not limited to, medical, psychiatric, psychological, vocational, educational, recreational, and social services and programs.
There shall be an assistant to the assistant commissioner, who shall have experience in the field of alcohol use disorder.
The assistant commissioner and the assistant commissioner's assistant shall be appointed by the commissioner.
The commissioner shall appoint and may remove such officers and employees of the division as the commissioner may deem necessary. There shall be an administrator of each facility operated by the department pursuant to this act. Each such administrator shall be a person qualified by training and experience to operate a facility for the treatment of persons with alcohol use disorder or intoxicated persons. The commissioner may establish such other positions in the division and employ such consultants as the commissioner may deem appropriate. Except as otherwise provided by law, all offices and positions in the division shall be subject to the provisions of Title 11A, Civil Service; provided, however, that the provisions of said title shall not apply to the assistant commissioner, physicians, and psychiatrists who have full medical-psychiatric, as opposed to administrative, responsibility; and provided, further, and notwithstanding the preceding proviso or any other provision of law, that all offices and positions, which as a condition of receiving federal grants for programs and activities to which federal standards for a merit system of personnel administration relate and make necessary the application of provisions of the Civil Service law, shall be subject to the provisions of Title 11A, Civil Service, if such federal standards are uniform in all states.
b. Except as provided in subsection c. of this section, monies in the fund shall be used exclusively for making grants, approved by the Assistant Commissioner of the Division of Mental Health and Addiction Services in the Department of Human Services, to programs that provide treatment for alcohol use disorder and other conditions related to the excessive consumption of alcoholic beverages among persons convicted of violating the State's drunk driving laws and others.
c. An amount not to exceed $150,000 in Fiscal Year 2002 and five percent of the total annual revenue allocated to the fund in each fiscal year thereafter may be expended from the fund to defray actual expenses incurred by the department in the administration of the fund subject to approval by the Director of the Division of Budget and Accounting.
a. Criteria for grantee eligibility;
b. The form and manner in which application for grants from the fund shall be made; and
c. The treatment services and treatment recipients for which grant funds may be expended.
The program may encourage regionalization of services and, if not otherwise available, provide for the following facilities, which need not be separately located:
a. Intoxication treatment centers, which centers shall render emergency medical care, including detoxification, shall be open 24 hours every day, and shall be located conveniently near population centers. Services shall be provided for the immediate physical and social needs, including the needs for medication and shelter, of intoxicated persons, and shall also provide for initial examination, diagnosis and referral. To the extent possible, such treatment centers shall be affiliated with a general or other hospital.
b. Inpatient facilities, for treatment of persons with an alcohol use disorder, which shall, to the extent possible, be affiliated with the medical service of a general hospital, mental hospital, community mental health center, or other hospital.
c. Outpatient facilities.
d. Residential aftercare facilities, such as halfway houses.
The department shall maintain, supervise and control all facilities operated by it pursuant to P.L.1975, c.305 (C.26:2B-7 et seq.) and all such facilities shall be staffed with an adequate number of qualified and trained personnel. The administrator of each such facility shall make an annual report of its activities to the director in such manner and form as the director may deem appropriate. All appropriate resources, particularly community mental health centers, shall whenever possible be utilized in and coordinated with the program.
Services delivered by the department pursuant to P.L.1975, c.305 (C.26:2B-7 et seq.) may be administered on the premises of institutions operated in whole or in part by the department of institutions and agencies. Such services shall be administered as such services are administered in the other facilities of the department and shall in all respects be therapeutic in nature rather than penal or correctional.
The department shall prepare and publish annually a list of all services operating in accordance with P.L.1975, c.305 (C.26:2B-7 et seq.) and shall make the list available upon request to members of the public. The department shall notify all law enforcement agencies and judges in the State of the location and capacity of intoxication treatment centers and other services operating in accordance with this act situated in or near their jurisdictions.
a. Plan, construct, cause to be established, and maintain such facilities as may be necessary or desirable for the conduct of its program;
b. Acquire, hold, and dispose of real property;
c. Acquire by purchase or otherwise, on such terms and conditions and in such manner as it may deem proper, or by the exercise of the power of eminent domain in accordance with the provisions of Title 20 of the Revised Statutes, and lease, hold and dispose of, real property or any interest therein, for the purposes of this act;
d. Make and enter into all contracts and agreements necessary or incidental to the performance of its duties and the execution of its powers under P.L.1975, c.305 (C.26:2B-7 et seq.); including, but not limited to, contracts with government departments and public and private agencies and facilities to pay them for services actually rendered or furnished to persons with an alcohol use disorder or intoxicated persons, at rates to be established pursuant to law;
e. Solicit and accept for use in relation to the purposes of this act any gift of money or property made by will or otherwise, and any grant or loan of money, services or property from the federal government, the State or any political subdivision thereof, or any private source, and do all things necessary to cooperate with the federal government or any of its agencies in connection with the application for any such grant or loan; provided, however, that any money received under this subsection shall be deposited with the State Treasurer to be kept in a separate fund in the treasury for expenditure by the department in accordance with the conditions of the gift, loan or grant without specific appropriation;
f. Develop, encourage and foster Statewide, regional and local plans and programs for the prevention, detection, and treatment of alcohol use disorder in cooperation with interested public agencies and private organizations and individuals and provide technical assistance and consultation services for these purposes;
g. Coordinate the efforts and enlist the assistance of all public agencies and private organizations and individuals interested in the prevention, detection, and treatment of alcohol use disorder;
h. Cooperate with the Department of Human Services in establishing and conducting a program for the prevention and treatment of alcohol use disorder in penal institutions;
i. Cooperate with police academies, nursing and medical schools, public agencies and private organizations and individuals in establishing programs for the prevention and treatment of intoxication and alcohol use disorder among juveniles and young adults;
j. Prepare, publish and disseminate educational materials dealing with the prevention, nature and effects of alcohol use disorder and the benefits of treatment;
k. Develop and implement an ongoing system of collecting, analyzing and distributing statistics on the incidence and prevalence of alcohol use disorder, alcohol-related problems and alcohol consumption among the citizens of New Jersey, with special emphasis on youth. This system shall include, but is not limited to, studies, surveys, random samplings and assessments, and use as its sources the variety of public agencies and private organizations concerned and connected with the subject, including the New Jersey Motor Vehicle Commission, the Superior Court, Chancery Division, Family Part, the youth bureaus, alcohol treatment programs, hospitals and mental health centers, the schools, the police departments, and the Division of Alcoholic Beverage Control. Special attention shall be given to the relationship of alcohol to automobile accidents, crime, delinquency and other social problems;
l. Encourage alcohol use disorder prevention, detection, and treatment programs in government and industry;
m. Organize and foster training programs for professional and para-professional workers in the treatment of intoxicated persons and persons with alcohol use disorder;
n. Approve and license public and private facilities in accordance with section 8 of P.L.1975, c.305 (C.26:2B-14);
o. Promulgate rules and regulations for the exercise of its powers and the performance of its duties under P.L.1975, c.305 (C.26:2B-7 et seq.);
p. Do all other acts and things necessary or convenient to carry out the powers expressly granted in P.L.1975, c.305 (C.26:2B-7 et seq.).
The department shall in the cases of public facilities, private facilities which contract on a fee-for-service basis with the State, and private facilities which accept for treatment persons assisted pursuant to section 10 of P.L.1975, c.305 (C.26:2B-10), promulgate rules and regulations establishing licensure and approval standards and requirements including, but not limited to:
a. the need for a facility in the community;
b. the financial and other qualifications of the applicant;
c. the proper operation of facilities;
d. the health and safety standards to be met by a facility;
e. the quality and nature of the treatment to be afforded patients at a facility; and
f. licensing fees, and procedures for making and approving license and approval applications.
In the case of private facilities that neither contract on a fee-for-service basis with the State nor accept for treatment persons assisted by police officers pursuant to section 10 of P.L.1975, c.305 (C.26:2B-10), the department shall promulgate rules and regulations establishing licensure standards and requirements but such standards and requirements shall concern only:
a. the health and safety standards to be met by a facility;
b. misrepresentations as to the treatment to be afforded patients at a facility;
c. licensing fees; and
d. procedures for making and approving license applications.
All facilities shall be individually licensed or approved. Different kinds of licenses or approvals may be granted for different kinds of facilities.
Each facility shall file with the department from time to time, on request, such data, statistics, schedules or information as the department may reasonably require for the purposes of this section, and any licensee or other person operating a private facility who fails to furnish any such data, statistics, schedules or information as requested, or who files fraudulent returns thereof, shall be punished by a fine of not more than $500.00.
The department, after holding a hearing, may refuse to grant, suspend, revoke, limit or restrict the applicability of or refuse to renew any license or approval for any failure to meet the requirements of its rules and regulations or standards concerning such facilities. However, in the case of private facilities which neither contract on a fee-for-service basis with the State nor accept for treatment persons assisted by police officers pursuant to section 10 of P.L.1975, c.305 (C.26:2B-10), the department, after holding a hearing may refuse to grant, suspend, revoke, limit or restrict the applicability of or refuse to renew any license for the following reasons only:
a. for failure to meet the requirements of its rules and regulations concerning the health and safety standards of such facilities; or
b. if there is a reasonable basis for the department to conclude that there is a discrepancy between representations by a facility as to the treatment services to be afforded patients and the treatment services actually rendered or to be rendered.
The department may temporarily suspend a license or approval in an emergency without holding a prior hearing; provided, however, that upon request of an aggrieved party, a hearing shall be held as soon after the license or approval is suspended as possible. Any party aggrieved by a final decision of the department pursuant to this section may petition for judicial review thereof.
No person, partnership, corporation, society, association, or other agency or entity of any kind, other than a licensed general hospital, a department, agency or institution of the Federal Government, the State or any political subdivision thereof, shall operate a facility without a license and no department, agency or institution of the State or any political subdivision thereof shall operate a facility without approval from the department pursuant to this section. The Superior Court shall have jurisdiction in equity upon petition of the department to restrain any violation of the provisions of this section and to take such other action as equity and justice may require to enforce its provisions. Whoever knowingly establishes or maintains a private facility without a license granted pursuant to this section shall, for a first offense, be punished by a fine of not more than $500.00 and for each subsequent offense by a fine of not more than $1,000.00 or imprisonment for not more than two years, or both.
Each facility shall be subject to visitation and inspection by the department and the department shall inspect each facility prior to granting or renewing a license or approval. The department may examine the books and accounts of any facility if it deems such examination necessary for the purposes of this section. The department is hereby authorized to make a complaint to a judge of any court of record, who may thereupon issue a warrant to any officers or employees of the department authorizing them to enter and inspect at reasonable times, and to examine the books and accounts of, any private facility refusing to consent to such inspection or examination by the department which the department has reason to believe is operating in violation of the provisions of this act. Refusal by the operator or owner to allow such entry and inspection pursuant to such a warrant shall for a first offense be punishable by a fine of not more than $100.00 and for each subsequent offense by a fine of not more than $1,000.00 or imprisonment for not more than two years, or both.
The director may require public facilities, private facilities which contract on a fee-for-service basis with the State, and private facilities which accept for treatment persons assisted pursuant to section 10 of P.L.1975, c.305 (C.26:2B-10) to admit as an inpatient or outpatient any person to be afforded treatment pursuant to this act. The department shall promulgate rules and regulations governing the extent to which the department may require other private facilities to admit as an inpatient or outpatient any person to be afforded treatment pursuant to this act; provided, however, that no licensed general hospital shall refuse treatment for intoxication or alcohol use disorder.
As soon as possible after the admission of any person, the administrator of the facility shall cause such person to be examined by a physician or by a medically competent individual designated by the department and under the supervision of a physician. If, upon examination, a determination is made that the person is intoxicated or is a person with an alcohol use disorder, and adequate and appropriate treatment is available, the person shall be admitted. Admission shall not be denied on the basis that the person is currently receiving medication assisted treatment for a substance use disorder administered by a licensed treatment provider, including but not limited to methadone, buprenorphine, naltrexone, or any other medication approved by the Food and Drug Administration for the treatment of a substance use disorder. If any person is not admitted for the reason that adequate and appropriate treatment is not available at the facility, the administrator of the facility, acting whenever possible with the assistance of the director, shall refer the person to a facility at which adequate and appropriate treatment is available. In the event that a person is not admitted to a facility, and has no funds, the administrator shall arrange for the person to be assisted to the person's residence, or, if the person has no residence, to a place where shelter will be provided.
Any person admitted to a facility may receive treatment at the facility for as long as the person wishes to remain at the facility or until the administrator determines that treatment will no longer benefit the person; provided, however, that any person who at the time of admission is intoxicated and is incapacitated, shall remain at the facility until the person is no longer incapacitated, but in no event shall the person be required to remain for a period greater than 48 hours.
When a person is admitted to a facility, the facility shall provide notice of admission to the person's spouse, parent, legal guardian, designated next of kin, or other designated emergency contact, as soon thereafter as possible, provided that: (1) such notice is provided in a manner that is consistent with federal requirements under 42 CFR Part 2 and federal HIPAA requirements under 45 CFR Parts 160 and 164; and (2) the patient, if an adult, has not withheld consent for such notice or expressly requested that notification not be given. If a patient who is not incapacitated withholds consent for such notice, or expressly requests that notification not be given, the patient's wishes shall be respected unless the patient is a minor child or adolescent, in which case, the minor's parent, legal guardian, designated next of kin, or other designated emergency contact shall be notified, provided that such notification is not inconsistent with, and would not violate, federal requirements under 42 CFR Part 2 and federal HIPAA requirements under 45 CFR Parts 160 and 164.
The manner in which any person is transported from one facility to another, or from a facility to the person's residence, and the financing thereof, shall be determined by the director in accordance with rules and regulations promulgated by the department.
When a patient is discharged or otherwise released from treatment at a facility, the patient shall be encouraged to consent to appropriate outpatient or residential aftercare treatment.
When a patient voluntarily withdraws, or is involuntarily evicted from a transitional sober living home, halfway house, or other residential aftercare facility, the facility shall provide notice of the patient's release from care to the patient's spouse, parent, legal guardian, designated next of kin, or other designated emergency contact, provided that: (1) such notice is provided in a manner that is consistent with federal requirements under 42 CFR Part 2 and federal HIPAA requirements under 45 CFR Parts 160 and 164; and (2) the patient, if an adult, has not withheld consent for such notice, or expressly requested that notification not be given. If a patient who is not incapacitated withholds consent for such notice, or expressly requests that notification not be given, the patient's wishes shall be respected unless the patient is a minor child or adolescent, in which case, the minor's parent, legal guardian, designated next of kin, or other designated emergency contact shall be notified, provided that such notification is not inconsistent with, and would not violate, federal requirements under 42 CFR Part 2 and federal HIPAA requirements under 45 CFR Parts 160 and 164.
Any person who is intoxicated in a public place may be assisted to his residence or to an intoxication treatment center or other facility by a police officer or other authorized person. To determine whether or not such person is intoxicated, the police officer may request the person to submit to any reasonable test, including, but not limited to, tests of his coordination, coherency of speech, and breath.
Any person who is intoxicated in a public place and who a police officer has reason to believe is incapacitated shall be assisted by the police officer to an intoxication treatment center or other facility.
A police officer acting in accordance with the provisions of this section may use such force, other than that which is likely to inflict physical injury, as is reasonably necessary to carry out his authorized responsibilities. If the police officer reasonably believes that his safety or the safety of other persons present so requires, he may search such person and his immediate surroundings, but only to the extent necessary to discover and seize any dangerous weapon which may on that occasion be used against the officer or other person present.
All persons acting under the provisions of this section shall be considered as acting in the conduct of their official duties and shall not be held criminally or civilly liable for such acts.
Any person assisted by a police officer to a facility pursuant to the provisions of this section shall receive treatment in accordance with section 9. In any event, if such person is determined upon examination to be intoxicated, the examining physician or other medically competent individual shall so certify and a duplicate copy of the certification shall be made available to the police officer.
A person assisted to a facility pursuant to the provisions of this section, shall not be considered to have been arrested and no entry or other record shall be made to indicate that he has been arrested.
The administrator of any intoxication treatment center, or of any other facility, shall cause any such person to be examined by a physician or by a medically competent individual designated by the department and under the supervision of a physician. If the physician or any other medically competent individual designated by the department determines upon examination that such person is intoxicated, and the administrator determines that adequate and appropriate treatment is available, the person shall be admitted. Any such person may be detained at the center or other facility until the person is no longer intoxicated, but in any event, not longer than 48 hours from the date of admission. At such time as the person is to be discharged from the facility, the person shall be informed by the administrator that if the person is a person with an alcohol use disorder who would benefit by treatment the person may, in the discretion of the court, be afforded treatment in lieu of prosecution, and that if the person so chooses the person may be examined at the facility for the purpose of determining whether the person is a person with an alcohol use disorder who would benefit by treatment. If the person requests an examination, the person shall be examined by a physician at the facility during a period of time not to exceed 48 hours. The police shall maintain such security conditions as may be necessary. Prior to releasing the person from the center or other facility, the administrator shall notify the police who shall transport the person therefrom for proceedings in the case.
When a person who is arrested for a violation of a municipal ordinance, or disorderly persons offense, and who is not also arrested for a misdemeanor, is brought before the court on such charge, the court shall inform the person that the person is entitled to request a medical examination to determine whether or not the person has alcohol use disorder if the person has been admitted to a facility pursuant to the provisions of the preceding paragraph and has not received a medical examination by a physician. The court shall further inform the defendant of the consequences which follow a determination by a physician that the person is a person with an alcohol use disorder who would benefit by treatment. Any request for an examination shall be in writing. If the person makes such request, the proceedings shall be stayed for the period during which the request is under consideration by the court. If the defendant requests an examination, the court shall appoint a physician to conduct the examination at an appropriate location designated by it.
In no event shall a request for an examination, any statement made by the defendant during the course of an examination or any finding of a physician pursuant to the provisions of this section be admissible against the defendant in any proceeding.
A physician who conducts an examination pursuant to the provisions of this section, shall determine whether or not the defendant is a person with an alcohol use disorder who would benefit by treatment. The physician shall report the findings to the court together with the facts upon which the findings are based and the reasons therefor as soon as possible but in any event not longer than three days after the completion of the examination.
If the physician reports that the defendant is a person with an alcohol use disorder who would benefit by treatment, the court shall inform the defendant that the defendant may request commitment to the division and advise the person of the consequences of the commitment.
If the defendant requests commitment, and if the court finds that the defendant is a person with an alcohol use disorder who would benefit by treatment, the court may stay the criminal proceeding and commit the defendant to the division as an inpatient or as an outpatient, whichever the court deems appropriate, for a specified period. The term of inpatient treatment shall not exceed 30 days, the term of outpatient treatment shall not exceed 60 days, and the total combined period of commitment, including both inpatient and outpatient treatment, if both are ordered, shall not exceed 90 days. The court shall inform the defendant that if he is committed the proceeding will be stayed for the term of the commitment.
In determining whether or not to grant the request for commitment, the court shall consider the report of the physician, the nature of the offense with which the defendant is charged, the past criminal record, if any, of the defendant, and any other relevant evidence.
If the court decides that the defendant's request for commitment should be granted, the court shall commit the defendant to the division if the division reports that adequate and appropriate treatment is available at a facility; provided, however, that if the court determines that commitment should be granted and the defendant is charged with a first offense, the proceedings shall be stayed until adequate and appropriate treatment is available at a facility. In cases where the defendant is not charged with a first offense and the division reports that adequate and appropriate treatment is not available, the court may, in its discretion, order that the stay of the proceeding remain outstanding until such time as adequate and appropriate treatment is available.
As a condition to the issuance of any commitment order by the court pursuant to the provisions of this section, the defendant shall consent in writing to the terms of the commitment.
If the physician reports that the defendant is not a person with an alcohol use disorder who would benefit by treatment, the defendant shall be entitled to request a hearing to determine whether the person is a person with an alcohol use disorder who would benefit by treatment. Thereupon the court may, of its own motion, or shall upon the request of the defendant or the person's counsel, appoint an independent physician to examine the defendant and to testify at the hearing. If the court determines that the defendant is a person with an alcohol use disorder who would benefit by treatment, the procedures and standards applicable to a defendant who is determined by the court, following the report of the first examining physician to be a person with an alcohol use disorder who would benefit by treatment, shall apply to the defendant.
If the court does not order that the defendant shall be afforded treatment in lieu of prosecution pursuant to the provisions of this section, the stay of the proceedings shall be vacated.
At any time during the term of commitment, the administrator may transfer any inpatient to an outpatient program if the administrator finds that the patient is a proper subject for outpatient treatment; provided, however, that the administrator may retransfer the patient to an inpatient program if the administrator finds that the person is not suitable for outpatient treatment.
Any patient committed to the division pursuant to this section shall be discharged from the facility to which the division has caused the patient to be admitted if at any time the administrator determines that treatment will no longer benefit the patient; provided, however, that such patient shall in any event be discharged at the termination of the period of commitment specified in the court order.
At the end of the commitment period, when the patient is discharged, or when the patient terminates treatment at the facility, whichever first occurs, the director shall report to the court on whether or not the defendant successfully completed the treatment program, together with a statement of the reasons for the director's conclusion. In reaching the determination of whether or not the defendant successfully completed the treatment program, the director shall consider, but shall not be limited to, whether the defendant cooperated with the administrator and complied with the terms and conditions imposed on the defendant during the commitment. If the report states that the defendant successfully completed the treatment program, the court shall dismiss the charges pending against the defendant. If the report does not so state, or if the defendant has not completed the term of commitment ordered by the court, then, based on the report and any other relevant evidence, the court may take such action as it deems appropriate, including the dismissal of the charges or the revocation of the stay of the proceedings. In the event that the court convicts a defendant who has been committed in lieu of prosecution pursuant to the provisions of this section and sentences the defendant to a term of incarceration, the court shall reduce the term of incarceration by the period during which the defendant was afforded treatment in lieu of prosecution pursuant to this section.
The State, municipal and local police shall, in cooperation with the department, provide temporary security at facilities to which persons are taken pursuant to this section, where it is necessary that such security be provided for the person arrested.
Each person who receives treatment at a facility shall be subject to the supervisory powers of the administrator exercised in accordance with rules and regulations of the department.
All rights afforded any person under this act shall apply to juveniles as may be consistent with present statutory law applying to minors.
a. The administrator of each facility shall keep a record of the treatment afforded each patient, which shall be confidential and shall be made available only upon proper judicial order, whether in connection with pending judicial proceedings or otherwise.
b. Any patient shall have the right to have a physician retained by him examine him, consult privately with his attorney, receive visitors, and send and receive communications by mail, telephone and telegraph. Such communications shall not be censored or read without the consent of such patient. The foregoing shall not limit the right of the administrator, subject to reasonable rules and regulations of the department, to prescribe reasonable rules governing visiting hours and the use of telephone and telegraph facilities.
c. No patient may be detained at any facility pursuant to the provisions of this act, without his consent except in accordance with the provision of section 9.
d. Insofar as is practicable a written, comprehensive, individualized treatment plan shall be kept by the administrator for each patient.
e. Each patient shall be entitled to receive adequate and appropriate treatment.
No patient shall be denied the right to vote while he is afforded treatment at a facility.
The State, the several counties and municipalities may establish services forces to assist the police in accordance with the provisions of section 9 of this act. Such service forces may be a part of police department, or may be a separate unit. Members of the force shall be trained to carry out certain responsibilities of the police, as these are set out in section 10, particularly with respect to the administration of first aid to intoxicated persons in need of medical assistance.
The division shall serve in a consulting capacity to such public and private agencies and shall foster and coordinate a full range of services which will be available for diagnosis, counseling and treatment for alcohol use disorder.
If a test conducted pursuant to this section discloses alcohol, the division shall insofar as is practicable make a determination whether or not alcohol use disorder was a probable factor in the drinking of the tested individual.
Test data collected and determinations made pursuant to this section shall be tabulated, compiled, and published by the division at least semiannually.
The division in cooperation with the office of the Attorney General and other interested State departments and agencies shall undertake a detailed and comprehensive review of State and local laws and regulations governing driving under the influence of alcohol. This review shall include, but need not be limited to, consideration of the relation of these laws and regulations to the legislative policies and purposes of this act, and what programs and punishments are appropriate for individuals convicted of drunk driving.
Within one year from the date of enactment of P.L.1975, c.305 (C.26:2B-7 et seq.), the division shall transmit to the Legislature a report on this review. This report shall include specific recommendations for any changes in the present laws and regulations the division deems appropriate.
The division, in cooperation with the office of the Attorney General and other interested State departments and agencies, shall undertake a broad review of State and local, criminal and civil, laws and regulations governing the manufacture, sale and consumption of alcoholic beverages. This review shall include, but need not be limited to, consideration of the relation of these laws and regulations both to the legislative policies and purposes of this act and to the public policy objective of permitting the temperate use of alcoholic beverages and preventing the abuse of such beverages. Within 2 years from the date of enactment of this act the division shall transmit to the Legislature a report on this review, which shall include specific recommendations for any changes in the present laws and regulations that the division deems appropriate.
No county, municipality, or other political subdivision of the State shall adopt any law, ordinance, bylaw, resolution or regulation having the force of law a. rendering public intoxication or being found in any place in an intoxicated condition an offense, a violation or the subject of criminal or civil penalties or sanctions of any kind; b. inconsistent with the provisions and policies of this act.
Nothing herein contained shall affect any laws, ordinances, bylaws, resolutions or regulations against driving after drinking alcohol, driving under the influence of alcohol, or other similar offenses that involve the operation of motor vehicles, machinery or other hazardous equipment.
All moneys heretofore appropriated for the Department of Health for activities authorized by said sections 1 through 5, inclusive, of P.L.1948, c.453 (C.26:2B-1 through C.26:2B-5) and remaining unexpended on the effective date of this act are hereby transferred to, and shall remain immediately available for expenditure by, the division created by this act.
All duly existing contracts, leases, and obligations of the Department of Health entered into pursuant to said sections 1 through 5, inclusive, of P.L.1948, c.453 (C.26:2B-1 through C.26:2B-5) shall remain in effect and shall be performed by the division created by this act. This act shall not affect any renewal provisions or option to renew contained in any such lease in existence on the effective date of this act. Without limiting the generality of the foregoing, all approvals of plans, projects, and Federal and State financial aid applications heretofore granted shall remain in full force and effect; provided, however, that nothing in this section shall prevent said division from withdrawing such approval if such action is otherwise in accordance with law.
All gifts and special grants made to the Department of Health under sections 1 through 5 of P.L.1948, c.453 (C.26:2B-1 through C.26:2B-5) and remaining unexpended on the effective date of this act shall be available for expenditure by the division created by this act in accordance with the conditions of the gift or grant without specific appropriation.
All hospital and clinic facilities established pursuant to section 3 of P.L.1948, c. 453 (C.26:2B-3) shall remain subject to the control and supervision of the department.
All officers and employees of the Department of Health engaged in activities authorized by sections 1 through 5, inclusive, of P.L.1948, c.453 (C.26:2B-1 through C.26:2B-5) who immediately prior to the effective date of this act hold permanent appointment in positions classified under Title 11 of the Revised Statutes, or have tenure in their positions by reason of law are hereby transferred to the division created by this act, every such transfer to be without impairment of civil service status, seniority, retirement, and other rights of the employee, without interruption of service, and without reduction in compensation and salary grade, notwithstanding any change in his title or duties made as a result of such transfer; subject, however, to the provisions of Title 11, and the rules and regulations established thereunder. All such officers and employees who immediately prior to the effective date do not hold permanent appointment in such positions, or do not hold such tenure, are hereby transferred to the division created by this act without impairment of seniority, retirement and other rights, without interruption of service, and without reduction in compensation and salary grade. Nothing in this section shall be construed to confer upon an officer or employee any rights not held prior to the transfer or to prohibit any subsequent reduction in compensation or salary grade not prohibited prior to the transfer.
Notwithstanding any other provision of law, no county, municipality, or other jurisdiction within the State shall adopt an ordinance, resolution, or other legislation creating an offense of public intoxication or any equivalent offense, and any existing ordinance, resolution, or other legislation creating such an offense is hereby repealed.
If any provision of this act or the application thereof to any person or circumstance is held invalid, such invalidity shall not affect any other provision or application of the act which can be given effect without such invalid provision or application, and to this end the provisions of this act are declared to be severable.
b. The annual comprehensive plan shall address the needs of urban areas with a population of 100,000 or over and shall demonstrate linkage with existing resources which serve persons with substance use disorder and their families. Special attention in the plan shall be given to substance use disorder and youth; intoxicated drivers and drivers with substance use disorder; women and substance use disorder; persons with disabilities and substance use disorder; substance use disorder on the job; substance use disorder and crime; public information; and educational programs as defined in subsection c. of this section. Each county shall identify, within its annual comprehensive plan, the Intoxicated Driver Resource Center which shall service its population, as is required under subsection (f) of R.S.39:4-50. The plan may involve the provision of programs and services by the county, by an agreement with a State agency, by private organizations, including volunteer groups, or by some specified combination of the above.
If the State in any year fails to deposit the amount of tax receipts as is required under section 3 of P.L.1983, c.531 (C.26:2B-32), a county may reduce or eliminate, or both, the operation of existing programs currently being funded from the proceeds deposited in the Alcohol Education, Rehabilitation and Enforcement Fund.
c. Programs established with the funding for education from the fund shall include all courses in the public schools required pursuant to P.L.1987, c.389 (C.18A:40A-1 et seq.), programs for students included in the annual comprehensive plan for each county, and in-service training programs for teachers and administrative support staff including nurses, guidance counselors, child study team members, and librarians. All moneys dedicated to education from the fund shall be allocated through the designated county substance use disorder agency and all programs shall be consistent with the annual comprehensive county plan submitted to the Assistant Commissioner of the Division of Mental Health and Addiction Services and the Governor's Council on Substance Use Disorder pursuant to this section. Moneys dedicated to education from the fund shall be first allocated in an amount not to exceed 20 percent of the annual education allotment for the in-service training programs, which shall be conducted in each county through the office of the county substance use disorder coordinator in consultation with the county superintendent of schools, local boards of education, local councils on substance use disorder and institutions of higher learning, including the Rutgers University Center of Alcohol and Substance Use Studies. The remaining money in the education allotment shall be assigned to offset the costs of programs such as those which assist employees, provide intervention for staff members, assist and provide intervention for students and focus on research and education concerning youth and substance use disorder. These funds shall not replace any funds being currently spent on education and training by the county.
d. The governing body of each county, in conjunction with the county agency, or individual, designated by the county with responsibility for services and programs for the care or rehabilitation of persons with substance use disorder, shall establish a Local Advisory Committee on Substance Use Disorder to assist the governing body in development of the annual comprehensive plan. The advisory committee shall consist of no less than 10 nor more than 16 members and shall be appointed by the governing body. At least two of the members shall be persons recovering from alcohol use disorder and at least two of the members shall be persons recovering from substance use disorder. The committee shall include the county prosecutor or the county prosecutor's designee, a wide range of public and private organizations involved in the treatment of substance use disorder-related problems and other individuals with interest or experience in issues concerning substance use disorder. Each committee shall, to the maximum extent feasible, represent the various socioeconomic, racial and ethnic groups of the county in which it serves.
Within 60 days of the effective date of P.L.1989, c.51 (C.26:2BB-1 et al.), the Local Advisory Committee on Substance Use Disorder shall organize and elect a chairperson from among its members.
e. The Assistant Commissioner of the Division of Mental Health and Addiction Services shall review the county plan pursuant to a procedure developed by the assistant commissioner. In determining whether to approve an annual comprehensive plan under this act, the assistant commissioner shall consider whether the plan is designed to meet the goals and objectives of the "Alcohol Use Disorder Treatment and Rehabilitation Act," P.L.1975, c.305 (C.26:2B-7 et seq.) and the "Narcotic and Drug Abuse Control Act of 1969," P.L.1969, c.152 (C.26:2G-1 et seq.) and whether implementation of the plan is feasible. Each county plan submitted to the assistant commissioner shall be presumed valid; provided it is in substantial compliance with the provisions of this act. Where the department fails to approve a county plan, the county may request a court hearing on that determination.
County Allotment = Population of County x Total Funds Appropriated
Population of State
( Per Capita Income of State (3 yr. average)
x ( .5 x -----------------------------------------------------
( Per Capita Income of County (3 yr. average)
Need in County )
Need in State )
in which Need in County and Need in State are estimates of the prevalence of alcohol use disorder according to the current New Jersey Behavioral Health Services Plan. The funds dedicated for the provision of educational programs from the Alcohol Education, Rehabilitation and Enforcement Fund shall be allocated to the counties on the basis of this formula.
b. As a condition for receiving the allotment calculated in subsection a. of this section, a county shall contribute a sum not less than 25 percent of that county's allotment to fund community services for persons with alcohol use disorder pursuant to the county's annual comprehensive plan. Those alcohol use disorder education, prevention and treatment programs already existing in a county may be combined under the county plan which establishes the annual comprehensive plan to be approved by the Assistant Commissioner of the Division of Mental Health and Addiction Services in the Department of Human Services. In determining the sum of money to be contributed by each county, the required 25 percent minimum county contribution may include any moneys currently appropriated by the county to meet the needs of the alcohol use disorder programs.
a. Moneys dedicated for enforcement from the Alcohol Education, Rehabilitation and Enforcement Fund shall be distributed as follows:
(1) One-third shall be distributed to the "Municipal Court Administration Reimbursement Fund" pursuant to subsection b. of this section.
(2) Two-thirds shall be distributed in the "Drunk Driving Enforcement Fund" established pursuant to section 1 of P.L.1984, c.4 (C.39:4-50.8).
b. (1) Each municipality in this State shall present to the Administrative Office of the Courts, before December 31, 1983, the number of drunk driving arrests in the municipality during calendar year 1980. This number shall be the base year number of arrests. In any municipality in which the number of drunk driving arrests for calendar year 1980 exceeds the average of the number of drunk driving arrests for calendar years 1979 and 1981, that municipality may substitute the lower average figure as the base figure for the calculation in this subsection. The municipality shall certify this substitution in writing to the Administrative Office of the Courts within 90 days of the effective date of this 1986 amendatory act. Once a substituted base year figure is used, it may not thereafter be changed. Beginning January 15, 1984, and each year thereafter the municipality shall report to the Administrative Office of the Courts the number of drunk driving arrests made in its municipality during the preceding calendar year.
(2) The Administrative Office of the Courts shall certify the amounts submitted by each municipality and shall calculate for each municipality any increase in the number of arrests between the base year and the number of arrests reported for the preceding calendar year. The Administrative Office of the Courts shall then calculate the sum of all increases for all municipalities reporting.
(3) Beginning for calendar year 1983, the following fraction shall be calculated for each municipality:
The increase in drunk driving arrests in the municipality between the base year and the preceding year over the total of increases in drunk driving arrests between the base year and the preceding year in all reporting municipalities in the State.
This fraction shall be multiplied by the total amount of the money available in the "Municipal Court Administration Reimbursement Fund" in the preceding calendar year. This amount shall be allocated to the municipality for the purpose of maintaining its municipal court, which may include payments to municipal court judges, municipal prosecutors and other municipal court personnel for work performed in addition to regular employment hours.
The Legislature further finds and declares that: few rehabilitation centers and professionals working with the deaf, hard of hearing and other disabled persons are adequately prepared or trained to identify, recognize or deal with the signs of substance use disorder; and New Jersey needs the development of specialized services for people with disabilities who have a substance use disorder.
b. Pursuant to Reorganization Plan No. 002-2004, the Commissioner of Human Services shall continue to operate the program established pursuant to subsection a. of this section through the Division of Mental Health and Addiction Services in the Department of Human Services, in consultation with the Governor's Council on Substance Use Disorder.
b. A drug treatment program which the Director of the Division of Addiction Services determines does not meet or substantially meet the requirements for licensing as a residential drug treatment program shall be advised by the director, within 60 days of the determination, specifically as to which requirement or requirements the program failed to meet. If such drug treatment program addresses the deficiency or deficiencies and can meet or substantially meet the requirements, the program may reapply for licensure as a residential drug treatment program.
c. The Commissioner of the Department of Human Services may promulgate rules and regulations, pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.), as may be necessary to effectuate the purposes of this act.
The Legislature further finds and declares that: as the cooperation and active participation of all communities in the State is necessary to achieve the goal of reducing substance use disorder, there should be established within the Governor's Council on Substance Use Disorder, an Alliance to Prevent Substance Use Disorder, to unite the communities of this State in a coordinated and comprehensive effort; and that the full resources of this State including counties, municipalities and residents of the State must be mobilized in a persistent and sustained manner in order to achieve a response capable of meaningfully addressing not only the symptoms but the root causes of this pervasive problem.
The council shall consist of 12 ex officio members and 14 public members.
a. The ex officio members of the council shall be: the Attorney General, the Commissioners of Labor and Workforce Development, Education, Human Services, Health, Children and Families, Community Affairs, Personnel and Corrections, the chair of the executive board of the New Jersey Presidents' Council, the Administrative Director of the Administrative Office of the Courts and the Adjutant General. An ex officio member may designate an officer or employee of the department or office which the ex officio member heads to serve as the member's alternate and exercise the member's functions and duties as a member of the Governor's Council on Substance Use Disorder.
b. The 14 public members shall be residents of the State who are selected for their knowledge, competence, experience or interest in connection with substance use disorder. They shall be appointed as follows: two shall be appointed by the President of the Senate, two shall be appointed by the Speaker of the General Assembly and 10 shall be appointed by the Governor, with the advice and consent of the Senate. At least two of the public members appointed by the Governor shall be persons rehabilitated from alcohol use disorder and at least two of the public members appointed by the Governor shall be persons rehabilitated from substance use disorders involving drugs.
c. The term of office of each public member shall be three years; except that of the first members appointed, four shall be appointed for a term of one year, five shall be appointed for a term of two years and five shall be appointed for a term of three years. Each member shall serve until a successor has been appointed and qualified, and vacancies shall be filled in the same manner as the original appointments for the remainder of the unexpired term. A public member shall be eligible for reappointment to the council.
d. The chairperson of the council shall be appointed by the Governor from among the public members of the council and shall serve at the pleasure of the Governor during the Governor's term of office and until the appointment and qualification of the chairperson's successor. The members of the council shall elect a vice-chairperson from among the members of the council. The Governor may remove any public member for cause, upon notice and opportunity to be heard.
e. The council shall meet at least monthly and at such other times as designated by the chairperson. Fourteen members of the council shall constitute a quorum. The council may establish any advisory committees it deems advisable and feasible.
f. The chairperson shall be the request officer for the council within the meaning of such term as defined in section 6 of article 3 of P.L.1944, c.112 (C.52:27B-15).
g. The public members of the council shall receive no compensation for their services, but shall be reimbursed for their expenses incurred in the discharge of their duties within the limits of funds appropriated or otherwise made available for this purpose.
b. The executive director shall be a person qualified by training and experience to perform the duties of the council.
c. The executive director shall have the authority to employ a deputy executive director, who shall be in the unclassified service of the Civil Service, and such staff as are necessary to accomplish the work of the council within the limits of available appropriations. The executive director may delegate to subordinate officers or employees of the council any of his powers which the executive director deems desirable to be exercised under the executive director's supervision and control. All employees of the council except the executive director and the deputy executive director shall be in the career service of the Civil Service.
d. The executive director shall attend all meetings of the Governor's Council on Substance Use Disorder.
a. Review and coordinate all State departments' efforts in regard to the planning and provision of treatment, prevention, research, evaluation, and education services for, and public awareness of, substance use disorder;
b. Prepare by July 1 of each year, the State government component of the Comprehensive Statewide Substance Use Disorder Master Plan for the treatment, prevention, research, evaluation, education and public awareness of substance use disorder in this State, which plan shall include an emphasis on prevention, community awareness, and family and youth services;
c. Review each County Annual Alliance Plan and the recommendations of the Division of Mental Health and Addiction Services in the Department of Human Services for awarding the Alliance grants and, by October 1 of each year, return the plan to the Local Advisory Committee on Substance Use Disorder with the council's proposed recommendations for awarding Alliance grants;
d. Submit to the Governor and, pursuant to section 2 of P.L.1991, c.164 (C.52:14-19.1), to the Legislature, by December 1 of each year, the Comprehensive Statewide Substance Use Disorder Master Plan which shall include recommended appropriate allocations to State departments, local governments and local agencies and service providers of all State and federal funds for the treatment, prevention, research, evaluation, education and public awareness of substance use disorder in accordance with the regular budget cycle, and shall incorporate and unify all State, county, local and private substance use disorder initiatives;
e. Distribute grants, upon the recommendation of the executive director of the council, by August 1 of each year to counties and municipalities for substance use disorder programs established under the Alliance to Prevent Substance Use Disorder;
f. Evaluate the existing funding mechanisms for substance use disorder services and recommend to the Governor and the Legislature any changes which may improve the coordination of services to citizens in this State;
g. Encourage the development or expansion of employee assistance programs for employees in both government and the private sector;
h. Evaluate the need for, and feasibility of, including other addictions, such as smoking and gambling, within the scope and responsibility of the council;
i. Collect from any State, county, local governmental entity or any other appropriate source data, reports, statistics or other materials which are necessary to carry out the council's functions; and
j. Pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.), adopt rules and regulations necessary to carry out the purposes of this act.
The council shall not accept or receive moneys from any source other than moneys deposited in, and appropriated from, the "Drug Enforcement and Demand Reduction Fund" established pursuant to N.J.S.2C:35-15 and any moneys appropriated by law for operating expenses of the council or appropriated pursuant to section 19 of P.L.1989, c.51.
The division shall be administered by assistant commissioner. The assistant commissioner shall be a person qualified by training and experience to perform the duties of the office. The assistant commissioner shall be appointed by the commissioner with the approval of the Governor and shall serve at the pleasure of the commissioner during the commissioner's term of office and until the appointment and qualification of the assistant commissioner's successor. The assistant commissioner shall receive a salary which shall be provided by law.
The Commissioner of Human Services shall report annually to the Governor and, pursuant to section 2 of P.L.1991, c.164 (C.52;14-19.1, the Legislature, on the activities of the division and include in that annual report an assessment of the adequacy of the current delivery of treatment services in the State and of the need for additional treatment services.
b. The Governor's Council on Substance Use Disorder shall adopt rules and regulations for participation in, and the operation of, the Alliance and for the awarding of grants to municipalities and counties from funds appropriated for such purposes pursuant to P.L.1989, c.51 (C.26:2BB-1 et al.), section 5 of P.L.1993, c.216 (C.54:43-1.3) and funds derived from the "Drug Enforcement and Demand Reduction Fund" established pursuant to N.J.S.2C:35-15, for the purpose of developing:
(1) Organized and coordinated efforts involving schools, law enforcement, business groups and other community organizations for the purpose of reducing substance use disorder;
(2) In cooperation with local school districts, comprehensive and effective substance use disorder education programs in grades kindergarten through 12;
(3) In cooperation with local school districts, procedures for the intervention, treatment, and discipline of students using alcohol or drugs;
(4) Comprehensive substance use disorder education, support and outreach efforts for parents in the community; and
(5) Comprehensive substance use disorder community awareness programs.
c. Funds disbursed under this section shall not supplant local funds that would have otherwise been made available for substance use disorder initiatives. Communities shall provide matching funds when and to the extent required by the regulations adopted pursuant to this section.
d. The county agency or individual designated by the governing body of each county pursuant to subsection a. of section 4 of P.L.1983, c.531 (C.26:2B-33), is authorized to receive from the Governor's Council on Substance Use Disorder moneys made available pursuant to this section. The designated county agency or individual shall establish a separate fund for the receipt and disbursement of these moneys.
(1) Local Advisory Committee on Substance Use Disorder;
(2) County Human Services Advisory Council;
(3) County Superintendent of Schools;
(4) Existing county council on alcohol use disorder, if any;
(5) County Prosecutor's office;
(6) Family part of the Chancery Division of the Superior Court;
(7) Youth Services Commission;
(8) County School Board Association;
(9) County health agency;
(10) County mental health agency;
(11) Local businesses;
(12) County affiliate of the New Jersey Education Association; and
(13) Other service providers.
b. The functions of the County Alliance Steering Subcommittee shall include:
(1) Development and submission of a County Annual Alliance Plan for the expenditure of funds derived from the "Drug Enforcement and Demand Reduction Fund," N.J.S. 2C:35-15;
(2) Development of programs and fiscal guidelines consistent with directives of the Governor's Council on Substance Use Disorder for the awarding of funds to counties and municipalities for substance use disorder Alliance activities;
(3) Identification of a network of community leadership for the expansion, replication and development of successful community model programs throughout the county; and
(4) Coordination of projects among and within municipalities to ensure cost effectiveness and avoid fragmentation and duplication.
c. The County Alliance Steering Subcommittee shall ensure that the funds dedicated to education pursuant to section 2 of P.L.1983, c.531 (C.54:32C-3.1) do not duplicate the Alliance effort.
d. The Local Advisory Committee on Substance Use Disorder shall review and approve the County Annual Alliance Plan and submit this plan by July 1 of each year to the Division of Mental Health and Addiction Services in the Department of Human Services and to the Governor's Council on Substance Use Disorder.
e. After the County Annual Alliance Plan is returned by the Governor's Council on Substance Use Disorder to the Local Advisory Committee on Substance Use Disorder with the council's proposed recommendations for awarding the Alliance grants, pursuant to subsection c. of section 4 of this amendatory and supplementary act, the committee, in conjunction with the council, may revise its plan in accordance with the council's proposed recommendations.
The revised plan shall be completed in such time that it can be included in the council's recommendations to the Governor and the Legislature that are due on December 1 of each year.
The Municipal Alliance Committee, in consultation with the Local Advisory Committee on Substance Use Disorder, shall identify substance use disorder prevention, education and community needs. The committee also shall implement the Alliance programs formulated pursuant to section 8 of P.L.1989, c.51 (C.26:2BB-8). The governing body of a municipality may match any funds it receives from the Alliance.
The advisory commission to the Alcohol Education, Rehabilitation and Enforcement Fund, established pursuant to section 3 of P.L.1983, c.531 (C.26:2B-32), is abolished.
All acts and parts of acts inconsistent with any of the provisions of this amendatory and supplementary act are, to the extent of such inconsistency, superseded and repealed.
This act shall be known and may be cited as the "Air Pollution Control Act (1954)."
"Air contaminant" means any substance, other than water or distillates of air, present in the atmosphere as solid particles, liquid particles, vapors, or gases;
"Air pollution" means the presence in the outdoor atmosphere of one or more air contaminants in such quantities and duration as are, or tend to be, injurious to human health or welfare, animal or plant life, or property, or would unreasonably interfere with the enjoyment of life or property throughout the State and in those areas of the State as shall be affected thereby, and excludes all aspects of an employer-employee relationship as to health and safety hazards;
"Antimicrobial pesticide" means a product that destroys or repels, or prevents or mitigates the growth of, any bacteria, fungus, virus or other micro-organism that is defined as a pest pursuant to 7 U.S.C. s.136w (c)(1), and includes any product required to be registered as an antimicrobial pesticide pursuant to the "Federal Insecticide, Fungicide and Rodenticide Act," 7 U.S.C. s.136 et seq.;
"Commissioner" means the Commissioner of Environmental Protection;
"Construct" or "construction" means to fabricate or erect equipment or control apparatus at a facility where it is intended to be used, but shall not include the dismantling of existing equipment or control apparatus, site preparation, or the ordering, receiving, temporary storage, or installation of equipment or control apparatus. Unless otherwise prohibited by federal law, "construct" or "construction" shall also not include the pouring of footings or placement of a foundation where equipment or control apparatus is intended to be used;
"Consumer Price Index" or "CPI" means the annual Consumer Price Index for a calendar year as determined year to year using the decimal increase in the September through August, 12-month average for the previous year of the Consumer Price Index for All Urban Consumers (CPI-U), as published by the United States Department of Labor;
"Control apparatus" means any device that prevents or controls the emission of any air contaminant;
"Council" means the Clean Air Council created pursuant to section 3 of P.L.1967, c.106 (C.26:2C-3.2);
"Department" means the Department of Environmental Protection;
"Emission fee" means an annual fee that is based on the emission of any regulated air contaminant;
"Emission statement" means an annual reporting of actual emissions of air contaminants as prescribed by rules and regulations therefor that shall be adopted by the department pursuant to the "Administrative Procedure Act, " P.L.1968, c.410 (C.52:14B-1 et seq.);
"EPA" means the United States Environmental Protection Agency;
"Equipment" means any device capable of causing the emission of an air contaminant either directly or indirectly into the outdoor atmosphere, and any stack, chimney, conduit, flue, duct, vent, or similar device connected or attached to, or serving, the equipment, and shall include, but need not be limited to, any equipment in which the preponderance of the air contaminants emitted is caused by a manufacturing process;
"Facility" means the combination of all structures, buildings, equipment, control apparatus, storage tanks, source operations, and other operations that are located on a single site or on contiguous or adjacent sites and that are under common control of the same person or persons. Research and development facilities that are located with other facilities shall be considered separate and independent entities for the purposes of complying with the operating permit requirements of P.L.1954, c.212 (C.26:2C-1 et seq.) or any codes, rules, or regulations adopted pursuant thereto;
"Federal Clean Air Act" means the federal "Clean Air Act" (42 U.S.C.s.7401 et seq.) and any subsequent amendments or supplements to that act;
"Grandfathered" means construction, reconstruction, or modification of equipment or control apparatus prior to the date of enactment of section 13 of P.L.1967, c.106 (C.26:2C-9.2) on June 15, 1967, or prior to the subsequent applicable revisions to rules and regulations codified at N.J.A.C.7:27-8.1 et seq. that occurred March 5, 1973, June 1, 1976, April 5, 1985, and October 31, 1994;
"HAP" or hazardous air pollutant" means any air pollutant listed in or pursuant to subsection (b) of section 112 of the federal Clean Air Act (42 U.S.C. s.7412);
"Hospital or medical disinfectant" means an antimicrobial product registered with the United States Environmental Protection Agency that qualifies to bear the name or claim to be a "hospital or medical environment disinfectant" pursuant to United States Environmental Protection Agency guidelines published pursuant to 7 U.S.C. s.136a (c)(2)(A), and shall include, but shall not be limited to, antimicrobial pesticides used in hospitals, doctor and dentist offices, and other medical environments;
"Install" or "installation" means to carry out final setup activities necessary to provide equipment or control apparatus with the capacity for use or service, and shall include, but need not be limited to, connection of equipment or control apparatus, associated utilities, piping, duct work, or conveyor systems, but shall not include construction or reconfiguration of equipment or control apparatus to an alternate configuration specified in a permit application and approved by the department;
"Major facility" means a major source, as that term is defined by the EPA in rules and regulations adopted pursuant to the federal Clean Air Act at 40 CFR 70.2 or any subsequent amendments thereto, that has the potential to emit any of the air contaminants listed below in an amount that is equal to or exceeds the applicable major facility threshold levels as follows:
Air Contaminant Threshold level
Carbon monoxide 100 tons per year
Particulate matter (PM-10) 100 tons per year
Total suspended particulates 100 tons per year
Sulfur dioxide 100 tons per year
Oxides of nitrogen 25 tons per year
VOC 25 tons per year
Lead 10 tons per year
Any HAP 10 tons per year
All HAPs collectively 25 tons per year
Any other air contaminant 100 tons per year;
"Modify" or "modification" means any physical change in, or change in the method of operation of, existing equipment or control apparatus that increases the amount of any air contaminant emitted by that equipment or control apparatus or that results in the emission of any air contaminant not previously emitted, but shall not include normal repair and maintenance;
"Operating permit" means the permit described in Title V of the federal Clean Air Act (42 U.S.C. s.7661 et seq.);
"Person" means an individual, public or private corporation, company, partnership, firm, association, society, joint stock company, international entity, institution, county, municipality, state, interstate body, the United States of America, or any agency, board, commission, employee, agent, officer, or political subdivision of a state, an interstate body, or the United States of America;
"Potential to emit" means the same as that term is defined by the EPA in rules and regulations adopted pursuant to the federal Clean Air Act at 40 CFR 70.2 or any subsequent amendments thereto;
"Process unit" means equipment assembled to produce intermediate or final products. A process unit can operate independently if supplied with sufficient feed or raw materials and sufficient storage facilities for the product. The storage and transfer of product or raw materials to and from the process unit shall be considered separate from the process unit for the purposes of making reconstruction determinations. Product recovery equipment shall be considered to be part of the process unit, not part of the control apparatus;
"Reconstruct" or "reconstruction" means the replacement of parts of equipment included in a process unit, or the replacement of control apparatus, if the fixed capital cost of replacing the parts exceeds both of the following amounts: (1) Fifty percent of the fixed capital cost that would be required to construct a comparable new process unit or control apparatus; and (2) $80,000 (in 1995 dollars) adjusted by the Consumer Price Index;
"Regulated air contaminant" means the same as the term "regulated air pollutant" as defined by the EPA in rules and regulations adopted pursuant to the federal Clean Air Act at 40 CFR 70.2 or any subsequent amendments thereto;
"Research and development facility" means any facility the primary purpose of which is to conduct research and development into new processes and products, including academic and technological research and development, provided that such a facility is operated under the close supervision of technically trained personnel and is not engaged in the manufacture of products for commercial sale, except in a de minimis manner; and
"VOC" or "volatile organic compound" means the same as that term is defined by the EPA in rules and regulations adopted pursuant to the federal Clean Air Act at 40 CFR 51.100 or any subsequent amendments thereto.
The Air Pollution Control Commission is hereby abolished. All of the functions, powers and duties of the Air Pollution Control Commission in the Department of Health are hereby transferred to the Department of Health.
(a) There is hereby created in the State Department of Health a Clean Air Council, which shall consist of 17 members, 3 of whom shall be the Commissioner of Commerce and Economic Development or a member of the Department of Commerce and Economic Development designated by him, the Commissioner of Community Affairs or a member of the Department of Community Affairs designated by him, and the Secretary of Agriculture or a member of the Department of Agriculture designated by him, who shall serve ex officio; six citizens of the State, representing the general public at least one of whom shall be a medical doctor licensed to practice in this State; and eight members to be appointed from persons to be nominated by the organizations hereinafter enumerated, by the Governor.
(b) Within 30 days following the effective date hereof and thereafter as required, at least one month prior to the expiration of the term of the member chosen from nominees of each organization hereinafter enumerated, each such organization shall submit to the Governor a list of three recommended nominees for membership on the council, from which list the Governor shall appoint one.
If any organization does not submit a list of recommended nominees at any time required by this act, the Governor may appoint a member of his choice.
The organizations which shall be entitled to submit recommended nominees are: New Jersey Health Officers Association, New Jersey State Chamber of Commerce, New Jersey Society of Professional Engineers, Inc., New Jersey Manufacturers Association, New Jersey Section of the American Industrial Hygiene Association, New Jersey State League of Municipalities, the New Jersey Freeholders' Association and the New Jersey State AFL-CIO.
(c) Of the 14 members first to be appointed, four shall be appointed for terms of one year, four for terms of two years, three for terms of three years and three for terms of four years. Thereafter, all appointments shall be made for terms of four years. All appointed members shall serve after the expiration of their terms until their respective successors are appointed and shall qualify, and any vacancy occurring in the appointed membership of the council, by expiration of term or otherwise, shall be filled in the same manner as the original appointment, for the unexpired term only, notwithstanding that the previous incumbent may have held over and continued in office as aforesaid. The Governor may remove any appointed member of the council for cause after a public hearing.
(d) Members of the council shall serve without compensation but shall be reimbursed for expenses actually incurred in attending meetings of the council and in the performance of their duties as members thereof.
(e) The council shall elect annually a chairman and vice-chairman from its own membership.
In addition to the membership of the Clean Air Council prescribed by P.L.1967, c. 106, s. 3 (C. 26:2C-3.2), the State Commissioner of Health or a member of his staff designated by him shall be a member of the council.
The Clean Air Council shall:
(a) Request from the commissioner information concerning the Air Pollution Control Program;
(b) Consider any matter relating to the preservation and improvement of the Air Pollution Control Program and advise the commissioner thereof;
(c) From time to time submit to the commissioner any recommendations which it deems necessary for the proper conduct and improvement of the Air Pollution Control Program;
(d) Study the Air Pollution Control Program and make its recommendations thereon to the commissioner;
(e) Study the codes, rules and regulations promulgated by the department in regard to air pollution control and make its recommendations for their improvement to the commissioner;
(f) Study and investigate the state of the art and the technical capabilities and limitations of air pollution control and report their findings and recommendations thereon to the commissioner;
(g) Study and investigate the need for programs for the long-range technical support of the Air Pollution Control Program and report their findings and recommendations thereon to the commissioner; and
(h) Hold public hearings at least once a year in regard to existing air pollution control, statutes, codes, rules and regulations and upon the state of the art and technical capabilities and limitations in air pollution control and report its recommendations thereon to the commissioner.
All codes, rules and regulations heretofore adopted by the Air Pollution Control Commission shall continue in full force and effect subject to the power of the department to amend and repeal such codes, rules and regulations as provided by this act.
b. Unless otherwise required by federal law, rule or regulation, no code, regulation, rule or standard may be adopted by the department that diminishes the efficacy of a hospital or medical disinfectant in killing or inactivating agents of infectious diseases, including, but not limited to, restrictions on the volatile organic compound content or emissions caused by the use of such products. No federal requirement to reduce volatile organic compound content or emissions in general may be construed to permit the department to regulate the volatile organic compounds found in, or released in the use of, a hospital or medical disinfectant, unless the federal law, rule or regulation establishing the federal requirement specifically requires the reduction of volatile organic compounds found in, or released in the use of, hospital or medical disinfectants.
b. The department, after consultation with the Director of the Division of Motor Vehicles, shall adopt rules and regulations, consistent with the federal Clean Air Act, establishing exhaust emission standards and test methods and standards for emission control apparatus and related items. The department shall not require the "I/M 240" test, but shall adopt an alternative test that is acceptable to the United States Environmental Protection Agency. The department may provide that the standards and test methods vary according to the model year, type, or other vehicle characteristic that the department deems necessary to facilitate inspections or to comply with the federal Clean Air Act. The emission standards and test methods adopted pursuant to this subsection shall not set any quota for emission test failures and shall not require the failure of motor vehicles at any predetermined rate. This subsection shall not preclude the use of the "I/M 240" test in sampling for performance evaluation only or the use of the test at the option of a private inspection facility.
Such codes, rules and regulations shall establish standards and requirements for the control of air contaminants from motor vehicles manufactured with air pollution control devices, systems or engine modifications consistent with the requirements of the "Motor Vehicle Air Pollution Control Act" (77 Stat. 392, 42 U.S.C. 1857) and any amendments and supplements thereto.
All codes, rules and regulations shall be formulated and promulgated in the manner provided for in section 8 of the act to which this act is a supplement.
(1) Enhanced vehicle inspection and maintenance program;
(2) Correction of reasonably available control technology rules for volatile organic compounds;
(3) Reasonably available control technology rules for volatile organic compounds;
(4) Reasonably available control technology rules for oxides of nitrogen;
(5) New source review regulations for volatile organic compounds, oxides of nitrogen, and carbon monoxide;
(6) Criteria and procedures for determining conformity between the State implementation plan and transportation plans; and
(7) Use in ozone nonattainment areas of federal reformulated gasoline that meets the requirements of subsection (k) of 42 U.S.C. s.7545 for sale and use in states other than the State of California.
b. As used in this section:
"Department" means the Department of Environmental Protection;
"Federal Clean Air Act" means the federal "Clean Air Act," 42 U.S.C. s.7401 et seq., and any subsequent amendments or supplements to that act; and
"State implementation plan" means the State implementation plan for national ambient air quality standards adopted for New Jersey pursuant to the federal Clean Air Act.
(1) summarize the State implementation plan and any amendments, alterations, or supplements to that plan that have been made or proposed since the last semi-annual report was issued; and
(2) analyze the progress and effectiveness of the State implementation plan with respect to ensuring that the State shall be, and shall remain, in compliance with all applicable requirements, standards, and deadlines set forth in the federal Clean Air Act.
As used in this subsection: "federal Clean Air Act" means the federal "Clean Air Act," 42 U.S.C. s.7401 et seq., and any subsequent amendments or supplements to that act; and "State implementation plan" means the State implementation plan for national ambient air quality standards adopted for New Jersey pursuant to the federal Clean Air Act.
b. (Deleted by amendment, P.L.2003, c.266).
c. (Deleted by amendment, P.L.2003, c.266).
The Legislature further finds and declares that in the summer of 2002, New Jersey had the highest number of smog violations per monitoring station in the nation; that in December 2003, the United States Environmental Protection Agency announced its intention to designate the entire State as out-of-compliance with the agency's health-based standard for ozone; and that this designation by the United States Environmental Protection Agency would require the State to adopt a stronger, more comprehensive clean air plan for the State.
The Legislature further finds and declares that a significant percentage of particulate emissions, smog-forming emissions, and airborne cancer risk comes from vehicle emissions; that pollution from automobiles is expected to increase with the projected population increase estimate of an additional 1,200,000 people in the State in the next decade; and that mobile sources of emissions have received less regulatory attention than industrial facilities and area sources of pollution.
The Legislature further finds and declares that ground-level ozone, or smog, is formed when automobile, industrial and other pollutants chemically react with bright sunshine and high temperatures; that ground-level ozone irritates the respiratory system and can cause coughing, wheezing, chest pain and headaches; that ozone especially aggravates chronic respiratory diseases such as asthma and bronchitis; that ground-level ozone and other air toxics have a substantial negative impact on the health and quality of life of residents of the State; and that reducing ground-level ozone pollution will help reduce these negative health effects.
The Legislature therefore determines that it is in the public interest to: implement the California Low Emission Vehicle program beginning January 1, 2009; establish a zero emission vehicle credit bank for manufacturers; establish a Low Emission Vehicle Review Commission charged with reviewing the implementation of the program, the availability and success of the incentive, and the technology of zero emission vehicles; and provide an incentive for the purchase or lease of zero emission vehicles.
"Advanced technology partial zero emission vehicle" means a vehicle certified as an advanced technology partial zero emission vehicle pursuant to the California Air Resources Board vehicle standards for the applicable model year;
"California Low Emission Vehicle program" means the second phase of the low emission vehicle program being implemented in the State of California, pursuant to the provisions of the Federal Clean Air Act and the California Code of Regulations;
"Commissioner" means the Commissioner of Environmental Protection;
"Department" means the Department of Environmental Protection;
"Federal Clean Air Act" means the federal "Clean Air Act," 42 U.S.C. s.7401 et seq., and any subsequent amendments or supplements to that act;
"Low Emission Vehicle Review Commission" means the commission established by subsection a. of section 5 of P.L.2003, c.266 (C.26:2C-8.19);
"Partial zero emission vehicle" means a vehicle certified as a partial zero emission vehicle pursuant to the California Air Resources Board vehicle standards for the applicable model year;
"State implementation plan" means the State implementation plan for national ambient air quality standards adopted for New Jersey pursuant to the federal Clean Air Act;
"Zero emission vehicle" means a vehicle certified as a zero emission vehicle pursuant to the California Air Resources Board zero emission vehicle standards for the applicable model year, but shall not include an advanced technology partial zero emission vehicle or a partial zero emission vehicle; and
"Zero emission vehicle requirement" means the percentage or number of those vehicles certified as zero emission vehicles pursuant to the California Air Resources Board vehicle standards and required to be delivered by a manufacturer for sale or lease for the applicable model year, and any additional percentages or numbers of advanced technology partial zero emission vehicles or partial zero emission vehicles that may be delivered by a manufacturer for sale or lease to satisfy the zero emission vehicle requirement established by the California Air Resources Board in lieu of vehicles that meet the pure zero emission vehicle standard.
b. The Commissioner of Environmental Protection, within 30 days after a proposed major substantive change to the California Low Emission Vehicle program that, if adopted, would necessitate a corresponding substantive change to the program in New Jersey adopted pursuant to subsection a. of this section, shall provide written notice and a summary of the proposed substantive change to the Senate Environment Committee and the Assembly Environment and Solid Waste Committee, or their successors as designated respectively by the President of the Senate and the Speaker of the General Assembly.
c. The commissioner shall adopt, pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.), any rules and regulations necessary to implement the California Low Emission Vehicle program in the State beginning on January 1, 2009.
(1) In establishing the credit bank required by this section, the commissioner shall use the highest multiplier used by the California Air Resources Board for determining the allowable vehicle equivalent credits for each advanced technology partial zero emission vehicle or partial zero emission vehicle delivered for sale or lease in the State by a manufacturer on or after January 1, 1999 until the effective date of P.L.2003, c.266 (C.26:2C-8.15 et al.).
(2) Beginning on the effective date of P.L.2003, c.266 (C.26:2C-8.15 et al.), the commissioner shall use the multiplier used by the California Air Resources Board for the applicable model year for each advanced technology partial zero emission vehicle or partial zero emission vehicle delivered for sale or lease in the State by a manufacturer on or after the effective date of P.L.2003, c.266 (C.26:2C-8.15 et al.) and through December 31, 2008.
b. (1) Within 180 days after the effective date of P.L.2003, c.266 (C.26:2C-8.15 et al.), the commissioner shall publish a list in the New Jersey Register of the make and model of those motor vehicles that qualify as advanced technology partial zero emission vehicles or partial zero emission vehicles for the 1999 through 2003 model years.
(2) Annually thereafter, the commissioner shall publish a list in the New Jersey Register of the make and model of those motor vehicles that qualify as advanced technology partial zero emission vehicles or partial zero emission vehicles for that respective model year.
(3) The commissioner may revise any list published pursuant to this subsection as necessary to comply with the California Air Resources Board vehicle standards for the applicable model year.
c. Notwithstanding the provisions of the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.) to the contrary, the commissioner shall, immediately upon filing the proper notice with the Office of Administrative Law, adopt such temporary rules and regulations as necessary to establish a zero emission vehicle credit bank pursuant to subsection a. of this section. These rules and regulations may include, but need not be limited to, the documentation to be submitted by a manufacturer to determine eligibility and participation in the credit bank established pursuant to subsection a. of this section, and fees for administrative services provided to implement the zero emission vehicle credit bank to be assessed to those manufacturers seeking to earn and bank credits. The temporary rules and regulations shall be in effect for a period not to exceed 270 days after the date of the filing, except that in no case shall the temporary rules and regulations be in effect one year after the effective date of P.L.2003, c.266 (C.26:2C-8.15 et al.). The temporary rules and regulations shall thereafter be amended, adopted or readopted by the commissioner as the commissioner determines is necessary in accordance with the requirements of the "Administrative Procedure Act."
d. The provisions of this section shall expire upon the passage of a concurrent resolution by the Legislature directing the department to implement the National Low Emission Vehicle program pursuant to subsection a. of section 6 of P.L.2003, c.266 (C.26:2C-8.20).
The Legislature therefore determines that in addition to the water testing currently conducted in the State and the investigation of remediation methods for existing contamination, it is of vital importance that contamination of drinking water from MTBE not occur in the State, and that the sale of gasoline containing MTBE must be prohibited in the State.
"Department" means the Department of Environmental Protection;
"MTBE" means methyl tertiary butyl ether.
b. Any person who violates this act, or any rule or regulation adopted pursuant thereto, shall be subject to the provisions of section 10 of P.L.1977, c.74 (C.58:10A-10).
c. Nothing in this act shall prohibit the manufacture, processing, or importation within the State of gasoline that contains more than 0.5% MTBE by volume for distribution in commerce outside the State.
The Legislature further finds and declares that, although some new diesel-powered vehicles and equipment operate more cleanly and may contribute less to air quality problems than their predecessors, diesel-powered trucks, buses, and off-road equipment tend to remain in service as long as 20 years or more; that, among these types of vehicles and equipment, diesel commercial buses and diesel solid waste vehicles operate in significant numbers in urban areas of the State where the reduction of fine particle diesel emissions should be prioritized because fine particle diesel emissions are at the highest concentrations in these areas; that the emissions from diesel school buses directly impact the health of school children throughout the State; that unless emissions from some on-road diesel-powered vehicles and off-road diesel-powered equipment currently operating in the State are controlled, all on-road diesel-powered vehicles and off-road diesel-powered equipment will continue to emit high levels of fine particles and contribute to air pollution in the State for many years to come; that filters and other devices and cleaner burning fuels are available to reduce emissions from older diesel vehicles and equipment; that retrofitting certain diesel-powered vehicles and equipment with emissions reducing devices, operating these vehicles and equipment on cleaner burning fuel, or both, could significantly improve air quality; that although such requirements impose costs, the costs are relatively small when compared with the costs of the vehicles or equipment they update or the cost of the impact on the public health from the air pollution that the requirements abate; that by exercising discretion in the types of vehicles and equipment and the matching of technologies to vehicles and equipment, the cost of installing and using pollution-reducing devices and fuels can be minimized and the air pollution reduction and public health benefits can be maximized; and that the Department of Environmental Protection has estimated that targeting reductions of fine particles from these vehicles and equipment could remove 315 tons per year from the ambient air in the State and could prevent more than 150 premature deaths.
The Legislature therefore determines that it is of vital importance to the health of the people of the State to begin to reduce significantly fine particle emissions and exposure of school children to these emissions; and that this start can be most effectively and economically accomplished by requiring the use of the best available retrofit technologies for the reduction of fine particle emissions in diesel-powered commercial buses, school buses, solid waste vehicles, and publicly owned on-road vehicles and off-road equipment.
"Best available retrofit technology" means the equipment, retrofit device, or fuel, or any combination thereof, designated by the United States Environmental Protection Agency as a verified technology for diesel retrofit programs, or by the California Air Resources Board as a verified technology for diesel emissions control, for use on or in specific makes, model years, types, and classes of on-road diesel vehicles or off-road diesel equipment, and that, as determined by the Department of Environmental Protection, may be used on or in regulated vehicles or regulated equipment, at a reasonable cost, to achieve substantial reduction of fine particle diesel emissions. "Best available retrofit technology" may include, but is not limited to, particle filters, diesel oxidation catalysts, flow through filters, and modified diesel fuel, provided that these diesel retrofit devices and diesel emissions control strategies are verified technologies according to the United States Environmental Protection Agency or the California Air Resources Board. "Best available retrofit technology" shall include only those retrofit devices and fuel for which the retrofit device manufacturer or fuel manufacturer agrees, in a manner determined appropriate by the department, that the installation and use of the retrofit device or the use of the special fuel would not jeopardize the original engine warranty in effect at the time of the installation or the commencement of use of the retrofit device or fuel, and for which the retrofit device manufacturer or fuel manufacturer has provided a warranty pursuant to the rules and regulations adopted pursuant to section 3 of P.L.2005, c.219 (C.26:2C-8.28). "Best available retrofit technology" shall not include repowering of any vehicle or piece of equipment, or the use of ultra-low sulfur diesel fuel;
"Commission" means the New Jersey Motor Vehicle Commission;
"Compliance form" means a form used for ascertaining compliance with the provisions of P.L.2005, c.219 (C.26:2C-8.26 et al.) or eligibility for reimbursement of costs associated therewith, and issued pursuant to section 6, section 7, section 16, or section 17 of P.L.2005, c.219 (C.26:2C-8.31, C.26:2C-8.32, C.26:2C-8.41, or C.26:2C-8.42);
"Constitutionally dedicated moneys" mean moneys dedicated pursuant to Article VIII, Section II, paragraph 6, subparagraph (d) of the State Constitution;
"Department" means the Department of Environmental Protection;
"Diesel commercial bus" means a diesel bus as defined pursuant to section 2 of P.L. 1995, c.157 (C.39:8-60), except that "diesel commercial bus" shall include only diesel commercial buses with a gross vehicle weight rating in excess of 14,000 pounds, and shall not include school buses;
"Diesel engine" means an internal combustion engine with compression ignition using diesel fuel, including the fuel injection system but excluding the exhaust system;
"Diesel Risk Mitigation Fund" or "fund" means the fund established pursuant to section 28 of P.L.2005, c.219 (C.26:2C-8.53);
"Diesel solid waste vehicle" means any on-road diesel vehicle with a gross vehicle weight rating in excess of 14,000 pounds that is used for the purposes of collecting or transporting residential or commercial solid waste, including vehicles powered by a diesel engine used for transporting waste containers, including, but not necessarily limited to, open boxes, dumpsters or compactors, which may be removed from the tractor. "Diesel solid waste vehicle" shall include solid waste cabs and solid waste single-unit vehicles;
"Fine particle" means a particle emitted directly into the atmosphere from exhaust produced by the combustion of diesel fuel and having an aerodynamic diameter of 2.5 micrometers or less;
"Fine particle diesel emissions" means emissions of fine particles from an on-road diesel vehicle or from off-road diesel equipment;
"Fleet" means one or more on-road diesel vehicles or pieces of off-road diesel equipment;
"Off-road diesel equipment" means any equipment or vehicle, other than a diesel construction truck, powered by a diesel engine that is used primarily for construction, loading, and other off-road purposes and, when in use, is not commonly operated on a roadway except when used for roadway construction and repair, including, but not necessarily limited to, rollers, scrapers, excavators, rubber tire loaders, crawler/dozers, and off-highway trucks. "Off-road diesel equipment" shall include equipment and vehicles that are not used primarily for transportation and are considered off-road equipment and vehicles but, for the purposes of moving the equipment and vehicles from place to place on the roadways of the State, are required to have "in-transit" plates issued by the New Jersey Motor Vehicle Commission. "Off-road diesel equipment" shall not include any non-mobile equipment, such as a generator or pump, and shall not include boats or trains;
"On-road diesel vehicle" means any vehicle, other than a private passenger automobile, that is powered by a diesel engine and operated on the roadways of the State, and shall include, but need not be limited to, diesel buses, diesel-powered motor vehicles, and heavy-duty diesel trucks as defined pursuant to section 2 of P.L.1995, c.157 (C.39:8-60);
"Owner" means any person, the State, or any political subdivision thereof, that owns any on-road diesel vehicle or off-road diesel equipment subject to the provisions of P.L.2005, c.219 (C.26:2C-8.26 et al.);
"Private regulated commercial bus" means any diesel commercial bus not owned by the New Jersey Transit Corporation, and any diesel commercial bus owned by the New Jersey Transit Corporation but leased or operated by a provider of diesel commercial bus service other than the New Jersey Transit Corporation;
"Public regulated commercial bus" means any diesel commercial bus owned and operated by the New Jersey Transit Corporation;
"Regulated commercial bus" means any diesel commercial bus registered and operating in the State;
"Regulated equipment" means any regulated off-road diesel equipment or any piece of off-road diesel equipment that is required to use best available retrofit technology pursuant to an approved fleet averaging plan;
"Regulated off-road diesel equipment" means any off-road diesel equipment operating in the State that is owned by the State or any political subdivision thereof, or a county or municipality, or any political subdivision thereof;
"Regulated on-road diesel vehicle" means any on-road diesel vehicle registered in the State that is owned by the State or any political subdivision thereof, a county or municipality, or any political subdivision thereof;
"Regulated school bus" means a school bus powered by a diesel engine, and owned by a school district, nonpublic school, or school bus contractor who has entered into a contract with a school district or a nonpublic school to transport children to and from a primary or secondary school in the State, that was originally designed to carry 10 or more passengers, and is in service on or after the effective date of P.L.2005, c.219 (C.26:2C-8.26 et al.);
"Regulated solid waste vehicle" means any diesel solid waste vehicle registered in the State that is owned by the State or any political subdivision thereof, or a county or municipality or any political subdivision thereof, or that is owned by a person who has entered into a contract in effect on or after the effective date of P.L.2005, c.219 (C.26:2C-8.26 et al.), with the State or any political subdivision thereof, or a county or municipality or any political subdivision thereof, to provide solid waste services;
"Regulated vehicle" means any regulated commercial bus, regulated on-road diesel vehicle, regulated solid waste vehicle, or any regulated school bus required to comply with any requirements pursuant to subsection b. of section 7 of P.L.2005, c.219 (C.26:2C-8.32) from model year 2006 or a preceding model year and registered in the State, or any on-road diesel vehicle registered in the State that is required to use best available retrofit technology pursuant to an approved fleet averaging plan;
"Retrofit device" means a best available retrofit technology that is an after-market apparatus installed on an on-road diesel vehicle or on a piece of off-road diesel equipment;
"School bus" means a school bus as defined under R.S.39:1-1;
"Technology" means any equipment, device, or fuel used alone or in combination to achieve the reductions in emissions required for best available retrofit technology; and
"Ultra-low sulfur diesel fuel" means diesel fuel that the United States Environmental Protection Agency designates or defines as ultra-low sulfur diesel fuel.
b. The rules and regulations adopted pursuant to subsection a. of this section shall include, but not need not be limited to:
(1) the designation of the required reduction in fine particle diesel emissions and choices of the best available retrofit technologies available to owners of regulated vehicles or regulated equipment to meet the required reduction for each make, model or type of regulated vehicles or regulated equipment, including, but not limited to, the description of the hierarchy and levels of best available retrofit technologies as they correspond to the emissions reductions anticipated from the use of each best available retrofit technology, and the requirements for implementing the use of best available retrofit technologies by any owner of regulated vehicles or regulated equipment who elects not to submit a fleet retrofit plan, combined fleet retrofit plan, or fleet averaging plan pursuant to section 7 or section 9 of P.L.2005, c.219 (C.26:2C-8.32 or C.26:2C-8.34);
(2) guidelines and requirements for developing fleet retrofit plans, combined fleet retrofit plans, and fleet averaging plans, and any supplements or modifications thereto, including, but not limited to:
(a) a description of the components that, at a minimum, are to be included in a fleet retrofit plan;
(b) guidelines for use by owners of regulated vehicles or regulated equipment concerning how to develop an inventory of regulated vehicles or regulated equipment, prepare the required fleet retrofit plan, and determine the technology required for each vehicle or piece of equipment;
(c) the choices of the best available retrofit technologies available to owners of regulated vehicles or regulated equipment for each make, model or type of regulated vehicle or regulated equipment to achieve reductions in fine particle emissions;
(d) information on how to select the specific best available retrofit technologies and ensure the fleet retrofit plan, combined fleet plan, or fleet averaging plan requirements are met;
(e) procedures and provisions for the review and approval, and enforcement of fleet retrofit plans, combined fleet retrofit plans, and fleet averaging plans for regulated vehicles or regulated equipment; and
(f) provisions ensuring, in the implementation requirements for fleet retrofit plans, combined fleet plans, or fleet averaging plans, due consideration of the efforts of owners of regulated vehicles or regulated equipment who voluntarily retrofit regulated vehicles or regulated equipment prior to the required submittal of a fleet retrofit plan, combined fleet retrofit plan, or fleet averaging plan;
(3) the procedures for contacting the department with questions about the requirements of, and compliance with, the provisions of P.L.2005, c.219 (C.26:2C-8.26 et al.), and for obtaining any technical guidance needed in preparing the fleet retrofit plans, combined fleet retrofit plans, or fleet averaging plans;
(4) in consultation with the Department of Education, the Department of Health and Human Services, the New Jersey Motor Vehicle Commission, and the Department of Law and Public Safety, provisions concerning the idling and queuing of school buses and enforcement of violations thereof, in accordance with section 8 of P.L.2005, c.219 (C.26:2C-8.33) and no less stringent than restrictions on idling pursuant to department rules and regulations in effect on the effective date of P.L.2005, c.219 (C.26:2C-8.26 et al.); and
(5) any requirements or guidelines concerning the installation of closed crankcase technology in regulated school buses or compliance with the provisions of section 6 of P.L.2005, c.219 (C.26:2C-8.31);
(6) warranty provisions for best available retrofit technologies and their installation and use on regulated vehicles or regulated equipment; and
(7) any other provisions the department determines necessary for the implementation of P.L.2005, c.219 (C.26:2C-8.26 et al.).
c. No provision of the rules and regulations adopted pursuant to subsection a. of this section may:
(1) designate any other types, makes, models, or classes of vehicles or equipment as regulated vehicles or regulated equipment other than regulated vehicles and regulated equipment as defined in section 2 of P.L.2005, c.219 (C.26:2C-8.27);
(2) require the installation and use of a retrofit device on a private regulated commercial bus earlier than 180 days after the owners of public regulated commercial buses have been required to install and have begun to use best available retrofit technologies that are retrofit devices on public regulated commercial buses;
(3) require the installation or use of a retrofit device on a regulated vehicle or piece of regulated equipment unless:
(a) the State Treasurer certifies that the constitutionally dedicated moneys have been deposited in the Diesel Risk Mitigation Fund for that year; and
(b) the Department of Environmental Protection certifies that sufficient moneys are available in the fund to pay for the cost of purchase and installation of the retrofit device required to be installed or used in that given year, by rule or regulation or by a provision of a plan submitted pursuant to section 7 or section 9 of P.L.2005, c.219 (C.26:2C-8.32 or C.26:2C-8.34).
Provided that the State Treasurer has issued the certification required under subparagraph (a) of paragraph (3) of this subsection for that year, the department may determine the amount of moneys available in the fund for that year, require the purchase and installation of those retrofit devices in those regulated vehicles or pieces of regulated equipment for which sufficient moneys are available, and certify that sufficient moneys are available for those retrofit devices in those regulated vehicles or pieces of equipment.
d. The rules and regulations adopted pursuant to paragraph (6) of subsection b. of this section shall at a minimum require that:
(1) the manufacturer of best available retrofit technology warrant to the owner of any regulated vehicle or piece of regulated equipment the full repair and replacement cost of the best available retrofit technology, including parts and labor, if the best available retrofit technology fails to perform as verified;
(2) the manufacturer of best available retrofit technology warrant to the owner of any regulated vehicle or piece of regulated equipment, if the installation or use of the best available retrofit technology damages the engine or the engine components of the regulated vehicle or piece of regulated equipment, the repair or replacement of engine components to return the engine components of the regulated vehicle or piece of regulated equipment to the condition they were in prior to damage caused by the best available retrofit technology;
(3) the manufacturers of best available retrofit technology authorize installers of best available retrofit technology other than fuel as authorized installers of the best available retrofit technology; and
(4) only authorized installers of best available retrofit technology install best available retrofit technology other than fuel.
The specific provisions of these requirements and the specific provisions of any warranty may be established by the department through rules and regulations adopted pursuant to this section or under separate rules and regulations adopted pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.), including but not limited to, the period of time during which a warranty would be in effect.
No owner of a regulated school bus shall be required to install closed crankcase technology pursuant to this subsection unless:
(1) the State Treasurer certifies in each of the two years after the effective date of P.L.2005, c.219 (C.26:2C-8.26 et al.) that the constitutionally dedicated moneys have been deposited in the Diesel Risk Mitigation Fund; and
(2) the Department of Environmental Protection certifies that sufficient moneys are available in the fund to pay the cost of purchase and installation of the closed crankcase technology required pursuant to this subsection in that two-year period.
Provided that the State Treasurer has issued the certification required under paragraph (1) of this subsection for that year, the department may determine the amount of moneys available in the fund for that year, require the purchase and installation of those retrofit devices in those regulated vehicles or pieces of regulated equipment for which sufficient moneys are available, and certify that sufficient moneys are available for those retrofit devices in those regulated vehicles or pieces of equipment.
b. The Department of Environmental Protection shall provide, and each owner of a regulated school bus shall obtain from the department, a compliance form for each regulated school bus. The owner of the regulated school bus shall submit a cost estimate to the department detailing the cost of any retrofit device to be installed as part of the closed crankcase technology and any cost associated with the installation of the closed crankcase technology prior to its purchase or installation. The department may determine whether the estimated costs are unreasonable, based upon criteria including, but not limited to, prevailing market rates and acquisition by the State of comparable technology. If the department makes such a determination, the department shall enter into negotiations with the owner of the regulated school bus to resolve the discrepancy.
The owner of the regulated school bus shall complete the compliance form, retain a copy for the owner's records, and return it to the department as soon as practicable after the installation of the closed crankcase technology to verify compliance with the requirements of subsection a. of this section and to seek reimbursement for the cost of the closed crankcase technology. The compliance form shall include the cost of any retrofit device installed as part of the closed crankcase technology and any cost associated with the installation of the closed crankcase technology. After the installation of the closed crankcase technology on a regulated school bus, a copy of the completed compliance form shall be kept on each regulated school bus at all times.
c. The department shall review the compliance forms submitted pursuant to subsection b. of this section and forward them to the State Treasurer. The State Treasurer shall reimburse each owner of a regulated school bus the cost of any retrofit device installed as part of the closed crankcase technology requirement and any cost associated with the installation of the closed crankcase technology indicated on the compliance form, in accordance with the provisions of sections 28 through 31, inclusive, of P.L.2005, c.219 (C.26:2C-8.53 through C.26:2C-8.56).
d. The Department of Environmental Protection shall provide any training necessary to implement the provisions of subsection d. of this section for any employees of, or persons contracted or licensed by, the New Jersey Motor Vehicle Commission, as determined necessary by the Chief Administrator of the New Jersey Motor Vehicle Commission.
e. The Department of Environmental Protection and the New Jersey Motor Vehicle Commission shall adopt jointly, pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.), rules and regulations concerning the installation of the crankcase technology required pursuant to this section and establishing the inspection requirements and procedures for verification of compliance with the crankcase technology requirement established pursuant to this section, the use of the compliance form in any inspection or as part of the inspection procedures and verification of compliance, any training necessary for any employees of, or persons contracted or licensed by, the New Jersey Motor Vehicle Commission, and the extent of that training to be provided by the Department of Environmental Protection, and in what manner that training shall be provided.
f. If for any reason, the owner of the regulated school bus is unable to comply with the requirements specified in this section, the owner shall notify the department, as soon as practicable, of the inability to comply. The department shall resolve the situation with the owner as soon as practicable, and the department shall issue any necessary documentation and other information to the owner of the regulated school bus.
(1) evaluate the relative contribution of emissions from both the crankcase and the tailpipe to in-cabin levels of fine particles; and
(2) evaluate the feasibility of requiring, and the environmental and health benefits of the reduction of fine particle levels from school bus tailpipe emissions through the use of additional retrofit devices.
b. If the Department of Environmental Protection finds as a result of the study conducted pursuant to subsection a. of this section that technologically feasible reductions in tailpipe emissions would significantly reduce the health risks associated with exposure of children to fine particles in the cabin of a standard school bus, the department may require the use of additional best available retrofit technologies in or on regulated school buses. If the department makes such a finding pursuant to the study, the department shall adopt, pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.), rules and regulations establishing:
(1) the best available retrofit technologies that regulated school buses shall be required to use, according to type, class, and other identifying vehicle information as designated by the department in these rules and regulations; and
(2) the requirements for submitting a fleet retrofit plan, combined fleet retrofit plan, or fleet averaging plan that are consistent with the requirements and provisions of section 9 and section 10 of P.L.2005, c.219 (C.26:2C-8.34 and C.26:2C-8.35) and the requirements for implementing the use of best available retrofit technologies for any owner who elects not to submit such a plan.
No use of additional best available retrofit technologies in or on regulated school buses may be required pursuant to this subsection for regulated school buses scheduled to be in service for less than two years on or after the date of notification pursuant to subsection d. of this section. No provision of the rules and regulations may require an owner of a regulated school bus to make a submittal to the department except as provided by this section.
c. No owner of a regulated school bus shall be required to install or use a retrofit device on a regulated school bus as required pursuant to the rules and regulations adopted pursuant to subsection b. of this section or pursuant to any part of a plan submitted pursuant to subsection e. of this section unless:
(1) the State Treasurer certifies that the constitutionally dedicated moneys have been deposited in the Diesel Risk Mitigation Fund for that year; and
(2) the Department of Environmental Protection certifies that sufficient moneys are available in the fund to pay for the cost of purchase and installation of the retrofit device required to be used by rule or regulation or by a provision of a plan submitted pursuant to subsection e. of this section in that given year.
Provided that the State Treasurer has issued the certification required under paragraph (1) of this subsection for that year, the department may determine the amount of moneys available in the fund for that year, require the purchase and installation of those retrofit devices in those regulated school buses for which sufficient moneys are available, and certify that sufficient moneys are available for those retrofit devices in those regulated school buses.
d. The Department of Environmental Protection shall notify each owner of a regulated school bus of the adoption of the rules and regulations pursuant to subsection b. of this section and the provisions of those rules and regulations. In establishing additional requirements pursuant to subsection b. of this section, the department shall require the compliance of regulated school buses before the compliance of other vehicles and equipment required to use best available retrofit technologies pursuant to P.L.2005, c.219 (C.26:2C-8.26 et al.). The State Treasurer shall prioritize the use of dedicated moneys in the Diesel Risk Mitigation Fund to allow for regulated school bus compliance with the provisions of this section, and shall prioritize payments made from the fund for regulated school buses complying with these additional requirements.
e. If rules and regulations are adopted pursuant to subsection b. of this section, each owner of a regulated school bus shall submit to the Department of Environmental Protection:
(1) an inventory of the diesel-powered school buses that are owned by the owner;
(2) notice by the owner that the owner shall comply with the requirements of P.L.2005, c.219 (C.26:2C-8.26 et al.) through the use of the best available retrofit technologies as designated and provided for under the rules and regulations adopted pursuant to subsection b. of this section, or that the owner cannot comply in that manner and is submitting a fleet retrofit plan, combined fleet retrofit plan, or fleet averaging plan; and
(3) the fleet retrofit plan, combined fleet retrofit plan, or fleet averaging plan being submitted in lieu of complying through the use of the best available retrofit technologies as designated and provided for under the rules and regulations adopted pursuant to P.L.2005, c.219 (C.26:2C-8.26 et al.), if the owner has elected to do so.
The owner shall make these submittals no later than 180 days after the effective date of the rules and regulations adopted pursuant to subsection b. of this section, or the date on or by which both certifications required pursuant to subsection c. of this section have been made, whichever is later.
f. No later than 180 days after the date of the submittals and notice pursuant to subsection e. of this section, the Department of Environmental Protection shall review, approve, and resolve any discrepancies concerning any submitted fleet retrofit plan, combined fleet retrofit plan, or fleet averaging plan, and shall issue final approval of the submitted plan. Any supplements or modifications to the fleet retrofit plan, combined fleet retrofit plan, or fleet averaging plan submitted pursuant to this subsection shall be made pursuant to section 10 of P.L.2005, c.219 (C.26:2C-8.35).
g. The department shall provide a one-page compliance form to each owner of a regulated school bus that submits a notice to comply pursuant to paragraph (2) of subsection e. of this section for each regulated school bus required to use best available retrofit technologies. The compliance form shall be similar to the compliance form issued pursuant to section 17 of P.L.2005, c.219 (C.26:2C-8.42) and shall be consistent with the provisions of subsection b. of that section. The department shall issue with the compliance form a notice of instructions describing the purpose of, and the procedures for completion of the compliance form, and the requirement to keep the compliance form with the regulated vehicle, or other vehicle included in a fleet averaging plan or modification thereto, for the life of the vehicle.
The owner of the regulated school bus shall complete the compliance form, retain a copy for the owner's records, and return it to the department as soon as practicable after the installation of, or commencement of the use of, the best available retrofit technologies required pursuant to the rules and regulations adopted pursuant to subsection b. of this section. The department shall review the compliance forms submitted and shall forward them to the State Treasurer, who shall reimburse each owner of a regulated school bus the cost of any retrofit device and the costs associated with the installation thereof, in accordance with the provisions of sections 28 through 31, inclusive, of P.L.2005, c.219 (C.26:2C-8.53 through C.26:2C-8.56).
(1) a warning shall be issued to the driver of the school bus operated in violation of these provisions, to the school district if the school district is not the owner of the school bus, and the principal or administrator of the school serviced by the school bus operated in violation of these provisions, for the first violation;
(2) for a first violation, a notice of violation shall be issued to, and the appropriate penalty imposed on, the owner of the school bus operated in violation of these provisions; and
(3) subsequent violations shall be enforced against the owner of the school bus operated in violation of these provisions, if other than the school district, and the school district serviced by the school bus operated in violation of these provisions.
No penalties may be assessed against any driver of any school bus that is operated in violation of the rules and regulations adopted pursuant to P.L.2005, c.219 (C.26:2C-8.26 et al.).
b. The Department of Environmental Protection shall consult with the Department of Education, individual school districts and school administrators concerning the issue of school bus idling, and develop and assist with the implementation of policies and procedures to achieve compliance with the rules and regulations adopted pursuant to paragraph (4) of subsection b. of section 3 of P.L.2005, c.219 (C.26:2C-8.28).
c. The Department of Law and Public Safety, in consultation with local law enforcement, the Department of Education, the Department of Environmental Protection, and the New Jersey Motor Vehicle Commission, shall adopt, pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.), any rules or regulations necessary to facilitate and ensure the enforcement of the rules and regulations adopted pursuant to paragraph (4) of subsection b. of section 3 of P.L.2005, c.219 (C.26:2C-8.28).
(1) an inventory of all on-road diesel vehicles and off-road diesel equipment owned, operated, or leased by the owner;
(2) notice by the owner that the owner shall comply with the requirements of P.L.2005, c.219 (C.26:2C-8.26 et al.) through the use of the best available retrofit technologies as designated and provided for under the rules and regulations adopted pursuant to section 3 of P.L.2005, c.219 (C.26:2C-8.28), or that the owner cannot comply in that manner and is submitting a fleet retrofit plan, combined fleet retrofit plan, or fleet averaging plan;
(3) the fleet retrofit plan, combined fleet retrofit plan, or fleet averaging plan being submitted in lieu of complying through the use of the best available retrofit technologies as designated and provided for under the rules and regulations adopted pursuant to section 3 of P.L.2005, c.219 (C.26:2C-8.28), if the owner has elected to do so; and
(4) an estimate of the cost of any retrofit device and any cost associated with the installation of that retrofit device, in accordance with the rules and regulations adopted pursuant to section 3 of P.L.2005, c.219 (C.26:2C-8.28).
The department may disapprove any notice submitted pursuant to paragraph (2) of this subsection by an owner complying with the requirements as designated and provided for under the rules and regulations adopted pursuant to section 3 of P.L.2005, c.219 (C.26:2C-8.28), if the department determines that the costs or cost estimates, submitted pursuant to paragraph (4) of this subsection, for the best available retrofit technology described in the notice, are unreasonable based upon criteria including, but not limited to, prevailing market rates and acquisition by the State of comparable technology. If the department makes such a determination, the department shall enter into negotiations with the owner to resolve the discrepancy. For owners complying by submitting a fleet retrofit plan, combined fleet retrofit plan, or fleet averaging plan pursuant to this subsection, the department shall review any notice, plan, cost, or cost estimate in accordance with the provisions of section 10 of P.L.2005, c.219 (C.26:2C-8.35).
b. Each owner of a regulated vehicle or regulated equipment shall make the submittals required pursuant to subsection a. in accordance with the following schedule:
(1) for regulated solid waste vehicles, no later than 180 days after the effective date of the rules and regulations adopted pursuant to section 3 of P.L.2005, c.219 (C.26:2C-8.28);
(2) for public regulated commercial buses, no later than one year after the effective date of the rules and regulations adopted pursuant to section 3 of P.L.2005, c.219 (C.26:2C-8.28);
(3) for private regulated commercial buses, no later than one year and 180 days after the effective date of the rules and regulations adopted pursuant to section 3 of P.L.2005, c.219 (C.26:2C-8.28); and
(4) for regulated on-road diesel vehicles and regulated equipment other than regulated solid waste vehicles and regulated commercial buses, no later than four years after the effective date of the rules and regulations adopted pursuant to section 3 of P.L.2005, c.219 (C.26:2C-8.28).
c. No owner of a private regulated commercial bus shall be required to make any submittal pursuant to subsection b. of this section until the owners of public regulated commercial buses have made their submittals required pursuant to that subsection, and no installation and use of a retrofit device on a private regulated commercial bus may be required earlier than 180 days after the owners of public regulated commercial buses have been required to install and have begun the use of retrofit devices on public regulated commercial buses.
d. The owner of regulated vehicles or regulated equipment who commences operation of a fleet after the effective date of the rules and regulations adopted pursuant to section 3 of P.L.2005, c.219 (C.26:2C-8.28) shall make the submittals required pursuant to subsection a. of this section within 180 days after the date on which they began operations, or the date provided in subsection b. of this section, whichever is later.
e. The owner of regulated vehicles or regulated equipment may coordinate or combine the development of a fleet retrofit plan with the development of a fleet retrofit plan of any other owner, or a group of owners, of regulated vehicles or regulated equipment, and with the guidance of the Department of Environmental Protection submit a combined fleet retrofit plan.
f. The fleet retrofit plan submitted pursuant to subsection a. of this section shall include a description by the owner of the best available retrofit technology and the specific regulated vehicle or piece of regulated equipment on which the specific best available retrofit technology would be used, as determined by the owner pursuant to the rules and regulations adopted pursuant to section 3 of P.L.2005, c.219 (C.26:2C-8.28).
g. If the owner of regulated vehicles or regulated equipment determines that the best available retrofit technology as required under the rules and regulations adopted pursuant to section 3 of P.L.2005, c.219 (C.26:2C-8.28) is not feasible for a specific regulated vehicle or pieces of regulated equipment, the owner may document this determination in the fleet retrofit plan and request the use of another level of best available retrofit technology to meet the requirement for that specific regulated vehicle or piece of regulated equipment, or provide documentation as to why the owner cannot use the best available retrofit technology that is required. The owner may also propose and negotiate an enforceable commitment to:
(1) retire the regulated vehicle or piece of regulated equipment and replace it with a vehicle or piece of equipment certified to fine particle emission levels at or below the emission levels that would have been achieved by the use of the required best available retrofit technology; or
(2) replace the engine of the vehicle or the equipment with an engine certified to that fine particle emissions level.
h. The owner of 75 or more regulated vehicles or pieces of regulated equipment, or any group of owners who elect to develop a combined fleet retrofit plan pursuant to subsection e. of this section under which 75 or more regulated vehicles or pieces of regulated equipment would be regulated, may propose to the Department of Environmental Protection a fleet averaging plan, in lieu of a fleet retrofit plan or a combined fleet retrofit plan, for the fleet or fleets affected. The owner or owners may propose a fleet averaging plan provided that the total net percent reductions in fine particle emissions under the proposed fleet averaging plan are equivalent to the estimated reductions in fine particle emissions that would have been achieved by the owner if a fleet retrofit plan were submitted and implemented for the regulated vehicles or regulated equipment, or both, or by the owners if the owners had submitted and implemented a combined fleet retrofit plan for their regulated vehicles or regulated equipment, or both, as calculated pursuant to the provisions of the rules and regulations adopted pursuant to section 3 of P.L.2005, c.219 (C.26:2C-8.28). The owner or group of owners may propose achieving fine particle emissions reductions from any on-road diesel vehicle, off-road diesel equipment, regulated vehicle, or regulated equipment owned by the owner or group of owners, or the retirement of any of those vehicles or equipment, and shall submit the proposed fleet averaging plan to the department as required by the rules and regulations adopted pursuant to section 3 of P.L.2005, c.219 (C.26:2C-8.28).
i. A fleet averaging plan proposed pursuant to subsection h. of this section that proposes the use of retrofit devices on any on-road diesel vehicle, off-road diesel equipment, regulated vehicle, or regulated equipment shall include: (1) a description by the owner of the best available retrofit technology and the specific vehicle or equipment on which the specific best available retrofit technology would be used, the specific vehicle or equipment to be retired, and how the required fine particle reductions shall be achieved through a combination of the use of best available retrofit technology on the specific vehicles or equipment; and (2) other measures or applications of best available retrofit technology consistent with the provisions of the rules and regulations adopted pursuant to section 3 of P.L.2005, c.219 (C.26:2C-8.28).
j. The Department of Environmental Protection shall give due consideration in the application of the fleet retrofit plan, combined fleet retrofit plan, or fleet averaging plan requirements to any efforts or actions by owners of regulated vehicles or regulated equipment who voluntarily retrofit, retire, or repower vehicles or equipment prior to the adoption of rules and regulations pursuant to section 3 of P.L.2005, c.219 (C.26:2C-8.28), and may modify any of the requirements of this section for such an owner in order to provide such due consideration.
k. The Department of Environmental Protection shall provide any technical guidance needed in preparing the fleet retrofit plans, combined fleet retrofit plans, and fleet averaging plans required pursuant to this section and any revisions, supplements, or modifications thereto required pursuant to P.L.2005, c.219 (C.26:2C-8.26 et al.).
l. No owner of regulated vehicles or regulated equipment shall be required to install or use a retrofit device on a regulated vehicle or regulated equipment as required pursuant to the rules and regulations adopted pursuant to section 3 of P.L.2005, c.219 (C.26:2C-8.28) or under a plan submitted pursuant to this section in any year unless the State Treasurer certifies for that year that the constitutionally dedicated moneys have been deposited in the Diesel Risk Mitigation Fund and the Department of Environmental Protection certifies that sufficient moneys are available in the fund to pay the cost of purchase and installation of the retrofit devices required to be used by rule and regulation or under an approved fleet retrofit plan, combined fleet retrofit plan, or fleet averaging plan or supplement or modification thereto, as applicable, by an owner in that year.
Provided that the State Treasurer has issued the certification that the constitutionally dedicated moneys have been deposited in the fund for that year, the department may determine the amount of moneys available in the fund for that year, require the purchase and installation of those retrofit devices in those regulated vehicles or pieces of regulated equipment for which sufficient moneys are available, and certify that sufficient moneys are available for those retrofit devices to be purchased for, and installed in, those regulated vehicles or pieces of regulated equipment.
(1) may direct the owner to comply with the approved part or parts of the fleet retrofit plan, the combined fleet retrofit plan, or the fleet averaging plan, as applicable, prior to final approval of other parts of the fleet retrofit plan, the combined fleet retrofit plan, or the fleet averaging plan; or
(2) in the case of a fleet averaging plan, may determine that the owner or the group of owners cannot comply with the requirements of P.L.2005, c.219 (C.26:2C-8.26 et al.) by implementing the proposed fleet averaging plan, and may require the owner to submit a fleet retrofit plan, or the group of owners of the fleets to submit a combined fleet retrofit plan or individual fleet retrofit plans.
Any determination made, or requirement established, pursuant to paragraph (2) of this subsection shall be made in writing and shall be provided in writing to each owner affected by the determination or requirement.
The department may disapprove any fleet retrofit plan, combined fleet retrofit plan, or fleet averaging plan, or any part thereof, submitted pursuant to paragraph (3) of subsection a. of section 9 of P.L.2005, c.219 (C.26:2C-8.34), if the department determines that the costs or cost estimates, submitted pursuant to paragraph (4) of subsection a. of section 9 of P.L.2005, c.219 (C.26:2C-8.34) for retrofit devices described in the fleet retrofit plan, combined fleet retrofit plan, or fleet averaging plan, as appropriate, are unreasonable based upon criteria including, but not limited to, prevailing market rates and acquisition by the State of comparable technology. If the department makes such a determination, the department shall enter into negotiations with the owner to resolve the discrepancy.
b. If the department exercises its authority under paragraph (2) of subsection a. of this section, the department shall issue a modified timetable for submittal of a fleet retrofit plan for the regulated vehicles or regulated equipment, a combined fleet retrofit plan for the group of owners, or individual fleet retrofit plans for the owners in the group. The department may require the submittal of these plans no earlier than 180 days after the date of the determination pursuant to paragraph (2) of subsection a. of this section, or the date on or by which both of the certifications required pursuant to subsection l. of section 9 of P.L.2005, c.219 (C.26:2C-8.34) have been made, whichever is later. The department shall review, approve or disapprove any fleet retrofit plan or combined fleet retrofit plan submitted in accordance with this modified timetable.
c. Whenever the department disapproves a fleet retrofit plan, combined fleet retrofit plan, or fleet averaging plan, or a part thereof, the department shall provide a detailed explanation to the owner indicating the deficiencies of the disapproved fleet retrofit plan, disapproved combined fleet retrofit plan, or the disapproved fleet averaging plan, or part thereof, and the recommendations of the department to correct the deficiencies.
d. During the review process or prior to final approval of a fleet retrofit plan, combined fleet retrofit plan, or fleet averaging plan, or the part thereof in question, the department may contact and enter into negotiations with the owner to resolve discrepancies between the rules and regulations adopted pursuant to section 3 of P.L.2005, c.219 (C.26:2C-8.28), the submitted fleet retrofit plan, combined fleet retrofit plan, or fleet averaging plan, and any requests by the owner for alternatives pursuant to subsection g. of section 9 of P.L.2005, c.219 (C.26:2C-8.34).
e. The owner or a group of owners whose fleet retrofit plan, combined fleet retrofit plan, or fleet averaging plan, or any part thereof, is disapproved by the department shall make the recommended revisions to the disapproved fleet retrofit plan, combined fleet retrofit plan, or fleet averaging plan, or the disapproved part thereof, within 60 days after the receipt of the disapproval notification from the department, and shall submit to the department the final revised fleet retrofit plan, final revised combined fleet retrofit plan, or the final revised fleet averaging plan, or the final revised part thereof that had been disapproved and revised. If the department does not take further action within 30 days after receipt of the final revised fleet retrofit plan, final revised combined fleet retrofit plan, the final fleet averaging plan, or the final revised part that had been disapproved, the fleet retrofit plan, combined fleet retrofit plan, or fleet averaging plan, or the part that had been disapproved and revised, shall be considered approved and in effect. If the department finds within 30 days after the receipt of the final revised fleet retrofit plan, final revised combined fleet retrofit plan, or the final revised fleet averaging plan, that the owner has not complied with the recommended revisions, the department may take further action to require compliance with this subsection, but the plan shall be in effect as of the date of the close of the 30-day period following the submittal of the final revised plan, or part thereof.
f. Upon the date of final approval of the fleet retrofit plan, combined fleet retrofit plan, or fleet averaging plan, or any part thereof, the owner shall be subject to the provisions of the fleet retrofit plan, combined fleet retrofit plan, fleet averaging plan, or that part thereof, and shall be required to comply with these provisions on or after the final approval date or the date on or by which both certifications required pursuant to subsection l. of section 9 of P.L.2005, c.219 (C.26:2C-8.34) have been made, whichever is later.
b. A supplement submitted pursuant to subsection a. of this section shall include:
(1) a description of any on-road diesel vehicles or off-road diesel equipment owned, operated, or leased by the owner added or removed from the fleet since the submission of the fleet retrofit plan or combined fleet retrofit plan, or the last supplement thereto; and
(2) for the regulated vehicles or regulated equipment added to the fleet, a description of the best available retrofit technology and the specific vehicle or piece of equipment on which the specific best available retrofit technology would be used.
c. A modification to a fleet averaging plan submitted pursuant to subsection a. of this section shall include:
(1) a description of any on-road diesel vehicles or off-road diesel equipment owned, operated, or leased by the owner or removed from the fleet since the submission of the fleet averaging plan or the last modification, thereto;
(2) for the regulated vehicles or regulated equipment added to the fleet, a description of the best available retrofit technology and the specific vehicle or piece of equipment on which the specific best available retrofit technology would be used that was not described in the fleet averaging plan or the last modification thereto; and
(3) a description of how the required fine particle reductions shall be achieved through a combination of the use of best available retrofit technology on specific regulated vehicles and other on-road diesel vehicles, or on specific regulated equipment and other off-road diesel equipment, and other measures or applications of best available retrofit technology consistent with the provisions of the rules and regulations adopted pursuant to section 3 of P.L.2005, c.219 (C.26:2C-8.28).
d. The department shall review, and approve or disapprove all parts of the supplement or the modification no later than one year after its submittal date. The department may approve or disapprove any supplement or modification to any plan in part, and require the owner of the regulated vehicles or regulated equipment to comply with the approved part or parts of the supplement or modification prior to final approval of other parts of the supplement or the modification.
e. Whenever the department disapproves a supplement to a fleet retrofit plan, combined fleet retrofit plan, or a modification to a fleet averaging plan, or a part thereof, the department shall provide a detailed explanation to the owner or operator of the fleet indicating the deficiencies of the disapproved supplement or modification, or part thereof, and the recommendations of the department to correct the deficiencies. The owner or a group of owners who receive disapproval of a supplement to a fleet retrofit plan or combined fleet retrofit plan, or of a modification to a fleet averaging plan, or a part thereof, shall make the recommended revisions to the supplement or the modification within 60 days after the receipt of the disapproval notification from the department, and submit the final revised supplement or modification, or the revised part that had been disapproved, to the department. If the department does not take further action within 30 days after receipt of the final revised supplement or modification, or the revised part that had been disapproved, the revised supplement to the fleet retrofit plan or combined fleet retrofit plan, or modification to the fleet averaging plan, or the revised part that had been disapproved shall be considered approved and in effect. If the department finds within 30 days after the receipt of the final revised supplement or modification or the final revised part that had been disapproved, that the owner has not complied with the recommended revisions, the department may take further action to require compliance with this subsection, but the supplement or modification shall be in effect as of the date of the close of the 30-day period after the receipt of the final revised supplement or modification.
f. Upon the date of final approval of the applicable part, and the date the final supplement or modification is in effect, the owner shall be subject to the provisions of the fleet retrofit plan or combined fleet retrofit plan, and the supplement thereto, or the fleet averaging plan and the modification thereto, except as may otherwise be provided pursuant to subsection e. of section 10 of P.L.2005, c.219 (C.26:2C-8.35).
g. No owner of a regulated vehicle or regulated equipment shall be required to install or use a retrofit device on a regulated vehicle or piece of regulated equipment as required pursuant to a supplement to a fleet retrofit plan or combined fleet retrofit plan, or a modification to a fleet averaging plan or, any part of such a supplement or a modification, in any year unless the State Treasurer certifies for that year that the constitutionally dedicated moneys have been deposited in the Diesel Risk Mitigation Fund, and the Department of Environmental Protection certifies that sufficient moneys are available in the fund to pay the cost of purchase and installation of the retrofit devices required to be used by an owner by rule or regulation or by the supplement to a fleet retrofit plan or combined fleet retrofit plan or the modification to a fleet averaging plan in that year.
Provided that the State Treasurer has issued the certification that the constitutionally dedicated moneys have been deposited in the fund for that year, the department may determine the amount of moneys available in the fund for that year, require the purchase and installation of those retrofit devices in those regulated vehicles or pieces of regulated equipment for which sufficient moneys are available, and certify that sufficient moneys are available for those retrofit devices to be purchased for, and installed in, those regulated vehicles or pieces of regulated equipment.
b. The owner of the fleet shall keep on each regulated vehicle or piece of regulated equipment, and on each vehicle or piece of equipment that is required to use best available retrofit technologies pursuant to an approved fleet averaging plan, or modification thereto, the current, updated compliance form issued pursuant to section 6, section 7, section 16 or section 17 of P.L.2005, c.219 (C.26:2C-8.31, C.26:2C-8.32, C.26:2C-8.41 or C.26:2C-8.42), and a copy thereof with the records required pursuant to subsection a. of this section.
b. As soon as practicable after the required best available retrofit technologies have been installed on the regulated equipment, the owner of regulated equipment shall complete the compliance form, retain a copy of the owner's records, and return it to the Department of Environmental Protection. Thereafter, a current copy of the completed compliance form shall be kept on each piece of regulated equipment at all times.
c. Each owner of regulated equipment seeking reimbursement for the cost of any retrofit device installed and any cost associated with the installation of the required best available retrofit technology for the regulated equipment shall submit a copy of the completed compliance form to the Department of Environmental Protection. The department shall review the submitted compliance form and forward it to the State Treasurer, who shall reimburse the owner the costs indicated on the completed compliance form.
b. The compliance form issued by the Department of Environmental Protection pursuant to subsection a. of this section shall be no longer than one page and shall have printed on the form: (1) the name and business address of the owner of the regulated vehicle or piece of regulated equipment; (2) the vehicle identification number for the regulated vehicle or the serial number for the piece of regulated equipment that is required to use best available retrofit technologies pursuant to the rules and regulations adopted pursuant to section 3 of P.L.2005, c.219 (C.26:2C-8.28), or the approved fleet retrofit plan, combined fleet retrofit plan, or the fleet averaging plan; (3) a description of the best available retrofit technologies that may be used by the specific regulated vehicle or piece of regulated equipment and the requirement under the approved fleet retrofit plan, combined fleet retrofit plan, or fleet averaging plan; (4) a description of the best available retrofit technology required for the vehicle or piece of equipment pursuant to the rules and regulations, the fleet retrofit plan, combined fleet retrofit plan, or fleet averaging plan, as the case may be; (5) an identified space for the label number for a required retrofit device to be entered into the form; (6) an identified space for the owner responsible for the submittal of the notice to comply by rules and regulations or the submittal and update of the fleet retrofit plan, combined fleet retrofit plan, or fleet averaging plan to certify that any required retrofit devices have been installed, and the date of that compliance; (7) an identified space for the examiner of the regulated vehicle to certify that the vehicle identification number that appears on the form corresponds to the vehicle on which the required retrofit device has been installed, and that the label identification number on the required retrofit device corresponds to the label identification number entered on the form of the regulated on-road diesel vehicle or other on-road diesel vehicle on which the required retrofit device has been installed; and (8) an identified space for the owner to record the cost of the retrofit device and its installation.
c. The Department of Environmental Protection shall issue with the forms sent to the owner of the fleet a notice of instructions describing the purpose of, and the procedures for completion of the compliance form, and the requirement to keep the compliance form with the regulated vehicle, or another vehicle included in a fleet averaging plan or modification thereto, for the life of the vehicle.
b. As soon as practicable after the requirement to implement the use of best available retrofit technologies for a specific vehicle or piece of equipment as provided in department rules and regulations, the approved regulated fleet retrofit plan, combined regulated fleet retrofit plan, or fleet averaging plan, or supplement or modification thereto, as applicable, has been complied with, the owner shall complete the appropriate portion of the form provided pursuant to section 6, section 7, section 16, or section 17 of P.L.2005, c.219 (C.26:2C-8.31, C.26:2C-8.32, C.26:2C-8.41, or C.26:2C-8.42). The owner, shall: (1) indicate the choice of best available retrofit technology that has been used to fulfill the requirement; (2) enter into the identified space on the compliance form the label identification number for any retrofit device that has been installed on the regulated vehicle or regulated equipment; (3) certify that the requirement on the form has been met for the regulated vehicle or piece of regulated equipment whose vehicle identification number or serial number, as applicable is printed on the form; and (4) provide and certify the date that the installation was done or compliance began on the compliance form.
c. For any regulated vehicle that is not required to be inspected under the periodic inspection program established pursuant to P.L.1995, c.157 (C.39:8-59 et seq.), the owner shall have the regulated vehicle inspected by a diesel emissions inspection center licensed pursuant to P.L.1995, c.157 (C.39:8-59 et seq.) for the presence of the required retrofit device and compliance with the requirement described on the compliance form issued pursuant to section 6, section 7, or section 17 of P.L.2005, c.219 (C.26:2C-8.31, C.26:2C-8.32, or C.26:2C-8.42), as soon as practicable after the requirements of subsection b. of this section have been met for the regulated vehicle.
d. For any regulated vehicle that is subject to inspection under the periodic inspection program pursuant to P.L. 1995, c.157 (C.39:8-59 et seq.), the owner, after complying with the provisions of subsection b. of this section, shall have the regulated vehicle inspected for compliance with the requirement printed on the form issued pursuant to section 6, section 7, or section 17 of P.L.2005, c.219 (C.26:2C-8.31, C.26:2C-8.32, or C.26:2C-8.42) at the next annual periodic inspection scheduled for the vehicle, or as soon as practicable after complying with the provisions of subsection b. of this section. No provision of this subsection shall be construed as requiring the owner to have any vehicle subject to a periodic inspection to have that vehicle registered at any scheduled periodic inspection.
e. A diesel emissions inspection center licensed pursuant to P.L.1995, c.157 (C.39:8-59 et seq.) shall inspect any regulated vehicle presented to it for inspection for compliance with the requirement on the form issued for the regulated vehicle pursuant to section 6, section 7, section 16, or section 17 of P.L.2005, c.219 (C.26:2C-8.31, C.26:2C-8.32, C.26:2C-8.41, or C.26:2C-8.42). The person performing the inspection shall verify the presence of the required retrofit device, the match of the label identification number on the form with the device in the vehicle, and shall certify that the requirement has been met based on the presence of the required retrofit device and the match of the label identification number on the form to the label identification number on the retrofit device on the vehicle, and the correct vehicle identification number on the form. No provision of this subsection shall be construed to require the diesel emissions inspection center to verify the functioning or the correct installation of the retrofit device, or to test for the level of emissions reduction attributed to the use of the retrofit device.
f. If the owner of the regulated vehicle is a licensed diesel inspection center or is otherwise authorized to self-inspect the vehicles owned by the owner, the owner may perform the inspection and provide the certification required pursuant to subsections d. and e. of this section.
g. Only one inspection per vehicle is required pursuant to this section.
b. The commission shall include, in its inspection of a diesel commercial bus pursuant to P.L.1995, c.157 (C.39:8-59 et al.), an inspection of any regulated commercial bus required to install a retrofit device pursuant to a regulated fleet retrofit plan, combined regulated fleet retrofit plan, or fleet averaging plan, after the retrofit device has been installed, to determine that the installation of the required best available retrofit technology has occurred as required pursuant to the approved regulated fleet retrofit plan, combined regulated fleet retrofit plan, or fleet averaging plan for the diesel commercial bus being inspected, or shall provide for such an inspection at a separate time requested by the owner, operator, or lessee of the regulated fleet of which the diesel commercial bus is a part. This inspection is required to be performed only once and after the required retrofit device has been installed. The owner, operator, or lessee of the regulated fleet containing the diesel commercial buses shall notify the New Jersey Motor Vehicle Commission that the required installation has been done for the diesel commercial bus being inspected as required pursuant to this subsection.
c. The owner of a regulated vehicle subject to inspection pursuant to subsection a. or subsection b. of this section shall present to the person performing the inspection the form for the regulated vehicle issued pursuant to section 6, section 7, or section 17 of P.L.2005, c.219 (C.26:2C-8.31, C.26:2C-8.32, or C.26:2C-8.42). The person performing the inspection pursuant to subsection a. or subsection b. of this section shall check for the presence of the required retrofit device, the match of the label identification number in the form and or the device in the vehicle, and shall certify that the requirement has been met based on the presence of the required retrofit device and the match of the label identification number to the form for the vehicle with the vehicle identification number on the form.
d. The Department of Environmental Protection shall provide any training necessary to implement the provisions of this section for any employees of, or persons contracted or licensed by, the New Jersey Motor Vehicle Commission, as determined necessary by the Chief Administrator of the New Jersey Motor Vehicle Commission.
e. No provision of this section shall be construed to require the New Jersey Motor Vehicle Commission to verify the functioning of the retrofit device, or its correct installation, or to test the function of the retrofit device for any level of emissions reduction attributed to the use of the retrofit device.
b. No provision of subsection a. of this section or any other rule or regulation adopted pursuant thereto, shall be construed to supersede or modify, the provisions of section 3, section 4, subsection a. or subsections d. through f., inclusive, of section 6, subsections a. through c. or subsections e. through f., inclusive, of section 7, sections 8 through 13, inclusive, subsection d. or e. of section 19, section 21, section 26, section 27, section 28, subsection a. of section 29, or subsection b. of section 30 of P.L.2005, c.219 (C.26:2C-8.28, C.26:2C-8.29, C.26:2C-8.31, C.26:2C-8.32, C.26:2C-8.33 through C.26:2C-8.38, C.26:2C-8.44, C.26:2C-8.46, C.26:2C-8.51, C.26:2C-8.52, C.26:2C-8.53, C.26:2C-8.54, or C.26:2C-8.55).
c. No entity performing the actual installation of a retrofit device who is reimbursed for the costs associated with the purchase and installation of retrofit devices pursuant to rules and regulations adopted pursuant to subsection a. of this section may impose any charge on any owner of a regulated vehicle or piece of regulated equipment for any cost associated with the purchase and installation of retrofit devices required pursuant to P.L.2005, c.219 (C.26:2C-8.26 et al.). No State agency, department, or political subdivision thereof may impose any charge on any owner of a regulated vehicle or piece of regulated equipment for any cost associated with the purchase and installation of retrofit devices required pursuant to P.L.2005, c.219 (C.26:2C-8.26 et al.) if entities performing the actual installation of a retrofit device are reimbursed for the costs pursuant to rules and regulations adopted pursuant to subsection a. of this section.
b. No sooner than July 15, 2006, and following a public hearing held by the Department of Environmental Protection on the availability of ultra-low sulfur diesel fuel in the State for use in on-road diesel vehicles and off-road diesel equipment, the department shall determine and issue a written notice of its determination as to whether sufficient supplies of ultra-low sulfur diesel fuel are available in the State to require a minimum of 80 percent of all diesel fuel annually sold, distributed, or used in the State to be ultra-low sulfur diesel fuel for use in on-road diesel vehicles or off-road diesel equipment, or both, on and after January 15, 2007, without significant disruption of, or significant price increases in, the wholesale and retail fuel market. If the department determines that supplies would be sufficient, the department shall require a certain percentage, to be determined by the department, of all diesel fuel annually sold, distributed, or used in the State to be ultra-low sulfur diesel fuel for use in on-road diesel vehicles or off-road diesel equipment, or both, on or after the 180th day after the date on which the department issues a written determination that supplies would be sufficient, provided that this percentage shall be the highest percentage that can practicably be required without significant disruption of, or significant price increases in, the wholesale and retail fuel market, but shall be no less than 80 percent of all diesel fuel annually sold, distributed, or used in the State.
c. If the department determines that sufficient supplies are not available pursuant to subsection b. of this section, the requirement to sell, distribute, or use only ultra-low sulfur diesel fuel in the State shall take effect only 180 days after the department issues a written determination that the supplies are sufficient to sell, distribute, or use only ultra-low sulfur diesel fuel in the State.
d. The Department of Environmental Protection, in consultation with the Department of Law and Public Safety, the Department of Labor and Workforce Development, and the Attorney General, shall adopt, pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.), rules and regulations necessary for the implementation of this section.
(1) Levy a civil administrative penalty in accordance with subsection b. of this section; or
(2) Bring an action for a civil penalty in accordance with subsection c. of this section.
Recourse to any of the remedies available under this section shall not preclude recourse to any of the other remedies prescribed in this section or by any other applicable law.
b. The commissioner is authorized to assess a civil administrative penalty of not more than $5,000 for each violation of P.L.2005, c.219 (C.26:2C-8.26 et al.), or any rule or regulation adopted pursuant thereto. In adopting rules and regulations establishing the amount of any penalty to be assessed, the commissioner may take into account the type, seriousness, and duration of the violation and the economic benefits from the violation gained by the violator. No assessment shall be levied pursuant to this section until after the party has been notified by certified mail or personal service. The notice shall: (1) identify the section of the law, rule, regulation, approval, or authorization violated; (2) recite the facts alleged to constitute a violation; (3) state the amount of the civil penalties to be imposed; and (4) affirm the rights of the alleged violator to a hearing. The ordered party shall have 20 days from receipt of the notice within which to deliver to the commissioner a written request for a hearing. After the hearing and upon finding that a violation has occurred, the commissioner may issue a final order after assessing the amount of the fine specified in the notice. If no hearing is requested, the notice shall become a final order after the expiration of the 20-day period. Payment of the assessment is due when a final order is issued or the notice becomes a final order. The authority to levy an administrative penalty is in addition to all other enforcement provisions in this act and in any other applicable law, rule, or regulation, and the payment of any assessment shall not be deemed to affect the availability of any other enforcement provisions in connection with the violation for which the assessment is levied. Any civil administrative penalty assessed under this section may be compromised by the commissioner upon the posting of a performance bond by the violator, or upon such terms and conditions as the commissioner may establish by regulation.
c. A person who violates any provisions of P.L.2005, c.219 (C.26:2C-8.26 et al.), or any rule or regulation adopted pursuant thereto, or who fails to pay a civil administrative penalty in full pursuant to subsection b. of this section, shall be subject, upon order of a court, to a civil penalty for such violation of not more than $5,000. Any civil penalty imposed pursuant to this subsection may be collected with costs in a summary proceeding pursuant to the "Penalty Enforcement Law of 1999," P.L.1999, c.274 (C.2A:58-10 et seq.). In addition to any penalties, costs or interest charges, the court may assess against the violator the amount of actual economic benefit accruing to the violator from the violation. The Superior Court and the municipal court shall have jurisdiction to enforce the provisions of the "Penalty Enforcement Law of 1999," P.L.1999, c.274 (C.2A:58-10 et seq.) in connection with the provisions of P.L.2005, c.219 (C.26:2C-8.26 et al.).
d. Any person who knowingly, recklessly, or negligently makes a false statement, representation, or certification in any application, record, or other document filed or required to be maintained under P.L.2005, c.219 (C.26:2C-8.26 et al.) shall be in violation of P.L.2005, c.219 (C.26:2C-8.26 et al.) and shall be subject to the penalties assessed pursuant to subsections b. and c. of this section.
(1) constitutionally dedicated moneys;
(2) such moneys as are appropriated by the Legislature; and
(3) any return on investment of moneys deposited in the fund.
b. Moneys in the fund may be used by the Department of the Treasury solely for:
(1) reimbursements to owners of regulated vehicles or regulated equipment to reimburse the cost of required retrofit devices and the installation thereof;
(2) the administrative costs incurred by the Department of Environmental Protection to implement the provisions of P.L.2005, c.219 (C.26:2C-8.26 et al.) up to $900,000 per year; and
(3) the administrative costs incurred by the New Jersey Motor Vehicle Commission to implement the provisions of P.L.2005, c.219 (C.26:2C-8.26 et al.) up to $250,000 per year.
c. No moneys in the fund may be made available for any costs associated with requirements imposed by P.L.2005, c.219 (C.26:2C-8.26 et al.), unless the State Treasurer certifies that the constitutionally dedicated moneys have been deposited in the fund in that year.
If the moneys provided for the administrative costs of the New Jersey Motor Vehicle Commission are not required by the commission in a given year because they exceed the amount of the administrative costs of the commission in that year, the State Treasurer shall provide those moneys unexpended for that purpose to the Department of Environmental Protection for administrative costs, provided that the administrative costs paid from the constitutionally dedicated moneys deposited in the fund do not exceed $1,150,000.
d. Any owner of a regulated vehicle or piece of regulated equipment is eligible for reimbursement from the fund. Notwithstanding the provisions of the "Local Budget Law" (N.J.S.40A:4-1 et seq.) to the contrary, a county, municipality, or an authority as defined in section 3 of P.L.1983, c.313 (C.40A:5A-3) required to comply with the provisions of P.L.2005, c.219 (C.26:2C-8.26 et al.) may anticipate in its annual budget or any amendments or supplements thereto those sums to be reimbursed from the fund for the costs of retrofit devices and their installation that are required to be used in or on any regulated vehicle or piece of regulated equipment in a given year in which the county, municipality, or authority incurs the cost. For the purposes of subsection 1. of section 3 of P.L.1976, c.68 (C.40A:4-45.3) and subsection g. of section 4 of P.L.1976, c.68 (C.40A:4-45.4), the costs of retrofit devices and their installation shall be considered an amount to be received from State funds in reimbursement for local expenditures and therefore exempt from the limitation on local budgets imposed pursuant to section 2 of P.L.1976, c.68 (C.40A:4-45.2).
b. The owner or operator of a regulated vehicle or piece of regulated equipment seeking the reimbursement authorized in subsection a. of this section shall file an application on a form to be developed by the State Treasurer and the Department of Environmental Protection, with the department, with the documentation required by the department and the State Treasurer pursuant to section 30 of P.L.2005, c.219 (C.26:2C-8.55). Neither the State Treasurer nor the Department of Environmental Protection may charge an application fee.
c. Upon a determination that an application for reimbursement meets all established criteria for an award from the fund, the Department of Environmental Protection and the State Treasurer shall approve the application. Upon the department approval of an application for reimbursement from the fund, the State Treasurer shall award the reimbursement to an owner upon the availability of sufficient moneys in the fund. If moneys in the fund are not sufficient at any point to fund all applications for reimbursement that have been approved by the State Treasurer, the State Treasurer shall award reimbursement to approved owners based upon the date of approval of the application.
(1) establishing the filing requirements for a complete application for reimbursement from the fund; and
(2) to require an owner:
(a) to submit documentation or other information demonstrating that the retrofit device has been purchased and installed on a regulated vehicle, which shall include the vehicle identification number of the vehicle, or on regulated equipment the serial number;
(b) to submit documentation of the actual costs incurred for the purchase of the retrofit device required to be installed, the nature and scope of work performed to install the retrofit device, and the actual costs incurred to install the technology;
(c) to submit a certification that the owner has not engaged in any of the conduct described in subsection a. of section 31 of P.L.2005, c.219 (C.26:2C-8.56);
(d) to submit a certification that the retrofit device installed on a regulated vehicle or regulated equipment is in conformance with rules and regulations of the Department of Environmental Protection; and
(e) to provide access at reasonable times to the regulated vehicles or regulated equipment to determine compliance with the terms and conditions of the reimbursement award.
b. In establishing requirements for applications for reimbursement, the State Treasurer:
(1) may not impose conditions that interfere with the everyday normal operations of an owner's business activities, except to the extent necessary to ensure the owner has complied with the provisions of P.L.2005, c.219 (C.26:2C-8.26 et al.);
(2) shall strive to minimize the complexity and costs to owners of complying with such requirements; and
(3) shall expeditiously process all applications in accordance with a schedule established, in consultation with the Department of Environmental Protection, for the review and the taking of final action within 30 days after the receipt of the completed application.
(1) the owner of a regulated vehicle or regulated equipment failed to commence or complete the purchase or installation of best available retrofit technology on the vehicle or equipment for which an application for reimbursement was filed in accordance with the applicable rules and regulations; or
(2) the owner of a regulated vehicle or regulated equipment provided false information or withheld information on an application that would render the owner ineligible for reimbursement from the fund, that resulted in the owner receiving a larger reimbursement than the owner would otherwise be eligible, or that resulted in payments from the fund in excess of the actual costs incurred by the owner or the amount to which the owner is legally eligible.
b. Nothing in this section shall be construed to require the State Treasurer, the Department of Environmental Protection, or any other State agency or department, to undertake an investigation or make any findings concerning the conduct described in subsection a. of this section.
b. On or after the date of implementation of the program developed pursuant to subsection a. of this section, and once each year for the next two years thereafter, the Department of Environmental Protection shall, subject to available funding, select for participation in the program no less than six school districts and school bus contractors that operate school buses, as described in section 1 of P.L.1996, c.96 (C.39:3B-1.1), so that during the third year of the program, no less than a total of 18 school districts or school bus contractors shall have been selected for participation in the program amongst the northern, central, and southern regions of the State. The department shall choose school districts and school bus contractors to participate in the program based on a competitive grant solicitation.
In each year, the department shall use its best efforts to select a mix of school districts that operate their own bus fleets and school districts that contract for school bus services; provided that, in each year, the department shall award no more than half of the grants to school bus contractors. Any school bus contractor applying to participate in the program shall apply in conjunction with a specific school district. In each year, at least half of the school districts or school bus contractors selected by the department, and at least half of the grant funding awarded by the department in each year shall be located in a "low-income, urban, or environmental justice community" as defined in section 2 of P.L.2019, c.362 (C.48:25-2) and from those selected, the department shall use its best efforts, in each year, to select, an equal number of grantees from the northern, central, and southern regions of the State respectively, subject to deviation based on the applicant pool. Grants shall be awarded in a manner that both prioritizes equity and tests a variety of technological and funding approaches, including but not limited to outright purchase, leased buses, leveraging of other funding sources, and vehicle-to-grid or vehicle-to-building technologies.
For purposes of this subsection: "northern," when referring to regions of the State, means the counties of Bergen, Essex, Hudson, Morris, Passaic, Union, Sussex, and Warren; "central," when referring to regions of the State, means the counties of Hunterdon, Mercer, Middlesex, Monmouth, and Somerset; and "southern," when referring to regions of the State, means the counties of Atlantic, Burlington, Camden, Cape May, Cumberland, Gloucester, Ocean, and Salem.
c. (1) Under the program, the department shall award grants to school districts or school bus contractors selected to participate in the program to purchase or lease electric school buses and to purchase or lease and install electric school bus charging infrastructure in coordination with any State department, board, bureau, commission, agency, public utility as defined pursuant to R.S.48:2-13 that provides electric service to end users in the State, municipal public utility as defined in N.J.S.40A:1-1 that provides electric service to end users in the State, authority as defined in section 3 of P.L.1983, c.313 (C.40A:5A-3) that provides electric service to end users in the State, or rural electric cooperative organized under the general corporation laws of this State as necessary. Pursuant to any outright purchase or lease arrangement entered into by a school district or school bus contractor participating in the program, an electric school bus and charging infrastructure vendor purchase or lease arrangement shall include, at a minimum, the following:
(a) an electric school bus having a minimum range of 90 miles per full charge, or 30 percent more range per full charge than the daily maximum miles used by the school district or school bus contractor, whichever is greater, and having telematics system capabilities. The department shall collect data from on-board telematics monitoring systems in order to evaluate parameters such as idle time, driving time, energy consumption, and frequency of charging;
(b) an electric school bus and charging infrastructure, as appropriate;
(c) appropriate training for bus maintenance personnel and bus drivers, and other relevant personnel, which shall be provided at no cost to a bus driver, bus maintenance personnel, or other relevant personnel; and
(d) electric school bus and charging infrastructure shop manuals and wiring schematics for troubleshooting and a complete list of component parts.
(2) Monies for the "Electric School Bus Program" shall be used by the Department of Environmental Protection to provide grants, pursuant to this subsection, over the three-year period. In the first year, grants shall be provided in accordance with P.L.2022, c.86 (C.26:2C-8.58 et al.) in the amount of $15,000,000 for electrification. Subject to the availability of funds, grants shall continue to be provided in accordance with P.L.2022, c.86 (C.26:2C-8.58 et al.) in the amount of $15,000,000 per year for a total of $45,000,000 over the three-year period. The department may use available monies to provide grants, pursuant to this subsection, singly or in combination, from the following sources: societal benefits charge revenues received pursuant to section 12 of P.L.1999, c.23 (C.48:3-60); the "Global Warming Solutions Fund" established pursuant to section 6 of P.L.2007, c.340 (C.26:2C-50); any available monies from utility programs to upgrade electrical infrastructure for purposes of electric vehicle charging; any appropriations made by the Legislature for the program established pursuant to P.L.2022, c.86 (C.26:2C-8.58 et al.); or any other sources of available funding. Up to five percent of the monies made available to the program may be used to administer the program.
The department shall determine the amount of each grant provided pursuant to this subsection and shall award grants in a manner that provides for the most efficient and highest efficacy use of the grant.
d. At least once every six months, the school districts or school bus contractors selected to participate in the program shall submit a report to the department detailing the cost to operate the electric school buses, the electric school bus maintenance records and transponder data, and any reliability issues related to the operation or delivery and procurement of the electric school buses. The first report shall be submitted six months after the school district or school bus contractor first completes its initial procurement of electric school buses.
e. (1) The department shall, no less than twice per calendar year, convene a working group which includes a representative of the Board of Public Utilities, the New Jersey Economic Development Authority, the Department of Transportation, the Department of Education, and the New Jersey Motor Vehicle Commission. The working group shall review the reports and, as appropriate, troubleshoot and recommend solutions to any issue raised in a report submitted by a program participant. The working group shall consider issues raised in the reports submitted by program participants and make recommendations regarding program implementation. The department may convene the working group on a more frequent basis as may be required for the effective administration of the program. The department shall collect any additional information and data necessary to complete any report required to be submitted to the Governor and Legislature pursuant to subsection f. of this section.
(2) The department shall permit a recipient of any grant under any State agency-administered program for the provision of an electric school bus and electric school bus charging infrastructure prior to the effective date of P.L.2022, c.86 (C.26:2C-8.58 et al.) to submit any additional information and data to the department to complement any data received by the department from program participants pursuant to this subsection.
f. The department, in collaboration with the Board of Public Utilities and the New Jersey Economic Development Authority shall submit an "Electric School Bus Program" report to the Governor and, pursuant to section 2 of P.L.1991, c.164 (C.52:14-19.1), to the Legislature. The report shall be submitted within six months after the conclusion of the program.
The department may use available monies, singly or in combination from the following sources, to procure professional services to assist with the development of the report: societal benefits charge revenues received pursuant to section 12 of P.L.1999, c.23 (C.48:3-60); the "Global Warming Solutions Fund" established pursuant to section 6 of P.L.2007, c.340 (C.26:2C-50); any available monies from utility programs to upgrade electrical infrastructure for purposes of electric vehicle charging; any appropriations made by the Legislature for the program established pursuant to P.L.2022, c.86 (C.26:2C-8.58 et al.); or any other sources of available funding.
The submitted report shall include:
(1) a description and comprehensive review of the program, including but not limited to, an evaluation of the program's effectiveness;
(2) a summary description of all grants provided under the program, including the names of the recipients, the amount of funding each recipient received, the current status of the funds provided to each recipient, and an itemization of the total project budget including vehicle costs, hardware costs, installation costs, training costs, and administrative costs;
(3) an analysis of the operational reliability and cost effectiveness of the use of electric school buses and charging infrastructure by each grantee and steps taken by the grantee to fix any operational problems;
(4) an estimate of the emission benefits of the electric school buses and charging infrastructure funded under this program;
(5) any preliminary findings from grant recipients pertaining to design or operation of electric school buses and charging infrastructure and potential improvements to make the buses and charging infrastructure safer, more economical or environmentally advantageous;
(6) as applicable, depending on deployment of grant recipients, an analysis of the potential costs and benefits of using electric school bus batteries for storing power to be returned to the electric grid or to school buildings during periods of peak electric power demand;
(7) an assessment of reliability of electric school buses and charging infrastructure; and
(8) an analysis of any additional external changes that the use of electric school buses and charging infrastructure may require regarding electric service rate schedules, school bus inspection standards, or any other major considerations.
In addition to the information included pursuant to paragraphs (1) through (8) of this subsection, the final report shall include recommendations regarding the establishment of grant and loan programs to provide assistance to school districts and school bus contractors for the replacement of their bus fleets, other types of financial agreements to assist school districts and school bus contractors with implementing and using electric school buses, and the optimization of electric school bus grant programs to most efficiently and effectively distribute available funds to maximize environmental and health benefits.
The final report shall also include recommendations for how additional funding may be distributed in the most efficient and effective manner to maximize the number of electric school buses operating in the State.
b. The department shall control air pollution in accordance with the provisions of any applicable code, rule, or regulation promulgated by the department and for this purpose shall have power to:
(1) Conduct and supervise research programs for the purpose of determining the causes, effects, and hazards of air pollution;
(2) Conduct and supervise Statewide programs of air pollution control education including the preparation and distribution of information relating to air pollution control;
(3) Require the registration of persons engaged in operations that may result in air pollution and the filing of reports, including but not limited to emission statements, by them containing information relating to location, size of outlet, height of outlet, rate and period of emission and composition of effluent, and such other information as the department shall prescribe to be filed relative to air pollution, all in accordance with applicable codes, rules, or regulations established by the department;
(4) Enter and inspect any building or place, except private residences, for the purpose of investigating an actual or suspected source of air pollution and ascertaining compliance or noncompliance with any codes, rules, or regulations of the department. Any information, other than actual or allowable air contaminant emissions, relating to secret processes or methods of manufacture or production obtained in the course of an inspection, investigation, or determination, shall be kept confidential and shall not be admissible in evidence in any court or in any other proceeding except before the department. If samples are taken for analysis, a duplicate of the analytical report shall be furnished promptly to the person suspected of causing air pollution;
(5) Receive or initiate complaints of air pollution, hold hearings in connection with air pollution, and institute legal proceedings for the prevention of air pollution and for the recovery of penalties, in accordance with P.L.1954, c.212 (C.26:2C-1 et seq.);
(6) With the approval of the Governor, cooperate with, and receive funds or other assistance from, the federal government, the State government, any interstate body, or any county or municipal government, or from private sources, for the study and control of air pollution;
(7) Charge, in accordance with a fee schedule that shall be adopted by the department pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.), (a) reasonable annual emission fees for major facilities as provided in section 5 of P.L.1995, c.188 (C.26:2C-9.5), and (b) administrative fees for any of the services the department performs or provides in connection with administering P.L.1954, c.212 (C.26:2C-1 et seq.). The administrative fees charged by the department pursuant to this subsection shall not exceed $25,000 per application based on criteria contained in the fee schedule;
(8) Issue, renew, reopen, and revise operating permits, and require any person who is required to obtain an operating permit under the provisions of the federal Clean Air Act to obtain an operating permit and to certify compliance therewith for all air pollution sources; and
(9) Establish, implement, and operate a small business stationary source technical and environmental compliance assistance program as required pursuant to 42 U.S.C. 7661f of the federal Clean Air Act.
No person shall obstruct, hinder or delay, or interfere with by force or otherwise, the performance by the department or its personnel of any duty under the provisions of this act, or of the act of which this act is amendatory and supplementary, or refuse to permit such personnel to perform their duties by refusing them, upon proper identification or presentation of a written order of the department, entrance to any premises at reasonable hours.
b. No operating permit, operating permit revision, or operating certificate or renewal thereof shall be issued unless the applicant demonstrates that the equipment or control apparatus will operate, or operates, in accordance with the provisions of P.L.1954, c.212 (C.26:2C-1 et seq.) and the rules and regulations adopted pursuant thereto.
c. Newly constructed, reconstructed, or modified equipment and control apparatus shall incorporate advances in the art of air pollution control as developed for the kind and amount of air contaminant emitted by the applicant's equipment and control apparatus as provided in this subsection.
(1) For equipment and control apparatus with a potential to emit any hazardous air pollutant equal to or greater than the de minimis levels specified by the EPA pursuant to subsection (g) of section 112 of the federal Clean Air Act (42 U.S.C. 7412) or with a potential to emit five tons per year or more of any other air contaminant, the applicant shall document advances in the art of air pollution control in accordance with the following criteria, as applicable:
(a) For an air contaminant subject to the prevention of significant deterioration technology requirement, advances in the art of air pollution control shall be the best available control technology (BACT) as set forth by the EPA at 40 CFR 52.21 (b)(12) or any subsequent amendments thereto;
(b) For an air contaminant subject to a significant emissions increase of a non-attainment air contaminant in a non-attainment area, advances in the art of air pollution control shall be the lowest achievable emission rate (LAER) as set forth by the EPA at 40 CFR 51.165(a)(1)(xiii) or any subsequent amendments thereto;
(c) For a hazardous air pollutant technology requirement, advances in the art of air pollution control shall be the maximum achievable control technology (MACT) as set forth at 42 U.S.C. 7412 or any subsequent amendments thereto; and
(d) For other air contaminants, advances in the art of air pollution control means up-to-date technology and methods, reflected in equipment, control apparatus, and procedures, that when applied to an emission source shall reasonably minimize air contaminant emissions. The technology shall have been demonstrated for similar air contaminant discharge parameters to be reliable and shall be available at reasonable cost commensurate with the reduction in air contaminant emissions.
(2) For equipment and control apparatus with a potential to emit hazardous air pollutants at less than the de minimis levels specified by the EPA pursuant to subsection (g) of section 112 of the federal Clean Air Act (42 U.S.C. 7412) and with a potential to emit less than five tons per year of any other air contaminant, the applicant need not document advances in the art of air pollution control, but shall document compliance with:
(a) reasonably available control technology as defined in rules and regulations that shall be adopted by the department pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.);
(b) applicable new source performance standards; and
(c) any other applicable State or federal standard, code, rule, or regulation.
(3) (a) In order to promote greater emissions reductions than would otherwise be achieved, the department may adopt, pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.), rules and regulations that offer a person the option of establishing in an operating permit a 15-year plan for reducing facility emissions beyond minimum air pollution control requirements in lieu of adhering to strict permit review schedules and complying with less effective State requirements. Such a plan shall include schedules setting forth milestones for reducing emissions at the facility. Milestones may be met by reducing emissions at the facility and by providing emissions reduction credits from non-facility sources pursuant to an emissions trading and banking program adopted pursuant to section 8 of P.L.1995, c.188 (C.26:2C-9.8).
(b) The department shall review the achievement of the milestones in the plan no less frequently than every five years when the operating permit is renewed. The department may require the person to submit, as part of the application for renewal of the operating permit, a summary and trend of the actual air contaminant emissions data reported in the facility's annual emission statements for the previous five years. If the department determines during the approval process for an operating permit renewal that the milestones in the plan have not been met at a facility and that there is no reasonable likelihood that the milestones can or will be met, the department may withdraw the opportunity for the facility to continue pursuant to the plan and shall require instead that the facility comply with the promulgated schedules for all applicable requirements.
(c) The department shall allow a person entering a 15-year plan the option of establishing in that person's operating permit reduced administrative application requirements for de minimis modifications of equipment and control apparatus at the facility, provided that: any increase in allowable emissions for any individual equipment and control apparatus is below de minimis levels defined by rule or regulation adopted by the department pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.); and, as part of the five-year achievement review set forth in subparagraph (b) of paragraph (3) of this subsection, the person includes a demonstration that confirms no net emissions increases have occurred at the facility over the previous five years.
(d) The department shall involve in the development of the rules and regulations for the 15-year plan program adopted pursuant to this paragraph representatives of the affected industry, environmental, and public interest groups as well as impacted governmental entities.
(4) Consistent with the provisions of P.L.1991, c.422 (C.13:1D-111 et seq.), the department shall periodically publish, with an opportunity provided for public comment, technology, methods, and performance levels with respect to air pollution control for use by applicants for demonstrating advances in the art of air pollution control.
(a) The department shall, within 18 months after the effective date of P.L.1995, c.188 (C.26:2C-9.5 et al.), publish the first technical manual containing technology, methods, and performance levels that can be used by applicants for demonstrating advances in the art of air pollution control. Public notice of the availability of each draft technical manual shall be published in the New Jersey Register, and each final technical manual shall consider any public comments thereon that are received by the department.
(b) Once the department has published a technical manual for advances in the art of air pollution pursuant to subparagraph (a) of paragraph (4) of this subsection, any application submitted that demonstrates compliance with that technical manual shall be considered to incorporate advances in the art of air pollution control for the source operations covered by the technical manual. The department shall periodically review and update each technical manual as necessary, after providing public notice and opportunity for public comment. If the department amends a technical manual, the new standard shall apply only to applications submitted after the final publication of the amended technical manual.
(c) Instead of relying on a technical manual for advances in the art of air pollution control, an applicant may propose "case-by-case" advances in the art of air pollution control applicable to a specific source operation. If the department determines that the proposal is consistent with the provisions of this subsection, the proposal shall be deemed to constitute advances in the art of air pollution control for that specific source operation.
(d) Advances in the art of air pollution control shall include new source performance standards adopted by the EPA on or after the effective date of P.L.1995, c.188 (C.26:2C-9.5 et al.) and those new source performance standards published as advances in the art of air pollution control pursuant to P.L.1954, c.212 (C.26:2C-1 et seq.).
(5) Before an operating permit, operating permit revision or operating certificate or any renewal thereof is issued, or as a condition of issuance, the department may require the applicant to conduct such tests as are necessary to determine the kind or amount of the air contaminant emitted from the equipment or whether the equipment or fuel or the operation of the equipment is in violation of any of the provisions of P.L.1954, c.212 (C.26:2C-1 et seq.) or of any codes, rules, or regulations adopted pursuant thereto. The tests shall be made at the expense of the applicant and shall be conducted in a manner approved by the department, and the test results shall be reviewed and professionally certified.
(6) Grandfathered equipment or control apparatus shall not be subject to a demonstration of advances in the art of air pollution control.
(7) An operating permit and operating certificate or any renewal thereof shall be valid for a period of five years from the date of issuance, unless sooner revoked for cause by order of the department, and may be renewed upon application to the department.
(8) Upon receipt of an application for the issuance of an operating certificate or any renewal thereof, the department, in its discretion, may issue a temporary operating certificate valid for 90 days or until a five-year operating certificate has been issued or denied.
d. The following are exempt from the provisions of subsections a. and b. of this section:
(1) One or two family dwellings;
(2) A dwelling of six or less family units, one of which is owner occupied;
(3) Equipment or control apparatus that is subject to a general permit issued pursuant to subsection h. of this section; and
(4) Equipment and control apparatus that is de minimis in terms of size or emissions as prescribed in rules and regulations that shall be adopted by the department pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.).
e. Except as otherwise prohibited by the EPA pursuant to the federal Clean Air Act, any person who has received or receives a facility-wide permit issued pursuant to the "Pollution Prevention Act," P.L.1991, c.235 (C.13:1D-35 et seq.) shall be deemed to satisfy the requirement for an operating permit issued pursuant to P.L.1954, c.212 (C.26:2C-1 et seq.).
f. The department may establish policies and procedures for categories of operations that specify the procedures to be followed for obtaining any permit required pursuant to this section.
g. Any requirement solely related to an air contaminant regulated by the department that is not a federally regulated air pollutant or contaminant shall be identified in an operating permit as a State-only requirement that would not be federally enforceable.
h. Notwithstanding the provisions of any other law, rule, or regulation to the contrary, the department may issue a general permit in lieu of any permit issued pursuant to this section. Prior to issuing a general permit, the department shall provide public notice and opportunity for public comment.
i. The department may require the reporting and evaluation of emissions information for any air contaminant. However, prior to requiring that such information be included on a permit or regulating any air contaminant not regulated by the EPA pursuant to the federal Clean Air Act, the department shall first make a determination and advise the public of its conclusion that regulating that air contaminant is in the best interest of human health, welfare and the environment, and publish that determination and justification in accordance with the provisions of the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.).
j. Except as otherwise prohibited by federal law, any person who has submitted to the department an application for a permit to construct, reconstruct, install, or modify equipment or control apparatus may place that equipment or control apparatus on the footings or foundation where it is intended to be used during the pendency of the permit application review process. A person intending to take action authorized pursuant to this subsection shall notify the department, via certified mail, of the intent to undertake the action at least seven days prior to the commencement of the action.
A person who constructs equipment or control apparatus in accordance with this subsection that the department determines is not consistent with applicable State laws, codes, rules, or regulations shall not be subject to civil or criminal penalties for that inconsistent action provided that the person's actions do not result in the emission of any air contaminants. Any costs incurred by the applicant in connection with such construction may not be used by the applicant as grounds for an appeal of the department's decision on the permit application.
k. For the purposes of P.L.1954, c.212 (C.26:2C-1 et seq.), the use of VOCs not otherwise listed by the EPA as hazardous air pollutants, or specified by the department pursuant to subsection i. of this section, shall be considered as a single pollutant. These VOCs may be used interchangeably and such use shall not be considered new installation or modification of equipment or control apparatus.
The Legislature therefore determines that it is within the public interest to allow private entities who have applied for permits to construct, install, maintain or operate pollution control equipment or devices or for permits to implement pollution prevention process modifications to undertake such construction, installation, maintenance or operation or to implement such process modifications while the department is reviewing their permit application, but with the clear and full understanding that they assume all risks for their actions.
Nothing in this section shall be construed to limit the department's discretion in establishing construction, installation, maintenance, and operating standards for such equipment or devices, or in otherwise reviewing the permit application, nor shall the costs incurred by the applicant for the construction, installation, maintenance or operation of such equipment or devices or the implementation of pollution prevention process modifications during the pendency of the permit application review process be used by an applicant as grounds for an appeal of the department's decision on the permit application. If the department determines that any pollution control equipment or devices or pollution prevention process modifications constructed, installed, maintained or implemented during the pendency of the permit application review process are not consistent with applicable federal and State laws, rules, or regulations, the department and the applicant shall enter into an agreement containing a schedule setting forth a date certain on which the applicant shall modify, replace or cease the operation of the pollution control equipment or devices or implementation of the pollution prevention process modifications. If the department and the applicant shall fail to enter into an agreement, the department may issue a schedule setting forth a date certain on which the applicant shall comply.
Failure of the applicant to comply with the schedule setting forth a date for compliance shall constitute a violation of P.L.1954, c.212 (C.26:2C-1 et seq.), and shall subject the applicant to penalties as prescribed by that act. A person who constructs, installs, maintains, or operates pollution control equipment or devices or who implements pollution prevention process modifications that the department determines are not consistent with applicable federal or State laws, rules, or regulations, shall not be subject to civil or criminal penalties for that inconsistent action as long as the person's actions do not result in (1) the emission of an air contaminant that was not previously being emitted or that was not authorized to be emitted by the person's permit or certificate; or (2) an exceedance of any applicable air contaminant emission level in the permit or certificate.
Nothing in this section shall be construed to authorize the emission of an air contaminant not otherwise authorized to be emitted under a permit or certificate or the emission of an air contaminant at a level in excess of the air contaminant emission limitations contained in the permit or certificate. The provisions of this section shall not be construed to authorize or permit any construction, installation, maintenance, or operation which would result in any new air contaminant emissions but shall only apply to existing sources of air contaminant emissions.
As used in this section:
(1) "private entity" means any private individual, corporation, company, partnership, firm, association, owner or operator but shall not include, and the provisions of this section shall not apply to, any municipal, county, or State agency or authority or to any agency, authority or subdivision created by one or more municipal, county or State governments;
(2) "pollution prevention process modifications" means any physical or operational change to a process which reduces air contaminant emissions to the environment.
(2) Emission fees for each State fiscal year shall be based on the information reported in the emission statement year two years prior thereto.
(3) The amount of any emission fee payable pursuant to this section shall be adjusted for each State fiscal year by the percentage, if any, by which the CPI exceeds the CPI for calendar year 1989.
b. (Deleted by amendment, P.L.2002, c.34).
c. (Deleted by amendment, P.L.2002, c.34).
d. (1) For the State fiscal year 2003 and each fiscal year thereafter, each major facility shall pay the following fees:
(a) An emission fee of $60 (in 1989 dollars adjusted by the CPI) per ton of each regulated air contaminant;
(b) An initial and renewal operating permit application fee per facility not to exceed $50,000. For the purpose of calculating the initial and renewal operating permit application fee, the significant equipment listed in the operating permit application shall be assessed at $125 per piece of equipment. The operating permit application fee shall be submitted at the time of submission of the operating permit application; and
(c) A fee for any significant modification in an amount calculated using a fee schedule therefor to be set forth in rules and regulations to be adopted by the department, except that no fee for a significant modification review shall exceed $50,000.
(2) Notwithstanding the provisions of paragraph (1) of this subsection to the contrary, no major facility shall pay an emission fee less than $3,000 for each of the State fiscal years 2003 and thereafter.
e. (Deleted by amendment, P.L.2002, c.34).
f. (Deleted by amendment, P.L.2002, c.34).
g. The provisions of P.L.1993, c.361 (C.13:1D-120 et seq.) shall not apply to the assessment or payment of emission fees required pursuant to this section.
h. (Deleted by amendment, P.L.2002, c.34).
a. An accounting of all direct and indirect costs incurred by the operating permit program; the revenues received from fees; a list of all fees still due; and the amount of penalties imposed and collected during the previous year; and
b. A staff and workload analysis of all components of the program to regulate, monitor, and control or prevent emissions of air contaminants.
The report shall also identify any need for legislative action to adjust the emission fee prescribed pursuant to section 5 of P.L.1995, c.188 (C.26:2C-9.5) to ensure that the fee is adequate to fund the air pollution control program in accordance with the mandates of the federal Clean Air Act, and discuss the advantages and disadvantages of setting higher emission fees for hazardous air pollutants.
b. The emissions trading rules and regulations shall be designed so that emissions reductions shall be realized earlier or at a more accelerated rate than would otherwise be achieved in accordance with applicable air quality mandates, and so that compliance with air quality mandates can be achieved with greater flexibility or at lower cost. The rules and regulations shall establish criteria for the generation and use of emissions reduction credits, including the use of emissions reduction credits in lieu of granting exemptions or waivers from compliance with emissions reduction requirements, and shall require that 10% of the emissions reduction credits gained shall be permanently retired for the public benefit when a trade occurs. The rules and regulations may include, but need not be limited to, provisions designating the pollutants to be involved in the program, designating the persons who may participate in the program, establishing emissions limitations and methods for projecting and verifying emissions, and establishing enforcement mechanisms, including emissions tracking, periodic program audits, and penalties.
For any emissions trading program adopted for the purpose of making progress toward attaining the National Ambient Air Quality Standard (NAAQS) for ozone, the department may allow reductions of volatile organic compounds (VOCs) to be substituted for required reductions of oxides of nitrogen (NOx) or reductions of oxides of nitrogen (NOx) to be substituted for required reductions of volatile organic compounds (VOCs). Any such substitution shall occur at a ratio established by the department by rule or regulation adopted pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.), which shall be developed in recognition of the role of each pollutant in the formation of ground level ozone.
c. The emissions trading rules and regulations adopted by the department shall not conflict with applicable federal law and shall constitute, contribute to, or be consistent with one or more strategies that result in quantifiable emissions reductions and are creditable under the State Implementation Plan (SIP) required pursuant to the federal Clean Air Act. These may be emission limiting or market-response strategies for mobile, stationary, or area sources, and shall include the creation, trading, and use of emissions reduction credits.
d. The department may establish the emissions trading programs as State, multi-state, or regional programs as long as the programs contribute to the goal of improving the air quality in New Jersey.
e. The department shall involve in the development of the rules and regulations for emissions trading programs representatives of the affected industry, environmental, and public interest groups as well as governmental entities with affected or related jurisdictions.
f. The department shall consider the role of a third party in the banking, verification, validation of use, enforcement, and program audits associated with emissions reduction credits, and, to the maximum extent possible, create and preserve opportunities for private sector participation in any emissions trading program established by the department.
g. The Department of Environmental Protection may establish by rule fees for administrative services provided to implement emission trading programs.
Whenever the department has cause to believe that any person is violating any code, rule or regulation promulgated by the department, the department shall cause a prompt investigation to be made in connection therewith.
If upon inspection the department discovers a condition which is in violation of the provisions of this act or any code, rule or regulation promulgated pursuant thereto, it shall be authorized to order such violation to cease and to take such steps necessary to enforce such an order. The order to cease the violation issued by the commissioner and sent to the violator by certified mail or personal service shall include a reference to the section of the statute, regulation, order, or permit condition violated; the amount of the fine which shall be imposed; a concise statement of the facts alleged to constitute the violation; and a statement of the right of the violator to a hearing.
The person responsible shall make the corrections necessary to comply with the requirements of this act or code, rule or regulation promulgated pursuant thereto within the time specified in the order.
Nothing herein shall be deemed to prevent the department from prosecuting any violation of this act or any code, rule or regulation promulgated pursuant thereto, notwithstanding that such violation is corrected in accordance with its order.
Any person aggrieved by an order of the department has 20 days from receipt of the order within which to deliver to the commissioner a written request for a hearing. Subsequent to the hearing, if requested, and upon a finding that a violation has occurred, the commissioner may issue a final order to cease the violation and assessing the amount of the fine specified in the order. If no hearing is requested, the order is a final order upon the expiration of the 20 day period. Payment of the penalty is due when a final order is issued or when the order becomes a final order. The authority to levy a civil administrative penalty is in addition to all other enforcement provisions in P.L. 1954, c. 212 (C. 26:2C-1 et seq.), and the payment of a civil administrative penalty does not affect the availability of any other enforcement provision in connection with the violation for which the penalty is levied. Pending the determination by the department and upon application therefor the department may stay the operation of such order upon such terms and conditions as it may deem proper.
The testimony taken at any hearing shall be under oath and recorded stenographically, but the parties shall not be bound by the strict rules of evidence prevailing in the courts of law and equity. True copies of any transcript and of any other record made of or at such hearing shall be furnished to any party thereto upon request and at his expense.
Any hearing required by this act to be held before the department shall be held before the State Commission of Health, or a member of the department designated by him, who shall have power to subpoena witnesses and compel their attendance, administer oaths and require the production for examination of any books or papers relating to any matter under investigation in any such hearing. The department, at the request of any respondent to a complaint made by it, or to it, pursuant to this act, shall subpoena and compel the attendance of such witnesses as the respondent may designate and require the production for examination of any books or papers relating to any matter under investigation in any such hearing.
b. Any person who violates the provisions of P.L.1954, c.212 (C.26:2C-1 et seq.) or any code, rule, regulation or order adopted or issued pursuant thereto shall be liable to a civil administrative penalty of not more than $10,000 for the first offense, not more than $25,000 for the second offense, and not more than $50,000 for the third and each subsequent offense. If the violation is of a continuing nature, each day during which it continues shall constitute an additional, separate and distinct offense. No civil administrative penalty shall be levied except upon an administrative order issued pursuant to section 14 of P.L.1954, c.212 (C.26:2C-14).
c. The department is hereby authorized and empowered to compromise and settle any claim for a penalty under this section in such amount in the discretion of the department as may appear appropriate and equitable under all of the circumstances.
d. Any person who violates the provisions of P.L.1954, c.212 (C.26:2C-1 et seq.) or any code, rule, regulation, or order adopted or issued pursuant thereto, or a court order issued pursuant to subsection a. of this section, or who fails to pay a civil administrative penalty in full pursuant to section 9 of P.L.1962, c.215 (C.26:2C-14.1), is subject, upon order of the court, to a civil penalty of not more than $10,000 for the first offense, not more than $25,000 for the second offense, and not more than $50,000 for the third and each subsequent offense. If the violation is of a continuing nature, each day during which the violation continues, or each day in which the civil administrative penalty is not paid in full, constitutes an additional, separate and distinct offense. Any penalty imposed under this subsection may be recovered with costs in a summary proceeding pursuant to "the penalty enforcement law" (N.J.S.2A:58-1 et seq.). The Law Division of the Superior Court has jurisdiction to enforce "the penalty enforcement law."
e. A person who causes a release of air contaminants in a quantity or concentration which poses a potential threat to public health, welfare or the environment or which might reasonably result in citizen complaints shall immediately notify the department. A person who fails to so notify the department is liable to the penalties and procedures prescribed in this section.
f. Any person who:
(1) purposely or knowingly violates the provisions of P.L.1954, c.212 (C.26:2C-1 et seq.), or any code, rule, regulation, administrative order, or court order adopted or issued pursuant thereto, is guilty of a crime of the third degree;
(2) purposely or knowingly violates any federally mandated air pollution control requirement, any operating permit condition, or any fee or filing requirement imposed in connection with an operating permit is guilty of a crime of the third degree, the sentence for which may include, notwithstanding the provisions of subsection b. of N.J.S.2C:43-3, an enhanced fine of $10,000 per day per violation;
(3) purposely or knowingly makes any false material statement, representation, or certification in any form, notice, statement, or report required in connection with an operating permit, or who purposely or knowingly renders inaccurate any monitoring device or method required by an operating permit, is guilty of a crime of the third degree, the sentence for which may include, notwithstanding the provisions of subsection b. of N.J.S.2C:43-3, an enhanced fine of $10,000 per day per violation;
(4) recklessly violates the provisions of P.L.1954, c.212 (C.26:2C-1 et seq.), or any code, rule, regulation, administrative order, or court order adopted or issued pursuant thereto, is guilty of a crime of the fourth degree.
g. In determining whether an odor unreasonably interferes with the enjoyment of life or property in violation of P.L.1954, c.212 (C.26:2C-1 et seq.) or any code, rule, regulation or order adopted or issued pursuant thereto, the department shall consider all of the relevant facts and circumstances, including, but not limited to, the character, severity, frequency, and duration of the odor, and the number of persons affected thereby. In considering these and other relevant facts and circumstances, no one factor shall be dispositive, but each shall be considered relevant in determining whether an odor interferes with the enjoyment of life or property, and, if so, whether such interference is unreasonable considering all of the circumstances.
The department shall publish in the New Jersey Register the guidelines and procedures utilized by the department for the investigation of citizen complaints regarding odors.
h. The department shall establish procedures for alternative dispute resolution as an option for settlement of contested cases. Alternative dispute resolution shall be voluntary and shall not be mandated by the department.
b. A person asserting an affirmative defense pursuant to subsection a. of this section shall notify the department of the violation by 5:00 p.m. of the second full calendar day following the occurrence, or if due diligence was exercised to discover the violation, by 5:00 p.m. of the second full calendar day after becoming aware of the occurrence, and, within 30 days thereof, shall submit written documentation on the circumstances of the violation and demonstrating as applicable, that:
(1) the violation occurred, and was caused by an equipment malfunction, an equipment start-up, or an equipment shut-down, or during the performance of necessary equipment maintenance, as applicable;
(2) the facility was being operated with due care;
(3) the violation did not result from operator error or failure to maintain the equipment with due care;
(4) the person has taken all reasonable steps to minimize levels of emissions caused by the violation; and
(5) with respect to violations caused by a malfunction, the malfunction is not a part of a recurrent pattern.
b. The affirmative defense established pursuant to section 2 of P.L.1993, c.89 (C.26:2C-19.2), shall not be available with respect to violations arising from equipment malfunctions, equipment start-ups, or equipment shut-downs, or during necessary equipment maintenance operations, that occur more frequently or persist for a longer duration than the maximum limitations established pursuant to subsection a. of this section.
Review of any final decision or action by the department shall be by procedure in lieu of prerogative writs. Review of the validity of any code, rule or regulation promulgated by the department shall likewise be by procedure in lieu of prerogative writs.
No existing civil or criminal remedy for any wrongful action which is a violation of any code, rule or regulation of the commission shall be excluded or impaired by this act.
Penalties for violations of ordinances of a governing body of a municipality or county or board of health shall not exceed $2,500.
Nothing set forth in the "County Environmental Health Act," P.L.1977, c.443 (C.26:3A2-21 et al.), or any codes, rules or regulations adopted pursuant thereto, shall affect the validity of local ordinances adopted pursuant to this section prior to the effective date of P.L.1995, c.188 (C.26:2C-9.5 et al.) or amendments thereto adopted as authorized pursuant to subsection b. of this section.
b. Notwithstanding the provisions of subsection a. of this section to the contrary, no fee imposed upon any facility by the governing body of a municipality or county or board of health relating to the control of air pollution, which fee was imposed pursuant to this section, section 7 of P.L.1991, c.99 (C.26:3A2-34), or any other law, may be increased above the amount imposed upon that facility as of June 15, 1995. In no event may any such fee imposed upon any facility exceed a total of $1,000 per year over a given fee cycle and any such fee that exceeds that amount shall be reduced to $1,000 after the effective date of P.L.1995, c.188 (C.26:2C-9.5 et al.). Ordinances adopted prior to the effective date of P.L.1995, c.188 (C.26:2C-9.5 et al.) that impose fees exceeding the $1,000 limit shall be amended to conform to the provisions of this subsection at or before the end of the present ordinance fee cycle. In order to prevent the pass through of fees capped by this section onto any facility engaging in activities not related to the control of air pollution, no fee imposed pursuant to section 7 of P.L.1991, c.99 (C.26:3A2-34) for such activities may be increased above the amount imposed upon that facility as of June 15, 1995.
c. Notwithstanding the provisions of subsection a. or b. of this section to the contrary, nothing in this section or in the "County Environmental Health Act," P.L.1977, c.443 (C.26:3A2-21 et al.) shall be construed to authorize ordinances providing for the local regulation of, or collection of fees from, any facility required to obtain an operating permit pursuant to section 13 of P.L.1967, c.106 (C.26:2C-9.2) or any research and development facility. However, local inspections of such facilities or research and development facilities delegated pursuant to the "County Environmental Health Act," P.L.1977, c.443 (C.26:3A2-21 et al.) may be conducted as necessary in response to citizen complaints.
The powers, duties and functions vested in the State Department of Health under the provisions of this act shall not be construed to affect in any manner the powers, duties and functions vested in the State Department of Health under any other provisions of law.
(a) There is hereby established a Clean Air Scholarship Intern Program.
(b) The Commissioner of the Department of Environmental Protection may provide for the payment of room, board, tuition and fees for eligible persons to attend any accredited college or university authorized by the commissioner as a regular student to receive an engineering degree or a degree with a major in the biological, physical or environmental sciences satisfactory to the commissioner until the eligible person satisfactorily completes 4 scholastic years.
(c) To be eligible for the Clean Air Scholarship Intern Program a person must:
(1) Be a citizen of the United States and the State of New Jersey;
(2) Be a high school graduate or have an equivalent education;
(3) Have been accepted for admission to the accredited college or university authorized by the commissioner as a regular student and accepted in said college or university to pursue a course of instruction satisfactory to the commissioner;
(4) Contract, with the consent of his parent or legal guardian if he is a minor, with the commissioner or his designated representative, to serve with the Department of Environmental Protection for a period of 3 years following graduation and further, to serve with the Department of Environmental Protection during the regular periods of summer vacation except for such vacation periods as the commissioner shall establish by regulation and provided further that the department shall not be liable to pay wages to said student during said vacation periods.
(d) The appointments made by the commissioner hereunder shall be subject to available appropriations and shall be awarded on a competitive basis.
(e) The Scholarship Intern Program shall be administered by the commissioner under such regulations as the commissioner shall prescribe.
The commissioner, subject to available appropriations and grants from other sources, may provide within the Department of Health for a program of graduate study for eligible persons to attend any accredited graduate program at a college or university in order to further the training of personnel for the purposes of administering this act. Said graduate program shall be administered by the commissioner under such regulations as the commissioner shall prescribe.
a. The Small Business Compliance Advisory Panel shall consist of seven members, as follows:
(1) two members, appointed by the Governor, who shall represent the general public and shall not be owners, or representatives of owners, of small business stationary sources;
(2) four members who shall own a small business stationary source or represent owners of small business stationary sources, of whom one each shall be appointed respectively by the President of the Senate, the Speaker of the General Assembly, the Senate Minority Leader, and the Assembly Minority Leader; and
(3) one member who shall be appointed by the Commissioner of Environmental Protection as the commissioner's representative.
b. (1) Members of the panel shall:
(a) serve for two-year terms;
(b) annually elect, by majority vote of the full membership of the panel, a chairperson and a vice-chairperson; and
(c) serve without compensation but shall be reimbursed for necessary expenses incurred in the performance of their duties.
(2) The panel shall meet at least four times per year.
c. It shall be the responsibility of the panel to:
(1) render advisory opinions to the Commissioner of Environmental Protection concerning the effectiveness of the department's program for assisting small business stationary sources with technical and environmental compliance issues with respect to air pollution control, as required pursuant to 42 U.S.C. 7661f of the federal Clean Air Act, and concerning air pollution control requirements, permitting, and enforcement pertaining to small business;
(2) make periodic reports to the Commissioner of Environmental Protection and the Administrator of the United States Environmental Protection Agency concerning compliance of the State's air pollution control program with the requirements of the federal "Paperwork Reduction Act" (44 U.S.C. 3501 et seq.), the federal "Regulatory Flexibility Act" (5 U.S.C. 601 et seq.), and the federal "Equal Access to Justice Act" (5 U.S.C. 504 et seq. and 28 U.S.C. 2412 et seq.) as they relate to small business;
(3) review information and air pollution control permit applications provided to small business stationary sources to assure that the information and applications are understandable to the layperson; and
(4) determine if the department provides for the development and dissemination of those advisory opinions and reports issued in accordance with the provisions of this section.
Within 90 days after the effective date of P.L.1995, c.188 (C.26:2C-9.5 et al.), the department shall also establish an industry and environmental work group to evaluate the effects of emissions reductions on emission fee revenues and the resultant impact on the department's air pollution control program. As part of the 1997 annual report required pursuant to section 7 of P.L.1995, c.188 (C.26:2C-9.7), the fee work group shall present its evaluation and a recommendation on alternatives to funding the department's air pollution control program other than through an increase in emission fees.
The fee work group shall also make such evaluations and recommendations concerning fee revenues and supplemental surcharge revenues as required pursuant to section 5 of P.L.1995, c.188 (C.26:2C-9.5).
This act shall be known and may be cited as the "Air Pollution Emergency Control Act (1967)."
The Legislature finds and declares that air pollution may at certain times and in certain places so seriously affect the health of the public and so directly threaten the lives of large portions of the population as to warrant the provision of emergency powers as in this act provided to prevent or minimize disasters of unforseeable proportions.
As used in this act "area" means and refers not only to that portion or portions of the State as shall be described in the air pollution emergency declaration of the Governor but also to any other portion or portions of the State where activities are carried on which contribute or may contribute to the air pollution emergency in the portion or portions of the State described in the Governor's declaration.
If the State Commissioner of Health determines at any time that air pollution, in any county, locality, place or other area in the State constitutes an unreasonable and emergency risk to the health of those present within said area of the State, such determination shall be communicated in writing, with the factual findings on which such determination is based, to the Governor; the commissioner may delegate in writing to any employee of the department the power to make such determination and deliver the same to the Governor in the absence of the commissioner from the State. Upon being so advised the Governor may by proclamation declare, as to all or any part of said area mentioned in the aforesaid determination, that an air pollution emergency exists, and upon making such declaration the Governor shall have the following powers which he may exercise in whole or in part by the issuance of an order or orders:
(a) To prohibit, restrict or condition motor vehicle travel of every kind, including trucks and buses, in the area;
(b) To prohibit, restrict or condition the operation of retail, commercial, manufacturing, industrial, or similar activity in the area;
(c) To prohibit, restrict or condition operation of incinerators in the area;
(d) To prohibit, restrict or condition the burning or other consumption of any type of fuel in the area;
(e) To prohibit, restrict or condition the burning of any materials whatsoever in the area;
(f) To prohibit, restrict or condition any and all other activity in the area which contributes or may contribute to the air pollution emergency.
The declaration by proclamation of the Governor of an air pollution emergency and any order issued by the Governor pursuant to such declaration shall be given maximum publicity throughout the State.
Any gubernatorial order may be amended or modified by further gubernatorial orders. Said order or orders shall not require any judicial or other order or confirmation of any type in order to become immediately effective as the legal obligation of all persons, firms, corporations and other entities within the State. Said order shall remain in effect for the duration of time set forth in same, and if no time limit is specified in said order, same shall remain in effect until the Governor declares by further proclamation that the emergency has terminated.
The aforesaid orders of the Governor shall be enforced by the Departments of Health, Defense, and the State and local police and air pollution enforcement personnel forces. Those enforcing any Governor's order shall require no further authority or warrant in executing same than the issuance of the order itself. Those authorized to enforce said orders may use such reasonable force as is required in the enforcement thereof, and may take such reasonable steps as are required to assure compliance therewith including, but without limiting the generality of the foregoing, the following:
(a) Entering any property or establishment whatsoever, commercial, industrial, or residential, believed to be violating said order (excepting single or double family homes or any dwelling unit within a multiple dwelling unit larger than a double family home) and, if a request does not produce compliance, causing compliance with said order;
(b) Stopping, detouring, rerouting, and prohibiting motor vehicle travel and traffic;
(c) Disconnecting incinerator or other types of combustion facilities;
(d) Terminating all burning activities;
(e) Closing down or restricting the use of any business, commercial, retail, manufacturing, industrial or other establishment.
Where any person authorized to enforce such an order believes or suspects that same is being violated in a single or double family residence or within the dwelling portion of a large multiple dwelling unit, said residence or dwelling portion thereof may be entered only upon obtaining a search warrant from any judge having power to issue same.
Any person, firm, corporation or other entity within this State which violates any Governor's order with knowledge of same, or knowingly fails to comply with the directions of those authorized by the Governor to enforce said order, or knowingly interferes with the enforcement of such an order or such directions, shall be guilty of a high misdemeanor and shall be punished by a fine of not more than $100,000.00 or by imprisonment for not more than 10 years, or both.
No cause of action against the State or any person authorized by the Governor to enforce any order issued pursuant to this act for false arrests, false imprisonment, or other tort shall arise out of the good faith attempt of such person to enforce such order.
Any aggrieved person, firm or corporation or other entity upon application to the commissioner shall be granted a public hearing on the question of whether or not the continuance of any such order in whole or in part is unreasonable in the light of the then prevailing conditions of air pollution, the contribution to the same of any particular activity, and the purposes of this act. Said public hearing shall be conducted as quickly as possible by said commissioner who shall give public notice of same. The commissioner shall have the power to compel attendance, testimony, and the production of documents by the use of subpoena powers. The number of witnesses and the extent of testimony shall be within his control. If the commissioner, upon conclusion of such hearing, determines that any such order should be terminated, or modified in any way whatsoever, he shall report such findings and recommendations to the Governor for such action as he deems appropriate.
The commissioner shall promulgate a set of proposed stand-by orders which might be appropriate for use by the Governor upon declaration of the emergency contemplated by this act. Such stand-by control proposals, when approved by the Governor, shall be distributed to the appropriate agencies and to all commercial and industrial concerns throughout this State concerned with enforcement or impact of this act, and notice of their contents shall be given to the public. The commissioner shall promulgate arrangements for the enforcement of said stand-by orders and, upon approval by the Governor, notice of said arrangements shall also be distributed to said authorities, commercial and industrial concerns, and to the general public. Said proposed stand-by orders and arrangements shall not, however, become operative except when directed by the Governor in any order issued by him pursuant to a declaration of emergency under this act.
The Legislature further finds and declares that, while carbon dioxide is the primary and most abundant greenhouse gas, other greenhouse gases known as short-lived climate pollutants, including black carbon, fluorinated gases, and methane, create a warming influence on the climate that is many times more potent over a shorter period of time than that of carbon dioxide, and have a dramatic and detrimental effect on air quality, public health, and climate change; and that reducing emissions of these pollutants can have an immediate beneficial impact on climate change and public health.
The Legislature therefore finds and declares that it is in the public interest to establish a greenhouse gas emissions reduction program that includes a comprehensive strategy to reduce short-lived climate pollutants and to limit the level of Statewide greenhouse gas emissions, and greenhouse gas emissions from electricity generated outside the State but consumed in the State, to the 1990 level or below, of those emissions by the year 2020, and to reduce those emissions to 80 percent below the 2006 level by the year 2050.
"Department" means the Department of Environmental Protection.
"Greenhouse gas" means carbon dioxide, methane, nitrous oxide, hydrofluorocarbons, perfluorocarbons, sulfur hexafluoride, and any other gas or substance determined by the Department of Environmental Protection to be a significant contributor to the problem of global warming.
"Statewide greenhouse gas emissions" means the sum of calendar year emissions of greenhouse gases from all sources within the State, and from electricity generated outside the State but consumed in the State, as determined by the department pursuant to subsection c. of section 5 of P.L.2007, c.112 (C.26:2C-41).
"2020 limit" means the level of greenhouse gas emissions equal to the 1990 level of Statewide greenhouse gas emissions.
"2050 limit" means the level of greenhouse gas emissions equal to 80 percent less than the 2006 level of Statewide greenhouse gas emissions.
b. No later than one year after the date of enactment of this act, the department shall establish:
(1) an inventory of the current and 2006 Statewide greenhouse gas emissions; and
(2) an inventory of the 1990 level of Statewide greenhouse gas emissions.
b. The rules and regulations adopted pursuant to subsection a. of this section shall identify all significant sources of Statewide greenhouse gas emissions including short-lived climate pollutants, and shall provide for, but need not be limited to, the following:
(1) monitoring and reporting of existing emissions and changes in emissions over time from the sources identified by the department;
(2) reporting the levels of those emissions and changes in those emissions levels annually, commencing 18 months after the effective date of P.L.2019, c.197; and
(3) monitoring progress toward the 2020 limit and the 2050 limit and any interim limits.
c. Pursuant to the rules and regulations adopted pursuant to subsection a. of this section, the department shall require reporting of the greenhouse gas emissions:
(1) associated with fossil fuels used in the State, as reported by entities that are manufacturers and distributors of fossil fuels, which may include, but need not be limited to, oil refineries, oil storage facilities, natural gas pipelines, and fuel wholesale and retail distributors;
(2) from any entity generating electricity in the State and from any entity that generates electricity outside the State that is delivered for end use in the State. With respect to electricity generated outside the State and imported into the State, the department shall determine the emissions from that generation by subtracting the kilowatt-hours of electricity generated in the State from the kilowatt-hours of electricity consumed in the State, and multiplying the difference by a default emissions rate determined by the department;
(3) from any gas public utility as defined in section 3 of P.L.1999, c.23 (C.48:3-51); and
(4) from any additional entities that are significant emitters of greenhouse gases, as determined by the department, and as appropriate to enable the department to monitor compliance with progress toward the 2020 limit and the 2050 limit.
d. No later than 18 months after the department prepares and transmits the report as required pursuant to subsection c. of section 6 of P.L.2007, c.112 (C.26:2C-42), the department shall adopt, pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.), rules and regulations establishing interim benchmarks necessary to achieve the 2050 limit, and measures necessary to achieve the 2050 limit and the established interim benchmarks.
b. No later than June 30, 2008, the department, and any other State agencies, as appropriate, shall prepare a report recommending the measures necessary to reduce greenhouse gas emissions to achieve the 2020 limit. The report shall include specific recommendations for legislative and regulatory action that will be necessary to achieve the 2020 limit. The report shall be transmitted to the Governor, to the State Treasurer, to the Legislature pursuant to section 2 of P.L.1991, c.164 (C.52:14-19.1) and to the members of the Senate Environment Committee and the Assembly Environment and Solid Waste Committee.
c. No later than one year after the effective date of P.L.2019, c.197, the department, in consultation with the Board of Public Utilities and any other State agencies, as appropriate, shall prepare a report recommending the measures necessary to reduce greenhouse gas emissions, including short-lived climate pollutants, to achieve the 2050 limit. The report shall include specific recommendations for legislative and regulatory action that will be necessary to achieve the 2050 limit and any established interim benchmarks. The report shall also include recommendations for additional policies and measures that will be required if the State is otherwise expected to exceed the 2020 limit and any additional measures that will be required to meet the 2050 limit. The report shall be transmitted to the Governor, to the State Treasurer, to the Legislature pursuant to section 2 of P.L.1991, c.164 (C.52:14-19.1) and to the members of the Senate Environment Committee and the Assembly Environment and Solid Waste Committee.
d. The Energy Master Plan Committee shall include in its adoption of the first update of the energy master plan completed after the date of enactment of P.L.2007, c.112 (C.26:2C-37 et al.), a list of recommended policies and measures to reduce the emission of greenhouse gases from the production, processing, distribution, transmission, storage, or use of energy that will contribute to achieving the 2020 limit.
e. Nothing in P.L.2007, c.112 (C.26:2C-37 et al.) shall impose any limit on the existing authority of the department, the Board of Public Utilities, or any other State department or agency to limit or regulate greenhouse gas emissions pursuant to law.
b. As part of the reports required pursuant to subsection a. of this section, the department shall evaluate the ecological, economic, and environmental factors and the technological capability affecting the attainment or maintenance of the 2020 limit and the 2050 limit established pursuant to this act.
b. The independent research review panel shall review the recommendations and evaluations of the department and any other State agencies, as appropriate, and shall, within 12 months of the date of transmittal of the reports required pursuant to section 6 of this act, prepare and transmit a report evaluating the ecological, economic and social impact of the proposed recommendations submitted by the department and any other State agencies, as appropriate, to the Governor, to the State Treasurer, to the Legislature pursuant to section 2 of P.L.1991, c.164 (C.52:14-19.1) and to the members of the Senate Environment Committee and the Assembly Environment and Solid Waste Committee.
c. This section shall not be construed to affect the requirements of the greenhouse gas emissions monitoring and reporting program or the department's administration of the program established pursuant to this act.
The Legislature further finds and declares that entering into agreements or arrangements with appropriate representatives of other states furthers the purposes of P.L.2007, c.340 (C.26:2C-45 et al.) and the "Global Warming Response Act," P.L.2007, c.112 (C.26:2C-37 et al.).
The Legislature further finds and declares that any carbon dioxide emissions allowance trading program established in the State to reduce emissions of greenhouse gases must provide both incentives to reduce emissions at their sources and funding or other consumer benefit incentives to reduce the demand for energy, which in turn would reduce the generation and emission of greenhouse gases.
The Legislature further finds and declares that funding consumer benefit purposes will result in reduced costs to New Jersey consumers, decreased energy use, decreased greenhouse gas emissions, and substantial and tangible benefits to the energy-using business sector.
The Legislature further finds and declares that efforts to reduce greenhouse gas emissions in New Jersey must include complementary programs to reduce greenhouse gas emissions from electricity generated outside of the State but consumed in New Jersey, and that one measure that may be most effective in doing so is the adoption of a greenhouse gas emissions portfolio standard as authorized pursuant to the "Global Warming Response Act," P.L.2007, c.112 (C.26:2C-37 et al.) and section 38 of P.L.1999, c.23 (C.48:3-87).
The Legislature further finds and declares that energy efficiency and conservation measures and increased use of renewable energy resources must be essential elements of the State's energy future and that greater reliance on energy efficiency, conservation, and renewable energy resources will provide significant benefits to the citizens of this State.
The Legislature further finds and declares that public utility involvement and competition in the renewable energy, conservation and energy efficiency industries are essential to maximize efficiencies and the use of renewable energy and that the provisions of P.L.2007, c.340 (C.26:2C-45 et al.) must be implemented to further competition.
The Legislature further finds and declares that any emissions allowance trading program established in the State to reduce emissions of greenhouse gases should transition to any federal program enacted by the federal government that is comparable to the emissions allowance trading program established in New Jersey.
The Legislature therefore determines that it is in the public interest to establish a program that requires the State to dedicate to consumer benefit purposes up to 100 percent of the revenues derived from the auction or other sale of allowances pursuant to an emissions allowance trading program and to require the Commissioner of Environmental Protection and the President of the Board of Public Utilities to further the purposes of P.L.2007, c.340 (C.26:2C-45 et al.) and the "Global Warming Response Act," P.L.2007, c.112 (C.26:2C-37 et al.), by participating with other states in the activity of a separate legal entity established for the purpose of administering the Regional Greenhouse Gas Initiative.
"Allowance" means a limited authorization, as defined by the department, to emit up to one ton of carbon dioxide or its equivalent.
"Board" means the Board of Public Utilities.
"Compliance entity" means an owner or operator of an electric generating unit, with a nameplate capacity equal to or greater than 25 megawatts of electrical output, in New Jersey that is required to obtain allowances in order to operate an electric generating unit that holds an operating permit from the department issued pursuant to P.L.1954, c.212 (C.26:2C-1 et seq.), whether that unit is in operation or in development. "Compliance entity" shall not include any cogeneration facility or combined heat and power facility that is an "on-site generation facility" as that term is defined in section 3 of P.L.1999, c.23 (C.48:3-51) and sells less than 10 percent of its annual gross electrical generation.
"Consumer benefit" means any action or measure to: promote energy efficiency; directly mitigate electricity ratepayer impacts; develop and deliver renewable or non-carbon-emitting energy technologies; stimulate or reward investment in the development of innovative carbon emissions abatement technologies with significant carbon emissions reduction potential; fund programs that promote measurable electricity end-use energy efficiency in the commercial, institutional, and industrial sectors; or fund the administration of greenhouse gas emissions allowance trading and consumer benefit programs.
"Department" means the Department of Environmental Protection.
"Dispatch agreement facility" means a facility that is a compliance entity that is a cogeneration facility or has a heat rate below 8,100 BTU per kilowatt-hour, and has entered into a power agreement: (1) with a duration of more than 15 years from its effective date; (2) that provides that the entity's counterpart to the agreement controls the electric dispatch of the facility; (3) which was executed prior to January 1, 2002; and (4) which does not allow for the entity to pass the cost of allowances on to the counterpart to the agreement.
"Global Warming Solutions Fund" or "fund" means the "Global Warming Solutions Fund" established pursuant to section 6 of P.L.2007, c.340 (C.26:2C-50).
"Greenhouse gas" means the same as the term is defined in section 3 of P.L.2007, c.112 (C.26:2C-39).
"Qualified participant" means a compliance entity or other entity that meets financial assurance and any other requirements to participate in an auction, as determined by the department in consultation with other entities participating in a regional, national or international program.
"Regional Greenhouse Gas Initiative" means the cooperative effort to reduce carbon dioxide emissions entered into by the governors of seven states through a Memorandum of Understanding signed on December 20, 2005, as amended.
(2) Approval and notice by the department of specific procedures and requirements for any auction or other sale of allowances which are formulated by a for-profit or non-profit corporation, association or organization which the department and the board participate in pursuant to section 11 of P.L.2007, c.340 (C.26:2C-55) shall not be subject to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.), provided that the specific procedures and requirements are consistent with the process and general requirements outlined in rules and regulations adopted by the department, and the public is afforded an opportunity for review and comment on such specific procedures and requirements.
b. Any auction to convey allowances:
(1) shall be conducted based on the schedule and frequency adopted by the department in consultation with other entities participating in a regional program;
(2) shall include auction design elements that minimize allowance price volatility, guard against bidder collusion, and mitigate the potential for market manipulation;
(3) shall include provisions to ensure the continued market availability of allowances to entities regulated under a greenhouse gas emissions allowance trading program, taking into account the outcomes of auctions and monitoring of the allowance market, which may include the adoption of a flexible process that allows for ongoing modification of auction design and procedures in response to allowance market conditions and allowance market monitoring data, provided that the process allows for public comment and input; and
(4) may be open to all qualified participants, and all qualified participants may sell or otherwise agree to transfer any or all allowances to any eligible entity.
c. The department shall review its position with the Regional Greenhouse Gas Initiative, or any subsequent regional auction, on an annual basis, including the amount of allowances that should be included in a regional auction. This annual review shall include consideration of the environmental and economic impact of the auction, leakage impacts, and the impact on electric generation facilities and ratepayers in the State. The department shall submit a written report of this review to the Governor and to the Legislature pursuant to section 2 of P.L.1991, c.164 (C.52:14-19.1). The report shall also be posted on the department's website.
a. At least once each year, the department shall notify the owners and operators of dispatch agreement facilities of the opportunity to purchase allowances at the price of $2 per allowance. Any offer by the department to sell allowances shall be for the quantity of allowances equal to the average annual carbon dioxide emissions for the dispatch agreement facility for the prior three-year period as determined by the department.
b. Within 30 days after receiving the notice required pursuant to subsection a. of this section, an owner or operator of a dispatch agreement facility shall notify the department whether it will accept the offer to purchase allowances and specify the quantity of allowances to be purchased up to the quantity determined pursuant to subsection a. of this section.
c. For any allowances not purchased by an owner or operator of a dispatch agreement facility pursuant to subsections a. and b. of this section, an owner or operator of a dispatch agreement facility shall purchase such allowances in accordance with the rules and regulations adopted by the department pursuant to section 3 of P.L.2007, c.340 (C.26:2C-47).
d. Any allowances purchased from the department pursuant to subsections a. and b. of this section and that are unused by a dispatch agreement facility for compliance at the end of a compliance period shall be assigned thereafter to the department.
e. The opportunity to purchase allowances pursuant to this section shall be limited to dispatch agreement facilities with power agreements that were executed prior to January 1, 2002, and the offer to purchase allowances shall expire upon termination or expiration of such agreement or when the services under a new contract become effective, whichever occurs earlier.
b. The certification submitted to the department pursuant to subsection a. of this section shall be through a sworn affidavit with supporting documentation from an independent entity that attests to the facility's adherence to the definition of dispatch agreement facility as set forth in section 2 of P.L.2007, c.340 (C.26:2C-46). The affidavit shall be signed by both an official representative of the independent entity and by the chief financial officer or their equivalent of the owner or operator of the dispatch agreement facility. If there are any material changes to the sworn affidavit or supporting documentation filed with the department, the independent entity and representative of the owner or operator of the dispatch agreement facility shall resubmit an affidavit pursuant to this section within 30 days after the change occurs.
c. The certification shall be received by the department at least 30 days prior to the department making a notification, pursuant to subsection a. of section 4 of P.L.2007, c.340 (C.26:2C-48), of an offer to sell allowances to dispatch agreement facilities in order for the dispatch agreement facility to be deemed eligible to participate in the sale.
d. The owner or operator of a dispatch agreement facility claiming certification pursuant to this section shall provide on site, upon the request of the department, any information the department requires to determine the validity and extent of the certification.
e. Any signatory to the sworn affidavit in subsection b. of this section who knowingly gives or causes to be given any false or misleading information or who knowingly makes any false or misleading statement in complying with the provisions of this section shall be subject to a civil penalty of not more than $500,000 for each offense and shall not be eligible to be certified as a dispatch agreement facility. Civil penalties imposed pursuant to this section shall be collected in a civil action by a summary proceeding pursuant to the "Penalty Enforcement Law of 1999," P.L.1999, c.274 (C.2A:58-10 et seq.). In addition to any penalties, the court may assess against the violator the amount of any economic benefit accruing to the violator from the violation of the provisions of this section.
f. All penalties collected pursuant to this section shall be deposited in the "Global Warming Solutions Fund," established pursuant to section 6 of P.L.2007, c.340 (C.26:2C-50), and kept separate from other receipts deposited therein, and appropriated for the purposes of that fund.
a. moneys received as a result of any sale, exchange or other conveyance of allowances through a greenhouse gas emissions allowance trading program;
b. such moneys as are appropriated by the Legislature; and
c. any return on investment of moneys deposited in the fund.
b. Moneys in the fund, after appropriation annually for payment of administrative costs authorized pursuant to subsection c. of this section, shall be annually appropriated and used for the following purposes:
(1) Sixty percent shall be allocated to the New Jersey Economic Development Authority to provide grants and other forms of financial assistance to commercial, institutional, and industrial entities to support end-use energy efficiency projects and new, efficient electric generation facilities that are state of the art, as determined by the department, including but not limited to energy efficiency and renewable energy applications, to develop combined heat and power production and other high efficiency electric generation facilities, to stimulate or reward investment in the development of innovative carbon emissions abatement technologies with significant carbon emissions reduction or avoidance potential, to develop qualified offshore wind projects pursuant to section 3 of P.L.2010, c.57 (C.48:3-87.1), and to provide financial assistance to manufacturers of equipment associated with qualified offshore wind projects. The authority, in consultation with the board and the department, shall determine: (a) the appropriate level of grants or other forms of financial assistance to be awarded to individual commercial, institutional, and industrial sectors and to individual projects within each of these sectors; (b) the evaluation criteria for selecting projects to be awarded grants or other forms of financial assistance, which criteria shall include the ability of the project to result in a measurable reduction of the emission of greenhouse gases or a measurable reduction in energy demand, provided, however, that neither the development of a new combined heat and power production facility, nor an increase in the electrical and thermal output of an existing combined heat and power production facility, shall be subject to the requirement to demonstrate such a measurable reduction; and (c) the process by which grants or other forms of financial assistance can be applied for and awarded including, if applicable, the payment terms and conditions for authority investments in certain projects with commercial viability;
(2) Twenty percent shall be allocated to the board to support programs that are designed to reduce electricity demand or costs to electricity customers in the low-income and moderate-income residential sector with a focus on urban areas, including efforts to address heat island effect and reduce impacts on ratepayers attributable to the implementation of P.L.2007, c.340 (C.26:2C-45 et al.) or to support the light duty plug-in electric vehicle incentive program and the incentive program for in-home electric vehicle service equipment established pursuant to sections 4 and 6 of P.L.2019, c.362 (C.48:25-4 and C.48:25-6). For the purposes of this paragraph, the board, in consultation with the authority and the department, shall determine the types of programs to be supported and the mechanism by which to quantify benefits to ensure that the supported programs result in a measurable reduction in energy demand or accomplishment of the plug-in electric vehicle goals established pursuant to section 3 of P.L.2019, c.362 (C.48:25-3);
(3) Ten percent shall be allocated to the department to support programs designed to promote local government efforts to plan, develop and implement measures to reduce greenhouse gas emissions, including but not limited to technical assistance to local governments, and the awarding of grants and other forms of assistance to local governments to conduct and implement energy efficiency, renewable energy, and distributed energy programs and land use planning where the grant or assistance results in a measurable reduction of the emission of greenhouse gases or a measurable reduction in energy demand. For the purpose of conducting any program pursuant to this paragraph, the department, in consultation with the authority and the board, shall determine: (a) the appropriate level of grants or other forms of financial assistance to be awarded to local governments; (b) the evaluation criteria for selecting projects to be awarded grants or other forms of financial assistance; (c) the process by which grants or other forms of financial assistance can be applied for and awarded; and (d) a mechanism by which to quantify benefits; and
(4) Ten percent shall be allocated to the department to support programs that enhance the stewardship and restoration of the State's forests and tidal marshes that provide important opportunities to sequester or reduce greenhouse gases.
c. (1) The department may use up to four percent of the total amount in the fund each year to pay for administrative costs justifiable and approved in the annual budget process, incurred by the department in administering the provisions of P.L.2007, c.340 (C.26:2C-45 et al.) and in administering programs to reduce the emissions of greenhouse gases including any obligations that may arise under subsection a. of section 11 of P.L.2007, c.340 (C.26:2C-55).
(2) The board may use up to two percent of the total amount in the fund each year to pay for administrative costs justifiable and approved in the annual budget process, incurred by the board in administering the provisions of P.L.2007, c.340 (C.26:2C-45 et al.) and in administering programs to reduce the emissions of greenhouse gases including any obligations that may arise under subsection a. of section 11 of P.L.2007, c.340 (C.26:2C-55).
(3) The New Jersey Economic Development Authority may use up to two percent of the total amount in the fund each year to pay for administrative costs justifiable and approved in the annual budget process, incurred by the authority in administering the provisions of P.L.2007, c.340 (C.26:2C-45 et al.) and in administering programs to reduce the emissions of greenhouse gases.
d. The State Comptroller shall conduct or supervise independent audit and fiscal oversight functions of the fund and its uses.
b. The guidelines and the priority ranking system developed pursuant to this section for selecting projects or programs to be awarded grants or other forms of financial assistance from the fund shall include but need not be limited to an evaluation of each eligible project or program as to its predicted ability to:
(1) result in a net reduction in greenhouse gas emissions in the State or in greenhouse gas emissions from electricity produced out of the State but consumed in the State or net sequestration of carbon;
(2) result in significant reductions in greenhouse gases relative to the cost of the project or program and the reduction of impacts on ratepayers attributable to the implementation of P.L.2007, c.340 (C.26:2C-45 et al.), and the ability of the project or program to significantly contribute to achievement of the State's 2020 limit and 2050 limit established pursuant to the "Global Warming Response Act," P.L.2007, c.112 (C.26:2C-37 et al.), relative to the cost of the project or program;
(3) reduce energy use;
(4) provide co-benefits to the State, including but not limited to creating job opportunities, reducing other air pollutants, reducing costs to electricity and natural gas consumers, improving local electric system reliability, and contributing to regional initiatives to reduce greenhouse gas emissions; and
(5) be directly responsive to the recommendations when submitted by the department to the Legislature pursuant to section 6 of the "Global Warming Response Act," P.L.2007, c.112 (C.26:2C-42).
c. In addition to the criteria set forth in subsection b. of this section, the guidelines and the priority ranking system developed pursuant to this section for selecting projects or programs to be awarded grants or other forms of financial assistance from the fund shall include factors to ensure that grants or other forms of financial assistance from the fund are allocated to projects or programs that will serve communities that are disproportionality impacted by the effects of environmental degradation and climate change, and alleviate the negative effects on human health and the environment resulting therefrom.
b. If the provisions of subsection a. of this section are not met on the effective date of an annual appropriations act for the State fiscal year, or if an amendment or supplement to an annual appropriations act for the State fiscal year should violate the requirements of subsection a. of this section, the Director of the Division of Budget and Accounting in the Department of the Treasury shall, not later than five days after the enactment of the annual appropriations act, or an amendment or supplement thereto, that violates any of the requirements of subsection a. of this section, certify to the Commissioner of Environmental Protection that the requirements of subsection a. of this section have not been met.
c. Sections 1 through 8 of P.L.2007, c.340 (C.26:2C-45 through C.26:2C-52) shall be without effect on and after the 10th day following a certification by the Director of the Division of Budget and Accounting in the Department of the Treasury pursuant to subsection b. of this section.
b. Within three months after the adoption of rules and regulations providing for implementation of a national emissions allowance trading program, the Commissioner of Environmental Protection shall render a final decision as to whether the national program is substantially comparable to the greenhouse gas emissions allowance trading program in which the State is participating at that time. If the commissioner determines that the national program is substantially comparable to the existing greenhouse gas emissions allowance trading program being implemented in the State, the department shall thereafter sell, exchange, retire or otherwise convey allowances only as part of the State's participation in the national program.
c. The commissioner shall notify, in writing, the Governor and the Legislature pursuant to section 2 of P.L.1991, c.164 (C.52:14-19.1) of the decisions made pursuant to this section.
d. The determination of the comparability of the programs, pursuant to subsections a. and b. of this section, shall be based upon the projected percent reductions of greenhouse gas emissions from electric generating facilities serving customers in the State under the greenhouse gas emissions allowance trading program being implemented in the State at the time as compared to the projected percent reductions of greenhouse gas emissions from electric generating facilities serving customers in the State under the national program and may consider the value of allowances or allowance auction proceeds directed to the State or other entity to benefit New Jersey energy consumers. Reductions anticipated through the implementation of other State regulated carbon reduction initiatives, including but not limited to a renewable energy portfolio standard or any energy efficiency portfolio standard adopted pursuant to section 38 of P.L.1999, c.23 (C.48:3-87), shall not be considered in determining the comparability of the programs.
(1) enter any agreement or arrangement with the appropriate representatives of other states, including the formation of a for-profit or non-profit corporation, any form of association, or any other form of organization, in this or another state; and
(2) participate in any such corporation, association, or organization, and in any activity in furtherance of the purposes thereof, in any capacity including, but not limited to, as directors or officers.
b. Any actions that are consistent with, and that further the purposes of, P.L.2007, c.340 (C.26:2C-45 et al.) and the "Global Warming Response Act," P.L.2007, c.112 (C.26:2C-37 et al.) taken by the commissioner or the board president, or any employee of the department or the board authorized to take such actions by the commissioner or the board president, to form such corporation, association or organization, to participate in its activities, or to enter an agreement or arrangement prior to the date of enactment of P.L.2007, c.340 (C.26:2C-45 et al.), are hereby validated.
c. Nothing in P.L.2007, c.340 (C.26:2C-45 et al.) shall be deemed to constitute a waiver of sovereign immunity. By entering any agreement or arrangement authorized pursuant to this section, neither the commissioner nor the board president, nor their respective designees, nor the State consents to suit outside of New Jersey or consents to the governance of such suit under any law other than that of New Jersey.
b. No later than 90 days after the final hearing is held, the department and the board shall jointly issue a report to the Governor and the Legislature, pursuant to section 2 of P.L.1991, c.164 (C.52:14-19.1), with their findings and recommendations.
b. Whenever relevant to assessing global warming impacts, the Department of Environmental Protection, the Board of Public Utilities, or any other State agency shall use the most recent version of the Intergovernmental Panel on Climate Change's Assessment Report, or a substantially similar, more recent report that addresses global warming impacts at a comparably rigorous level.
c. Whenever the Department of Environmental Protection, the Board of Public Utilities, or any other State agency performs a socio-economic impact analysis pursuant to section 4 of P.L.1968, c.410 (C.52:14B-4), and that analysis involves the socio-economic impact of global warming, the agency shall use the lowest discount rates that are consistent with federal guidelines, including the federal Office of Management and Budget Circular A-94, or successor guidance.
"Class I substance" and "class II substance" mean those substances listed in 42 U.S.C. s.7671a, as that section read on November 15, 1990, or those substances listed in Appendix A or B of Subpart A of 40 C.F.R. Part 82, as those appendices read on January 3, 2017.
"Department" means the Department of Environmental Protection.
"Hydrofluorocarbons" means the class of greenhouse gases that are saturated organic compounds containing hydrogen, fluorine, and carbon.
"Manufacturer" means any person, firm, association, partnership, corporation, governmental entity, organization, or joint venture that produces any product that contains or uses hydrofluorocarbons or is an importer or domestic distributor of such a product.
"Residential consumer refrigeration product" means the same as that term is defined in 10 C.F.R. s.430.2, as that section read on January 3, 2017.
"Retrofit" means the same as that term is defined in 40 C.F.R s.82.152, as that section read on January 3, 2017.
"Substitute" means a chemical, product substitute, or alternative manufacturing process, whether existing or new, that is used to perform a function previously performed by a class I substance or class II substance and any substitute subsequently adopted to perform that function, including, but not limited to, hydrofluorocarbons.
Except where existing equipment is retrofitted, nothing in this subsection shall require a person to cease using a product or equipment that was manufactured prior to the effective date of restrictions set forth in subsection b. of this section. A product or equipment manufactured prior to the applicable effective date of the restriction specified in subsection b. of this section may be sold, imported, exported, distributed, installed, and used after the applicable effective date.
b. For the following products and equipment identified in Appendix U and Appendix V of Subpart G of 40 C.F.R. Part 82, as those appendices read on January 3, 2017, the prohibition set forth in subsection a. of this section shall take effect beginning:
(1) July 1, 2020, for:
(a) propellants;
(b) rigid polyurethane applications and spray foam, flexible polyurethane, integral skin polyurethane, flexible polyurethane foam, polystyrene extruded sheet, polyolefin, and phenolic insulation board and bunstock; and
(c) supermarket systems, remote condensing units, and stand-alone units;
(2) January 1, 2021, for:
(a) refrigerated food processing and dispensing equipment;
(b) compact residential consumer refrigeration products; and
(c) polystyrene extruded boardstock and billet, and rigid polyurethane low-pressure two-component spray foam;
(3) January 1, 2022, for :
(a) residential consumer refrigeration products other than compact and built-in residential consumer refrigeration products; and
(b) vending machines;
(4) January 1, 2023, for:
(a) cold storage warehouses; and
(b) built-in residential consumer refrigeration products;
(5) January 1, 2024, for centrifugal chillers and positive displacement chillers; and
(6) On either July 1, 2020, or the effective date of the restrictions identified in Appendix U and Appendix V of Subpart G of 40 C.F.R. Part 82, as those appendices read on January 3, 2017, whichever is later, for all other applications and end uses for substitutes not covered by the categories listed in paragraphs (1) through (5) of this subsection.
c. The department may, by rule or regulation adopted pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.):
(1) modify the effective date of a prohibition established in subsection b. of this section, if the department determines that such modification reduces the overall risk to human health or the environment and reflects the earliest date that a substitute is currently or potentially available;
(2) prohibit the use of a substitute if the department determines that the prohibition reduces the overall risk to human health or the environment and that a lower risk substitute is currently or potentially available;
(3) (a) adopt a list of approved substitutes, use conditions, or use limits, if any; and (b) add or remove substitutes, use conditions, or use limits to or from the list of approved substitutes, use conditions, or use limits if the department determines such action reduces the overall risk to human health and the environment; and
(4) designate acceptable uses of hydrofluorocarbons for medical uses that shall be exempt from the prohibitions set forth in subsection b. of this section.
d. (1) No later than one year after enactment by another state of restrictions on substitutes applicable to new light duty vehicles, the department may adopt restrictions applicable to the sale, lease, rental, or other introduction into commerce by a manufacturer of new light duty vehicles consistent with the restrictions identified in appendix B of Subpart G of 40 C.F.R. Part 82, as that appendix read on January 3, 2017.
(2) If the United States Environmental Protection Agency approves a previously prohibited hydrofluorocarbon blend with a global warming potential of 750 or less for foam blowing of polystyrene extruded boardstock and billet and rigid polyurethane low-pressure two-component spray foam pursuant to the significant new alternatives policy program established pursuant to the federal "Clean Air Act," 42 U.S.C. s.7671k, the department may propose a rule in accordance with the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.), to conform the requirements established under this section with that federal action.
e. The authority granted by this section to the department for restricting the use of substitutes is supplementary to the authority to control air pollution pursuant to the "Air Pollution Control Act (1954)," P.L.1954, c.212 (C.26:2C-1 et seq.).
b. In lieu of submitting a separate report pursuant to this section, the department may include the information required to be submitted pursuant to subsection a. of this section in the report required pursuant to subsection c. of section 6 of P.L.2007, c.112 (C.26:2C-42), provided that report is transmitted to the appropriate parties prior to December 1, 2020.
(1) serve as a resource to State departments and local governments on fuel cell issues;
(2) assist in the growth of fuel cell businesses in the State;
(3) increase the use of fuel cells throughout State government departments and agencies;
(4) develop a strategy for the development of infrastructure to support the use of fuel cells; and
(5) provide information and educational materials to the public, government, and industry about the use and benefits of fuel cells.
In conducting its duties, the task force shall consult with the United States Department of Energy and any fuel cell organizations that may exist in other states.
b. The task force shall consist of 15 members as follows:
(1) The Commissioner of Environmental Protection, the President of the Board of Public Utilities, the Commissioner of Transportation, the Commissioner of Community Affairs, the Chief Executive Officer of the New Jersey Economic Development Authority, who shall serve ex officio, or their respective designees; and
(2) the following public members, appointed by the Governor:
(a) one member representing a fuel cell advocacy group in the State;
(b) one member representing fuel cell manufacturers;
(c) one member representing suppliers of hydrogen for fuel cells;
(d) one member representing fuel cell vehicle manufacturers;
(e) two members of the academic community with expertise in fuel cells;
(f) one member representing a manufacturer of stationary fuel cells;
(g) one member with expertise in fuel cell powered material handling equipment;
(h) one member representing local government with expertise in municipal land use matters; and
(i) one member with expertise in retail fuel sales and distribution.
c. All appointments to the task force shall be made no later than 90 days after the effective date of this act. Each public member shall serve for four years or until a successor is appointed, and vacancies shall be filled in the same manner as the original appointments. The members of the task force shall serve without compensation, but shall be eligible for reimbursement for necessary and reasonable expenses incurred in the performance of their official duties within the limits of funds appropriated or otherwise made available to the task force for its purposes.
d. The task force shall organize as soon as practicable following the appointment of all its public members and shall select a chairperson and a vice-chairperson from among its members, as well as a secretary who need not be a member of the task force. A majority of the full membership of the task force shall constitute a quorum for the transaction of task force business. The task force may meet and hold hearings at the place or places the task force designates.
The Board of Public Utilities shall provide staff support to the task force. The task force shall be entitled to call to its assistance and avail itself of the services of the employees of any State, county, or municipal department, board, bureau, commission, or agency as the task force may require and as may be available to the task force for its purposes.
e. No later than one year after its organization, and annually thereafter, the task force shall prepare and submit to the Governor and, pursuant to section 2 of P.L.1991, c.164 (C.52:14-19.1), to the Legislature, a report detailing the task force's plan to increase the use of fuel cells in the State, including any recommendations for legislative or regulatory action that are necessary to effectuate the plan.
This act shall be known and may be cited as the "Radiation Protection Act."
As used in this act, unless the context indicates another or different meaning or intent:
(a) "Commission" means the Commission on Radiation Protection created pursuant to this act;
(b) "Department" means the Department of Environmental Protection;
(c) "Unnecessary radiation" means the use or presence of electromagnetic radiation including microwave, infrared, visible, ultraviolet, X-ray, and gammaray; sonic, infrasonic, or ultrasonic waves; and particle radiation including alphas, betas, high energy electrons, neutrons, protons and other atomic or nuclear particles in such manner as to be or tend to be injurious or dangerous to the health of the people or the industrial or agriculture potential of the State, or to the ecology of the State and its wildlife.
There is hereby created in the Department of Environmental Protection the Commission on Radiation Protection, which shall consist of 10 members, three of whom shall be the Commissioner of Environmental Protection, the Commissioner of Health, and the Commissioner of Labor, or their designees, who shall serve ex officio and seven members with scientific training in medicine, radiology, nonionizing radiation, infrasonics, ultrasonics, radiation physics, medical physics, epidemiology, atomic energy or biology or engineering, to be appointed by the Governor, with the advice and consent of the Senate.
Commissioners appointed by the Governor shall be appointed for a term of four years commencing on July 1 of the year of appointment, except that of those first appointed, two shall be appointed for terms of one year, one for a term of two years, one for a term of three years, and one for a term of four years, which terms shall commence on July 1, 1958. Of the two commissioners first appointed to the commission pursuant to the provisions of this 1986 amendatory act, one commissioner shall serve a term of four years and one commissioner shall serve a term of two years. Each commissioner shall hold over after the expiration of his term until his successor has been appointed and has qualified.
Vacancies shall be filled for the unexpired terms only in the manner provided for the original appointments.
Commissioners shall serve without compensation but shall be entitled to be reimbursed for expenses necessarily incurred in the performance of their duties.
The commission annually shall organize as soon as possible after July 1, and shall elect a chairman, vice-chairman and a secretary from its own membership. Five members of the commission shall constitute a quorum to transact its business. Codes, rules and regulations shall be adopted, amended or repealed by an affirmative vote of at least six members.
The commission shall have the power to formulate, adopt, promulgate, amend and repeal codes, rules and regulations as may be necessary to prohibit and prevent unnecessary radiation in accordance with the provisions of the "Administrative Procedure Act," P.L.1968, c. 410 (C. 52:14B-1 et seq.).
It shall be the duty of the commission to review the policies and program of the department as developed under authority of this act; to make recommendations thereon to the department; to provide the department with such technical advice and assistance as may be requested by the department.
The department shall:
(a) Administer this act and codes, rules or regulations promulgated by the commission;
(b) Provide the commission with the necessary personnel required to carry out its duties;
(c) Develop comprehensive policies and programs for the evaluation and determination of hazards associated with the use of radiation, and for their amelioration;
(d) Advise, consult, and cooperate with other agencies of the State, the Federal Government, other states and interstate agencies, and with affected groups, political subdivisions and industries;
(e) Accept and administer according to law loans, grants or other funds or gifts from the Federal Government and from other sources, public or private, for carrying out its functions under this act;
(f) Encourage, participate in or conduct studies, investigations, training, research and demonstrations relating to the control of radiation hazards, the measurement of radiation, the effects on health of exposure to radiation and related problems as it may deem necessary or advisable for the discharge of its duties under this act;
(g) Collect and disseminate health education information relating to radiation protection;
(h) Require registration of sources of radiation, and require records concerning sources of radiation to be kept in such manner as may be prescribed by codes, rules or regulations of the commission;
(i) Review plans and specifications on the design and shielding for radiation sources submitted pursuant to codes, rules or regulations of the commission for the purpose of determining possible radiation hazards;
(j) Enter and inspect any building or place for the purpose of investigating an actual or suspected source of radiation and ascertaining compliance with this act or any rule, regulation or order promulgated or issued pursuant thereto and inspect radiation sources, their shielding and immediate surroundings and records concerning their operation for the determination of any possible radiation hazard;
(k) Have power, to be exercised subject to codes, rules and regulations of the commission, to require, issue, renew, amend, suspend and revoke licenses for the construction, operation or maintenance of sources of radiation including byproduct materials, source materials and special nuclear materials in quantities not sufficient to form a critical mass. The codes, rules and regulations may provide for recognition of other State or Federal licenses, subject to the registration requirements prescribed by or under the authority of this act;
(l) Have the power in accordance with a fee schedule adopted as a rule or regulation in accordance with the "Administrative Procedure Act," P.L.1968, c. 410 (C. 52-14B-1 et seq.), to establish and charge fees for any of the services it performs, which fees shall be annual or periodic as the department shall determine. The fees charged by the department pursuant to this section shall be based on criteria contained in the fee schedule. The criteria shall reflect the actual or projected expense incurred by the department in the performance of the service for which the fee is charged;
(m) Be empowered to issue orders for the implementation and enforcement of the provisions of this act or of any rule or regulation promulgated pursuant hereto.
The Governor, on behalf of the State, may enter into agreements with the Federal Government providing for discontinuance by the Federal Government and assumption by the State of the authority, in the interest of the protection of the public from radiation hazards, to regulate sources of radiation including by-product materials, source materials and special nuclear materials in quantities not sufficient to form a critical mass. Subject to the terms of such agreements, regulatory authority assumed by the State by virtue of such agreements shall be exercised by the department in the manner provided in this act and as may be further provided by codes, rules and regulations of the commission promulgated pursuant to this act.
The department may (a) enter into agreements, subject to the approval of the Governor, with the Federal Government, other States or interstate agencies to perform inspections and other radiation protection functions on a co-operative basis with the Federal Government, other States or interstate agencies; and (b) subject to available appropriations, make its personnel available for participation in training programs of the Federal Government and otherwise secure assistance from the Federal Government to maintain and improve the department's administration of this act.
All sources of radiation shall be shielded, transported, handled, used and kept in such manner as to prevent all users thereof and all persons within effective range thereof from being exposed to unnecessary radiation.
Notwithstanding any other remedy available to the department, whenever an agent of the department finds or has probable cause to believe that any material, machine, appliance, apparatus or device, or any part thereof, is a radiation hazard or danger of such nature as to constitute a threat to public health or welfare, or is being operated in a manner as to result in such a threat, he may embargo such article by affixing thereto a tag or other appropriate marking, giving notice that such article is, or is suspected to be, a radiation hazard or danger and has been detained or embargoed, and warning all persons not to use, remove or dispose of such article by sale or otherwise until permission for use, removal or disposal is given by the department, or he may cause any material, machine, appliance, apparatus or device to be secured or impounded. It shall be a violation of this act for any person to remove or dispose of such detained or embargoed article by sale or otherwise without such permission.
Within 10 days after embargoing or impounding any source of radiation, the department shall give notice to the person causing the violation or hazardous condition prescribing circumstances under which the source of radiation will be returned to the custody of the person. If the person, within a reasonable time as may be fixed by the department, does not furnish satisfactory evidence to the department of present and intended future compliance with the conditions, the rights of the person, with respect to the source of radiation so secured or impounded, shall become the property of the State to be disposed of by the department on behalf of the State in any manner consistent with public health and safety.
Any person aggrieved by an embargo imposed under the provisions of this act who shall apply therefor within 30 days after the imposition of such embargo, shall be granted a hearing before the department. Pending the determination by the department before or after such hearing, the department may stay the operation of the embargo upon such terms and conditions, including performance bonds, as it may deem proper.
Whenever the department finds that an emergency exists requiring immediate action to protect the public health or welfare, it may issue an order reciting the existence of such an emergency and requiring that such action be taken as it deems necessary to meet the emergency. Such order shall be effective immediately. Any person to whom such order is directed shall comply therewith immediately, but, on application to the department, shall be afforded a hearing within 5 days. On the basis of such hearing the department may continue such order in effect or revoke, amend or modify such order.
The department may bring a civil action in the Superior Court to prevent the violation of the provisions of this act or codes, rules or regulations promulgated by the commission and orders of the department and said court may proceed in the action in a summary manner or otherwise and may restrain in all such cases any person or legal entity from violating any of the provisions of this act or said codes, rules, regulations or orders.
Any person who violates the provisions of this act or any rule, regulation or order promulgated or issued pursuant hereto or uses, removes, or disposes of any property in violation of an embargo imposed under the provisions of this act shall be liable to a penalty of not more than $2,500.00 to be collected in a civil action by a summary proceeding under "the penalty enforcement law" (N.J.S. 2A:58-1 et seq.) or in any case before a court of competent jurisdiction wherein injunctive relief has been requested. If the violation is of a continuing nature, each day during which it continues shall constitute an additional, separate and distinct offense.
The department is authorized and empowered to compromise and settle any claim for a penalty under this section in an amount in the discretion of the department as may appear appropriate and equitable under all of the circumstances.
Any notice, order or other instrument issued pursuant to this act may be served personally or by mailing a copy thereof by certified mail directed to the person or legal entity affected.
No existing civil or criminal remedy for any action which is a violation of any code, rule or regulation of the commission shall be excluded or impaired by this act.
Any code, or rule or regulation of the commission or determination or finding of the department shall be reviewable in the Superior Court by a proceeding in lieu of prerogative writ.
No ordinance, resolution or regulation concerning unnecessary radiation adopted by any municipality, county or local board of health shall be effective until a certified copy of such ordinance or regulation has been submitted to the commission and approved by the commissioner of the department. Such ordinances or regulations may not be approved unless the same shall be consistent with this act or any code, rule or regulation issued pursuant hereto.
No person shall transport into or through the State, or store, hold or detain pending or during such transit, any of the following materials without first having obtained a certificate of handling from the department:
a. Plutonium isotopes in any quantity and form exceeding two grams or 20 curies, whichever is less;
b. Uranium enriched in the isotope U-235 exceeding 25 atomic per cent of the total uranium content in quantities where the U-235 content exceeds one kilogram;
c. Any of the actinides the activity of which exceeds 20 curies;
d. Spent reactor fuel elements or mixed fission products associated with such spent fuel elements the activity of which exceeds 20 curies;
e. Any quantity of radioactive material which exceeds 20 curies; or
f. Any lesser quantity of radioactive material which, when combined with any other quantity of such material, exceeds 20 curies.
a. Any person seeking to obtain such a certificate shall submit to the department, not less than 7 business days prior to the storage or transporting of any of the materials specified in section 1 of this act, the following information:
(1) Name of shipper, (2) Name of carrier, (3) Type and quantity of radioactive material, (4) Date and time of shipment, (5) Starting point, scheduled route, and destination, (6) Location and manner of storage, and (7) Other information required by the department.
b. The department, after consultation with the Chief of the State Police, shall issue the "certificate of handling" upon a finding that the storage or transporting of such material shall be accomplished in a manner necessary to protect public health and safety of the citizens of the State. The department, in its discretion, may require changes in the location or manner of storage or changes in dates, routes or time of transporting such material if necessary to maximize protection to public health and safety.
In the event of a discharge of radioactivity, or threat thereof, resulting from a radiation source in storage or transit in this State, the department may recover from any shipper, carrier, bailor, bailee, or any other person responsible for the storage or transportation of such radiation source, the costs incurred by the department for the prevention or abatement of such discharge or the removal of the effects thereof.
Without limiting or impairing in any way the powers heretofore provided by the act to which this act is a supplement, the commission is hereby empowered and directed to adopt, pursuant to the provisions of the "Administrative Procedure Act" P.L.1968, c. 410 (C. 52:14B-1 et seq.) such rules and regulations necessary to carry out the provisions of this act.
Any person who violates any provision of this act shall be liable to the penalties contained in P.L.1958, c. 116. Any person who violates any provision of this act shall be guilty of a crime of the fourth degree. The State Police shall, and any local police department may, enforce the provisions of P.L.1977, c. 233 (C. 26:2D-18 et seq.).
No person shall obstruct, hinder, delay or interfere with, by force or otherwise, the performance by the department, its personnel or any of its authorized agents of any duty under the provisions of this act or refuse to permit the personnel or authorized agents to perform their duties by refusing them upon proper presentation of a written order of the department, entrance to any premises at reasonable hours.
It shall be unlawful for any person to transport or store in transit the following radioactive materials in any county in New Jersey which has an average population density exceeding 1,000 persons per square mile as measured in the most recent decennial census:
a. Plutonium isotopes in any quantity and form exceeding 20 curies;
b. Uranium enriched in the isotope U-235 exceeding 25 atomic per cent of the total uranium content in quantities where the U-235 content exceeds 1 kilogram;
c. Any of the actinides (i.e., elements with atomic number 89 or greater) the activity of which exceeds 20 curies; or
d. Spent reactor fuel elements or mixed fission products associated with such spent fuel elements the activity of which exceeds 20 curies.
Any quantity of radioactive material specified as "Low Specific Activity" by the Nuclear Regulatory Commission in 10 CFR Part 71, entitled "Packaging of Radioactive Material for Transport" shall be exempt from the provisions of this act.
The department may, pursuant to the "Administrative Procedure Act" P.L.1968, c. 410 (C. 52:14B-1 et seq.), designate or define any categories or subcategories of radioactive material covered under this act, except radiopharmaceuticals and radioactive substances, the principal purpose of which is associated with the manufacture of the radiopharmaceuticals, to be banned from areas designated by the department. The department shall only do so where it finds that such material may create an unwarranted hazard to public safety and where the transportation of the material in the area is not essential to the public welfare.
Notwithstanding the provisions of sections 1 and 2 of this act, the department may issue "certificates of handling" on a case-by-case basis for radioactive materials covered under this act:
a. For compelling reasons involving urgent public policy or national security interests which transcend public health and safety concerns;
b. For research or development activities, medical therapy, or educational purposes which the department determines do not pose significant threats to public health and safety;
c. For the transportation of fresh or non-irradiated nuclear fuel to any nuclear generating facility upon a finding by the department that there is no feasible alternate route or mode of transportation which involves less risk to the public; or
d. For the transportation of spent or irradiated nuclear fuel from any nuclear electricity generating facility upon a finding by the department that there is no feasible alternate route or mode of transportation or method of disposition which involves less risk to the public health and safety; provided, however, that no certificate of handling shall be issued for the transportation of any spent or irradiated nuclear fuel in New Jersey unless the department and the State Police have jointly determined that adequate safety precautions have been taken by the transporter and that adequate emergency response capabilities exist to protect the public during such transportation, and the department has further determined that the shipment of such fuel is secured by a limit of insurance or other form of indemnification, either by law or privately obtained, which is appropriate for the protection of the public in view of the risks associated with such transportation.
Any person who violates the provisions of this act shall, in addition to any penalties imposed pursuant to section 13 of P.L.1958, c. 116 (C. 26:2D-13), have all certificates of handling in the possession of that person revoked and shall be ineligible to receive any certificate of handling for 3 years.
The Legislature hereby finds and declares that the citizens of the State of New Jersey are entitled to the maximum protection practicable from the harmful effects of excessive and improper exposure to ionizing radiation; that the protection can be increased by requiring appropriate training and experience of persons operating medical equipment emitting ionizing radiation and requiring them to operate the equipment under the specific direction of a licensed practitioner; and that it is therefore necessary to establish standards of education, training and experience for these operators and to provide for the appropriate examination and certification thereof.
This act shall be known and may be cited as the "Radiologic Technologist Act."
a. "Board" means the Radiologic Technology Board of Examiners created pursuant to section 5 of P.L.1981, c.295 (C.26:2D-28).
b. "License" means a certificate issued by the board authorizing the licensee to use equipment emitting ionizing radiation on human beings for diagnostic or therapeutic purposes in accordance with the provisions of this act.
c. "Chest x-ray technologist" means a person, other than a licensed practitioner, whose practice of radiologic technology is limited to the chest area for diagnostic purposes only.
d. "Commissioner" means the Commissioner of Environmental Protection.
e. "Dental x-ray technologist" means a person, other than a licensed practitioner, whose practice of radiologic technology is limited to intraoral radiography for diagnostic purposes only.
f. "Health physicist" means a person who is certified by the American Board of Health Physics or the American Board of Radiology in radiation physics.
g. "Licensed practitioner" means a person licensed or otherwise authorized by law to practice medicine, dentistry, dental hygiene, podiatric medicine, osteopathy or chiropractic.
h. "Radiation therapy technologist" means a person, other than a licensed practitioner, whose application of radiation on human beings is for therapeutic purposes.
i. "Diagnostic x-ray technologist" means a person, other than a licensed practitioner, whose application of radiation on human beings is for diagnostic purposes.
j. "Radiologic technologist" means any person who is licensed pursuant to this act.
k. "Radiologic technology" means the use of equipment emitting ionizing radiation on human beings for diagnostic or therapeutic purposes under the supervision of a licensed practitioner.
l. "Podiatric x-ray technologist" means a person, other than a licensed practitioner, whose practice of radiologic technology is limited to the operation of x-ray machines as used by podiatrists on the lower leg, foot and ankle area for diagnostic purposes only.
m. "Orthopedic x-ray technologist" means a person, other than a licensed practitioner, whose practice of radiologic technology is limited to the spine and extremities for diagnostic purposes only.
n. "Urologic x-ray technologist" means a person, other than a licensed practitioner, whose practice of radiologic technology is limited to the abdomen and pelvic area for diagnostic purposes only.
o. "Radiologist" means a licensed practitioner specializing in radiology certified by the American Board of Radiology, the American Osteopathic Board of Radiology or other national radiologic certifying body approved by the board.
p. "Radiologist assistant" means a person, other than a licensed practitioner, who is a licensed radiologic technologist, is certified and registered with a national radiologic certifying body approved by the board, and is credentialed to provide primary advanced-level radiology health care under the supervision of a licensed radiologist.
b. A person holding a license as a diagnostic x-ray technologist may use the title "licensed radiologic technologist" or the letters (LRT) (R) after his name. No other person shall be entitled to use the title or letters, or any other title or letters after his name that indicate or imply that he is a licensed diagnostic x-ray technologist; nor may any person hold himself out in any way, whether orally or in writing, expressly or by implication, as a licensed diagnostic technologist.
c. A person holding a limited license as a chest x-ray technologist may use the title "licensed chest x-ray technologist" or the letters (LRT) (C) after his name. No other person shall be entitled to use the title or letters, or any other title or letters after his name that indicate or imply that he is a licensed chest x-ray technologist; nor may any person hold himself out in any way, whether orally or in writing, expressly or by implication, as a licensed chest x-ray technologist.
d. A person holding a limited license as a dental x-ray technologist may use the title "licensed dental x-ray technologist" or the letters (LRT) (D) after his name. No other person shall be entitled to use the title or letters, or any other title or letters after his name that indicate or imply that he is a licensed dental x-ray technologist; nor may any person hold himself out in any way, whether orally or in writing, expressly or by implication, as a licensed dental x-ray technologist.
e. A person holding a license as a radiation therapy technologist may use the title "licensed therapy technologist" or (LRT) (T) after his name. No other person shall be entitled to use the title or letters, or any other title or letters after his name that indicate or imply that he is a licensed therapy technologist; nor may any person hold himself out in any way, whether orally or in writing, expressly or by implication, as a licensed therapy technologist.
f. A person holding a license as provided by this act shall use medical equipment emitting ionizing radiation on human beings only for diagnostic or therapeutic purposes on a case by case basis at the specific direction of a licensed practitioner, and only if the application of the equipment is limited in a manner hereinafter specified.
g. Nothing in the provisions of this act relating to radiologic technologists shall be construed to limit, enlarge or affect, in any respect, the practice of their respective professions by duly licensed practitioners.
h. The requirement of a license shall not apply to a hospital resident specializing in radiology, who is not a licensed practitioner in the State of New Jersey, or a student enrolled in and attending a school or college of medicine, osteopathy, podiatric medicine, dentistry, dental hygiene, dental assistance, chiropractic or radiologic technology, who applies radiation to a human being while under the direct supervision of a licensed practitioner.
i. A person holding a license as a diagnostic x-ray technologist and a license as a radiation therapy technologist may use the letters (LRT) (R) (T) after his name.
j. A person holding a limited license as a podiatric x-ray technologist may use the title "licensed podiatric x-ray technologist" or the letters (LRT) (P) after his name. No other person shall be entitled to use the title or letters, or any other title or letters after his name that indicate or imply that he is a licensed podiatric x-ray technologist; nor may any person hold himself out in any way, whether orally or in writing, expressly or by implication, as a licensed podiatric x-ray technologist.
k. A person holding a limited license as an orthopedic x-ray technologist may use the title "licensed orthopedic x-ray technologist" or the letters (LRT) (O) after his name. No other person shall be entitled to use the title or letters, or any other title or letters after his name that indicate or imply that he is a licensed orthopedic x-ray technologist; nor may any person hold himself out in any way, whether orally or in writing, expressly or by implication, as a licensed orthopedic x-ray technologist.
l. A person holding a limited license as a urologic x-ray technologist may use the title "licensed urologic x-ray technologist" or the letters (LRT) (U) after his name. No other person shall be entitled to use the title or letters, or any other title or letters after his name that indicate or imply that he is a licensed urologic x-ray technologist; nor may any person hold himself out in any way, whether orally or in writing, expressly or by implication, as a licensed urologic x-ray technologist.
m. A person holding a limited license as a radiologist assistant may use the title "licensed radiologist assistant" or the letters (RA) after the person's name. No other person shall be entitled to use the title or letters, or any other title or letters after the person's name that indicate or imply that the person is a licensed radiologist assistant; nor may any person represent in any way, whether orally or in writing, expressly or by implication, that such person is a licensed radiologist assistant.
For the purposes of this section:
"Hybrid fusion imaging technology" means equipment capable of performing two or more medical imaging examinations simultaneously, merging the data to form a composite image. Hybrid fusion imaging equipment shall include, but not be limited to, PET/CT (Positron Emission Tomography/Computed Tomography) equipment, SPECT/CT (Single-Photon Emission Computed Tomography/Computed Tomography) equipment, and attenuation correction. Hybrid fusion imaging equipment shall not include ultrasound equipment.
"Licensed nuclear medicine technologist" means a person who possesses a valid license issued by the Department of Environmental Protection to engage in the practice of nuclear medicine technology.
b. The terms of office of the members appointed by the Governor shall be three years. Vacancies shall be filled for an unexpired term only in the manner provided for the original appointment.
c. Members of the board shall serve without compensation but shall be reimbursed for their reasonable and necessary traveling and other expenses incurred in the performance of their official duties.
d. The commissioner shall designate an officer or employee of the department to act as secretary of the board who shall not be a member of the board.
e. The board, for the purpose of transacting its business, shall meet at least once every four months at times and places fixed by the board. At its first meeting each year it shall organize and elect from its members a chairman. Special meetings also may be held at times as the board may fix, or at the call of the chairman or the commissioner. A written and timely notice of the time, place and purpose of any special meeting shall be mailed by the secretary to all members of the board.
f. A majority of the members of the board shall constitute a quorum for the transaction of business at any meeting.
(1) At the time of application is at least 18 years of age;
(2) Is of good moral character;
(3) Has successfully completed a four-year course of study in a secondary school approved by the State Board of Education, or passed an approved equivalency test.
b. In addition to the requirements of subsection a. hereof, any person seeking to obtain a license in a specific area of radiologic technology shall comply with the following requirements:
(1) Each applicant for a license as a diagnostic x-ray technologist (LRT (R)) shall have satisfactorily completed a 24-month course of study in radiologic technology approved by the board or its equivalent, as determined by the board.
(2) Each applicant for a license as a radiation therapy technologist (LRT(T)) shall have satisfactorily completed a 24-month course in radiation therapy technology approved by the board or the equivalent of such, as determined by the board.
(3) Each applicant for a license as a chest x-ray technologist (LRT(C)) shall have satisfactorily completed the basic curriculum for chest radiography as approved by the board or its equivalent, as determined by the board.
(4) Each applicant for a license as a dental x-ray technologist (LRT(D)) shall have satisfactorily completed the curriculum for dental radiography as approved by the board or its equivalent, as determined by the board.
(5) Each applicant for a license as a podiatric x-ray technologist (LRT(P)) shall have satisfactorily completed the basic curriculum for podiatric radiography as approved by the board or its equivalent, as determined by the board.
(6) Each applicant for a license as an orthopedic x-ray technologist (LRT(O)) shall have satisfactorily completed the basic curriculum for orthopedic radiography as approved by the board or its equivalent, as determined by the board.
(7) Each applicant for a license as an urologic x-ray technologist (LRT(U)) shall have satisfactorily completed the basic curriculum for urologic radiography as approved by the board or its equivalent, as determined by the board.
(8) Each applicant for a license as a radiologist assistant (RA) shall have satisfactorily completed the basic curriculum for a radiologist assistant as approved by the board or its equivalent, as determined by the board.
c. The board shall establish criteria and standards for programs of diagnostic or radiation therapy and approve these programs upon a finding that the standards and criteria have been met.
b. The program of radiation therapy technology shall be at least a 24-month course of study or its equivalent, as determined by the board. The curriculum for the course may follow the Commission on Accreditation of Allied Health Education Programs (CAAHEP) standards; provided that the standards are not in conflict with board policies.
c. The board shall establish criteria and standards for programs of chest radiography, podiatric radiography, orthopedic radiography, urologic radiography, dental radiography, and radiologist assistants and approve the programs upon a finding that the standards and criteria have been met.
d. An approved program of radiologic technology may be offered by a medical or educational institution or other public or private agency or institution, and, for the purpose of providing the requisite clinical experience, shall be affiliated with one or more hospitals that, in the opinion of the board, are likely to provide the experience.
a. Each applicant shall be required to pass a license examination designated and approved by the board for his specialty.
b. The board shall hold an examination at least once every 6 months at times and places as the board may determine.
c. An applicant who fails to pass the examination may reapply for the examination; provided the applicant complies with the conditions established by the board.
d. The board may accept, in lieu of its own examination, a current certificate of the American Registry of Radiologic Technologists issued on the basis of a registry examination satisfactory to the board, provided that the standards of that agency are at least as stringent as those established by the board.
e. The board may accept, in lieu of its own examination, a current certificate, registration or license as a radiologic technologist issued by another state, provided that the standards in the other state are at least as stringent as those established by the board.
f. The board may accept, in lieu of its own examination, a current certificate of the New Jersey Board of Dentistry issued on the basis of satisfactory completion of the certification examination given by the Certifying Board of the American Dental Assistants' Association and any educational requirements as may be prescribed by the New Jersey Board of Dentistry, provided that the standards of that association are at least as stringent as those established by the board.
a. The board shall issue a license to each candidate who has either successfully passed the examination, or who has paid the prescribed fee and has qualified under subsection d., e. or f. of section 8 of this act.
b. The board may, in its discretion, issue a limited license to any applicant who does not qualify, by reason of a restricted area or duration of training and experience, for the issuance of a license under the provisions of section 7 or 9 of this act, but who has demonstrated to the satisfaction of the board by examination that he is capable of performing the functions of a radiologic technologist in chest x-ray technology or of acting as a dental x-ray technologist, orthopedic x-ray technologist, urologic x-ray technologist or podiatric x-ray technologist. A limited license shall specify the activities that its holder may engage in, and shall be issued only if the board finds that its issuance will not violate the purposes of this act or tend to endanger the public health and safety.
c. The board may, in its discretion, issue a temporary license to any person whose license or relicense may be pending and in whose case the issuance of a temporary license may be justified by reason of special circumstances. A temporary license shall be issued only if the board finds that its issuance will not violate the purposes of this act or tend to endanger the public health and safety. A temporary license shall expire 90 days after the date of the next examination, if the applicant is required to take the same, or, if the applicant does not take the examination, then on the date of the examination. In all other cases, a temporary license shall expire when the determination is made either to issue or deny the applicant a regular license and in no event shall a temporary license be issued for a period longer than 180 days.
d. Every radiologic technologist shall carry his current license on his person at work. The license shall be displayed on request.
a. All licenses are renewable on December 31 of every even numbered year following the year of its issuance. A license shall be renewed by the board for a period of 2 years upon payment of a renewal fee in an amount to be determined by rule of the commission.
b. A radiologic technologist who has been heretofore duly licensed in this State and whose license has not been revoked or suspended, and who has temporarily ceased his activities as a radiologic technologist for not more than 5 years, may apply for the reissuance of a license upon compliance with the application provisions of this act, including payment of any outstanding fee.
c. Any person who, as of the effective date of this act, holds an unlimited certificate as a certified x-ray technologist (CXT) issued pursuant to P.L.1968, c. 291 shall be licensed as both a diagnostic x-ray and radiation therapy technologist until the expiration date of that certificate. Any person who, as of the effective date of this act, holds a limited certificate in chest x-ray, dental x-ray or radiation therapy pursuant to P.L.1968, c. 291 shall be licensed in that category until the expiration date of that certificate.
d. All CXT certifications shall be renewed by the board by the issuance of a license as a diagnostic x-ray technologist. All limited certificates shall be renewed only by the issuance of a license in the same limited category.
e. Within 5 years of the effective date of this act, the board may issue a license as a radiation therapy technologist to anyone upon the expiration of his CXT certificate upon the submission of a separate application accompanied by such information as required by the board and a fee as established by regulation.
(1) Is guilty of any fraud or deceit in the person's activities as a radiologic technologist or has been guilty of any fraud or deceit in procuring a license;
(2) Has been convicted in a court of competent jurisdiction, either within or without this State, of a crime involving moral turpitude, except that if the conviction has been reversed and the holder of the license discharged or acquitted, or if the person has been pardoned or the person's civil rights restored, the license may be restored;
(3) Has or had any medical problem, disability, or substance use disorder which, in the opinion of the board, would impair the person's professional competence;
(4) Has aided and abetted a person who is not a licensed radiologic technologist or otherwise authorized pursuant to section 4 of P.L.1981, c.295 (C.26:2D-27) in engaging in the activities of a radiologic technologist;
(5) Has undertaken or engaged in any practice beyond the scope of the authorized activities of a radiologic technologist pursuant to P.L.1981, c.295 (C.26:2D-24 et seq.);
(6) Has falsely impersonated a duly licensed or former duly licensed radiologic technologist or is engaging in the activities of a radiologic technologist under an assumed name;
(7) Has been guilty of unethical conduct as defined by rules promulgated by the commission;
(8) Has continued to practice without obtaining a license renewal as required by P.L.1981, c.295 (C.26:2D-24 et seq.);
(9) Has applied ionizing radiation to a human being without the specific direction of a duly licensed practitioner as defined herein; or to any person or part of the human body outside the scope of the specific authorization;
(10) Has acted or is acting as an owner, co-owner, or employer in any enterprise engaged in the application of ionizing radiation to human beings for the purpose of diagnostic interpretation, chiropractic analysis, or the treatment of disease;
(11) Has expressed to a member of the public an interpretation of a diagnostic x-ray film or fluorescent image;
(12) Has used or is using the prefix "Dr.," unless entitled to do so pursuant to a degree granted, the word "doctor" or any suffix or affix to indicate or imply that the radiologic technologist is a duly licensed practitioner as defined herein when not so licensed; or
(13) Is or has been guilty of incompetence or negligence in the person's activities as a radiologic technologist.
b. Proceedings against any radiologic technologist under this section shall be instituted by filing with the board a written charge or charges under oath against the radiologic technologist. The charges may be preferred by any person, corporation, association or public officer, or by the board in the first instance. A copy thereof, together with a report of the investigation as the board shall deem proper, shall be referred to the commission for its recommendation to the commissioner. If the commissioner determines the matter to be a contested case, the commissioner shall either designate three or more members of the board as a committee to hear and report on the charges and shall set a time and place for the hearing or shall refer the matter to the Office of Administrative Law for hearing before an administrative law judge, pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.). For the purpose of this section, the board, its committee, or the administrative law judge shall have power to issue subpenas for the appearance of witnesses, and to take testimony under oath. Upon review of the record of the hearing, the commissioner may affirm, modify, or reject the written report and recommendation of the committee or the administrative law judge. If the commissioner finds that the charges have not been proved, the commissioner shall order them dismissed. If the charges are found to be true, the commissioner may, in the commissioner's discretion, issue an order suspending or revoking the license of the accused, or otherwise disciplining the accused.
c. When the license of any person has been revoked or annulled, as herein provided, the board may, after the expiration of two years, accept an application for restoration of the license.
a. No person shall knowingly or negligently employ as a radiologic technologist any person who requires and does not possess a valid license to engage in the activities of a radiologic technologist.
b. No person shall knowingly or negligently employ as a radiologist assistant any person who requires and does not possess a valid license to engage in the activities of a radiologist assistant.
Any person who violates any provision of this act or any rule, regulation or order promulgated or issued pursuant to the act to which this act is supplementary shall be subject to the sanctions contained in P.L.1958, c. 116 (C. 26:2D-1 et seq.) as amended and supplemented.
This act shall be known and may be cited as "The Radiation Accident Response Act."
The Legislature hereby finds and determines that the citizens of the State of New Jersey are entitled to the maximum protection possible from any and all threats to their health and welfare which may result from a radiation accident at a nuclear facility or during the transportation of radioactive material; that existing emergency response capabilities to abate these threats are dispersed among various State and local agencies and private organizations and limited in geographic scope; and that the dangers posed by these accidents can best be minimized by the development and implementation of a comprehensive and coherent response plan to coordinate and guide all necessary and appropriate resources and personnel into a unified course of action.
As used in this act:
a. "Department" means the Department of Environmental Protection;
b. "Division" means the Division of State Police in the Department of Law and Public Safety;
c. "Nuclear facility" means any facility which would pose a threat to the health and welfare of the public in the event of a radiation accident, including, but not limited to, atomic fission or fusion electric generating facilities, nuclear fuel fabrication plants, nuclear fuel reprocessing plants, nuclear waste handling and disposal facilities, and any other facility requiring a certificate of handling pursuant to P.L.1977, c. 233;
d. "Plan" means the State Radiation Emergency Response Plan mandated by section 4 of this act;
e. "Radiation accident" means any occurrence or event during the operation and maintenance of any nuclear facility or during the transportation of radioactive material, which results in the release of unnecessary radiation, as defined in section 1 of P.L.1958, c. 116 (C. 26:2D-1);
f. "Operator" means the company or corporation operating a nuclear electric generating facility, when the company or corporation is a public electric utility authorized to petition the Board of Public Utilities to recover expenses directly related to the operation of a nuclear electric generating facility in New Jersey; however, when the facility is being operated by an affiliate or associated corporation of a public electric utility, "operator" means the public electric utility and not the affiliated or associated corporation.
The department and the division, after consultation with the Departments of Health, Energy, and Transportation and after careful review of all relevant guidelines established by the Federal Emergency Management Agency, shall, within 18 months of the effective date of this act, jointly prepare or cause to be prepared and adopt a State Radiation Emergency Response Plan. The plan shall be based upon planning criteria, objectives, requirements, responsibilities and concepts of operation for the implementation of all necessary and appropriate protective or remedial measures to be taken with respect to a radiation accident, or threatened radiation accident, at a nuclear facility or during the transportation of radioactive material, including but not limited to, the designation of all counties and municipalities which shall prepare radiation emergency response plans, the establishment and implementation of appropriate training programs for all personnel who may be involved in any aspect of radiation emergency planning and response, the establishment of an emergency operations headquarters proximate to the site of each nuclear facility from which emergency response operations can be coordinated efficiently and effectively, the development and installation of a mechanism to monitor all temporary circumstances or conditions such as road repairs, utility activities, and floods, which may impede or preclude implementation of the emergency response plan and apprise all relevant emergency response personnel thereof, the preparation and updating of an inventory of temporary housing facilities which may be required in the event of a radiation accident, the development and administration of a communications system to efficiently and effectively discharge all responsibilities and duties in the event of a radiation accident, the preparation of a public emergency response plan for residents of the affected area, the establishment of procedures and practices to review and monitor potential threats from nuclear facilities in neighboring states and to coordinate emergency response plans with any such plans established for such out-of-State-facilities, and a public emergency notification and public information and educational program to furnish all citizens who may be affected with information as they may require to act safely and prudently. The plan shall be revised and updated at least bi-annually; provided, however, that a thorough revision and updating shall be undertaken and completed at least 6 months prior to the projected commencement of operations of any new nuclear facility. The criteria, objectives, requirements, concepts of operation, and designations shall be published by the department and division within 3 months of the effective date of this act.
Every municipality in each county wherein is located one or more nuclear facilities or which is designated as an affected municipality within 6 months of the adoption of the designation and in conformity with the criteria and objectives, requirements, responsibilities, and concepts of operation established, shall prepare and submit to the county wherein it is located, a local radiation emergency response plan. The local radiation emergency response plans shall be submitted through the county for approval by the division and the department. The local plans shall be reviewed at least once every 18 months and revised, subject to county approval. Any municipality required to prepare an emergency response plan pursuant to this section may apply to the department for financial and technical assistance therefor.
Every county wherein is located one or more nuclear facilities or which is designated as an affected county, shall, within 6 months of the designation and in conformity with criteria and guidelines established, prepare and submit to the department and the division a county radiation emergency response plan which coordinates and supplements and, if necessary, replaces radiation emergency response plans of municipalities within its jurisdiction. The county emergency response plan shall, after initial approval, be updated at least every 18 months.
The department is authorized and directed to:
a. Carry out all duties and responsibilities established by any memorandum of understanding between the department and the division necessary or incident to the implementation of the plan;
b. Assess any danger attendant to a radiation accident, provide immediate public health and safety and other technical guidance, and coordinate on-site radiation emergency abatement procedures;
c. Provide public health and safety and other technical advice and guidance as it may deem appropriate with respect to the preparation and implementation of the plan;
d. Review, approve or modify, in cooperation with the division, all radiation emergency response plans and procedures developed or modified pursuant to this act;
e. Conduct, in cooperation with the division, public hearings annually in each designated county to determine the adequacy and effectiveness of the plan;
f. Direct, in cooperation with the division, the testing and evaluation of all plans developed pursuant to this act upon their adoption, and annually thereafter, to assure that all personnel with emergency response duties and responsibilities effectively carry out their assigned tasks;
g. Develop and implement a comprehensive monitoring strategy which shall include, but not necessarily be limited to, the daily monitoring of levels of radioactivity in the environment; and
h. Seek and apply for funds, grants, and other forms of financial assistance from the Federal Emergency Management Agency and any other public and private sources to support the purposes and provisions of this act.
The division is authorized and directed to:
a. Carry out all duties and responsibilities established by any memorandum of understanding between the department and the division necessary or incident to the implementation of the plan;
b. Exercise operational control during any threatened or actual radiation emergency;
c. Review, approve or modify, in cooperation with the department, all radiation emergency response plans and procedures developed or modified pursuant to this act;
d. Direct, in cooperation with the department, the testing and evaluation of all emergency response plans developed pursuant to this act upon their adoption, and annually thereafter, to assure that all personnel with emergency response duties and responsibilities effectively carry out their assigned tasks.
The Department of Health shall, within 1 year of the effective date of this act:
a. Complete and update annually a study of the public health aspects of nuclear emergency response planning, which study shall include, but not necessarily be limited to, an evaluation of existing medical facilities and personnel to determine the State's present capacity to respond to any radiation threat to public health; an evaluation of the evacuation plans of hospitals and other health care facilities and alternate sources of care for patients; and an inventory of the standby plans, capacity, and distribution of all prophylactic or preventive supplies and equipment deemed medically advisable for use, as well as an evaluation of the feasibility and desirability of the State purchase and distribution of potassium iodide in order to minimize the adverse effects of the radiation accident. The results of the study, and any recommendations, shall be submitted to the department and the division for their use in preparing the plan and relevant portions of such study shall be submitted by the department to the municipalities charged with developing local emergency response plans to assist them in the preparation of such plans;
b. Establish standards and criteria to identify those persons at greatest health risk in the event of radiation exposure so that they may be afforded maximum protection;
c. Develop a plan for medical services to evacuees en route and at the sites of temporary shelter, and submit such plan to the department and the division for incorporation into the plan;
d. Develop and implement appropriate training programs for emergency medical personnel, health facility managers, and health officers;
e. Develop and implement, in cooperation with the division and the department, public educational programs concerning the effects and hazards of radiation.
The Department of Transportation shall, within 1 year of the effective date of this act:
a. Complete a study evaluating all means of transportation serving affected counties and municipalities and, in conjunction with the Department of Health, develop an inventory of emergency transport vehicles. Such study shall be submitted to the department and the division, and relevant portions thereof shall be submitted by the department to municipalities charged with developing local emergency response plans for their use in preparing emergency response plans;
b. Prepare and submit to the department and the division for inclusion in the plan, and annually update, a radiation emergency transportation plan, which plan shall include, but not be limited to, the designation, construction, and maintenance of primary and secondary routes to be used by radiation emergency response personnel and the general public in the event of a radiation accident or threatened radiation accident, and the development of traffic management procedures sufficient to assure rapid access to and from any affected county or municipality.
The Department of Energy shall, within 1 year of the effective date of this act:
a. Complete a study and evaluation of all existing emergency energy supplies available to the State and accessible to affected counties and municipalities in the event of a radiation accident or threatened radiation accident, and submit such study to the department and the division, and relevant portions shall be submitted by the department thereof to municipalities charged with developing local emergency response plans for their use in preparing emergency response plans; and
b. Develop and submit to the department and the division, for inclusion in the plan, and update annually, an emergency energy supply plan to assure that any area affected by a radiation accident or threatened radiation accident, will have access to sufficient energy supplies to implement any emergency response plans or procedures.
b. The assessment against the operator of a single nuclear electric generating facility shall not exceed $2,750,000 (in 2003 dollars adjusted by the CPI) and, in the case of an operator of two or more nuclear electric generating facilities, the assessment shall not exceed $5,500,000 (in 2003 dollars adjusted by the CPI), and shall be assessed in an amount equal to the sum of the amounts in paragraphs (1) and (2) of this subsection and determined annually by the State Treasurer on or before June 30 in the following manner:
(1) The total amount appropriated to the various local, county and State agencies by law for the purpose of discharging their responsibilities under P.L.1981, c.302 (C.26:2D-37 et seq.) for the State's next fiscal year for costs related directly to a particular nuclear electric generating facility shall be assessed against the operator of that particular nuclear electric generating facility.
(2) All other amounts appropriated to the State agencies by law for the purpose of discharging their responsibilities under P.L.1981, c.302 (C.26:2D-37 et seq.) for the next fiscal year shall be assessed equally against each operator of a nuclear electric generating facility.
The assessment prescribed above shall be levied by the State Treasurer not later than July 1, and shall be paid within 30 days after mailing by first class mail to the affected operator of the nuclear electric generating facility notice thereof and a statement of the amount;
c. The assessments shall be appropriated through the regular appropriation process in accordance with a joint budget to be submitted by the division and the department;
d. Any costs of a local, county or State agency incurred in discharging its responsibilities under P.L.1981, c.302 (C.26:2D-37 et seq.), not reasonably required to carry out the purposes of P.L.1981, c.302 (C.26:2D-37 et seq.) or not generally associated with or related to the operation of nuclear electric generating facilities located in New Jersey, shall not be included in any such assessment or appropriation;
e. "CPI" means the annual Consumer Price Index for a calendar year as determined year to year using the decimal increase in the September through August, 12-month average for the previous year of the Consumer Price Index for All Urban Consumers (CPI-U), as published by the United States Department of Labor.
The amount of the assessment shall be determined by the State Treasurer. In making that determination, the State Treasurer shall include the salaries of the State Police and State National Guard personnel assigned supplemental security duties, the costs of all necessary specialized equipment and training, and all other expenditures directly related to having the State provide supplemental security at each nuclear electric generating facility. The amount of the assessment so determined shall not exceed the actual aggregate costs incurred by the State in providing supplemental security at these facilities.
To the greatest extent practicable, the State Treasurer shall apportion the assessment among the operators to reflect the actual costs incurred by the State in providing supplemental security at each particular nuclear electric generating facility.
The assessment apportioned each operator shall be due and payable at a time and in a manner prescribed by the State Treasurer.
Within 15 days after the date of mailing a statement as provided in this act, the operator of a nuclear electric generating facility against which the statement is rendered may file with the State Treasurer its objections thereto. Not less than 30 nor more than 60 days after giving notice thereof to the objecting utility, the State Treasurer shall hold a hearing on the objections.
If, after the hearing, the State Treasurer finds that any part of the charge against the objecting operator of a nuclear electric generating facility is excessive, erroneous, or invalid, he shall transmit to the operator of a nuclear electric generating facility, by registered mail, an amended statement in accordance with the findings, which shall have the same force and effect as an original statement. If the State Treasurer finds the entire statement invalid, he shall notify the objecting operator of a nuclear electric generating facility, by registered mail, of the determination, and the original statement shall be null and void. If the State Treasurer finds that the statement as rendered is neither excessive, erroneous, unlawful nor invalid, in whole or in part, he shall transmit notice thereof to the objecting utility by registered mail.
No action or proceeding shall be maintained in any court for the purpose of restraining or delaying the collection or payment of a statement rendered in compliance with the provisions of this act. An operator of a nuclear electric generating facility against which a statement is rendered shall pay the amount thereof, and after the payment may, in the manner provided by this act, at any time within two years from the date of the payment, bring against the State an action at law to recover the amount paid, with legal interest thereon from the date of payment, upon the ground that the assessment was excessive, erroneous, or invalid in whole or in part.
If any affected operator of a nuclear electric generating facility, to which a statement for the amount assessed against it as provided in this act has been rendered, fails to pay the amount within 30 days, or fails to file with the State Treasurer objections to the statement as provided herein, the State Treasurer shall proceed to collect the amount stated to be due, with legal interest, by seizure and sale of any goods or chattels, including stocks, securities, bank accounts, evidences of debt and accounts receivable belonging to the affected operator of a nuclear electric generating facility anywhere within the State.
The department and the division are authorized in accordance with the provisions of the "Administrative Procedure Act," P.L.1968, c. 410 (C. 52:14B-1 et seq.), to jointly promulgate, adopt, and enforce any rules and regulations necessary or appropriate to carry out the purposes and intent of this act.
The department and the division shall have the authority to enter and inspect any building or place for the purpose of determining compliance or noncompliance with the provisions of this act, any rules or regulations adopted pursuant thereto, or the plan.
The existing State Radiation Emergency Plan, as contained in the PIPAG Manual (Procedures for Implementing Protective Action Guides), or any other radiation emergency plan approved pursuant to State or federal law shall continue in full force and effect until all emergency response plans required by this act are adopted.
If any section, part, phrase, or provision of this act or the application thereof to any person be adjudged invalid by any court of competent jurisdiction, the judgment shall be confined in its operation to the section, part, phrase, provision, or application directly involved in the controversy in which the judgment shall have been rendered and it shall not affect or impair the validity of the remainder of this act or the application thereof to other persons.
Any person who willfully violates this act or any rule, or regulation promulgated pursuant hereto, including the State Radiation Emergency Response Plan, shall be liable to a penalty of not more than $2,500.00 for each offense, to be collected by the department and the division in a summary proceeding under "the penalty enforcement law" (N.J.S. 2A:58-1 et seq.) or in any case before a court of competent jurisdiction wherein injunctive relief is requested. If the violation is of a continuing nature, each day during which it continues shall constitute an additional, separate and distinct offense. The department and the division are authorized to compromise and settle any claim for penalty under this section in an amount in their discretion as may appear appropriate in all these circumstances.
In implementing the provisions of this act, the department and the division shall seek the advice of the Governor's Advisory Council for Emergency Services established pursuant to P.L.1972, c. 133.
The Department of Environmental Protection shall prepare and transmit to the Governor and Legislature a study concerning the dangers posed to the public health, safety, and welfare by the presence of radon gas and radon progeny in residential dwellings, schools, and public buildings in the State. The study shall identify the potential sources of contamination in the State, identify demographic, geologic, and geographic areas subject to an actual or potential threat or danger of contamination, and develop a cost-effective strategy for radon gas and radon progeny contamination testing. The study shall include recommendations for private actions to solve or alleviate potential health problems and any legislative or executive action that should be taken. The department shall prepare and transmit to the Governor and the Senate Institutions, Health and Welfare Committee and the General Assembly Agriculture and Environment Committee interim reports on its progress in implementing this section. The department shall transmit its first report on May 1, 1986 and subsequent reports every six months thereafter.
The Department of Health shall conduct an epidemiologic study of cancer and the presence of radon gas and radon progeny in residential dwellings and shall maintain a voluntary registry of persons at risk of radiogenic lung cancer. The department shall communicate promptly to persons on the registry new techniques for the prevention of mortality from the disease.
The Department of Environmental Protection and the Department of Health shall coordinate to establish a program of confirmatory monitoring of the presence of radon gas and radon progeny in residential dwellings, utilizing local health officers and the Department of Environmental Protection personnel.
The Departments of Environmental Protection and Health shall also coordinate to establish a public information and education program to inform the public of the potential health effects of the presence of radon gas and radon progeny in residential dwellings, and the presence of radium in potable water supplies, and the geographic areas in the State subject to an actual or potential threat of danger and the measures which can be taken to protect the health, safety, and welfare of the citizens of the State. This public information and education program shall include:
a. A cooperative program with county and local health departments to facilitate health education in response to requests from the public; and
b. A toll-free public telephone information service within the Department of Environmental Protection to answer questions from residents of the State concerning radon gas and radon progeny contamination, or radium contamination, or both, as the case may be. The availability of the public telephone information service shall be published in the major newspapers circulated in the geographic areas of this State subject to an actual or potential threat of danger from radon gas or radon progeny contamination, or from the presence of radium in potable water supplies, as appropriate.
The Department of Environmental Protection shall within 180 days of the enactment of this act establish a program for the certification of persons who test for the presence of radon gas and radon progeny in buildings.
The Department of Environmental Protection shall within 180 days of the enactment of this act establish a program for the certification of persons who mitigate, and safeguard buildings from, the presence of radon gas and radon progeny.
Beginning 90 days after the establishment of the certification programs by the Department of Environmental Protection pursuant to sections 1 and 2 of this act, no person who is not certified pursuant to section 1 or section 2 of this act, as appropriate, shall test for, or mitigate or safeguard a building from, the presence of radon gas and radon progeny. The provisions of this section shall not apply to a person performing this testing or mitigation on a building which he owns, or to a person performing testing or mitigation without remuneration.
No person shall disclose to any person, except to the Department of Environmental Protection or the Department of Health, the address or owner of a nonpublic building that the person tested or treated for the presence of radon gas and radon progeny, unless the owner of the building waives, in writing, this right of confidentiality.
The provisions of this section shall not apply to a person performing testing or treatment on a building which he owns, or to instances where disclosure is necessary to contract for further testing or to contract for the mitigating and safeguarding of a building from the presence of radon gas and radon progeny. In the case of a prospective sale of a building which has been tested for radon gas and radon progeny, the seller shall provide the buyer, at the time the contract of sale is entered into, with a copy of the results of that test and evidence of any subsequent mitigation or treatment, and any prospective buyer who contracts for the testing shall have the right to receive the results of that testing.
A person certified pursuant to section 1 or 2 of this act to provide testing or mitigation services shall, within 30 days of the provision of these services, disclose to the Department of Environmental Protection the address or location of the building, the name of the owner of the building where the services were provided, and the results of any tests performed. The Department of Environmental Protection shall provide to the Department of Health this information upon the request of the Department of Health.
The department shall establish a fee schedule to cover the costs of the certification programs established pursuant to sections 1 and 2 of this act.
The department shall, pursuant to the "Administrative Procedure Act," P.L. 1968, c. 410 (C. 52:14B-1 et seq.), adopt rules and regulations to implement the provisions of this act.
A person who violates the provisions of section 3, 4, or 5 of this act, or any rule or regulation adopted pursuant thereto, is guilty of a crime of the third degree.
For the purposes of P.L. 1963, c. 73 (C. 47:1A-1 et seq.), health data relating to individuals and data relating to radon gas and radon progeny contamination at specific properties, including residential dwellings, gathered pursuant to the provisions of this act and the provisions of P.L. 1985, c. 408 (C. 26:2D-59 et seq.) shall not be deemed to be public records. The Department of Health and Environmental Protection shall destroy all information in their possession relating to the names and addresses of persons owning properties on which data were collected relating to radon gas and radon progeny contamination, at the end of five years from the date on which the data were collected.
The Departments of Environmental Protection and Health are authorized to employ persons with specialized scientific training necessary to implement the provisions of P.L. 1985, c. 408 (C. 26:2D-59 et seq.) without regard to the provisions of Title 11 of the Revised Statutes.
The Department of Community Affairs is authorized to enter into an agreement with a public or private agency to carry out testing for radon gas and radon progeny at the sites of residential dwellings, the construction of which is in progress or commences on or after the effective date of this act, and to provide funding for that testing, provided that each $1.00 of that funding is matched by $1.00 from other public or private sources.
The Legislature finds and declares that:
Tanning facilities are not regulated by the State of New Jersey and the number of tanning facilities is rapidly growing throughout the State; various physical complications can arise from frequent and unsupervised use of these tanning facilities such as, overexposure to ultraviolet radiation which can cause severe sunburn and eye injury including cataracts and corneal damage; repeated exposure to ultraviolet light in tanning facilities can also cause premature aging of the skin, skin cancers and abnormal skin sensitivity in persons who may be using certain drugs including some tranquilizers, diuretics, antibiotics, high blood pressure medicines and birth control pills.
It is, therefore, desirable that citizens are protected against any problems which may result from improperly functioning equipment in tanning facilities, and given the potential for harm that is presented by establishments using artificial suntan sources, it is imperative that effective minimum safety standards in this health area be established.
As used in this act: "tanning facility" means any location, place, area, structure or business that, either as a sole service or in conjunction with other services, provides patrons with access to sunlamps, ultraviolet lamps or other equipment intended to induce skin tanning through the irradiation of any part of the human body for cosmetic or nonmedical purposes.
b. (1) A tanning facility operator shall permit a person who is at least 14 years of age to use spray tanning in a tanning facility.
(2) A tanning facility operator shall not permit a person who is under 17 years of age to use a tanning bed. A tanning facility operator shall permit a person who is at least 17 years of age to use a tanning bed, provided that the person's parent or guardian is present at the tanning facility for the initial consultation.
(3) An emancipated minor shall be exempt from the provisions of this subsection upon legal proof documenting said emancipation.
c. (Deleted by amendment, P.L.2013, c.39).
d. The penalties for violating the provisions of this section shall be as provided in section 7 of P.L.1989, c.234 (C.26:2D-87).
a. Establishment of a maximum safe time of exposure to radiation and a maximum safe temperature at which tanning devices may be operated;
b. A requirement that a patron at a tanning facility wear protective eye glasses when using tanning equipment and that a patron be supervised as to the length of time the patron uses tanning equipment at the facility;
c. A requirement that the facility operator post easily legible, permanent warning signs near the tanning equipment which state: "DANGER-ULTRAVIOLET RADIATION FOLLOW ALL INSTRUCTIONS";
d. A requirement that the facility have protective shielding for tanning equipment in the facility; and
e. A requirement that the facility operator post a sign in conspicuous view at or near the reception area which states: "PERSONS UNDER AGE 14 SHALL NOT BE PERMITTED TO USE SPRAY TANNING IN THIS TANNING FACILITY. PERSONS WHO ARE AT LEAST 17 YEARS OF AGE SHALL BE PERMITTED TO USE A TANNING BED IN THIS FACILITY PROVIDED THAT A PARENT OR LEGAL GUARDIAN IS PRESENT FOR THE INITIAL CONSULTATION."
The local board of health in the municipality in which a tanning facility is located shall certify that a facility is in compliance with the safety standards established pursuant to section 3 of this act and shall periodically inspect the facility to ensure continued compliance with the standards.
b. The Department of Health shall establish a registration fee schedule, by regulation, to cover the costs of implementing the provisions of this act, including the costs incurred by local boards of health pursuant to section 4 of this act.
A penalty recovered under the provisions of P.L.1989, c.234 (C.26:2D-81 et seq.) and P.L.2006, c.48 (C.26:2D-82.1 et al.) shall be recovered by and in the name of the Commissioner of Health or by and in the name of the local board of health. When the plaintiff is the Commissioner of Health the penalty recovered shall be paid by the commissioner into the treasury of the State. When the plaintiff is a local board of health, the penalty recovered shall be paid by the local board of health into the treasury of the municipality where the violation occurred.
This act shall be known as the Public Health Priority Funding Act of 1977.
The Legislature also recognizes that there exists a framework for the provision of such services at the municipal, regional and county levels but that changing socio-economic, environmental and technological conditions warrant a redirection of the ways of addressing these health problems. The Legislature finds that there should be provided funds to support certain public health priority activities.
For the purposes of this act unless the context clearly requires a different meaning:
(a) "Local health agency" means any county, regional, municipal or other governmental agency organized for the purpose of providing health services, administered by a full-time health officer and conducting a public health program pursuant to law.
(b) "Commissioner" shall mean the State Commissioner of Health or his designee.
(c) "Special projects and development fund" shall mean the fund established in section 7 of this act.
(d) "Priority health services" means those core activities pertaining to communicable disease and chronic illness as contained in the "standards of performance" or supplemented from the list of recognized activities as contained in the "standards of performance," and designated annually by the commissioner with the approval of the Public Health Council. For the purposes of this subsection, "standards of performance" means the "Recognized Public Health Activities and Minimum Standards of Performance for Local Boards of Health in New Jersey" as prescribed by the Public Health Council of the State Department of Health under authority of P.L.1947, c. 177 (C. 26:1A-1 et seq.).
(e) "Public health priority fund" shall mean State funds for priority health services to be rendered by local health agencies but shall not include grants from the special projects and development fund.
(f) "Annual expenditures for health purposes" shall mean the local effort as represented by the expenditures by a local health agency for health services which comply with the "standards of performance" excluding any sum paid to the local health agency as public health priority funds under the provisions of this act.
(g) (1) "Noninstitutional population" shall mean the number of inhabitants of a municipality or a group of municipalities making up a local health agency jurisdiction as enumerated in the last Federal census, or by a special census made by the Federal Bureau of the Census, or as estimated annually by the Department of Labor and Industry, whichever is the most recent, except that military personnel living on military reservations, inmates of Federal, State, and county institutions, and boarding students of colleges and universities shall be excluded.
(2) "Special needs population" shall mean the sum of the number of persons having income less than the poverty level and the number of persons over the age of 65, as listed in the most recent Federal census.
(h) "Full-time health officer" means a holder of a license as a health officer issued by the State Department of Health and who is employed by a local health agency to function during all the working hours of the regularly scheduled work week of the governmental unit to which the local health agency is attached and not regularly employed during the working hours of that scheduled work week in other activities for which he receives remuneration.
(i) Deleted by amendment.
(j) Deleted by amendment.
(k) "Criteria for participation" shall mean that a local health agency serving a minimum population of 25,000 is under the administrative direction of a full-time health officer, and all other employees are appropriately qualified and licensed as required by law. The minimum population of 25,000 may be waived at the discretion of the commissioner in the case of a local health agency which from the period beginning January 1, 1960, has carried on and continues to carry on a comprehensive public health program under the direction of a full-time health officer.
Public health priority funds for each municipality within the local health agency shall be determined by the following formula:
PHPF=(p/c factor x nip x (2-rfs)) + (p/c factor x snp)
PHPF =Public health priority fund
p/c factor=Per capita amount deemed necessary to provide priority health services
NIP =Noninstitutional population
SNP =Special needs population
RFS =The relative fair share factor of a municipality, and is the ratio that the equalized valuation of a municipality divided by its noninstitutional population bears to the total equalized valuation of all municipalities divided by the noninstitutional population of the State. The equalized valuation for each municipality is the equalized valuation promulgated by the Director of the Division of Taxation pursuant to P.L.1954, c. 86 (C. 54:1-35.1) plus the amount determined by dividing the sum of the amounts received by the municipality for personal property tax replacement pursuant to P.L.1966, c. 135 (C. 54:11D-1 et seq.) and from public utility franchise and gross receipt taxes pursuant to P.L.1940, c. 4 (C. 54:30A-16 et seq.) by the equalized tax rate of the municipality. The equalized tax rate of a municipality is determined by dividing the amount on which the local tax rate is computed, as indicated in the table of aggregates prepared pursuant to R.S. 54:4-52, by the equalized valuation promulgated by the Director of the Division of Taxation. For any municipality whose ratio is one-half or less, its factor shall be zero. For any municipality whose ratio is greater than two, its factor is two.
Public health priority funds shall be used only for the support of priority health services provided by the local health agency, and shall not be provided for use in substitution for the mean annual expenditures for health purposes of the agency during the 2 years immediately preceding the year for which public health priority funds are requested.
(b) Except as provided in subsection (c) of this section, grants from the special projects and development fund for specific purposes shall be made on an annual basis for a period not in excess of 5 years and such grants shall be in diminishing amounts during this period. The commissioner shall determine the conditions applicable to each such grant including the extent of local financial participation to be required. Grants from the special projects and development fund to voluntary health agencies shall not exceed 40% of said fund.
(c) (1) Grants from the special projects and development fund shall be made on an annual basis to local health agencies for local enforcement efforts concerning the sale and commercial distribution of tobacco products to persons under the age of 21 years, in an amount determined by the commissioner. The grants shall be distributed based on the number of cigarette retail dealer and vending machine licenses issued within a local health agency's jurisdictional authority in order to ensure Statewide coverage and Statewide consistency of enforcement efforts; except that the commissioner may designate up to 5% of available funds, annually, for incentive grants to local health agencies to enhance enforcement efforts.
Each grant recipient shall report quarterly to the commissioner on the number of compliance check inspections it has completed and the results of those compliance checks. The commissioner shall determine any other conditions applicable to the grants.
(2) Beginning in 1999, notwithstanding the provisions of paragraph (1) of this subsection to the contrary, the commissioner may make grants from the special projects and development fund to public and private local agencies to reduce teenage use of addictive substances.
A local health agency may qualify for a grant under one or more of the sections of this act.
Pending final passage of the applicable General Appropriations Act, the commissioner shall notify each eligible local health agency as to the priority health services and the amount of public health priority funds estimated to be payable during the next calendar year to provide these services. On or before a date set by the commissioner, the health officer of each local health agency, or in his absence another person designated by the official body under which the local health agency operates, may submit an application for public health priority funds for the following calendar year. The application shall include the budget of the agency, the plan of work and such other information as the commissioner may require, to be presented in a form prescribed by the commissioner. It shall be the responsibility of the applicant to describe in detail in the application how all the public health priority services will be met by the local health agency. The application shall be certified, under the penalties of perjury, as true to the best knowledge of the person making it.
The sum payable as public health priority funds to each local health agency shall be payable one-half on July 1, and one-half on January 1. Payments shall be made by the State Treasurer upon certificate of the commissioner and warrant of the Director of the Division of Budgeting and Accounting.
In order to insure that the public health priority funds are expended in conformance with the provisions of this act, the commissioner shall, when he deems it in order, have an audit made of the expenditures of moneys and of services provided by the local health agency receiving public health priority funds and shall, when he shall deem it necessary, have examined all books, papers and vouchers of the agency and its fiscal agent shall have free and unrestricted access thereto for that purpose.
Following fiscal audits, all unexpended public health priority funds and audit exceptions as determined by the commissioner shall be returned to the State Department of Health within 3 months of notification. Such funds shall be expended for priority health services in accordance with the standards of performance and made available as special grants to local health agencies upon application and amounts approved by the commissioner with concurrence of the Public Health Council.
When it has been determined that a local health agency fails to provide priority health services in accordance with standards of performance called for in its plan of work as stated in its application for public health priority funds or ceases to comply with the criteria for participation, public health priority funds may be reduced or discontinued by the commissioner when, in his judgment, such action serves to further the general purposes of this act. When it has been determined that a local health agency fails to meet the dates established pursuant to sections 9 and 14 of P.L.1966, c. 36 (C. 26:2F-9 and C. 26:2F-14) for submission of the application for public health priority funds or required reports, public health priority funds will be reduced by one day's allocation of the total amount, for each day that the application or report is late. This penalty may be waived, or modified, at the discretion of the commissioner for good cause shown. The penalty may be imposed by decreasing the local health agency allocation of public health funds for the following year.
Unallocated public health priority funds for the fiscal year may be carried forward and made available in the following fiscal year as special grants to local health agencies upon application by such agencies. The amounts of special grants shall be approved by the commissioner with the concurrence of the Public Health Council. Such special grants shall be made available to local health agencies only for extraordinary purposes.
The commissioner shall have all the powers necessary to make, establish and amend, after consultation with the Public Health Council, such administrative rules as may be necessary, desirable or proper to carry out his powers and duties under this act.
Each local health agency receiving public health priority funds shall on or before October 15 in each year, following the year for which the public health priority funds were received, prepare and file with the commissioner an annual report for the preceding State fiscal year. Such report shall state the condition of the public health within the limits of its jurisdiction, noting therein any special cause for the deterioration of health or of hazard thereto, and shall contain answers to any questions which may have been addressed to the local health agency by the commissioner.
The per capita factor for the purposes of this act shall be specified for each year in the General Appropriations Act or in a supplement thereto.
a. For over 25 years, New Jersey's public health leaders have pursued interest in establishing a public health institute dedicated to promoting health, well-being, and quality of life for people throughout New Jersey.
b. Public health institutes are typically independent, nonprofit organizations that collaborate with public and private sector stakeholders, philanthropists, charitable organizations, and other agencies to foster public health solutions and systematically improve the way health agencies and organizations respond to public health threats and inequities.
c. Across the United States, there are currently over 40 designated public health institutes working in partnership with State and local departments of health to enhance cross-sector initiatives and bridge gaps between health care and community services.
d. These existing public health institutes help states leverage and diversify the personnel, infrastructure, and resources needed to accelerate solutions to various forms of public health threats including, but not limited to, communicable disease outbreaks, chronic and sexually transmitted diseases, substance use epidemics, issues related to food access and security, and systemic racial inequities affecting health care.
e. The COVID-19 pandemic has amplified the need for a public health institute in New Jersey that can work with public and private health care officials and providers to ensure a coordinated, resilient, equitable response to any public health emergency or state of emergency.
f. In 2022, the Nicholson Foundation and Robert Wood Johnson Foundation collaborated with a wide range of stakeholders from public health, healthcare, social services, and community organizations and issued a report entitled, "Seizing the Moment: How a Public Health Institute Would Advance Health Equity in New Jersey."
g. The report observed that New Jersey's public health infrastructure and system has been strained for several decades due to a lack of funding and insufficient coordination across health and related sectors and further noted that the impact of social and economic determinants of health have caused health inequities along racial, ethnic, income, and other fault lines
h. The report recommended the establishment of a public health institute in New Jersey centered around efforts to address the root causes of health disparities and inequities, create a more stable, robust, public health infrastructure that systemically advances health equity and quality of life for all, and provide timely and nimble administrative and operational support to New Jersey's public health agencies.
i. In order to support and sustain a relationship between State government and a public health institute, it is necessary to establish a framework by which the New Jersey Department of Health may engage in a public-private partnership with an organization that can serve as the State's "Public Health Institute."
j. The Public Health Institute will actively promote collaborative and community-driven partnerships designed to improve public health systems and services throughout the State.
k. The primary role of the Public Health Institute will be to collaborate with State departments and agencies, as well as private sector health care, academic, philanthropic, business and faith communities, and New Jersey's Regional Health Hubs, to coordinate and implement strategies in areas of policymaking, research and innovation, data collection, workforce development, and community-based interventions and services, and to improve the overall state of public health in New Jersey, with a particular focus on eliminating racial disparities and inequities in public health.
"Commissioner" means the Commissioner of Health.
"Department" means the Department of Health
"Public Health Institute" means an entity designated by the Department of Health as the State's Public Health Institute pursuant to section 3 of P.L.2025, c.46 (C.26:2FF-3).
b. The purpose and objective of the Public Health Institute shall be to:
(1) coordinate among national, State, and local agencies including, but not limited to, local and county health departments, Regional Health Hubs designated pursuant to P.L. 2019, c.517 (C.30:4D-8.16 et seq.), licensed health care facilities, public health-related advocacy and membership organizations, and private organizations for the purposes of promoting equitable public health services in New Jersey;
(2) provide timely and nimble administrative, operational, and fiscal support to public and private health agencies, community-based organizations, and other strategic partners;
(3) develop and implement projects, programs, initiatives, or services designed to improve public health outcomes, address racial disparities in public health, including the underlying systemic root causes of health disparities and inequities, and bridge gaps between public and private sector health care and community services;
(4) promote, support, and fund programs related to workforce development, education, applied research, policy development, and other initiatives that advance the purposes of the Public Health Institute;
(5) enter into contracts for the purchase of medical countermeasures, supplies or therapeutics, or other products or service agreements as may be necessary to aid the department in advancing or protecting the public health; and
(6) engage in charitable programs dedicated to the purposes and objectives of the Public Health Institute.
c. The commissioner shall establish criteria that an entity must satisfy to be designated as a Public Health Institute, which criteria shall include, at a minimum, the following:
(1) be a nonprofit organization located in New Jersey which is exempt from federal taxation pursuant to Section 501(c)(3) of the federal Internal Revenue Code (26 U.S.C. s.501(c)(3));
(2) be recognized by the National Network of Public Health Institutes or any successor accreditation body for public health institutes;
(3) possess the capacity to integrate and coordinate public health functions on a local, county, and Statewide level;
(4) maintain a network of personnel with expertise in the areas of health care data collection and analysis, health care policy, health care information systems, and public health research; and
(5) any other criteria established by the commissioner.
d. An entity designated as the Public Health Institute pursuant to subsection a. of this section shall enter into an agreement with the department requiring the entity to:
(1) comply with all applicable laws and regulations necessary to qualify for and maintain its nonprofit status, including, but not limited to, the "New Jersey Nonprofit Corporation Act," N.J.S.15A:1-1 et seq., and section 501(c) of the federal Internal Revenue Code (26 U.S.C. s.501(c));
(2) regularly consult with and give due consideration to the input and recommendations of the Department of Health and local health departments in carrying out its duties under this act;
(3) develop and submit to the department an operational plan that includes a mission statement that supports, complements, and supplements the missions of the department;
(4) submit to the department an initial startup plan of certain issues, projects, and action items the Public Health Institute shall pursue in the first three years of its designation;
(5) submit periodic planning documents and progress reports to the department at such intervals as may be determined by the commissioner;
(6) provide information, assistance, and services as may be required by the department in order to design, plan, implement, or coordinate any projects, programs, initiatives, or services that advance the mutual purposes of the department and the Public Health Institute;
(7) report any data collected or maintained by the Public Health Institute to the department, including data related to public health projects, programs, initiatives, or services, and any other information that may advance the mutual purposes of the department and the Public Health Institute, provided that such data is submitted to the department in a manner consistent with any applicable State and federal law, rule, regulation, or agreement; and
(8) comply with any other requirements as may be determined by the commissioner.
e. The commissioner may, as a condition of a nonprofit entity maintaining its designation as the Public Health Institute, require such nonprofit entity to perform such additional tasks or satisfy additional requirements on a continuing basis.
f. The commissioner may rescind the commissioner's designation of the Public Health Institute in accordance with the terms of agreement entered into pursuant to subsection d. of this section.
There is hereby established in the Department of Health a division which shall be known as the Division of Narcotic and Drug Abuse Control.
As used in this act, unless the context clearly indicates otherwise, the word "division" means the Division of Narcotic and Drug Abuse Control established herein.
The administrator and head of the division shall be a director, who shall be known as the Director of Narcotic and Drug Abuse Control, and who shall be a person qualified by training and experience to perform the duties of his office. The director shall be appointed by the Governor, with the advice and consent of the Senate, and shall serve at the pleasure of the Governor during the Governor's term of office and until the appointment and qualification of the director's successor. The director shall receive such salary as shall be provided by law.
a. To survey and analyze the State's need and formulate a comprehensive plan for the long-range development, through the utilization of federal, State, local, and private resources, of adequate services and facilities for the prevention and control of substance use disorders involving drugs and the diagnosis, treatment, and rehabilitation of persons with substance use disorders involving drugs, and from time to time to revise such plan.
b. To promote, develop, establish, co-ordinate, and conduct unified programs for education, prevention, diagnosis, treatment, aftercare, community referral, rehabilitation, and control in the field of substance use disorders involving drugs, based on the comprehensive plan formulated under paragraph a. of this section, and, in co-operation with such other Federal, State, local, and private agencies as are necessary and within the amount made available by appropriation therefor implement and administer such programs.
c. To direct and carry on basic, clinical, epidemiological, social science, and statistical research in substance use disorders involving drugs either individually or in conjunction with other agencies, public or private and, within the amount made available by appropriation therefor, develop pilot programs. In pursuance of the foregoing and notwithstanding any other provision of law, the director is empowered to establish, direct, and carry on experimental pilot clinic programs for the treatment of substance use disorders involving drugs and of the condition of persons with substance use disorders involving drugs.
d. To provide education and training in prevention, diagnosis, treatment, rehabilitation, and control of substance use disorders involving drugs for medical students, physicians, nurses, teachers, social workers, and others with responsibilities for persons with substance use disorders involving drugs, either alone or in conjunction with other agencies, public or private.
e. To provide public education on the nature and results of substance use disorders involving drugs and on the potentialities of prevention and rehabilitation in order to promote public understanding, interest, and support.
f. To disseminate information relating to public and private services and facilities in the State available for the assistance of persons with substance use disorders involving drugs and persons with potential substance use disorders involving drugs.
g. To gather information and maintain statistical and other records relating to persons with substance use disorders involving drugs and substance use disorders involving drugs in the State. It shall be the duty of every physician, dentist, veterinarian, or other person who is authorized to administer or professionally use narcotic, depressant, or stimulant drugs, or hospitals, clinics, dispensaries, or persons authorized to dispense narcotic, depressant, or stimulant drugs and all public officials having duties to perform with respect to such drugs or users of such drugs to report and supply such information in relation thereto as the director shall by rule, regulation, or order require.
h. To submit to the Governor, the Legislature and the Commissioner of Health an annual report of the division's operations and specific recommendations pertaining to matters within the scope of its jurisdiction in proper bill form not later than January 15 of each year.
i. To provide psychiatric, medical and psychological services to the Department of Human Services and similar agencies of the political subdivisions of the State with respect to prisoners and parolees who have or had at any time a substance use disorder involving drugs.
j. With the approval of the Governor, to accept as agent of the State any gift, grant, devise, or bequest, whether conditional or unconditional, for any of the purposes of P.L.1969, c.152 (C.26:2G-1 et seq.). Any moneys so received may be expended by the director to effectuate any purpose of P.L.1969, c.152 (C.26:2G-1 et seq.) subject to the same limitations as to approval of expenditures and audit as are prescribed for State moneys appropriated for the purposes of P.L.1969, c.152 (C.26:2G-1 et seq.).
k. To make agreements with the federal government, political subdivisions, public agencies or private agencies to do or cause to be done that which may be necessary, desirable or proper to carry out the purposes and objectives of this article within the amounts made available therefor by appropriation, gift, grant, devise, or bequest.
l. To control and regulate the manufacture, sale, distribution, possession, and use of narcotic, depressant, and stimulant drugs in accordance with the provisions of this act and chapter 18 of Title 24 of the Revised Statutes.
m. To prescribe, amend, and rescind rules and regulations to effectuate the purposes of P.L.1969, c.152 (C.26:2G-1 et seq.).
(a) The director shall organize the division and establish therein such bureaus and subordinate organizational units as he may deem necessary and expedient. He may formulate and adopt rules and regulations and prescribe duties for the efficient conduct of the business work and general administration of the division, its officers and employees. In addition the director may delegate to subordinate officers or employees in the division such of his powers as he may deem desirable, to be exercised under his supervision and direction.
(b) The director shall designate any officer or employee in the department to perform all of the powers, functions and duties of the director during the absence or disability of the director. Such designation shall be subject to the approval of the Governor, and the Commissioner of Health, and shall be in writing and filed with the Secretary of State. In the event that the director shall die, resign or be removed from his office or become disqualified to execute the duties of his office or a vacancy shall occur in the office of director for any cause whatever, the person designated as aforesaid shall have and exercise the powers and perform the functions, powers and duties of the director until the successor of the director is appointed and shall qualify.
The director may apply for and accept on behalf of the State any grants from the Federal Government or any agency thereof, or from any foundation, corporation, association or individual, and may comply with the terms, conditions and limitations thereof, for any of the purposes of the division. Any money so received may be expended by the division, subject to any limitations imposed in such grants to effect any of the purposes of the division, as the case may be, upon warrant of the Director of the Division of Budget and Accounting of the Department of the Treasury on vouchers certified and approved by the director. The power herein granted shall be in addition to and shall in no way limit the authority granted to the director by other existing law.
All appropriations and other moneys available and to become available to any department, division, bureau or other agency, the functions, powers and duties of which have been herein assigned or transferred to the Division of Narcotic and Drug Abuse Control, are hereby transferred to the Division of Narcotic and Drug Abuse Control established hereunder, and shall be available for the objects and purposes for which appropriated, subject to any terms, restrictions, limitations or other requirements imposed by State or Federal law.
Such employees of any department, commission, council, board, authority, office or other agency, the functions, powers and duties of which have been herein assigned or transferred to the Division of Narcotic and Drug Abuse Control or to any office, authority or agency designated, continued or constituted therein, as the Director of Narcotic and Drug Abuse Control may determine are needed for the proper performance of the functions and duties imposed upon the Division of Narcotic and Drug Abuse Control, or such office, authority or agency therein, are hereby transferred to the department, division, office, authority or agency to which such functions, powers and duties have been herein assigned or transferred.
Nothing in this act shall be construed to deprive any person of any tenure rights or of any right or protection provided him by Title 11, Civil Service, of the Revised Statutes, or under any pension law or retirement system.
All files, books, papers, records, equipment and other property of any department, commission, council, board, office, authority or other agency, the functions, powers and duties of which have been herein assigned or transferred to the Division of Narcotic and Drug Abuse Control or to any office, authority or agency designated, continued or constituted hereunder, shall upon the effective date of this act be transferred to the department, division, office, authority or agency to which such assignment or transfer has been made hereunder.
This act shall not affect the orders, rules and regulations heretofore made or promulgated by any department, commission, council, board, authority, officer or other agency, the functions, powers and duties of which have been herein assigned or transferred to the Division of Narcotic and Drug Abuse Control or to any officer, authority or agency designated, continued or constituted hereunder; but such orders, rules and regulations shall continue with full force and effect until amended or repealed pursuant to law.
This act shall not affect actions or proceedings, civil or criminal, brought by or against any department, commission, council, board, authority, officer or other agency, the functions, powers and duties of which have been herein assigned or transferred to the Division of Narcotic and Drug Abuse Control or to any officer, authority or agency designated, continued or constituted hereunder, and pending on the effective date of this act, but such actions or proceedings may be prosecuted or defended in the same manner and to the same effect by the department, division, office, authority or agency to which such assignment or transfer has been made hereunder, as if the foregoing provisions had not taken effect; nor shall any of the foregoing provisions affect any order or recommendation made by, or other matters or proceedings before, any department, commission, council, board, officer, authority or agency, the functions, powers and duties of which have been herein assigned or transferred to the Division of Narcotic and Drug Abuse Control or to any officer, authority or agency designated, continued or constituted hereunder, and all such matters or proceedings pending before such department, commission, council, board, officer, authority or other agency on the effective date of this act shall be continued by the department, division, officer, authority or agency to which such assignment or transfer has been made hereunder, as if the foregoing provisions had not taken effect.
Unless specifically otherwise provided in this act or by any operative law, whenever, pursuant to existing law, reports, certifications, applications or requests are required or permitted to be made to the department, board, division, commission, office or officer, whose powers and duties are herein assigned or transferred, such reports and certifications shall hereafter be required to be filed with, and such applications or requests shall hereafter be made to, the department, division, officer or agency to which such assignment or transfer has been made hereunder.
All acts and parts of acts inconsistent with any of the provisions of this act are, to the extent of such inconsistency, hereby repealed.
If any provision of this act or the application thereof to any person or circumstances or the exercise of any power or authority thereunder is held invalid or contrary to law, such holding shall not affect other provisions or applications of the act which can be given effect without the invalid provisions or applications or affect other exercises of power or authority under said provisions not contrary to law, and to this end the provisions of this act are declared to be severable.
It is declared to be the public policy of this State to provide for the development, establishment and enforcement of basic standards to insure safe care and adequate treatment of individuals in narcotic and drug abuse treatment centers, as hereinafter defined.
"Commissioner" means the Commissioner of Health.
"Narcotic drug" means any narcotic, drug, or dangerous controlled substance, as defined in any law of the State of New Jersey or of the United States.
"Patient" means a person with a substance use disorder, or who otherwise has a physical or mental impairment from the use of narcotic drugs and who requires continuing care of a substance use disorder treatment center.
"Substance use disorder treatment center" means any establishment, facility or institution, public or private, whether operated for profit or not, which primarily offers, or purports to offer, maintain, or operate facilities for the residential or outpatient diagnosis, care, treatment, or rehabilitation of two or more nonrelated individuals, who are patients as defined herein, excluding, however, any hospital or mental hospital otherwise licensed by Title 30 of the Revised Statutes.
The rules and regulations adopted pursuant to this section shall, at a minimum, require a transitional sober living home, halfway house, or other residential aftercare facility to provide notice to a patient's spouse, parent, legal guardian, designated next of kin, or other designated emergency contact, whenever the patient voluntarily withdraws, or is involuntarily evicted from, such facility, provided that: (1) such notice is provided in a manner that is consistent with federal requirements under 42 CFR Part 2 and federal HIPAA requirements under 45 CFR Parts 160 and 164; and (2) the patient, if an adult, has not withheld consent for such notice or expressly requested that notification not be given. If a patient who is not incapacitated withholds consent for such notice, or expressly requests that notification not be given, the department shall require the patient's wishes to be respected unless the patient is a minor child or adolescent, in which case, the department shall require the minor's parent, legal guardian, designated next of kin, or other designated emergency contact to be notified, provided that such notification is not inconsistent with, and would not violate, federal requirements under 42 CFR Part 2 and federal HIPAA requirements under 45 CFR Parts 160 and 164.
b. The information maintained in the database shall include, by county:
(1) the address and telephone number of the residential substance use disorders treatment facility;
(2) the type of services provided by the facility;
(3) the licensed bed capacity of the facility; and
(4) the number of open beds that are available for treatment, based on the information received pursuant to section 2 of this act.
c. The information described in subsection b. of this section shall be:
(1) prominently displayed on the website of the department;
(2) made available to the public, upon request, through the addictions telephone hotline and the Statewide 2-1-1 telephone system; and
(3) made available using any other means that the Commissioner of Human Services deems appropriate.
d. The commissioner is authorized to solicit, receive, and accept grants, funds, or anything of value from any public or private entity and receive and accept contributions of money, property, labor, or any other thing of value from any legitimate source for the purpose of the development and maintenance of a database pursuant to this act.
The commissioner shall make or cause to be made such inspection of the premises, for which a certificate of approval has been issued, from time to time, as he may deem necessary to be assured that the holder thereof and the premises comply at all times with the provisions of this act and the rules and regulations promulgated, and the minimum standards established hereunder.
The commissioner after a hearing may deny, revoke, or suspend any certificate of approval granted under authority of this act to any person, firm, partnership, corporation or association violating the provisions hereof or the rules and regulations promulgated hereunder.
Notice of the pending revocation, suspension, or denial of a certificate of approval together with a specification of charges shall be sent to the applicant or holder of a certificate of approval by registered mail and the notice shall set forth the particular reasons for the denial, suspension, or revocation of the license. Such denial, suspension, or revocation shall become effective 30 days after mailing, unless the applicant or holder of a certificate of approval, within such 30-day period shall meet the requirements of the commissioner, or shall give written notice to the commissioner of its desire for a hearing, in which case the denial, suspension, or revocation shall be held in abeyance until the hearing has been concluded and a final decision rendered; provided, however, that such applicant or holder of a certificate of approval may appeal from such denial, suspension, or revocation, to any court having jurisdiction of such matters.
The commissioner shall arrange for prompt and fair hearings on all such cases, render written decisions stating conclusions and reasons therefor upon each matter so heard, and is empowered to enter orders of denial, suspension, or revocation consistent with the circumstances in each case.
The penalties authorized by this section shall be recovered in a summary proceeding instituted by the Attorney General, at the request of the commissioner, pursuant to the "Penalty Enforcement Law of 1999," P.L.1999, c.274 (C.2A:58-10 et seq.). Money penalties, when recovered, shall be payable to the General State Fund.
Any facility for which a certificate of approval is required which is in operation at the time of promulgation of rules and regulations and minimum standards hereunder shall obtain such certificate and comply with such rules and regulations and minimum standards within 90 days after promulgation.
As used in this act:
(a) "Commissioner" means the Commissioner of the New Jersey State Department of Health, or the person specifically designated by him to perform his functions and duties pursuant to this act.
(b) "System" means the Statewide system of Drug Abuse Treatment and Counseling Clinics established hereunder.
The Commissioner of the Department of Health shall establish a Statewide system of Drug Abuse Treatment and Counseling Clinics. The system shall be administered by the commissioner through regional centers organized to supervise and coordinate the operation of clinics in certain areas. Outreach offices may also be established to assist the clinics in their operation. The number and location of such clinics, regional centers and outreach offices shall be as the commissioner determines after appropriate study.
educational programs;
confidential drug counseling;
vocational guidance and job placement;
psychiatric, psychological, and social case work services;
induction and outreach services;
24-hour telephone emergency capability;
urine monitoring;
detoxification;
methadone maintenance;
individual and community prevention program;
individual self-help and group therapy;
referral services for in-patient treatment;
all areas of treatment and rehabilitation of persons with substance use disorder;
aftercare treatment; and
probation services for the courts and correctional systems.
The Commissioner of the Department of Health shall appoint and employ subject to the provisions of Title 11 of the Revised Statutes such employees, advisers, and consultants as he deems necessary to carry out the provisions of this act. The President of the Civil Service Commission and the Commissioner of the Department of Health shall determine which, if any, of such appointments need not comply with the provisions of said Title.
The commissioner is authorized to adopt, promulgate and enforce rules and regulations and establish operating standards which shall be applicable to clinics which are part of the system established hereunder and to persons, groups or agencies which are not part of said system but which offer the same or similar programs or services.
The commissioner is authorized to contract for and to accept any gifts, grants, devises, bequests, funds, facilities, property, services, or assistance in any form from the Federal Government, or any agency or instrumentality thereof, or from any private agency or person for any of the purposes of this act. Any moneys so received may be expended by the commissioner to effectuate the purposes of this act, subject to the same limitation as to approval of expenditures and audits as are prescribed for State moneys appropriated for the purposes of this act.
b. The performance report shall show and compare the overall performance of each substance use treatment provider in the State with the Statewide average performance based on national outcome measures for each level of care. The division shall use the national outcome measures identified in subsection c., and, as appropriate, any other national outcome measures identified by the Substance Abuse and Mental Health Services Administration.
c. The performance report shall include the following national outcome measures: (1) percentage of clients abstinent from alcohol on admission and discharge; (2) percentage of clients abstinent from drugs on admission and discharge; (3) percentage of clients employed on admission and discharge; (4) percentage of clients enrolled in school or a job training program at admission and discharge; (5) percentage of clients who are homeless on admission and discharge; and (6) average length of client treatment. The performance report may also include any other information the Assistant Commissioner deems appropriate.
d. The division shall post the performance report on its website, and shall make a hard copy of the report available to the public, upon request.
e. As used in this section:
"Assistant Commissioner" means the Assistant Commissioner for the New Jersey Division of Mental Health and Addiction Services in the Department of Human Services.
"Client" means a person who received treatment for substance use from a substance use treatment provider during the annual reporting period.
"Substance use treatment provider" means any substance use treatment provider licensed by the Department of Human Services.
b. To the extent consistent with the terms of a national opioid litigation resolution subject to this act, the State Treasurer shall deposit into the fund the State's share of moneys received as a result of such resolution. Any interest and other income earned on moneys in the fund, and any other moneys that may be appropriated or otherwise become available for purposes of the fund, shall be credited to and deposited in the fund. For the purposes of this section, moneys paid to counties or municipalities shall not be considered to be part of the State's share of moneys received as a result of a national opioid litigation resolution. Any moneys received by any State department pursuant to a national opioid litigation settlement subject to this act shall be transferred into the fund.
c. (1) Moneys in the fund are hereby appropriated, shall be subject to the applicable requirements of the relevant national opioid litigation resolution and any applicable agreement entered into pursuant to section 3 of P.L.2023, c.25 (C.26:2G-41), and shall be dedicated and used only for:
(a) the purposes described in subsection e. of this section; and
(b) the payment of attorneys' fees, costs, and related litigation expenses related to the national opioid litigation resolution.
(2) The Department of Human Services shall be designated the lead agency for the State for purposes of directing the disbursement and allocation of the State's share of any moneys that are allocated to or otherwise received by the State as a result of a national opioid litigation resolution and for monitoring the use of moneys disbursed to counties or municipalities under a national opioid litigation resolution or under an agreement entered into pursuant to section 3 of P.L.2023, c.25 (C.26:2G-41), to the extent required by such agreements, and, in coordination with the State Comptroller and the Attorney General, ensuring that the use of such moneys complies with the purposes set forth in this act and is consistent with the terms of the applicable national opioid litigation resolution and any applicable agreement entered into pursuant to section 3 of P.L.2023, c.25 (C.26:2G-41).
(a) The department shall have primary responsibility for ensuring that the various reporting, compliance, and administrative functions imposed upon the State pursuant to the terms and conditions of any national opioid litigation resolution and any applicable agreement entered into pursuant to section 3 of P.L.2023, c.25 (C.26:2G-41) are performed, and shall serve as the single point of contact for the State for settlement fund administrators and trustees to submit requests for disbursement of settlement funds.
(b) The department shall be authorized to make determinations regarding disbursement and allocation of the State's share of such proceeds in accordance with the requirements or terms of any national opioid litigation resolution and any applicable agreement entered into pursuant to section 3 of P.L.2023, c.25 (C.26:2G-41), which may include designations of regions for the allocation of the State's share of such proceeds, in addition to taking such other actions as may be assigned or required to be performed by the lead agency or single point of contact for the State under the terms of any national opioid litigation resolution and any applicable agreement entered into pursuant to section 3 of P.L.2023, c.25 (C.26:2G-41).
(c) The department shall receive and review reports from each county regarding the expenditure of any moneys received by the county as a result of a national opioid litigation resolution.
(d) (i) The department shall be authorized to adopt, amend, or repeal regulations as necessary to carry out the intent and provisions of P.L.2023, c.25 (C.26:2G-39 et seq.).
(ii) Notwithstanding the provisions of the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.), to the contrary, the department may, immediately upon filing proper notice with the Office of Administrative Law, adopt rules and regulations as shall be necessary to enable it to carry out the department's duties, functions, and powers with respect to this act. Rules and regulations adopted pursuant to this subsubparagraph shall be effective immediately upon filing with the Office of Administrative Law and shall be in effect for a period not to exceed 18 months, and shall, thereafter, be amended, adopted, or readopted by the department in accordance with the provisions of the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.).
(3) Notwithstanding any other law or regulation to the contrary, there is hereby appropriated: (a) moneys from the fund to the Department of Human Services, which shall allocate the appropriated funds in accordance with the provisions of subsections d., e., and f. of this section; and (b) to the extent applicable, moneys paid to the State as a result of a national opioid litigation resolution that have been allocated to a county or municipality in accordance with the terms of the national opioid litigation resolution or a related agreement entered into pursuant to section 3 of P.L.2023, c.25 (C.26:2G-41), and to the extent necessary to effectuate such resolution, which shall be used in accordance with the provisions of subsections d., e., and f. of this section.
(4) Moneys from the fund may be transferred to other State departments as directed by the Commissioner of Human Services in support of the purposes provided for in this act, subject to the approval of the Director of Budget and Accounting.
d. Notwithstanding section 2 of P.L.1999, c.129 (C.56:8-14.3), section 15 of P.L.2003, c.76 (C.56:8-133), and the "New Jersey False Claims Act," P.L.2007, c.265 (C.2A:32C-1 et seq.), the department shall direct the allocation and disbursement of moneys in the Opioid Recovery and Remediation Fund established by this section, and shall do so in consultation with the Opioid Recovery and Remediation Advisory Council, established pursuant to section 2 of this act. The department shall allocate funds with an emphasis on supporting programs and strategies that are evidence-based or evidence-informed and, in making such allocations, shall consider equitable access for underserviced communities Statewide.
e. Moneys, other than attorneys' fees, costs, and expenses related to litigation, that are allocated to or otherwise received by the State or any county or municipality as a result of a national opioid litigation resolution, shall be dedicated and used, consistent with the terms of an applicable national opioid litigation resolution and any applicable agreement entered into pursuant to section 3 of P.L.2023, c.25 (C.26:2G-41), for the purpose of addressing opioid use disorder and any co-occurring substance use disorder or mental health conditions through evidence-based or evidence-informed practices or strategies that may include, but shall not be limited to, the following:
(1) Supporting the treatment of opioid use disorders and any co-occurring substance use disorder or mental health conditions through evidence-based or evidence-informed programs or strategies;
(2) Supporting individuals in recovery from opioid use disorder, as well as any co-occurring substance use disorder or mental health conditions, through evidence-based or evidence-informed programs or strategies, including, but not limited to, providing support services to the families of such individuals;
(3) Providing connections to care for people who have, or are at risk of developing, an opioid use disorder or a co-occurring substance use disorder or mental health condition, through evidence-based or evidence-informed programs or strategies;
(4) Using evidence-based or evidence-informed programs or strategies to address the needs of persons with an opioid use disorder or a co-occurring substance use disorder or mental health condition who are involved in, are at risk of becoming involved in, or are transitioning out of, the criminal justice system;
(5) Using evidence-based or evidence-informed programs or strategies to address the needs of pregnant or parenting persons with opioid use disorder or a co-occurring substance use disorder or mental health condition, and the needs of the families of such individuals, including babies with neonatal abstinence syndrome;
(6) Supporting efforts to prevent over-prescribing and ensure appropriate prescribing and dispensing of opioids through evidence-based or evidence-informed programs or strategies;
(7) Using evidence-based or evidence-informed programs or strategies to support efforts to discourage or prevent the misuse of, and the development of substance use disorders involving, opioids;
(8) Using evidence-based or evidence-informed programs or strategies to support efforts to prevent or reduce overdose deaths or other opioid-related harms;
(9) Educating law enforcement or other first responders regarding appropriate practices and precautions when dealing with fentanyl and other drugs;
(10) Providing wellness and support services for first responders and others who experience secondary trauma associated with opioid-related emergency events;
(11) Supporting efforts to provide leadership, planning, coordination, facilitations, training, and technical assistance to abate the opioid epidemic through activities, programs, and strategies;
(12) Supporting training to abate the opioid epidemic through activities, programs, or strategies;
(13) Supporting opioid abatement research;
(14) Supporting such other strategies as may be expressly identified in any national opioid litigation resolution; and
(15) Administrative expenses, subject to limits imposed by any national opioid litigation resolution or by any agreement entered pursuant to section 3 of P.L.2023, c.25 (C.26:2G-41).
f. Moneys, other than attorneys' fees, costs, and expenses related to litigation, that are allocated to or otherwise received by the State or any of its counties or municipalities as a result of a national opioid litigation resolution shall be used to supplement, and shall not supplant, federal, State, county, or municipal funds, as the case may be, that otherwise would have been used to carry out the purposes delineated in this act, and no amount of such moneys shall be used to reimburse the State or any of its counties or municipalities for past expenditures, except as may otherwise be required to refund to the federal government a portion of the moneys.
g. For the purposes of P.L.2023, c.25 (C.26:2G-39 et seq.), "national opioid litigation resolution" means a settlement agreement, entered into by the Attorney General of New Jersey on behalf of the State and by other state attorneys general on behalf of their respective states, which provides for the participation of states, counties, and municipalities to resolve claims by the State attorneys general and counties and municipalities against opioid manufacturers, opioid distributors, or pharmacies, or persons or entities affiliated with an opioid manufacturer, opioid distributor, or pharmacy, related to the manufacture, marketing, distribution, or dispensing of opioids, or a bankruptcy plan which is governed by an agreement entered into pursuant to section 3 of P.L.2023, c.25 (C.26:2G-41) and which has received final approval and that channels, releases, or otherwise finally disposes of such claims including those of the State and its counties and municipalities.
(1) gather and evaluate data regarding the availability of, gaps in, and barriers to substance use disorder prevention and treatment programs and recovery services;
(2) solicit feedback, in a manner and method established by the council, from stakeholders, local providers, advocates, individuals with lived experience with opioid use disorders, including people who have or are in recovery from an opioid use disorder and family members of people with an opioid use disorder, the academic community, individuals with expertise in areas related to substance use disorders, community groups, and members of the public, regarding the services needed to prevent and treat substance use disorders across the State;
(3) review and evaluate recommendations submitted by the public using the online portal that was established by the State on August 31, 2022 to enable members of the public to provide recommendations on the expenditure of proceeds from national opioid litigation resolutions;
(4) evaluate approaches taken by New Jersey and other states in administering proceeds from national opioid litigation resolutions;
(5) consult with experts and other knowledgeable individuals in both the public and private sectors on any aspect of its duties as the council deems necessary and appropriate; and
(6) take any other actions as the council deems appropriate to inform its recommendations, with the purpose of promoting the equitable and efficient distribution of settlement funds, including the distribution of funds using evidence-based and evidence-informed practices and strategies.
b. The council shall comprise:
(1) the Commissioner of Human Services, the Commissioner of Health, the Commissioner of Children and Families, and the Attorney General, or their designees, who shall serve ex-officio;
(2) at least 10 public members appointed by the Governor who reflect the diversity of New Jersey and who shall include public health and policy experts and two or more individuals who have lived experience with opioid use disorders, including one or more individuals who have or are in recovery from an opioid use disorder and one or more family members of a person with an opioid use disorder; and
(3) such additional ex officio and public members as the Governor deems appropriate.
c. The public members of the council shall serve at the pleasure of the Governor. The Commissioner of Human Services or the commissioner's designee shall serve as the chairperson of the council.
d. The council shall organize as soon as practicable following the appointment of its members and shall meet at such frequencies as shall be required by the Governor as well as at the call of the chairperson. The members of the council shall serve without compensation, but shall be eligible for reimbursement for necessary and reasonable expenses incurred in the performance of their official duties within the limits of funds appropriated or otherwise made available to the council for its purposes.
e. The council shall be entitled to receive assistance and services from any State, county, or municipal department, board, commission, or agency as may be made available to it for its purposes. The Department of Human Services shall provide such staff and administrative support to the council as it requires to carry out its responsibilities.
f. (1) To the extent permissible under the terms of a national opioid litigation resolution, the council shall not be required to, and may refrain from, making recommendations for expenditures that would primarily benefit counties or municipalities that were eligible to participate in the national opioid litigation resolution that yielded such funds but did not participate in the resolution, provided that nothing in this subsection shall be deemed to prevent the council from exercising its discretion to make such recommendations should it determine to do so.
(2) The council may, but shall not be required to, provide information and general recommendations to counties and municipalities concerning the expenditure of the share of proceeds from national opioid litigation resolutions allocated to those counties and municipalities, and may coordinate with any similarly situated county advisory council as the chairperson deems appropriate.
g. The council shall expire 180 days after all proceeds from opioid litigation resolutions are expended and the Department of Human Services issues the final report required pursuant to subsection b of section 5 of P.L.2023, c.25 (C.26:2G-43).
b. No later than 180 days after all proceeds from national opioid litigation resolutions have been expended, the Department of Human Services shall prepare and issue to the Governor, and to the Legislature pursuant to section 2 of P.L.1991, c.164 (C.52:14-19.1), a final report concerning the State's expenditure of opioid litigation resolution proceeds, including: the amounts allocated; descriptions of the programs funded using the proceeds; community providers involved in programs receiving allocations from the proceeds; outcomes from programs receiving allocations from the proceeds; overall outcomes resulting from the expenditure of the proceeds, including changes in substance use disorder rates, overdose deaths, participation in substance use disorder treatment and recovery programs, successful treatment outcomes, outcomes involving dual diagnoses involving substance use disorders in combination with other behavioral health conditions, and expansions in substance use disorder and other behavioral health care provider and treatment capacity; and such other information and data as the department deems necessary to fully evaluate the use of opioid litigation resolution funds pursuant to this act.
c. The department shall post the information and reports required pursuant to this section on its Internet website.
a. "Health care facility" means the facility or institution, whether public or private, that is engaged principally in providing services for health maintenance organizations, diagnosis, or treatment of human disease, pain, injury, deformity, or physical condition, including, but not limited to, a general hospital, special hospital, mental hospital, public health center, diagnostic center, treatment center, rehabilitation center, extended care facility, skilled nursing home, nursing home, intermediate care facility, tuberculosis hospital, chronic disease hospital, maternity hospital, outpatient clinic, dispensary, home health care agency, residential health care facility, dementia care home, and bioanalytical laboratory (except as specifically excluded hereunder), or central services facility serving one or more such institutions but excluding institutions that provide healing solely by prayer and excluding such bioanalytical laboratories as are independently owned and operated, and are not owned, operated, managed, or controlled, in whole or in part, directly or indirectly by any one or more health care facilities, and the predominant source of business of which is not by contract with health care facilities within the State of New Jersey and which solicit or accept specimens and operate predominantly in interstate commerce.
b. "Health care service" means the preadmission, outpatient, inpatient, and postdischarge care provided in or by a health care facility, and such other items or services as are necessary for such care, which are provided by or under the supervision of a physician for the purpose of health maintenance organizations, diagnosis, or treatment of human disease, pain, injury, disability, deformity, or physical condition, including, but not limited to, nursing service, home care nursing, and other paramedical service, ambulance service, service provided by an intern, resident in training or physician whose compensation is provided through agreement with a health care facility, laboratory service, medical social service, drugs, biologicals, supplies, appliances, equipment, bed and board, but excluding services provided by a physician in his private practice, except as provided in sections 7 and 12 of P.L.1971, c.136 (C.26:2H-7 and 26:2H-12), or by practitioners of healing solely by prayer, and services provided by first aid, rescue and ambulance squads as defined in the "New Jersey Highway Traffic Safety Act of 1987," P.L.1987, c.284 (C.27:5F-18 et seq.).
c. "Construction" means the erection, building, or substantial acquisition, alteration, reconstruction, improvement, renovation, extension, or modification of a health care facility, including its equipment, the inspection and supervision thereof; and the studies, surveys, designs, plans, working drawings, specifications, procedures, and other actions necessary thereto.
d. "Board" means the Health Care Administration Board established pursuant to this act.
e. (Deleted by amendment, P.L.1998, c.43).
f. "Government agency" means a department, board, bureau, division, office, agency, public benefit, or other corporation, or any other unit, however described, of the State or political subdivision thereof.
g. (Deleted by amendment, P.L.1991, c.187).
h. (Deleted by amendment, P.L.1991, c.187).
i. "Department" means the Department of Health.
j. "Commissioner" means the Commissioner of Health.
k. "Preliminary cost base" means that proportion of a hospital's current cost which may reasonably be required to be reimbursed to a properly utilized hospital for the efficient and effective delivery of appropriate and necessary health care services of high quality required by such hospital's mix of patients. The preliminary cost base initially may include costs identified by the commissioner and approved or adjusted by the commission as being in excess of that proportion of a hospital's current costs identified above, which excess costs shall be eliminated in a timely and reasonable manner prior to certification of the revenue base. The preliminary cost base shall be established in accordance with regulations proposed by the commissioner and approved by the board.
l. (Deleted by amendment, P.L.1992, c.160).
m. "Provider of health care" means an individual (1) who is a direct provider of health care service in that the individual's primary activity is the provision of health care services to individuals or the administration of health care facilities in which such care is provided and, when required by State law, the individual has received professional training in the provision of such services or in such administration and is licensed or certified for such provision or administration; or (2) who is an indirect provider of health care in that the individual (a) holds a fiduciary position with, or has a fiduciary interest in, any entity described in subparagraph b(ii) or subparagraph b(iv); provided, however, that a member of the governing body of a county or any elected official shall not be deemed to be a provider of health care unless he is a member of the board of trustees of a health care facility or a member of a board, committee or body with authority similar to that of a board of trustees, or unless he participates in the direct administration of a health care facility; or (b) received, either directly or through his spouse, more than one-tenth of his gross annual income for any one or more of the following:
(i) Fees or other compensation for research into or instruction in the provision of health care services;
(ii) Entities engaged in the provision of health care services or in research or instruction in the provision of health care services;
(iii) Producing or supplying drugs or other articles for individuals or entities for use in the provision of or in research into or instruction in the provision of health care services;
(iv) Entities engaged in producing drugs or such other articles.
n. "Private long-term health care facility" means a nursing home, skilled nursing home, or intermediate care facility presently in operation and licensed as such prior to the adoption of the 1967 Life Safety Code by the Department of Health in 1972 and which has a maximum 50-bed capacity and which does not accommodate Medicare or Medicaid patients.
o. (Deleted by amendment, P.L.1998, c.43).
p. "State Health Planning Board" means the board established pursuant to section 33 of P.L.1991, c.187 (C.26:2H-5.7) to conduct certificate of need review activities.
q. "Integrated health care" means the systematic coordination of general and behavioral healthcare. This care may address mental illnesses, substance use disorders, health behaviors including their contributions to chronic medical illnesses, life stressors and crises, stress-related physical symptoms, and ineffective patterns of health care utilization.
Members serving on the board on the effective date of this act shall continue to serve until the expiration of their terms. Successors shall be appointed only from among consumers of health care services who are not providers of such services until there are at last six such members on the board. Successors shall thereafter be appointed from among both consumers and providers of health care services in a manner consistent with the terms of this act.
b. The commissioner, with the approval of the board, shall adopt and amend rules and regulations in accordance with the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.) to effectuate the provisions and purposes of this act, including but not limited to: (1) the establishment of requirements for a uniform Statewide system of reports and audits relating to the quality of health care provided, health care facility utilization and costs; (2) certification by the department of schedules of rates, payments, reimbursement, grants and other charges for health care services as provided in section 18; and (3) standards and procedures relating to the licensing of health care facilities and the institution of certain additional health care services.
c. The commissioner may enter into contracts with any government agency, institution of higher learning, voluntary nonprofit agency, or appropriate planning agency or council; and such entities are authorized to enter into contracts with the commissioner to effectuate the provisions and purposes of this act.
d. The commissioner may provide consultation and assistance to health care facilities in operational techniques, including but not limited to, planning, principles of management, and standards of health care services, and, in the case of a general hospital, to appoint a monitor if the commissioner determines that a monitor is warranted for a hospital that is in financial distress or at risk of being in financial distress, and to participate in the development and oversight of corrective measures to resolve a hospital's financial or potential financial difficulties, pursuant to section 2 of P.L.2008, c.58 (C.26:2H-5.1a).
e. At the request of the commissioner, health care facilities shall furnish to the Department of Health and Senior Services such reports and information as it may require to effectuate the provisions and purposes of this act, excluding confidential communications from patients.
f. The commissioner may institute or cause to be instituted in a court of competent jurisdiction proceedings to compel compliance with the provisions of this act or the determinations, rules, regulations and orders of the commissioner.
g. Notwithstanding any rules and regulations governing private long-term health care facilities and enforcing the 1967 Life Safety Code, as amended and supplemented, the commissioner shall permit third floor occupancy of such facilities by owners, members of their immediate families, and licensed professionals employed at such facilities.
The Commissioner of Health shall, to the extent possible and reasonable within the Department of Health's responsibilities under P.L.1971, c.136 (C.26:2H-1 et seq.), coordinate its annual inspection of a hospital with the triennial inspection conducted by the Joint Commission for the Accreditation of Healthcare Organizations to prevent duplication during the inspection process.
For the purpose of this subsection, the commissioner shall require health care facilities to:
(1) routinely inquire whether a patient is in pain;
(2) maintain policies and procedures as prescribed by the commissioner for asking patients to rate their degree of pain for a specified period of time and to record their responses; and
(3) routinely record levels of pain intensity on patient charts.
b. The requirements to be adopted pursuant to subsection a. of this section shall take effect no later than the 180th day after the effective date of this act.
(1) the name and certification or licensure title, as applicable, of the homemaker-home health aide or other health care professional whose practice is regulated pursuant to Title 45 of the Revised Statutes, to be displayed on an identification tag as required for homemaker-home health aides by regulation of the New Jersey Board of Nursing, or as otherwise to be prescribed by regulation of the commissioner for other health care professionals, that the homemaker-home health aide or other health care professional shall wear at all times while examining, observing, or caring for the patient; and
(2) a copy of the most current edition of the consumer guide to homemaker-home health aides published by the New Jersey Board of Nursing.
b. The consumer guide required pursuant to subsection a. of this section shall be provided:
(1) in advance of the provision of services to the patient, whenever possible; and
(2) otherwise upon the homemaker-home health aide's initial visit to the patient's home.
c. Beginning on the first day of the 13th month after the date of enactment of this act, the identification tag required pursuant to subsection a. of this section shall include a photograph of the homemaker-home health aide or other health care professional.
d. The commissioner, pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.), shall adopt rules and regulations to effectuate the purposes of this section.
(1) the number of registered professional nurses providing direct patient care and the ratio of patients to registered professional nurses;
(2) the number of licensed practical nurses providing direct patient care and the ratio of patients to licensed practical nurses;
(3) the number of certified nurse aides providing direct patient care and the ratio of patients to certified nurse aides;
(4) the number of other licensed or registered health care professionals meeting State staffing requirements; and
(5) the methods used by the hospital for determining and adjusting direct patient care staffing levels.
b. (1) A nursing home licensed pursuant to P.L.1971, c.136 (C.26:2H-1 et seq.) shall compile, and shall include with the information about health care professionals who are directly responsible for resident care, which it is required under federal law to post in areas where this information can be viewed by residents and members of the public, information that details the ratio of these health care professionals to residents for that particular day on each shift.
(2) The nursing home shall also provide to a member of the public, upon request, the information that is posted in accordance with the provisions of paragraph (1) of this subsection.
c. The information that is posted pursuant to subsections a. and b. of this section shall be displayed in a manner that is visible and accessible to all patients or residents, as applicable, their families and caregivers in the facility, as determined by regulation of the Commissioner of Health and Senior Services and subject to the applicable requirements of federal law.
d. A general hospital and nursing home shall report the information compiled pursuant to subsection a. or b. of this section, respectively, to the commissioner on a monthly basis, on a form and in a manner prescribed by the commissioner. The commissioner shall make this information available to the public on a quarterly basis, accompanied by a written explanation, which the commissioner shall prepare in consultation with the Quality Improvement Advisory Committee established by the commissioner, to assist members of the public in interpreting the information reported pursuant to this section.
e. A general hospital or nursing home that fails to comply with the provisions of this act, or any rules or regulations adopted pursuant thereto, shall be subject to a penalty as determined by the commissioner pursuant to sections 13 and 16 of P.L.1971, c.136 (C.26:2H-13 and C.26:2H-16).
a. the number of vaginal deliveries performed;
b. the number of cesarean deliveries performed; and
c. the rate of complications experienced by a patient receiving maternity care:
(1) for a vaginal delivery, which shall include the rate of maternal hemorrhage, laceration, infection, or other complication as prescribed by the Commissioner of Health; and
(2) for a cesarean delivery, which shall include the rate of maternal hemorrhage, infection, operative complication, or other complication as prescribed by the Commissioner of Health.
(1) (a) For a request by a patient or the patient's legally authorized representative for a medical record, whether such record is stored electronically, on microfilm or microfiche, or on paper, the fee for reproducing the record shall not exceed $1 per page or $50 per individual admission record, whichever is less. The fee for reproducing a medical record shall not exceed $50 per individual admission or patient record, exclusive of any additional fees specified in paragraph (3) of this subsection;
(b) If a patient requests a copy of the patient's own medical records in accordance with the federal "Health Insurance Portability and Accountability Act of 1996," Pub.L.104-191, the requirements provided under 45 C.F.R. 164.524(b) with respect to the time required to respond to such requests and the applicable fees shall apply;
(c) A hospital shall not charge any fee to provide an electronic or paper reproduction of a billing record requested by a patient, or a patient's legally authorized representative;
(d) For a request by an authorized third party, the fee for reproducing medical and billing records that are not stored on microfilm or microfiche shall be no more than $1 per page, and the fee for reproducing records stored on microfilm or microfiche shall be $1.50 per image; and
(e) A fee for the reproduction of x-rays or any other material that cannot be routinely copied or duplicated on a commercial photocopy machine, which shall be no more than $15 per printed image or $30 per compact disc (CD) or digital video disc (DVD), plus an administrative fee of $10.
(2) Delivery of an electronic reproduction of a patient's medical or billing record shall be required only if:
(a) the entire request can be reproduced from an electronic health record system;
(b) the record is specifically requested to be delivered in electronic format; and
(c) the record can be delivered electronically.
(3) In addition to per-page fees, a hospital shall apply the following charges for patients, patients' legally authorized representatives, and authorized third parties:
(a) a search fee of no more than $20 per request; provided that no search fee shall be charged to a patient who is requesting the patient's own record. If a search fee may be charged under this subparagraph, the fee shall apply even if no medical records are found as a result of the search;
(b) (Deleted by amendment, P.L.2022, c.114)
(c) a fee for certification of a copy of a medical record of no more than $10 per certification; and
(d) costs for delivering records in any medium, plus sales tax, if applicable.
(4) The fees established in this subsection shall be charged for electronic reproductions as well as paper copies of medical records.
(5) The hospital shall establish a policy assuring access to copies of medical records for patients who do not have the ability to pay for the copies.
(6) The hospital shall establish a fee policy providing an incentive for the use of abstracts or summaries of medical records; however, a patient and a patient's legally authorized representative shall have the right to receive a full or certified copy of the medical record.
(7) Subject to the requirements of paragraph (2) of this subsection, medical and billing records shall be delivered in the manner specified by the requestor, which may include, but shall not be limited to, mailing the record to any address or faxing the record to any number specified by the requestor, including the requestor's attorney. Subject to the requirements of federal law, the method of delivery specified by a requestor shall not affect the fees that would ordinarily apply to the request under paragraphs (1) and (3) of this subsection, subject to any policies established pursuant to paragraphs (5) and (6) of this subsection and subject to the provisions of subsections c. and d. of this section.
b. Access to a copy of a patient's medical record shall be limited only to the extent necessary to protect the patient. The patient's attending physician shall provide a verbal explanation for any denial of access to the patient, legally authorized representative, or authorized third party, and shall document the denial and explanation in the medical record. In the event that direct access to a copy by the patient is medically contraindicated, as documented by a physician in the patient's medical record, the hospital shall not limit access to the record to a legally authorized representative of the patient, an authorized third party, or the patient's attending physician.
c. A hospital shall not assess any fees or charges for a copy of individual admission records as provided herein other than those provided for in this section.
d. The fees authorized by this section shall not be imposed on:
(1) A patient who does not have the ability to pay and who presents either: (a) a statement certifying to annual income at or below 250 percent of the federal poverty level; or (b) proof of eligibility for, or enrollment in, a State or federal assistance program including, but not limited to: the federal Supplemental Nutrition Assistance Program established pursuant to the "Food and Nutrition Act of 2008," Pub.L.110-246 (7 U.S.C. s.2011 et seq.); the federal Supplemental Security Income program established pursuant to Title XVI of the federal Social Security Act, Pub.L.92-603 (42 U.S.C. s.1381 et seq.); the National School Lunch Program established pursuant to the "Richard B. Russell National School Lunch Act," Pub.L.79-396 (42 U.S.C. s.1751 et seq.); the federal special supplemental food program for women, infants, and children established pursuant to Pub.L.95-627 (42 U.S.C. s.1786); the State Medicaid program established pursuant to the "New Jersey Medical Assistance and Health Services Act," P.L.1968, c.413 (C.30:4D-1 et seq.); the NJ FamilyCare Program established pursuant to the "Family Health Care Coverage Act," P.L.2005, c.156 (C.30:4J-8 et al.); the Work First New Jersey program established pursuant to the "Work First New Jersey Act," P.L.1997, c.38 (C.44:10-55 et seq.); the New Jersey Supplementary Food Stamp Program established pursuant to the "New Jersey Supplementary Food Stamp Program Act," P.L.1998, c.32 (C.44:10-79 et seq.); any successor program; or any other State or federal assistance program now or hereafter established by law;
(2) A not-for-profit corporation indicating in writing that it is representing a patient;
(3) A health care practitioner;
(4) An attorney representing a patient on a pro bono basis, provided that the attorney submits with the request a certification that the attorney is representing the patient on a pro bono basis. An attorney representing a patient on a contingency fee basis shall be assessed the ordinary fees to obtain a copy of individual admission records; or
(5) A patient or an attorney representing a patient who has a pending application for, or is currently receiving, federal Social Security disability benefits provided under Title II or Title XVI of the federal Social Security Act, Pub.L.92-603 (42 U.S.C. s.1351 et al.).
e. As used in this section:
"Authorized third party" means a third party, who is not a legally authorized representative of the patient, with a valid authorization, subpoena, legal process, or court order granting access to a patient's medical or billing records.
"Legally authorized representative" means: the patient's spouse, domestic partner, or civil union partner; the patient's immediate next of kin; the patient's legal guardian; the patient's attorney; the patient's automobile insurer; or the patient's worker's compensation carrier, if the carrier is authorized to access to the patient's treatment or billing records by contract or law, provided that access by a worker's compensation carrier shall be limited only to that portion of the treatment or billing record that is relevant to the specific work-related incident at issue in the worker's compensation claim.
"Appropriate" means consistent with applicable legal, health, and professional standards, the patient's clinical and other circumstances, and the patient's reasonably known wishes and beliefs.
"Hospice care" means a coordinated program of home, outpatient, and inpatient care and services that is operated by a public agency or private organization, or subdivision of either of these entities, and that provides care and services to hospice patients and to hospice patients' families, through a medically directed interdisciplinary team, under interdisciplinary plans of care in order to meet the physical, psychological, social, spiritual, and other special needs that are experienced during the final stages of illness, dying, and bereavement. A hospice care program includes: nursing care by or under the supervision of a registered professional nurse; physical, occupational, or speech or language therapy; medical social services by a certified or licensed social worker under the direction of a physician; services of a certified home health aide; medical supplies, including drugs and biologicals, and the use of medical appliances related to terminal diagnosis; physician's services; short-term inpatient care, including both palliative and respite care and procedures; spiritual and other counseling for hospice patients and hospice patients' families; services of volunteers under the direction of the provider of the hospice care program; and bereavement services for hospice patients' families.
"Medical care" means services provided, requested, or supervised by a physician, physician assistant, or advanced practice nurse.
"Palliative care" means patient-centered and family-centered medical care that optimizes quality of life by anticipating, preventing, and treating suffering caused by serious illness. Palliative care throughout the continuum of illness involves addressing physical, emotional, social, and spiritual needs and facilitating patient autonomy, access to information, and choice. Palliative care includes, but is not limited to: comprehensive pain and symptom management and discussion of treatment options appropriate to the patient, including hospice care, when appropriate.
"Serious illness" means any medical illness or physical injury or condition that substantially impacts quality of life for more than a short period of time. Serious illness includes, but is not limited to: cancer; heart, renal, or liver failure; lung disease; and Alzheimer's disease and related dementias.
b. The purpose of the program is to maximize the effectiveness of palliative care and hospice care initiatives in the State by ensuring that comprehensive and accurate information and education about palliative care and hospice care are available to the public, to health care providers, and to health care facilities.
c. The Palliative Care and Hospice Care Advisory Council, established pursuant to section 4 of P.L.2019, c.227 (C.26:2H-5r) shall, in collaboration with the Cancer Institute of New Jersey, develop and implement the program established under this section, including developing and implementing any initiatives regarding palliative care and hospice care services and education that the council determines would further the purposes of this section.
b. If a hospital, nursing home, or facility fails to comply with the requirements of subsection a. of this section, the Commissioner of Health may require the hospital, nursing home, or facility to provide a plan of action to bring the hospital, nursing home, or facility into compliance.
c. In implementing the provisions of this section, the department shall:
(1) consult with the Palliative Care and Hospice Care Advisory Council established pursuant to section 4 of P.L.2019, c.227 (C.26:2H-5r); and
(2) take into account factors that may impact the ability of a hospital, nursing home, or facility to comply with the requirements of subsection a. of this section. These factors may include, but are not limited to: the size of the hospital, nursing home, or facility; access and proximity to palliative care and hospice care services, including the availability of palliative care and hospice care board-certified practitioners and related workforce staff; and geographic factors.
b. It shall be the duty of the council, in collaboration with the Cancer Institute of New Jersey, to implement the provisions of P.L.2019, c.227 (C.26:2H-5o et seq.), including establishing the Palliative Care and Hospice Care Consumer and Professional Information and Education Program pursuant to section 2 of P.L.2019, c.227 (C.26:2H-5p), developing and facilitating the provision of information about palliative care and hospice care for the purposes of section 3 of P.L.2019, c.227 (C.26:2H-5q), and developing resources and programs to facilitate access to palliative care and hospice care services for patients and residents.
c. (1) The council shall be comprised of eleven members, to be appointed as follows: one member of the Senate appointed by the Senate President; one member of the General Assembly appointed by the Speaker of the General Assembly; three public members appointed by the Senate President; threepublic members appointed by the Speaker of the General Assembly; and three public members appointed by the Governor.
(2) In selecting the public members, the Senate President, the Speaker of the General Assembly, and the Governor shall seek to include persons who have experience, training, or academic background in issues related to the provision of palliative care or hospice care, with an emphasis on addressing physical, emotional, social, and spiritual needs and facilitating patient autonomy, access to information, and choice. Seven of the nine public members shall be comprised as follows: one physician, one advanced practice nurse or physician assistant, one nurse, one social worker, one chaplain, one pediatric oncologist, and one hospice administrator. The public members shall be board certified or have a hospice and palliative care certification, as appropriate to their discipline. Selections of public members may be made in consultation with: the State Board of Medical Examiners, the New Jersey Board of Nursing, the Physician Assistant Advisory Committee, the Board of Pharmacy, the New Jersey Hospital Association, the Health Care Association of New Jersey, the Medical Society of New Jersey, the New Jersey Association of Osteopathic Physicians and Surgeons, the New Jersey State Nurses Association, the Home Care and Hospice Association of New Jersey, LeadingAge New Jersey, the New Jersey State Society of Physician Assistants, and the New Jersey Hospice and Palliative Care Organization.
d. All appointments shall be made within 30 days after the effective date of P.L.2019, c.227 (C.26:2H-5o et seq.).
e. The public members shall serve for a term of five years; but, of the members first appointed, three shall serve for a term of three years, three for a term of four years, and three for a term of five years. Members are eligible for reappointment upon the expiration of their terms. Vacancies in the membership shall be filled in the same manner as the original appointments.
f. The council shall organize as soon as is practicable upon the appointment of a majority of its members, and shall select a chairperson from among the members.
g. The members of the council shall serve without compensation but may be reimbursed, within the limits of funds made available to the council, for necessary travel expenses incurred in the performance of their duties.
h. The council shall be entitled to call to its assistance and avail itself of the services of the employees of any State, county, or municipal department, board, bureau, commission, or agency as it may require and as may be available for its purposes.
i. The Department of Health shall provide staff support to the council.
(1) the adoption of a standardized screening tool , as recommended by the Department of Health, for use by health care professionals in the emergency department to facilitate the identification of patients who present to the emergency department for acute symptom management, pain relief, or otherwise, who would benefit from palliative care services;
(2) the provision of patient-centered information , as developed by the Department of Health, concerning the benefits of palliative care, the conditions, diagnoses, and disease stage for which palliative care is generally appropriate, and referrals to providers of outpatient palliative care services, when appropriate; and
(3) consideration of the unique needs of patients with intellectual or developmental disabilities or behavioral health issues who present to the emergency department and for whom palliative care may be indicated.
The Commissioner of the Department of Health shall, on a continuous basis, collect information concerning all costs and revenues of residential health care facilities licensed pursuant to P.L.1971, c. 136 (C. 26:2H-1 et seq.) so as to provide a means for the Legislature to determine whether it is advisable for the commissioner to set variable rates for payment to such facilities and whether payments for Supplemental Security Income under P.L.1973, c. 256 (C. 44:7-85 et seq.) for eligible residents of such facilities should be supplemented in accordance with any such rates.
One year following the effective date of this act, the commissioner shall submit a report to the Legislature's Joint Appropriations Committee and Standing Reference Committees on Institutions, Health and Welfare containing the information required herein to be collected.
To collect information concerning the costs and resources of residential health care facilities, the commissioner is authorized to conduct such field visits and audits as may be necessary, and the owners of such facilities shall submit such reports, audits and accountings of cost as the commissioner may require by regulation; provided, however, that such reports, audits and accountings shall be the minimum necessary to implement the provisions of this section.
b. The thresholds of specified financial indicators and corresponding Department of Health involvement that may be triggered by them shall include, but are not limited to, measures relating to:
(1) days cash-on-hand;
(2) average daily census;
(3) days in accounts receivable;
(4) average payment period;
(5) operating margin;
(6) operating margin adjusted to account for fees, allocations, and other business interactions with interested persons as those terms are defined in IRS Form 990, with the term "interested person" to include owners for the purposes of a for-profit hospital; and
(7) any other factor which the commissioner deems appropriate, including failure to provide required or requested financial information.
c. If the commissioner determines that a hospital is in financial distress or at risk of being in financial distress after considering the specified financial indicators set forth in subsection b. of this section, then the commissioner may provide notice of the hospital's financial state to the mayor, city administrator, and members of the Legislature who represent the municipality in which the hospital is located. The commissioner may appoint, in consultation with the hospital, a monitor to prevent further financial deterioration, in which case the commissioner, within 30 days of making the appointment, shall provide notice of the appointment of the monitor to the mayor, city administrator, and members of the Legislature who represent the municipality in which the hospital is located.
The appointed monitor shall have demonstrated expertise in hospital administration, management, or operations. A monitor: (1) shall be authorized to attend all hospital board meetings, executive committee meetings, finance committee meetings, steering committee meetings, turnaround committee meetings, or any other meetings concerning the hospital's fiscal matters; (2) may be authorized to have voting and veto powers over actions taken in the above mentioned meetings; (3) shall report to the commissioner and the full hospital board of trustees in a manner prescribed by the commissioner; and (4) shall serve for such period of time as may be determined by the commissioner in consultation with the hospital.
The commissioner shall maintain continuing oversight of the actions and recommendations of the monitor to ensure that the public interest is protected.
a. (1) provide to the Department of Health: monthly and quarterly unaudited financial information, quarterly unaudited financial statements, annual audited financial statements, and such other financial information as the department may request; and
(2) annually, upon renewal of its license, post on its Internet website the most recent public inspection copy that is available of Internal Revenue Service Form 990 and all schedules and supporting documentation required to be submitted to the Internal Revenue Service in conjunction with Form 990 ; except that, if the hospital does not file a Form 990 with the Internal Revenue Service, the hospital shall post on its Internet website all governance, financial, and operating information that would otherwise be reported on Form 990 for the prior tax year, including the information that would be required to be submitted in the schedules and supporting documentation in conjunction with Form 990, to the extent that such information exists with respect to a for-profit hospital; and
(3) no less than 90 days prior to signing an agreement for the sale or the lease of the land or property on which the hospital is located, provide notice to the Department of Health of the hospital's intent to sign an agreement to sell or lease land or property on which the hospital is located. Notification to the department shall include a copy of the agreement, the names of all parties included, and the intended use of proceeds from the sale or lease of land or property;
b. permit the Commissioner of Health, or a monitor appointed by the commissioner, as applicable, to oversee its financial operations, and, if the commissioner determines that the hospital is at risk of being in financial distress or is in financial distress based on criteria specified by regulation, participate in the development and implementation of a corrective plan to resolve the hospital's financial difficulties, pursuant to section 2 of P.L.2008, c.58 (C.26:2H-5.1a); and
c. if the hospital is owned or managed by a for-profit entity, including an entity that has a majority ownership interest in the hospital, provide to the department the following information, to the extent that such information is not otherwise reported pursuant to subsection a. of this section:
(1) a report of each business transaction in the fiscal year with an interested person which exceeds $10,000. The report of business transactions with interested persons shall be the same as defined in Internal Revenue Service Form 990, except that the term "interested persons" shall also include owners of any for-profit hospital;
(2) a chart that identifies all related organizations, including any corporation, company, limited liability company, partnership, individual trust, or other governing body, entity, or person as defined in Internal Revenue Service Form 990, including the full name, location, and tax-exempt status of the entity or person;
(3) whether the owners or managers of the hospital maintain one or more offices, employees, or agents outside the United States that do business with the hospital, and any revenues and expenses of more than $10,000 transacted outside the United States;
(4) a list of investors and joint ventures between the hospital owners and its investors, including the name of the joint venture entity, whether for-profit or nonprofit, a description of its primary activity, and the percent of profit or stock ownership held by each of the officers, directors, physicians, and key employees of the hospital in the joint venture;
(5) the name and address of any management company paid to provide services to the hospital, a description of the primary activity of the company, and the percent of profit or stock ownership held by each of the officers, directors, physicians, and key employees of the hospital in the management company;
(6) the amounts paid to any affiliates for management or consulting services;
(7) a description of any trust that holds an interest in the hospital, including the names of the trustees, beneficial owners, and grantor or settlor of the trust, along with a copy of the full trust agreement;
(8) a list of any properties for which the hospital has claimed a tax abatement; and
(9) if the hospital had surplus revenues for the prior fiscal year, the total amount of any such surplus revenue used for each of the following: debt retirement; plant or facility expansion; or a reserve for operating contingencies.
d. The information submitted to the department pursuant to this section during the period of time encompassing the hospital's current or most recent tax year shall be posted on the hospital's Internet website, with the exception of any information provided to the department under subsection c. deemed proprietary by the Commissioner of Health. The department shall provide a link on the department's Internet website to the information posted on the hospital's Internet website, as required pursuant to this subsection.
(1) process quality indicators of infection control as selected by the commissioner in consultation with the Quality Improvement Advisory Committee within the department; and
(2) beginning 30 days after the adoption of regulations pursuant to this act, data on infection rates for the major site categories that define facility-associated infection locations, multiple infections, and device-related and non-device related infections, as selected by the commissioner in consultation with the Quality Improvement Advisory Committee within the department.
b. The information reported pursuant to this section shall be transmitted in such a manner as to not include identifying information about patients.
c. The commissioner shall promptly advise an ambulatory care facility in the event that the commissioner determines, based on information reported by the facility, that a change in facility practices or policy is necessary to improve performance in the prevention of facility-associated infection and quality of care provided at the facility.
d. The commissioner shall make available to members of the public, on the official Internet website of the department, the information reported pursuant to this section, in such a format as the commissioner deems appropriate to enable comparison among ambulatory care facilities with respect to the information.
e. In order to effectuate the purposes of this section, the commissioner, in consultation with the Quality Improvement Advisory Committee in the department, shall, by regulation: establish standard methods for identifying and reporting facility-associated infections; identify the major site categories for which infections shall be reported, taking into account the categories most likely to improve the delivery and outcome of health care in the State; and specify the methodology for presenting the data to the public, including procedures to adjust for differences in case mix and severity of infections among facilities.
b. The regulations shall:
(1) identify services authorized to be provided as primary care, mental health care, or substance use disorder treatment pursuant to an integrated health care facility license;
(2) require a single integrated health care facility license for a facility, which license shall specify the scope of primary care, mental health care, and substance use disorder treatment services that the facility is authorized to provide under the integrated health care facility license;
(3) permit a facility to hold a designation as an ambulatory care facility, community mental health program, substance use disorder treatment facility, or other type of facility recognized under State or federal law under the integrated health care facility license without requiring a separate license;
(4) identify staffing requirements consistent with staff members' scope of professional practice and credentials;
(5) establish standards for information sharing among providers and among core and non-core team members;
(6) establish requirements for collection of data on identified outcome measures;
(7) permit sharing of clinical space, administrative staff, medical records storage, and other facility resources among different categories of services, unless a separation is necessary to protect the health and safety of patients or the public or to comply with federal or State health privacy laws and regulations; and
(8) establish application requirements, compliance inspections, investigations, and enforcement actions, including but not limited to fees and penalties.
c. In developing the regulations, the commissioner shall:
(1) consult with the Division of Medical Assistance and Health Services in the Department of Human Services to develop policies that minimize barriers to participation and reimbursement in the Medicaid and NJ FamilyCare programs faced by licensed facilities for all qualifying services; and
(2) promote policies that:
(a) support an effective and efficient administration of a full range of integrated, comprehensive health care;
(b) support providers' identification of risk factors for mental illness and substance use disorders, which may include physical health diagnoses;
(c) support an increased awareness of prevention and treatment;
(d) reduce the stigma associated with receiving behavioral health treatment;
(e) will lead to improved access to mental health care and substance use disorder treatment services for all persons;
(f) will lead to improved general health and wellness, including physical health, mental health, and substance use disorders, and prevent chronic disease; and
(g) will leverage partnerships with local health authorities, employers, faith-based organizations, and others involved in promoting community health.
Of the additional public members first appointed pursuant to P.L.1998, c.43, two shall serve for a term of two years and two shall serve for a term of three years. Following the expiration of the original terms, the public members shall serve for a term of four years and are eligible for reappointment. Public members serving on the board on the effective date of P.L.1998, c.43 shall continue to serve for the term of their appointment. Any vacancy shall be filled in the same manner as the original appointment, for the unexpired term. Public members shall continue to serve until their successors are appointed. The public members shall serve without compensation but may be reimbursed for reasonable expenses incurred in the performance of their duties, within the limits of funds available to the board.
a. A member or employee of the State Health Planning Board shall not, by reason of his performance of any duty, function, or activity required of, or authorized to be undertaken by the board, be held civilly or criminally liable if that person acted within the scope of his duty, function, or activity as a member or employee of the board, without gross negligence or malice toward any person affected thereby.
b. A member of the State Health Planning Board shall not vote on any matter before the board concerning an individual or entity with which the member has, or within the last 12 months has had, any substantial ownership, employment, medical staff, fiduciary, contractual, creditor, or consultative relationship. A member who has or has had such a relationship with an individual or entity involved in any matter before the board shall make a written disclosure of the relationship before any action is taken by the board with respect to the matter and shall make the relationship public in any meeting in which action on the matter is to be taken.
b. The State Health Planning Board shall review applications for certificates of need and make recommendations to the Commissioner of Health.
c. In the case of an application for a certificate of need to transfer ownership of an existing general acute care hospital or to close or eliminate a health care facility or service that is subject to review by the State Health Planning Board, the State Health Planning Board shall hold at least one public hearing in the service area of the health care facility or service; except that, in the event the Attorney General or the Department of Health is required by State law to hold a public hearing on the transfer of ownership of the hospital, the State Health Planning Board shall not be required to hold a public hearing on the application for a certificate of need to transfer ownership of the hospital. The public hearing shall be held no later than 30 days after an application is deemed complete by the Commissioner of Health. Public notice of the hearing shall be provided at least two weeks in advance of the date of the hearing.
Notwithstanding the provisions of this subsection to the contrary, in the event that the commissioner determines that a proposed closure or elimination of a health care facility or service should be considered on an expedited basis in order to preserve the quality of health care provided to the community, the commissioner may reduce the period of time required for public notice of the hearing.
a. The use of conventional needles results in increased risk of HIV infection and hepatitis B and C to health care workers;
b. Each year, from 150 to 200 health care workers die and many suffer chronic and debilitating diseases due to needle stick injuries;
c. Equipment exists to prevent most injuries that result from needle stick injuries but overall concern with cutting health care costs has impeded the widespread use of advanced, safer technology; and
d. Newer, safer needle technology should be adopted in health care facilities.
"Commissioner" means the Commissioner of Health.
"Department" means the Department of Health.
"Needle stick injury" means the parenteral introduction into the body of a health care worker of blood or other potentially infectious material by a needle or other sharp device during the worker's performance of health care duties in a health care facility.
b. By a date established by the commissioner by regulation, but no later than 36 months after the date of enactment of this act, the requirements of subsection a. of this section shall also apply to pre-filled syringes, as that term is defined by the commissioner by regulation pursuant to this act.
c. No later than six months after the date of enactment of this act, the commissioner shall develop evaluation criteria for use by an evaluation committee established pursuant to subsection a. of section 4 of this act in selecting needles and other sharp devices for use by a health care facility.
d. In the event that there is no cleared or approved for marketing product with integrated safety features for a specific patient use, the licensed health care facility shall continue to use the appropriate needle or other sharp device that is available, including any needle or other sharp device with non-integrated, add-on safety features, until such time as a product with integrated safety features is cleared or approved for marketing and is commercially available for that specific patient use.
e. No later than six months after the date of enactment of this act, the commissioner shall develop and make available to health care facilities a standardized form that shall be used by health care professionals and the health care facility's evaluation committee for applying for a waiver and in reviewing a request for a waiver, respectively, and for reporting the use of a needle or other sharp device without integrated safety features in an emergency situation by a health care professional, pursuant to the provisions of subsection d. of section 4 of this act.
f. Notwithstanding the provisions of this section to the contrary, a dentist who determines that use of a needle or other sharp device with integrated safety features potentially may have a negative impact on patient safety or the success of a specific medical procedure may use a needle or other sharp device without integrated safety features, without obtaining a waiver from the evaluation committee and without providing notification to the evaluation committee pursuant to section 4 of P.L.1999, c.311 (C.26:2H-5.13).
a. Establish an evaluation committee in which at least half of the members are direct-care health care workers who shall select needles and other sharp devices from each class of needle or other sharp device for which the commissioner has developed evaluation criteria pursuant to subsection c. of section 3 of this act;
b. Provide for education and training, as appropriate, in the use of designated needles and other sharp devices;
c. Develop a mechanism to continually review and evaluate newly introduced needles and other sharp devices available in the marketplace for use in a health care facility;
d. Establish a waiver procedure for health care professionals wherein a health care professional practicing at the health care facility may request the evaluation committee to grant the professional a waiver from the requirements of subsection a. or b. of section 3 of this act for a specific product that will be used for a specific medical procedure that shall be performed on a specific class of patients. The evaluation committee shall grant a waiver if it determines that use of a needle or other sharp device with integrated safety features potentially may have a negative impact on patient safety or the success of a specific medical procedure.
A health care professional may use a needle or other sharp device without integrated safety features in an emergency situation, without obtaining a waiver from the evaluation committee, if the professional determines that use of a needle or other sharp device with integrated safety features potentially may have a negative impact on patient safety or the success of a specific medical procedure, and the professional notifies the evaluation committee, in writing, within five days of the date the needle or other sharp device was used of the reasons why that needle or other sharp device was necessary.
The use of a needle or other sharp device that does not meet the requirements of subsection a. or b. of section 3 of this act shall be permitted under this act if it is used in accordance with the requirements of this subsection;
e. Record needle stick injuries in a Sharps Injury Log or an OSHA 200 Log, and shall include in the log a description of the injury, including the type and brand name of the needle or other sharp device involved in the injury; and
f. Report to the department quarterly, in a form and manner prescribed by the department: (1) all entries of an injury in a Sharps Injury Log or an OSHA 200 Log; and (2) all waivers granted to health care professionals and the reasons therefor, and all emergency uses by health care professionals of needles and other sharp devices without integrated safety features and the reasons therefor, pursuant to subsection d. of this section.
a. Violence is an escalating problem in many health care settings in the State and across the nation, and although violence is an increasing problem for many workers, health care workers are at a particularly high risk;
b. According to the Bureau of Labor Statistics, the incidence of injury from nonfatal assaults of health service workers is significantly higher than that of other workers;
c. The actual incidence of violence is likely higher than reported for various reasons, including inadequate reporting mechanisms and because victims under-report incidents out of fear of reprisal, isolation and embarrassment;
d. Violence against health care workers exacts a significant toll on victims, their co-workers, patients, families and visitors;
e. Insurance claims, lost productivity, disruptions to operations, legal expenses and property damage are only a few of the negative effects that workplace violence has on health care facilities;
f. Preventing workplace violence is essential for creating a safe and therapeutic environment for patients;
g. Health care professionals who leave their occupations because of assaults or threats of assault contribute to the general shortage of health care professionals; and
h. It is possible to reduce and mitigate the effects of violence in health care settings through employer-based violence prevention programs.
"Covered health care facility" means a general or special hospital or nursing home licensed by the Department of Health and Senior Services pursuant to P.L.1971, c.136 (C.26:2H-1 et al.), a State or county psychiatric hospital, or a State developmental center.
"Health care worker" means an individual who is employed by a covered health care facility.
"Violence" or "violent act" means any physical assault, or any physical or credible verbal threat of assault or harm against a health care worker.
a. (1) The covered health care facility shall establish a violence prevention committee, which shall include a representative of management, or his designee, who shall be responsible for overseeing all aspects of the program. At least 50% of the members of the committee shall be health care workers who provide direct patient care or otherwise have contact with patients. In a facility or health care system where health care workers are represented by one or more collective bargaining agents, the management of the facility or system shall consult with the applicable collective bargaining agents regarding the selection of the health care worker committee members.
The remaining committee members shall have experience, expertise, or responsibility relevant to violence prevention.
(2) In the case of a health care system that owns or operates more than one covered health care facility or Department of Human Services facilities, the violence prevention program and the committee may be operated at the system or department level, provided that: (a) committee membership includes at least one health care worker from each facility who provides direct care to patients, (b) the committee develops a violence prevention plan for each facility, and (c) data related to violence prevention remain distinctly identifiable for each facility.
b. Within 18 months of the effective date of this act, the committee shall develop and maintain a detailed, written violence prevention plan that identifies workplace risks, and provides specific methods to address them. The plan shall, at a minimum:
(1) provide an annual comprehensive violence risk-assessment for the covered health care facility that considers, to the extent applicable:
(a) the facility's layout, access restrictions, crime rate in surrounding areas, lighting, and communication and alarm devices;
(b) impact of staffing, including security personnel;
(c) the presence of individuals who may pose a risk of violence; and
(d) a review of any records relating to violent incidents at the facility, including incidents required to be reported pursuant to subsection f. of this section, the Occupational Safety and Health Administration Log of Work-Related Injuries and Illnesses (OSHA Form 300), and workers' compensation records;
(2) identify violence prevention policies; and
(3) specify methods to reduce identified risks, including training, and changes to job design, staffing, security, equipment and facility modifications.
c. The covered health care facility shall make a copy of the plan available, upon request, to the Commissioners of Health and Senior Services, Children and Families, and Human Services for on-site inspection, and upon request, to each health care worker and collective bargaining agent that represents health care workers at the facility, except that, in the event the committee determines that the plan contains information that would pose a threat to security if made public, any such information shall be excluded before providing copies to workers or collective bargaining agents.
d. The covered health care facility shall annually conduct violence prevention training. The training shall include a review of: the facility's relevant policies; techniques to de-escalate and minimize violent behavior; appropriate responses to workplace violence, including use of restraining techniques, reporting requirements and procedures; location and operation of safety devices; and resources for coping with violence.
e. The covered health care facility shall have personnel sufficiently trained to identify aggressive and violent predicting factors and the ability to appropriately respond to and manage violent disturbances.
f. The covered health care facility shall keep a record of all violent acts against employees while at work. The records shall be maintained for at least five years following the reported act, during which time employees, their authorized representatives, and the Department of Health and Senior Services shall have access to the record. The record shall include:
(1) the date, time and location of the incident;
(2) the identity and job title of the victim, except that the victim's identity shall not be included if it would not be entered on the Occupational Safety and Health Administration Log of Work-Related Injuries and Illnesses (OSHA Form 300) because it is a privacy concern case under OSHA;
(3) whether the act was committed by a patient, visitor, or employee;
(4) the nature of the violent act, including whether a weapon was used;
(5) a description of physical injuries, if any;
(6) the number of employees in the vicinity when the incident occurred and their actions in response to the incident, if any; and
(7) the actions taken by the facility in response to the incident.
The records established pursuant to this subsection shall not be considered public or government records under P.L.1963, c.73 (C.47:1A-1 et seq.) or P.L.2001, c.404 (C.47:1A-5 et al.).
g. The covered health care facility shall establish a post-incident response system that provides, at a minimum, an in-house crisis response team for employee-victims and their co-workers, and individual and group crisis counseling, which may include support groups, family crisis intervention, and professional referrals.
b. A health care facility shall prominently display a written notice in a conspicuous public location that contains the following or substantially similar statement: "It is a crime to assault a health care professional, any volunteer working for a health care professional or working at a health care facility, any supportive services staff member working for a health care professional or working at a health care facility, or any employee of a health care professional or a health care facility while the health care professional, volunteer, supportive services staff member, or employee is performing official duties. Any person who assaults a health care professional, volunteer, supportive services staff member, or employee in violation of this prohibition shall be subject to a fine, imprisonment, or both under the New Jersey Code of Criminal Justice, N.J.S.2C:1-1 et seq."
c. The Commissioner of Health may adopt rules and regulations, in accordance with the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.), as are necessary to effectuate the provisions of this section.
a. According to the American Association of Retired Professional's Public Policy Institute, at any given time, an estimated 1.75 million people in New Jersey provide varying degrees of unreimbursed care to adults with limitations in daily activities. The total value of the unpaid care to individuals in need of long-term services and supports amounts to an estimated $13 billion per year.
b. Caregivers are often members of the individual's immediate family, but friends and other community members also serve as caregivers. Although most caregivers are asked to assist an individual with basic activities of daily living, such as mobility, eating, and dressing, many are expected to perform complex tasks on a daily basis, such as administering multiple medications, providing wound care, and operating medical equipment.
c. Despite the vast importance of caregivers in the individual's day-to-day care, and despite the fact that 78 percent of caregivers report managing multiple medications, administering injections, and performing other health maintenance tasks, research has shown that many caregivers feel that they do not have the necessary skill set to perform the caregiving tasks they are asked to perform when a loved one is discharged from the hospital.
d. The federal Centers for Medicare & Medicaid Services (CMS) estimates that $17 billion in Medicare funds is spent each year on unnecessary hospital readmissions. Additionally, hospitals desire to avoid the imposition of new readmission penalties under the federal "Patient Protection and Affordable Care Act," Pub.L.111-148, as amended by the "Health Care and Education Reconciliation Act of 2010," Pub.L.111-152 (ACA).
e. In order to successfully address the challenges of a surging population of older adults and others who have significant needs for long-term services and supports, the State must develop methods to enable caregivers to continue to support their loved ones at home and in the community, and avoid costly hospital readmissions.
f. The New Jersey Hospital Association and hospitals in its Hospital Engagement Network have utilized transitional caregiver models to reduce readmissions by over 13 percent from January 2012 to December 2013, leading to 5,492 fewer patients being readmitted during that time, at a cost savings of over $52 million.
g. Therefore, it is the intent of the Legislature that this act enables caregivers to provide competent post-hospital care to their family and other loved ones, at minimal cost to the taxpayers of this State.
"After-care assistance" means any assistance provided by a caregiver to a patient following the patient's discharge from a hospital that is related to the patient's condition at the time of discharge, including, but not limited to: assisting with basic activities of daily living; instrumental activities of daily living; and other tasks as determined to be appropriate by the discharging physician or other health care professional licensed pursuant to Title 45 or Title 52 of the Revised Statutes.
"Caregiver" means any individual designated as a caregiver by a patient pursuant to this act who provides after-care assistance to a patient in the patient's residence. The term includes, but is not limited to, a relative, spouse, partner, friend, or neighbor who has a significant relationship with the patient.
"Discharge" means a patient's exit or release from a hospital to the patient's residence following any medical care or treatment rendered to the patient following an inpatient admission.
"Entry" means a patient's admission into a hospital for the purposes of receiving inpatient medical care.
"Hospital" means a general acute care hospital licensed pursuant to P.L.1971, c.136 (C.26:2H-1 et seq.).
"Residence" means the dwelling that the patient considers to be the patient's home. The term shall not include any rehabilitation facility, hospital, nursing home, assisted living facility, or group home licensed by the Department of Health.
b. In the event that the patient is unconscious or otherwise incapacitated upon entry into the hospital, the hospital shall provide the patient or the patient's legal guardian with an opportunity to designate a caregiver within a given timeframe, at the discretion of the attending physician, following the patient's recovery of consciousness or capacity. The hospital shall promptly document the attempt in the patient's medical record.
c. In the event that the patient or legal guardian declines to designate a caregiver pursuant to this act, the hospital shall promptly document this declination in the patient's medical record.
d. In the event that the patient or the patient's legal guardian designates an individual as a caregiver under this act:
(1) The hospital shall promptly request the written consent of the patient or the patient's legal guardian to release medical information to the patient's designated caregiver following the hospital's established procedures for releasing personal health information and in compliance with all State and federal laws, including the federal "Health Insurance Portability and Accountability Act of 1996," Pub.L.104-191, and related regulations.
(a) If the patient or the patient's legal guardian declines to consent to release medical information to the patient's designated caregiver, the hospital is not required to provide notice to the caregiver under section 4 of P.L.2014, c.68 (C.26:2H-5.27) or provide information contained in the patient's discharge plan under section 5 of P.L.2014, c.68 (C.26:2H-5.28).
(2) The hospital shall record the patient's designation of caregiver, the relationship of the designated caregiver to the patient, and the name, telephone number, and address of the patient's designated caregiver in the patient's medical record.
e. A patient or the patient's legal guardian may elect to change the patient's designated caregiver at any time, and the hospital must record this change in the patient's medical record before the patient's discharge.
f. This section shall not be construed to require a patient or a patient's legal guardian to designate any individual as a caregiver.
g. A designation of a caregiver by a patient or a patient's legal guardian does not obligate the designated individual to perform any after-care assistance for the patient.
h. In the event that the patient is a minor child, and the parents of the patient are divorced, the custodial parent shall have the authority to designate a caregiver. If the parents have joint custody of the patient, they shall jointly designate the caregiver.
(1) The name and contact information of the caregiver designated under this act;
(2) A description of all after-care assistance tasks necessary to maintain the patient's ability to reside at home; and
(3) Contact information for any health care, community resources, and long-term services and supports necessary to successfully carry out the patient's discharge plan, and contact information for a hospital employee who can respond to questions about the discharge plan after the instruction provided pursuant to subsection b. of this section.
b. The hospital issuing the discharge plan must provide caregivers with instructions in all after-care assistance tasks described in the discharge plan. Training and instructions for caregivers may be conducted in person or through video technology, at the discretion of the caregiver. Any training or instructions provided to a caregiver shall be provided in non-technical language, to the extent possible. At a minimum, this instruction shall include:
(1) A live or recorded demonstration of the tasks performed by an individual designated by the hospital, who is authorized to perform the after-care assistance task, and is able to perform the demonstration in a culturally-competent manner and in accordance with the hospital's requirements to provide language access services under State and federal law;
(2) An opportunity for the caregiver to ask questions about the after-care assistance tasks; and
(3) Answers to the caregiver's questions provided in a culturally-competent manner and in accordance with the hospital's requirements to provide language access services under State and federal law.
c. Any instruction required under this act shall be documented in the patient's medical record, including, at a minimum, the date, time, and contents of the instruction.
b. A patient may designate a caregiver in an advance directive.
b. A hospital, a hospital employee, or any consultants or contractors with whom a hospital has a contractual relationship shall not be held liable, in any way, for the services rendered or not rendered by the caregiver to the patient at the patient's residence.
c. Nothing in this act shall be construed to obviate the obligation of an insurance company, health service corporation, hospital service corporation, medical service corporation, health maintenance organization, or any other entity issuing health benefits plans to provide coverage required under a health benefits plan.
d. (1) A caregiver shall not be reimbursed by any government or commercial payer for after-care assistance that is provided pursuant to this act.
(2) Nothing in this act shall be construed to impact, impede, or otherwise disrupt or reduce the reimbursement obligations of an insurance company, health service corporation, hospital service corporation, medical service corporation, health maintenance organization, or any other entity issuing health benefits plans.
"Health care facility" or "facility" means a health care facility licensed pursuant to P.L.1971, c.136 (C.26:2H-1 et seq.).
"Health care professional" means a person licensed to practice a health care profession pursuant to Title 45 of the Revised Statutes.
b. (1) The existing policies and procedures utilized by a health care facility shall, to the maximum extent possible, govern the taking of any action by a health care professional pursuant to sections 1 through 20 of P.L.2019, c.59 (C.26:16-1 et seq.) on the premises owned by, or under the direct control of, the facility, except as otherwise prescribed by regulation of the Commissioner of Health pursuant to paragraph (4) of this subsection.
(2) Any action taken by a health care facility to participate in P.L.2019, c.59 (C.26:16-1 et al.) shall be voluntary on the part of the facility.
(3) A health care facility shall not be subject to a licensure enforcement action by the Department of Health for any action taken in compliance with the provisions of P.L.2019, c.59 (C.26:16-1 et al.).
(4) The Commissioner of Health, pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.), shall adopt such rules and regulations as are necessary to implement the provisions of sections 1 through 20 of P.L.2019, c.59 (C.26:16-1 et seq.), concerning their application to a health care facility and any action taken by a health care professional on the premises owned by, or under the direct control of, the facility.
(5) The provisions of this subsection shall not preclude a health care facility or health care professional from providing to a patient any health care services to which the provisions of sections 1 through 20 of P.L.2019, c.59 (C.26:16-1 et seq.) do not apply.
b. As used in this section:
"Caregiver" means a relative, spouse, partner, friend, or neighbor who has a significant relationship to the patient;
"Dementia" means a chronic or persistent disorder of the mental processes due to organic brain disease, for which no curative treatment is available, and marked by memory disorders, changes in personality, deterioration in personal care, impaired reasoning ability, and disorientation; and
"Health care professional" means a physician, physician assistant, or advanced practice nurse, who is acting within the scope of the professional's practice and is licensed or whose professional practice is otherwise regulated pursuant to Title 45 of the Revised Statutes.
b. Each cultural competency training program implemented pursuant to subsection a. of this section shall include training on how to collect race, ethnicity, sexual orientation, and gender identity in a culturally competent and sensitive manner. This may include the following topics:
(1) common terminology for race and ethnicity, sexual orientation, and gender identity data;
(2) information on the relationship between patient health and collecting race and ethnicity, sexual orientation, and gender identity data;
(3) information on how race and ethnicity, sexual orientation, and gender identity data will be used;
(4) information on how to navigate discomfort in patients and staff when asking patients for their race and ethnicity, sexual orientation, and gender identity information; and
(5) information on how to create an inclusive and affirming environment for all patients.
c. Each staff member who is employed by or working under the supervision of the general acute care hospital, has direct contact with patients, and is responsible for collecting race and ethnicity, sexual orientation, and gender identity information from patients, shall:
(1) complete the cultural competency training program implemented pursuant to subsection a. of this section at such times and intervals as the hospital shall require; and
(2) complete a cultural competency refresher course at least once biennially if completion of the course is deemed necessary by the hospital.
a. The regulatory structure for the State's health care delivery system put in place in the 1970's was an outgrowth of federal legislation predicated on the idea that the most satisfactory means of controlling health care costs was the allocation of health care resources by government through a highly centralized health planning mechanism;
b. For two decades, the State established strong controls over the health care delivery system by such means as the setting of hospital rates and through the certificate of need program, which allocated the provision of services among providers, regulated hospital expansion, and regulated the purchase of equipment and the use of medical technology;
c. The evolution of market-based means of controlling costs, most notably the growth of managed care, and the rapid development of new medical techniques and innovations in medical technology exposed the inefficiencies inherent in centralized health care planning, which was unable to respond quickly to the changing needs of the health care system;
d. In 1992, the Legislature began to dismantle the existing regulatory structure, responding to the needs of the health care system in New Jersey by eliminating hospital rate setting, leaving hospital charges to be established through negotiation between hospitals and those who paid for health care services and, by providing access to health insurance to all citizens of the State, without regard to health status or preexisting condition, contributed to the significant changes taking place in the underlying economics of the health care delivery system by helping to create a more competitive health care environment;
e. The certificate of need program is the last remaining vestige of the highly regulated environment, and its original purpose, which was to control costs by limiting the proliferation of health care services through State control of those services, has been undermined by the significant changes in the economics of the health care system that have taken place since its inception;
f. Decisions as to health care services, the acquisition of medical technology, and the expansion of facilities can best be made by the health care provider based on his own expertise in delivering health care services to the community he serves;
g. The appropriate role of the State with respect to services no longer subject to certificate of need is that of licensure of facilities and services, to ensure the quality of care;
h. For reasons of maintaining the quality of certain health care services, a limitation of the proliferation of such services may continue to be essential to protect the viability of the services as well as the providers now rendering them, to protect the role of such institutions as urban hospitals, whose importance to the Statewide health care system is indisputable, and to guard against the closing of important facilities and the transfer of services from facilities in a manner which is harmful to the public interest; and
i. Therefore, it is essential, in order to promote greater efficiency in the State's health care delivery system, to eliminate the certificate of need requirement for many services immediately, to eliminate the requirement for other services over a more extended period, and to create a commission to consider whether certain remaining health care services should continue to be subject to a certificate of need requirement in the interest of the well-being of the public and to ensure the maintenance of quality health care throughout the State.
Except as provided in section 19 of P.L.1992, c.160 (C.26:2H-7a) and section 16 of P.L.1998, c.43 (C.26:2H-7c), the provisions of this section shall apply to:
a. The initiation of any health care service as provided in section 2 of P.L.1971, c.136 (C.26:2H-2);
b. The initiation by any person of a health care service which is the subject of a health planning regulation adopted by the Department of Health;
c. The purchase by any person of major moveable equipment whose total cost is over $2 million;
d. The expenditure by a licensed health care facility of over $2 million for construction of a new health care facility; and
e. The construction of a facility by any person, whose total project cost exceeds $2 million, if the facility-type is the subject of a health planning regulation adopted by the Department of Health.
The commissioner may periodically increase the monetary thresholds established in this section, by regulation, to reflect inflationary increases in the costs of health care equipment or construction.
For the purposes of this section, "health care service" shall include any service which is the subject of a health planning regulation adopted by the Department of Health, and "person" shall include a corporation, company, association, society, firm, partnership, and joint stock company, as well as an individual.
A physician who initiates a health care service which is the subject of a health planning regulation or purchases major moveable equipment pursuant to subsection b. or c. of this section, may apply to the commissioner for a waiver of the certificate of need requirement if: the equipment or health care service is such an essential, fundamental, and integral component of the physician's practice specialty, that the physician would be unable to practice his specialty according to the acceptable medical standards of that specialty without the health care service or equipment; the physician bills at least 75% of his total amount of charges in the practice specialty which uses the health care service or equipment; and the health care service or equipment is not otherwise available and accessible to patients, pursuant to standards established by the commissioner, by regulation. The commissioner shall make a determination about whether to grant or deny the waiver, within 120 days from the date the request for the waiver is received by the commissioner and shall so notify the physician who requested the waiver. If the request is denied, the commissioner shall include in that notification the reason for the denial. If the request is denied, the initiation of a health care service or the purchase of major moveable equipment shall be subject to the certificate of need requirements pursuant to this section.
A health maintenance organization which furnishes at least basic comprehensive care health services on a prepaid basis to enrollees either through providers employed by the health maintenance organization or through a medical group or groups which contract directly with the health maintenance organization, which initiates a health care service, or constructs a health care facility pursuant to subsection a., b., d., or e. of this section, may apply to the commissioner for a waiver of the certificate of need requirement if: the initiation of the health care service or the construction is in the best interests of State health planning; and the health maintenance organization is in compliance with the provisions of P.L.1973, c.337 (C.26:2J-1 et seq.) and complies with the provisions of subsection d. of section 3 of P.L.1973, c.337 (C.26:2J-3) regarding notification to the commissioner. The commissioner shall make a determination about whether to grant or deny the waiver within 45 days from the date the request for the waiver is received by the commissioner and shall so notify the health maintenance organization. If the request for a waiver is denied on the basis that the request would not be in the best interests of State health planning, the commissioner shall state in that notification the reason why the request would not be in the best interests of State health planning. If the request for a waiver is denied, the health maintenance organization's initiation of a health care service or construction project shall be subject to the certificate of need requirements pursuant to this section.
The requirement to obtain a certificate of need for major moveable equipment pursuant to subsection c. of this section shall not apply if a contract to purchase that equipment was entered into prior to July 1, 1991.
Community-based primary care centers;
Outpatient drug and alcohol services;
Hospital-based medical detoxification for drugs and alcohol;
Ambulance and invalid coach services;
Mental health services which are non-bed related outpatient services;
Full service diagnostic catheterization services, primary angioplasty services, and elective angioplasty services in accordance with a license issued under section 2 of P.L.2021, c.18 (C.26:2H-7.23);
Residential health care facility services;
Dementia care homes;
Capital improvements and renovations to health care facilities;
Additions of medical/surgical, adult intensive care, and adult critical care beds in hospitals;
An increase in the level of neonatal care designation of a health care facility, which provides inpatient, maternity services, from “community perinatal center-basic” to “community perinatal center – intermediate,” as these terms are defined in N.J.A.C.8:33-1.3, or its successor regulation;
Inpatient special psychiatric beds used solely for services for patients with co-occurring mental health and substance use disorders;
Replacement of existing major moveable equipment;
Inpatient operating rooms;
Alternate family care programs;
Hospital-based subacute care;
Ambulatory care facilities;
Comprehensive outpatient rehabilitation services;
Special child health clinics;
New technology in accordance with the provisions of section 18 of P.L.1998, c.43 (C.26:2H-7d);
Transfer of ownership interest except in the case of an acute care hospital;
Change of site for approved certificate of need within the same county;
Additions to vehicles or hours of operation of a mobile intensive care unit;
Relocation or replacement of a health care facility within the same county except for an acute care hospital;
Continuing care retirement communities authorized pursuant to P.L.1986, c.103 (C.52:27D-330 et seq.);
Magnetic resonance imaging;
Adult day health care facilities;
Pediatric day health care facilities;
Chronic or acute renal dialysis facilities; and
Transfer of ownership of a hospital to an authority in accordance with P.L.2006, c.46 (C.30:9-23.15 et al.).
Extracorporeal shock wave lithotripter;
Hyperbaric chamber;
Positron emission tomography;
Residential drug and alcohol services;
Ambulatory surgical facilities;
Basic obstetric and pediatric services and birth centers, including additions of basic obstetric and pediatric beds in hospitals; and
Linear accelerator, including Cobalt 60 unit.
b. Notwithstanding the provisions of subsection a. of this section to the contrary, if the Commissioner of Health determines that Department of Health licensing standards for a health care service or facility listed in subsection a. of this section have been adopted by regulation of the department pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.), the commissioner may exempt the health care service or facility from the provisions of section 7 of P.L.1971, c.136 (C.26:2H-7) prior to the 20-month period established in subsection a. of this section.
The commissioner shall publish notice of any exemptions established pursuant to this subsection in the New Jersey Register and provide for 45 days' public notice prior to the effective date of the exemption.
c. In the case of any health care service or facility that is not exempted from the provisions of section 7 of P.L.1971, c.136 (C.26:2H-7) pursuant to this section or section 19 of P.L.1992, c.160 (C.26:2H-7a) and is not subject to expedited review, the commissioner shall publish a call schedule for the initiation of the services or facilities within 90 days of the date of enactment of this act. In the event that the commissioner determines that there is insufficient need to support the initiation of the service or facility, the commissioner is authorized to cancel the call. The commissioner shall provide public notice of the cancellation at least 45 days prior to the scheduled call date.
a. The new technology shall be directly related to a health care service for which the provider is already licensed and has obtained a certificate of need, when required.
b. The provider shall notify the Commissioner of Health about the intent to initiate the new technology at least 60 days prior to the date the provider will begin use of the technology.
c. The new technology shall have pre-market approval from the federal Food and Drug Administration.
d. The provider shall use the new technology in accordance with guidelines approved by The Joint Commission until such time as the Department of Health has adopted licensing standards for the new technology. The provider shall be required to comply with the department's licensing standards for the new technology upon adoption of the standards.
e. The provider shall agree to submit to the department appropriate patient information and other data concerning use of the new technology to assist the department in establishing licensing standards. The provider shall submit the information and other data on a quarterly basis until such time as licensing standards are adopted for the new technology.
f. The commissioner may suspend a provider's use of the new technology if he determines that the provider is not in compliance with the requirements of this section.
Any nonprofit entity chartered by the State of New Jersey as a nonprofit corporation pursuant to Title 15 of the Revised Statutes, which had been so chartered and had acquired land for the purpose of constructing a hospital prior to the effective date of the act to which this act is a supplement, and when the land so acquired by such nonprofit corporation is located within a municipality that has provided an appropriation for the construction of a health care facility as authorized by P.L.1954, c. 266 (C. 44:5-10.2), then the proposed hospital of such nonprofit corporation shall be exempt from the requirement of section 7 of P.L.1971, c. 136 (C. 26:2H-7) relating to a certificate of need.
b. A nursing home which is exempt from the certificate of need requirement pursuant to subsection a. of this section shall be required to meet the Statewide average for the percentage of beds that are to be reserved for patients who are eligible for medical assistance pursuant to P.L.1968, c.413 (C.30:4D-1 et seq.).
"Commissioner" means the Commissioner of Health.
"Hospital" means an acute care general hospital licensed pursuant to P.L.1971, c.136 (C.26:2H-1 et seq.).
"Subacute care" means a comprehensive in-patient program for patients who have had an acute illness, injury or exacerbation of a disease process, have a determined course of treatment prescribed, and do not require intensive diagnostic or intensive invasive procedures, but the patient's condition requires physician direction, intensive nursing care, frequent recurrent patient assessment and review of the clinical course and treatment plan for a period of time, significant use of ancillary medical services and an interdisciplinary approach using professional teams of physicians, nurses and other relevant professional disciplines to deliver complex clinical interventions.
"Subacute care unit" means a unit located within a hospital which utilizes licensed long-term care beds to provide subacute care for patients.
(1) the subacute care unit's beds shall be licensed by the Department of Health as long-term care beds and shall meet all applicable State licensing and federal certification requirements, including the physical requirements for skilled nursing beds under the federal Medicare program established pursuant to Pub.L.89-97 (42 U.S.C.s.1395 et seq.), with reasonable waiver provisions as determined by the commissioner or the federal Centers for Medicare & Medicaid Services, as appropriate;
(2) the maximum length of stay in the unit shall not exceed eight days;
(3) the unit shall be certified to participate in the Medicare program as a skilled nursing facility;
(4) the unit shall be comprised of not more than 7% of the hospital's licensed medical-surgical bed capacity or 12 beds, whichever is greater;
(5) the hospital's licensed medical-surgical bed capacity shall be reduced, by the commissioner, by the number of beds used to establish a subacute care unit under the provisions of this section. Long-term care beds in a hospital's subacute care unit shall not be transferred to, or combined with, a subacute care unit in another hospital. Bed limitations for a hospital shall include both conversions of existing acute care beds and any purchases or other acquisitions or rentals of beds to be used by a hospital for the provision of subacute care under this act;
(6) (Deleted by amendment, P.L.1998, c.43).
(7) the hospital shall be subject to the fee for the filing of an application for a license for long-term care beds and any renewal thereof as established by the Department of Health pursuant to section 12 of P.L.1971, c.136 (C.26:2H-12).
b. Subacute care shall not be covered by the Medicaid program established pursuant to P.L.1968, c.413 (C.30:4D-1 et seq.). The long-term care beds in a subacute care unit shall not be included in long-term care bed inventories for certificate of need review purposes.
(1) Diagnostic categories include patients with: strokes, congenital anomalies, major multiple trauma, polyarthritis including rheumatoid arthritis, neurological disorders including multiple sclerosis, motor neuron diseases, polyneuropathy, muscular dystrophy and Parkinson's disease, brain injury including traumatic or non-traumatic, spinal cord injury, amputations, joint replacements, fracture of the femur including hip fracture and burns.
(2) Criteria for inpatient rehabilitation hospital care include patients who meet or require all of the following:
(a) close medical supervision by a physician with specialized training or experience in rehabilitation;
(b) 24-hour rehabilitation nursing;
(c) a relatively intense level of rehabilitation services;
(d) a multi-disciplinary team approach to the delivery of the program;
(e) a coordinated program of care;
(f) significant practical improvement is expected in a reasonable period of time; and
(g) realistic goals of self-care or independence in activities of daily living.
b. An acute care hospital shall forward information on clinically stable patients to a licensed comprehensive rehabilitation hospital or an acute care hospital that has licensed comprehensive rehabilitation beds. The licensed comprehensive rehabilitation hospital or the acute care hospital that has licensed comprehensive rehabilitation beds shall then make a recommendation, signed by a physician with specialized training or experience in rehabilitation, regarding placement within 24-hours of receipt of the information from the acute care hospital and which, together with the concurring or alternate recommendation from a case manager at the acute care hospital, shall be forwarded to the patient's attending physician.
c. A patient in a skilled nursing home who is admitted to and discharged from an acute care hospital shall not be admitted to the hospital's subacute care unit unless the skilled nursing home is unable to readmit the patient within 24 hours after notification by the acute care hospital that the patient is ready for readmission to the skilled nursing home. If a patient is admitted to the hospital's subacute care unit because that patient could not be readmitted to the skilled nursing home, the patient shall be discharged to the skilled nursing facility of origin as soon as the home agrees to accept the patient.
d. In addition to the reports required in section 5 of P.L.1996, c.102 (C.26:2H-7.8), an acute care hospital with a subacute care unit shall file an annual report with the Department of Health demonstrating compliance with the provisions of this section. The report shall include information on the number of patients who were admitted to the hospital's subacute care unit when the admission was contrary to the recommendation of a physician with specialized training or experience in rehabilitation, provided however, that the recommendation of the physician was for immediate placement of the patient, that is, within 24-hours, in a licensed comprehensive rehabilitation hospital or an acute care hospital that has licensed comprehensive rehabilitation beds. The report also shall include information on the number of patients admitted to the hospital's subacute care unit pursuant to subsection c. of this section because the patient could not be readmitted to a skilled nursing home.
e. The commissioner shall develop a procedure to assess an acute care hospital with a hospital subacute care unit's compliance with the provisions of this section and section 3 of this act.
f. Failure to comply with the provisions of this section or section 3 of this act may result in the suspension or revocation of a hospital subacute care license.
g. If an acute care hospital which has a subacute care unit plans to transfer a patient from the hospital to the subacute care unit, the hospital shall discharge the patient from the hospital and admit the patient to the subacute care unit. Each admission to a subacute care unit shall be subject to a $35 health care quality fee to be paid to the Department of Health, the revenues from which shall be deposited in a dedicated fund to be established by the commissioner, and designated as the "Health Care Quality Monitoring Fund."
b. A hospital that has or converts beds for subacute care shall file with the Department of Health quarterly reports showing each patient admitted to the subacute care unit during the quarter by diagnosis, the patient's length of stay in the unit, and any other information required by the department by regulation.
For the purposes of P.L.2000, c.143 (C.26:2H-7.10 et seq.), "acquisition" means the purchase, lease, exchange, conversion, restructuring, merger, division, consolidation, transfer of control, or other disposition of a substantial amount of assets or operations, whether through a single transaction or series of transactions, with one or more persons or entities.
P.L.2000, c.143 (C.26:2H-7.10 et seq.) shall not apply to a nonprofit hospital if the proposed acquisition is in the usual and regular course of its activities and the Attorney General has given the nonprofit hospital a written waiver as to the proposed acquisition. As used in this section, a proposed acquisition is not in the usual and regular course of a nonprofit hospital's activities if it effects a fundamental corporate change that involves transfer of ownership or control of charitable assets or a change of the nonprofit hospital's mission or purpose.
a. (1) Within five working days of submitting an application pursuant to this section, the nonprofit hospital shall publish a notice of the proposed acquisition, in a form approved by the Attorney General, in a newspaper of general circulation in the service area of the hospital once per week for three weeks. The notice shall state the names of the parties to the agreement, describe the contents of the application to the Attorney General, and state the date by which a person may submit written comments about the application to the Attorney General.
(2) Within 30 days after receipt of an initial application, the Attorney General shall advise the applicant in writing whether the application is complete, and, if not, shall specify what additional information is required.
(3) The Attorney General shall, upon receipt of the information requested, notify the applicant in writing of the date of completion of the application.
b. Within 90 days of the date of completion of the application, the Attorney General, in consultation with the Commissioner of Health, shall review the application and support the proposed acquisition, with or without any specific modifications, or, if the Attorney General finds that it is not in the public interest, oppose the proposed acquisition. The Attorney General or commissioner may, for good cause, extend the time for review of an application submitted pursuant to this section.
The proposed acquisition shall not be considered to be in the public interest unless the Attorney General determines that appropriate steps have been taken to safeguard the value of the charitable assets of the hospital and to ensure that any proceeds from the proposed acquisition are irrevocably dedicated for appropriate charitable health care purposes; and the Commissioner of Health determines that the proposed transaction is not likely to result in the deterioration of the quality, availability, or accessibility of health care services in the affected communities.
c. In determining whether the acquisition meets the criteria of subsection b. of this section, the Attorney General shall consider:
(1) Whether the acquisition is permitted under the "New Jersey Nonprofit Corporation Act," Title 15A of the New Jersey Statutes, and other applicable State statutes governing nonprofit corporations;
(2) Whether the nonprofit hospital exercised due diligence in deciding to effectuate the acquisition, selecting the other party to the acquisition and negotiating the terms and conditions of the acquisition;
(3) The procedures used by the nonprofit hospital in making its decision, including whether appropriate expert assistance was used;
(4) Whether conflicts of interest were disclosed, including, but not limited to, conflicts of interest related to board members of, executives of, and experts retained by, the nonprofit hospital, purchaser, or other parties to the acquisition;
(5) Whether any management contract under the acquisition is for reasonable fair value;
(6) Whether the acquisition proceeds will be used for appropriate charitable health care purposes consistent with the nonprofit hospital's original purpose or for the support and promotion of health care, and whether the proceeds will be controlled as charitable funds independently of the purchaser or parties to the acquisition; and
(7) Any other criteria the Attorney General establishes by regulation to determine whether the proposed acquisition is in the public interest.
d. In determining whether an acquisition by any person or entity other than a corporation organized in this State for charitable purposes under Title 15A of the New Jersey Statutes meets the criteria of subsection b. of this section, the Attorney General shall consider, in addition to the criteria set forth in subsection c., the following criteria:
(1) Whether the nonprofit hospital will receive full and fair market value for its assets. The Attorney General may employ, at the nonprofit hospital's expense, reasonably necessary expert assistance in making this determination;
(2) Whether charitable funds are placed at unreasonable risk, if the acquisition is financed in part by the nonprofit hospital;
(3) Whether a right of first refusal has been retained to repurchase the assets by a successor nonprofit corporation or foundation if, following the acquisition, the hospital is subsequently sold to, acquired by, or merged with another entity;
(4) Whether the nonprofit hospital established appropriate criteria in deciding to pursue a conversion in relation to carrying out its mission and purposes;
(5) Whether the nonprofit hospital considered the proposed conversion as the only alternative or as the best alternative in carrying out its mission and purposes;
(6) Whether the nonprofit hospital exercised due care in assigning a value to the existing hospital and its charitable assets in proceeding to negotiate the proposed conversion;
(7) Whether officers, directors, board members, or senior management will receive future contracts in existing, new, or affiliated hospitals or foundations; and
(8) Any other criteria the Attorney General establishes by regulation to determine whether a proposed acquisition by any person or entity other than a corporation organized in this State for charitable purposes under Title 15A of the New Jersey Statutes is in the public interest.
e. In the Attorney General's review of the proposed acquisition, the Attorney General may assess the entity proposing to acquire the nonprofit hospital for reasonable costs related to the review, as determined by the Attorney General to be necessary. Reasonable costs may include expert review of the acquisition and a process for educating the public about the acquisition and obtaining public input.
f. The Attorney General and the Commissioner of Health shall, during the course of the review pursuant to this section, hold at least one public hearing in which any person may file written comments and exhibits or appear and make a statement. The public hearing may, if the Attorney General and commissioner so agree, be conducted jointly. The commissioner may satisfy the requirements of this subsection by conducting a public hearing in conjunction with the certificate of need review process pursuant to P.L.1971, c.136 (C.26:2H-1 et seq.). The Attorney General or the commissioner may subpoena additional information or witnesses, including, but not limited to, information about any transaction that is collateral to the proposed acquisition and any related documents, require and administer oaths, require sworn statements, take depositions, and use related discovery procedures for purposes of the hearing and at any time prior to completing the review of the proposed acquisition.
The Attorney General shall make the information received pursuant to this section, and the Department of Health shall make any information in its records relating to the proposed acquisition, available for inspection at no cost to the public.
The public hearing shall be held no later than 60 days after the date that an application from a nonprofit hospital is deemed complete by the Attorney General. Public notice of the hearing shall be provided at least two weeks in advance of the date of the hearing.
g. In a proposed acquisition subject to review under subsection d. of this section, the Attorney General, after consultation with the principal parties to the transaction, shall make a determination as to the amount of assets which the nonprofit hospital shall set aside as a charitable obligation, based on the full and fair market value of the hospital at the time of the proposed acquisition as determined by the Attorney General.
h. Upon execution of a proposed acquisition subject to review under subsection d. of this section, the amount determined by the Attorney General to be set aside as a charitable obligation shall be placed in a nonprofit charitable trust or one or more existing or newly established tax-exempt charitable organizations operating pursuant to 26 U.S.C. s.501(c)(3). The charitable mission and grant-making functions of any charitable entity that receives assets pursuant to subsection g. of this section shall be dedicated to serving the health care needs of the community historically served by the predecessor nonprofit hospital. Any charitable entity that receives assets pursuant to subsection g. of this section, the directors, officers, and trustees of any such charitable entity, and the assets of any such charitable entity, including any stock involved in the acquisition, shall be independent of any influence or control by the acquiring entity, its directors, officers, trustees, subsidiaries, or affiliates.
(1) The governance of the charitable trust that results from the acquisition or of any newly established charitable organization that is to receive charitable assets pursuant to subsection g. of this section shall be subject to review and approval by the Attorney General. The governance of any existing charitable organization that is to receive charitable assets pursuant to subsection g. of this section shall be subject to review by the Attorney General. The governance of the charitable trust or the charitable organization shall be broadly based, and neither the trust or organization nor any officer, director, or senior manager of the trust or organization shall be affiliated with the acquiring entity and no officer, director, or senior manager of the trust or organization shall be a full-time employee of State government. No officer, director, or senior manager of the trust or organization shall have been a director, officer, agent, trustee, or employee of the nonprofit hospital during the three years immediately preceding the effective date of the acquisition, unless that person can demonstrate to the satisfaction of the Attorney General that the person's assumption of the position of officer, director, or senior manager of the trust or organization would not constitute a breach of fiduciary duty or other conflict of interest.
(2) The governing body of the charitable trust or organization shall establish or demonstrate that it has in place, as the case may be, a mechanism to avoid conflicts of interest and to prohibit grants that benefit the board of directors and management of the acquiring entity or its affiliates or subsidiaries.
(3) The governing body of the charitable trust or organization shall provide the Attorney General with an annual report which shall include an audited financial statement and a detailed description of its grant-making and other charitable activities related to its use of the charitable assets received pursuant to P.L.2000, c.143 (C.26:2H-7.10 et seq.). The annual report shall be made available to the public at both the Attorney General's office and the office of the charitable trust or organization. Nothing contained in P.L.2000, c.143 (C.26:2H-7.10 et seq.) shall affect the obligations of an entity possessing endowment funds under P.L.1975, c.26 (C.15:18-15 et seq.).
(4) (a) Upon notice to the Attorney General, and the nonprofit charitable entity or entities into which charitable assets were placed pursuant to this subsection, in the case of a nonprofit hospital previously acquired at any time after November 2, 2000 by any person or entity other than a corporation organized in this State for charitable purposes under Title 15A of the New Jersey Statutes in accordance with P.L.2000, c.143 (C.26:2H-7.10 et seq.), which is subsequently acquired by a charitable entity that operates a nonprofit hospital that in purpose, form and function is equivalent to the previously acquired nonprofit hospital and serves the same population served by the previously acquired nonprofit hospital, any remaining charitable assets that were placed in a nonprofit charitable entity pursuant to subsection h. of this section shall be subject to review by the Superior Court to determine whether allocating such assets to the nonprofit charitable entity acquiring the previously acquired nonprofit hospital would be more consistent with the previously acquired nonprofit hospital's original purpose. The Attorney General may submit to the court a recommendation concerning an application for allocation of assets authorized pursuant to this subparagraph.
(b) Upon notice to the Attorney General and the nonprofit charitable entity or entities into which charitable assets were placed pursuant to this subsection, in the case of establishment or operation by a charitable entity of a nonprofit hospital that in purpose, form and function is equivalent to and serves the same population served by a nonprofit hospital previously acquired at any time after November 2, 2000 by any person or entity other than a corporation organized in this State for charitable purposes under Title 15A of the New Jersey Statutes in accordance with P.L.2000, c.143 (C.26:2H-7.10 et seq.), which resulted in the placement of charitable assets in a nonprofit charitable entity pursuant to subsection h. of this section, any remaining charitable assets from such placement shall be subject to review by the Superior Court to determine whether allocating such assets to the nonprofit charitable entity establishing or operating the equivalent nonprofit hospital would be more consistent with the previously acquired nonprofit hospital's original purpose. The Attorney General may submit to the court a recommendation concerning an application for allocation of assets authorized pursuant to this subparagraph.
(c) For purposes of this subsection, "remaining charitable assets" means charitable assets that were placed in a nonprofit charitable entity pursuant to this subsection that:
(i) remain in the possession of the charitable entity and have not been disbursed by that entity and already used for the purpose of serving the health care needs of the community historically served by the predecessor nonprofit hospital; or
(ii) have at any time before, on or after the effective date of P.L.2014, c.82 been transferred by the nonprofit charitable entity to a donor-advised fund, or to any other entity, to use as recommended or as required by the nonprofit charitable entity, and have not been disbursed by that fund or entity and already used for the purpose of serving the health care needs of the community historically served by the predecessor nonprofit hospital.
i. (1) The entity acquiring the nonprofit hospital, if determined to be necessary by the Commissioner of Health, shall provide funds, in an amount determined by the Commissioner of Health, for the hiring by the Department of Health of an independent health care access monitor to monitor and report quarterly to the Department of Health on community health care access by the entity, including levels of uncompensated care for indigent persons provided by the entity. The funding shall be provided for three years after the date of the acquisition. The entity acquiring the hospital shall provide the monitor with appropriate access to the entity's records in order to enable the monitor to fulfill this function.
To prevent the duplication of any information already reported by the entity, the monitor shall, to the extent possible, utilize data already provided by the entity to the Department of Health.
No personal identifiers shall be attached to any of the records obtained by the monitor, and all such records shall be subject to the privacy and confidentiality provisions of medical records provided by law.
(2) Following the monitoring period, or in the event that no monitoring period is established, if the Commissioner of Health receives information indicating that the acquiring entity is not fulfilling its commitment to the affected service area pursuant to P.L.2000, c.143 (C.26:2H-7.10 et seq.) and determines that the information is true, the commissioner shall order the acquiring entity to comply with a corrective action plan. The commissioner shall retain oversight of the acquiring entity's obligations under the corrective action plan for as long as necessary to ensure compliance with P.L.2000, c.143 (C.26:2H-7.10 et seq.).
j. The trustees and senior managers of the nonprofit hospital are prohibited from investing in the acquiring entity for a period of three years following the acquisition.
k. No director, officer, agent, trustee, or employee of the nonprofit hospital shall benefit directly or indirectly from the acquisition, including the receipt of any compensation directly related to the proposed acquisition.
l. Upon completion by the Attorney General of the review of the application required by P.L.2000, c.143 (C.26:2H-7.10 et seq.), the nonprofit hospital shall apply to the Superior Court for approval of the proposed acquisition. In that proceeding, the Attorney General shall advise the court as to whether the Attorney General supports or opposes the proposed acquisition, with or without any specific modifications, and the basis for that position. Any person who filed a written comment or exhibit or appeared and made a statement in the public hearing held by the Attorney General pursuant to subsection f. of this section shall be considered a party to the proceeding, including consumers or community groups representing the citizens of the State.
m. Notwithstanding the provisions of subsections a. and f. of this section to the contrary, in the event that the Attorney General or the Commissioner of Health determines that a proposed acquisition should be considered on an expedited basis in order to preserve the quality of health care provided to the community, the Attorney General and the commissioner may combine the public notice about the acquisition with the notice for a public hearing as required in subsections a. and f., respectively, and may reduce the period of time required for notice, as necessary. In considering a proposed acquisition on an expedited basis, the Attorney General and commissioner may agree to reduce the period of time for review of a completed application to less than 90 days.
n. The Attorney General, in consultation with the Commissioner of Health, shall adopt regulations pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.) to carry out the purposes of P.L.2000, c.143 (C.26:2H-7.10 et seq.).
"Assisted living" means a coordinated array of supportive personal and health services, available 24 hours per day, which promote resident self-direction and participation in decisions that emphasize independence, individuality, privacy, dignity, and homelike surroundings to residents who have been assessed to need these services, including residents who require formal long-term care.
"Assisted living program" means the provision of or arrangement for meals and assisted living services, when needed, to the residents of publicly subsidized housing, which because of any federal, State, or local housing laws, rules, regulations, or requirements cannot become licensed as an assisted living residence.
"Assisted living residence" means a facility licensed by the Department of Health to provide apartment-style housing and congregate dining and to assure that assisted living services are available when needed, for four or more adult persons unrelated to the proprietor. Apartment units shall offer, at a minimum, one unfurnished room, a private bathroom, a kitchenette, and a lockable door on the unit entrance.
"Commissioner" means the Commissioner of Health.
a. of good moral character;
b. economically capable of constructing or expanding, as appropriate, and maintaining an assisted living residence or program, as applicable;
c. capable of successfully providing assisted living services that meet or surpass the licensing standards for assisted living residences or programs, as applicable, as set by the commissioner;
d. capable of demonstrating an acceptable track record, if appropriate, of the applicant's past and current compliance with State licensure requirements, applicable federal requirements and State certificate of need requirements pursuant to section 7 of P.L.1971, c.136 (C.26:2H-7); and
e. capable of demonstrating an acceptable track record of the applicant's past and current compliance with State licensure or applicable federal or State requirements for, and the financial success of, any health care-related or other business activity that involves construction, operation or management of the activity.
b. An assisted living administrator certified by the department prior to the effective date of this act, upon whom a criminal history record background check has not been conducted pursuant to this act, shall be required to undergo that criminal history record background check as a condition of renewal of certification following the effective date of this act.
c. An assisted living administrator, who is a licensed nursing home administrator and has undergone a criminal history record background check as a result of having obtained a nursing home administrator's license, shall not be required to undergo a criminal history record background check pursuant to this act.
d. A person shall be disqualified from certification if that person's criminal history record background check reveals a record of conviction of any of the following crimes and offenses:
(1) In New Jersey, any crime or disorderly persons offense:
(a) involving danger to the person, meaning those crimes and disorderly persons offenses set forth in N.J.S.2C:11-1 et seq., N.J.S.2C:12-1 et seq., N.J.S.2C:13-1 et seq., N.J.S.2C:14-1 et seq. or N.J.S.2C:15-1 et seq.; or
(b) against the family, children or incompetents, meaning those crimes and disorderly persons offenses set forth in N.J.S.2C:24-1 et seq.; or
(c) involving theft as set forth in chapter 20 of Title 2C of the New Jersey Statutes; or
(d) involving any controlled dangerous substance or controlled substance analog as set forth in chapter 35 of Title 2C of the New Jersey Statutes except paragraph (4) of subsection a. of N.J.S.2C:35-10.
(2) In any other state or jurisdiction, of conduct which, if committed in New Jersey, would constitute any of the crimes or disorderly persons offenses described in paragraph (1) of this subsection.
e. Notwithstanding the provisions of subsection a. of this section, no person shall be disqualified from certification on the basis of any conviction disclosed by a criminal history record background check performed pursuant to this act if the person has affirmatively demonstrated to the commissioner clear and convincing evidence of the person's rehabilitation. In determining whether a person has affirmatively demonstrated rehabilitation, the following factors shall be considered:
(1) the nature and responsibility of the position which the convicted person would hold, has held or currently holds, as the case may be;
(2) the nature and seriousness of the offense;
(3) the circumstances under which the offense occurred;
(4) the date of the offense;
(5) the age of the person when the offense was committed;
(6) whether the offense was an isolated or repeated incident;
(7) any social conditions which may have contributed to the offense; and
(8) any evidence of rehabilitation, including good conduct in prison or in the community, counseling or psychiatric treatment received, acquisition of additional academic or vocational schooling, successful participation in correctional work-release programs, or the recommendation of those who have had the person under their supervision.
f. If a person subject to the provisions of this act refuses to consent to, or cooperate in, the securing of a criminal history record background check, the commissioner shall, as applicable:
(1) not issue an assisted living administrator certification and shall notify the applicant, and the applicant's employer, if the applicant is conditionally employed as provided in subsection d. of section 4 of this act or the applicant's prospective employer, if known, of that denial; or
(2) revoke the person's current assisted living administrator certification and notify the person, and the person's employer, if known, of that revocation.
b. Upon receipt of the criminal history record information for a person from the Federal Bureau of Investigation or the Division of State Police, the commissioner shall immediately notify, in writing, the applicant, and the applicant's employer, if the applicant is conditionally employed as provided in subsection d. of this section, or the applicant's prospective employer, if known, or a certified assisted living administrator who is required to undergo a criminal history record background check pursuant to section 3 of this act and that person's employer, as applicable, of the person's qualification or disqualification for certification under this act. If the person is disqualified, the conviction or convictions which constitute the basis for the disqualification shall be identified in the notice to the person, but shall not be identified in the notice to the person's employer or prospective employer.
c. The person who is the subject of the background check shall have 30 days from the date of the written notice of disqualification to petition the commissioner for a hearing on the accuracy of the person's criminal history record information or to establish the person's rehabilitation under subsection e. of section 3 of this act. The commissioner shall notify the person's employer or prospective employer of the person's petition for a hearing within five days following the receipt of the petition from the person. Upon the issuance of a final decision upon a petition to the commissioner pursuant to this subsection, the commissioner shall notify the person and the person's employer or prospective employer as to whether the person remains disqualified from certification under this act.
d. (1) An applicant for certification may be issued conditional certification and may be employed as an assisted living administrator conditionally for a period not to exceed 60 days, pending completion of a criminal history record background check required under this act by the Division of State Police based upon an examination of its own files, in accordance with section 7 of P.L.2002, c.25 (C.53:1-20.9c), and for an additional period not to exceed 60 days pending completion of a criminal history record background check by federal authorities as arranged for by the Division of State Police pursuant to section 7 of P.L.2002, c.25 (C.53:1-20.9c), if the person submits to the commissioner a sworn statement attesting that the person has not been convicted of any crime or disorderly persons offense as described in section 3 of this act. A person who submits a false sworn statement shall be disqualified from certification, and shall not have an opportunity to establish rehabilitation pursuant to subsection e. of section 3 of this act.
(2) A conditionally employed person or an employed certified assisted living administrator, who disputes the accuracy of the criminal history record information and who files a petition requesting a hearing pursuant to subsection c. of this section, may remain employed until the commissioner rules on the person's petition but, pending the commissioner's ruling, the person shall not have unsupervised contact with residents at the assisted living residence or program.
e. (1) A licensed assisted living residence or program, as applicable, that has received an application from or conditionally employs an applicant for assisted living administrator or employs a certified assisted living administrator, and:
(a) receives notice from the commissioner that the applicant or certified assisted living administrator has been determined by the commissioner to be disqualified from certification as an assisted living administrator pursuant to this act; or
(b) terminates its employment of a conditionally employed applicant for assisted living administrator or a certified assisted living administrator because the person was disqualified from employment at the assisted living residence or program on the basis of a conviction of a crime or disorderly persons offense as described in section 3 of this act after commencing employment at the assisted living residence or program;
shall be immune from liability for disclosing that disqualification or termination in good faith to another licensed health care facility or other entity that is qualified by statute or regulation to employ the person as a certified administrator.
(2) A licensed health care facility or other entity which discloses information pursuant to paragraph (1) of this subsection shall be presumed to be acting in good faith unless it is shown by clear and convincing evidence that the health care facility or other entity acted with actual malice toward the person who is the subject of the information.
f. (1) An assisted living residence or program, as applicable, upon receiving notice from the commissioner that a person employed by it as an assisted living administrator, including a conditionally employed person, has been convicted of a crime or disorderly persons offense as described in section 3 of this act after commencing employment at the assisted living residence or program, shall:
(a) immediately terminate the person's employment as an assisted living administrator; and
(b) report information about the termination to the commissioner in a manner prescribed by the commissioner, who shall thereupon deem the person to be disqualified from certification as an assisted living administrator, subject to the provisions of subsection c. of this section.
(2) An assisted living residence or program shall be immune from liability for any actions taken in good faith pursuant to paragraph (1) of this subsection and shall be presumed to be acting in good faith unless it is shown by clear and convincing evidence that the assisted living residence or program acted with actual malice toward the employee.
"Angioplasty" or "percutaneous coronary intervention" means the mechanical reopening of an occluded vessel in the heart or corona using a balloon-tipped catheter.
"Applicant hospital" means a general hospital that has entered into a collaboration agreement with a cardiac surgery center licensed in New Jersey.
"Application" means all information required by the commissioner of an applicant hospital to determine compliance with P.L.2021, c.18 (C.26:2H-7.22 et al.).
"C-PORT-E study" means the Atlantic Cardiovascular Patient Outcomes Research Team Elective Angioplasty Study clinical trial.
"Collaboration agreement" means an agreement between a licensed cardiac surgery center and a general hospital that includes:
(1) written protocols for enrolled patients who require transfer to, and receipt at, a cardiac surgery center's operating room within one hour of the determination of the need for such transfer, including the emergency transfer of patients who require an intra-aortic balloon pump;
(2) regular consultation between the two hospitals on individual cases, including use of technology to share case information in a rapid manner; and
(3) evidence of adequate cardiac surgery on-call backup.
"Commissioner" means the Commissioner of Health.
"Department" means the Department of Health.
"Elective angioplasty" means an angioplasty or percutaneous coronary intervention performed on a non-emergent basis.
"Full service adult diagnostic cardiac catheterization facility" means an acute care general hospital that provides invasive cardiac diagnostic services to adult patients without cardiac surgery backup, is equipped with laboratories, and performs at least 250 cardiac catheterizations each year.
"Primary angioplasty" means an angioplasty or percutaneous coronary intervention performed on an acute or emergent basis.
(1) is not licensed as a cardiac surgery center;
(2) demonstrates the ability to provide full service adult diagnostic catheterization services consistent with national standards of care and current best practices;
(3) commencing in the second year of licensure pursuant to this subsection, and in each year thereafter, performs at least 250 catheterizations per year, with each interventional cardiologist performing at least 50 catheterizations per year; and
(4) meets such other requirements as the commissioner may establish by regulation including, but not limited to, participation in the department's data collection programs and in national registries such as the National Cardiovascular Data Registry to monitor quality, outcomes, and compliance with State regulations.
b. An applicant hospital may apply to the commissioner for a license to provide primary angioplasty services. The commissioner shall issue a license pursuant to such application to any hospital that:
(1) is not licensed as a cardiac surgery center;
(2) has been licensed for at least six months pursuant to subsection a. of this section to provide full service adult diagnostic catheterization services;
(3) demonstrates the ability to consistently provide primary angioplasty services 24 hours per day and seven days per week, consistent with national standards of care and current best practices; and
(4) meets such other requirements as the commissioner may establish by regulation.
c. An applicant hospital may apply to the commissioner for a license to provide elective angioplasty services. The commissioner shall issue a license pursuant to such application to any hospital that:
(1) is not licensed as a cardiac surgery center;
(2) holds licensure to participate in the C-PORT-E study or the Elective Angioplasty Demonstration Project, or is an applicant hospital licensed by the department to provide primary angioplasty services pursuant to subsection b. of this section;
(3) demonstrates the ability to provide elective angioplasty services consistent with the provisions of N.J.A.C.8:33-3.11 or any successor regulation, as well as national standards of care and current best practices, including ensuring that all patients considered for elective angioplasty undergo careful selection, screening, and risk stratification pursuant to requirements promulgated by the department by regulation, and ensuring that patients who do not meet such screening criteria are transferred to an appropriate cardiac surgery facility for elective angioplasty;
(4) commencing in the second year of licensure pursuant to this subsection, and in each year thereafter, performs a minimum of 200 angioplasty procedures per year, with each interventional cardiologist performing at least 50 angioplasty procedures per year; and
(5) meets such other requirements as the commissioner may establish by regulation.
d. (1) A hospital issued a license pursuant to subsection a. or b. of this section that fails to meet the qualification requirements for that license shall be subject to corrective administrative action or other remedial action as the commissioner may establish by regulation, including, but not limited to, submitting a corrective action plan to the department for approval and meeting any benchmarks or deadlines for compliance as may be required by the department.
(2) A hospital issued a license pursuant to subsection c. of this section shall have two years to meet the volume requirements set forth in paragraph (4) of subsection c. of this section. A hospital that fails to meet or maintain the qualification requirements for that license, including the volume requirements set forth in paragraph (4) of subsection c. of this section, shall be subject to corrective administrative action or other remedial action as the commissioner may establish by regulation, including, but not limited to, submitting a corrective action plan to the department for approval and meeting any benchmarks or deadlines for compliance as may be required by the department. If a hospital that has entered into a corrective action plan pursuant to this subsection fails to meet and maintain the qualification requirements for a license issued pursuant to subsection c. of this section, including attaining the volume requirements set forth in paragraph (4) of subsection c. of this subsection, within two years after the hospital enters into a corrective action plan, the hospital's license issued pursuant to subsection c. of this section shall be revoked.
e. The department may impose fines, suspend or revoke a license, require corrective administrative action or other remedial action, including requiring submission of a corrective action plan, or impose other lawful remedies against any entity issued a license pursuant to this section that violates any of the requirements of this section. Subject to the provisions of subsection d. of this section, the department may revoke the license of a hospital authorized to provide any cardiac service, including elective angioplasty, which fails to comply with the licensing requirements set forth in this section related to that license, including facility volume requirements, within two years after the date of licensure.
f. (1) Diagnostic cardiac catheterization and angioplasty programs in all cardiac surgery facilities shall meet such other requirements as the commissioner may establish by regulation including, but not limited to, participation in the department's data collection programs and in national registries such as the National Cardiovascular Data Registry to monitor quality, outcomes, and compliance with State regulations.
(2) A licensed cardiac surgery facility may request a waiver based on documented and continued accreditation by the Accreditation for Cardiovascular Excellence or by a national organization or association that meets similar standards specific to cardiac catheterization and percutaneous coronary intervention. Licensed facilities that seek accreditation shall provide the department with access to reports, site visits, site visit reviews, any notice related to compliance standards, and notices related to change of accreditation status.
g. The commissioner shall establish by regulation the application and renewal fees for licenses issued pursuant to this section, including a nonrefundable fee for initial licensure in the amount of at least $5,000.
a. notice included with the informed consent form that the procedure is not being performed at a licensed cardiac surgery center, and in the event that the patient requires emergency cardiac surgery, the patient will be transferred to a licensed cardiac surgery center; and
b. details concerning the applicant hospital's plan and protocols for transferring patients who require emergency cardiac surgery, including the name and location of the cardiac surgery center with which the applicant hospital has entered into a collaboration agreement.
The applicant hospital shall, upon request, furnish the patient with a written copy of the hospital's transfer protocols, including transportation and associated charges for transportation, and a summary of the collaboration agreement.
(1) the transfer of ownership fee established by the department;
(2) a cover letter stating the applicant's intent to purchase the nursing home, and identification of the nursing home by name, address, county, and number and type of licensed beds;
(3) a description of the proposed transaction, including:
(a) identification of the current owners of the nursing home;
(b) identification of 100 percent of the proposed new owners, including the names and addresses of all principals and interested parties; and
(c) if applicable, a copy of an organizational chart, including parent corporations and wholly-owned subsidiaries; and
(4) a copy of the agreement of sale and, if applicable, a copy of any lease and management agreements.
The applicant may additionally submit a summary of the application materials that includes such details concerning the application as are required by the department, but that omits any proprietary information in the contracts for the sale or management of the nursing home, and any home addresses, social security numbers, or other personal information of any proposed owner, principal, or interested party. A summary prepared by the applicant may only be used for the purposes of posting information concerning the application on the department's Internet website pursuant to paragraph (1) of subsection d. of this section.
b. Information submitted pursuant to subsection a. of this section or subsection a. of section 3 of this act by an applicant for transfer of ownership of a nursing home shall not be used in any adverse licensure action or disciplinary action against the applicant.
c. Approval of a transfer of ownership of a nursing home is contingent upon:
(1) a review of the applicant's history of disciplinary actions assessed in connection with any other facility owned, operated, or managed by the proposed owners and principals in New Jersey, and a determination based on that review that approval of the transfer of ownership will not present a material risk to the health, safety, or welfare of residents of the nursing home that is the subject of the transfer application; and
(2) payment of all outstanding and issued Medicaid audit claims and State penalties issued by the department against the current owner, unless such claims remain under appeal, in which case, if the claim remains under appeal, the applicant shall submit written verification that either the applicant or the current owners of the nursing home will assume responsibility for payment of such audit recoveries and State penalties at the conclusion of the appeal.
d. (1) A copy of each transfer of ownership application, or a summary of the application prepared by the applicant that includes the names of the proposed owners, principals, and interested parties, shall be published on the department's Internet website no later than 30 days after the date the department receives the application; provided that the department shall redact the materials to the extent necessary to ensure that no proprietary information in the contracts for the sale or management of the nursing home, and no home addresses, social security numbers, or other personal information of any proposed owner, principal, or interested party, is included in the materials published on the department's Internet website.
(2) Each application for the transfer of ownership of a nursing home shall be subject to a public comment period that shall commence not less than 30 days after the date the application is received by the department, and which comment period shall remain open for a period of not less than 30 days. The department shall establish a procedure for acknowledging receipt of public comments submitted. The text of comments submitted on a transfer of ownership application shall not be published on the department's Internet website, but shall be considered a government record pursuant to P.L.1963, c.73 (C.47:1A-1 et seq.) or P.L.2001, c.404 (C.47:1A-5 et al.).
e. The Department shall complete review of any transfer of ownership application submitted pursuant to subsection a. of this section no later than 120 days after the date the application is received. If a transfer of ownership application has been reviewed and deemed acceptable, the department shall send an approval letter to the applicant.
f. Within five days after the transaction has been completed, the applicant shall submit to the department certification of closing from an attorney or a notarized letter from the applicant stating the date on which the transaction occurred, along with an executed bill of sale or assignment. To facilitate the timely transfer of Medicare and Medicaid provider numbers, the department shall issue the new license to the applicant no later than 30 days after the date the notice is received by the department.
g. No nursing home may delegate substantial management control of the nursing home's operations to a third party entity without providing prior written notice to the department. The notice provided by the owners of the facility to the department shall include:
(1) a copy of the management agreement;
(2) an organizational chart of the third party entity's proposed management team for the nursing home;
(3) the names and addresses of all owners, principals, and interested parties of the third party entity; and
(4) a list of any other licensed health care facilities owned, operated, or managed by the third party entity in any state or territory of the United States or in the District of Columbia for the preceding three years, along with owner-certified financial statements for each such facility for the last three years during which the facility was owned, operated, or managed by the third party entity. If the third party entity owned, operated, or managed facilities located outside New Jersey in the preceding three years, the application shall include disclosures by the third party entity of any enforcement actions imposed during that period of time against any facility owned, operated, or managed by the third party entity in any jurisdiction.
h. (1) Upon request by the Commissioner of Health and subject to the provisions of P.L.1968, c.266 (C.52:9M-1 et seq.), the State Commission of Investigation shall undertake an investigation of one or more nursing homes in the State or the entities owning, operating, or managing one or more nursing homes in the State, provided that, if the commission determines that the request for an investigation from the Commissioner of Health exceeds the commission's capacity to perform such investigations, the commission may advise the Commissioner of Health as to any requests upon which it finds itself unable to proceed. The State Commission of Investigation may, at any time, submit to the Governor, the Commissioners of Health and Human Services, and, pursuant to section 2 of P.L.1991, c.164 (C.52:14-19.1), the Legislature, recommendations for administrative or legislative action to improve oversight and transparency in nursing homes.
(2) The State Auditor shall undertake a review of the oversight of nursing homes by the Department of Health and the Department of Human Services at least once every three years, with particular focus on compliance with federal inspection requirements, responses to complaints and response times in reviewing complaints, and actions taken to follow up on violations affecting the health, safety, or welfare of residents.
i. As used in sections 2 through 4 of this act:
"Interested party" means any individual or entity with an interest of one percent or more but less than five percent in an applicant to receive a transfer of ownership of a nursing home or the land or other real property on which a nursing home is located.
"Principal" means any individual or entity with an interest of five percent or more in an applicant to receive a transfer of ownership of a nursing home or the land or real property on which a nursing home is located.
(1) In the case of an application to transfer controlling interest in a nursing home to an individual or entity that has never previously owned or operated a licensed health care facility in New Jersey, or for any application to transfer controlling interest in a nursing home that is submitted within six months after a prior application for transfer of controlling interest in the nursing home was approved, the applicant shall:
(a) submit a projection of profits and losses for the next three years and a capital budget projection for the next three years;
(b) disclose any licensed health care facilities owned, operated, or managed by the proposed owners and principals in any state or territory of the United States or in the District of Columbia in the preceding three years, along with owner-certified financial statements for each such facility for the last three years during which the facility was owned, operated, or managed by the owner or principal and disclosures by the applicant as to any enforcement actions imposed during that period of time against any facility owned, operated, or managed by the applicant in any jurisdiction;
(c) hold a public hearing on the application no earlier than 30 days after the date the application is received by the department. Notice of the public hearing shall be published at least seven days in advance of the public hearing on the Internet websites of the department, the nursing home, and the applicant, as well as in at least one newspaper published in each county, if any newspapers are published therein. The nursing home shall invite the Attorney General and the Commissioner of Health, or their designated representatives, to attend the hearing. The transfer of ownership application may not be approved until after the public hearing is completed; and
(d) consistent with the requirements of subsection b. of this section, submit to a criminal history record background check of each proposed owner and principal;
(2) In the case of an application to transfer controlling interest in a nursing home to an individual or entity that has previously owned or operated a licensed health care facility in New Jersey, the applicant shall:
(a) submit a projection of profits and losses for the next three years and a capital budget projection for the next three years; and
(b) disclose any licensed health care facilities owned, operated, or managed by the proposed owners and principals in any state or territory of the United States or in the District of Columbia in the preceding year, along with owner-certified financial statements for each facility owned, operated, or managed by the proposed owners and principals in New Jersey for the last year during which the facility was owned, operated, or managed by owner or principal;
(3) In the case of an application to transfer less than a controlling interest in a nursing home to an individual or entity that has never previously owned or operated a licensed health care facility in New Jersey, the applicant shall:
(a) disclose any licensed health care facilities owned, operated, or managed by the proposed owners and principals in any state or territory of the United States or in the District of Columbia in the preceding year and any enforcement actions imposed during the preceding year against any facility owned, operated, or managed by the applicant in any jurisdiction; and
(b) consistent with the requirements of subsection b. of this section, submit to a criminal history record background check of each proposed owner and principal; and
(4) In the case of an application to transfer less than a controlling interest in a nursing home to an individual or entity that has previously owned or operated a licensed health care facility in New Jersey, the applicant shall disclose any licensed health care facilities owned, operated, or managed by the proposed owners and principals in any state or territory of the United States or in the District of Columbia in the preceding year and any enforcement actions imposed during the preceding year against any facility owned, operated, or managed by the applicant in any jurisdiction.
b. (1) An applicant for a transfer of ownership of a nursing home who is required to complete a criminal history record background check pursuant to subsection a. of this section shall submit to being fingerprinted in accordance with applicable State and federal laws, rules, and regulations. An applicant shall bear the cost for the criminal history record background check, including all costs of administering and processing the check.
(2) For the purposes of subsection a. of this section, the department is authorized to exchange fingerprint data with and receive criminal history record background information from the Division of State Police and the Federal Bureau of Investigation consistent with the provisions of applicable federal and State laws, rules, and regulations. Upon receipt of such notification, the department shall make a determination as to whether transferring all or part of the ownership of a nursing home to the applicant would constitute a material risk to the health, safety, or welfare of residents of the nursing home, which shall include determining whether any owner or principal has a prior conviction involving fraud or any other criminal offense of a financial nature, or a prior conviction that may bear on the health and safety of residents of a long-term care facility, including, but not limited to, a prior conviction involving abuse, neglect, or exploitation of any person.
(3) The Division of State Police shall promptly notify the department in the event that an individual who was the subject of a criminal history record background check conducted pursuant to subsection a. of this section is convicted of a crime or offense in this State after the date the background check was performed. Upon receipt of that notification, the department shall make a determination regarding the continued eligibility for the individual to be an owner or principal of a nursing home.
(1) the sale or transfer of real property fee established by the Department of Health;
(2) a cover letter stating the applicant's intent to purchase the land or other real property on which a nursing home is located, and identification of the nursing home by name, address, and county;
(3) a description of the proposed transaction, including:
(a) identification of the current owners of the land or other real property on which a nursing home is located;
(b) identification of 100 percent of the proposed new owners, including the names and addresses of all principals and interested parties; and
(c) if applicable, a copy of an organizational chart, including parent corporations and wholly-owned subsidiaries;
(4) a copy of the agreement of sale or transfer, the proposed terms of the lease, rent, or use agreement with the nursing home and, if applicable, a copy of any management agreements; and
(5) an attestation by the new owners of the land or other real property that they will lease, rent, or authorize use of the land or other real property by the nursing home at a rate that is consistent with the fair market value for the lease, rent, or use of similar facilities in the same market area.
b. A summary of the notice submitted pursuant to subsection a. of this section, including the names of the prospective new owners, shall be made available on the Department of Health's Internet website.
c. Nursing homes shall report to the Department of Health their rates or average rates for the lease, rent, or use of land or other real property in a manner determined by the department. The department shall post the rates or average rates for the lease, rent, or use of land or other real property reported by nursing homes on its Internet website.
In the case of an application by a health care facility established or operated by any recognized religious body or denomination the needs of the members of such religious body or denomination for care and treatment in accordance with their religious or ethical convictions may be considered to be a public need.
The board shall provide adequate mechanisms for full consideration of each application submitted to the board and for developing recommendations thereon. Such recommendations, whether favorable or unfavorable, shall be forwarded to the commissioner within 90 days of the date of referral of the application. A copy of the recommendations made shall be forwarded to the applicant.
Recommendations concerning certificates of need shall be governed and based upon the principles and considerations set forth in section 8 of P.L.1971, c.136 (C:26:2H-8).
No member, officer or employee of the State Health Planning Board shall be subject to civil action in any court as the result of any act done or failure to act, or of any statement made or opinion given, while discharging his duties under this act as such member, officer, or employee, provided he acted in good faith with reasonable care and upon proper cause.
b. (1) Application for a license for a health care service or health care facility shall be made upon forms prescribed by the department. The department shall charge a single, nonrefundable fee for the filing of an application for and issuance of a license and a single, nonrefundable fee for any renewal thereof, and a single, nonrefundable fee for a biennial inspection of the facility, as it shall from time to time fix in rules or regulations, provided, however, that no such licensing fee shall exceed $10,000 in the case of a hospital and $4,000 in the case of any other health care facility for all services provided by the hospital or other health care facility, and no such inspection fee shall exceed $5,000 in the case of a hospital and $2,000 in the case of any other health care facility for all services provided by the hospital or other health care facility. No inspection fee shall be charged for inspections other than biennial inspections. Any surgical practice required to apply for licensure by the department as an ambulatory care facility pursuant to P.L.2017, c.283 shall be exempt from the initial and renewal license fees required by this section. The application shall contain the name of the health care facility, the kind or kinds of health care service to be provided, the location and physical description of the institution, and such other information as the department may require.
(2) A license shall be issued by the department upon its findings that the premises, equipment, personnel, including principals and management, finances, rules and bylaws, and standards of health care service are fit and adequate and there is reasonable assurance the health care facility will be operated in the manner required by this act and rules and regulations thereunder.
(3) The department shall post on its Internet website each inspection report prepared following an inspection of a residential health care facility, as defined in section 1 of P.L.1953, c.212 (C.30:11A-1) or licensed pursuant to P.L.1971, c.136 (C.26:2H-1 et seq.), that is performed pursuant to this subsection, along with any other inspection report prepared by or on behalf of the department for such facility.
If an inspection reveals a serious health and safety violation at a residential health care facility, the department shall post the inspection report, including the name of the facility and the owner of the facility, on its website no later than 72 hours following the inspection. If a license of a residential health care facility is suspended, the department shall post the suspension on its website no later than 72 hours following the suspension. The department shall update its website to reflect the correction of a serious health and safety violation and the lifting of a suspension.
The department shall notify, as soon as possible, the Commissioner of Human Services, or the commissioner's designee, and the director of the county board of social services or county welfare agency, as appropriate, in the county in which a residential health care facility is located, of a serious health and safety violation at the facility and of any suspension of a license to operate such facility.
If the inspection responsibilities under this subsection with respect to such facility are transferred or otherwise assigned to another department, that other department shall post on its Internet website each inspection report prepared following an inspection of such facility performed pursuant to this subsection, along with any other inspection report prepared by or on behalf of that department for such facility, and shall comply with the other requirements specified in this subsection.
c. (Deleted by amendment, P.L.1998, c.43)
d. The commissioner may amend a facility's license to reduce that facility's licensed bed capacity to reflect actual utilization at the facility if the commissioner determines that 10 or more licensed beds in the health care facility have not been used for at least the last two succeeding years. For the purposes of this subsection, the commissioner may retroactively review utilization at a facility for a two-year period beginning on January 1, 1990.
e. If a prospective applicant for licensure for a health care service or facility that is not subject to certificate of need review pursuant to P.L.1971, c.136 (C.26:2H-1 et al.) so requests, the department shall provide the prospective applicant with a pre-licensure consultation. The purpose of the consultation is to provide the prospective applicant with information and guidance on rules, regulations, standards, and procedures appropriate and applicable to the licensure process. The department shall conduct the consultation within 60 days of the request of the prospective applicant.
f. Notwithstanding the provisions of any other law to the contrary, an entity that provides magnetic resonance imaging or computerized axial tomography services shall be required to obtain a license from the department to operate those services prior to commencement of services, except that a physician who is operating such services on the effective date of P.L.2004, c.54 shall have one year from the effective date of P.L.2004, c.54 to obtain the license.
g. (1) (Deleted by amendment, P.L.2017, c.283)
(2) (Deleted by amendment, P.L.2017, c.283)
(3) (Deleted by amendment, P.L.2017, c.283)
(4) A surgical practice in operation on the date of enactment of P.L.2017, c.283 shall be required to apply to the department for licensure as an ambulatory care facility licensed to provide surgical and related services within one year of the date of enactment of P.L.2017, c.283.
A surgical practice that is certified by the Centers for Medicare and Medicaid Services (CMS) shall not be required to meet the physical plant and functional requirements specified in N.J.A.C.8:43A-19.1 et seq. A surgical practice that is not Medicare certified, either by CMS or by any deeming authority recognized by CMS, but which has obtained accreditation from the American Association of Ambulatory Surgery Facilities or any accrediting body recognized by CMS and is in operation on the date of enactment of P.L.2017, c.283, shall not be required to meet the physical plant and functional requirements specified in N.J.A.C.8:43A-19.1 et seq. A surgical practice not in operation on the date of enactment of P.L.2017, c.283, if it is certified by CMS as an ambulatory surgery center provider, shall also be exempt from these requirements. A surgical practice required by this subsection to meet the physical plant and functional requirements specified in N.J.A.C.8:43A-19.1 et seq. may apply for a waiver of any such requirement in accordance with N.J.A.C.8:43A-2.9. The commissioner shall grant a waiver of those physical plant and functional requirements, as the commissioner deems appropriate, if the waiver does not endanger the life, safety, or health of patients or the public.
Through State Fiscal Year 2025, a surgical practice required to be licensed pursuant to this subsection shall be exempt from the ambulatory care facility assessment pursuant to section 7 of P.L.1992, c.160 (C.26:2H-18.57), except that, if the entity expands to include any additional room dedicated for use as an operating room, the entity shall be subject to the assessment. Beginning in State Fiscal Year 2026, a surgical practice required to be licensed pursuant to this subsection shall no longer be exempt from the ambulatory care facility assessment.
(5) As used in this subsection and subsection i. of this section, "surgical practice" means a structure or suite of rooms that has the following characteristics:
(a) has no more than one room dedicated for use as an operating room which is specifically equipped to perform surgery and is designed and constructed to accommodate invasive diagnostic and surgical procedures;
(b) has one or more post-anesthesia care units or a dedicated recovery area where the patient may be closely monitored and observed until discharged; and
(c) is established by a physician, physician professional association surgical practice, or other professional practice form specified by the State Board of Medical Examiners pursuant to regulation solely for the physician's, association's, or other professional entity's private medical practice.
(6) Nothing in this subsection shall be construed to limit the State Board of Medical Examiners from establishing standards of care with respect to the practice of medicine.
h. An ambulatory care facility licensed to provide surgical and related services shall be required to obtain ambulatory care accreditation from an accrediting body recognized by the Centers for Medicare and Medicaid Services as a condition of licensure by the department.
An ambulatory care facility that is licensed to provide surgical and related services on the effective date of this section of P.L.2009, c.24 shall have one year from the effective date of this section of P.L.2009, c.24 to obtain ambulatory care accreditation.
i. Beginning on the effective date of this section of P.L.2009, c.24, and as provided in P.L.2017, c.283, the department shall not issue a new license to an ambulatory care facility to provide surgical and related services unless:
(1) in the case of a licensed facility in which a transfer of ownership of the facility is proposed, the commissioner reviews the qualifications of the new owner or owners and approves the transfer;
(2) (a) except as provided in subparagraph (b) of this paragraph, in the case of a licensed facility for which a relocation of the facility is proposed, the relocation is within 20 miles of the facility's current location or the relocation is to a "Health Enterprise Zone" designated pursuant to section 1 of P.L.2004, c.139 (C.54A:3-7), there is no expansion in the number of operating rooms provided at the new location from that of the current location, and the commissioner reviews and approves the relocation prior to its occurrence; or
(b) in the case of a licensed facility described in paragraph (5) or (6) of this subsection for which a relocation of the facility is proposed, the commissioner reviews and approves the relocation prior to its occurrence;
(3) the entity is a surgical practice required to be licensed pursuant to subsection g. of this section and meets the requirements of that subsection;
(4) the entity has filed its plans, specifications, and required documents with the Health Care Plan Review Unit of the Department of Community Affairs or the municipality in which the surgical practice or facility will be located, as applicable, on or before the 180th day following the effective date of this section of P.L.2009, c.24;
(5) the facility is owned jointly by a general hospital in this State and one or more other parties;
(6) the facility is owned by a hospital or medical school in this State, or the facility is owned by any hospital approved on or before the effective date of P.L.2015, c.305 to provide ambulatory surgery services in this State, or the facility is owned by a hospital which applied on or before the effective date of P.L.2015, c.305 to provide ambulatory surgery services in this State so long as the hospital is later approved to provide ambulatory surgery services at the facility, or the facility is owned by any hospital approved to provide ambulatory surgery services at another facility in this State; or
(7) (a) the facility is a newly licensed ambulatory surgical facility that was created by combining two or more registered surgical practices, provided that the number of operating rooms at the newly licensed facility is not greater than the total number of operating rooms prior to the establishment of the newly licensed facility;
(b) the facility is a licensed ambulatory surgical facility that has expanded by combining with one or more registered surgical practices, provided that the number of operating rooms at the newly expanded facility is not greater than the total number of operating rooms prior to the combination of the practices and facility; or
(c) the facility is a licensed ambulatory surgical facility that has expanded through the combination of two or more licensed ambulatory surgical facilities, provided that the number of operating rooms at the newly expanded facility is not greater than the total number of operating rooms prior to the combining of the facilities.
Beginning on the effective date of P.L.2017, c.283, the department shall not issue a new registration to a surgical practice. Any surgical practice in operation on the effective date of P.L.2017, c.283 that proposes to relocate on or after the effective date of P.L.2017, c.283 shall be required to be licensed by the department as an ambulatory care facility providing surgical and related services pursuant to subsection g. of this section.
j. (Deleted by amendment, P.L.2017, c.283)
k. An ambulatory care facility licensed to provide surgical and related services and a surgical practice shall:
(1) report to the department any change in ownership of the facility within 30 days of the change in ownership; and
(2) annually report to the department the name of the facility's medical director, physician director, and physician director of anesthesia, as applicable, and the director of nursing services. The facility shall notify the department if there is any change in a named director within 30 days of the change of the director.
b. Nothing in this act shall be construed to require a hospital to grant admitting privileges to a psychologist or to permit the exercise of those privileges granted by the hospital without appropriate collaboration with the attending physician of the patient who is receiving or will receive care or treatment from the psychologist.
b. A health care entity shall maintain for a period of four years all records and source data relating to its mortality, morbidity, complication, infection, and readmission and shall make the records available to the division, the board which licenses, or otherwise authorizes the health care professional, the review panel and the Department of Health, as applicable, upon request.
c. A health care entity which fails to maintain the records required pursuant to this section shall be subject to such penalties as the Department of Health shall determine pursuant to sections 13 and 14 of P.L.1971, c.136 (C.26:2H-13 and 26:2H-14) and section 16 of P.L.1997, c.192 (C.26:2S-16), or the director shall determine pursuant to P.L.1989, c.331 (C.34:8-43 et seq.), as applicable.
(1) for reasons relating to the health care professional's impairment, incompetency, or professional misconduct, which incompetency or professional misconduct relates adversely to patient care or safety: (a) has full or partial privileges summarily or temporarily revoked or suspended, or permanently reduced, suspended, or revoked; (b) has been removed from the list of eligible employees of a health services firm or staffing registry; (c) has been discharged from the staff; or (d) has had a contract to render professional services terminated or rescinded;
(2) has conditions or limitations placed on the exercise of clinical privileges or practice within the health care entity for reasons relating to the health care professional's impairment, incompetency, or professional misconduct or, which incompetency or professional misconduct relates adversely to patient care or safety, including, but not limited to, second opinion requirements, non-routine concurrent or retrospective review of admissions or care, non-routine supervision by one or more members of the staff, or the completion of remedial education or training;
(3) voluntarily resigns from the staff if: (a) the health care entity is reviewing the health care professional's patient care or reviewing whether, based upon its reasonable belief, the health care professional's conduct demonstrates an impairment or incompetence or is unprofessional, which incompetence or unprofessional conduct relates adversely to patient care or safety; or (b) the health care entity, through any member of the medical or administrative staff, has expressed an intention to do such a review;
(4) voluntarily relinquishes any partial privilege or authorization to perform a specific procedure if: (a) the health care entity is reviewing the health care professional's patient care or reviewing whether, based upon its reasonable belief, the health care professional's conduct demonstrates an impairment or incompetence or is unprofessional, which incompetence or unprofessional conduct relates adversely to patient care or safety; or (b) the health care entity, through any member of the medical or administrative staff, has expressed an intention to do such a review;
(5) while under, or subsequent to, a review by the health care entity of the health care professional's patient care or professional conduct is granted a leave of absence for reasons relating to a physical, mental, or emotional condition or drug or alcohol use which impairs the health care professional's ability to practice with reasonable skill and safety, except that no report is required for pregnancy-related leaves of absence or if the health care professional has sought assistance from a professional assistance or intervention program approved or designated by the division or a board to provide confidential oversight of the health care professional and is following the treatment regimen or monitoring as that program requires; or
(6) is a party to a medical malpractice liability suit, to which the health care entity is also a party, and in which there is a settlement, judgment, or arbitration award.
As used in this subsection, incompetence, professional misconduct, and unprofessional conduct shall not include personal conduct, such as tardiness, insubordination, or other similar behavior, which does not relate to patient care or safety.
b. A health care entity shall notify the division in writing if it is in possession of information that indicates that a health care professional has failed to comply with a request to seek assistance from a professional assistance or intervention program approved or designated by the division or a board to provide confidential oversight of the health care professional, or has failed to follow the treatment regimen or monitoring program required by that program to assure that the health care professional's physical, mental, or emotional condition or drug or alcohol use does not impair the health care professional's ability to practice with reasonable skill and safety.
c. A health care entity shall notify the division in writing if any health care professional who has been the subject of a report pursuant to this section, has had conditions or limitations on the exercise of clinical privileges or practice within the health care entity altered, or privileges restored, or has resumed exercising clinical privileges that had been voluntarily relinquished.
d. In the case of a health care professional who is providing services at a health care entity pursuant to an agreement with a health care services firm or staffing agency and is the subject of a notice pursuant to this section, the health care entity shall, when it submits a notice to the division concerning that health care professional, provide a copy of the notice to the health care services firm or staffing agency.
e. The form of notification shall be prescribed by the Commissioner of Health, in consultation with the Commissioner of Human Services in the case of psychiatric facilities and developmental centers, and shall contain such information as may be required by the division and shall be made within seven days of the date of the action, settlement, judgment, or award.
f. A health care entity which fails to provide such notice to the division or fails to cooperate with a request for information by the division, the board or the Medical Practitioner Review Panel established pursuant to section 8 of P.L.1989, c.300 (C.45:9-19.8) shall be subject to such penalties as the Department of Health may determine pursuant to sections 13 and 14 of P.L.1971, c.136 (C.26:2H-13 and 26:2H-14).
g. A health care entity, or any employee thereof, which provides information to the division, the board, the Medical Practitioner Review Panel, a health care services firm or staffing agency, or the Department of Health, in good faith and without malice, regarding a health care professional pursuant to the provisions of this section or section 3 of P.L.1989, c.300 (C.26:2H-12.2a), is not liable for civil damages in any cause of action arising out of the provision or reporting of the information.
h. A health care entity shall provide the health care professional who is the subject of a notice pursuant to paragraphs (1), (2), (4), and (5) of subsection a. of this section and subsection c. of this section with a copy of the notice provided to the division, when the health care entity submits the notice to the division.
i. For the purposes of this section, section 3 of P.L.1989, c.300 (C.26:2H-12.2a) and section 15 of P.L.2005, c.83 (C.26:2H-12.2c):
"Board" means a professional and occupational licensing board within the Division of Consumer Affairs in the Department of Law and Public Safety which licenses or otherwise authorizes a health care professional to practice a health care profession.
"Division" means the Division of Consumer Affairs in the Department of Law and Public Safety.
"Health care entity" means a health care facility licensed pursuant to P.L.1971, c.136 (C.26:2H-1 et seq.), a health maintenance organization authorized to operate pursuant to P.L.1973, c.337 (C.26:2J-1 et seq.), a carrier which offers a managed care plan regulated pursuant to P.L.1997, c.192 (C.26:2S-1 et seq.), a State or county psychiatric hospital, a State developmental center, a staffing registry, and a home care services agency as defined in section 1 of P.L.1947, c.262 (C.45:11-23).
"Health care professional" means a person licensed or otherwise authorized pursuant to Title 45 or Title 52 of the Revised Statutes to practice a health care profession that is regulated by the Director of the Division of Consumer Affairs or by one of the following boards: the State Board of Medical Examiners, the New Jersey Board of Nursing, the New Jersey State Board of Dentistry, the New Jersey State Board of Optometrists, the New Jersey State Board of Pharmacy, the State Board of Chiropractic Examiners, the Acupuncture Examining Board, the State Board of Physical Therapy, the State Board of Respiratory Care, the Orthotics and Prosthetics Board of Examiners, the State Board of Psychological Examiners, the State Board of Social Work Examiners, the State Board of Veterinary Medical Examiners, the State Board of Examiners of Ophthalmic Dispensers and Ophthalmic Technicians, the Audiology and Speech-Language Pathology Advisory Committee, the State Board of Marriage and Family Therapy Examiners, the Occupational Therapy Advisory Council and the Certified Psychoanalysts Advisory Committee. "Health care professional" also includes a nurse aide and a personal care assistant certified by the Department of Health.
(1) disclose whether, within the seven years preceding the inquiry, it provided any notice to the division pursuant to section 2 of P.L.2005, c.83 (C.26:2H-12.2b), or to the review panel, as required by section 3 of P.L.1989, c.300 (C.26:2H-12.2a), with respect to the health care professional about whom the inquiry has been made, providing a copy of the form of notification and any supporting documentation that was provided to the division, a professional or occupational licensing board in the Division of Consumer Affairs in the Department of Law and Public Safety, or the review panel; and
(2) provide information about a current or former employee's job performance as it relates to patient care, as provided in this section, and, in the case of a former employee, the reason for the employee's separation.
b. For the purposes of this section, "job performance" shall relate to the suitability of the employee for re-employment at a health care entity, and the employee's skills and abilities as they relate to suitability for future employment at a health care entity. Information about a current or former employee's job performance pursuant to this paragraph shall be based on the employee's performance evaluation, and provided to another health care entity only if: (1) the evaluation has been signed by the evaluator and shared with the employee; (2) the employee has had the opportunity to respond; and (3) the employee's response, if any, has been taken into consideration when providing the information to another health care entity.
Job performance as it relates to patient care shall not include the current or former employee's participation in labor activities pursuant to the "National Labor Relations Act," 29 U.S.C. s.151 et seq.
c. A health care entity, or any employee designated by the entity, which, pursuant to this section, provides information in good faith and without malice to another health care entity concerning a health care professional, including information about a current or former employee's job performance as it relates to patient care, is not liable for civil damages in any cause of action arising out of the provision or reporting of the information.
d. A health care entity which fails to truthfully disclose information to another health care entity making an inquiry pursuant to this section or fails to cooperate with such request for information by the other health care entity shall be subject to such penalties as the Department of Health may determine pursuant to sections 13 and 14 of P.L.1971, c.136 (C.26:2H-13 and 26:2H-14) and section 16 of P.L.1997, c.192 (C.26:2S-16), or the director shall determine pursuant to P.L.1989, c.331 (C.34:8-43 et seq.), as applicable.
b. A health care professional who provides information pursuant to this section, in good faith and without malice, shall not be liable for civil damages in any cause of action arising out of the provision of such information.
c. The reporting requirement in this section shall be in addition to the reporting requirement for health care professionals established in section 12 of P.L.2005, c.83 (C.45:1-37).
A general hospital which has had an average of 20% or more of its beds vacant on weekends over a six month period may apply to the Commissioner of Health for permission to establish a hospital respite care program for senior citizens. Under such a program, otherwise empty hospital facilities, in a section separate from medical and surgical patients, shall be used to provide shelter, food, recreation and supervision to senior citizens age 65 or older who are ordinarily dependent upon family members or others for their care. The purpose of the hospital respite care program is to provide quality care to the elderly while enabling those who ordinarily care for an elderly person to be temporarily relieved of the stress of this responsibility. A hospital having an overall vacancy rate in excess of 20% over a six month period may also apply to the commissioner for permission to offer this service on weekdays for periods determined by the commissioner.
The Commissioner of Health shall, pursuant to the "Administrative Procedure Act," P.L. 1968, c. 410 (C. 52:14B-1 et seq.), promulgate such rules and regulations as may be necessary to effectuate the purposes of this act.
If a federal statute or regulation requires that the State submit its regulations and policy to the federal government for approval in order to qualify for federal funding, then the Department of Health shall so comply.
b. The resource guide shall include information on the signs of child abuse and neglect, the services provided by the State which help in preventing child abuse and neglect, including the availability of home visitation resources, the legal ramifications of abusing or neglecting a child, and tips on child safety.
c. The department shall distribute the resource guide, at no charge, to all the hospitals and birthing facilities in the State. The department shall update the resource guide as necessary, and shall make additional copies of the resource guide available to health care providers upon request.
d. In addition to the resource guide prepared pursuant to subsection a. of this section, the department, in consultation with the Department of Health, shall prepare a pamphlet in both English and Spanish that includes information on the prevention of shaken baby syndrome and detailed suggestions for how to cope with a crying baby. The pamphlet shall be distributed to each parent present during the infant's birth, by the personnel at a hospital or birthing facility, prior to the mother's discharge, as part of the hospital or birthing facility's discharge procedures. The department shall: distribute the pamphlet, at no charge, to all hospitals and birthing facilities in the State; update the pamphlet as necessary; and make additional copies of the pamphlet available to health care providers upon request.
"Commissioner" means the Commissioner of Health.
"Division on Women" means the Division on Women in the Department of Children and Families.
"Emergency care to sexual assault victims" means a medical examination, procedure, or service provided by an emergency health care facility to a sexual assault victim following an alleged sexual offense.
"Emergency contraception" means one or more prescription drugs to prevent pregnancy, used separately or in combination, administered to or self-administered by a patient within a medically recommended time after sexual intercourse, dispensed for that purpose in accordance with professional standards of practice and determined to be safe by the United States Food and Drug Administration.
"Emergency health care facility" means a general hospital or satellite emergency department licensed pursuant to P.L.1971, c.136 (C.26:2H-1 et seq.).
"Medically and factually accurate and objective" means verified or supported by the weight of research conducted in compliance with accepted scientific methods and standards, published in peer-reviewed journals and recognized as accurate and objective by leading professional organizations and agencies with relevant expertise in the field of obstetrics and gynecology.
"Sexual Assault Nurse Examiner program" means the Statewide Sexual Assault Nurse Examiner program in the Division of Criminal Justice in the Department of Law and Public Safety, established pursuant to P.L.2001, c.81 (C.52:4B-50 et seq.).
"Sexual assault victim" means a female who alleges or is alleged to have suffered a personal, physical, or psychological injury as a result of a sexual offense.
"Sexual offense" means sexual assault and aggravated sexual assault as set forth in N.J.S.2C:14-2, criminal sexual contact and aggravated criminal sexual contact as set forth in N.J.S.2C:14-3, fourth degree lewdness as set forth in subsection b. of N.J.S.2C:14-4 and endangering the welfare of a child by engaging in sexual conduct which would impair or debauch the morals of the child as set forth in N.J.S.2C:24-4.
a. provide each sexual assault victim with medically and factually accurate and objective oral and written information about emergency contraception and sexually transmitted diseases, as provided for in section 4 of this act;
b. orally inform each sexual assault victim of her option to be provided emergency contraception at the health care facility; and
c. provide emergency contraception to the sexual assault victim, upon her request, unless contraindicated. If the emergency contraceptive is in the form of pills, the provision of the emergency contraception shall include the initial dose that the victim may take at the emergency health care facility, as well as the follow-up dose that the victim can self-administer later.
An emergency health care facility shall not be required to provide emergency contraception to a sexual assault victim who is pregnant.
a. are trained to provide medically and factually accurate and objective information about emergency contraception and sexually transmitted diseases to a sexual assault victim; and
b. provide that information to a sexual assault victim.
b. The information shall be clearly written and readily comprehensible in a culturally competent manner, as the commissioner, in collaboration with the Division on Women, the New Jersey Coalition Against Sexual Assault, and the Sexual Assault Nurse Examiner program, deems necessary to inform a sexual assault victim. The information shall explain:
(1) the nature of emergency contraception, the effectiveness of emergency contraception in preventing pregnancy, where emergency contraception can be obtained, and treatment options; and
(2) the symptoms and effects of sexually transmitted diseases, and treatment options.
c. The information shall be distributed to all hospital and satellite emergency departments in the State for use in those facilities pursuant to P.L.2005, c.50.
(1) investigate every complaint of noncompliance with the provisions of P.L.2005, c.50 (C.26:2H-12.6b et seq.) by an emergency health care facility, including the failure of a facility to provide the services required by P.L.2005, c.50;
(2) determine whether the complaint is substantiated, and if so, what action shall be taken by the emergency health care facility or commissioner to address the complaint;
(3) notify the Sexual Assault Nurse Examiner program of all substantiated complaints;
(4) compile the substantiated complaints;
(5) analyze the substantiated complaints, at least annually, to determine if there is any pattern of failure to provide services pursuant to P.L.2005, c.50; and
(6) determine, at least annually, whether an emergency health care facility is complying with the provisions of P.L.2005, c.50. The commissioner may utilize all means within his regulatory authority concerning health care facilities to verify a facility's compliance with P.L.2005, c.50.
b. If the commissioner determines that an emergency health care facility is not in compliance with the provisions of P.L.2005, c.50, the commissioner may assess such penalties and take other actions against the facility, as provided in P.L.1971, c.136 (C.26:2H-1 et seq.). Any such penalties assessed for noncompliance shall be paid to the Department of the Treasury and allocated, on a quarterly basis, to the Division on Women for supplemental funding for designated rape crisis centers.
c. The commissioner shall prepare an annual report, which shall be available to the public, summarizing the substantiated complaints, the actions taken by an emergency health care facility or the commissioner to address the complaints, and the commissioner's findings concerning any pattern of failure to provide services under, or noncompliance with, the provisions of P.L.2005, c.50.
"Commissioner" means the Commissioner of Health.
"Birthing center" means a birthing center licensed pursuant to P.L.1971, c.136 (C.26:2H-1 et seq.).
"Doula" means a trained professional who provides continuous physical, emotional, and informational support to a mother before, during, and after labor and childbirth, to help her to achieve the healthiest, most satisfying experience possible.
"Hospital" means every general or special hospital licensed pursuant to P.L.1971, c.136 (C.26:2H-1 et seq.) that provides maternity services.
b. Each hospital and birthing center shall, commencing no later than the 180th day after the effective date of this act, adopt and maintain written policies and procedures authorizing a patient to select a doula of the patient's choice to accompany the patient within the facility's premises for the purposes of providing support before, during, and after labor and childbirth.
c. Each hospital and birthing center shall provide a written copy of the policies and procedures adopted pursuant to subsection b. of this section to:
(1) each health care provider providing maternity services at the facility;
(2) each patient receiving maternity services at the facility; and
(3) any other person, at the request of the patient.
d. Each hospital and birthing center shall post a summary of the facility's policies and procedures adopted pursuant to subsection b. of this section on the facility's Internet website.
e. Each hospital and birthing center shall designate a staff member to serve as a liaison between the facility and doulas and doula organizations in order to provide information concerning the facility's policies and procedures adopted pursuant to subsection b. of this section.
The Legislature finds and declares that a person admitted to a general hospital often feels overwhelmed and uncertain as to his condition and course of treatment, and that the declaration of a bill of rights for hospital patients may lead to fuller understanding and greater security on the part of patients as well as greater sensitivity by the providers of medical care.
a. To considerate and respectful care consistent with sound nursing and medical practices, which shall include being informed of the name and licensure status of a student nurse or facility staff member who examines, observes, or treats the patient and the right to expect and receive appropriate assessment, management, and treatment of pain as an integral component of that person's care;
b. To be informed of the name of the physician responsible for coordinating his care;
c. To obtain from the physician complete, current information concerning his diagnosis, treatment, and prognosis in terms he can reasonably be expected to understand. When it is not medically advisable to give this information to the patient, it shall be made available to another person designated by the patient on his behalf;
d. To receive from the physician information necessary to give informed consent prior to the start of any procedure or treatment and which, except for those emergency situations not requiring an informed consent, shall include as a minimum the specific procedure or treatment, the medically significant risks involved, and the possible duration of incapacitation, if any, as well as an explanation of the significance of the patient's informed consent. The patient shall be advised of any medically significant alternatives for care or treatment, however, this does not include experimental treatments that are not yet accepted by the medical establishment;
e. To refuse treatment to the extent permitted by law and to be informed of the medical consequences of this act;
f. To privacy to the extent consistent with providing adequate medical care to the patient. This shall not preclude discussion of a patient's case or examination of a patient by appropriate health care personnel;
g. To privacy and confidentiality of all records pertaining to the patient's treatment, except as otherwise provided by law or third party payment contract, and to access to those records, including receipt of a copy thereof at reasonable cost, upon request, unless the patient's physician states in writing that access by the patient is not medically advisable;
h. To expect that within its capacity, the hospital will make reasonable response to the patient's request for services, including the services of an interpreter in a language other than English if 10% or more of the population in the hospital's service area speaks that language;
i. To be informed by the patient's physician of any continuing health care requirements which may follow discharge and to receive assistance from the physician and appropriate hospital staff in arranging for required follow-up care after discharge;
j. To be informed by the hospital of the necessity of transfer to another facility prior to the transfer and of any alternatives to it which may exist, which transfer shall not be effected unless it is determined by the physician to be medically necessary;
k. To be informed, upon request, of other health care and educational institutions that the hospital has authorized to participate in his treatment;
l. To be advised if the hospital proposes to engage in or perform human research or experimentation and to refuse to participate in these projects. For the purposes of this subsection "human research" does not include the mere collecting of statistical data;
m. To examine and receive an explanation of the patient's bill, regardless of source of payment, and to receive information or be advised on the availability of sources of financial assistance to help pay for the patient's care, as necessary;
n. To expect reasonable continuity of care;
o. To be advised of the hospital rules and regulations that apply to his conduct as a patient;
p. To treatment without discrimination as to race, age, religion, sex, national origin, or source of payment; and
q. To contract directly with a New Jersey licensed registered professional nurse of the patient's choosing for private professional nursing care during his hospitalization. A registered professional nurse so contracted shall adhere to hospital policies and procedures in regard to treatment protocols and policies and procedures so long as those policies and procedures are the same for private duty and regularly employed nurses. The registered professional nurse shall not be considered an agent or employee of the hospital for purposes of any financial liabilities, including, but not limited to, State or federal employee taxes, worker's compensation payments or coverage for professional liability.
The hospital, upon a patient's or the patient's designee's request for private professional nursing care, shall provide the patient or the patient's designee with a list of local nonprofit professional nurses association registries that refer nurses for private professional nursing care.
The administrator of a general hospital shall insure that a written summary of the rights set forth in this act be given to the patient or his guardian upon admittance to the hospital and to each individual already in residence, and that a written notice listing these rights is posted in a conspicuous place in the patient's room. The administrator shall also post this notice in a conspicuous public place in the hospital.
A patient may file a written complaint against a hospital for a failure to comply with the provisions of this act, or any rule or regulation adopted pursuant to this act, either with the hospital or the Department of Health. The hospital or the Department of Health, as appropriate, shall respond promptly in writing to the complaint. The Department of Health shall investigate a written complaint filed with the department and report its findings to the hospital and the patient.
The Commissioner of Health is authorized to adopt rules and regulations in accordance with the provisions of the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.) to effectuate the purposes of this act.
a. In the case of a claim filed on behalf of the health care facility's patient, the health care facility shall file the claim within 60 days of the last date of service for a course of treatment, on the standard claim form adopted by the Commissioner of Banking and Insurance pursuant to section 1 of P.L.1999, c.154 (C.17B:30-23).
b. In the case of a claim in which the patient has assigned the patient's benefits to the health care facility, the health care facility shall file the claim within 180 days of the last date of service for a course of treatment, on the standard claim form adopted by the Commissioner of Banking and Insurance pursuant to section 1 of P.L.1999, c.154 (C.17B:30-23). If the health care facility does not file the claim within 180 days of the last date of service for a course of treatment, the third party payer shall reserve the right to deny payment of the claim, in accordance with regulations established by the Commissioner of Banking and Insurance, and the health care facility shall be prohibited from seeking any payment directly from the patient.
(1) In establishing the standards for denial of payment, the Commissioner of Banking and Insurance shall consider the length of delay in filing the claim, the good faith use of information provided by the patient to the health care facility with respect to the identity of the patient's third party payer, delays in filing a claim related to coordination of benefits between third party payers and any other factors the commissioner deems appropriate, and, accordingly, shall define specific instances where the sanctions permitted pursuant to this subsection shall not apply.
(2) A health care facility which fails to file a claim within 180 days and whose claim for payment has been denied by the third party payer in accordance with this subsection may, in the discretion of a judge of the Superior Court, be permitted to refile the claim if the third party payer has not been substantially prejudiced thereby. Application to the court for permission to refile a claim shall be made within 14 days of notification of denial of payment and shall be made upon motion based upon affidavits showing sufficient reasons for the failure to file the claim with the third party payer within 180 days.
c. The provisions of this section shall not apply to any claims filed pursuant to P.L.1972, c.70 (C.39:6A-1 et seq.).
d. A health care facility which violates the provisions of subsection a. of this section may be subject to a civil penalty of $250 for each violation plus $50 for each day after the 60th day that the health care facility fails to submit a claim. The penalty shall be sued for and collected by the Department of Health pursuant to the "Penalty Enforcement Law of 1999," P.L.1999, c.274 (C.2A:58-10 et seq.).
b. The owner or operator of a general hospital who is a supplier of water but is not required to prepare a Consumer Confidence Report pursuant to the "Safe Drinking Water Act Amendments of 1996," and who is required to conduct tests of its drinking water by the Department of Environmental Protection, shall post a chart setting forth the results of the water tests, including the level of detection and, as appropriate for each contaminant, the maximum contaminant level, highest level allowed, action level, treatment technique, or other expression of an acceptable level, for each contaminant, in the area of each major entrance and in each admitting room in the general hospital. The chart also shall include in bold print the statement required to be included in a Consumer Confidence Report pursuant to 40 CFR s.141.154(a). The chart shall not include contaminants that are not detected.
c. As used in this section, "general hospital" shall mean any general hospital licensed pursuant to P.L.1971, c.136 (C.26:2H-1 et seq.).
d. The provisions of this section shall be enforced by the Department of Health. The Department of Health shall not be required to conduct on-site inspections to determine compliance with this section more frequently than any on-site inspections of general hospitals are conducted by the department pursuant to any other law.
b. The owner or operator of a rehabilitation center, extended care facility, skilled nursing home, or nursing home who is a supplier of water but is not required to prepare a Consumer Confidence Report pursuant to the "Safe Drinking Water Act Amendments of 1996," and who is required to conduct tests of its drinking water by the Department of Environmental Protection, shall post a chart setting forth the results of the water tests, including the level of detection and, as appropriate for each contaminant, the maximum contaminant level, highest level allowed, action level, treatment technique, or other expression of an acceptable level, for each contaminant, in at least one conspicuous location in the rehabilitation center, extended care facility, skilled nursing home, or nursing home. The chart also shall include in bold print the statement required to be included in a Consumer Confidence Report pursuant to 40 CFR s.141.154(a). The chart shall not include contaminants that are not detected.
c. As used in this section, "rehabilitation center," "extended care facility," "skilled nursing home," and "nursing home" shall mean a rehabilitation center, extended care facility, skilled nursing home, or nursing home licensed pursuant to P.L.1971, c.136 (C.26:2H-1 et seq.).
d. The provisions of this section shall be enforced by the Department of Health. The Department of Health shall not be required to conduct on-site inspections to determine compliance with this section more frequently than any on-site inspections of rehabilitation centers, extended care facilities, skilled nursing homes, or nursing homes are conducted by the department pursuant to any other law.
As used in this section, "unlicensed assistive personnel" means any unlicensed or uncertified personnel employed by a licensed health care facility that perform nursing tasks which do not require the skill or judgment of a registered professional nurse and which are assigned to them by, and carried out under the supervision of, a registered professional nurse.
b. The regulations adopted pursuant to subsection a. of this section, shall require, at a minimum, that:
(1) unlicensed assistive personnel employed by a health care facility meet the standards and requirements for education and competency evaluation prescribed by the New Jersey Board of Nursing pursuant to paragraph (26) of subsection d. of section 2 of P.L.1947, c.262 (C.45:11-24); and
(2) a health care facility, prior to implementing the use of unlicensed assistive personnel, establish a multidisciplinary committee, including representation from registered professional nurses, physicians, administrative staff, and unlicensed assistive personnel, to evaluate the need for using these personnel, formulate and adopt a plan to implement their use, and monitor the implementation of the plan.
c. The plan for implementing the use of unlicensed assistive personnel pursuant to paragraph (2) of subsection b. of this section shall, at a minimum:
(1) require the use and specify the composition of multidisciplinary patient care teams operating under the plan;
(2) prescribe materials and protocols for the orientation and training of health care facility staff with respect to implementing the plan;
(3) provide for the periodic monitoring and evaluation of the use of unlicensed assistive personnel by the multidisciplinary committee established pursuant to subsection b. of this section; and
(4) require in-service training and educational programming for both registered professional nurses and unlicensed assistive personnel which include subject matter relating to the delegation of nursing tasks to unlicensed assistive personnel and the supervision of these personnel by registered professional nurses.
b. A new facility that is licensed to operate an assisted living residence or comprehensive personal care home after the effective date of this act shall reserve 10% of its total bed compliment for use by Medicaid-eligible persons. The 10% utilization by Medicaid-eligible persons shall be met through Medicaid conversion of persons who enter the assisted living residence or comprehensive personal care home as private paying persons and subsequently become eligible for Medicaid, or through direct admission of Medicaid-eligible persons. An assisted living residence or comprehensive personal care home shall achieve this 10% utilization within three years of licensure to operate and shall maintain this level of utilization thereafter.
c. Existing assisted living residences and comprehensive personal care homes that add additional assisted living beds shall be required, as a condition of licensure approval, to maintain 10% of the additional beds for Medicaid-eligible persons through Medicaid conversion of persons who enter the assisted living residence or comprehensive personal care home as private paying persons and subsequently become eligible for Medicaid, or through direct admission of Medicaid-eligible persons. If the total number of additional beds is less than 10, at least one of the additional beds shall be reserved for a Medicaid-eligible person.
(1) No visitors are allowed;
(2) The health care facility reasonably determines that the presence of a particular visitor would endanger the health or safety of a patient, a member of the staff of the facility, or another visitor to the facility, or would significantly disrupt the operations of the facility; or
(3) The patient has indicated to health care facility staff that the patient does not want the person to visit.
b. The provisions of subsection a. of this section shall not be construed as prohibiting a health care facility from otherwise establishing reasonable restrictions upon visitations, including restrictions upon the hours of visitation and number of visitors.
a. Adverse events, some of which are the result of preventable errors, are inherent in all systems, and the health care literature demonstrates that the great majority of medical errors result from systems problems, not individual incompetence;
b. Well-designed systems have processes built in to minimize the occurrence of errors, as well as to detect those that do occur; they incorporate mechanisms to continually improve their performance;
c. To enhance patient safety, the goal is to craft a health care delivery system that minimizes, to the greatest extent feasible, the harm to patients that results from the delivery system itself;
d. An important component of a successful patient safety strategy is a feedback mechanism that allows detection and analysis not only of adverse events, but also of "near-misses";
e. To encourage disclosure of these events so that they can be analyzed and used for improvement, it is critical to create a non-punitive culture that focuses on improving processes rather than assigning blame. Health care facilities and professionals must be held accountable for serious preventable adverse events; however, punitive environments are not particularly effective in promoting accountability and increasing patient safety, and may be a deterrent to the exchange of information required to reduce the opportunity for errors to occur in the complex systems of care delivery. Fear of sanctions induces health care professionals and organizations to be silent about adverse events, resulting in serious under-reporting; and
f. By establishing an environment that both mandates the confidential disclosure of the most serious, preventable adverse events, and also encourages the voluntary, anonymous and confidential disclosure of less serious adverse events, as well as preventable events and near misses, the State seeks to increase the amount of information on systems failures, analyze the sources of these failures and disseminate information on effective practices for reducing systems failures and improving the safety of patients.
"Adverse event" means an event that is a negative consequence of care that results in unintended injury or illness, which may or may not have been preventable.
"Anonymous" means that information is presented in a form and manner that prevents the identification of the person filing the report.
"Commissioner" means the Commissioner of Health.
"Department" means the Department of Health.
"Event" means a discrete, auditable, and clearly defined occurrence.
"Health care facility" or "facility" means a health care facility licensed pursuant to P.L.1971, c.136 (C.26:2H-1 et seq.) and a State psychiatric hospital operated by the Department of Human Services and listed in R.S.30:1-7.
"Health care professional" means an individual who, acting within the scope of the individual's licensure or certification, provides health care services, and includes, but is not limited to, a physician, dentist, nurse, pharmacist, or other health care professional whose professional practice is regulated pursuant to Title 45 of the Revised Statutes.
"Near-miss" means an occurrence that could have resulted in an averse event but the adverse event was prevented.
"Preventable event" means an event that could have been anticipated and prepared against, but occurs because of an error or other system failure.
"Serious preventable adverse event" means an adverse event that is a preventable event and results in death or loss of a body part, or disability or loss of bodily function lasting more than seven days or still present at the time of discharge from a health care facility.
b. In accordance with the requirements established by the commissioner by regulation, pursuant to this act, a health care facility shall develop and implement a patient safety plan for the purpose of improving the health and safety of patients at the facility.
The patient safety plan shall, at a minimum, include:
(1) a patient safety committee, as prescribed by regulation;
(2) a process for teams of facility staff, which teams are comprised of personnel who are representative of the facility's various disciplines and have appropriate competencies, to conduct ongoing analysis and application of evidence-based patient safety practices in order to reduce the probability of adverse events resulting from exposure to the health care system across a range of diseases and procedures;
(3) a process for teams of facility staff, which teams are comprised of personnel who are representative of the facility's various disciplines and have appropriate competencies, to conduct analyses of near-misses, with particular attention to serious preventable adverse events and adverse events; and
(4) a process for the provision of ongoing patient safety training for facility personnel.
The provisions of this subsection shall not be construed to eliminate or lessen a hospital's obligation under current law or regulation to have a continuous quality improvement program.
c. A health care facility shall report to the department or, in the case of a State psychiatric hospital, to the Department of Human Services, in a form and manner established by the commissioner, every serious preventable adverse event that occurs in that facility.
d. A health care facility shall assure that the patient affected by a serious preventable adverse event or an adverse event specifically related to an allergic reaction, or, in the case of a minor or a patient who is incapacitated, the patient's parent or guardian or other family member, as appropriate, is informed of the serious preventable adverse event or adverse event specifically related to an allergic reaction, no later than the end of the episode of care, or, if discovery occurs after the end of the episode of care, in a timely fashion as established by the commissioner by regulation. The time, date, participants, and content of the notification shall be documented in the patient's medical record in accordance with rules and regulations adopted by the commissioner. The content of the documentation shall be determined in accordance with the rules and regulations of the commissioner. If the patient's physician determines that the disclosure would seriously and adversely affect the patient's health, then the facility shall assure that the family member, if available, is notified in accordance with rules and regulations adopted by the commissioner. In the event that an adult patient is not informed of the serious preventable adverse event or adverse event specifically related to an allergic reaction, the facility shall assure that the physician includes a statement in the patient's medical record that provides the reason for not informing the patient pursuant to this section.
e. (1) A health care professional or other employee of a health care facility is encouraged to make anonymous reports to the department or, in the case of a State psychiatric hospital, to the Department of Human Services, in a form and manner established by the commissioner, regarding near-misses, preventable events, and adverse events that are otherwise not subject to mandatory reporting pursuant to subsection c. of this section.
(2) The commissioner shall establish procedures for and a system to collect, store, and analyze information voluntarily reported to the department pursuant to this subsection. The repository shall function as a clearinghouse for trend analysis of the information collected pursuant to this subsection.
f. Any documents, materials, or information received by the department, or the Department of Human Services, as applicable, pursuant to the provisions of subsections c. and e. of this section concerning serious preventable adverse events, near-misses, preventable events, and adverse events that are otherwise not subject to mandatory reporting pursuant to subsection c. of this section, shall not be:
(1) subject to discovery or admissible as evidence or otherwise disclosed in any civil, criminal, or administrative action or proceeding;
(2) considered a public record under P.L.1963, c.73 (C.47:1A-1 et seq.) or P.L.2001, c.404 (C.47:1A-5 et al.); or
(3) used in an adverse employment action or in the evaluation of decisions made in relation to accreditation, certification, credentialing, or licensing of an individual, which is based on the individual's participation in the development, collection, reporting or storage of information in accordance with this section. The provisions of this paragraph shall not be construed to limit a health care facility from taking disciplinary action against a health care professional in a case in which the professional has displayed recklessness, gross negligence, or willful misconduct, or in which there is evidence, based on other similar cases known to the facility, of a pattern of significant substandard performance that resulted in serious preventable adverse events.
The information received by the department, or the Department of Human Services, as applicable, shall be shared with the Attorney General in accordance with rules and regulations adopted pursuant to subsection j. of this section, and may be used by the department, the Department of Human Services, and the Attorney General for the purposes of this act and for oversight of facilities and health care professionals; however, the departments and the Attorney General shall not use the information for any other purpose.
In using the information to exercise oversight, the department, Department of Human Services, and Attorney General, as applicable, shall place primary emphasis on assuring effective corrective action by the facility or health care professional, reserving punitive enforcement or disciplinary action for those cases in which the facility or the professional has displayed recklessness, gross negligence, or willful misconduct, or in which there is evidence, based on other similar cases known to the department, Department of Human Services or the Attorney General, of a pattern of significant substandard performance that has the potential for or actually results in harm to patients.
g. Any documents, materials, or information developed by a health care facility as part of a process of self-critical analysis conducted pursuant to subsection b. of this section concerning preventable events, near-misses, and adverse events, including serious preventable adverse events, and any document or oral statement that constitutes the disclosure provided to a patient or the patient's family member or guardian pursuant to subsection d. of this section, shall not be:
(1) subject to discovery or admissible as evidence or otherwise disclosed in any civil, criminal, or administrative action or proceeding; or
(2) used in an adverse employment action or in the evaluation of decisions made in relation to accreditation, certification, credentialing, or licensing of an individual, which is based on the individual's participation in the development, collection, reporting, or storage of information in accordance with subsection b. of this section. The provisions of this paragraph shall not be construed to limit a health care facility from taking disciplinary action against a health care professional in a case in which the professional has displayed recklessness, gross negligence or willful misconduct, or in which there is evidence, based on other similar cases known to the facility, of a pattern of significant substandard performance that resulted in serious preventable adverse events.
h. Notwithstanding the fact that documents, materials, or information may have been considered in the process of self-critical analysis conducted pursuant to subsection b. of this section, or received by the department or the Department of Human Services pursuant to the provisions of subsection c. or e. of this section, the provisions of this act shall not be construed to increase or decrease, in any way, the availability, discoverability, admissibility, or use of any such documents, materials, or information if obtained from any source or context other than those specified in this act.
i. The investigative and disciplinary powers conferred on the boards and commissions established pursuant to Title 45 of the Revised Statutes, the Director of the Division of Consumer Affairs in the Department of Law and Public Safety and the Attorney General under the provisions of P.L.1978, c.73 (C.45:1-14 et seq.) or any other law, rule, or regulation, as well as the investigative and enforcement powers conferred on the department and the commissioner under the provisions of Title 26 of the Revised Statutes or any other law, rule or regulation, shall not be exercised in such a manner so as to unduly interfere with a health care facility's implementation of its patient safety plan established pursuant to this section. However, this act shall not be construed to otherwise affect, in any way, the exercise of such investigative, disciplinary, and enforcement powers.
j. The commissioner shall, pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.), adopt such rules and regulations necessary to carry out the provisions of this act. The regulations shall establish: criteria for a health care facility's patient safety plan and patient safety committee; the time frame and format for mandatory reporting of serious preventable adverse events at a health care facility; the types of events that qualify as serious preventable adverse events and adverse events specifically related to an allergic reaction; the circumstances under which a health care facility is not required to inform a patient or the patient's family about a serious preventable adverse event or adverse event specifically related to an allergic reaction; and a system for the sharing of information received by the department and the Department of Human Services pursuant to subsections c. and e. of this section with the Attorney General. In establishing the criteria for reporting serious preventable adverse events, the commissioner shall, to the extent feasible, use criteria for these events that have been or are developed by organizations engaged in the development of nationally recognized standards.
The commissioner shall consult with the Commissioner of Human Services with respect to rules and regulations affecting the State psychiatric hospitals and with the Attorney General with respect to rules and regulations regarding the establishment of a system for the sharing of information received by the department and the Department of Human Services pursuant to subsections c. and e. of this section with the Attorney General.
k. Nothing in this act shall be construed to increase or decrease the discoverability, in accordance with Christy v. Salem, No. A-6448-02T3 (Superior Court of New Jersey, Appellate Division, February 17, 2004)(2004 WL291160), of any documents, materials or information if obtained from any source or context other than those specified in this act.
The commissioners shall jointly issue an annual report of their findings and recommendations to the Governor, and to the Legislature pursuant to section 2 of P.L.1991, c.164 (C.52:14-19.1), to be made available on the official Internet website of the Department of Health.
(1) Foreign body left during procedure (PSI 05);
(2) Iatrogenic pneumothorax (PSI 06);
(3) Postoperative hip fracture (PSI 08);
(4) Postoperative hemorrhage or hematoma (PSI 09);
(5) Postoperative deep vein thrombosis (DVT) or pulmonary embolism (PE) (PSI 12);
(6) Postoperative sepsis (PSI 13);
(7) Postoperative wound dehiscence (PSI 14);
(8) Accidental puncture or laceration (PSI 15);
(9) Transfusion reaction (PSI 16);
(10) Birth trauma (PSI 17);
(11) Obstetric trauma-vaginal delivery with instrument (PSI 18);
(12) Obstetric trauma-vaginal delivery without instrument (PSI 19);
(13) Air embolism; and
(14) Surgery on the wrong side, wrong body part, or wrong person, or wrong surgery performed on a patient.
b. The Commissioner of Health, in consultation with the Quality Improvement Advisory Committee in the Department of Health, may include additional patient safety indicators in the annual report, by regulation. The commissioner shall consider indicators that: (1) are recommended by the federal Agency for Healthcare Research and Quality or the Centers for Medicare & Medicaid Services; (2) are suitable for comparative reporting and public accountability, and are risk adjusted; (3) have a strong evidence base with no substantial evidence against their use for comparative reporting; and (4) can be measured through data that are available through hospital procedure and diagnosis codes.
c. The commissioner shall request the Quality Improvement Advisory Committee to study and make recommendations to the commissioner on how to expand public reporting by the department of patient pressure ulcers, patient infections due to hospital care, and falls by patients in general hospitals.
d. The commissioner shall, in accordance with the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.), adopt such rules and regulations as the commissioner deems necessary to carry out the provisions of this act.
b. A general hospital shall be required to notify its patients of the provisions of this section.
c. Nothing in this section shall be construed to deny any party access to any existing payment appeals process.
d. In any civil action alleging professional negligence against a general hospital, the provisions of this section shall not modify the requirement, where applicable, for expert testimony in accordance with the established case law of this State.
e. The Commissioners of Health and Senior Services and Banking and Insurance shall collaborate in developing standards for general hospitals and third party payers to implement the provisions of this section.
a. acquire at least one defibrillator as defined in section 2 of P.L.1999, c.34 (C.2A:62A-24), which shall be maintained in a central location within the nursing home or assisted living facility that shall be made known and available to the employees of the nursing home or assisted living facility for the purposes of this act;
b. ensure that the defibrillator is tested and maintained, and provide notification to the appropriate first aid, ambulance, or rescue squad, or other appropriate emergency medical services provider regarding the defibrillator, the type acquired, and its location, pursuant to section 3 of P.L.1999, c.34 (C.2A:62A-25);
c. arrange and pay for training in cardio-pulmonary resuscitation and the use of a defibrillator for employees of the nursing home or assisted living facility to ensure that the employees hold current certification from the American Red Cross, American Heart Association, or other training program recognized by the Department of Health and Senior Services in cardio-pulmonary resuscitation and use of a defibrillator; and
d. ensure that an employee who uses a defibrillator requests emergency medical assistance from the appropriate first aid, ambulance, or rescue squad as soon as practicable.
a. Despite significant advances in diagnosis, treatment and prevention, stroke remains a common disorder; an estimated 700,000 to 750,000 new and recurrent strokes occur each year in this country; and with the aging of the population, the number of persons who have strokes is projected to increase;
b. Although new treatments are available to improve the clinical outcomes of stroke, many acute care hospitals lack the necessary staff and equipment to optimally triage and treat stroke patients, including the provision of optimal, safe and effective emergency care for these patients;
c. Two levels of stroke centers should be established for the treatment of acute stroke. Primary stroke centers should be established in as many acute care hospitals as possible. These centers would evaluate, stabilize and provide emergency care to patients with acute stroke and then, depending on the patient's needs and the center's capabilities, either admit the patient and provide inpatient care or transfer the patient to a comprehensive stroke center. Comprehensive stroke centers should be established in hospitals that meet the criteria set forth in this act, to ensure coverage for all patients throughout the State who require this level of care. These centers would provide complete and specialized care to patients who experience the most complex strokes, which require specialized testing, highly technical procedures and other interventions. Also, these centers would provide education and guidance to affiliated primary stroke centers;
d. There is a public health need for acute care hospitals in this State to establish stroke centers to ensure the rapid triage, diagnostic evaluation and treatment of patients suffering a stroke. This should result in increased survival and a decrease in the disabilities associated with stroke; and
e. Therefore, it is in the best interest of the residents of this State to establish a program to designate stroke centers throughout the State, to provide specific patient care and support services criteria that stroke centers must meet in order to ensure that stroke patients receive safe and effective care, and to provide financial support to acute care hospitals to encourage them to develop stroke centers in all areas of the State.
a. A hospital shall apply to the commissioner for designation and shall demonstrate to the satisfaction of the commissioner that the hospital has been certified as a primary, thrombectomy-capable, or comprehensive stroke center or as an acute stroke ready hospital, respectively, by the Joint Commission, the American Heart Association, DNV GL, or another organization that provides such certifications as may be approved by the commissioner. A facility designated as a primary or comprehensive stroke center prior to the effective date of P.L.2019, c.476 (C.26:2H-12.28a et al.) shall retain such designation by obtaining, and providing the commissioner with documentation of, the appropriate certification by the Joint Commission, the American Heart Association, DNV GL, or other approved organization within three years of the effective date of P.L.2019, c.476 (C.26:2H-12.28a et al.), except that the commissioner may grant the facility up to two one-year extensions to obtain the appropriate certification, provided the facility certifies that the additional time is necessary to obtain the appropriate certification. Failure to meet the requirements of this subsection shall be deemed a voluntary surrender of the hospital's prior designation as a primary or comprehensive stroke center. A hospital that has its certification by the Joint Commission, the American Heart Association, DNV GL, or other certifying organization revoked shall report the revocation to the Department of Health no later than five days after the date the hospital receives notice of the revocation from the certifying entity.
b. The commissioner shall designate as many hospitals as primary stroke centers as apply for the designation, provided that the hospital meets the certification requirements set forth in subsection a. of this section.
c. The commissioner shall designate as many hospitals as thrombectomy-capable stroke centers as apply for the designation, provided that the hospital meets the certification requirements set forth in subsection a. of this section.
d. The commissioner shall designate as many hospitals as comprehensive stroke centers as apply for the designation, provided that the hospital meets the certification requirements set forth in subsection a. of this section.
e. The commissioner shall designate as many hospitals as acute stroke ready hospitals as apply for the designation, provided that the hospital meets the certification requirements set forth in subsection a. of this section.
f. The commissioner shall appropriately recognize stroke centers that have attained a level of stroke care distinction recognized by the Joint Commission, the American Heart Association, DNV GL, or another nationally-recognized, guidelines-based organization that provides such distinctions and is approved by the commissioner. Stroke centers that have attained a distinction that shall be recognized pursuant to this subsection may include, but shall not be not limited to, centers that offer mechanical endovascular therapies.
g. The commissioner may suspend or revoke a hospital's designation as a stroke center or acute stroke ready hospital, after notice and hearing, if the commissioner determines that the hospital is not in compliance with the requirements of this act.
h. The commissioner shall encourage primary, thrombectomy-capable, and comprehensive stroke centers to coordinate, by written agreement, with acute stroke ready hospitals throughout the State to provide appropriate access to care for acute stroke patients. Agreements made pursuant to this subsection shall include: (1) transfer agreements for the transport to and acceptance of stroke patients by stroke centers for the provision of stroke treatment therapies an acute stroke ready hospital is unable to provide; and (2) any communication criteria and protocols as shall be necessary to effectuate the agreement.
i. Each hospital that is not a designated comprehensive stroke center shall, no later than 180 days after the effective date of P.L.2019, c.476 (C.26:2H-12.28a et al.), enter into an agreement with at least one State-designated comprehensive stroke center, which agreement shall, at a minimum:
(1) include protocols for engaging in prompt telephonic or video consultation to assess and make treatment recommendations for suspected stroke patients;
(2) provide, where most clinically appropriate, consistent with patient safety and patient consent, for the effective and efficient transfer of patients needing the services of the comprehensive stroke center, particularly in time-sensitive cases including, but not limited to, large vessel occlusion; and
(3) include a provision to access educational resources available from the comprehensive stroke center to expand the knowledge base of providers at the acute care general hospital.
The agreement shall be filed with the Department of Health within 30 days.
j. The Commissioner of Health shall prepare, maintain, and make available on the Department of Health website a list of facilities designated as primary stroke centers, thrombectomy-capable stroke centers, comprehensive stroke centers, and acute stroke ready hospitals. A current copy of the list shall be transmitted to each emergency medical services provider, as defined in subsection e. of section 3 of P.L.2019, c.476 (C.27:5F-27.1), no later than June 1 of each year.
k. (1) Primary, thrombectomy-capable, and comprehensive stroke centers and acute stroke ready hospitals shall, on a quarterly basis, submit to the department data concerning stroke care that are deemed appropriate by the Department of Health, and that, at a minimum, align with the stroke consensus measures jointly supported by the Joint Commission, the United States Centers for Disease Control and Prevention's Paul Coverdell National Acute Stroke Registry, American Heart Association, and the American Stroke Association.
(2) Data submitted pursuant to paragraph (1) of this subsection shall be compiled by the department into a Statewide stroke database, which shall be made available on the department website.
(3) Data submitted pursuant to paragraph (1) of this subsection shall not contain or be construed to require disclosure of confidential or personal identifying information.
b. The Stroke Care Advisory Panel established under this section shall organize as soon as practicable but no later than 60 days after the effective date of P.L.2019, c.476 (C.26:2H-12.28a et al.), and, except as provided in subsection c. of this section, shall select a chairperson and a vice-chairperson from among its members. The chairperson shall appoint a secretary who need not be a member of the panel. The panel shall meet no less than four times per year and at such other times as may be necessary to discharge its duties. Members shall serve without compensation but shall be reimbursed for necessary expenses incurred in the performance of their duties within the limits of funds appropriated for that purpose. The Department of Health shall provide staff services to the panel.
c. The chairperson, vice-chairperson, and any public members of the Stroke Advisory Panel constituted in the Department of Health as of the effective date of P.L.2019, c.476 (C.26:2H-12.28a et al.) may choose to remain on the Stroke Care Advisory Panel for up to one year following the effective date of P.L.2019, c.476 (C.26:2H-12.28a et al.). Thereafter, the public members shall be eligible for reappointment pursuant to subsection a. of this section, and the chairperson and vice-chairperson shall be eligible for re-selection for their positions pursuant to subsection b. of this section.
d. The Stroke Care Advisory Panel established pursuant to this section shall continue any duties and responsibilities vested in the Stroke Advisory Panel constituted in the Department of Health as of the effective date of P.L.2019, c.476 (C.26:2H-12.28a et al.). In addition, the Stroke Care Advisory Panel shall be charged with assessing the stroke system of care in New Jersey and identifying and recommending means of improving the provision of stroke care. In addition to any other actions or recommendations as it finds necessary and appropriate, the panel shall:
(1) analyze the Statewide stroke database maintained pursuant to paragraph (2) of subsection k. of section 2 of P.L.2004, c.136 (C.26:2H-12.28) to identify potential interventions to improve the provision of stroke care in the State, with a focus on identifying and improving care in underserved regions and populations of the State;
(2) encourage the sharing of information and data among health care providers on ways to improve the quality of care provided to stroke patients in the State;
(3) facilitate the communication and analysis of health information and data among the health care professionals providing care for stroke patients;
(4) enhance coordination and communication between hospitals, primary, thrombectomy-capable, and comprehensive stroke centers, acute stroke ready hospitals, and other support services necessary to assure access to effective and efficient stroke care, particularly in time-sensitive cases including, but not limited to, large vessel occlusion;
(5) develop treatment protocols regarding the transitioning of patients to community-based follow-up care in hospital outpatient, physician office, and ambulatory clinic settings for ongoing care after hospital discharge following acute treatment for stroke;
(6) establish a data oversight process and implement a plan for achieving continuous quality improvement in the quality of care provided under the Statewide stroke system of care; and
(7) develop model protocols for the assessment, treatment, and transport of stroke patients for use by emergency medical services providers, which shall include best practice standards for the triage and transport of acute stroke patients.
e. The Department of Health shall assign a current employee to the Stroke Care Advisory Panel, which employee shall have primary responsibility for assisting the panel in carrying out its responsibilities with respect to data analysis, data sharing, data oversight, and data reporting. If the department does not have a current employee available who has the requisite skills, training, and experience to fulfil this role, the department may contract with an appropriate third party patient safety organization to perform this function for the panel on an at cost or no cost basis.
f. No later than one year after the date of organization, and annually thereafter, the Stroke Care Advisory Panel shall submit a report to the Governor and, pursuant to section 2 of P.L.1991, c.164 (C.52:14-19.1), to the Legislature, detailing its activities, findings, and proposals for legislative, executive, or other action to improve and enhance the Statewide stroke system of care.
b. A hospital seeking designation as a stroke center shall apply to the commissioner for a matching grant, in a manner and on a form required by the commissioner, and provide such information as the commissioner deems necessary to determine if the hospital is eligible for the grant.
c. The commissioner may provide matching grants to as many hospitals as the commissioner deems appropriate, except that:
(1) Matching grant awards shall be made to at least two applicant hospitals in the northern region of this State (comprising Bergen, Hudson, Essex, Passaic, Morris, Sussex, and Warren counties), at least two applicant hospitals in the central region of this State (comprising Union, Somerset, Hunterdon, Mercer, Middlesex, and Monmouth counties) and at least two applicant hospitals in the southern region of this State (comprising Burlington, Camden, Gloucester, Salem, Cumberland, Cape May, Atlantic, and Ocean counties), provided in the case of each region that the applicant hospitals receiving the awards must be eligible therefor under the provisions of this act; and
(2) No more than 20% of the funds appropriated pursuant to this act shall be allocated to hospitals that seek designation as comprehensive stroke centers.
(1) the ownership of each long-term care facility and adult day health services facility licensed by the department; and
(2) any violation of statutory standards or rules and regulations of the department pertaining to the care of patients or physical plant standards found at any such facility by the department.
As used in this section, "long-term care facility" means a nursing home, assisted living residence, comprehensive personal care home, residential health care facility, or dementia care home licensed pursuant to P.L.1971, c.136 (C.26:2H-1 et seq.).
b. The information made available to the public pursuant to subsection a. of this section shall be provided in a manner that would enable a member of the public to search the website by name of a facility or its owner in order to access the information. The department shall also make the information available in writing, upon request.
c. The information regarding the ownership of a long-term care or adult day health services facility that is made available to the public pursuant to subsection a. of this section shall provide, at a minimum: the name of the owner of a facility as listed on the facility's license and, if there is more than one owner or the facility is owned by a corporation, the name of each person who holds at least a 10 percent interest in the facility; the name of any other licensed long-term care or adult day health services facility in the State owned by this owner, corporation, and each person who holds at least a 10 percent interest in the facility, as applicable; and the address and contact information for the facility.
d. The information that is displayed on the official department website pursuant to subsection a. of this section shall include Internet web links to the New Jersey Report Card for Nursing Homes maintained by the department and the Medicare Nursing Home Compare database maintained by the federal Centers for Medicare & Medicaid Services.
(2) The training shall be completed no later than six months after the date that the person is appointed as a member of the board, except that a person who is appointed as a member of a hospital board of trustees on or after the date of enactment of this act but prior to the effective date thereof shall complete the training no later than six months after the effective date.
(3) A person who was appointed as a member of a hospital board of trustees prior to the date of enactment of P.L.2007, c.74 shall complete the training no later than six months after the effective date of P.L.2008, c.57.
b. The commissioner shall, in consultation with the New Jersey Hospital Association, the Hospital Alliance of New Jersey, and the New Jersey Council of Teaching Hospitals:
(1) prescribe the subject matter of the training, which shall include, but need not be limited to, a review of the types of financial, organizational, legal, regulatory, and ethical issues that a hospital trustee may be required to consider in the course of discharging the trustee's governance responsibilities;
(2) arrange for, or specify, the entity or entities to provide the training;
(3) specify the timeframe within which the training is to be completed;
(4) certify completion of the training for each trustee upon receipt of documentation thereof, as provided on a form and in a manner prescribed by the commissioner, or otherwise arrange for certification by the training entity; and
(5) take such other actions as the commissioner determines appropriate to effectuate the purposes of this act.
a. Two million patients in this country become infected after entering hospitals each year and about 90,000 of those patients die as a result of those infections;
b. Methicillin-Resistant Staphylococcus aureus (MRSA) is a common staph infection which is resistant to powerful antibiotics and which is increasingly prevalent in health care settings;
c. MRSA can survive on cloth and plastic for up to 90 days, and is frequently transmitted by contaminated hands, clothes and non-invasive instruments, so that the number of patients who can become infected from even one carrier multiplies dramatically;
d. The federal Centers for Disease Control and Prevention (CDC) estimates that one in 20 patients entering a hospital carries MRSA, and reported that MRSA accounted for 60% of infections in American hospitals in 2004, up from 2% in 1974;
e. The annual nationwide cost to treat hospitalized patients infected with MRSA is estimated to be more than $4 billion;
f. These infections are preventable, and recent data support a multi-faceted approach to successfully combat them, including routine screening, isolation of colonized and infected patients, strict compliance with hygiene guidelines, and a change in culture to ensure that infection prevention and control is everyone's job and is a natural component of care at each patient encounter each day;
g. Virtually all published analyses comparing the costs of screening patients upon admission and adopting effective infection control practices with the costs of caring for infected patients have concluded that caring for infected patients is much more expensive;
h. Routine screening and isolation of all patients with MRSA in hospitals in Denmark and Holland have reduced MRSA to 10% of their bacterial infections, and a pilot program undertaken by the Department of Veterans Affairs (VA) Pittsburgh Healthcare System that reduced MRSA infections in its surgical care unit by 70% was so successful that all VA health care facilities have been directed to develop and implement similar approaches to prevent the spread of MRSA in at least one unit, with the goal to apply successful strategies facility-wide; and
i. It is a matter of public health and fiscal policy that patients in New Jersey's health care facilities receive health care that incorporates these best practices in infection control, not only to protect their health and lives, but also to ensure the economic viability of New Jersey's health care institutions.
Ultimately, the hospital shall expand the infection prevention program to all areas of the hospital, with the exception of an inpatient psychiatric unit, if applicable. The expansion of the infection prevention program shall be completed as quickly as feasible, taking into account the hospital's patient population, physical plant, and other facility-specific circumstances.
b. In addition to any other best practices and effective strategies, the hospital shall incorporate the following strategies:
(1) identification and isolation of both colonized and infected patients by screening patients upon admission in order to break the chain of transmission;
(2) contact precautions for patients found to be MRSA positive, as "contact precautions" is defined by the Centers for Disease Control and Prevention;
(3) patient cultures for MRSA upon discharge or transfer from the unit where the infection prevention program has been implemented, and flagging of patients who are readmitted to the hospital;
(4) strict adherence to hygiene guidelines;
(5) a written infections prevention and control policy with input from frontline caregivers; and
(6) a worker education requirement regarding modes of transmission of MRSA, use of protective equipment, disinfection policies and procedures, and other preventive measures.
c. A general hospital shall report to the Department of Health, in a manner and according to a schedule prescribed by the Commissioner of Health, the number of cases of hospital-acquired MRSA that occur in its facility.
a. Health care facility-associated infections constitute a major public health problem in this country, affecting from 5% to 10% of hospitalized patients annually, resulting in an estimated two million infections, and 90,000 deaths, and adding an estimated $4.5 to $5.7 billion in health care costs;
b. Many health care facility-associated infections can be prevented, and a goal of zero health care facility-associated infections is desirable. There are many simple and effective practices in hospitals that can dramatically reduce the incidence of health care facility-associated infections, such as hand washing, using gloves and properly sterilized equipment, and following the same established best practices, every time, for procedures such as the insertion of an intravenous tube to deliver fluids and medication;
c. The uniform reporting of health care facility-associated infections to the State, and the review and analysis of this data by the Department of Health, will provide a measurable means to assist hospitals in improving patient outcomes;
d. The federal Centers for Disease Control and Prevention recommends that states establishing public reporting systems for health care facility-associated infections focus on major site categories to report rates of health care facility-associated infections related to procedures and conditions including, but not limited to, urinary tract infections, surgical site infections, ventilator-associated pneumonia, and central line-related bloodstream infections. A focus on major site categories helps ensure that data collection is concentrated in populations where health care facility-associated infections are more prevalent, and that the infection rates reported are most useful for targeting prevention practices and making comparisons among hospitals and within hospitals, over time;
e. The Department of Health currently provides comparative hospital performance data in its annual New Jersey Hospital Performance Report, and including information about hospital infection rates will further enhance the value of the report to the public and health care providers; and
f. Therefore, it is a matter of public health and fiscal policy that patients in New Jersey's hospitals receive health care that incorporates best practices in infection control, not only to protect their health and lives, but also to ensure the economic viability of New Jersey's hospitals.
a. process quality indicators of hospital infection control that have been identified by the federal Centers for Medicare & Medicaid Services, as selected by the commissioner in consultation with the Quality Improvement Advisory Committee within the department; and
b. beginning 30 days after the adoption of regulations pursuant to this act, data on infection rates for the major site categories that define health care facility-associated infection locations, multiple infections, and device-related and non-device related infections, identified by the federal Centers for Disease Control and Prevention, as selected by the commissioner in consultation with the Quality Improvement Advisory Committee within the department.
The regulations shall: establish standard methods for identifying and reporting health care facility-associated infections; identify the major site categories for which infections shall be reported, taking into account the categories most likely to improve the delivery and outcome of health care in the State; and specify the methodology for presenting the data to the public, including procedures to adjust for differences in case mix and severity of infections among hospitals.
b. If the patient elects to donate umbilical cord blood or placental tissue as provided in subsection a. of this section:
(1) The patient shall provide to the hospital the collection kit supplied by the NMDP-affiliated public umbilical cord blood bank to collect the blood or placental tissue and shall arrange for the kit to be transported to the umbilical cord blood bank at no cost to the hospital; and
(2) The donation shall be made without monetary expense to the woman or the hospital for the collection or storage of the blood or placental tissue.
c. If the patient elects to store her newborn child's umbilical cord blood or placental tissue for family use with a private umbilical cord blood bank:
(1) The patient shall provide to the hospital the collection kit supplied by the private umbilical cord blood bank to collect the blood or placental tissue and shall arrange for the kit to be transported to the blood bank at no cost to the hospital; and
(2) The hospital shall collect the blood or placental tissue in accordance with the patient's directions.
d. The provisions of subsections a., b., and c. of this section shall not be construed to:
(1) require a hospital to collect umbilical cord blood or placental tissue if, in the professional judgment of the patient's attending physician, the collection would threaten the health of the mother or newborn child; or
(2) apply to a physician, nurse, or other hospital employee or contractor who, or a hospital that, is directly affiliated with a religious denomination that adheres to the tenet that blood transfer is contrary to the moral principles which the denomination considers to be an essential part of its beliefs and practices. The physician, nurse, other hospital employee or contractor, or hospital, as applicable, shall record, in writing, its refusal to participate in the activity provided in subsections a., b., and c. of this section, and include a copy of the refusal in the patient's medical record.
a. a description of the health benefits to the community from donating umbilical cord blood or placental tissue to an NMDP-affiliated public umbilical cord blood bank;
b. a description of the potential benefits to the patient and her family from storing umbilical cord blood or placental tissue with a private umbilical cord blood bank;
c. notice to the patient of her option to decline to donate umbilical cord blood or placental tissue to an NMDP-affiliated public umbilical cord blood bank or to store it with a private umbilical cord blood bank; and
d. notice to the patient that a private umbilical cord blood bank may assess fees for the donation and storage of umbilical cord blood or placental tissue, and that she may donate umbilical cord blood or placental tissue to an NMDP-affiliated public umbilical cord blood bank at no charge to herself or her family.
The hospital shall ensure that:
a. at a minimum, the chief executive officer of the hospital, the chairman of the hospital board of trustees, and at least 25% of the members of the hospital board of trustees are present at the meeting and available to respond to questions from members of the public;
b. the meeting is open to members of the public and organized so as to provide the community served by the hospital with information about the operation of the hospital, and to provide an opportunity for members of the public to ask questions and raise issues of concern to them; and
c. public notice of the meeting is provided:
(1) at least 14 days prior to the date of the meeting by posting written notice in the hospital in a conspicuous location that is available to the public, and by publishing the notice in a daily or weekly newspaper of general circulation in the service area of the hospital; and
(2) at least 30 days prior to the date of the meeting by posting notice on the hospital's Internet website.
d. notice of the meeting is provided to the Department of Health and Senior Services at least 30 days prior to the date of the meeting.
a. Pressure ulcers, or bedsores, are a serious public health concern, and elderly persons, who comprise the majority of residents in nursing homes in this State, are most at risk of experiencing pressure ulcers;
b. There are four stages of pressure ulcers, ranging from Stage 1 (skin still intact), to Stage 4 (loss of tissue and exposed muscle, tendon, and bone);
c. Persons with pressure ulcers can experience severe pain, as well as complications from infection;
d. According to 2007 survey data reported by the Centers for Medicare and Medicaid Services, nursing home residents in New Jersey had pressure ulcer rates that were higher than the national overall average. New Jersey ranked fourth highest among all states and the District of Columbia in the percentage of nursing home residents with pressure ulcers and fifth highest in the percentage of nursing home residents with pressure ulcers at the time of admission to the facility; and
e. The use of pressure redistribution mattresses is widely recognized as one of the more effective ways to prevent and treat pressure ulcers.
b. No later than three years after the effective date of this act, a nursing home shall replace all mattresses used by its nursing home residents with pressure redistribution mattresses that are designed to address, at a minimum, Stage 1 pressure ulcers.
"Assisted living facility" means an assisted living residence or comprehensive personal care home licensed pursuant to P.L.1971, c.136 (C.26:2H-1 et seq.);
"Medicaid" means the program established pursuant to P.L.1968, c.413 (C.30:4D-1 et seq.); and
"Medicaid-eligible" means that a person is determined to meet the financial and clinical eligibility standards and has been approved by the Department of Health and Senior Services for participation in a federally approved 1915(c) Medicaid waiver program that provides assisted living services.
b. An assisted living facility licensed pursuant to P.L.1971, c.136 (C.26:2H-1 et al.) shall provide to a prospective private pay resident, the financially responsible party for the prospective resident, or the prospective resident's legal guardian, as appropriate, a written informational sheet, prepared and updated by the Department of Health and Senior Services and the Division of Medical Assistance and Health Services in the Department of Human Services pursuant to section 2 of this act, that explains eligibility for participation in a federally approved 1915(c) Medicaid waiver program that provides assisted living services.
c. The written informational sheet provided to the prospective private pay resident, financially responsible party, or legal guardian, pursuant to subsection b. of this section, shall be accompanied by a written statement, signed by an authorized representative of the assisted living facility stating that:
(1) The assisted living facility is unable to guarantee the availability of a bed for use by a Medicaid-eligible resident, pursuant to P.L.2001, c.234 (C.26:2H-12.16 et seq.) at the assisted living facility at the time that the resident becomes Medicaid-eligible; and
(2) If there is no bed for use by a Medicaid-eligible resident, pursuant to P.L.2001, c.234 (C.26:2H-12.16 et seq.) available at the time the resident becomes Medicaid-eligible, the assisted living facility has the option to transfer the resident to a nursing home or another assisted living facility, as appropriate.
d. If a private pay resident of an assisted living facility, or the resident's financially responsible party, or legal guardian, as appropriate, provides written notice to the assisted living facility that the resident is likely to become Medicaid-eligible within the next six months, the assisted living facility, upon receipt of such notice, shall inform the resident, financially responsible party, or legal guardian, as appropriate, in writing, of the position at the time of the notice of the resident's placement on any list of residents awaiting a bed for use by a Medicaid-eligible resident, pursuant to P.L.2001, c.234 (C.26:2H-12.16 et seq.).
b. The brochure shall describe:
(1) the health benefits to the community from making a bone marrow or PBSC donation through the NMDP;
(2) how to register with the NMDP;
(3) the procedures for making a bone marrow or PBSC donation through the NMDP, including notice that there is no charge to the donor or the donor's family for making the donation;
(4) the circumstances and procedures by which a patient may receive a transfusion of the patient's previously donated blood; and
(5) any other aspects of bone marrow or PBSC donation that the commissioner deems appropriate for the purposes of this act.
c. The commissioner, within the limits of resources available to the Department of Health for this purpose, shall seek to promote awareness among physicians and the general public in this State about the option to become a bone marrow or PBSC donor. In doing so, the commissioner shall consult with at least the following: the Medical Society of New Jersey, the Institute of Medicine and Public Health of New Jersey, the NMDP, and other organizations that are seeking to increase bone marrow and PBSC donation among various ethnic groups within the State in need of these donations.
b. In the event the health care facility does not submit a bill to the beneficiary within 90 days from the date the payment from Medicare or other third party payer is finalized, the health care facility shall not be permitted to report any nonpayment of the bill by the beneficiary to a consumer reporting agency.
c. A health care facility that violates the provisions of this section shall be subject to such penalties as the Commissioner of Health and Senior Services may determine pursuant to sections 13 and 14 of P.L.1971, c.136 (C.26:2H-13 and 26:2H-14).
d. As used in this section:
"Consumer reporting agency" means any person which, for monetary fees, dues, or on a cooperative nonprofit basis, regularly engages, in whole or in part, in the practice of assembling or evaluating consumer credit information or other information on consumers for the purpose of furnishing consumer reports to third parties, and which uses any means or facility for the purpose of preparing or furnishing consumer reports.
b. The facility shall cover any costs necessary to utilize actuarial services as the Department of Health may require to determine the amount to be escrowed pursuant to subsection a. of this section.
c. In the event of a facility bankruptcy, any monies left over after all creditors have been paid shall be used, to the maximum extent practicable, to cover the cost of care provided to a resident in an alternate State-licensed assisted living residence or comprehensive personal care home pursuant to subsection a. of this section.
"Health care facility" means a hospital or other health care facility licensed pursuant to P.L.1971, c.136 (C.26:2H-1 et seq.).
"Surgical technologist" means a person who is authorized to practice surgical technology pursuant to the provisions of this act.
"Surgical technology" means surgical patient care that includes, but is not limited to, the following tasks or functions:
(1) preparing the operating room for surgical procedures by ensuring that surgical equipment is functioning properly and safely;
(2) preparing the operating room and the sterile field for surgical procedures by preparing sterile supplies, instruments, and equipment using sterile technique;
(3) anticipating the needs of the surgical team based on knowledge of human anatomy and pathophysiology and how they relate to the surgical patient and the patient's surgical procedure; and
(4) as directed, performing tasks at the sterile field including:
(a) passing supplies, equipment or instruments;
(b) sponging or suctioning an operative site;
(c) preparing and cutting suture material;
(d) transferring and irrigating with fluids;
(e) transferring and administering drugs within the sterile field, according to applicable law;
(f) handling specimens;
(g) holding retractors and other instruments;
(h) applying electrocautery to clamps on bleeders;
(i) connecting drains to suction apparatus;
(j) applying dressings to closed wounds; and
(k) performing sponge, needle, supply and instrument counts with the registered nurse circulator.
a. has successfully completed a nationally or regionally accredited educational program for surgical technologists; or
b. holds and maintains a certified surgical technologist credential administered by the National Board of Surgical Technology and Surgical Assisting or its successor, or other nationally recognized credentialing organization; or
c. has completed an appropriate training program for surgical technology in the Army, Navy, Air Force, Marine Corps, or Coast Guard of the United States or in the United States Public Health Service Commissioned Corps; or
d. provides evidence that the person was employed to practice surgical technology in a health care facility on the effective date of P.L.2011, c.148 (C.26:2H-12.62 et seq.) or that the person was employed to practice surgical technology in a surgical practice, as defined in subsection g. of section 12 of P.L.1971, c.136 (C.26:2H-12), on the effective date of section 1 of P.L.2017, c.283; or
e. is in the service of the federal government, to the extent that individual is performing surgical technology duties related to that service.
"Public wastewater collection system" means any collection system regulated by the Department of Environmental Protection pursuant to the "Water Pollution Control Act," P.L.1977, c.74 (C.58:10A-1 et seq.), and which system consists of structures which, operating alone or with other structures, result in the collection and conveyance or transmission of wastewater from private, commercial, institutional, or industrial sources, to public wastewater treatment systems for subsequent treatment.
"Septic system" means a system for the disposal of sanitary sewage into the ground, which is designed and constructed to treat sanitary sewage in a manner that will retain most of the settled solids in a septic tank and discharge the liquid effluent to a disposal field.
b. Nothing in this act shall be construed to limit or prohibit a health care facility from lawfully discharging, disposing of, flushing, pouring, or emptying into a public wastewater collection system or a septic system any non-prescription medication or an intravenous solution containing only dextrose, saline, sterile water, or electrolytes, or a combination thereof.
c. Notwithstanding the provisions of subsection a. of this section to the contrary, a health care facility, or any employee, staff person, contractor, or other person under the direction or supervision of the health care facility, may discharge, dispose of, flush, pour, or empty any unused prescription medication into a public wastewater collection system or a septic system if, pursuant to the product insert, product label, product packaging, or prescription:
(1) the dose of prescription medication is to be partially wasted prior to administration of the medication per physician order;
(2) the prescription medication is a controlled substance as defined by federal law, rule or regulation; or
(3) the prescription medication is not deemed hazardous by the United States Environmental Protection Agency or the National Institute of Occupational Safety and Health, in the Centers for Disease Control and Prevention within the United States Department of Health and Human Services.
b. Any health care facility that fails to establish and implement a policy, procedure, plan, or practice for the disposal of unused prescription medications as required pursuant to subsection a. of section 2 of this act shall be liable to a civil administrative penalty of not more than $1,000 for a first violation and not more than $2,500 for each subsequent violation. Any penalty issued pursuant to this section shall be administered in accordance with the provisions of sections 13 and 14 of P.L.1971, c.136 (C.26:2H-13 and C.26:2H-14).
c. The Department of Health and Senior Services is authorized and empowered to compromise and settle any claim for a monetary penalty under this section in such amount in the discretion of the department as may appear appropriate and equitable under all of the circumstances.
b. A general hospital shall establish contingency SCTU transport protocols in the event that the hospital's designated SCTU is not immediately available for dispatch.
c. The Department of Health shall ensure, by means of its periodic inspection of a hospital and such other measures as it deems appropriate, that the hospital has established and implemented the protocols required pursuant to subsections a. and b. of this section.
d. A hospital that fails to comply with the provisions of this act shall be liable to a penalty in accordance with the provisions of sections 13 and 14 of P.L.1971, c.136 (C.26:2H-13 and C.26:2H-14).
a. Many children in the State with limited life expectancies or complex, life-limiting illnesses receive care at pediatric medical day care facilities, but the families of these children remain responsible for the overall care of their children and become overwhelmed because they lack the built-in breaks typically available to most families;
b. Inadequate support services exist to provide respite for families responsible 24 hours per day for children with limited life expectancies or complex, life-limiting illnesses;
c. Community-based, comprehensive, family-centered pediatric respite care facilities established in other states have been shown to enhance the quality of life for children with limited life expectancies or complex, life-limiting illnesses and for their families by providing curative care when possible, pediatric palliative care, respite care, hospice care, and bereavement services, and by addressing their psychological, and spiritual needs; and
d. Similar pediatric respite care facilities should be authorized to operate in this State, and in order to ensure that children and their families receive the best possible support, it is appropriate that these facilities be licensed by the Department of Health.
a. criminal history record background checks of each staff member and administrator of the facility;
b. payment of any reasonable fees for the issuance or renewal of licenses as determined by the commissioner; and
c. documentation of compliance with standards and policies established by the commissioner regarding:
(1) the core services to be provided;
(2) professional personnel requirements;
(3) standards of patient care; and
(4) administration of the facility.
The provisions of this section shall not apply to pediatric long-term care facilities licensed in accordance with N.J.A.C.8:33H-1.5.
"Commissioner" means the Commissioner of Community Affairs;
"Department" means the Department of Community Affairs;
"Distributed Energy Resource" or "DER" means an energy efficient technology, approved by the Energy Resilience Bank, capable of supporting emergency operations in a facility during a prolonged electrical outage;
"Energy Resilience Bank" or "ERB" means the financing initiative administered through a joint collaboration by the New Jersey Board of Public Utilities and the New Jersey Economic Development Authority to provide grant or loan funding to facilities that meet specified requirements established by the ERB to aid in the cost of the installation;
"Facility" means a nursing home or assisted living facility licensed pursuant to P.L.1971 c.136 (C.26:2H-1 et seq.), a comprehensive personal care home, pediatric community transitional home, federally qualified health center, dialysis center, hospice in-patient care, or residential health care facility connected to another licensed facility;
"Generator" means an emergency power generator that is integrated with the electrical system of the facility;
"Generator ready" means equipped with an appropriate electrical transfer switch and wiring to which a portable generator can be connected in order to provide back-up electrical power; and
"Health Care Plan Review Unit" means the Health Care Plan Review Unit, or its successor, in the Department of Community Affairs.
b. Within one year of the effective date of this act, a facility shall:
(1) be equipped with an electrical transfer switch and wiring that complies with applicable standards administered by the Health Care Plan Review Unit and have a signed contract to have a generator delivered to the facility in the event of a power outage that: (a) can be connected to the electrical transfer switch;
(b) provides backup electrical power that meets the requirements of subsection c. of this section; and
(c) complies with applicable standards administered by the Health Care Plan Review Unit; or
(2) have a signed contract to have an on-site generator installed at the facility within three years of the effective date of this act that:
(a) provides backup electrical power that meets the requirements of subsection c. of this section in the event of a power outage; and
(b) complies with applicable standards administered by the Health Care Plan Review Unit.
c. The generator or generator connection shall be capable of supporting the following for a minimum of 48 hours:
(1) critical life support equipment;
(2) refrigeration for medications and at least one refrigerator for perishable food;
(3) lighting for means of egress, exit signs, and exit directional signs as required in the NFPA 101, Life Safety Code, 2012 Edition;
(4) emergency lighting in common areas;
(5) equipment necessary for maintaining back-up communications;
(6) elevator service if required for the relocation of patients or residents within the facility or evacuation from the facility;
(7) a fire pump, well pump, or sump pump, if installed;
(8) a sewerage pump, if installed;
(9) fire, smoke and other safety detection alarm systems; and
(10) emergency lighting and power required for the generator at the generator connection point.
d. If the generator or generator connection does not provide sufficient lighting, heating, cooling and duplex receptacles to provide required services in individual sleeping rooms occupied by a patient or resident, it shall support:
(1) sufficient duplex receptacles to provide required services in common areas used to shelter patients or residents in place; and
(2) equipment to provide sufficient heating and cooling in common areas used to shelter patients or residents in place; or
(3) sufficient heating and cooling in common areas adjacent to patient or resident rooms along with sufficient duplex receptacles in patient or resident rooms to shelter in place and provide required services to patients or residents.
e. The facility shall obtain the review and approval of the Health Care Plan Review Unit for the installation of the contracted-for transfer switch and generator.
f. A facility that elects to proceed with an on-site generator shall have the on-site generator:
(1) checked weekly;
(2) tested under load monthly; and
(3) serviced in accordance with manufacturer instructions.
The facility shall maintain a log of the testing and service required by this subsection and shall provide the log to the department upon request.
g. The commissioner or his or her designee may waive the transfer switch or on-site generator requirement if, in his or her opinion, such waiver would not endanger the life, safety, or health of residents, patients or the public and the following conditions are met:
(1) the facility seeking a waiver has applied in writing to the department's Division of Certificate of Need and Licensing with the following information:
(a) a statement from the facility indicating that it has applied for an ERB grant or loan for the installation of a DER energy source and the estimated date that ERB will issue a determination approving or denying the application, or written assurance from the facility of alternative means of financing the DER energy source;
(b) a statement describing the DER energy source, the facility equipment and services the DER energy source can support, and the duration of time that the equipment and services will be supported; and
(c) if the facility is seeking an ERB grant or loan, a copy of the completed application submitted to the ERB.
(2) the facility shall supplement the waiver application by submitting a copy of:
(a) the ERB's determination letter to the department's Division of Certificate of Need and Licensing upon the facility's receipt thereof; or
(b) written confirmation of alternative means of financing.
h. The commissioner or his or her designee may request additional information before processing the request for a waiver.
i. If the commissioner or his or her designee denies a DER waiver application, the facility shall comply with the transfer switch or on-site generator requirement within one year from the date of the denial of the DER waiver.
j. A waiver request submitted for reasons other than installation of a DER energy source shall comply with N.J.A.C. 8:43E-5.6.
b. A hospital that establishes a hospital and physician incentive plan shall contract, directly or indirectly, with an independent third party to administer the plan, including applying the plan's incentive methodology and calculating direct payments of incentives from the hospital to physicians, which shall be based on the physician's performance in meeting the hospital's institutional and specialty-specific goals as determined using an incentive payment methodology that meets the requirements set forth in section 4 of this act.
c. A hospital that establishes a hospital and physician incentive plan shall establish a hospital steering committee, which shall meet the requirements set forth in section 4 of this act.
d. If a hospital and physician incentive plan includes multiple hospital participants, the plan shall utilize a facilitator-convener to provide for efficient implementation and operation of the plan. For each hospital, the facilitator-convener shall coordinate with the independent third party administering the plan and with the hospital steering committee to facilitate plan administration, disseminate information concerning best practices, and serve as the point of contact for the Department of Health.
b. (1) A hospital and physician incentive plan shall be filed with the Department of Health by the hospital or facilitator-convener prior to the anticipated start date of the plan. The plan shall set forth the physician incentive methodology, institutional and specialty-specific goals, quality and cost performance standards, and any standards, programs, or protocols designed to ensure the plan meets the requirements of this act. Hospitals that have implemented a hospital and physician incentive plan shall submit an annual report to the department setting forth the distributions made to physicians, quality and cost performance standards, proposed revisions to the plan, if any, and such other information as the department may require.
(2) The department shall review plans submitted pursuant to paragraph (1) of this subsection, and shall notify the hospital if its plan does not meet the requirements of this act. The department shall provide the hospital with a reasonable opportunity to remedy any deficiencies in the plan, and may terminate a plan that continues to fail to meet the requirements of this act.
c. (1) A participating physician may withdraw from a plan upon reasonable notice to the hospital.
(2) A hospital may terminate a plan upon reasonable notice to the department and to physicians participating in the plan.
d. Patients shall be notified of the hospital and physician incentive plan in advance of admission to the hospital.
(1) no payments may be made for reducing or limiting medically necessary care;
(2) the appropriate course of treatment for each patient is determined, in consultation with the patient or the patient's representative, by the attending physician or surgeon of record;
(3) adequate safeguards are in place to ensure that there are no incentives to avoid difficult or complex medical cases, or to withhold, reduce, or limit quality care;
(4) no incentive payment may be made in any individual case for exceeding best practice standards established under the plan; and
(5) overall payments to individual physicians under a plan shall not exceed 50 percent of the total professional payments for services related to the cases for which that physician receives incentive payments under the plan.
b. The steering committee shall establish an incentive payment methodology, which shall be internally consistent and shall ensure that:
(1) individual physician performance is objectively measured, taking into account the severity of the medical issues presented by an individual patient;
(2) incentive payments objectively correlate with physician performance and are applied in a consistent manner to all physicians participating in the plan;
(3) participating physicians are treated uniformly relative to their respective individual contributions to institutional efficiency and quality of patient care;
(4) performance and best practice standards established under the plan are based primarily on local and regional data;
(5) the methodology recognizes both individual physician performance, including a physician's utilization of inpatient resources compared to the physician's peers, and improvements in individual physician performance, including a physician's utilization of inpatient resources compared with the physician's own performance over time; and
(6) the elements of the methodology are properly balanced to meet the needs of physicians, hospitals, and patients.
c. The steering committee shall adopt a mechanism to protect the financial health of the hospital.
d. At least half of the members of the steering committee shall be physicians.
b. The department shall have authority to terminate a hospital and physician incentive plan if the department's review finds that the hospital and physician incentive plan fails to comply with State or federal law, or if it results in a degradation of quality of patient care.
c. A hospital and physician incentive plan shall not expire or otherwise be terminated solely as a result of the department's failure to conduct a review required pursuant to subsection a. of this section.
b. (1) Any licensed health care facility that provides primary health care services and behavioral health care services in the same shared clinical space, pursuant to the provisions of subsection a. of this section, shall: (a) continue to comply with the department's health care facility licensing requirements, as set forth in P.L.1971, c.136 (C.26:2H-1 et seq.) and the regulations adopted thereunder; (b) be appropriately licensed by the Department of Human Services as a mental health or substance use disorder service provider; and (c) comply with all applicable regulatory requirements, adopted by the Department of Human Services, which govern the operation of mental health or substance use disorder treatment facilities, as appropriate. Such a health care facility shall submit to the department, a copy of any license obtained from the Department of Human Services, which authorizes the facility to provide behavioral health care services.
(2) When applying for an initial license from the Department of Human Services, pursuant to the requirements of paragraph (1) of this subsection, a health care facility shall include the following information in the license application:
(a) a copy of any Medicaid "Change in Scope of Service" reporting forms that have been prepared in association with the facility's provision of behavioral health care services;
(b) a written statement attesting that the applicant is the exact same legal entity that holds the health care facility license issued by the department pursuant to P.L.1971, c.136 (C.26:2H-1 et seq.); and
(c) a written statement indicating whether the license applicant is or is not planning to make any changes to the physical plant to accommodate the provision of behavioral health care services, and, if any physical plant changes are planned, a copy of the letter received from the department approving and authorizing the changes, or indicating that such department approval is not required.
(3) If a licensed health care facility, as of the effective date of this act, has already obtained a license from the Department of Human Services authorizing the facility's provision of behavioral health care services, the facility shall submit the information required by paragraph (2) of this subsection on the date that it is next required to file an application for license renewal with the Department of Human Services.
c. As used in this section:
"Behavioral health care" and "behavioral health care services" mean procedures or services, other than primary health care services, which are provided by a health care practitioner to a patient for the treatment of a mental illness, emotional disorder, or drug or alcohol use disorder that is of mild to moderate severity. "Behavioral health care" and "behavioral health care services" shall not include procedures or services that are provided for the treatment of severe mental illness, severe emotional disorder, or severe drug or alcohol use disorder.
"Health care facility" means the same as that term is defined by section 2 of P.L.1971, c.136 (C.26:2H-2).
"Primary health care" and "primary health care services" mean preventative, diagnostic, treatment, management, or reassessment services, which are provided in a family-centered and community oriented manner to an individual with acute or chronic illness: (1) in the areas of family practice, general internal medicine, general pediatrics, general obstetrics, gynecology, or clinical prevention; (2) at the time of the individual's initial point of contact with the health care system; and (3) by a health care practitioner who, regardless of the presence or absence of disease, has assumed responsibility for the individual and has an ongoing responsibility to coordinate the individual's medical care. "Primary health care services" includes sick or well care that is provided to any and all age groups, from perinatal and pediatric care to geriatric care.
b. A policy adopted pursuant to subsection a. of this section shall, at a minimum:
(1) require the person receiving behavioral health care services be a qualifying patient authorized for the use of medical cannabis pursuant to P.L.2009, c.307 (C.24:6I-1 et al.), and that the parent, guardian, or designated caregiver be authorized to assist the person with the medical use of cannabis pursuant to P.L.2009, c.307 (C.24:6I-1 et al.);
(2) establish protocols for verifying the registration status and ongoing authorization pursuant to P.L.2009, c.307 (C.24:6I-1 et al.) concerning the medical use of cannabis for the person and the parent, guardian, or designated caregiver;
(3) expressly authorize parents, guardians, and designated caregivers to administer medical cannabis to the person receiving behavioral health care services while the person is at the facility; and
(4) identify locations at the facility where medical cannabis may be administered.
c. Medical cannabis may be administered to a person receiving behavioral health care services at a facility that offers such services while the person is at the facility, provided that such administration is consistent with the requirements of the policy adopted pursuant to this section and the provisions of P.L.2009, c.307 (C.24:6I-1 et al.).
d. Nothing in this section shall be construed to authorize medical cannabis to be smoked in any place where smoking is prohibited pursuant to N.J.S.2C:33-13.
e. As used in this section, "behavioral health care services" means procedures or services provided by a health care practitioner to a patient for the treatment of a mental illness or emotional disorder that is of mild to moderate severity. "Behavioral health care" and "behavioral health care services" shall not include procedures or services that are provided for the treatment of severe mental illness, severe emotional disorder, or any drug or alcohol use disorder.
"Cohorting" means the practice of grouping patients who are or are not colonized or infected with the same organism to confine their care to one area and prevent contact with other patients.
"Department" means the Department of Health.
"Endemic level" means the usual level of given disease in a geographic area.
"Isolating" means the process of separating sick, contagious persons from those who are not sick.
"Long-term care facility" means a nursing home, licensed pursuant to P.L.1971, c.136 (C.26:2H-1 et seq.).
"Outbreak" means any unusual occurrence of disease or any disease above background or endemic levels.
b. Notwithstanding any provision of law to the contrary, as a condition of licensure, the department shall require long-term care facilities to develop an outbreak response plan within 180 days after the effective date of this act, which plan shall be customized to the facility, based upon national standards and developed in consultation with the facility's infection prevention and control committee. At a minimum, each facility's plan shall include, but shall not be limited to:
(1) a protocol for isolating and cohorting infected and at-risk residents in the event of an outbreak of a contagious disease until the cessation of the outbreak;
(2) clear policies for the notification of residents, residents' families, visitors, and staff in the event of an outbreak of a contagious disease at a facility;
(3) information on the availability of laboratory testing, protocols for assessing whether facility visitors are ill, protocols to require ill staff to not present at the facility for work duties, and processes for implementing evidence-based outbreak response measures;
(4) policies to conduct routine monitoring of residents and staff to quickly identify signs of a communicable disease that could develop into an outbreak;
(5) policies for reporting outbreaks to public health officials in accordance with applicable laws and regulations; and
(6) a documented strategy for securing more staff in the event of an outbreak of infectious disease among staff or another emergent or non-emergent situation affecting staffing levels at the facility during an outbreak of an infectious disease.
c. (1) In addition to the requirements set forth in subsection b. of this section, the department shall require long-term care facilities to include in the facility's outbreak response plan written policies to meet staffing, training, and facility demands during an infectious disease outbreak to successfully implement the outbreak response plan, including employing the following individuals:
(a) an individual who meets the requirements of subparagraph (b) of paragraph (1) of subsection e. of this section; and
(b) a physician who meets the requirements of subparagraph (a) of paragraph (1) of subsection e. of this section.
(2) Each nursing home that has not previously submitted an outbreak response plan to the department shall submit an outbreak response plan to the department for verification as provided in paragraph (3) of this subsection.
(3) The department shall verify that the outbreak response plans submitted by nursing homes are in compliance with the requirements of subsection b. of this section and with the requirements of paragraph (1) of this subsection.
(4) The department shall have the authority to require any long-term care facility to revise its outbreak response plan as needed to come into compliance with the requirements of subsection b. of this section and the requirements of paragraph (1) of this subsection. The department may assess civil penalties or take other administrative actions against a facility in the event the department determines the facility is not in compliance with the requirements of this section.
(5) Each long term-care facility shall perform an annual training exercise to ensure its outbreak response plan is practical, comprehensive, and ensures the safety and well-being of residents and staff. The annual training exercise shall include, but shall not be limited to, coordinating with emergency medical services, hospitals, and fire and police departments. Each long-term care facility shall record a summary of the effectiveness of the training exercise and any need for future modifications to the training exercise.
d. (1) Each long-term care facility shall review and, if necessary, update its outbreak response plan on an annual basis.
(2) If a nursing home makes any material changes to its outbreak response plan, the nursing home shall, within 30 days after completing the material change, submit to the department an updated outbreak response plan. The department shall, upon receiving an updated outbreak response plan, verify that the plan is compliant with the requirements of subsections b. and c. of this section.
e. (1) The department shall require each long-term care facility to establish an infection prevention and control committee and assign to the facility's infection prevention and control committee:
(a) a physician who has completed an infectious disease fellowship, who shall be employed on a full-time or part time basis or contracted with on a consultative basis; and
(b) an individual designated as the infection preventionist who;
(i) has primary professional training in medicine, nursing, medical technology, microbiology, epidemiology, or a related field;
(ii) is qualified by education, training, and at least five years of infection control experience, or by certification in infection control by the Certification Board of Infection Control and Epidemiology;
(iii) is employed by the facility consistent with the requirements of subsection f. of this section; and
(iv) has completed specialized training in infection prevention and control.
(2) The infection prevention and control committee shall meet on at least a quarterly basis. The physician assigned to the committee pursuant to this subsection shall attend at least half of the meetings held by the infection prevention and control committee, and the infection preventionist assigned to the committee pursuant to this subsection shall attend all of the meetings held by the infection prevention and control committee.
f. (1) An infection preventionist assigned to a long-term care facility's infection prevention and control committee pursuant to subsection e. of this section shall be a managerial employee and shall be employed:
(a) in the case of a long-term care facility with a licensed bed capacity equal to 100 or fewer beds, on at least a part time basis; and
(b) in the case of a long-term care facility with a licensed bed capacity equal to more than 100 beds or that provides on-site hemodialysis services, on a full-time basis.
(2) The infection preventionist shall report directly to the administrator of the long-term care facility and shall provide the administrator quarterly reports detailing the effectiveness of the long-term care facility's infection prevention policies.
(3) The infection preventionist shall be responsible for:
(a) contributing to the development of policies, procedures, and a training curriculum for long-term care facility staff based on best practices and clinical expertise;
(b) monitoring the implementation of infection prevention and control policies and recommending disciplinary measures for staff who routinely violate those policies; and
(c) assessing the facility's infection prevention and control program by conducting internal quality improvement audits.
(4) A long-term facility that is unable to hire an infection preventionist on a full-time or part-time basis may contract with an infection preventionist on a consultative basis until February 1, 2022. A long-term care facility shall provide notice to the Department of Health, within 60 days after the effective date of P.L.2021, c.190 (C.26:2H-87.3 et al.), if the facility is unable to hire an infection preventionist on a full-time or part-time basis and if the facility has contracted with an infection preventionist on a consultative basis. A long-term care facility shall hire an infection preventionist on a full-time or part-time basis after February 1, 2022, except that the Department of Health may waive this requirement if a long-term care facility is unable to hire an infection preventionist folllowing the facility's good faith efforts to hire an infection preventionist.
g. Each long-term care facility shall publish the facility's outbreak response plan on its Internet website if the facility maintains an Internet website, distribute copies of the plan to residents and their families upon admission to the facility, and provide notice to residents and their families any time the facility makes material changes to its plan. Each long-term care facility shall make its outbreak response plan available upon request if the facility does not maintain an Internet website.
h. Each long-term care facility shall annually perform preparedness drills to evaluate the effectiveness of its outbreak response plan.
(1) a count of the total number of single-resident rooms in nursing homes, a determination as to what percentage of the total number of authorized nursing home beds in New Jersey are utilized in single-resident rooms, and a review of the ability of nursing homes to convert multiple-resident rooms to single-resident rooms or otherwise expand the number of single-resident rooms;
(2) a survey of the maintenance status of heating, ventilating, air conditioning, and refrigeration systems in nursing homes;
(3) a study of the utilization of negative pressure rooms and other physical plant features that are designed or may be implemented to increase infection control and prevention capability in nursing homes; and
(4) any other infrastructure-related infection control or prevention considerations as are recommended for assessment by the New Jersey Task Force on Long-Term Care Quality and Safety established pursuant to P.L.2020, c.88. No later than 30 days after the effective date of this act, the Department of Health shall request that the New Jersey Task Force on Long-Term Care Quality and Safety provide the department with recommendations for infrastructure-related infection control and prevention considerations to be assessed pursuant to this section, which recommendations shall be provided by the task force to the department no later than 30 days after the date of the request.
b. The assessment required under subsection a. of this section shall be completed no later than one year after the effective date of this act.
c. No later than 180 days after completing the assessment required pursuant to subsection a. of this section, the department shall develop a Statewide nursing home infection control and prevention infrastructure improvement plan, which plan shall:
(1) establish standards and requirements for improvements to the infrastructure in nursing homes to improve infection control and prevention and to ensure the nursing homes are primarily focused on resident safety and the quality of services provided to residents;
(2) establish a long-term strategy to redesign the nursing home industry in New Jersey to ensure the system is primarily focused on resident safety and the quality of services provided to residents, which strategy shall include design and construction standards for new facilities and facilities undergoing significant modifications;
(3) review and seek to incorporate best practice standards in place in other states; and
(4) establish specific goals and timelines for improvements, which shall take into account the age of the facilities, the availability of land for expansion or new construction, the costs of improvements, and the authorizations that would be required.
In developing the Statewide nursing home infection control and prevention infrastructure improvement plan pursuant to this subsection, the department shall consult with representatives from the nursing home industry, including representatives from for-profit and non-profit facilities, groups representing nursing home workers, including both direct care providers and support staff, resident advocates, and the families of residents.
"Assisted living facility" means an assisted living residence licensed pursuant to P.L.1971, c.136 (C.26:2H-1 et seq.).
"Cohorting" means the practice of grouping patients who are or are not colonized or infected with the same organism to confine their care to one area and prevent contact with other patients.
"Comprehensive personal care home " means a comprehensive personal care home licensed pursuant to P.L.1971, c.136 (C.26:2H-1 et seq.).
"Dementia care home" means a dementia care home licensed pursuant to P.L.1971, c.136 (C.26:2H-1 et seq.).
"Department" means the Department of Health.
"Endemic level" means the usual level of given disease in a geographic area.
"Facility" means an assisted living facility, a comprehensive personal care home, a dementia care home, or a residential health care facility.
"Isolating" means the process of separating sick, contagious persons from those who are not sick.
"Outbreak" means any unusual occurrence of disease or any disease above background or endemic levels.
"Residential health care facility" means a residential health care facility licensed pursuant to P.L.1971, c.136 (C.26:2H-1 et seq.).
b. Notwithstanding any provision of law to the contrary, as a condition of licensure, the department shall require facilities to develop an outbreak response plan within 180 days after the effective date of this act, which plan shall be customized to the facility, based upon national standards and developed in consultation with the facility's infection prevention and control committee. At a minimum, each facility's plan shall include, but shall not be limited to:
(1) a protocol for isolating and cohorting infected and at-risk residents in the event of an outbreak of a contagious disease until the cessation of the outbreak;
(2) clear policies for the notification of residents, residents' families, visitors, and staff in the event of an outbreak of a contagious disease at a facility;
(3) information on the availability of laboratory testing, protocols for assessing whether facility visitors are ill, protocols to require ill staff to not present at the facility for work duties, and processes for implementing evidence-based outbreak response measures;
(4) policies to conduct routine monitoring of residents and staff to quickly identify signs of a communicable disease that could develop into an outbreak;
(5) policies for reporting outbreaks to public health officials in accordance with applicable laws and regulations; and
(6) a documented strategy for securing more staff in the event of an outbreak of infectious disease among staff or another emergent or non-emergent situation affecting staffing levels at the facility during an outbreak of an infectious disease.
c. (1) In addition to the requirements set forth in subsection b. of this section, the department shall require a facility to include in the facility's outbreak response plan written policies to meet staffing, training, and facility demands during an infectious disease outbreak to successfully implement the outbreak response plan, including employing an individual who meets the requirements of paragraph (1) of subsection e. of this section.
(2) Each facility that has not previously submitted an outbreak response plan to the department shall submit an outbreak response plan to the department for verification as provided in paragraph (3) of this subsection.
(3) The department shall verify that the outbreak response plans submitted by facilities are in compliance with the requirements of subsection b. of this section and with the requirements of paragraph (1) of this subsection.
(4) The department shall have the authority to require any facility to revise its outbreak response plan as needed to come into compliance with the requirements of subsection b. of this section and the requirements of paragraph (1) of this subsection. The department may assess civil penalties or take other administrative actions against a facility in the event the department determines the facility is not in compliance with the requirements of this section.
d. (1) Each facility shall review and, if necessary, update its outbreak response plan on an annual basis.
(2) If a facility makes any material changes to its outbreak response plan, the facility shall, within 30 days after completing the material change, submit to the department an updated outbreak response plan. The department shall, upon receiving an updated outbreak response plan, verify that the plan is compliant with the requirements of subsections b. and c. of this section.
e. (1) The department shall require each facility to establish an infection prevention and control committee and assign to the facility's infection prevention and control committee an individual designated as the infection preventionist who is a licensed health care provider and who possesses five years of experience in infection control, or an individual who has successfully completed an online infection prevention course through the federal Centers for Disease Control and Prevention or the American Health Care Association course with a valid certificate therefrom.
(2) The infection prevention and control committee shall meet on at least a quarterly basis. The infection preventionist assigned to the committee pursuant to this subsection shall attend all of the meetings held by the infection prevention and control committee.
f. (1) An infection preventionist assigned to a facility's infection prevention and control committee pursuant to subsection e. of this section shall be a managerial employee and:
(a) in the case of a facility with multiple locations, the facility shall be permitted to employ one full-time infection preventionist who shall be responsible for up to five locations; and
(b) in the case of a facility located in the same building or on the same property as a nursing home or a facility that is located within a continuing care retirement community, the facility shall be permitted to hire one full-time infection control preventionist who will be responsible for the facilityand the nursing home or for the facility and the continuing care retirement community.
(2) The infection preventionist shall report directly to the administrator of the facility and shall provide the administrator quarterly reports detailing the effectiveness of the facility's infection prevention policies.
(3) The infection preventionist shall be responsible for:
(a) contributing to the development of policies, procedures, and a training curriculum for facility staff based on best practices and clinical expertise;
(b) monitoring the implementation of infection prevention and control policies and recommending disciplinary measures for staff who routinely violate those policies;
(c) assessing the facility's infection prevention and control program by conducting internal quality improvement audits;
(d) directly training all employees in infection prevention at such intervals as determined by the department.
(4) A facility that is unable to hire an infection preventionist on a full-time or part-time basis may contract with an infection preventionist on a consultative basis until February 1, 2022. A facility shall provide notice to the Department of Health, within 60 days after the effective date of P.L.2021, c.190 (C.26:2H-87.3 et al.), if the facility is unable to hire an infection preventionist on a full-time or part-time basis and if the facility has contracted with an infection preventionist on a consultative basis. A facility shall hire an infection preventionist on a full-time or part-time basis after February 1, 2022, except that the Department of Health may waive this requirement if a facility is unable to hire an infection preventionist following the facility's good faith efforts to hire an infection preventionist.
g. Each facility shall publish the facility's outbreak response plan on its Internet website if the facility maintains an Internet website, distribute copies of the plan to residents and their families upon admission to the facility, and provide notice to residents and their families any time the facility makes material changes to its plan. Each facility shall make its outbreak response plan available upon request if the facility does not maintain an Internet website.
h. Each facility shall annually perform preparedness drills to evaluate the effectiveness of its outbreak response plan.
i. Each facility shall designate employees who receive special training in infection control and who shall be representative of the facility's staff, including certified nurse aides, licensed practical nurses, and registered nurses. Such employees shall assist training staff, distribute infection control information, assist with infection control implementation and policy development, and participate in quarterly infection control training exercises to maintain competency in using personal protection equipment.
b. The Department of Health shall have primary responsibility for the operations of the LTCEOC, but the Department of Human Services and other appropriate State agencies shall provide any staff support as shall be requested by the Commissioner of Health. The Commissioner of Health may additionally contract with a third party entity to provide staffing services as needed. At a minimum, the Commissioner of Health shall ensure that the LTCEOC has on call at all times such appropriate staff and consultants as are needed to respond to a declared public health emergency affecting or likely to affect one or more long-term care facilities, including representatives from county and local boards of health, the Office of the New Jersey Long-Term Care Ombudsman, and the Office of Emergency Management in the New Jersey State Police, the acute and post-acute health care industry, as well as experts in public health, infection control, elder affairs, disability services, emergency response, and medical transportation.
c. The primary responsibilities of the LTCEOC shall include, but shall not be limited to:
(1) establishing ongoing, direct communication with the owners and staff of long-term care facilities, unions, advocates representing residents of long-term care facilities and their families, individuals with expertise in the needs of people with specialized health care needs, and such other stakeholders as the Commissioner of Health deems necessary and appropriate during a public health emergency affecting or likely to affect one or more long-term care facilities, which may include the use of existing communication mechanisms and feedback loops in the Department of Health's Office of Disaster Resilience or Health Systems branch, as appropriate;
(2) providing technical assistance to the long-term care industry during the public health emergency, which may be facilitated through local health departments;
(3) ensuring supplies and equipment needed to respond to the public health emergency are acquired and distributed in an effective and efficient manner among long-term care facilities;
(4) utilizing the National Healthcare Safety Network database managed by the federal Centers for Disease Control and Prevention to:
(a) identify and respond to critical staffing shortages in long-term care facilities;
(b) if applicable, identify and respond to critical personal protective equipment or ventilator shortages in long-term care facilities;
(c) monitor facility capacity; and
(d) if applicable, monitor infectious disease case counts and deaths by facility; and
(5) ensuring all policies and guidance developed by the Department of Health in response to the public health emergency are effectively communicated to all long-term care industry stakeholders.
d. In the event of a public health emergency declared in response to an infectious disease outbreak, epidemic, or pandemic affecting or likely to affect one or more long-term care facilities, the LTCEOC, in consultation with other offices within the Department of Health and the Office of Emergency Management in the New Jersey Division of State Police, shall determine the need for the establishment of regional hubs capable of accepting patients who have, and are capable of transmitting, the infectious disease and who do not require hospitalization, which hubs shall comply with State and federal guidance regarding infection control practices related to the infectious disease. In the event of a surge in number of identified cases of the infectious disease, the LTCEOC shall actively monitor capacity levels at long-term care facilities and at regional hubs established pursuant to this subsection, if any, using the National Healthcare Safety Network database managed by the federal Centers for Disease Control and Prevention, and shall take steps to direct patient placements as necessary to manage capacity levels and ensure, to the extent possible, that no regional hub or long-term care facility exceeds safe capacity levels.
e. As used in sections 1 through 5 of P.L.2020, c.87 (C.26:2H-12.90 through C.26:2H-12.94), "infectious disease" means a disease caused by a living organism or other pathogen, including a fungus, bacteria, parasite, protozoan, virus, or prion. An infectious disease may, or may not, be transmissible from person to person, animal to person, or insect to person.
b. The department shall identify appropriate sources of State, federal, and private funding to facilitate the implementation of this section, including, but not limited to, any funding or other support as may be available through the Federal Emergency Management Agency.
(1) separate residents who test positive for or who are suspected of having contracted the infectious disease from those who have not tested positive for, and are not suspected of having contracted, the infectious disease;
(2) follow guidance issued by the federal Centers for Disease Control and Prevention or other appropriate entities as may be identified by the Commissioner of Health with regard to determining whether a resident who has contracted the infectious disease is recovered from the infectious disease, and the appropriate procedures and protocols for interactions between those residents and staff and other residents at the facility; and
(3) comply with current orders, guidance, and directives concerning admissions and readmissions to the facility.
b. The Department of Health shall establish a mechanism by which hospitals can identify long-term care facilities that are currently accepting admissions and readmissions of residents to the facility.
(1) counts of residents and facility personnel with suspected cases of the infectious disease and who have a laboratory test confirming infection with the infectious disease;
(2) counts of residents and facility personnel whose death is suspected to have been, or was confirmed by laboratory test to have been, caused by the infectious disease;
(3) the total number of authorized resident beds and the current resident census;
(4) staffing shortages;
(5) the quantity of personal protective equipment, hand hygiene supplies, cleaning supplies, and sanitization supplies, along with an assessment of the number of days that will be supported by current inventory;
(6) for facilities with ventilator-dependent units, ventilator capacity and the quantity of ventilator supplies, along with an assessment of the number of days that will be supported by current inventory; and
(7) any other metrics as the Commissioner of Health shall require as an essential or relevant component of the State's response to the infectious disease outbreak, epidemic, or pandemic in long-term care facilities.
b. To facilitate the enforcement of P.L.2019, c.330 (C.26:2H-18.79), commencing with the onset of influenza season each year and for the duration of that influenza season, each long-term care facility and home health employer in the State shall report to the National Healthcare Safety Network database managed by the federal Centers for Disease Control and Prevention the number of employees who have received the influenza vaccination, the number of employees who have not received the influenza vaccination due to an authorized medical exemption, and the number of employees who have not received the influenza vaccination who do not have a valid medical exemption.
c. A long-term care facility that fails to submit a report required pursuant to subsection a. or subsection b. of this section shall be liable to a civil penalty of $2,000 for each report that is not submitted. A civil penalty assessed pursuant to this section shall be collected by and in the name of the Department of Health in summary proceedings before a court of competent jurisdiction pursuant to the provisions of the "Penalty Enforcement Law of 1999," P.L.1999, c.274 (C.2A:58-10 et seq.).
b. Subject to the availability of funding for this purpose, the Department of Health shall make grants available to long-term care facilities to provide assistance in implementing or upgrading to an electronic health record system that meets the requirements of subsection a. of this section, which grants shall be distributed to long-term care facilities based on demonstrated need.
"Cohorting" means the same as that term is defined by section 1 of P.L.2019, c.243 (C.26:2H-12.87). "Commissioner" means the Commissioner of Health.
"Department" means the Department of Health.
"Long-term care facility" or "facility" means a nursing home, assisted living facility, comprehensive personal care home, residential health care facility, or dementia care home licensed pursuant to P.L.1971, c.136 (C.26:2H-1 et seq.).
"Religious and recreational activities" includes any religious, social, or recreational activity that is consistent with the resident's preferences and choosing, regardless of whether the activity is coordinated, offered, provided, or sponsored by facility staff or by an outside activities provider.
"Resident" means a senior citizen or other person who resides in a long-term care facility.
"Social isolation" means a state of isolation wherein a resident of a long-term care facility is unable to engage in social interactions and religious and recreational activities with other facility residents or with family members, friends, and external support systems.
b. The social isolation prevention policies adopted by each long-term care facility pursuant to this section shall:
(1) authorize, and include specific protocols and procedures to encourage and enable, residents of the facility to engage in in-person contact, communications, and religious and recreational activities with other facility residents and with family members, friends, and other external support systems, except when such in-person contact, communication, or activities are prohibited, restricted, or limited, as permitted by federal and State statute, rule, or regulation;
(2) authorize, and include specific protocols and procedures to encourage and enable, residents to engage in face-to-face or verbal/auditory-based contact, communication, and religious and recreational activities with other facility residents and with family members, friends, and other external support systems, through the use of electronic or virtual means and methods, including, but not limited to, computer technology, the Internet, social media, videoconferencing, and other innovative technological means or methods, whenever such residents are subject to restrictions that limit their ability to engage in in-person contact, communications, or religious and recreational activities as authorized by paragraph (1) of this subsection;
(3) provide for residents of the facility who have disabilities that impede their ability to communicate, including, but not limited to, residents who are blind, deaf, or deaf-blind, residents who have Alzheimer's disease or other related dementias, and residents who have developmental disabilities, to be given access to assistive and supportive technology as may be necessary to facilitate the residents' engagement in face-to-face or verbal/auditory-based contact, communications, and religious and recreational activities with other residents, family members, friends, and other external support systems, through electronic means, as provided by paragraph (2) of this subsection;
(4) include specific administrative policies, procedures, and protocols governing: (a) the acquisition, maintenance, and replacement of computers, videoconferencing equipment, distance-based communications technology, assistive and supportive technology and devices, and other technological equipment, accessories, and electronic licenses, as may be necessary to ensure that residents are able to engage in face-to-face or verbal/auditory-based contact, communications, and religious and recreational activities with other facility residents and with family members, friends, and external support systems, through electronic means, in accordance with the provisions of paragraphs (2) and (3) of this subsection; (b) the use of environmental barriers and other controls when the equipment and devices acquired pursuant to this section are in use, especially in cases where the equipment or devices are likely to become contaminated with bodily substances, are touched frequently with gloved or ungloved hands, or are difficult to clean; and (c) the regular cleaning of the equipment and devices acquired pursuant to this paragraph and any environmental barriers or other physical controls used in association therewith;
(5) require appropriate staff to assess and regularly reassess the individual needs and preferences of facility residents with respect to the residents' participation in social interactions and religious and recreational activities, and include specific protocols and procedures to ensure that the quantity of devices and equipment maintained on-site at the facility remains sufficient, at all times, to meet the assessed social and activities needs and preferences of each facility resident;
(6) require appropriate staff, upon the request of a resident or the resident's family members or guardian, to develop an individualized visitation plan for the resident, which plan shall: (a) identify the assessed needs and preferences of the resident and any preferences specified by the resident's family members; (b) address the need for a visitation schedule, and establish a visitation schedule if deemed to be appropriate; (c) describe the location and modalities to be used in visitation; and (d) describe the respective responsibilities of staff, visitors, and the resident when engaging in visitation pursuant to the individualized visitation plan;
(7) include specific policies, protocols, and procedures governing a resident's requisition, use, and return of devices and equipment maintained pursuant to this act, and require appropriate staff to communicate those policies, protocols, and procedures to residents; and
(8) designate at least one member of the therapeutic recreation or activities department, or, if the facility does not have such a department, designate at least one senior staff member, as determined by facility management, to train other appropriate facility employees, including, but not limited to, activities professionals and volunteers, social workers, occupational therapists, and therapy assistants, to provide direct assistance to residents, upon request and on an as-needed basis, as necessary to ensure that each resident is able to successfully access and use, for the purposes specified in paragraphs (2) and (3) of this subsection, the technology, devices, and equipment acquired pursuant to this paragraph.
c. The department shall distribute civil monetary penalty (CMP) funds, as approved by the federal Centers for Medicare and Medicaid Services, and any other available federal and State funds, upon request, to facilities for communicative technologies and accessories needed for the purposes of this act.
b. In addition to any other applicable penalties provided by law, a long-term care facility that fails to comply with the provisions of this act or properly implement the policies, protocols, and procedures adopted pursuant thereto:
(1) shall be liable to pay an administrative penalty, the amount of which shall be determined in accordance with a schedule established by department regulation, which schedule shall provide for an enhanced administrative penalty in the case of a repeat or ongoing violation; and
(2) may be subject to adverse licensure action, as deemed by the department to be appropriate.
c. Whenever a complaint received or an investigation conducted by the Office of the State Long-Term Care Ombudsman discloses evidence that a long-term care facility has failed to comply with the provisions of this act or to properly implement the policies, protocols, and procedures adopted pursuant thereto, the Office of the State Long-Term Care Ombudsman shall refer the matter to the department as provided by section 7 of P.L.1977, c.239 (C.52:27G-7) and, notwithstanding such referral, may take any other appropriate investigatory or enforcement action, with respect to the matter, as may be authorized by P.L.1977, c.239 (C.52:27G-1 et seq.).
(1) In the case of a facility that is part of a system that owns or operates eight or more facilities, 30 days;
(2) In the case of a facility that is part of a system that owns or operates fewer than eight facilities, 60 days; and
For the purposes of meeting the requirements of this subsection, a facility that is not part of a system or that is part of a system that owns or operates fewer than eight facilities may enter into a collaborative agreement with other facilities or with one or more systems, which collaborative agreement shall be deemed to render the facility part of a system comprised of the health care facility and any other health care facilities that are party to the collaborative agreement or that are part of a system that is party to the collaborative agreement. The collaborative agreement shall, at a minimum, include protocols for sharing personal protective equipment among facilities that are part of the system established pursuant to the collaborative agreement.
b. Each general acute care hospital shall make a good faith effort to maintain at least a 90-day emergency stockpile of personal protective equipment at all times. A system comprising multiple hospitals may count the total emergency stockpile of personal protective equipment available at all hospitals that are part of that system when determining whether a hospital is in compliance with the personal protective equipment emergency stockpile requirements set forth in this subsection, provided that the total quantity of personal protective equipment available throughout the system is equivalent to at least a 90-day emergency supply of personal protective equipment for each hospital that is a part of the system.
c. For the purposes of this act, any determination as to whether a long-term care facility has made a good faith effort to maintain a minimum stockpile of personal protective equipment consistent with the requirements of subsection a. of this section or whether a hospital has made a good faith effort to maintain a minimum stockpile of personal protective equipment consistent with the requirements of subsection b. of this section shall take into consideration the current state of the supply chain of personal protective equipment in the State, including, but not limited to, unit cost, recent price increases, overall availability, and delays in shipping times.
d. In determining the quantity of personal protective equipment a long-term care facility or hospital will need to maintain in order to meet the requirements of this section, the facility or hospital shall:
(1) take into account prevailing conditions in the State that may affect the need for and availability of personal protective equipment;
(2) take into account anticipated surges, over the next 90 days, in the need for personal protective equipment at that facility or hospital and at other facilities or hospitals that are part of the same system as the facility or hospital; and
(3) utilize any burn rate calculator or other tool as the Department of Health may designate for use in determining the anticipated need for personal protective equipment.
Each facility and hospital shall immediately reevaluate the adequacy of its stockpile of personal protective equipment upon any declaration of a state of emergency by the Governor or a public health emergency pursuant to P.L.2005, c.222 (C.26:13-1 et seq.) in response to an outbreak, epidemic, or pandemic involving an infectious disease, and shall acquire such additional supplies of personal protective equipment as it determines are necessary to meet increases in the need for and use of personal protective equipment during the state of emergency or public health emergency.
e. The Department of Health may impose fines or other administrative remedies against any facility or hospital that violates the requirements of this section.
f. As used in this section:
"General acute care hospital" means a general acute care hospital licensed pursuant to P.L.1971, c.136 (C.26:2H-1 et seq.).
"Infectious disease" means a disease caused by a living organism or other pathogen, including a fungus, bacteria, parasite, protozoan, virus, or prion. An infectious disease may, or may not, be transmissible from person to person, animal to person, or insect to person.
"Long-term care facility" means a nursing home, assisted living residence, comprehensive personal care home, residential health care facility, or dementia care home licensed pursuant to P.L.1971, c.136 (C.26:2H-1 et seq.).
"Personal protective equipment" means any items commonly used to protect an individual from bacterial or viral infections, including, but not limited to, disinfecting wipes, disposable gloves, disposable gowns, face shields, N95 face masks, surgical masks, or parts thereof.
"Gender expression" means a person's gender-related appearance and behavior, whether or not stereotypically associated with the person's assigned sex at birth.
"Gender identity" means a person's internal, deeply held knowledge or sense of their own gender, regardless of the sex the person was assigned at birth.
"Gender-nonconforming" means a person whose gender expression does not conform to stereotypical expectations of that person's gender.
"Gender transition" means a process in which a person begins to live according to that person's gender identity, rather than the sex the person was assigned at birth, which process may include changing one's clothing, appearance, name, or identification documents, or undergoing medical treatments.
"Intersex" means a person whose sexual or reproductive anatomy or chromosomal pattern is not consistent with typical definitions of male or female.
"LGBTQI" means lesbian, gay, bisexual, transgender, questioning, queer, and intersex.
"Long-term care facility" means a nursing home, assisted living residence, comprehensive personal care home, residential health care facility, or dementia care home licensed pursuant to P.L.1971, c.136 (C.26:2H-1 et seq.).
"Long-term care facility staff" means all individuals employed by, or contracted directly with, a long-term care facility.
"Resident" means resident or patient of a long-term care facility.
"Queer" means a person whose gender expression, gender identity, or sexual orientation does not conform to dominant expectations or standards.
"Questioning" means a person who is exploring or unsure about the person's own sexual orientation or gender identity or expression.
"Sexual orientation" means a person's romantic or sexual attraction to other people.
"Transgender" means a person whose gender identity or gender expression differs from the sex assigned to the person at birth.
"Undesignated/non-binary" means a person whose gender identity is not exclusively male or female, including, but not limited to, a person whose gender identity is intersex, agender, amalgagender, androgynous, bigender, demigender, genderfluid, genderqueer, neutrois, non-binary, pangender, third sex, transgender, Two Spirit, or otherwise unspecified by the person.
(1) denying admission to a long-term care facility, transferring or refusing to transfer a resident within a facility or to another facility, or discharging or evicting a resident from a facility;
(2) denying a request by residents to share a room;
(3) Subject to the provisions of paragraph (5) of subsection (e) of 42 CFR s.483.10, where rooms are assigned by gender, assigning, reassigning, or refusing to assign a room to a transgender or non-binary resident other than in accordance with the transgender or undesignated/non-binary resident's gender identity, unless at the transgender or undesignated/non-binary resident's request;
(4) prohibiting a resident from using, or harassing a resident who seeks to use or does use, a restroom available to other persons of the same gender identity, regardless of whether the resident is making a gender transition, has taken or is taking hormones, has undergone gender affirmation surgery, or presents as gender-nonconforming. For the purposes of this paragraph, harassment includes, but is not limited to, requiring a resident to show identity documents in order to gain entrance to a restroom available to other persons of the same gender identity;
(5) repeatedly failing to use a resident's chosen name or pronouns after being clearly informed of the chosen name or pronouns;
(6) denying a resident the right to wear or be dressed in clothing, accessories, or cosmetics or to engage in grooming practices that are permitted to any other resident;
(7) restricting a resident's right to associate with other residents or with visitors, including the right to consensual sexual relations;
(8) denying or restricting medical or nonmedical care that is appropriate to a resident's organs and bodily needs, or providing medical or nonmedical care that, to a similarly-situated, reasonable person, unduly demeans the resident's dignity or causes avoidable discomfort; or
(9) refuse or willfully fail to provide any service, care, or reasonable accommodation to a resident or an applicant for services or care.
b. The requirements of this act shall not apply to the extent that compliance with the requirement is incompatible with any professionally-reasonable clinical judgment.
c. Each facility shall post the following notice alongside its current nondiscrimination policy and alongside its written materials providing notice of resident rights pursuant to N.J.A.C.8:39-4.1, in all places and on all materials where that policy or those written materials are posted:
"(Name of facility) does not discriminate and does not permit discrimination, including, but not limited to, bullying, abuse, or harassment, on the basis of actual or perceived sexual orientation, gender identity, gender expression, intersex status, or HIV status, or based on association with another individual on account of that individual's actual or perceived sexual orientation, gender identity, gender expression, intersex status, or HIV status. You may file a complaint with the Office of the State Long-Term Care Ombudsman, (provide current contact information), if you believe you have experienced this kind of discrimination."
The facility shall take appropriate steps to minimize the likelihood of inadvertent or accidental disclosure of such information to other residents, visitors, or facility staff, except to the minimum extent necessary for facility staff to perform their duties.
b. Unless expressly authorized by the resident or the resident's authorized representative, long-term facility staff not directly involved in providing direct care to a resident, including, but not limited to, a transgender, undesignated/non-binary, intersex, or gender-nonconforming resident, shall not be present during a physical examination of, or the provision of personal care to, that resident if the resident is partially or fully unclothed. A facility shall use doors, curtains, screens, or other effective visual barriers to provide bodily privacy for all residents, including, but not limited to, transgender, undesignated/non-binary, intersex, or gender-nonconforming residents, whenever they are partially or fully unclothed.
c. Informed consent shall be required in relation to any non-therapeutic examination or observation of, or treatment provided to, a resident of the facility.
d. Transgender residents shall be provided access to such transition-related assessments, therapy, and treatments as have been recommended by the resident's health care provider, including, but not limited to, transgender-related medical care, including hormone therapy and supportive counseling.
(1) caring for LGBTQI seniors and seniors living with HIV; and
(2) preventing discrimination based on sexual orientation, gender identity or expression, intersex status, and HIV status.
b. At a minimum, the training required pursuant to this section shall include:
(1) the definition of the terms commonly associated with sexual orientation, gender identity and expression, intersex status, and HIV;
(2) best practices for communicating with or about LGBTQI seniors and seniors living with HIV, including the use of a resident's chosen name and pronouns;
(3) a description of the health and social challenges historically experienced by LGBTQI seniors and seniors living with HIV, including discrimination when seeking or receiving care at long-term care facilities, and the demonstrated physical and mental health effects within the LGBTQI community associated with such discrimination;
(4) strategies to create a safe and affirming environment for LGBTQI seniors and seniors living with HIV, including suggested changes to facility policies and procedures, forms, signage, communication between residents and their families, activities, and staff training and in-services; and
(5) an overview of the provisions of this act.
c. The training required pursuant to this section shall be provided by an entity that has demonstrated expertise in identifying the legal, social, and medical challenges faced by, and in creating safe and affirming environments for, LGBTQI seniors and seniors living with HIV who reside in long-term care facilities in New Jersey.
d. (1) Each long-term care facility shall designate two employees, including one employee representing management at the facility and one employee representing direct care staff at the facility, to receive in-person training within six months after the effective date of this act, which designated employees shall serve as points of contact for the facility regarding compliance with the provisions of this act and shall develop a general training plan for the facility. In the event a designated employee ceases to be employed by the facility, the facility shall designate another employee, who is representative of the employee group represented by the former designee, who shall complete the in-person training required pursuant to this paragraph, serve as a point of contact for the facility regarding compliance with the provisions of this act, and have joint responsibility for the facility's training plan.
(2) Administrators and staff members currently employed by a long-term care facility, other than an employee designated pursuant to paragraph (1) of this subsection, shall complete the training required pursuant to this section within one year after the effective date of this act. Administrators and staff hired by a long-term care facility after the effective date of this act shall complete the training required pursuant to this section within one year after the date of hire, unless the individual provides documentation demonstrating that the individual has completed equivalent training within the past two years.
(3) Each long-term care facility shall retain records documenting the completion of the training required pursuant to this section by each administrator and staff member at the long-term care facility. Compliance records shall be made available, upon request, to the Department of Health, the Department of Human Services, and the Office of the State Long-Term Care Ombudsman.
e. Each long-term care facility shall assume the cost of providing the training required pursuant to this section.
"Long-term care facility" means a facility or distinct part of a facility licensed by the New Jersey Department of Health as a long-term care facility.
“Pharmacist” means a pharmacist licensed pursuant to P.L.2003, c.280 (C.45:14-40 et seq.).
b. Each long-term care facility shall have a consultant pharmacist and either a provider pharmacist or, if the facility has an in-house pharmacy, a director of pharmaceutical services.
c. A New Jersey-licensed pharmacist shall serve as director of pharmaceutical services or as consultant pharmacist. The pharmacist shall comply with federal and State statutes, rules, regulations, and currently accepted standards of practice.
d. Each long-term care facility shall have an interdisciplinary pharmacy and therapeutics committee, appointed by and reporting to the facility’s administrator and consisting of at least the administrator, a representative of the nursing staff, and the facility’s consultant pharmacist, with oversight as needed by the facility’s medical director. The committee may include a licensed pharmacist representing the provider pharmacy. The committee shall hold meetings at least quarterly. Records, including the dates of meetings, attendance, activities, findings, and recommendations, shall be maintained by the committee.
e. Each long-term care facility shall appoint a consultant pharmacist who is not also the director of pharmaceutical services or pharmacist provider, and who attests that he or she does not have an affiliation with either the facility’s director of pharmaceutical services or the facility’s pharmacist provider. Following the appointment of the consultant pharmacist, the consultant pharmacist shall avoid all real or potential conflicts of interest with the facility’s director of pharmaceutical services or the facility’s pharmacist provider.
f. If a long-term care facility keeps emergency injectable or oral controlled substances, the facility shall ensure that a current Drug Enforcement Administration registration and controlled dangerous substance registration for that location is available.
(1) all health professionals who provide perinatal treatment and care to pregnant persons at the hospital or birthing center regardless of the compensation agreement, contractual status, or privilege status that may exist between the health professional and the hospital or birthing center; and
(2) all supportive services staff members, as defined by the Department of Health, who interact with pregnant persons at the hospital or birthing center.
A hospital or birthing center that implements an explicit and implicit bias training program pursuant to this section shall ensure that the program is structured in a manner that permits health care professionals to be eligible to receive continuing education credits for participation in the program.
b. The training program shall include, but not be limited to:
(1) identifying previous and current unconscious biases and misinformation when providing perinatal treatment and care to, or interacting with, pregnant persons;
(2) identifying environmental, personal, interpersonal, institutional, and cultural barriers to inclusion;
(3) information on the effects of historical and contemporary exclusion and oppression of minority communities;
(4) information about cultural identity across racial, ethnic, and other marginalized groups;
(5) information about communicating more effectively across racial, ethnic, religious, and gender identities;
(6) information about reproductive justice;
(7) a discussion on power dynamics and organizational decision-making and their effects on explicit and implicit bias;
(8) a discussion on inequities and racial, ethnic and other disparities within the field of perinatal care, and how explicit and implicit bias may contribute to pregnancy-related deaths and maternal and infant health outcomes;
(9) corrective measures to decrease explicit and implicit bias at the interpersonal and institutional levels; and
(10) review of the annual report of the New Jersey Maternal Mortality Review Committee.
The Department of Health shall identify an explicit and implicit bias training tool to be utilized by the explicit and implicit bias training program implemented by a hospital or birthing center pursuant to this section. The use of the department's training tool by a hospital or birthing center shall not preclude the hospital or birthing center from utilizing additional or customized training tools in addition to the department's training tool.
c. A health care professional who provides perinatal treatment and care to pregnant persons at a hospital that provides inpatient maternity services or a birthing center licensed in the State pursuant to P.L.1971, c.136 (C.26:2H-1 et seq.) and all supportive staff members who interact with pregnant persons at the hospital or birthing center shall:
(1) complete the training program on explicit and implicit bias at such times and intervals as the hospital or birthing center shall require;
(2) complete a refresher course under the training program, designed to provide the health care professional or supportive staff member with updated information about racial, ethnic, and cultural identity, and best practices in decreasing interpersonal and institutional implicit bias, every two years or on a more frequent basis, if deemed necessary by the hospital or birthing center; and
(3) receive a certification of completion from the hospital or birthing center upon successful completion of the training program.
d. A health care professional who completes a continuing education course on explicit and implicit bias pursuant to section 2, 3, 4, 5, or 7 of P.L.2021, c.79 (C.45:9-7.9, C.45:9-27.25c, C.45:9-1a, C.45:11-26.4, or C.45:10-23) shall be deemed to have satisfied the explicit and implicit bias training requirement set forth in subsection c. of this section for the licensure or certification period in which the continuing education course was completed.
e. In the event that a hospital or birthing center fails to implement an explicit and implicit bias training program pursuant to this section, the Department of Health shall invoke penalties or take administrative action against the hospital or birthing center. Any penalties imposed or administrative actions taken by the department pursuant to this subsection may be imposed in a summary proceeding.
f. As used in this section:
"Explicit bias" means attitudes and beliefs about a person or group on a conscious level.
"Health care professional" means a person licensed or certified to practice a health care profession pursuant to Title 45 of the Revised Statutes.
"Implicit bias" means a bias in judgment or behavior that results from subtle cognitive processes, including implicit prejudice and implicit stereotypes, that often operate at a level below conscious awareness and without intentional control.
"Implicit stereotypes" means the unconscious attributions of particular qualities to a member of a certain social group, influenced by experience, and based on learned associations between various qualities and social categories, including race and gender.
"Perinatal care" means the provision of care during pregnancy, labor, delivery, postpartum and neonatal periods.
(1) referrals to outpatient primary care and behavioral health care services;
(2) appropriate follow-up care and treatment management assistance;
(3) assistance identifying and procuring sources of health benefits coverage, including, but not limited to, coverage under the State Medicaid and NJ FamilyCare programs pursuant to P.L.1968, c.413 (C.30:4D-1 et seq.) and P.L.2005, c.156 (C.30:4J-8 et al.) ; and
(4) assistance in identifying and accessing appropriate social services, including, but not limited to, food, transportation, housing, employment, and child care assistance.
Such hospital shall notify the Department of Health as to the wrap-around services intended to be provided pursuant to this section and if any such service is subject to the Department of Health's healthcare facility licensing requirements the service shall be licensed prior to it being provided. To the extent practicable, a hospital may collaborate with a regional health hub to provide the wrap-around services described in paragraphs (1) through (4) of this subsection.
b. Housing for individuals who are homeless or housing insecure constructed, rehabilitated, or remediated by a hospital, or its partners or contractors, pursuant to subsection a. of this section shall be:
(1) deemed a permitted use in all residential and nonresidential districts of a municipality and shall be exempt from local zoning restrictions ; and
(2) exempt from the Department of Health's health care facility licensing requirements, provided that, if wrap-around services provided in connection with the housing are provided in a health clinic or other comparable health care facility licensed pursuant to P.L.1971, c.136 (C.26:2H-1 et seq.), the clinic or facility shall comply with the department's health care facility licensing requirements.
c. Commencing one year after the date a hospital, or its partners or contractors, first constructs, rehabilitates, or remediates housing and begins providing wrap-around services for individuals who are homeless or housing insecure pursuant to subsection a. of this section, and annually thereafter, the hospital shall report to the Department of Health concerning any reductions in the number of inpatient admissions and emergency department visits at the hospital and increased usage of preventative care related to the construction, rehabilitation, or remediation of housing and the provision of wrap-around services by the hospital or its partners or contractors, to individuals who are homeless or housing insecure over the previous year. The report shall include data based on each payer type for inpatient admissions and emergency department visits, including charity care and, to the extent practicable, shall include input from local stakeholders, including regional health hubs, on program design and implementation. The report may be shared with regional health hubs to assist the Department of Health in program design, population analysis, strategic planning, and other appropriate functions.
d. The Department of Health shall annually provide to the Legislature a report aggregating the data contained in the reports submitted to the department by a hospital pursuant to subsection c. of this section for five years following the effective date of P.L.2021, c.134 (C.26:2H-12.109) and quinquennially thereafter.
e. As used in this section, "individual who is homeless or housing insecure" means a person or household who is homeless or experiences periods of homelessness as either of those terms is defined pursuant to the federal McKinney-Vento Homeless Assistance Act, (42 U.S.C. s.11301 et seq.), the Qualified Allocation Plan adopted by the New Jersey Housing and Mortgage Finance Agency, or any other State or federal program specifically designed to assist such persons or households; or a person or household eligible for and occupying very-low-income housing, low-income housing, or moderate-income housing as those terms are defined in section 4 of P.L.1985, c.222 (C.52:27D-304).
f. This section shall not be construed to invalidate or otherwise limit the credit or bonus credit for which a municipality may otherwise be eligible to receive in accordance with P.L.1985, c.222 (52:27D-301 et seq.) or any court order issued or settlement agreement executed consistent therewith.
g. This section shall not be construed to invalidate or otherwise limit the authority or ability to facilitate or enter into such arrangements, or agreements, or projects under existing law.
"Behavioral health care" means procedures or services, other than primary health care services, which are provided by a health care practitioner to a patient for the treatment of a mental illness, emotional disorder, or drug or alcohol use disorder.
"Behavioral health care provider" means a psychiatrist, psychiatric advanced practice nurse, psychologist, clinical social worker, marriage and family therapist, any other mental health or substance use disorder treatment provider licensed pursuant to Title 45 of the Revised Statutes, a practitioner otherwise authorized to provide behavioral health care in the State, or a treatment provider who is licensed or otherwise authorized to provide behavioral health care in the State acting in the provider's capacity as an employee or contractor for a facility licensed by the Department of Health to provide behavioral health care.
"Emergency shelter for the homeless" means a building or structure in which a public entity or a private, nonprofit organization provides shelter, or food and shelter, to individuals and families having neither a home nor the means to obtain a home or other temporary lodging.
b. A behavioral health care provider shall be authorized to provide behavioral health care services to homeless persons within an emergency shelter for the homeless, on the condition that:
(1) the services are made available to all residents to whom such services are applicable;
(2) the services are provided in an environment that ensures, to the extent feasible given the layout and structure of the shelter, ongoing visual and auditory privacy for individual or group counseling services;
(3) in the case of residents not receiving behavioral health care and to the extent feasible given the layout and structure of the shelter, the privacy and the right not to be disturbed of such residents are protected; and
(4) participation in any behavioral health care program is not made mandatory for any person residing within the shelter.
A behavioral health care provider may provide the services authorized pursuant to this section in response to emergencies, on a part-time or full-time basis, and within a temporary or permanent location within the emergency shelter for the homeless that is exclusively used by the behavioral health care provider. The shelter shall set forth a schedule designating the days and hours that the services may be provided. Nothing in this section shall be construed to prohibit the provision of behavioral health care, if necessary, on an emergency basis outside the designated days and hours.
c. The Commissioner of Human Services shall apply for such State plan amendments or waivers to provide behavioral health care, as described in this section, and secure federal financial participation for the associated State Medicaid expenditures under the federal Medicaid program.
"Health care facility" means a health care facility licensed by the Department of Health pursuant to P.L.1971, c.136 (C.26:2H-1 et seq.). "Health care facility" does not mean a long-term care facility, a provider of adult medical day care services, a home health agency, or a psychiatric hospital.
"Long-term care facility" means a nursing home, an assisted living residence, an assisted living program, a comprehensive personal care home, a residential health care facility, or a dementia care home licensed pursuant to P.L.1971, c.136 (C.26:2H-1 et seq.).
"Provider of adult medical day care services" means an adult day health services facility licensed by the Department of Health, which provides preventive, diagnostic, therapeutic, and rehabilitative services under medical and nursing supervision to meet the needs of functionally impaired adult participants for a period of time that does not exceed 12 hours during any calendar day.
"Smoke evacuation system" means smoke evacuation equipment and technologies designed to capture, filter, or eliminate surgical smoke at the site of origin and before the surgical smoke makes ocular contact or contact with the respiratory tract of an individual.
"Surgical smoke" means the surgical plume that is generated from the use of an energy generating surgical device, and shall include, but shall not be limited to, smoke plume, bio-aerosols, laser-generated airborne contaminants, and lung damaging dust.
b. Each health care facility shall adopt and implement policies to prevent exposure to surgical smoke via use of a smoke evacuation system for each procedure that generates surgical smoke.
“Community access location” shall mean a facility that includes the following components and provides the following services to all patients without regard to their ability to pay: forty-eight medical surgical/observation beds with at least twelve acuity adaptable beds capable of providing intensive care; a full-service emergency department that complies with 42 U.S.C. 1395dd; inpatient and outpatient psychiatric services; surgical services with general anesthesia that can support more than twenty-four hours of recovery in a surgery center/surgical outpatient department with up to six operating rooms; outpatient clinics; and comprehensive diagnostic imaging services.
“Hospital” shall mean a general acute care hospital licensed pursuant to P.L.1971, c.136 (C.26:2H-1 et seq.).
“Underserved community” means a municipality with a population greater than 30,000 residents in calendar year 2024, according to the Department of Labor and Workforce Development, which has only one hospital within the municipality, and which: is within a Medically Underserved Area or includes a Medically Underserved Population, as designated by the Health Resources and Services Administration in the United States Department of Health and Human Services in 2025; has an Index of Medical Underservice Score, as designated by the Health Resources and Services Administration, that is less than, or equal to, 62.0 in 2025; and has been identified as a medically underserved municipality by the Commissioner of Health based on the New Jersey Medically Underserved Index.
b. The community access location shall operate at the relocated hospital’s original location in an underserved community and under the same license as the relocated hospital and may be:
(1) operated as a remote location of the relocated hospital as this term is defined by 42 C.F.R. 413.65; and
(2) overseen by the same administration, support departments, and clinical departments as apply to the relocated hospital.
c. The Department of Health shall have the authority to grant waivers from the mandatory requirements set forth in this act or any other applicable requirements set forth in N.J.A.C.8:43G-1 et seq., or its successor regulation, that may be necessary for the hospital to maintain a community access location at its original location in an underserved community pursuant to this act in a manner that facilitates integration with the relocated hospital.
b. In support of its application pursuant to subsection a. of this section, the hospital shall provide the Department of Health with the following information:
(1) the financial data that was submitted in support of the hospital’s approved certificate of need application;
(2) a description of the services to be provided at the community access location and the anticipated costs associated with developing and maintaining the services and infrastructure of a community access location at the hospital’s original location; and
(3) a description of any proposed community health programs that support continued access to care in the underserved community and the anticipated costs associated with developing and implementing such community health programs.
b. Notwithstanding subsection a. of this section, upon expiration of the pilot program, a relocated hospital that participated in the pilot program may maintain inpatient and outpatient psychiatric services subject to N.J.A.C.8:33-1 et seq., or its successor regulation, at its original location in accordance with the terms and conditions of the pilot program until such time as the hospital seeks, and the Department of Health approves, an application to modify its license.
In addition to authority granted to the department by this act or any other law, the department after serving the licensee with specific charges in writing, may assess penalties and collect the same within the limitations imposed by this act, deny, place on probationary or provisional license, revoke or suspend any and all licenses granted under authority of this act to any person, firm, partnership, corporation or association violating or failing to comply with the provisions of this act, or the rules and regulations promulgated hereunder.
Notice of the assessment of penalties, revocation, suspension, the placing on probationary or provisional license or denial of a license together with a specification of charges shall be served on the applicant or licensee, personally or sent by certified mail to the address of record and the notice shall set forth the particular reasons for the assessment, denial, suspension, the placing on probationary or provisional license or revocation of the license. Such assessment, denial, suspension, the placing on probationary or provisional license, or revocation shall become effective 30 days after mailing, unless the applicant or licensee, within such 30-day period shall meet the requirements of the department or shall file with the department a written answer to the charges and give written notice to the department of its desire for a hearing in which case the assessment, denial, suspension, the placing on probationary or provisional license, or revocation may be held in abeyance until the hearing has been concluded and a final decision rendered.
The department shall afford the licensee an opportunity for a prompt hearing on the question of the assessment of penalties, the issuance, suspension or the placing on a probationary or provisional license, or revocation of the license. The procedure governing such hearings shall be in accordance with the rules and regulations of the department. Either party may be represented by counsel of his own choosing, and shall have the right to subpoena witnesses and to compel their attendance on forms furnished by the department.
The commissioner shall arrange for prompt and fair hearings on all such cases, render written decisions stating conclusions and reasons therefor upon each matter so heard, and is empowered to enter orders of denial, suspension, placing on probationary or provisional license or revocation consistent with the circumstances in each case, and may assess penalties and collect the same within the limitations imposed by this act.
A person making application for, or who has been issued, a license to operate a residential health care facility who conceals the fact that the person has been denied a license to own or operate a residential facility, or that the person's license to own or operate a residential facility has been revoked by a department or agency of state government in this or any other state is liable for a civil penalty of not more than $5,000.00, and any license to operate a residential health care facility which has been issued to that person shall be immediately revoked.
Any person, firm, partnership, corporation or association who shall, except in cases of an emergency, maintain more patients in his premises than he is licensed so to do, shall be subject to a penalty, in accordance with the procedure set forth in section 13, in an amount equal to the daily charge collected from such patient or patients plus $25.00 for each day each extra patient is so maintained.
As used in this act:
a. "Department" means the State Department of Health.
b. "Heat emergency" means an indoor air temperature of 85 degrees Fahrenheit or higher for a continuous period of four hours or longer.
b. A health care facility included within the provisions of this act shall be required to notify the department immediately in the event of a heat emergency.
a. Each health care facility included within the provisions of this act and which is not equipped with air conditioning on the effective date of P.L.1989, c.173 (C.26:2H-14.4 et al.), shall provide for and operate adequate ventilation in all areas used by patients or residents, including, but not limited to, the use of ceiling fans, wall fans or portable fans, where appropriate, so that the temperature in these areas does not exceed 81 degrees Fahrenheit, but the health care facility shall not directly assess patients or residents for the purchase or installation of the fans or other ventilating equipment.
(1) The regulations shall also provide that within two years after the effective date of P.L.1989, c.173 (C.26:2H-14.4 et al.), every nursing home included within the provisions of this act, and every residential health care facility as specified in this paragraph, shall be equipped with air conditioning, except that the commissioner may grant a nursing home or residential health care facility a waiver from the air conditioning requirement to give the nursing home or residential health care facility one additional year to comply with the air conditioning requirement, for which waiver the nursing home or residential health care facility shall apply on a form and in a manner prescribed by the commissioner, if the nursing home or residential health care facility can demonstrate to the satisfaction of the commissioner that the failure to grant such a waiver would pose a serious financial hardship to the nursing home or residential health care facility. The air conditioning shall be operated so that the temperature in all areas used by patients or residents does not exceed 81 degrees Fahrenheit. The air conditioning requirement established in this subsection shall apply to a residential health care facility only: (1) upon enactment into law of legislation that increases the rate of reimbursement provided by the State under the Supplemental Security Income program, P.L.1973, c.256 (C.44:7-85 et seq.), which rate is certified by the Commissioner of Health to be sufficient to enable the facility to meet the costs of complying with the requirement; and (2) if the facility qualifies for funds for energy efficiency rehabilitation through the "Petroleum Overcharge Reimbursement Fund," established pursuant to P.L.1987, c.231 (C.52:18A-209 et seq.), which funds can be applied towards equipping the facility with air conditioning. A nursing home or residential health care facility shall not directly assess patients or residents for the purchase or installation of the air conditioning equipment.
(2) The regulations shall also provide that within two years after the effective date of P.L.2015, c.125 (C.55:13B-5.1 et al.), every dementia care home shall be equipped with air conditioning, except that the commissioner may grant a dementia care home a waiver from the air conditioning requirement to give the dementia care home one additional year to comply with the air conditioning requirement, for which waiver the dementia care home shall apply on a form and in a manner prescribed by the commissioner, if the dementia care home can demonstrate to the satisfaction of the commissioner that the failure to grant such a waiver would pose a serious financial hardship to that facility. The air conditioning shall be operated so that the temperature in all areas used by residents does not exceed 81 degrees Fahrenheit. A dementia care home shall not directly assess residents for the purchase or installation of the air conditioning equipment; and
b. Patients or residents are identified by predisposition, due to illness, medication or otherwise, to heat-related illness and that during a heat emergency, their body temperature, dehydration status and other symptoms of heat-related illness are monitored frequently and regularly, any anomalies are promptly reported to the attending physician, and any necessary therapeutic or palliative measures are instituted, including the provision of liquids, where required.
c. A nursing home, or a residential health care facility owned by a licensed health care facility and licensed by the Department of Health pursuant to P.L.1971, c.136 (C.26:2H-1 et seq.), shall not exceed the temperature limit established pursuant to this section, unless permitted by applicable regulation of the Centers for Medicare and Medicaid Services.
(1) designated for activities requiring physical exertion; or
(2) where residents can individually control the temperature in their own living units, independent from other areas.
b. A nursing home, or a residential health care facility owned by a licensed health care facility and licensed by the Department of Health pursuant to P.L.1971, c.136 (C.26:2H-1 et seq.), may maintain a temperature in an area used by patients or residents that does not fall within the range provided pursuant to subsection a. of this section, provided that the temperature is within a range permitted pursuant to applicable regulation of the Centers for Medicare and Medicaid Services.
a. The residential health care facility shall: (1) invest that money in shares of an insured money market fund established by an investment company based in this State and registered under the "Investment Company Act of 1940," 54 Stat. 789 (15 U.S.C. s. 80a-1 et seq.) whose shares are registered under the "Securities Act of 1933," 48 Stat. 74 (15 U.S.C. s. 77a et seq.) and the only investments of which fund are instruments maturing in one year or less, or (2) deposit that money in a State or federally chartered bank, savings bank or savings and loan association in this State insured by an agency of the federal government in an account bearing a variable rate of interest, which shall be established at least quarterly, which is similar to the average rate of interest on active interest-bearing money market transaction accounts paid by the bank or association, or equal to similar accounts of an investment company described in paragraph (1) of this subsection, less an amount not to exceed 1% per annum of the amount so invested or deposited for the costs of servicing and processing the accounts.
b. Immediately after the security money is invested, the residential health care facility shall notify the resident in writing of the name and address of the investment company, State or federally chartered bank, savings bank or savings and loan association in which the deposit or investment of security money is made, and the amount of the deposit.
c. All of the money so deposited or advanced may be deposited or invested by the residential health care facility in one interest-bearing or dividend yielding account as long as the residential health care facility complies with all the other requirements of this act.
d. The residential health care facility is entitled to receive as administration expenses, a sum equivalent to 1% per annum thereon or 12.5% of the aggregate interest yield on the security deposit, whichever is greater, less the amount of any service fee charged by an investment company, a State or federally chartered bank, savings bank or savings and loan association for money deposited pursuant to this section, which is in lieu of all other administrative and custodial expenses. The balance of the interest or earnings paid thereon by the investment company, State or federally chartered bank, savings bank or savings and loan association shall belong to the resident and shall be permitted to compound to the benefit of the resident, or be paid to the resident in cash, or be credited toward the payments due on the anniversary of the resident's admission to the residential health care facility in accordance with the terms of the contract or agreement.
e. If the residential health care facility fails to notify the resident of the name and address of the investment company, State or federally chartered bank, savings bank or savings and loan association in which the deposit or investment of the security is made, and the amount thereof, within 30 days after receipt of the money from the resident, the resident may give written notice to the residential health care facility that the security money shall be applied on account of payments due or to become due from the resident, and thereafter the resident shall be without obligation to make any further security deposit and the residential health care facility shall not be entitled to make further demand for a security deposit.
f. Within 60 days after the person is no longer a resident of the residential health care facility, the residential health care facility shall return to the former resident or, if appropriate, to the resident's estate, by personal delivery or by registered or certified mail the sum so deposited plus the former resident's portion of the interest or earnings accumulated thereon, less any charges expended in accordance with the terms of a contract or agreement. The interest or earnings and any such deductions shall be itemized and the resident or, if appropriate, the resident's estate, notified thereof by personal delivery or by registered or certified mail.
g. The Commissioner of Banking may promulgate rules and regulations with respect to the establishment of the method of computing the interest due to either the residential health care facility or to the resident pursuant to the provisions of this act in accordance with the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.) if the money is deposited in an account or in shares of an investment company upon which the interest varies on a periodic basis.
a. The residential health care facility shall pay the resident interest on the security deposit equal to the average rate of interest paid by State or federally chartered banks, savings banks or savings and loan associations located in the municipality in which the residential health care facility is located and insured by an agency of the federal government, in an account bearing a variable rate of interest which shall be established at least quarterly, which is similar to the average rate of interest on active interest-bearing money market transaction accounts paid by a bank or association, less an amount not to exceed 1% per annum of the security deposit for the cost of servicing the security deposit account. The residential health care facility shall obtain the interest rate to be paid on the security deposit at least quarterly by contacting at least three banks or associations in the municipality in which the facility is located, and shall document each call with the name of the bank or association called, the person contacted at the bank or association, the rate of interest quoted and the type of account to which the interest rate applies.
b. The residential health care facility shall notify the resident in writing that the facility will be holding the security deposit, the amount of the security deposit and the initial interest rate to be paid on the deposit. If the residential health care facility fails to so notify the resident in writing within 30 days after the effective date of this act, the resident may give written notice to the residential health care facility that the security money shall be applied on account of payments due or to become due from the resident, and thereafter the resident shall be without obligation to make any further security deposit and the residential health care facility shall not be entitled to make further demand for a security deposit.
c. The residential health care facility is entitled to receive as administration expenses, a sum equivalent to 1% per annum thereon or 12.5% of the aggregate interest yield on the security deposit, whichever is greater, which is in lieu of all other administrative and custodial expenses associated with the resident's security deposit account. The balance of the interest or earnings paid to the account shall belong to the resident and shall be permitted to compound to the benefit of the resident, or be paid to the resident in cash, or be credited toward the payments due on the anniversary of the resident's admission to the residential health care facility in accordance with the terms of the contract or agreement. The residential health care facility shall provide the resident with a quarterly statement of his security deposit account showing the security deposit balance, the interest rate paid on the security deposit, the amount of interest earned and any deductions made from the account.
a. In New Jersey, nurses, nurse aides, orderlies and attendants, combined, have the highest number of nonfatal occupational injuries and illnesses involving days away from work of other occupations;
b. Chronic back pain and other job-related musculoskeletal disorders contribute significantly to the decision by nurses and other health care workers to leave their professions, which exacerbates the shortage of health care providers in this State;
c. Studies show that manual patient handling and movement negatively affect patient safety, quality of care and patient comfort, dignity and satisfaction;
d. The American Hospital Association has stated that work-related musculoskeletal disorders account for the largest proportion of workers' compensation costs in hospitals and long-term care facilities;
e. Studies demonstrate that assistive patient handling technology reduces workers' compensation and medical treatment costs for musculoskeletal disorders among health care workers, and that employers can recoup their initial investment in equipment and training within three years;
f. Therefore, it is appropriate public policy to minimize unassisted patient handling as set forth in this act.
"Assisted patient handling" means patient handling using: mechanical patient handling equipment including, but not limited to, electric beds, portable base and ceiling track-mounted full body sling lifts, stand assist lifts, and mechanized lateral transfer aids; and patient handling aids including, but not limited to, gait belts with handles, sliding boards and surface friction-reducing devices.
"Covered health care facility" means a general or special hospital or nursing home licensed by the Department of Health and Senior Services pursuant to P.L.1971, c.136 (C.26:2H-1 et al.), a State developmental center and a State or county psychiatric hospital.
"Health care worker" means an individual who is employed by a covered health care facility whose job duties entail patient handling.
"Patient" means a patient or resident at a covered health care facility.
"Patient handling" means the lifting, transferring, repositioning, transporting or moving of a patient in a covered health care facility.
"Unassisted patient handling" means patient handling using a health care worker's body strength without the use of mechanical patient handling equipment or patient handling aids.
a. The facility shall:
(1) maintain a detailed written description of the program and its components;
(2) provide a copy of the written description of the program to the Department of Health and Senior Services or Department of Human Services, as applicable, and make the description available to health care workers at the facility and to any collective bargaining agent representing health care workers at the facility;
(3) establish a safe patient handling policy, as provided in subsection b. of this section;
(4) include in the safe patient handling policy a statement concerning the right of a patient to refuse the use of assisted patient handling, as provided in subsection e. of this section;
(5) post the safe patient handling policy in a location easily visible to staff, patients, and visitors; and
(6) designate a representative of management at the facility who shall be responsible for overseeing all aspects of the safe patient handling program.
b. A safe patient handling program shall include:
(1) a safe patient handling policy on all units and for all shifts that minimizes unassisted patient handling, taking into account the patient's physical and cognitive condition, and that is consistent with patient safety and well-being;
(2) an assessment of the safe patient handling assistive devices needed to carry out the facility's safe patient handling policy;
(3) recommendations for a three-year capital plan to purchase safe patient handling equipment and patient handling aids necessary to carry out the safe patient handling policy, which plan takes into account the financial constraints of the facility;
(4) protocols and procedures for assessing and updating the appropriate patient handling requirements of each patient of the facility;
(5) a plan for achieving prompt access to and availability of mechanical patient handling equipment and patient handling aids;
(6) a provision requiring that all such equipment and aids be stored and maintained in compliance with their manufacturers' recommendations;
(7) a training program for health care workers that:
(a) covers the identification, assessment, and control of patient handling risks; the safe, appropriate, and effective use of patient handling equipment and aids, and proven safe patient handling techniques;
(b) requires trainees to demonstrate proficiency in the techniques and practices presented;
(c) is provided during paid work time; and
(d) is conducted upon commencement of the facility's safe patient handling program and at least annually thereafter, with appropriate interim training for individuals beginning work between annual training sessions; and
(8) educational materials for patients and their families to help orient them to the facility's safe patient handling program.
c. A facility shall conduct an annual evaluation of the program, and make revisions to the program based on data analysis.
d. A facility shall conduct the initial training as required in this section within 36 months of the effective date of this act.
e. Nothing in this act shall be construed to limit the right of a patient to refuse the use of assisted patient handling.
(1) each covered health care facility shall establish a safe patient handling committee, which shall be responsible for all aspects of the development, implementation and periodic evaluation and revision of the facility's safe patient handling program, including the evaluation and selection of patient handling equipment and aids and other appropriate engineering controls;
(2) in the case of a health care system that owns or operates more than one covered health care facility or Department of Human Services facilities, the safe patient handling committee may be operated at the system or department level, provided that committee membership includes at least one health care worker from each facility, and a safe patient handling program is developed for each facility, taking into account the characteristics of the patients at the facility.
b. At least 50% of the members of the committee shall be health care workers who are representative of the different disciplines of health care workers employed at the facility or facilities, in the case of a health care system. In a facility or health care system where health care workers are represented by one or more collective bargaining agents, the management of the facility or system shall consult with the collective bargaining agents regarding the selection of the health care worker committee members.
The remaining members of the committee shall have experience, expertise, or responsibility relevant to the operation of a safe patient handling program.
c. The committee shall meet as needed, but no less than quarterly.
As used in this section, "retaliatory action" shall have the same meaning as provided in section 2 of P.L.1986, c.105 (C.34:19-2).
Any person, firm, association, partnership or corporation, not licensed hereunder, but who holds out to the public by advertising or other means that the medical and nursing care contemplated by this act will be furnished to persons seeking admission as patients, shall cease and desist from such practice and shall be liable to a penalty of $100.00 for the first offense and $500.00 for each subsequent offense, such penalty to be recovered as provided for herein.
The penalties prescribed and authorized by this act shall be recovered in a summary civil proceeding, brought in the name of the State in the Superior Court pursuant to the Penalty Enforcement Law (N.J.S. 2A:58-1 et seq.).
The commissioner may, in his discretion and subject to rules and regulations, accept from any licensee an offer in compromise in such amount as may in his judgment be proper under the circumstances in lieu of any suspension of any license by the commissioner. In no case shall the penalty be compromised for a sum less than $250.00 for the first offense and $500.00 for the second and each subsequent offense; provided, however, that any penalty of less than $250.00 or $500.00, as the case may be, may be compromised for a lesser sum.
All penalties collected pursuant to this section shall be deposited in a special fund which is designated as the "Health Care Facilities Improvement Fund." The fund shall be dedicated for use by the commissioner to make corrections in a health care facility which is in violation of a licensure standard and in which the owner or operator is unable or unwilling to make the necessary corrections. The owner of the facility is required to repay the fund any monies plus interest at the prevailing rate that were expended by the State to correct the violation at the facility. If the owner fails to promptly reimburse the fund, the commissioner shall have a lien in the name of the State against the facility for the cost of the corrections plus interest and for any administrative cost incurred in filing the lien.
The department may maintain an action in the name of the State to enjoin any person, firm, partnership, association or corporation from continuing to conduct, manage or operate a health care facility without a license, or after suspension or revocation of license, or in violation of rules and regulations promulgated hereunder.
All orders or determinations under this act shall be subject to review by a court of competent jurisdiction in accordance with the Rules of Court.
b. (Deleted by amendment, P.L.1992, c.160).
c. Payment by government agencies other than those made through the "New Jersey Medical Assistance and Health Services Act," P.L.1968, c.413 (C.30:4D-1 et seq.) for health services provided by health care facilities other than hospitals shall be at reasonable rates set by the commissioner based on financial elements approved by him; provided, however, that nothing herein shall be construed to prohibit the Commissioner of Human Services from contracting with the commissioner for the setting of rates by which health care facilities other than hospitals are reimbursed pursuant to the "New Jersey Medical Assistance and Health Services Act," P.L.1968, c.413 (C.30:4D-1 et seq.).
d. (Deleted by amendment, P.L.1992, c.160).
e. To establish and maintain a fair and equitable system for determining such payments, the commissioner shall require each health care facility to report such financial, statistical and patient information as may be required, in accordance with a uniform system of reporting established by him. The commissioner may propose regulations for approval by the board which assess penalties for failure to report such information within such time as may be prescribed therein.
b. The designation by the Commissioner of Health pursuant to subsection a. of this section shall be made subsequent to, and shall be contingent upon, the execution of a written agreement between Cooper University Hospital and a majority of the acute care hospitals providing inpatient pediatric services which are located in the counties listed in subsection a. of this section.
The written agreement shall state that the other facility recognizes Cooper University Hospital as the State's specialty acute care children's hospital for the counties listed in subsection a. of this section and shall set forth the basis on which the other facility shall make referrals to Cooper University Hospital.
b. The designation by the Commissioner of Health pursuant to subsection a. of this section shall be made subsequent to, and shall be contingent upon, the execution of a written agreement between Robert Wood Johnson University Hospital/St. Peter's University Hospital and a majority of the acute care hospitals providing inpatient pediatric services which are located in the counties listed in subsection a. of this section.
The written agreement shall state that the other facility recognizes Robert Wood Johnson University Hospital/St. Peter's University Hospital as the State's specialty acute care children's hospital for the counties listed in subsection a. of this section and shall set forth the basis on which the other facility shall make referrals to Robert Wood Johnson University Hospital/St. Peter's University Hospital.
b. The designation by the Commissioner of Health pursuant to subsection a. of this section shall be made subsequent to, and shall be contingent upon, the execution of a written agreement between St. Joseph's Hospital and Medical Center and a majority of the acute care hospitals providing inpatient pediatric services which are located in the counties listed in subsection a. of this section.
The written agreement shall state that the other facility recognizes St. Joseph's Hospital and Medical Center as the State's specialty acute care children's hospital for the counties listed in subsection a. of this section and shall set forth the basis on which the other facility shall make referrals to St. Joseph's Hospital and Medical Center.
b. The designation by the Commissioner of Health pursuant to subsection a. of this section shall be made subsequent to, and shall be contingent upon, the execution of written transfer agreements between Morristown Memorial Hospital and a majority of the acute care hospitals providing inpatient pediatric services which are located in Morris and Union counties.
The written agreement shall state that the other facility recognizes Morristown Memorial Hospital as the State's specialty acute care children's hospital for Morris and Union counties and shall set forth the basis on which the other facility shall make referrals to Morristown Memorial Hospital.
b. The designation of each hospital by the Commissioner of Health pursuant to subsection a. of this section shall be made subsequent to, and shall be contingent upon, the execution of written transfer agreements, respectively, between: Jersey Shore University Medical Center and a majority of the acute care hospitals providing inpatient pediatric services located in Monmouth and Ocean counties; and Monmouth Medical Center and a majority of the acute care hospitals providing inpatient pediatric services located in Monmouth and Ocean counties.
The written agreement shall state that the other facility recognizes Jersey Shore University Medical Center and Monmouth Medical Center, as applicable, as the State's specialty acute care children's hospitals for Monmouth and Ocean counties and shall set forth the basis on which the other facility shall make referrals to Jersey Shore University Medical Center or Monmouth Medical Center, as applicable.
b. The commissioner, pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.), may adopt rules and regulations to effectuate the purposes of this act.
The Department of Health, to effectuate the provisions and purposes of sections 10 and 11 of this act and to support the functions described therein, may charge health care facilities such reasonable annual fees as shall be provided by law.
The Legislature finds and declares that:
a. Access to quality health care shall not be denied to residents of the State because of their inability to pay for the care; there are many residents of the State, particularly those with incomes below the federal poverty level, who cannot pay for needed hospital care and in order to ensure that these persons have equal access to hospital care it is necessary to maintain a mechanism which will ensure payment of uncompensated hospital care; and to protect the fiscal solvency of the State's general hospitals, as provided for in P.L.1971, c.136 (C.26:2H-1 et al.), it is necessary that all payers of health care services share equally in the payment of uncompensated care on a Statewide basis.
b. The "New Jersey Uncompensated Care Trust Fund," created pursuant to P.L.1986, c.204, and continued pursuant to P.L.1989, c.1 (C.26:2H-18.4 et seq.), which law expired on December 31, 1990, by which hospitals were able to collect their reasonable cost of approved uncompensated care, resulted in unobstructed access to health care for residents without insurance who otherwise are unable to afford care.
c. Having received and thoroughly reviewed the reports issued by the Commissioner of Health and the Governor's Commission on Health Care Costs on uncompensated care, its economic implications and various means of financing uncompensated care, it is evident that provision for a trust fund is necessary, with modifications, to ensure access to hospital care for those who cannot afford to pay and the fiscal solvency of hospitals. At the same time, the State should take further actions to: provide more comprehensive Medicaid coverage for the medically indigent, reduce the rate of increase in health insurance premiums and explore and implement various initiatives to reduce the amount of uncompensated care in this State without impairing access to care.
As used in sections 1 through 26 of P.L.1991, c.187 (C.26:2H-18.24 et al.):
"Assessment" means monies that are required to be remitted to the fund by hospitals pursuant to this act.
"Commission" means the Hospital Rate Setting Commission established pursuant to section 5 of P.L.1978, c.83 (C.26:2H-4.1).
"Commissioner" means the Commissioner of Health.
"Department" means the Department of Health.
"Disproportionate share hospital" means a hospital designated by the Commissioner of Human Services pursuant to Pub.L.89-97 (42 U.S.C. s.1396a et seq.).
"Fund" means the "New Jersey Health Care Trust Fund" established pursuant to this act.
"Hospital" means a general acute care hospital whose schedule of rates is approved by the commission pursuant to section 11 of P.L.1978, c.83 (C.26:2H-18.1).
"Medicaid" means the New Jersey Medical Assistance and Health Services Program in the Department of Human Services established pursuant to P.L.1968, c.413 (C.30:4D-1 et seq.).
"Payer" means a governmental or nongovernmental third party payer or any purchaser of hospital services whose hospital reimbursement rates are established by the commission pursuant to P.L.1971, c.136 (C.26:2H-1 et al.), but shall not include the Medicaid program and the Medicare program established pursuant to Pub.L.89-97 (42 U.S.C. s.1395 et seq.), except as provided for in subsection a. of section 5 of this act.
"Uncompensated care" means inpatient and outpatient care provided to medically indigent persons and bad debts as defined by regulation of the department pursuant to P.L.1971, c.136 (C.26:2H-1 et al.).
The commission is authorized to approve a hospital's rates to achieve an equitable collection and distribution mechanism among hospitals in the State for payment of uncompensated care pursuant to the provisions of this act.
There is established the "New Jersey Health Care Trust Fund" in the Department of Health.
a. The fund shall be comprised of assessments remitted by hospitals pursuant to this act and any other monies appropriated thereto to carry out the purposes of this act.
The fund shall be a nonlapsing fund dedicated for use by the State: (1) to distribute payments for the cost of uncompensated care in the State, (2) to subsidize a pilot health insurance program for small business employees, (3) to fund the reasonable cost of administering the fund, (4) to fund the reasonable cost of preparing and disseminating health insurance information to employers pursuant to section 17 of P.L.1991, c.187 (C.26:2H-18.39) and (5) to fund primary health care provided by community health centers, on a pilot basis, pursuant to section 23 of P.L.1991, c.187 (C.26:2H-18.45); except that, monies remitted by hospitals pursuant to this act shall not be used for the purpose of subsidizing pilot health insurance programs for small business employees. Interest earned on monies deposited in the fund shall be credited to the fund.
b. The fund shall be administered by a person appointed by the commissioner.
The administrator of the fund is responsible for overseeing and coordinating the collection and disbursement of fund monies. The administrator is responsible for promptly informing the commission and the Commissioners of Health and Human Services if monies are not or are not reasonably expected to be collected or disbursed or if the fund's reserve as established in subsection c. of this section falls below the required level.
c. The fund shall maintain a reserve in an amount not to exceed $25 million. The commissioner shall adopt rules and regulations to govern the use of the reserve and to ensure the integrity of the fund, pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.).
The add-on shall be determined by dividing the Statewide amount of approved uncompensated care plus an amount adequate to fund the reasonable cost of administering the fund pursuant to subsection a. of section 4 of P.L.1991, c.187 (C.26:2H-18.27) and to maintain the reserve pursuant to subsection c. of section 4 of P.L.1991, c.187 (C.26:2H-18.27), by the Statewide amount of approved revenue for all payers and approved revenue for medically indigent persons less the Statewide amount of approved uncompensated care.
The Medicaid program shall provide its share of the uncompensated care add-on, as determined by the commission, through a direct contribution to the fund of an amount equal to the Medicaid program's State share of the uncompensated care add-on.
The add-on and any increases made to the add-on are an allowable cost and shall be included as part of the hospital's rates as established by the commission.
b. The amount of money raised by the uniform Statewide uncompensated care add-on, as a percentage of all governmental and nongovernmental approved revenue, shall not exceed 13%, except that the add-on shall not exceed 19.1%.
The commissioner shall establish the following target levels for the add-on: 16% by July 1, 1993, 13% by July 1, 1994 and 10% by July 1, 1995.
c. The uniform Statewide uncompensated care add-on for patients whose hospital bills are paid by a health maintenance organization or other payer which has negotiated a discounted rate of payment with the hospital shall be based on the full rate of reimbursement for the services provided by the hospital to the patient under the hospital reimbursement system established pursuant to P.L.1978, c.83, rather than on the discounted rate of payment.
d. No provision of this section shall be construed to preclude the commission from approving individual hospital rate increases for uncompensated care in addition to the add-on. Such increases, however, shall not be paid from the moneys in the Health Care Trust Fund.
A hospital shall not be reimbursed from the fund for the cost of uncompensated care for health care services provided to a patient who is a resident of another state other than emergency care services for life-threatening conditions. As used in this subsection, "life-threatening condition" means any medical condition which poses an imminent risk to a patient's life if emergency medical care is not provided to that patient, as certified by the patient's attending physician in accordance with the medical treatment protocol utilized by the hospital.
The commission shall require a hospital which engages in inefficient or inappropriate provision of uncompensated care services to submit to the commission a cost reduction plan. The commission may prospectively reduce the hospital's uncompensated care payments for failure to submit or implement a cost reduction plan that has been approved by the commission.
b. The hospital mandatory assessment shall be funded by the uniform Statewide uncompensated care add-on determined pursuant to section 5 of P.L.1991, c.187 (C.26:2H-18.28) which is charged by the hospital to all payers.
A hospital shall collect all monies received from the uncompensated care add-on pursuant to subsection a. of section 5 of P.L.1991, c.187 (C.26:2H-18.28) and remit all such monies to the fund as the hospital's mandatory assessment.
Such funds as may be necessary from the assessment shall be appropriated from the fund to the Division of Medical Assistance and Health Services in the Department of Human Services for payment to disproportionate share and non-disproportionate share hospitals for payments of approved uncompensated care costs.
The commission shall determine the amount that the Division of Medical Assistance and Health Services in the Department of Human Services shall pay to each hospital.
The Commissioner of Human Services shall adopt rules and regulations pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.) to carry out the provisions of this subsection.
b. If a hospital is delinquent in its payment of the mandatory assessment to the fund, the commission may, pursuant to rules and regulations adopted by the commissioner, remove from that hospital's schedule of rates the uniform Statewide uncompensated care add-on or levy a reasonable penalty on the hospital. The penalty shall be recovered in a summary civil proceeding brought in the name of the State in the Superior Court pursuant to "the penalty enforcement law" (N.J.S.2A:58-1 et seq.). Penalties collected pursuant to this section shall be deposited in the fund established pursuant to this act.
c. A hospital authorized to receive payments from the Division of Medical Assistance and Health Services in the Department of Human Services pursuant to subsection b. of section 6 of P.L.1991, c.187 (C.26:2H-18.29), shall receive the payments on a monthly basis. The first payment shall be made within 45 days of the effective date of this section.
a. A hospital shall not be reimbursed for the cost of uncompensated care unless the commissioner certifies to the commission that the hospital has followed the procedures pursuant to this section and section 11 of P.L.1991, c.187 (C.26:2H-18.33). For the purposes of this section and section 11 of P.L.1991, c.187 (C.26:2H-18.33), "designated hospital employee" means an employee of the hospital who has received training in the collection of patient financial data and identification of third party coverage and in assessing a patient's eligibility for public assistance; and "responsible party" means any person who is responsible for paying a patient's hospital bill.
b. A designated hospital employee shall interview a patient upon the patient's initial request for care. If the emergent nature of the patient's required health care makes the immediate patient interview impractical, the designated hospital employee shall interview the patient's family member, responsible party or guardian, as appropriate, but if there is no family member, responsible party or guardian, the designated hospital employee shall interview the patient within five working days of the patient's admission into the hospital or prior to discharge, whichever date is sooner.
c. A patient interview shall, at a minimum, include the following inquiries, except as provided in paragraph (5) of this subsection:
(1) The designated hospital employee shall obtain documentation of proper identification of the patient. Documentation of proper identification may include, but shall not be limited to, a driver's license, a voter registration card, an alien registry card, a birth certificate, an employee identification card, a union membership card, an insurance or welfare plan identification card or a Social Security card. Proper identification of the patient may also be provided by personal recognition by a person not associated with the patient. For the purposes of this paragraph, "proper identification" means the patient's name, mailing address, residence telephone number, date of birth, Social Security number, and place and type of employment, employment address and employment telephone number, as applicable.
(2) The designated hospital employee shall inquire of the patient, family member, responsible party or guardian, as appropriate, whether the patient is covered by health insurance, and if so, shall request documentation of the evidence of health insurance coverage. Documentation may include, but shall not be limited to, a government sponsored health plan card or number, a group sponsored or direct subscription health plan card or number, a commercial insurance identification card or claim form or a union welfare plan identification card or claim form.
(3) If evidence of health insurance coverage for the patient is not documented or if evidence of health insurance coverage is documented but the patient's health insurance coverage is unlikely to provide payment in full for the patient's account at the hospital, the designated hospital employee shall make an initial determination of whether the patient is eligible for participation in a public assistance program. If the employee concludes that the patient may be eligible for a public assistance program, the employee shall so advise the patient, family member, responsible party or guardian, as appropriate. The employee, either directly or through the hospital's social services office, shall give the patient, family member, responsible party or guardian, as appropriate, the name, address and phone number of the public assistance office that can assist in enrolling the patient in the program. The employee, or the social services office of the hospital, shall also advise the public assistance office of the patient's possible eligibility, including possible retroactive or presumptive eligibility, for the program.
Notwithstanding the provisions of this paragraph to the contrary, if a county welfare agency employee is assigned to the hospital pursuant to section 9 of P.L.1991, c.187 (C.26:2H-18.32) the designated hospital employee shall refer the patient, family member, responsible party or guardian, as appropriate, to the county welfare agency employee who shall determine if the patient is eligible for Medicaid.
(4) If evidence of health insurance coverage for the patient is not documented or if evidence of health insurance coverage is documented but the patient's health insurance coverage is unlikely to provide payment in full for the patient's account at the hospital, and the patient does not appear to be eligible for public assistance, the designated hospital employee shall determine if the patient is eligible for charity care pursuant to regulations adopted by the commissioner. If the patient does not qualify for charity care, the designated hospital employee shall request from the patient, family member, responsible party or guardian, as appropriate, the patient's or responsible party's place of employment, income, real property and durable personal property owned by the patient or responsible party and bank accounts possessed by the patient or responsible party, along with account numbers and the name and location of the bank.
(5) In the case of a patient seeking outpatient services, the designated hospital employee shall make the inquiries and obtain the documentation required pursuant to paragraphs (1) and (2) of this subsection. If the patient provides the required documentation, the designated hospital employee is not required to make further inquiries, but if the patient cannot provide the required documentation, the designated hospital employee shall follow the procedures required pursuant to paragraphs (3) and (4) of this subsection.
d. The provisions of this section shall not apply to a patient who is investigated by a county adjuster and found to be indigent by a court of competent jurisdiction pursuant to the provisions of chapter 4 of Title 30 of the Revised Statutes. A patient so found shall qualify for charity care under rules and regulations adopted by the commissioner.
A designated hospital shall reimburse the county welfare agency for the nonfederal share of costs associated with the county welfare agency employee, as certified by the Commissioner of Human Services. The Commissioner of Human Services shall bill the hospital quarterly for the nonfederal share of costs and reimburse the county welfare agency upon receipt of payment from the hospital.
a. If, upon the discharge of a patient from the hospital, the patient's account has not been paid in full by the patient or responsible party or by health insurance, or it is unlikely that the patient's account will be paid in full by the patient or responsible party or by health insurance, as identified pursuant to paragraphs (2) and (3) of subsection c. of section 8 of P.L.1991, c.187 (C.26:2H-18.31), and the patient or responsible party is likely to have assets such as those identified pursuant to paragraph (4) of subsection c. of section 8 of P.L.1991, c.187 (C.26:2H-18.31), a hospital shall follow the collection procedure pursuant to this section unless the patient's aggregate outstanding balance is less than $250 or unless and until the cost of collecting the account exceeds the patient's outstanding balance.
b. The hospital shall commence the collection procedure within two weeks after a patient's discharge from the hospital or date of service at the hospital.
The collection procedure shall include:
(1) At least three billing statements, each sent at intervals of no longer than four weeks, shall be sent to the patient's or responsible party's mailing address.
At least two collection follow-up letters shall follow the three billing statements. The collection follow-up letters shall be sent to the patient's or responsible party's mailing address at an interval of no longer than three weeks. Each collection follow-up letter shall state the amount due and owing, the collection history on the account and the hospital's intention to proceed with legal action if the outstanding balance is not paid in full or, in the alternative, the patient or responsible party fails to enter into payment arrangements with the hospital. Each collection follow-up letter shall request a partial payment of the outstanding balance in the patient's account as the minimum amount due and shall offer to establish a payment schedule for the remainder of the outstanding balance in the patient's account based upon the patient's or responsible party's ability to pay. The letter shall clearly indicate the name of a person for the patient or responsible party to contact, and a telephone number for the patient or responsible party to call, in order to arrange such a payment schedule.
A hospital is not required to comply with the requirements of sending a third billing statement or two collection follow-up letters if mail has twice been returned to the hospital, and hospital personnel, despite reasonable efforts, are unable to determine a new mailing address for the patient or responsible party;
(2) At least three attempts to reach the patient or responsible party by telephone shall be made if hospital personnel have determined a residence or business telephone number for the patient or responsible party. If hospital personnel are not able to make telephone contact with the patient or responsible party after three attempts, the hospital shall send a collection telegram;
(3) Legal action to collect the amount due and owing on the patient's account shall be taken; and
(4) The hospital shall request the department, on behalf of the fund, to request the Department of the Treasury to apply or cause to be applied the income tax refund or homestead rebate due the patient or responsible party, or both the income tax refund and homestead rebate, or so much of either or both as is necessary to recover the amount due and owing on the patient's account, pursuant to section 1 of P.L.1981, c.239 (C.54A:9-8.1), for which purpose the patient's outstanding balance shall be considered a debt to the fund and the fund shall be considered an agency of State government.
c. Unless the cost of completing the procedure, in part or in its entirety, exceeds the outstanding balance on a patient's account, a hospital shall complete the procedures in paragraphs (1) and (2) of subsection b. of this section before submitting appropriate documentation and requesting from the commissioner that the hospital be reimbursed on a delinquent account from the fund.
If any payment on a delinquent account is received as a result of compliance with the procedures in subsection b. of this section and the hospital has already received payment from the fund, the amount of money the hospital is entitled to receive from the fund shall be adjusted pursuant to procedures established by the commission.
d. This section shall not apply to a patient who: qualifies for charity care pursuant to rules and regulations adopted by the commissioner; is found to be indigent by a court of competent jurisdiction pursuant to the provisions of chapter 4 of Title 30 of the Revised Statutes; or qualifies for care under the federal Hill-Burton program pursuant to 42 U.S.C. s. 291 et seq.
e. The commissioner shall adopt rules and regulations to effectuate the purposes of this section and section 8 of P.L.1991, c.187 (C.26:2H-18.31); except that nothing in this section or section 8 of P.L.1991, c.187 (C.26:2H-18.31) shall be construed to prohibit the commissioner from adopting rules and regulations that are more stringent than the provisions of this section and section 8 of P.L.1991, c.187 (C.26:2H-18.31).
a. The department shall annually provide for an audit of each hospital's uncompensated care within a time frame established by rules and regulations adopted by the commissioner.
b. Prior to the department's final approval of the audit, the results of the audit shall be reviewed with the hospital. If a hospital disputes an audit adjustment, the hospital may appeal the adjustment to the commission. The commission shall resolve the dispute within 90 calendar days of the date on which the hospital appealed the adjustment.
c. Upon receipt and acceptance of the final audit, the commission, within 90 calendar days, shall adjust a hospital's schedule of rates so that the rates reflect the audit adjustment.
The department shall, for the purpose of developing patient profiles, require a hospital to report the following information about any patient who was served on an inpatient basis or on any patient served on an outpatient basis with an account balance greater than $125, whose account has been referred to a collection agency or for legal action pursuant to paragraph (3) of subsection b. of section 10 of P.L.1989, c.1 (C.26:2H-18.13) or to paragraph (3) of subsection b. of section 11 of P.L.1991, c.187 (C.26:2H-18.33): the patient's age; sex; marital status; employment status and if employed, whether the employment is full or part-time; type of health insurance coverage, and if the patient is a child under 18 years of age who does not have health insurance coverage or a married person who does not have health insurance coverage, whether the child's parent or the married person's spouse, as the case may be, has health insurance coverage.
The hospital shall also include a copy of any billing information about the patient's account, at the point of write-off as a bad debt, which is provided to a collection agency or any other person for legal action, including whether the amount due and owing represents the patient or responsible party's failure to pay a full hospital bill, a partial hospital bill, or an insurance copayment or deductible.
The hospital shall provide the information to the department on a quarterly basis, on a form developed by the department, in consultation with the New Jersey Hospital Association.
The Department of the Treasury shall compile and submit to the Department of Health information about the income of persons whose income tax refund or homestead rebate was applied to recover the amount due and owing on a patient's account pursuant to paragraph (4) of subsection b. of section 10 of P.L.1989, c.1 (C.26:2H-18.13) or to paragraph (4) of subsection b. of section 11 of P.L.1991, c.187 (C.26:2H-18.33).
The information compiled by the department shall identify the number of persons whose annual income for 1990 is: below $10,000; between $10,000 and $20,000; between $20,001 and $40,000; between $40,001 and $60,000; between $60,001 and $80,000; and greater than $80,000.
The State Auditor shall conduct quality control reviews of the audits of hospital uncompensated care for calendar years 1989 and 1990 that are required pursuant to section 11 of P.L.1989, c.1 (C.26:2H-18.14). The State Auditor shall select a representative sample of hospital audits to complete the reviews, except that each year's review shall include, at a minimum, the audits from the 20 hospitals with the highest uncompensated care costs in the State.
The State Auditor shall report to the chairmen of the Senate Institutions, Health and Welfare and General Assembly Health and Human Services Committees and the Commissioner of Health on the results of the reviews and make any recommendations necessary to improve the system for monitoring compliance with the patient interview and collection procedures required pursuant to this act.
The Department of Health shall promptly provide the State Auditor with a copy of the completed audits of each hospital's uncompensated care for 1989, and the completed audits for 1990, as soon as they are available, for the purpose of conducting the reviews.
The commission shall adjust a hospital's schedule of rates to ensure that services which are provided to emergency room patients who do not require those services on an emergency basis are reimbursed at a rate appropriate for primary care, according to regulations adopted by the commissioner. Nothing in this section shall be construed to restrict the right of the commission to increase a hospital's schedule of rates for required emergency services, except that the increase shall not be solely to offset a reduction in hospital revenue as a result of reduced rates for primary care provided in the emergency room.
Nothing in this section shall be construed to permit a hospital to refuse to provide emergency room services to a patient who does not require the services on an emergency basis.
Any employer in this State who does not provide health insurance coverage to its employees is required to provide employer assistance and to inform all of its current and prospective employees about the importance of having health insurance coverage. The employer shall also make a good faith effort to assist any employee who wishes to purchase health insurance from a health insurance carrier.
For the purposes of this section, "employer assistance" means the dissemination to all current and prospective employees of information obtained from the department on health insurance products available in the State for employees and their dependents.
The department, in consultation with the Department of Insurance, shall prepare and have ready for dissemination to employers information on health insurance products available in the State.
The monies remaining in the "Uncompensated Care Reduction--Pilot Program" account of the New Jersey Uncompensated Care Trust Fund established pursuant to P.L.1989, c.1 (C.26:2H-18.4 et seq.) on December 31, 1990 shall be used to subsidize or otherwise provide financial assistance for a health insurance pilot program for small business employees; except that the monies, and any interest earned thereon, shall remain in the account until such time as a law is enacted which establishes the health insurance pilot program for small business employees and which appropriates the monies in the account.
A hospital shall not advertise by any means the availability of uncompensated care that is provided at the hospital pursuant to this act. Nothing in this section shall be construed to prohibit a hospital from advertising its requirement to provide charity care under the federal Hill-Burton program pursuant to 42 U.S.C. s. 291 et seq.
a. The cost of advanced life support services provided pursuant to P.L.1984, c.146 (C.26:2K-7 et seq.) to medically indigent persons incurred through a hospital's provision of advanced life support services shall be compensated pursuant to this act. The commission shall, by regulation, establish a schedule of reimbursement rates for advanced life support services. Reimbursement for mobile intensive care unit uncompensated care shall only include those uninsured patients who are classified as charity care pursuant to regulations promulgated by the commissioner. Reimbursement shall exclude bad debt, the difference in a contractual allowance, or any medical denials for a service.
b. The cost of advanced life support services provided by the University of Medicine and Dentistry of New Jersey University Hospital to uninsured patients who are classified as charity care shall be uncompensated care, except that such uncompensated care shall be exempt from any reimbursement limitations for uncompensated care that apply to University Hospital. Reimbursement for advanced life support services uncompensated care for University Hospital shall not be paid from the fund, but shall be paid through the reimbursement rates of University Hospital as established by the commission.
For all periods for which an audit for reimbursement for uncompensated care through the Uncompensated Care Trust Fund established pursuant to P.L.1989, c.1 (C.26:2H-18.4 et seq.) shall be conducted, the requirements regarding the determination of eligibility for charity care pursuant to sections 9 and 10 of P.L.1989, c.1 (C.26:2H-18.12 and 18.13) shall not apply to a patient who is investigated by a county adjuster and found to be indigent by a court of competent jurisdiction pursuant to the provisions of chapter 4 of Title 30 of the Revised Statutes. A patient so found shall qualify for charity care.
a. The commissioner shall establish a pilot program to create a partnership between urban hospitals with high uncompensated care costs and community health centers in order to provide primary health care in the most appropriate community setting. The commissioner shall select one hospital with high uncompensated care costs in the northern, central and southern regions of the State, respectively, to participate in the program. The commissioner shall establish the program by September 1, 1991.
b. Each hospital selected to participate in the program shall establish a formal agreement with a community health center located near the hospital, in which the hospital agrees to refer emergency room patients who are not in need of emergency care, but require primary care, to the community health center for the needed medical services. The agreement shall stipulate that if the patient who is referred to the community health center cannot afford to pay for the health care services provided at the center and qualifies for charity care pursuant to requirements established by the commissioner, the center shall submit the bill to the referring hospital and the hospital shall include the amount of the bill in its uncompensated care costs. The hospital shall reimburse the center for the approved charity care provided pursuant to this pilot program. The agreement shall also stipulate that the community health center shall operate at hours that reflect the needs of the community and shall provide an emergency contact during nonoperating hours.
a. The commissioner shall include in the first report a summary of the findings of the 1990 annual audit of each hospital's uncompensated care conducted pursuant to section 12 of P.L.1991, c.187 (C.26:2H-18.34). The summary shall include the percentage of uncompensated care for each hospital that is classified as charity care and as bad debt, respectively. The report shall also include a compilation of the information collected pursuant to section 13 of P.L.1991, c.187 (C.26:2H-18.35).
b. The commissioner shall include in the second report a compilation of the information collected pursuant to section 13 of P.L.1991, c.187 (C.26:2H-18.35) and provided by the Department of the Treasury pursuant to section 14 of P.L.1991, c.187 (C.26:2H-18.36).
a. There is established in the Department of Health a special fund to be known as the "Health Care Cost Reduction Fund."
The monies in the Health Care Cost Reduction Fund are hereby appropriated for the purposes and in amounts not to exceed the amounts specified in this subsection:
(1) Local health planning - $3 million per year;
(2) Demographic study of hospital patients whose accounts are classified as bad debts - $50,000;
(3) Primary Care Physician and Dentist Loan Redemption Program - $1 million per year;
(4) Provision of funds to community health centers funded under sections 329 or 330 of the "Public Health Service Act," (42 U.S.C. s. 254b, 254c) or which have been designated by the Health Resources and Services Administration in the United States Public Health Service as a Federally Qualified Health Center, to enable these centers to expand their hours of operation to evenings and weekends, and to enhance and advertise their primary health care services as an alternative to hospital emergency rooms - $10 million per year;
(5) Expansion of eligibility for the Medicaid program to 185% of the poverty level for pregnant women and infants up to one year of age;
(6) Establishment of a "HealthStart Plus" program for pregnant women and infants up to age one whose income is between 185% and 300% of the poverty level - $8 million per year;
(7) Establishment of the "Competitive Initiatives Fund" to strengthen relationships between hospitals and community health centers - $6 million per year; and
(8) Other reform measures established by law which are designed to contain the cost of uncompensated care.
The department shall maintain a separate account for each of the reform measures funded by the Health Care Cost Reduction Fund.
b. Notwithstanding any law to the contrary, each hospital whose rates are established by the commission pursuant to P.L.1978, c.83 (C.26:2H-1 et al.) shall pay .53% of its approved revenue base for 1991 to the Department of Health for deposit in the Health Care Cost Reduction Fund. The hospital shall make monthly payments to the department for a period of 24 months beginning on the first month following the date of enactment of this act, except that the total amount paid into the Health Care Cost Reduction Fund plus interest shall not exceed $40 million per year. The commissioner shall determine the manner in which the payments shall be made.
c. The commissioner shall report to the Senate Institutions, Health and Welfare Committee and the General Assembly Health and Human Services Committee quarterly on the status of the Health Care Cost Reduction Fund. The report shall specify the amount of revenues received by the fund and the specific expenditures made, and proposed to be made, from the fund.
The employees, appropriations and other moneys, files, books, papers, records, equipment and other property of the "New Jersey Uncompensated Care Trust Fund" and the "Uncompensated Care Trust Fund Advisory Committee," established pursuant to P.L.1986, c.204, and continued pursuant to P.L.1989, c.1 (C.26:2H-18.4 et seq.), which law expired on December 31, 1990, are transferred, pursuant to the "State Agency Transfer Act," P.L.1971, c.375 (C.52:14D-1 et seq.) to the "New Jersey Health Care Trust Fund" established pursuant to this act.
This amendatory and supplementary act shall be known and may be cited as the "Health Care Cost Reduction Act."
a. It is of paramount public interest for the State to take all necessary and appropriate actions to ensure access to and the provision of high quality and cost-effective hospital care to its citizens.
b. The highly regulated system under which acute care hospitals have been forced to operate in New Jersey since the enactment of P.L.1978, c.83 was intended to control health care costs and promote the efficient and effective delivery of health care; however, because health care costs have continued to increase at an alarming rate, the State clearly needs to eliminate the current Diagnosis Related Group (DRG) rate setting methodology it initiated in 1980 and move in the direction of a deregulated hospital reimbursement system which will provide hospitals with a truly competitive market environment and strong incentives to offer only those services which meet the demands of health care purchasers and consumers.
c. Access to quality health care shall not be denied to residents of this State because of their inability to pay for the care; there are many residents of this State who cannot afford to pay for needed hospital care and in order to ensure that these persons have equal access to hospital care, it is necessary to provide disproportionate share hospitals with a charity care subsidy supported by a broad-based funding mechanism.
d. In order to provide financial support to those hospitals with a disproportionately large number of Medicare patients, it is also necessary to provide for a Medicare hospital subsidy, also supported by a broad-based funding mechanism, as a temporary means to distribute payments to disproportionate share hospitals which experience a significant shortfall in their revenues due to the difference between the hospital's actual rates for health care services and the rates paid by the Medicare program for those services.
e. There is a need to continue this State's current system of providing disproportionate share payments to hospitals in the State, and in order to ensure continuity of these payments, this act establishes the Health Care Subsidy Fund.
f. In order to ensure a smooth transition to a new, deregulated hospital reimbursement system that significantly alters the State's policy towards the delivery of health care, it is necessary to establish an independent commission which is not tied to past practices of hospital rate regulation.
"Administrator" means the administrator of the Health Care Subsidy Fund appointed by the commissioner.
"Charity care" means care provided at disproportionate share hospitals that may be eligible for a charity care subsidy pursuant to this act.
"Charity care subsidy" means the component of the disproportionate share payment that is attributable to care provided at a disproportionate share hospital to persons unable to pay for that care, as provided in this act.
"Commission" means the New Jersey Essential Health Services Commission established pursuant to section 4 of this act.
"Commissioner" means the Commissioner of Health.
"Department" means the Department of Health.
"Disproportionate share hospital" means a hospital designated by the Commissioner of Human Services pursuant to Pub.L.89-97 (42 U.S.C. s.1396a et seq.) and Pub.L.102-234.
"Disproportionate share payment" means those payments made by the Division of Medical Assistance and Health Services in the Department of Human Services to hospitals defined as disproportionate share hospitals by the Commissioner of Human Services in accordance with federal laws and regulations applicable to hospitals serving a disproportionate number of low income patients.
"Fund" means the Health Care Subsidy Fund established pursuant to section 8 of this act.
"Hospital" means an acute care hospital licensed by the Department of Health pursuant to P.L.1971, c.136 (C.26:2H-1 et al.).
"Medicaid" means the New Jersey Medical Assistance and Health Services Program in the Department of Human Services established pursuant to P.L.1968, c.413 (C.30:4D-1 et seq.).
"Medicare" means the program established pursuant to Pub.L.89-97 (42 U.S.C. s.1395 et seq.).
The revenue cap shall establish the maximum amount a hospital may collect in revenues in 1993 from all payers, but shall not include payments from the fund. The revenue cap shall be based upon the same financial elements used to prepare the preliminary cost base for 1992, but shall not include any amounts provided in 1992 for a subsidy to Blue Cross and Blue Shield of New Jersey, Inc. and for patient appeals. The revenue cap shall include:
(1) a component for a hospital's bad debt as determined by the hospital's payment for bad debt from the New Jersey Health Care Trust Fund in 1992 pursuant to P.L.1991, c.187 (C.26:2H-18.24 et al.), but the total amount allowed for bad debt plus the amount a hospital is eligible to receive from the fund for its charity care subsidy shall not exceed the total amount of uncompensated care payments the hospital received in 1992 from the New Jersey Health Care Trust Fund;
(2) the hospital specific amount agreed to by a hospital and the Hospital Rate Setting Commission pursuant to the 1990 voluntary settlement program (N.J.A.C.8:31B-3.65); and
(3) an amount to be determined by the Hospital Rate Setting Commission which represents a hospital's share of the total outstanding reconciliation amounts as of December 31, 1992, including any reasonably projected reconciliation amounts for calendar year 1992, which total amount shall be adjusted so that a hospital's revenue cap does not exceed the hospital's preliminary cost base for 1992.
b. In addition to the categories of revenues described in paragraphs (1), (2) and (3) of subsection a. of this section, which together shall constitute the hospital revenue cap for 1993, each hospital subject to this section may also retain any revenues collected in 1993 that represent an amount to provide for the financial impact of a certificate of need approved service or project that was not included in the hospital's preliminary cost base for 1992. This addition will be calculated by the department as follows:
(1) For new inpatient services, the addition to the preliminary cost base is determined by multiplying the appropriate DRG rate by the 1993 admissions resulting from that new or expanded service.
(2) For any new outpatient services, the addition to the preliminary cost base is calculated by multiplying the appropriate charge by the number of admissions related to the new or expanded service.
(3) Increased debt service costs allocated to new patient services above that debt service included in the 1992 preliminary cost base will be additions to the 1992 preliminary cost base.
This addition to the cap for any hospital which implements a new certificate of need approved service in 1992 or 1993 shall be verified by the hospital's auditor through an agreed-upon procedures report. The report shall be submitted in accordance with the procedures outlined by the department pursuant to subsection c. of this section. The department shall review and approve any addition to a hospital revenue cap due to new certificate of need projects prior to such additions being implemented.
The additional revenues that provide for the financial impact of a certificate of need approved service or project shall not be considered in the calculations of a hospital's revenue cap or in the assessment of any revenue cap penalties levied pursuant to subsection d. of this section. A hospital shall continue to provide any public health services which were formerly supported by grant funds but whose costs were included in that hospital's preliminary cost base for 1992 and shall provide for its regional hemophilia center and regional maternal and child health consortia, as applicable.
c. The department shall provide for an audit of a hospital's revenues for 1993 in a time frame established by the department.
d. A hospital whose revenues exceeded its revenue cap during 1993 shall be liable to a civil penalty of payment of an amount not to exceed 1.5 times the amount of revenue in excess of the revenue cap.
The civil penalty provided for in this section shall be recovered in an administrative proceeding held pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.). Any monies recovered pursuant to this penalty shall be deposited in the fund.
e. In order to minimize the disruption in the transition year, any discounts negotiated between hospitals and non-governmental third party payers shall reflect cost savings resulting from the efficient use of resources and not merely cost shifts from one payer to another. The final rate shall be mutually agreeable to both parties.
f. In the event that the revenues collected by a hospital during the transition year are insufficient, the State shall not be liable for any deficiency.
L1992,c.160,s.3; amended 1994,c.120.
b. Whenever, in any rule, regulation, order, contract, document, judicial or administrative proceeding or otherwise, reference is made to the New Jersey Essential Health Services Commission or the officers thereof, the same shall mean and refer to the Department of Health or the officers thereof.
c. This transfer shall be subject to the provisions of the "State Agency Transfer Act," P.L.1971, c.375 (C.52:14D-1 et seq.).
a. Administer the fund and establish a mechanism to allocate monies received from the Commissioner of Labor pursuant to section 29 of P.L.1992, c.160 (C.43:21-7b) to the appropriate accounts in the fund as specified in this act;
b. Establish eligibility determination and claims pricing systems for the charity care component of the disproportionate share subsidy, including the development of uniform forms for determining eligibility and submitting claims. The commissioner may contract with a private claims administrator or processor for the purpose of processing hospital claims for charity care pursuant to this act;
c. Establish and implement by January 1, 1997, a schedule of payments for reimbursement of the charity care component of the disproportionate share payment for services provided to emergency room patients who do not require those services on an emergency basis;
d. In cooperation with the Departments of Insurance and Human Services, develop and provide for the implementation of the Health Access New Jersey program pursuant to section 15 of P.L.1992, c.160 (C.26:2H-18.65);
e. Study and, if feasible, establish hospital cost and outcome reports to provide assistance to consumers of health care in this State in making prudent health care choices;
f. Compile demographic information on recipients of, and types of services paid for by, the charity care component of the disproportionate share payment and periodically report a summary of this information to the Governor and Legislature. The demographic information shall include, at a minimum, the recipient's age, sex, marital status, employment status, type of health insurance coverage, if any, and if the recipient is a child under 18 years of age who does not have health insurance coverage or a married person who does not have health insurance coverage, whether the child's parent or the married person's spouse, as the case may be, has health insurance;
g. (Deleted by amendment, P.L.1995, c.133.)
h. (Deleted by amendment, P.L.1995, c.133.)
i. (Deleted by amendment, P.L.1995, c.133.)
j. (Deleted by amendment, P.L.1995, c.133.)
k. (Deleted by amendment, P.L.1995, c.133.)
l. Encourage the use of centralized data storage and transmission technology that utilizes personal and image identification systems as well as identity verification technology for the purposes of enabling a hospital to access medical history, insurance information and other personal information, as appropriate;
m. (Deleted by amendment, P.L.1995, c.133.)
n. (Deleted by amendment, P.L.1995, c.133.)
o. Take such other actions as the commissioner deems necessary and appropriate to carry out the provisions of P.L.1992, c.160 (C.26:2H-18.51 et al.); and
p. Report annually, by December 1 of each year, to the Governor and the Senate and General Assembly standing reference committees on budget and appropriations on the status of the fund.
(1) the employer's name and address;
(2) the number of recipients of charity care who are employed by the employer; and
(3) the cost to the State of providing charity care for the employer's employees and their dependents.
b. In order to compile the information required pursuant to this section, the commissioner may require hospitals and other health care facilities to submit such information as may be necessary for this purpose.
c. The commissioner may include comparable information about recipients of other public health care coverage programs, and other information as the commissioner deems appropriate regarding employer-based coverage for persons covered under public insurance programs.
d. The information compiled by the commissioner shall not include the name of any charity care recipient or any family member of a recipient.
e. The commissioner shall provide the information required pursuant to this section to the Commissioner of Human Services for inclusion in the annual report on Access to Employer-Based Health Insurance, as provided in section 1 of P.L.2006, c.87 (C.30:4J-17).
The revenues raised by the hospital per adjusted admission charge shall be used by the department to carry out its duties pursuant to P.L.1992, c.160 (C.26:2H-18.51 et al.) and for administrative costs related to health planning.
Effective July 1, 2018, the assessment shall apply to all general acute care hospitals, rehabilitation hospitals, long-term acute care hospitals, and non-public psychiatric hospitals. Any General Fund savings resulting from the assessment meeting the permissibility standards set forth in 42 C.F.R. s.433.68 shall be used to create a supplemental funding pool, known as Safety Net Graduate Medical Education, for the State's graduate medical education subsidy.
Notwithstanding the provisions of any law or regulation to the contrary, and except as otherwise provided and subject to such modifications as may be required by the Centers for Medicare and Medicaid Services in order to achieve any required federal approval and full federal financial participation, $24,285,714 is appropriated from the General Fund for Safety Net Graduate Medical Education and conditioned upon the following:
Funds from the Safety Net Graduate Medical Education pool shall be available to eligible hospitals that meet the following eligibility criteria: An eligible hospital has a Relative Medicaid Percentage (RMP) that is in the top third of all acute care hospitals that have a residency program. The RMP is a ratio calculated using the 2016 Audited C.160 SHARE Cost Reports. The numerator of the RMP equals a hospital's gross revenue from patient care for Medicaid and Medicaid HMO as reported on Line 1, Col. D & Col. H of Forms E5 and E6. The denominator of the RMP equals a hospital's gross revenue from patient care as reported on Line 1, Col. E of Form E4. For instances where hospitals that have a single Medicare identification number submit a separate cost report for each campus, the values referenced above shall be consolidated.
Payments to eligible hospitals shall be made in the following manner:
(1) the subsidy payment shall be split into a Direct Medical Education (DME) allocation, which is calculated by multiplying the total subsidy amount by the ratio of 2016 total median Medicaid Managed Care DME costs to total 2016 median Medicaid Managed Care GME costs, and an Indirect Medical Education (IME) allocation, which is calculated by multiplying the total subsidy amount by the ratio of 2016 total Medicaid Managed Care IME costs to total 2016 Medicaid Managed Care GME costs.
(2) Each hospital's percentage of total 2016 Medicaid Managed Care DME costs shall be multiplied by the DME allocation to calculate its DME payment. Each hospital's percentage of total 2016 Medicaid Managed Care IME costs shall be multiplied by the IME allocation to calculate its IME payment.
(3) Source data used shall come from the Medicaid cost report for calendar year (CY) 2016 submitted by each acute care hospital by November 30, 2017 and Medicaid Managed Care encounter payments for Medicaid and NJ FamilyCare clients as reported by insurers to the State for the following reporting period: services dates between January 1, 2016 and December 31, 2016; payment dates between January 1, 2016 and December 31, 2017; and a run date of not later than January 31, 2018.
(4) In the event that a hospital reported less than 12 months of 2016 Medicaid costs, the number of reported months of data regarding days, costs, or payments shall be annualized. In the event the hospital completed a merger, acquisition, or business combination or a supplemental cost report for the calendar year 2016 submitted by the affected acute care hospital by November 30, 2017 shall be used. In the event that a hospital did not report its Medicaid Managed Care days on the cost report utilized in this calculation, the Department of Health (DOH) shall ascertain Medicaid Managed Care encounter days for Medicaid and NJ FamilyCare clients as reported by insurers to the State.
(5) Medicaid Managed Care DME cost is defined as the approved intern and residency program costs using the 2016 Medicaid cost report total residency costs, reported on Worksheet B, Pt I, Column 21, line 21 plus Worksheet B, Pt I, Column 22, Line 22 divided by 2016 resident full time equivalent employees (FTE), reported on Worksheet S—3, Pt 1, Column 9, Line 14 to develop an average cost per FTE for each hospital used to calculate the overall median cost per FTE.
(6) The median cost per FTE is multiplied by the 2016 resident FTEs reported on Worksheet S—3, Pt 1, Column 9, Line 14 to develop approved total residency program costs.
(7) The approved residency costs are multiplied by the quotient of Medicaid Managed Care days, reported on Worksheet S—3, Column 7, line 2, divided by the quantity of total days, on Worksheet S—3, Column 8, Line 14, less nursery days, on Worksheet S—3, Column 8, Line 13.
(8) Medicaid Managed Care IME cost is defined as the Medicare IME factor multiplied by Medicaid Managed Care encounter payments for Medicaid and NJ FamilyCare clients as reported by insurers to the State.
(9) The IME factor is calculated using the Medicare IME formula as follows: 1.35 * [(1 + x) ^0.405 - 1], in which "x" is the quotient of submitted IME resident full-time equivalencies reported on Worksheet S—3, Pt 1, Column 9, Line 14, divided by the quantity of total available beds less nursery beds reported on Worksheet S—3, Column 2, Line 14.
(10) In the event that a hospital believes that there are mathematical errors in the calculations, or data not matching the actual source documents used to calculate the subsidy as defined above, hospitals shall be permitted to file calculation appeals within 15 working days of receipt of the subsidy allocation letter. If, upon review, it is determined by the department that the error has occurred and would constitute at least a five percent change in the hospital's allocation amount, a revised industry-wide allocation shall be issued.
b. Effective July 1, 2004, the department shall assess each licensed ambulatory care facility that is licensed to provide one or more of the following ambulatory care services: ambulatory surgery, computerized axial tomography, comprehensive outpatient rehabilitation, extracorporeal shock wave lithotripsy, magnetic resonance imaging, megavoltage radiation oncology, positron emission tomography, orthotripsy, and sleep disorder services. The Commissioner of Health may, by regulation, add additional categories of ambulatory care services that shall be subject to the assessment if such services are added to the list of services provided in N.J.A.C.8:43A-2.2(b) after the effective date of P.L.2004, c.54.
The assessment established in this subsection shall not apply to an ambulatory care facility that is licensed to a hospital in this State as an off-site ambulatory care service facility.
(1) For Fiscal Year 2005, the assessment on an ambulatory care facility providing one or more of the services listed in this subsection shall be based on gross receipts for the 2003 tax year as follows:
(a) a facility with less than $300,000 in gross receipts shall not pay an assessment; and
(b) a facility with at least $300,000 in gross receipts shall pay an assessment equal to 3.5 percent of its gross receipts or $200,000, whichever amount is less.
The commissioner shall provide notice no later than August 15, 2004 to all facilities that are subject to the assessment that the first payment of the assessment is due October 1, 2004 and that proof of gross receipts for the facility's tax year ending in calendar year 2003 shall be provided by the facility to the commissioner no later than September 15, 2004. If a facility fails to provide proof of gross receipts by September 15, 2004, the facility shall be assessed the maximum rate of $200,000 for Fiscal Year 2005.
The Fiscal Year 2005 assessment shall be payable to the department in four installments, with payments due October 1, 2004, January 1, 2005, March 15, 2005, and June 15, 2005.
(2) For Fiscal Year 2006, the commissioner shall use the calendar year 2004 data submitted in accordance with subsection c. of this section to calculate a uniform gross receipts assessment rate for each facility with gross receipts over $300,000 that is subject to the assessment, except that no facility shall pay an assessment greater than $200,000. The rate shall be calculated so as to raise the same amount in the aggregate as was assessed in Fiscal Year 2005. A facility shall pay its assessment to the department in four payments in accordance with a timetable prescribed by the commissioner.
(3) Beginning in Fiscal Year 2007 and for each fiscal year thereafter through Fiscal Year 2010, the uniform gross receipts assessment rate calculated in accordance with paragraph (2) of this subsection shall be applied to each facility subject to the assessment with gross receipts over $300,000, as those gross receipts are documented in the facility's most recent annual report to the department, except that no facility shall pay an assessment greater than $200,000. A facility shall pay its annual assessment to the department in four payments in accordance with a timetable prescribed by the commissioner.
(4) Beginning in Fiscal Year 2011 and for each fiscal year thereafter through Fiscal Year 2025, the uniform gross receipts assessment shall be applied at the rate of 2.95 percent to each facility subject to the assessment with gross receipts over $300,000, as those gross receipts are documented in the facility's most recent annual report submitted to the department pursuant to subsection c. of this section, except that no facility shall pay an assessment greater than $350,000. A facility shall pay its annual assessment to the department in four payments in accordance with a timetable prescribed by the commissioner.
(5) Beginning in Fiscal Year 2026 and for each fiscal year thereafter, the uniform gross receipts assessment shall be applied at the rate of 2.5 percent to each facility subject to the assessment. A facility shall pay its annual assessment to the department in four payments in accordance with a timetable prescribed by the commissioner.
(6) An ambulatory care facility that was exempt from the assessment prior to Fiscal Year 2026 pursuant to section 12 of P.L.1971, c.136 (C.26:2H-12) shall report in Fiscal Year 2026 the facility's gross receipts from its operating room services, pursuant to subsection c. of this section, and the department shall assess 2.5 percent of the facility's gross receipts beginning in Fiscal Year 2027 . As used in this paragraph, "operating room services" shall mean surgical or diagnostic procedures performed in a room specifically equipped to perform surgery and designed and constructed to accommodate invasive diagnostic and surgical procedures.
(7) Effective the first day of the third quarter of Fiscal Year 2026, and subject to any necessary federal approvals applied for by the Commissioner of Human Services pursuant to section 2 of P.L.2025, c.336 (C.26:2H-18.57a), no facility shall pay an assessment greater than $2,000,000 annually under the assessment enacted and imposed pursuant to paragraph (5) of this subsection as amended by P.L.2025, c.70, effective June 30, 2025.
c. Each ambulatory care facility that is subject to the assessment provided in subsection b. of this section shall submit an annual report including, at a minimum, data on volume of patient visits, charges, and gross revenues, by payer type, for patient services, beginning with calendar year 2004 data. The annual report shall be submitted to the department according to a timetable and in a form and manner prescribed by the commissioner.
The department may audit selected annual reports in order to determine their accuracy.
d. (1) If, upon audit as provided for in subsection c. of this section, it is determined that an ambulatory care facility understated its gross receipts in its annual report to the department, the facility's assessment for the fiscal year that was based on the defective report shall be retroactively increased to the appropriate amount, and the facility shall be liable for a penalty in the amount of the difference between the original and corrected assessment.
(2) A facility that fails to provide the information required pursuant to subsection c. of this section shall be liable for a civil penalty not to exceed $500 for each day in which the facility is not in compliance.
(3) A facility that is operating one or more of the ambulatory care services listed in subsection b. of this section without a license from the department, on or after July 1, 2004, shall be liable for double the amount of the assessment provided for in subsection b. of this section, in addition to such other penalties as the department may impose for operating an ambulatory care facility without a license.
(4) The commissioner shall recover any penalties provided for in this subsection in an administrative proceeding in accordance with the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.).
e. The revenues raised by the ambulatory care facility assessment pursuant to this section shall be deposited in the Health Care Subsidy Fund established pursuant to section 8 of P.L.1992, c.160 (C.26:2H-18.58).
a. The fund shall be comprised of revenues from employee and employer contributions made pursuant to section 29 of P.L.1992, c.160 (C.43:21-7b), revenues from the hospital assessment made pursuant to section 12 of P.L.1992, c.160 (C.26:2H-18.62), revenues pursuant to section 11 of P.L.1996, c.28 (C.26:2H-18.58c), revenues from interest and penalties collected pursuant to this act and revenues from other sources as the Legislature shall determine. Interest earned on the monies in the fund shall be credited to the fund. The fund shall be a nonlapsing fund dedicated for use by the State to: (1) distribute charity care and other uncompensated care disproportionate share payments to hospitals, and other eligible providers pursuant to section 8 of P.L.1996, c.28 (C.26:2H-18.59f), provide subsidies for the Health Access New Jersey program established pursuant to section 15 of P.L.1992, c.160 (C.26:2H-18.65), and provide funding for children's health care coverage in the NJ FamilyCare Program pursuant to P.L.2005, c.156 (C.30:4J-8 et al.); (2) provide funding for federally qualified health centers pursuant to section 12 of P.L.1992, c.160 (C.26:2H-18.62); and (3) provide for the payment in State fiscal year 2002 of appropriate Medicaid expenses, subject to the approval of the Director of the Division of Budget and Accounting.
b. The fund shall be administered by a person appointed by the commissioner.
The administrator of the fund is responsible for overseeing and coordinating the collection and reimbursement of fund monies. The administrator is responsible for promptly informing the commissioner if monies are not or are not reasonably expected to be collected or disbursed.
c. The commissioner shall adopt rules and regulations to ensure the integrity of the fund, pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.).
d. The administrator shall establish separate accounts for the charity care component of the disproportionate share hospital subsidy, other uncompensated care component of the disproportionate share hospital subsidy, federally qualified health centers funding, and the payments for subsidies for insurance premiums to provide care in disproportionate share hospitals, known as the Health Access New Jersey subsidy account, respectively.
e. In the event that the charity care component of the disproportionate share hospital subsidy account has a surplus in a given year after payments are distributed pursuant to the methodology established in section 13 of P.L.1995, c.133 (C.26:2H-18.59b) and section 7 of P.L.1996, c.28 (C.26:2H-18.59e) and within the limitations provided in subsection e. of section 9 of P.L.1992, c.160 (C.26:2H-18.59), the surplus monies in calendar years 2002, 2003 and 2004 shall lapse to the unemployment compensation fund established pursuant to R.S.43:21-9, and each year thereafter shall lapse to the charity care component of the disproportionate share hospital subsidy account for distribution in subsequent years.
b. The Health Care Subsidy Fund shall be supported with revenues derived from efficiencies achieved by State use of an electronic data interchange system for health care claims and related information, in amounts necessary to provide funding for the provision of charity care pursuant to P.L.1992, c.160 (C.26:2H-18.51 et al.).
b. In fiscal year 1998 and each fiscal year thereafter, the Governor shall recommend and the Legislature shall appropriate to the Hospital Health Care Subsidy account for distribution to disproportionate share hospitals which are eligible for reimbursement pursuant to subsection a. of this section, those federal funds received in connection with the provision of hospital reimbursements from that account.
b. In fiscal year 1999 and each fiscal year thereafter, the Governor shall recommend and the Legislature shall appropriate to the Division of Medical Assistance and Health Services for the purposes of subsection a. of this section, those federal funds received in connection with the provision of children's health care coverage in the NJ FamilyCare Program pursuant to P.L.2005, c.156.
a. commencing July 1, 1998 and ending June 30, 2006: after the deposit required pursuant to section 5 of P.L.1982, c.40 (C.54:40A-37.1), the first $150,000,000 of revenue collected annually from the "Cigarette Tax Act," P.L.1948, c.65 (C.54:40A-1 et seq.) and the first $5,000,000 of revenue collected annually from the "Tobacco Products Wholesale Sales and Use Tax Act," P.L.1990, c.39 (C.54:40B-1 et seq.), shall be deposited into the Health Care Subsidy Fund established pursuant to section 8 of P.L.1992, c.160 (C.26:2H-18.58); and the next $390,000,000 of revenue collected annually from the "Cigarette Tax Act," P.L.1948, c.65 (C.54:40A-1 et seq.) shall be appropriated annually for health programs, and the next $50,000,000 of revenue collected annually from the "Cigarette Tax Act," P.L.1948, c.65 (C.54:40A-1 et seq.) shall be appropriated annually to the New Jersey Economic Development Authority for payment of debt service incurred by the authority for school facilities projects and in fiscal years commencing July 1, 2002 and July 1, 2003, the next $30,000,000 of revenue collected annually from the "Cigarette Tax Act," P.L.1948, c.65 (C.54:40A-1 et seq.) shall be directed to the Department of Health to fund anti-smoking initiatives, except that the amount shall be $40,000,000 in the fiscal year commencing July 1, 2004 and $45,000,000 in the fiscal year commencing July 1, 2005;
b. commencing with fiscal years beginning on and after July 1, 2006, after the deposit required pursuant to section 5 of P.L.1982, c.40 (C.54:40A-37.1), the first $150,000,000 of revenue collected annually from the "Cigarette Tax Act," P.L.1948, c.65 (C.54:40A-1 et seq.) and the first $5,000,000 of revenue collected annually from the "Tobacco Products Wholesale Sales and Use Tax Act," P.L.1990, c.39 (C.54:40B-1 et seq.), shall be deposited into the Health Care Subsidy Fund established pursuant to section 8 of P.L.1992, c.160 (C.26:2H-18.58). In addition, commencing with fiscal years beginning on and after July 1, 2006 but before July 1, 2009, there shall be deposited $215,000,000 of revenue collected annually from the "Cigarette Tax Act," P.L.1948, c.65 (C.54:40A-1 et seq.) in accordance with the provisions of section 5 of P.L.2004, c.68 (C.34:1B-21.20), and, commencing with fiscal years beginning on and after July 1, 2009, there shall be deposited $241,500,000 of revenue collected annually from the "Cigarette Tax Act," P.L.1948, c.65 (C.54:40A-1 et seq.) in accordance with the provisions of section 5 of P.L.2004, c.68 (C.34:1B-21.20). In addition, commencing with fiscal years beginning on and after July 1, 2018, an amount equal to one percent of the total revenues collected annually from the "Cigarette Tax Act," P.L.1948, c.65 (C.54:40A-1 et seq.) and the "Tobacco Products Wholesale Sales and Use Tax Act," P.L.1990, c.39 (C.54:40B-1 et seq.) shall be directed to the Department of Health to fund and implement evidence-based tobacco control programs that align with the federal Centers for Disease Control and Prevention Best Practices for Comprehensive Tobacco Control Programs and that include the goals of preventing youth initiation of tobacco usage, reducing exposure to secondhand smoke, and promotion of cessation. Funding priority shall be given to programs that aim to reduce the incidence of smoking among the State's Medicaid population and youth; and
c. commencing with fiscal years beginning on or after July 1, 2025, $2,000,000 of revenue collected annually from the tax on liquid nicotine pursuant to section 5 of P.L.2018, c.50 (C.54:40B-3.2) and the tax on container e-liquid pursuant to section 5 of P.L.2019, c.147 (C.54:40B-3.4) shall be deposited into the Health Care Subsidy Fund established pursuant to section 8 of P.L.1992, c.160 (C.26:2H-18.58).
b. For the period January 1, 1993 to December 31, 1993, the commission shall allocate $500 million to the charity care component of the disproportionate share hospital subsidy account. The Department of Health shall recommend the amount that the Division of Medical Assistance and Health Services shall pay to an eligible hospital on a provisional, monthly basis pursuant to paragraphs (1) and (2) of this subsection. The department shall also advise the commission and each eligible hospital of the amount a hospital is entitled to receive.
(1) The department shall determine if a hospital is eligible to receive a charity care subsidy in 1993 based on the following:
Hospital Specific Approved Uncompensated Care-1991
Hospital Specific Preliminary Cost Base-1992
= Hospital Specific % Uncompensated Care (%UC)
A hospital is eligible for a charity care subsidy in 1993 if, upon establishing a rank order of the %UC for all hospitals, the hospital is among the 80% of hospitals with the highest %UC.
(2) The maximum amount of the charity care subsidy an eligible hospital may receive in 1993 shall be based on the following:
Hospital Specific Approved Uncompensated Care-1991
Total approved Uncompensated Care All Eligible Hospitals-1991
X $500 million
= Maximum Amount of Hospital Specific Charity Care Subsidy for 1993
(3) A hospital shall be required to submit all claims for charity care cost reimbursement, as well as demographic information about the persons who qualify for charity care, to the department in a manner and time frame specified by the Commissioner of Health, in order to continue to be eligible for a charity care subsidy in 1993 and in subsequent years.
The demographic information shall include the recipient's age, sex, marital status, employment status, type of health insurance coverage, if any, and if the recipient is a child under 18 years of age who does not have health insurance coverage or a married person who does not have health insurance coverage, whether the child's parent or the married person's spouse, as the case may be, has health insurance.
(4) A hospital shall be reimbursed for the cost of eligible charity care at the same rate paid to that hospital by the Medicaid program; except that charity care services provided to emergency room patients who do not require those services on an emergency basis shall be reimbursed at a rate appropriate for primary care, according to a schedule of payments developed by the commission.
(5) The department shall provide for an audit of a hospital's charity care for 1993 within a time frame established by the department.
c. For the period January 1, 1994 to December 31, 1994, a hospital shall receive disproportionate share payments from the Division of Medical Assistance and Health Services based on the amount of charity care submitted to the commission or its designated agent, in a form and manner specified by the commission. The commission or its designated agent shall review and price all charity care claims and notify the Division of Medical Assistance and Health Services of the amount it shall pay to each hospital on a monthly basis based on actual services rendered.
(1) (Deleted by amendment, P.L.1995, c.133.)
(2) If the commission is not able to fully implement the charity care claims pricing system by January 1, 1994, the commission shall continue to make provisional disproportionate share payments to eligible hospitals, through the Division of Medical Assistance and Health Services, based on the charity care costs incurred by all hospitals in 1993, until such time as the commission is able to implement the claims pricing system.
If there are additional charity care balances available after the 1994 distribution based on 1993 charity care costs, the department shall transfer these available balances from the fund to the Division of Medical Assistance and Health Services for an approved one-time additional disproportionate share payment to hospitals according to the methodology provided in section 12 of P.L.1995, c.133 (C.26:2H-18.59a). The total payment for all hospitals shall not exceed $75.5 million.
(3) A hospital shall be reimbursed for the cost of eligible charity care at the same rate paid to that hospital by the Medicaid program; except that charity care services provided to emergency room patients who do not require those services on an emergency basis shall be reimbursed at a rate appropriate for primary care, according to a schedule of payments developed by the commission.
(4) (Deleted by amendment, P.L.1995, c.133.)
d. (Deleted by amendment, P.L.1995, c.133.)
e. The total amount allocated for charity care subsidy payments shall be: in 1994, $450 million; in 1995, $400 million; in 1996, $310 million; in 1997, $300 million; for the period January 1, 1998 through June 30, 1998, $160 million; and in fiscal year 1999 and each fiscal year thereafter through fiscal year 2004, $320 million. Total payments to hospitals shall not exceed the amount allocated for each given year.
f. Beginning January 1, 1995:
(1) The charity care subsidy shall be determined pursuant to section 13 of P.L.1995, c.133 (C.26:2H-18.59b).
(2) A charity care claim shall be valued at the same rate paid to that hospital by the Medicaid program, except that charity care services provided to emergency room patients who do not require those services on an emergency basis shall be valued at a rate appropriate for primary care according to a schedule of payments adopted by the commissioner.
(3) The department shall provide for an audit of a hospital's charity care within a time frame established by the commissioner.
The hospital-specific additional payment shall be equal to the difference between the hospital's recalculated 1994 charity care value and the hospital's 1993 charity care amount as audited by the department and approved for reimbursement by the commission in 1994; except that, the amount a hospital may receive as an additional payment shall be limited so as to ensure that the hospital's adjusted operating margin is not in excess of the Statewide target adjusted operating margin. Those hospitals with an adjusted operating margin equal to or greater than the Statewide target adjusted operating margin shall not be eligible to receive an additional payment.
As used in this section:
a. The hospital-specific "1993 approved charity care" shall be equal to the hospital's 1993 charity care amount as audited by the department, plus 45.53% of the hospital's bad debt as reported on the hospital's 1993 Actual Cost Reports and valued at 1994 Medicaid reimbursement rates;
b. The hospital-specific "1993 revenue from private payers" shall be equal to the sum of the gross revenues, as reported to the department in the hospital's 1993 Actual Cost Reports for all non-governmental third party payers including, but not limited to, Blue Cross and Blue Shield plans, commercial insurers and health maintenance organizations;
c. The hospital-specific "payer mix factor" shall be equal to the hospital's 1993 approved charity care divided by its 1993 revenue from private payers;
d. The "Statewide target payer mix factor" is the lowest payer mix factor to which all hospitals receiving charity care subsidies can be reduced by spending all available charity care subsidy funding for that year;
e. The hospital-specific "recalculated 1994 charity care value" shall be determined by allocating available charity care funds so as to equalize hospital-specific payer mix factors to the Statewide target payer mix factor. For those hospitals with a payer mix factor greater than the Statewide target payer mix factor, the recalculated 1994 charity care value is the subsidy amount which would have been necessary to reduce their payer mix factor to that Statewide target payer mix factor; for those hospitals with a payer mix factor that is equal to or less than the Statewide target payer mix factor, their recalculated 1994 charity care value equals zero;
f. The hospital-specific "adjusted operating margin" shall be equal to the sum of the hospital's 1993 income from operations plus the hospital's 1994 commission approved charity care subsidy plus the hospital's additional payment minus the hospital's 1993 charity care subsidy, divided by the sum of the hospital's 1993 total operating revenue plus the hospital's 1994 commission approved charity care subsidy plus the hospital's additional payment minus the hospital's 1993 charity care subsidy; and
g. The "Statewide target adjusted operating margin" is the highest adjusted operating margin to which hospitals can be raised within the limit of the funds available for the additional payment.
The hospital-specific charity care subsidy shall be determined by allocating available charity care funds so as to equalize hospital-specific payer mix factors to the Statewide target payer mix factor. Those hospitals with a payer mix factor greater than the Statewide target payer mix factor shall be eligible to receive a subsidy sufficient to reduce their factor to that Statewide level; those hospitals with a payer mix factor that is equal to or less than the Statewide target payer mix factor shall not be eligible to receive a subsidy.
The commissioner shall adjust the distribution of subsidies to hospitals under this methodology to account for any provisional or interim payments made to hospitals in 1995 prior to the effective date of P.L.1995, c.133 (C.26:2H-18.59a et al.). In no case shall the total amount of payments to any hospital exceed what the hospital would have otherwise received if this methodology had been in effect for the entire year.
As used in this subsection:
(1) The hospital-specific "1993 approved charity care" shall be equal to the hospital's 1993 charity care as audited by the department plus 28.36% of the hospital's bad debt as reported on the hospital's 1993 Actual Cost Reports and valued at 1994 Medicaid reimbursement rates;
(2) The hospital-specific "operating margin" shall be equal to: the hospital's 1993 income from operations minus its 1993 charity care subsidy divided by the hospital's 1993 total operating revenue minus its 1993 charity care subsidy. After calculating each hospital's operating margin, the department shall determine the Statewide median operating margin;
(3) The hospital-specific "profitability factor" shall be determined as follows. Those hospitals that are equal to or below the Statewide median operating margin shall be assigned a profitability factor of "1." For those hospitals that are above the Statewide median operating margin, the profitability factor shall be equal to:
.75 x (hospital specific operating
margin - Statewide median operating margin)
1 - ...................................................................
highest hospital specific operating
margin - Statewide median operating margin
(4) The hospital-specific "adjusted charity care" shall be equal to the hospital-specific 1993 approved charity care times the hospital-specific profitability factor;
(5) The hospital-specific "revenue from private payers" shall be equal to the sum of the gross revenues, as reported to the department in the hospital's 1993 Actual Cost Reports for all non-governmental third party payers including, but not limited to, Blue Cross and Blue Shield plans, commercial insurers and health maintenance organizations;
(6) The hospital-specific "payer mix factor" shall be equal to the hospital's adjusted charity care divided by its revenue from private payers; and
(7) The "Statewide target payer mix factor" is the lowest payer mix factor to which all hospitals receiving charity care subsidies can be reduced by spending all of the $400 million in funding allocated for charity care subsidies for 1995.
b. For the purposes of this section and section 12 of P.L.1995, c.133 (C.26:2H-18.59a), "income from operations" and "total operating revenue" shall be defined by the department in accordance with financial reporting requirements established pursuant to N.J.A.C.8:31B-3.3.
c. Any charity care subsidy funds that are not distributed in a given year pursuant to this section shall lapse to the Health Care Subsidy Fund and may be transferred by the commissioner to the Health Access New Jersey subsidy account in the fund.
a. A hospital shall submit demographic information about the persons who qualify for charity care or to whom the hospital provides uncompensated care, which includes, at a minimum: the individual's age, sex, marital status, employment status, type of health insurance coverage, if any, and if the individual is a child under 18 years of age who does not have health insurance coverage or a married person who does not have health insurance coverage, whether the child's parent or the married person's spouse, as the case may be, has health insurance.
b. A hospital shall submit all financial data required by the department for the purposes of calculating the payer mix factor as defined in sections 12 and 13 of P.L.1995, c.133 (C.26:2H-18.59a and C.26:2H-18.59b) and section 7 of P.L.1996, c.28 (C.26:2H-18.59e).
c. A hospital which fails to provide the information required pursuant to this section in a manner and time frame specified by the commissioner, shall be liable to a civil penalty not to exceed $1,000 for each day in which the hospital is not in compliance. The commissioner shall recover the penalty in an administrative proceeding held pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.).
If the Statewide total of adjusted charity care is less than available charity care funding, a hospital's charity care subsidy shall equal its adjusted charity care.
If the Statewide total of adjusted charity care is greater than available charity care funding, then the hospital-specific charity care subsidy shall be determined by allocating available charity care funds so as to equalize hospital-specific payer mix factors to the Statewide target payer mix factor. Those hospitals with a payer mix factor greater than the Statewide target payer mix factor shall be eligible to receive a subsidy sufficient to reduce their factor to that Statewide level; those hospitals with a payer mix factor that is equal to or less than the Statewide target payer mix factor shall not be eligible to receive a subsidy.
Charity care subsidy payments shall be based upon actual documented hospital charity care.
As used in this section:
(1) The hospital-specific "documented charity care" shall be equal to the dollar amount of charity care provided by the hospital that is verified in the department's most recent charity care audit conducted under the most recent charity care eligibility rules adopted by the department and valued at the same rate paid to that hospital by the Medicaid program.
For 1996, documented charity care shall equal the audited, Medicaid-priced amounts reported for the first three quarters of 1995. This amount shall be multiplied by 1.33 to determine the annualized 1995 charity care amount. For 1997 and the period from January 1, 1998 through June 30, 1998, documented charity care shall be equal to the audited Medicaid-priced amounts for the last quarter two years prior to the payment period and the first three quarters of the year prior to the payment period. For fiscal year 1999 and each fiscal year thereafter, documented charity care shall be equal to the audited Medicaid-priced amounts for the most recent calendar year;
(2) In 1996, the hospital-specific "operating margin" shall be equal to: the hospital's 1993 and 1994 income from operations minus its 1993 and 1994 charity care subsidies divided by its 1993 and 1994 total operating revenue minus its 1993 and 1994 charity care subsidies. After calculating each hospital's operating margin, the department shall determine the Statewide median operating margin.
In 1997 and each year thereafter, the hospital-specific "operating margin" shall be calculated in the same manner as for 1996, but on the basis of income from operations, total operating revenue and charity care subsidies data from the three most current years;
(3) The hospital-specific "profitability factor" shall be determined annually as follows. Those hospitals that are equal to or below the Statewide median operating margin shall be assigned a profitability factor of "1." For those hospitals that are above the Statewide median operating margin, the profitability factor shall be equal to:
.75 x (hospital specific operating
margin - Statewide median operating margin)
1 - ______________________________________________
highest hospital specific operating margin - Statewide
median operating margin
(4) The hospital-specific "adjusted charity care" shall be equal to a hospital's documented charity care times its profitability factor;
(5) The hospital-specific "revenue from private payers" shall be equal to the sum of the gross revenues, as reported to the department in the hospital's most recently available New Jersey Hospital Cost Reports for all non-governmental third party payers including, but not limited to, Blue Cross and Blue Shield plans, commercial insurers and health maintenance organizations;
(6) The hospital-specific "payer mix factor" shall be equal to a hospital's adjusted charity care divided by its revenue from private payers; and
(7) The "Statewide target payer mix factor" is the lowest payer mix factor to which all hospitals receiving charity care subsidies can be reduced by spending all available charity care subsidy funding for that year.
b. For the purposes of this section, "income from operations" and "total operating revenue" shall be defined by the department in accordance with financial reporting requirements established pursuant to N.J.A.C.8:31B-3.3.
c. Charity care subsidy payments shall commence on or after the date of enactment of P.L.1996, c.28 and the full calendar year 1996 allocation shall be disbursed by January 31, 1997.
a. The demonstration program shall be administered by a program administrator under contract with the State Treasurer pursuant to this section and shall operate for a two-year period. For the purposes of this section, program administrator may include, but not be limited to, an acute care hospital which receives charity care reimbursements or a health maintenance organization.
b. The Commissioner of Health and Senior Services, in consultation with the Commissioner of Human Services and the State Treasurer, shall, within 30 days after approval of the federal waiver, and at appropriate intervals thereafter, solicit proposals from entities in the State interested in administering the demonstration program.
c. The contract shall include, but not be limited to, provisions for:
(1) providing charity care services on a managed care basis as specified by the Commissioner of Health and Senior Services, in consultation with the Commissioner of Human Services and the State Treasurer. An administrator shall be responsible for determining the most appropriate and cost-effective means of providing the health care services required by an eligible person and for directing the person to that means for receipt of the services;
(2) the determination of eligibility criteria for health care providers who choose to participate in the demonstration program;
(3) a methodology established by the Commissioner of Health and Senior Services for reimbursement of participating hospitals and other health care providers;
(4) the development and use of a uniform method for determining eligibility of residents of the designated region or county for health care services under the demonstration program; and
(5) the submission of quarterly reports to the Department of Health and Senior Services and the Department of the Treasury, in a form and manner required by the department, detailing expenditures of health care funds in the demonstration program.
The contract shall also provide that provider participation in the demonstration program shall ensure the maximum receipt by the State of federal disproportionate share monies pursuant to Pub.L.89-97 (42 U.S.C.s.1396a et seq.) and Pub.L.102-234.
d. The Commissioner of Health and Senior Services shall report 12 months after the contract with the administrator or administrators is entered into by the State Treasurer and upon the conclusion of the demonstration program to the standing reference committees on health and appropriations of the Senate and General Assembly and the Governor on:
(1) expenditures related to the provision of health care services on a managed care basis, the number of persons served, the types of services provided, the hospitals participating in the demonstration program, the number and types of other health care providers participating in the demonstration program and such other information as may be required by the Legislature;
(2) the effectiveness of the demonstration program in containing or reducing costs for providing health care services to qualified low income residents of the designated region or county; and
(3) recommendations developed in consultation with the Commissioner of Human Services and the State Treasurer concerning additional cost containment actions that may be adopted for the provision of health care services to qualified low income persons, including, but not limited to, expansion of the demonstration program to encompass other regions or counties within the State.
e. Nothing in this section shall be construed to expand covered health care services provided under the demonstration program to include services not covered by the charity care program in effect on the effective date of P.L.1996, c.28.
f. The implementation of the demonstration program pursuant to this section or other subsidies for charity care that affect the Medicaid State plan shall be contingent upon receipt of federal approvals that assure continuation of an acceptable level of federal Medicaid matching funds, including disproportionate share monies, as determined by the Director of the Division of Medical Assistance and Health Services in the Department of Human Services and the Director of the Division of Budget and Accounting in the Department of the Treasury.
The State Treasurer, in consultation with the Commissioners of Health and Human Services may, if deemed to be in the State's best interests, include system features and provisions in the technology infrastructure to satisfy the requirements of multiple programs and purposes, including, but not limited to, programs such as, Medicaid, food stamps, public assistance, and purposes such as the exchange and consolidation of health care information permitted by law, eligibility and identity verification, claims processing, the use of electronic patient identification technology, and electronic data interchange.
(1) Reimbursed documented charity care shall be equal to the Medicaid-priced amounts of charity care claims submitted to the Department of Health for the most recent calendar year, adjusted, as necessary, to reflect the annual audit results. These amounts shall be augmented to reflect payments to hospitals by the Medicaid program for Graduate Medical Education and Indirect Medical Education based on the most recent Graduate Medical Education and Indirect Medical Education formulas utilized by the federal Medicare program.
(2) Hospital-specific reimbursed documented charity care shall be equal to the Medicaid-priced dollar amount of charity care provided by a hospital as submitted to the Department of Health for the most recent calendar year. A sample of the claims submitted by the hospital to the department shall be subject to an annual audit conducted pursuant to applicable charity care eligibility criteria.
b. Beginning July 1, 2004 and each year thereafter, the charity care subsidy shall be determined according to the following methodology:
(1) Each hospital shall be ranked in order of its hospital-specific, relative charity care percentage, or RCCP, by dividing the amount of hospital-specific gross revenue for charity care patients by the hospital's total gross revenue for all patients.
(2) The 10 hospitals with the highest RCCPs shall receive a charity care payment equal to 96 percent of each hospital's hospital-specific reimbursed documented charity care. The hospital ranked number 11 shall receive a charity care payment equal to 94 percent of its hospital-specific reimbursed documented charity care, and each hospital ranked number 12 and below shall receive two percentage points less than the hospital ranked immediately above that hospital.
(3) Notwithstanding the provisions of paragraph (2) of this subsection to the contrary, each of the hospitals located in the 10 municipalities in the State with the lowest median annual household income according to the most recent census data, shall be ranked from the hospital with the highest hospital-specific reimbursed documented charity care to the hospital with the lowest hospital-specific reimbursed documented charity care. The hospital in each of the 10 municipalities, if any, with the highest documented hospital-specific charity care shall receive a charity care payment equal to 96 percent of its hospital-specific reimbursed documented charity care.
(4) Notwithstanding the provisions of this subsection to the contrary, no hospital shall receive reimbursement for less than 43 percent of its hospital-specific reimbursed documented charity care.
c. To ensure that charity care subsidy payments remain viable and appropriate, the State shall maintain the charity care subsidy at an amount not less than 75 percent of the Medicaid-priced amounts of charity care provided by hospitals in the State. In addition, these amounts shall be augmented to reflect payments to hospitals by the Medicaid program for Graduate Medical Education and Indirect Medical Education based on the most recent Graduate Medical Education and Indirect Medical Education formulas utilized by the federal Medicare program.
d. Notwithstanding any other provisions of this section to the contrary, in the event that the change from the charity care subsidy formula in effect for fiscal year 2004 to the formula established pursuant to this section in effect for fiscal year 2005, reduces, for any reason, the amount of the charity care subsidy payment to a hospital below the amount that the hospital received under the formula in effect in fiscal year 2004, the hospital shall receive a payment equal to the amount it would have received under the formula in effect for fiscal year 2004.
e. The Legislature finds and declares that it is the intent of Legislature to provide that the provisions of P.L.2021, c.330, which increases by one the number of hospitals eligible for a charity care payment equal to 96 percent of the hospital's hospital-specific reimbursed documented charity care, shall apply to the newly eligible hospital's State fiscal year 2022 charity care payment. Any State fiscal year 2022 charity care payment change resulting from this formula modification shall be issued, as soon as practicable, in the form of a supplemental payment to each impacted hospital.
b. A person whose individual or, if applicable, family gross income is less than or equal to 300% of the poverty level shall be eligible for charity care or reduced charge charity care for necessary health care services provided at a hospital.
The commissioner shall establish:
(1) the maximum level of income at which a person is eligible for full charity care;
(2) a sliding scale based on income which specifies the percentage of hospital charges for which a person who is eligible for reduced charity care is responsible; and
(3) assets eligibility criteria for full charity care and reduced charge charity care, respectively.
(1) investigate charity care claims, which that office or the Department of Health reasonably suspects may be fraudulent, with the same authority as that granted to the Medicaid Inspector General to investigate complaints related to Medicaid integrity, fraud, and abuse pursuant to P.L.2007, c.58 (C.30:4D-53 et al.); and
(2) recover monies from third party payers that were paid as charity care subsidies based upon fraudulent charity care claims.
b. The commissioner and the Medicaid Inspector General shall take such actions as are necessary to ensure that any monies recovered pursuant to subsection a. of this section are deposited in the Health Care Subsidy Fund and used for the purposes of providing charity care subsidies pursuant to P.L.1992, c.160 (C.26:2H-18.51 et al.).
Such funds as may be necessary shall be transferred by the department from the fund to the Division of Medical Assistance and Health Services in the Department of Human Services for payment to disproportionate share hospitals.
b. The determination of whether a hospital is eligible to receive a subsidy shall be based on the following:
Hospital Specific Other Uncompensated Care for Year
...................................................................
Hospital Specific Revenue for Year
= Hospital Specific %
Other Uncompensated Care (%OUC)
A hospital is eligible for a subsidy if, upon establishing a rank order of the %OUC for all hospitals:
(1) in 1993, the hospital is among the 45% of hospitals with the highest %OUC;
(2) in 1994, the hospital is among the 30% of hospitals with the highest %OUC; and
(3) in 1995, the hospital is among the 15% of hospitals with the highest %OUC.
c. The amount of the subsidy an eligible hospital shall receive shall be based on the following:
Hospital Specific Other Uncompensated Care for Year
............................................................
Total Other Uncompensated Care
for All Eligible Hospitals for Year
X Total Amount of Subsidy Allocated for the Year
= Hospital Specific Subsidy for the Year
In 1993, the formulas shall use 1991 Hospital Specific Other Uncompensated Care and Total Other Uncompensated Care for All Eligible Hospitals, and a hospital's 1992 preliminary cost base established pursuant to section 18 of P.L.1971, c.136 (C.26:2H-18), for "Hospital Specific Revenue for Year."
In 1994 and through the payment for April of 1995, the formulas shall use 1992 Hospital Specific Other Uncompensated Care and Total Other Uncompensated Care for All Eligible Hospitals, and a hospital's 1993 revenue cap established pursuant to section 3 of this act for "Hospital Specific Revenue for Year." Payments made under these formulas for February, March and April of 1995 shall, as of May 1, 1995, be final payments and shall not be subject to any reconciliation or other adjustment.
Beginning with the payment for May of 1995, the formulas shall use actual 1993 Medicare revenues, as approved by the department, in place of "Hospital Specific Other Uncompensated Care for Year" and "Total Other Uncompensated Care for All Eligible Hospitals for Year," and a hospital's 1993 total operating revenue as defined by the department in accordance with financial reporting requirements established pursuant to N.J.A.C.8:31B-3.3, in place of "Hospital Specific Revenue for Year."
d. The department shall notify the Division of Medical Assistance and Health Services of the amount of Other Uncompensated Care hospital subsidy payment to be included in the disproportionate share payment to each eligible hospital.
b. (Deleted by amendment, P.L.2005, c.237).
c. (1) Notwithstanding any law to the contrary, each general hospital and each specialty heart hospital shall pay .53% of its total operating revenue to the department for deposit in the Health Care Subsidy Fund. The hospital shall make monthly payments to the department beginning July 1, 1993. The commissioner shall determine the manner in which the payments shall be made.
For the purposes of this subsection, "total operating revenue" shall be defined by the department in accordance with financial reporting requirements established pursuant to N.J.A.C.8:31B-3.3 and shall include revenue from any ambulatory care facility that is licensed to a general hospital as an off-site ambulatory care service facility.
(2) The commissioner shall allocate the monies paid by hospitals pursuant to paragraph (1) of this subsection as follows:
(a) In State fiscal years 2006 and 2007, $35 million of those monies shall be allocated to the support of federally qualified health centers in this State, and the remainder shall be allocated to the support of (i) the infant mortality reduction program in the Department of Health, (ii) the primary care physician and dentist loan redemption program established in the Higher Education Student Assistance Authority by article 3 of P.L.1999, c.46 (C.18A:71C-32 et seq.), and (iii) the development and use of health information electronic data interchange technology pursuant to P.L.1999, c.154 (C.17B:30-23 et al.); and
(b) In State fiscal year 2008 and thereafter, $40 million of those monies shall be allocated to the support of federally qualified health centers in this State.
Monies allocated to the support of federally qualified health centers in the State under this paragraph shall be used for the purpose of compensating them for health care services provided to uninsured patients.
d. The monies paid by the hospitals and allocated under subsection c. of this section for the support of federally qualified health centers shall be credited to the federally qualified health centers account.
e. (1) Monies paid by hospitals under subsection c. of this section in excess of $40 million, federal matching funds received on account of such monies, and interest received on such payments and funds shall be allocated exclusively to support funding to hospitals.
(2) In the event that any approval, application, or other condition necessary for the implementation of this subsection and the distribution of funds pursuant thereto consistent with the Fiscal Year 2011 annual appropriations act is not obtained, granted, or satisfied, the Departments of Health and Human Services shall jointly prepare a plan concerning charity care and related hospital funding, which shall be subject to the approval of the Joint Budget Oversight Committee.
(1) payment of interest on the amount of the excess benefits or subsidy payments at the maximum legal rate in effect on the date the benefits were provided to the person or payment was made to the person or entity, for the period from the date upon which benefits were provided or payment was made to the date upon which repayment is made to the department; and
(2) payment of an amount not to exceed three times the amount of the excess benefit or subsidy payment.
b. A hospital which, without intent to violate this act, obtains a subsidy payment in excess of the amount to which it is entitled, shall be liable to a civil penalty of payment of interest on the amount of the excess payment at the maximum legal rate in effect on the date the payment was made to the hospital, from the date upon which payment was made to the date upon which repayment is made to the department, except that a hospital shall not be liable to the civil penalty when an excess subsidy payment is obtained by the hospital as a result of an error made by the department, as determined by the commissioner.
c. All interest and civil penalties provided for in this section shall be recovered in an administrative proceeding held pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.).
d. In order to satisfy any recovery claim asserted against a hospital under this section, whether or not that claim has been the subject of final agency adjudication, the commissioner is authorized to withhold subsidy payments otherwise payable under this act to the hospital.
e. A person who is seeking health care services at a hospital as a patient for a non-emergency or elective procedure who does not furnish proof of health insurance coverage for the services or eligibility for charity care or reduced charge charity care in accordance with the provisions of section 10 of P.L.1992, c.160 (C.26:2H-18.60), or for any other program of benefits funded by the State, shall be required to provide sworn financial information sufficient to determine eligibility for any such program of benefits. Notwithstanding any other provision of law to the contrary, if the person does not provide the required financial information or the hospital determines that the person is ineligible for any of the aforementioned benefits, the hospital shall be entitled to conclude an arrangement with the person, or an individual acting on the person's behalf, to receive payment from or on behalf of that person as a condition of the provision of health care services to that person.
For the purposes of this subsection, "non-emergency or elective procedure" means a procedure to treat a condition that is not an "emergency" as defined in N.J.A.C.8:38-1.2.
f. Commencing one year after the effective date of P.L.2007, c.217 (C.26:2H-18.60a et al.) and notwithstanding the provisions of any other statute or regulation to the contrary, a hospital that receives a subsidy payment pursuant to P.L.1992, c.160 (C.26:2H-18.51 et al.), on the basis of a charity care claim that the hospital had reasonable cause to suspect was fraudulent as determined by the commissioner, shall, in addition to any other penalty to which the hospital may be subject under law, be subject to a reduction of $2 in the distribution of charity care subsidy payments that it receives during the next succeeding fiscal year for each $1 of subsidy payment received by the hospital on the basis of the fraudulent claim.
If the hospital complied with the regulations and procedures established by the department with respect to charity care documentation, the claims shall be deemed to be presumptively non-fraudulent unless the commissioner determines that the hospital knew or should have known that the information submitted was inaccurate.
g. In any year in which the Legislature and Governor reuses a base year for the calculation of charity care reimbursement, notwithstanding the provisions of section 3 of P.L.2004, c.113 (C. 26:2H-18.59i) to the contrary, a hospital subject to a penalty under subsection f. of this section for that base year shall not be subject to the penalty for the same fraudulent claims in the subsequent year when the base year is reused.
A hospital which violates this section shall be liable to a civil penalty of $10,000 for each violation. The penalty shall be sued for and recovered pursuant to "the penalty enforcement law," N.J.S.2A:58-1 et seq. and shall be deposited in the fund.
The commissioner shall adopt regulations pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.) that determine eligibility for the program and the allocation of all funds in this account.
The commissioner shall contract with health insurance carriers, health maintenance organizations and other appropriate entities in the State to administer the program.
b. The division shall administer a claim reimbursement program to reimburse licensed health care facilities and licensed health care providers for their costs incurred in providing services pursuant to subsection c. of this section for any necessary medical follow-up and treatment of lead poisoned children: (1) whose family income does not exceed 400% of the federal poverty level; (2) who are eligible to receive benefits under a contract, policy, or plan that qualifies as a high deductible health plan for which qualified medical expenses are paid using a health savings account established pursuant to section 223 of the federal Internal Revenue Code of 1986 (26 U.S.C. s.223); and (3) for whom the deductible limits of that contract, policy, or plan have not been exceeded.
c. Licensed health care facilities and licensed health care providers shall provide necessary medical follow-up and treatment of lead poisoned children: (1) whose family income does not exceed 400% of the federal poverty level; (2) who are covered under a contract, policy, or plan that qualifies as a high deductible health plan for which qualified medical expenses are paid using a health savings account established pursuant to section 223 of the federal Internal Revenue Code of 1986 (26 U.S.C. s.223); and (3) for whom the deductible limits of that contract, policy, or plan are not exceeded. Licensed health care facilities and licensed health care providers shall not seek reimbursement for any costs incurred pursuant to this subsection from the insureds covered under a contract, policy, or plan that qualifies as a high deductible health plan for which medical expenses are paid using a health savings account established pursuant to section 223 of the federal Internal Revenue Code of 1986 (26 U.S.C. s.223) or the carrier that issued the high deductible health plan for which medical expenses are paid using a health savings account established pursuant to section 223 of the federal Internal Revenue Code of 1986 (26 U.S.C. s.223).
d. (1) Licensed health care facilities and licensed health care providers shall submit claims for necessary medical follow-up and treatment cost reimbursement to the division in a form and manner as prescribed by the director by regulation.
(2) The director of the division shall, at least once every other month, or more frequently as provided by regulation, certify the amount of reimbursement claims submitted by licensed health care facilities and licensed health care providers and forward the certification to the Commissioner of Community Affairs. The commissioner shall, upon receipt of the certification, immediately transfer the specified amount of funds, not to exceed $500,000 annually, from the "Lead Hazard Control Assistance Fund" established pursuant to section 4 of P.L.2003, c.311 (C.52:27D-437.4) to the division.
(3) Upon receipt of the funds, the division shall provide reimbursements for services provided pursuant to subsection c. of this section to the licensed health care facilities and licensed health care providers at the Medicaid rate.
b. As used in this act, "uninsured low-income person" means a patient who:
(1) is a resident of New Jersey;
(2) has an individual or, if applicable, family gross income that would qualify that person for charity care pursuant to section 10 of P.L.1992, c.160 (C.26:2H-18.60); and
(3) has no health insurance coverage for the renal dialysis treatment and services provided.
c. Compliance with the requirements of this act may be calculated on an aggregate basis for separately licensed ambulatory care facilities in this State that have common ownership, except that the total amount of uncompensated renal dialysis treatment and services provided shall equal the sum of the amounts required for each separately licensed facility.
a. The final report of the New Jersey Commission on Rationalizing Health Care Resources, issued on January 24, 2008, demonstrated that a large number of New Jersey general hospitals are in poor financial health and in financial distress due to a number of causes, including lack of universal coverage, underpayment by public payers, misaligned incentives and interests between physicians and hospitals, lack of transparency of performance or cost, a need for more responsible governance at certain hospitals, and excessive geographic hospital density;
b. The financial challenges faced by general hospitals in New Jersey have caused many to close in recent years, and additional hospitals may close in the future;
c. A general hospital's sudden closure or significant reduction in services can threaten access to health care providers and specialized health care services in the hospital's primary service area;
d. It is vitally important to the residents of this State that continuity and stability be maintained when a general hospital closes or reduces services in order to assure access to high-quality and cost-effective health care services and referrals to residents of the affected community;
e. It is fitting and appropriate that the State of New Jersey provide temporary funding to continue access to and availability of health care services in time of emergent need and to condition that funding on adherence to requirements to ensure efficient and effective delivery of health care services; and
f. To that end, the Health Care Stabilization Fund is established for the purpose of providing emergency grants to general hospitals and other licensed health care facilities to ensure continuation of access and availability of necessary health care services to residents in a community served by a hospital facing closure or significantly reducing services due to financial distress.
b. Monies from the fund shall be disbursed solely as grants to qualifying licensed health care facilities pursuant to eligibility criteria, and subject to conditions, prescribed by the Commissioner of Health in accordance with the requirements of this act.
a. Extraordinary circumstances threaten access to essential health services for residents in a community;
b. Persons in a community will be without ready access to essential health care services in the absence of the award of a grant from the fund;
c. Funding is unavailable from other sources to preserve or provide essential health care services;
d. A grant from the fund is likely to stabilize access to the essential health care services;
e. There is a reasonable likelihood that the essential health care services will be sustainable upon the termination of the grant;
f. The proposed recipient of the grant agrees to conditions established by the commissioner for receipt of a grant; and
g. The hospital or other licensed health care facility serves a significant number of uninsured and underinsured persons.
The facility shall agree to: the provision of essential health care services to the community as determined by the commissioner; facilitating the enrollment of individuals in appropriate government insurance programs; and providing the Department of Health with quality of care, utilization, and financial information as determined by the commissioner to be reasonable and necessary. In the case of a facility whose financial condition created or contributed to the extraordinary circumstances necessitating the award of the grant, the facility shall agree to such corrective steps to its governance, management, and business operations as the commissioner deems reasonable and appropriate in light of the facility's circumstances and the health care needs of the community.
b. Within one year of the award of a grant from the fund, the commissioner, in consultation with the State Comptroller, shall cause to be conducted an audit to evaluate:
(1) whether a grantee's use of the funds was consistent with the provisions of this act, the commissioner's regulations, and any conditions imposed upon the award of the grant; and
(2) whether a grantee's use of the funds furthered the purposes of this act.
c. The commissioner, pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.), shall adopt such rules and regulations as are necessary to effectuate the purposes of this act. The regulations shall specify eligibility criteria for, and conditions that must be met by, a health care facility to receive a grant from the fund.
Notwithstanding any provision of P.L.1968, c.410 (C.52:14B-1 et seq.) to the contrary, the commissioner may adopt immediately upon filing with the Office of Administrative Law such regulations as the commissioner deems necessary to implement the provisions of this act, which shall be effective for a period not to exceed 270 days following enactment of this act and may thereafter be amended, adopted, or readopted by the department in accordance with the requirements of P.L.1968, c.410.
d. The commissioner shall annually, by March 1 of each year, submit a report on the Health Care Stabilization Fund to the Governor, and to the Legislature pursuant to section 2 of P.L.1991, c.164 (C.52:14-19.1). The commissioner shall include a copy of the report on the department's website.
The report shall identify the health care facilities that received grants during the reporting period, the purpose for which the grant was allocated to the facility, and the extent to which the awarding of the grant furthered the purposes of this act. The report shall include a copy of any audits conducted pursuant to subsection b. of this section.
"Commissioner" means the Commissioner of Health.
"Health care facility" means a general or special hospital, nursing home, or home health care agency licensed pursuant to P.L.1971, c.136 (C.26:2H-1 et seq.).
b. Commencing with the onset of the first influenza season next following the effective date of this act, each health care facility shall establish and implement an annual influenza vaccination program in accordance with the current recommendations of the Department of Health, which shall in making its recommendations consider the recommendations of the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention in the federal Department of Health and Human Services and, as appropriate, the recommendations of the American Academy of Pediatrics, the American Academy of Family Physicians, the American College of Obstetricians and Gynecologists, and the American College of Physicians, and any rules and regulations adopted by the commissioner pursuant to this act.
c. For the purposes of its annual influenza vaccination program, each health care facility shall:
(1) annually provide an on-site or off-site influenza vaccination to each of its employees;
(2) require that each employee at the facility receive an influenza vaccination annually, no later than December 31 of the current influenza season as determined by the federal Centers for Disease Control and Prevention, which vaccination shall be provided by the health care facility, except that an employee may, in lieu of receiving the influenza vaccination at the facility, present acceptable proof, comprising:
(a) an attestation from the employee, which shall be submitted in a form and manner designated by the facility, of a current influenza vaccination if the employee receives the vaccination from another vaccination source, which attestation shall include the lot number of the vaccination the employee received; or
(b) a medical exemption, which shall be submitted using a form
designated by the Department of Health, stating that the influenza vaccination for that employee is medically contraindicated, as enumerated by the Department of Health. An attestation of a medical exemption shall be subject to approval by the facility following a review by the facility to confirm the medical exemption is consistent with standards enumerated by the Department of Health;
(3) maintain a record or attestation, as applicable, of influenza vaccinations and medical exemptions for each employee and report to the Department of Health, in a manner and according to a schedule prescribed by the commissioner, the vaccination percentage rate of its workforce in receiving influenza vaccinations as part of the facility's annual vaccination program or by other means as attested to by the workforce, as applicable. The report may also include other information that the facility deems relevant to its vaccination percentage rate, including, but not limited to, the number of employees who received medical exemptions;
(4) provide an educational component to its program that is designed to inform employees about: influenza vaccination; non-vaccine influenza control measures; and the symptoms, transmission, and potential impact of influenza;
(5) annually conduct an evaluation of the program with the goal of improving the rate of vaccination among its employees; and
(6) require any employee who does not receive an influenza vaccination to wear a surgical or procedural mask when in direct contact with patients and in common areas, as specified in facility policy, or to be removed from direct patient care responsibilities during influenza season.
d. A health care facility may suspend its annual influenza vaccination program pursuant to this act in the event of a shortage of influenza vaccine as determined by the commissioner.
e. (1) The commissioner may assess such penalties and take other actions against a health care facility, as provided in P.L.1971, c.136 (C.26:2H-1 et seq.), or any rules and regulations adopted pursuant thereto, for any determination by the commissioner of noncompliance by a health care facility or any of its employees with the provisions of this act.
(2) The commissioner shall seek to minimize any record-keeping burden imposed on a health care facility pursuant to this act and shall take such actions as are necessary to ensure the confidentiality of any data furnished to the department pursuant to this act that may contain information identifying an individual employee.
(3) The commissioner shall make available to the public aggregate data reported by a facility pursuant to paragraph (3) of subsection c. of this section.
f. A health care facility shall not discharge or reduce the pay of an employee who receives a medical exemption from the annual influenza vaccination requirement.
g. Nothing in this section shall be construed to prohibit a health care facility from adopting additional policies and procedures with regard to the annual influenza vaccine that are not inconsistent with the requirements of this section.
All of the functions, powers and duties of the State Board of Control, the Commissioner of Institutions and Agencies and the Department of Institutions and Agencies and its Hospital Licensing Board related to administration of law governing and concerning residential health care facilities, private mental hospitals, convalescent homes, private nursing homes and private hospitals, and relating to the planning, construction and licensing of health care facilities as defined in this act and the power to receive, allocate, expend, and authorize the expenditure of Federal moneys available for health care facility construction and renovation are hereby transferred and assigned to, assumed by and devolved upon the State Department of Health. To effectuate such transfer there shall also be transferred such officers and employees as are necessary, all appropriations or reappropriations, to the extent of remaining unexpended or unencumbered balances thereof, whether allocated or unallocated and whether obligated or unobligated, and all necessary books, papers, records and property. All rules, regulations, acts, determinations and decisions in force at the time of such transfer and proceedings or other such matters undertaken or commenced by or before the Department of Institutions and Agencies or the Hospital Licensing Board pertaining to the planning, construction, licensing and operation of such health care facilities, and the administration of Federal moneys for health care facility construction, and renovation pending at the time of such transfer, shall continue in force and effect until duly modified, abrogated or completed by the Department of Health.
Employees of the present Bureau of Community Institutions in the Department of Institutions and Agencies responsible for administration of laws governing and concerning residential health care facilities, private mental hospitals, convalescent homes, private nursing homes and private hospitals are hereby transferred to the State Department of Health. Persons so transferred shall be assigned such duties as the State Commissioner of Health shall determine.
All functions, powers, duties, records, and property of the Department of Institutions and Agencies, and personnel of the Bureau of Medical Facilities Construction and Planning relating to receipt of money from the Federal Government for the purpose of making payments for construction of hospitals, including public health centers and related facilities within the State, and for an inventory and survey in connection therewith under or pursuant to any Federal law providing for the payment of such moneys as established and authorized by the provisions of c. 83, P.L.1947 (C. 30:1-19 et seq.), are hereby transferred to the State Department of Health.
The Hospital Licensing Board created pursuant to P.L.1947, c. 340, s. 7 (C. 30:11-6) is hereby abolished. Upon the establishment of the Health Care Administration Board, all the functions, powers and duties of the Hospital Licensing Board, transferred to and vested in the Department of Health pursuant to section 19 of this act, shall be assumed by and developed upon the Department of Health, to be exercised by the said Health Care Administration Board. Pending the appointment of members, establishment and convening of said Health Care Administration Board, all the functions, powers and duties thereof shall be exercised by the department.
With respect to the functions, powers and duties of the State Board of Control, the Commissioner of Institutions and Agencies and the Department of Institutions and Agencies, which are herein transferred and vested in the Department of Health, whenever in any law, rule, regulation, contract, document or otherwise, reference is made to the State Board of Control or the Department of Institutions and Agencies the same shall be deemed to mean and refer to the Department of Health, and reference to the Commissioner of Institutions and Agencies in connection therewith shall be deemed to mean and refer to the Commissioner of Health.
If any clause, sentence, paragraph, subsection or section of this act shall be adjudged by any court of competent jurisdiction to be invalid, the judgment shall not affect, impair or invalidate the remainder thereof, but shall be confined in its operation to the clause, sentence, paragraph, subsection or section thereof directly involved in the controversy in which this judgment shall have been rendered.
Nothing in this act shall be construed to deprive any person of any tenure rights or of any right or protection provided him by Title 11 of the Revised Statutes, Civil Service, or under any pension law or retirement system.
This act shall be known and may be cited as the "Health Care Facilities Planning Act."
All of the powers, functions and duties heretofore exercised by the State Board of Control of the Department of Institutions and Agencies pursuant to P.L.1968, c. 356 (C. 30:11-11 et seq.), and all amendments thereto, are hereby transferred to and vested in the State Department of Health.
The Nursing Home Administrator's Licensing Board established by P.L.1968, c. 356 (C. 30:11-11 et seq.), and all amendments thereto, together with all of its powers, functions and duties incident thereto, is hereby transferred to and vested in the State Department of Health.
As used in this act "nursing home" or "convalescent home" means a health care facility licensed by the Department of Health to provide professional nursing care on a daily basis and includes intermediate care facilities.
No nursing home or convalescent home may charge a patient or resident for drugs more than the cost thereof to the home plus an amount not in excess of 5% to reimburse the home for the administrative costs of purchasing and dispensing such drugs.
Any person who violates the provisions of this act shall be liable for a penalty of $100.00 to be collected by a summary proceeding instituted by the Attorney General at the request of the Commissioner of Health pursuant to the Penalty Enforcement Law (N.J.S. 2A:58-1 et seq.).
a. "Nursing home" means a facility providing therein nursing care to persons who are sick, invalid, convalescing, or who have disabilities, in addition to providing lodging and board or health-related service, or any combination of the foregoing and in addition thereto, providing nursing care and health-related service, or either of them, to persons who are not occupants of the facility.
b. "Affiliate" means (1) with respect to a partnership, each partner thereof; (2) with respect to a corporation, each officer, director, principal stockholder, or controlling person thereof; (3) with respect to a natural person, (a) each member of said person's immediate family, (b) each partnership and each partner thereof of which said person or any affiliate of said person is a partner, and (c) each corporation in which said person or any affiliate of said person is an officer, director, principal stockholder, or controlling person.
c. "Controlling person" of any corporation, partnership, or other entity means any person who has the ability, directly or indirectly, to direct or cause the direction of the management or policies of said corporation, partnership, or other entity.
d. "Immediate family" of any person includes each parent, child, spouse, brother, sister, first cousin, aunt and uncle of such person, whether such relationship arises by birth, marriage or adoption, as well as the person's domestic partner or partner in civil union of that person as defined in section 3 of P.L.2003, c.246 (C.26:8A-3) or section 2 of P.L.2006, c.103, (C.37:1-29) and the partner's parent and adult child.
e. "Principal stockholder" of a corporation means any person who beneficially owns, holds or has the power to vote, 10% or more of any class of securities issued by said corporation.
Every nursing home operating in the State shall, within 90 days after the end of its fiscal year, file an annual report with the State Commissioner of Health. Such annual report shall be in such form and shall contain such information as shall be prescribed by the commissioner, including the following:
a. A balance sheet of the nursing home as of the end of such fiscal year, setting forth assets and liabilities at such date including all capital, surplus, reserve, depreciation and similar accounts;
b. A statement of operations of the nursing home for such fiscal year, setting forth all revenues, expenses, taxes, extraordinary items and other credits or charges;
c. The name and address of each of the following persons:
(1) The operator of the nursing home;
(2) Any person who, directly or indirectly, beneficially owns any interest in the land on which the nursing home is located;
(3) Any person who, directly or indirectly, beneficially owns any interest in the building in which the nursing home is located;
(4) Any person who, directly or indirectly, beneficially owns a 10% or greater interest in any mortgage, note, deed of trust or other obligation secured in whole or in part by the land on which or building in which the nursing home is located;
(5) Any person who directly or indirectly, has any interest as lessor or lessee in any lease or sublease of the land on which or the building in which the nursing home is located;
(6) Any person who, directly or indirectly, beneficially owns a 10% or greater interest in any mortgage, note, deed of trust or other obligation which, although not secured by the land on which or building in which the nursing home is located, is considered an outstanding liability on the books of the nursing home and was executed to finance directly or indirectly the purchase of the nursing home, land, building, lease or sublease pertaining thereto;
d. If the nursing home or any person named in response to subsection c. is a partnership, then the name and address of each partner;
e. If the nursing home or any person named in response to subsection c. is a corporation, other than a corporation whose shares are traded on a national securities exchange or a commercial bank, savings bank or savings and loan association, then the name and address of each officer, director, principal shareholder and controlling person of such corporation;
f. If any corporation named in response to subsection c. is a corporation whose shares are traded on a national securities exchange or which is a commercial bank, savings bank or savings and loan association, then the name and address of the principal executive officers and each director, principal stockholder and controlling person of said corporation;
g. If the nursing home paid or received an aggregate of $2,500.00 or more during the fiscal year in connection with transactions with any person named in response to subsections c., d., e., or f., or any affiliate of said person, a description of the transactions, naming the parties thereto and describing the relationships which require the transactions to be described and the goods, services, payment or other consideration received by each party to the transactions.
Every report required to be filed by a nursing home pursuant to this act shall contain a written statement, sworn to by or on behalf of such nursing home and the operator of such nursing home to the effect that the report is true and complete and prepared in accordance with the provisions of this act.
The State Commissioner of Health shall compile and periodically update a report which compares evaluative profiles of all nursing homes in this State. The report shall compare nursing homes on the basis of size, staff to patient ratio, the number of actions initiated by State agencies based upon verified complaints about the quality of patient care and conditions in each home, the number and types of violations charged against each home and shall contain such other information as the commissioner deems pertinent. The commissioner shall periodically publicize the existence of the report and shall supply a copy of the report, free of charge, to any member of the public who requests it.
Whenever the Department of Health determines that a life threatening condition exists at any nursing home in this State, the commissioner may as soon as is reasonably possible issue a public notice describing the details of the condition in such a manner as to make members of the public generally aware of the matter. The commissioner may postpone issuing the public notice until such time as the notice would not jeopardize an ongoing investigation of the nursing home.
The Legislature finds:
a. Many senior citizens in the State are residing in boarding homes or nursing homes. Their life, safety, health and welfare is largely dependent upon the conditions and care provided in these homes;
b. Some homes are providing inadequate medical and nursing care, inadequate living conditions, and are in substantial or habitual violation of Federal or State laws or regulations concerning health, safety or resident care;
c. It is necessary in order to protect the public welfare and the residents of the homes that a summary statutory procedure be established to eliminate substantial or habitual deficiencies in resident care or living conditions or violations of Federal or State laws or regulations in these homes.
a. "Boarding or nursing home" or "home" means: a private nursing home or convalescent home regulated under chapter 11 of Title 30 of the Revised Statutes; a facility or institution, private or public, regulated and licensed as an extended care facility, skilled nursing home, nursing home, or intermediate care facility pursuant to P.L.1971, c.136 (C.26:2H-1 to 26:2H-26); a residential health care facility, as defined in section 1 of P.L.1953, c.212 (C.30:11A-1) or licensed pursuant to P.L.1971, c.136 (C.26:2H-1 to 26:2H-26); or a dementia care home as defined in section 17 of P.L.2015, c.125 (C.26:2H-148).
b. "Owner" means the holder or holders of the title in fee simple to the property on which the home is located.
c. "Licensee" means the holder or holders of a license to operate a boarding or nursing home pursuant to chapter 11 of Title 30 of the Revised Statutes, P.L.1953, c.212 (C.30:11A-1 to 30:11A-14) or P.L.1971, c.136 (C.26:2H-1 to 26:2H-26).
d. "Department" means the State Department of Health.
A proceeding by the State Department of Health, or any other State governmental agency having an interest in the matter, a resident or residents or the guardian of a resident of a boarding or nursing home for a judgment directing the appointment of a receiver for the purposes of remedying a condition or conditions of a home in substantial violation of the standards of health, safety or resident care established under Federal or State law or regulations or of remedying a pattern and practice of habitual violations of the standards of health, safety or resident care established under Federal or State law or regulations may be maintained in a court of competent jurisdiction. If the action is not brought by the department, a copy of the complaint shall be served upon it.
The complaint shall:
a. (1) Set forth material facts showing that there exists in the boarding or nursing home a condition or conditions in substantial violation of the standards of health, safety or resident care established under Federal or State law or regulations or any other conditions dangerous to life, health or safety or (2) that there exists in the boarding or nursing home a pattern and practice of habitual violation of the standards of health, safety or patient care established under Federal or State law or regulations.
b. Set forth that the facts set forth in subsection a. of this section have been brought to the attention of the owner and licensee of the home and that the condition or conditions have not been remedied within a reasonable period of time or that the condition or conditions although periodically remedied habitually exists in the home as pattern and practice.
c. Set forth a brief description of what is necessary to remedy the condition and an estimate of the cost thereof.
d. State the relief sought.
It shall be a sufficient defense to the proceeding if the owner or licensee establishes that the condition or conditions alleged in the complaint do not in fact exist or that such condition or conditions have been removed or remedied or that such condition or conditions, although periodically remedied, have not habitually existed as pattern and practice.
The court shall proceed in a summary manner and shall render a judgment either:
a. Dismissing the complaint for failure to affirmatively establish the allegations thereof or because of the affirmative establishment by the owner or licensee of a defense specified in this act; or
b. Ordering the appointment of a receiver approved by the department in accordance with the provisions of this act; or
c. Granting such other and further relief as the court deems just and proper. Upon the request of the department, if a receiver has been appointed the relief may include a requirement that the owner transfer his ownership interest to an entity approved by the department.
a. The court is authorized and empowered to appoint as a receiver any responsible person or persons approved by the department, except that no owner, licensee or administrator of the home shall be appointed as receiver.
b. The receiver, in his discretion, may either (1) assume the role of administrator or manager and take control of all day-to-day operations, or (2) direct the administrator or manager on actions and procedure to be taken to eliminate or rectify the conditions specified in the complaint.
c. With the approval of the court the receiver shall have any or all of the following powers:
(1) To hire any consultants or to undertake any studies of the home he deems appropriate.
(2) To make any repairs, improvements or expenditures to eliminate the conditions specified in the complaint and to direct the method or procedures by which this shall be accomplished.
(3) To hire or discharge any employees including the administrator or manager.
(4) To receive or expend in a reasonable and prudent manner the revenues of the home due on the date of the entry of such judgment and to become due under such judgment.
(5) To continue the business of the home and the care of the residents of the home in all its aspects.
(6) To do all acts necessary or appropriate to conserve the property and promote the health, safety or resident care of the residents in the home.
(7) To exercise such other powers as he deems necessary or appropriate to implement the court order.
d. No provision in this section shall limit the right of any owner upon the approval of the department to sell or mortgage any home subject to receivership under this act.
a. provide, at the nursing home's expense, or direct such nursing home to management support services and resources, as well as any other supports as may be necessary and appropriate to avoid bankruptcy proceedings or cessation of operations;
b. if the nursing homes does not take sufficient and timely action to avoid an impending bankruptcy or closure, and if the department finds the bankruptcy or closure would have a significant adverse effect on the health, safety, and welfare of the residents of the nursing home or would leave the area in which the nursing home is located lacking sufficient nursing home services after assessing the need for and availability of other nursing home services in the area, initiate proceedings in a court of competent jurisdiction for the appointment of a receiver for the nursing home, which receiver shall have the powers and authorities conferred by the order of receivership, which may include, but shall not be limited to, the authority to:
(1) hire any consultants or to undertake any studies of the nursing home the receiver deems appropriate;
(2) make any repairs or improvements as are necessary to ensure the safety of nursing home residents and staff;
(3) hire or discharge any employees, including the administrator or manager of the nursing home;
(4) receive or expend in a reasonable and prudent manner the revenues of the nursing home due on the date of the entry of the order of receivership and to become due under such order;
(5) continue the business of the nursing home and the care of the residents of the nursing home in all its aspects;
(6) do all acts necessary or appropriate to conserve the property and promote the health, safety, and welfare of the residents of the nursing home; and
(7) exercise such other powers as the receiver deems necessary or appropriate to implement the court order; and
c. Take such other steps and actions as may be available to ensure continuity of care for, and the safety of, residents of the nursing home.
a. If, after a trial, the court shall determine that the evidence warrants the granting of the relief sought and if the owner or licensee of the home shall apply to the court to be permitted to remove or remedy the conditions specified in the complaint and shall demonstrate the ability to promptly undertake and complete the work required, then the court, in lieu of rendering judgment as provided in this act, may issue an order permitting such person to perform the work in accordance with a time schedule and subject to such conditions, including the posting of a bond as security for the performance of the work, as may be fixed by the court.
b. If, after the issuance of an order pursuant to subsection a. of this section, it shall appear that the person permitted to do the same is not proceeding in accordance with the time schedule or in accordance with the conditions imposed by the court, the plaintiff may apply to the court on notice to those persons who have appeared in the proceeding for a hearing to determine whether judgment should be rendered immediately as provided in subsection c. of this section.
c. If, upon a hearing authorized in subsection b. hereof, the court shall determine the owner or licensee is not proceeding in accordance with the time schedule or with the conditions imposed by the court, the court shall issue a final judgment appointing a receiver as authorized in the act. If the person has posted a bond to secure completion of the work, the security or such part of the security as is necessary may be used by the receiver to remedy the conditions.
The court shall require the filing, at periodic intervals, of reports of action taken by the receiver and of accounts itemizing the revenues and expenditures. The reports shall be open to inspection to all parties to the case. Upon motion of the court or the receiver or of the owner, or licensee, the court may require a presentation or settlement of the accounts. Notice of a motion for presentation or settlement of such accounts shall be served on the owner, licensee and any party of record who appeared in the proceeding and any party in interest in such revenues and expenditures.
The receiver, owner or licensee may make a motion to terminate the receivership on grounds that the conditions complained of have been eliminated or remedied. The court may immediately terminate the receivership, or terminate the receivership subject to such terms as the court feels necessary or appropriate to prevent the condition or conditions complained of from recurring.
The court shall allow from the revenues of the home a reasonable amount of compensation for the expenditures and services of a receiver appointed under the provisions of this act. The receiver so appointed may be required to furnish a bond, the amount and form of which shall be approved by the court. The cost of such bond shall be paid for by the home.
(1) identifying and eliminating duplicative reporting;
(2) establishing standardized formats, requirements, protocols, and systems for data reporting, which may include requiring nursing homes to report data in machine-readable formats to facilitate the processing and analysis of reported data;
(3) establishing a centralized, cross-agency workgroup to monitor nursing home reporting;
(4) assessing State health information technology needs to support technology-enabled and data-driven regulatory oversight across State departments and agencies, anticipate potential uses for the enhanced technologies and systems, enable systems to readily accept and analyze additional data metrics required pursuant to subsection b. of this section, and identify opportunities to centralize and modernize State health data infrastructure, processes, and analytic capabilities;
(5) assessing nursing home health information technology needs to support population health management, interoperability, and modernized reporting requirements; and
(6) identifying and applying for federal funding to support health information technology infrastructure development.
b. (1) The department shall require all nursing homes to post on their Internet websites annual owner-certified financial statements along with the nursing home's most recent cost reports submitted to the federal Centers for Medicare and Medicaid Services. The department shall include on its Internet website a link to the page where each nursing home's certified financial statements and cost reports are posted. Nursing homes that are part of a health care system may post financial statements and cost reports pursuant to this paragraph that aggregate the financial data across all nursing homes that are a part of that health care system. A nonprofit nursing home that posts a copy of its most recent Internal Revenue Service Form 990 on its Internet website shall be deemed to have met the requirement for the nursing home to post an owner-certified financial statement on its Internet website pursuant to this paragraph, and the nursing home's posted Internal Revenue Service Form 990 shall be considered an owner-certified financial statement for the purposes of this paragraph and subparagraph (d) of paragraph (1) of subsection f. of this section.
(2) The department shall require all nursing homes to:
(a) participate in the National Health Care Safety Network's Long-term Care Facility Component;
(b) complete the network's long-term care facility annual facility survey; and
(c) participate in the network's long-term care facility monthly reporting plan, including:
(i) the healthcare-associated infection reporting modules for urinary tract infections, the laboratory-identified event module for Clostrum difficile (C.diff) infection and multidrug-resistant organisms, and prevention measures; and
(ii) the monthly reporting plan for prevention process measures, including hand hygiene, gloves, and gown adherence.
c. The department may develop additional data reporting requirements for nursing homes as are necessary to improve transparency and facilitate the department's ability to oversee and regulate operations in nursing homes, including, but not limited to, data related to occupancy, operating expenses and other appropriate financial metrics, and utilization and staffing data. In developing additional reporting requirements pursuant to this subsection, the department shall solicit feedback from nursing homes, advocacy groups for nursing home residents and their families, the New Jersey Long-Term Care Ombudsman, and Medicaid managed care organizations concerning proposed new data metrics, methods of maximizing the efficiency of data collection and specification, minimizing duplicative data reporting, and identifying ways to consolidate, automate, or streamline the data required to be reported by State and federal agencies and managed care organizations.
d. The department shall establish centralized State protocols for nursing home communications to reduce duplicative outreach and enhance information sharing capabilities.
e. The department shall require nursing homes to:
(1) post on their Internet websites a link to the dashboard developed and maintained by the department pursuant to paragraph (1) of subsection f. of this section; and
(2) designate a staff person who shall be responsible for responding to questions from the public concerning the nursing home, including questions about the nursing home's policies, procedures, and operations. The contact information for members of the public to direct questions and request information shall be posted on the nursing home's Internet website.
f. (1) The department shall develop, make available on its Internet website, and update at least quarterly, a data dashboard that provides a separate page or listing for each nursing home licensed in the State with links to the sites where information and data relevant to the nursing home may be found, as well as a description of the data and information that is accessible through each link. The data dashboard shall be searchable by nursing home. The data and information links available through the dashboard shall include, at a minimum, for each nursing home:
(a) the nursing home's star rating issued by the federal Centers for Medicare and Medicaid Services;
(b) the total number of complaints involving the nursing home, the number and nature of substantiated complaints involving the nursing home, the number of open investigations of complaints involving the nursing home, and the total number of outstanding complaints involving the nursing home that have not been investigated or resolved;
(c) the dates and results of inspections and surveys of the nursing home by the Department of Health, the Department of Human Services, and the federal Centers for Medicare and Medicaid Services, including links to any deficiencies or violations for which the nursing home was cited and to any corrective action plans in place at the nursing home;
(d) a link to the website where each nursing home's certified financial statements and the nursing home's cost reports submitted to the federal Centers for Medicare and Medicaid Services are posted;
(e) general staffing levels at the nursing home and, to the extent feasible, rates of compliance with mandatory staffing ratios;
(f) the frequency with which antipsychotic medication was administered to residents of the nursing home;
(g) the number of residents who developed a pressure ulcer, including the number of residents who developed multiple pressure ulcers;
(h) the number of each type of facility-acquired infection at the nursing home as reported to the National Health Care Safety Network's Long-term Care Facility Component pursuant to paragraph (2) of subsection b. of this section; and
(i) such other data as the department determines appropriate to allow the public to make informed choices when evaluating and selecting a nursing home.
(2) The department shall prepare and publish on its Internet website annual reports on New Jersey's nursing home system of care.
(3) For the purposes of making available to the public the data described in subparagraph (h) of paragraph (1) of this subsection, the department shall: request from the National Healthcare Safety Network, on a quarterly basis, data concerning the number of infections reported to the network by New Jersey nursing homes pursuant to paragraph (2) of subsection b. of this section; make the data available on the department's Internet website; and update the data at least quarterly using the most current data obtained from the National Healthcare Safety Network. The data shall provide details concerning the number of reported infections, by infection type, for each nursing home licensed in the State. The department shall additionally provide on its Internet website data concerning the Statewide and national averages for each type of reported infection in nursing homes.
Every skilled or intermediate care nursing facility in this State shall assist its residents in applying to establish eligibility for medical assistance or other payment mechanisms when their self-pay, private insurance, or medicare capability in respect of payment for nursing home facility care, may become sufficiently depleted to necessitate discharge.
In order to facilitate the provision of assistance to certain residents by skilled or intermediate care nursing facilities in obtaining medical assistance or other payment mechanisms for nursing home facility care pursuant to sections 1 and 2 of P.L. 1977, c. 387 (C. 26:2H-47 and 26:2H-48), the fiduciary of any resident, 65 years of age or older, for whom the fiduciary expends funds for the nursing home facility care of the resident shall, at least 90 days before those funds are exhausted, notify in writing the resident, the nursing facility to whom the funds are paid, the resident's next of kin and any other person or agency interested in the resident's welfare, of the impending exhaustion of those funds.
To facilitate the offering of such assistance, each such facility shall make an assessment of the extensiveness of the self-pay, private insurance, or medicare capability of each resident no later than 1 week after admission to the facility and on a periodic basis thereafter, provided, however, that no such assessment is made against a resident's will.
Each such facility shall also assist its residents in obtaining medically necessary post-discharge care, which shall include, but need not be limited to: home health and health-related services; medical day care services; or residential care services in another nursing facility or other similar licensed facility located in the vicinity of the facility from which discharge is made.
The State Department of Health shall monitor the implementation of the provisions of this act and shall, in consultation with the Department of Institutions and Agencies, assist skilled or intermediate care nursing facilities to identify sources of payment and care for residents by maintaining a current inventory of such resources available in the State.
Nothing in this act shall be construed to apply to any skilled or intermediate care nursing facility operated by and for those who rely exclusively upon treatment by spiritual means through prayer for healing in accordance with the levels and practices of any well recognized church or religious denomination.
The Commissioner of Health is hereby authorized to adopt reasonable rules and regulations, in accordance with the provisions of the Administrative Procedure Act, P.L.1968, c. 410 (C. 52:14B-1 et seq.) to carry out its functions and duties under this act and to effectuate its purposes.
a. Adults have the fundamental right, in collaboration with their health care providers, to control decisions about their own health care unless they lack the mental capacity to do so. This State recognizes, in its law and public policy, the personal right of the individual patient to make voluntary, informed choices to accept, to reject, or to choose among alternative courses of medical and surgical treatment.
b. Modern advances in science and medicine have made possible the prolongation of the lives of many seriously ill individuals, without always offering realistic prospects for improvement or cure. For some individuals, the possibility of extended life is experienced as meaningful and of benefit. For others, artificial prolongation of life may seem to provide nothing medically necessary or beneficial, serving only to extend suffering and prolong the dying process. This State recognizes the inherent dignity and value of human life and within this context recognizes the fundamental right of individuals to make health care decisions to have life-prolonging medical or surgical means or procedures provided, withheld, or withdrawn.
c. In order that the right to control decisions about one's own health care should not be lost in the event a patient loses decision making capacity and is no longer able to participate actively in making such health care decisions, this State recognizes the right of adults, who have the mental capacity, to plan ahead for health care decisions through the execution of advance directives, such as living wills and durable powers of attorney, and to have the wishes expressed therein respected, subject to certain limitations.
d. The right of individuals to forego life-sustaining measures is not absolute and is subject to certain interests of society. The most significant of these societal interests is the preservation of life, understood to embrace both an interest in preserving the life of the particular patient and a related but distinct interest in preserving the sanctity of all human life as an enduring social value. A second, closely related societal interest is the protection of individuals from direct and purposeful self-destruction, motivated by a specific intent to die. A third interest is the protection of innocent third parties who may be harmed by the patient's decision to forego therapy; this interest may be asserted to prevent the emotional and financial abandonment of the patient's minor children or to protect the paramount concerns of public health or safety. A fourth interest encompasses safeguarding the ethical integrity of the health care professions, individual professionals, and health care institutions, and maintaining public confidence and trust in the integrity and caring role of health care professionals and institutions. Finally, society has an interest in ensuring the soundness of health care decision making, including both protecting vulnerable patients from potential abuse or neglect and facilitating the exercise of informed and voluntary patient choice.
e. In accordance with these State interests, this State expressly rejects on both legal and moral grounds the practice of active euthanasia. No individual shall have the right to, nor shall any physician or other health care professional be authorized to engage in, the practice of active euthanasia.
f. In order to assure respect for patients' previously expressed wishes when the capacity to participate actively in decision making has been lost or impaired; to facilitate and encourage a sound decision making process in which patients, health care representatives, families, physicians, and other health care professionals are active participants; to properly consider patients' interests both in self-determination and in well-being; and to provide necessary and appropriate safeguards concerning the termination of life-sustaining treatment for patients who lack mental capacity as the law and public policy of this State, the Legislature hereby enacts the New Jersey Advance Directives for Health Care Act.
"Adult" means an individual who has reached majority pursuant to section 3 of P.L.1972, c.81 (C.9:17B-3).
"Advance directive for health care" or "advance directive" means a writing executed in accordance with the requirements of P.L.1991, c.201. An "advance directive" may include a proxy directive or an instruction directive, or both.
"Attending physician" means the physician selected by, or assigned to, the patient who has primary responsibility for the treatment and care of the patient.
"Decision making capacity" means a patient's ability to understand and appreciate the nature and consequences of health care decisions, including the benefits and risks of each, and alternatives to any proposed health care, and to reach an informed decision. A patient's decision making capacity is evaluated relative to the demands of a particular health care decision.
"Declarant" means an adult who has the mental capacity to execute an advance directive and does so.
"Do not resuscitate order" means a physician's written order not to attempt cardiopulmonary resuscitation in the event the patient suffers a cardiac or respiratory arrest.
"Emergency care" means immediate treatment provided in response to a sudden, acute, and unanticipated medical crisis in order to avoid injury, impairment, or death.
"Health care decision" means a decision to accept or to refuse any treatment, service, or procedure used to diagnose, treat, or care for a patient's physical or mental condition, including life-sustaining treatment. "Health care decision" also means a decision to accept or to refuse the services of a particular physician, nurse, other health care professional or health care institution, including a decision to accept or to refuse a transfer of care.
"Health care institution" means all institutions, facilities, and agencies licensed, certified, or otherwise authorized by State law to administer health care in the ordinary course of business, including hospitals, nursing homes, residential health care facilities, dementia care homes, home health care agencies, hospice programs operating in this State, mental health institutions, facilities or agencies, or institutions, facilities, and agencies for the developmentally disabled. The term "health care institution" shall not be construed to include "health care professionals" as defined in P.L.1991, c.201.
"Health care professional" means an individual licensed by this State to administer health care in the ordinary course of business or practice of a profession.
"Health care representative" means the individual designated by a declarant pursuant to the proxy directive part of an advance directive for the purpose of making health care decisions on the declarant's behalf, and includes an individual designated as an alternate health care representative who is acting as the declarant's health care representative in accordance with the terms and order of priority stated in an advance directive.
"Instruction directive" means a writing which provides instructions and direction regarding the declarant's wishes for health care in the event that the declarant subsequently lacks decision making capacity.
"Life-sustaining treatment" means the use of any medical device or procedure, artificially provided fluids and nutrition, drugs, surgery or therapy that uses mechanical or other artificial means to sustain, restore, or supplant a vital bodily function, and thereby increase the expected life span of a patient.
"Other health care professionals" means health care professionals other than physicians and nurses.
"Patient" means an individual who is under the care of a physician, nurse, or other health care professional.
"Permanently unconscious" means a medical condition that has been diagnosed in accordance with currently accepted medical standards and with reasonable medical certainty as total and irreversible loss of consciousness and capacity for interaction with the environment. The term "permanently unconscious" includes without limitation a persistent vegetative state or irreversible coma.
"Physician" means an individual licensed to practice medicine and surgery in this State.
"Proxy directive" means a writing which designates a health care representative in the event the declarant subsequently lacks decision making capacity.
"State" means a state, territory, or possession of the United States, the District of Columbia, or the Commonwealth of Puerto Rico.
"Terminal condition" means the terminal stage of an irreversibly fatal illness, disease or condition. A determination of a specific life expectancy is not required as a precondition for a diagnosis of a "terminal condition," but a prognosis of a life expectancy of six months or less, with or without the provision of life-sustaining treatment, based upon reasonable medical certainty, shall be deemed to constitute a terminal condition.
b. A declarant may revoke an advance directive, including a proxy directive, or an instruction directive, or both, by the following means:
(1) Notification, orally or in writing, to the health care representative, physician, nurse, or other health care professional, or other reliable witness, or by any other act evidencing an intent to revoke the document; or
(2) Execution of a subsequent proxy directive or instruction directive, or both, in accordance with section 4 of P.L.1991, c.201 (C.26:2H-56).
c. Designation of the declarant's spouse as health care representative shall be revoked upon divorce or legal separation, and designation of the declarant's domestic partner as defined in section 3 of P.L.2003, c.246 (C.26:8A-3) as health care representative shall be revoked upon termination of the declarant's domestic partnership or designation of the declarant's partner in a civil union as defined in section 2 of P.L.2006, c.103 (C.37:1-29) shall be revoked upon termination of the declarant's civil union, unless otherwise specified in the advance directive.
d. A patient who lacks mental capacity may suspend an advance directive, including a proxy directive, an instruction directive, or both, by any of the means stated in paragraph (1) of subsection b. of this section. A patient who lacks mental capacity and has suspended an advance directive may reinstate that advance directive by oral or written notification to the health care representative, physician, nurse, or other health care professional of an intent to reinstate the advance directive.
e. Reaffirmation, modification, revocation, or suspension of an advance directive is effective upon communication to any person capable of transmitting the information including the health care representative, the attending physician, nurse, or other health care professional responsible for the patient's care.
(1) An adult who has mental capacity, including, but not limited to, a declarant's spouse, partner in a civil union as defined in section 2 of P.L.2006, c.103 (C.37:1-29), domestic partner as defined in section 3 of P.L.2003, c.246 (C.26:8A-3), adult child, parent, or other family member, friend, religious or spiritual advisor, or other person of the declarant's choosing, may be designated as a health care representative.
(2) An operator, administrator, or employee of a health care institution in which the declarant is a patient or resident shall not serve as the declarant's health care representative unless the operator, administrator, or employee is related to the declarant by blood, marriage, domestic partnership, civil union, or adoption.
This restriction does not apply to a physician, if the physician does not serve as the patient's attending physician and the patient's health care representative at the same time.
(3) A declarant may designate one or more alternate health care representatives, listed in order of priority. In the event the primary designee is unavailable, unable, or unwilling to serve as health care representative, or is disqualified from such service pursuant to this section or any other law, the next designated alternate shall serve as health care representative. In the event the primary designee subsequently becomes available and able to serve as health care representative, the primary designee may, insofar as then practicable, serve as health care representative.
(4) A declarant may direct the health care representative to consult with specified individuals, including alternate designees, family members, and friends, in the course of the decision making process.
(5) A declarant shall state the limitations, if any, to be placed upon the authority of the health care representative including the limitations, if any, which may be applicable if the declarant is pregnant.
b. A declarant may execute an instruction directive, pursuant to the requirements of section 4 of P.L.1991, c.201 (C.26:2H-56), stating the declarant's general treatment philosophy and objectives; or the declarant's specific wishes regarding the provision, withholding, or withdrawal of any form of health care, including life-sustaining treatment; or both. An instruction directive may, but need not, be executed contemporaneously with, or be attached to, a proxy directive.
b. Treatment decisions pursuant to an advance directive shall not be made and implemented until there has been a reasonable opportunity to establish, and where appropriate confirm, a reliable diagnosis and prognosis for the patient.
b. The attending physician's determination of a lack of decision making capacity shall be confirmed by one or more physicians. The opinion of the confirming physician shall be stated in writing and made a part of the patient's medical records in the same manner as that of the attending physician. Confirmation of a lack of decision making capacity is not required when the patient's lack of decision making capacity is clearly apparent, and the attending physician and the health care representative agree that confirmation is unnecessary.
c. If the attending physician or the confirming physician determines that a patient lacks decision making capacity because of a mental or psychological impairment or a developmental disability, and neither the attending physician or the confirming physician has specialized training or experience in diagnosing mental or psychological conditions or developmental disabilities of the same or similar nature, a determination of a lack of decision making capacity shall be confirmed by one or more physicians with appropriate specialized training or experience. The opinion of the confirming physician shall be stated in writing and made a part of the patient's medical records in the same manner as that of the attending physician.
d. A physician designated by the patient's advance directive as a health care representative shall not make or confirm the determination of a lack of decision making capacity.
e. The attending physician shall inform the patient, if the patient has any ability to comprehend that he has been determined to lack decision making capacity, and the health care representative that: (1) the patient has been determined to lack decision making capacity to make a particular health care decision; (2) each has the right to contest this determination; and (3) each may have recourse to the dispute resolution process established by the health care institution pursuant to section 14 of P.L.1991, c.201 (C.26:2H-66).
Notice to the patient and the health care representative shall be documented in the patient's medical records.
f. A determination of lack of decision making capacity under this act is solely for the purpose of implementing an advance directive in accordance with the provisions of this act, and shall not be construed as a determination of a patient's incapacity for any other purpose.
g. For purposes of this section, a determination that a patient lacks decision making capacity shall be based upon, but need not be limited to, evaluation of the patient's ability to understand and appreciate the nature and consequences of a particular health care decision, including the benefits and risks of, and alternatives to, the proposed health care, and to reach an informed decision.
b. If a different individual has been appointed as the patient's legal guardian, the health care representative shall retain legal authority to make health care decisions on the patient's behalf, unless the terms of the legal guardian's court appointment or other court decree provide otherwise.
c. The conferral of legal authority on the health care representative shall not be construed to impose liability upon the health care representative for any portion of the patient's health care costs.
d. An individual designated as a health care representative or as an alternate health care representative may decline to serve in that capacity.
e. The health care representative shall exercise the patient's right to be informed of the patient's medical condition, prognosis and treatment options, and to give informed consent to, or refusal of, health care.
f. In the exercise of these rights and responsibilities, the health care representative shall seek to make the health care decision the patient would have made had he possessed decision making capacity under the circumstances, or, when the patient's wishes cannot adequately be determined, shall make a health care decision in the best interests of the patient.
a. The attending physician shall make an affirmative inquiry of the patient, his family or others, as appropriate under the circumstances, concerning the existence of an advance directive. The attending physician shall note in the patient's medical records whether or not an advance directive exists, and the name of the patient's health care representative, if any, and shall attach a copy of the advance directive to the patient's medical records. The attending physician shall document in the same manner the reaffirmation, modification, or revocation of an advance directive, if he has knowledge of such action.
b. A physician may decline to participate in the withholding or withdrawing of measures utilized to sustain life, in accordance with his sincerely held personal or professional convictions. In such circumstances, the physician shall act in good faith to inform the patient and the health care representative, and the chief of the medical staff or other designated institutional official, of this decision as soon as practicable, to effect an appropriate, respectful and timely transfer of care, and to assure that the patient is not abandoned or treated disrespectfully.
In the event of transfer of a patient's care, the attending physician shall assure the timely transfer of the patient's medical records, including a copy of the patient's advance directive.
c. A nurse or other health care professional may decline to participate in the withholding or withdrawing of measures utilized to sustain life, in accordance with his sincerely held personal or professional convictions. In these circumstances, the nurse or other health care professional shall act in good faith to inform the patient and the health care representative, and the head of the nursing or other professional staff or other designated institutional official, of this decision as soon as practicable, to cooperate in effecting an appropriate, respectful and timely transfer of care, and to assure that the patient is not abandoned or treated disrespectfully.
d. Nothing in this act shall be construed to require a physician, nurse or other health care professional to begin, continue, withhold, or withdraw health care in a manner contrary to law or accepted professional standards.
(1) Discussion of the proposed treatment and its alternatives shall include, as appropriate under the circumstances, the availability, benefits and burdens of rehabilitative treatment, therapy, and services.
(2) The decision making process shall allow, as appropriate under the circumstances, adequate time for the health care representative to understand and deliberate about all relevant information before a treatment decision is implemented.
b. Following a determination that a patient lacks decision making capacity, the health care representative and the attending physician shall, to a reasonable extent, discuss the treatment options with the patient, and seek to involve the patient as a participant in the decision making process. The health care representative and the attending physician shall seek to promote the patient's capacity for effective participation and shall take the patient's expressed wishes into account in the decision making process.
Once decision making authority has been conferred upon a health care representative pursuant to an advance directive, if the patient is subsequently found to possess adequate decision making capacity with respect to a particular health care decision, the patient shall retain legal authority to make that decision. In such circumstances, the health care representative may continue to participate in the decision making process in an advisory capacity, unless the patient objects.
Notwithstanding any other provision of this act to the contrary, if a patient who lacks decision making capacity clearly expresses or manifests the contemporaneous wish that medically appropriate measures utilized to sustain life be provided, that wish shall take precedence over any contrary decision of the health care representative and any contrary statement in the patient's instruction directive.
c. In acting to implement a patient's wishes pursuant to an advance directive, the health care representative shall give priority to the patient's instruction directive, and may also consider, as appropriate and necessary, the following forms of evidence of the patient's wishes:
(1) The patient's contemporaneous expressions, including nonverbal expressions;
(2) Other reliable sources of information, including the health care representative's personal knowledge of the patient's values, preferences and goals; and
(3) Reliable oral or written statements previously made by the patient, including, but not limited to, statements made to family members, friends, health care professionals or religious leaders.
d. If the instruction directive, in conjunction with other evidence of the patient's wishes, does not provide, in the exercise of reasonable judgment, clear direction as applied to the patient's medical condition and the treatment alternatives, the health care representative shall exercise reasonable discretion, in good faith, to effectuate the terms, intent, and spirit of the instruction directive and other evidence of the patient's wishes.
e. Subject to the provisions of this act, and unless otherwise stated in the advance directive, if the patient's wishes cannot be adequately determined, then the health care representative shall make a health care decision in the patient's best interests.
b. If the instruction directive is, in the exercise of reasonable judgment, not specific to the patient's medical condition and the treatment alternatives, the attending physician, in consultation with a legally appointed guardian, if any, family members, or others acting on the patient's behalf, shall exercise reasonable judgment to effectuate the wishes of the patient, giving full weight to the terms, intent, and spirit of the instruction directive. Departure from the specific terms and provisions of the instruction directive shall be based upon clearly articulable factors not foreseen or contemplated by the instruction directive, including, but not limited to, the circumstances of the patient's medical condition.
c. Nothing in this act shall be construed to impair the legal force and effect of an instruction directive executed prior to the effective date of this act.
(1) A health care institution shall adopt such policies and practices as are necessary to provide for routine inquiry, at the time of admission and at such other times as are appropriate under the circumstances, concerning the existence and location of an advance directive.
(2) A health care institution shall adopt such policies and practices as are necessary to provide appropriate informational materials concerning advance directives to all interested patients and their families and health care representatives, and to assist patients interested in discussing and executing an advance directive.
(3) A health care institution shall adopt such policies and practices as are necessary to educate patients and their families and health care representatives about the availability, benefits and burdens of rehabilitative treatment, therapy and services, including but not limited to family and social services, self-help and advocacy services, employment and community living, and use of assistive devices. A health care institution shall, in consultation with the attending physician, assure that such information is discussed with a patient and his health care representative and made a part of the decision making process set forth in section 11 of this act, as appropriate under the circumstances.
(4) In situations in which a transfer of care is necessary, including a transfer for the purpose of effectuating a patient's wishes pursuant to an advance directive, a health care institution shall, in consultation with the attending physician, take all reasonable steps to effect the appropriate, respectful and timely transfer of the patient to the care of an alternative health care professional or institution, as necessary, and shall assure that the patient is not abandoned or treated disrespectfully. In such circumstances, a health care institution shall assure the timely transfer of the patient's medical records, including a copy of the patient's advance directive.
(5) A health care institution shall establish procedures and practices for dispute resolution, in accordance with section 14 of this act.
(6) A health care institution shall adopt such policies and practices as are necessary to inform physicians, nurses and other health care professionals of their rights and responsibilities under this act, to assure that such rights and responsibilities are understood, and to provide a forum for discussion and consultation regarding the requirements of this act.
b. A private, religiously-affiliated health care institution may develop institutional policies and practices defining circumstances in which it will decline to participate in the withholding or withdrawing of specified measures utilized to sustain life. Such policies and practices shall be written, and shall be properly communicated to patients and their families and health care representatives prior to or upon the patient's admission, or as soon after admission as is practicable.
If the institutional policies and practices appear to conflict with the legal rights of a patient wishing to forego health care, the health care institution shall attempt to resolve the conflict, and if a mutually satisfactory accommodation cannot be reached, shall take all reasonable steps to effect the appropriate, timely and respectful transfer of the patient to the care of another health care institution appropriate to the patient's needs, and shall assure that the patient is not abandoned or treated disrespectfully.
c. Nothing in this act shall be construed to require a health care institution to participate in the beginning, continuing, withholding or withdrawing of health care in a manner contrary to law or accepted medical standards.
b. A health care professional involved in the patient's care, other than the attending physician, or an administrator of a health care institution may also invoke the dispute resolution process established by the health care institution to seek to resolve a disagreement concerning the patient's decision making capacity or the appropriate interpretation and application of the terms of an advance directive.
(1) When the life-sustaining treatment is experimental and not a proven therapy, or is likely to be ineffective or futile in prolonging life, or is likely to merely prolong an imminent dying process;
(2) When the patient is permanently unconscious, as determined by the attending physician and confirmed by a second qualified physician;
(3) When the patient is in a terminal condition, as determined by the attending physician and confirmed by a second qualified physician; or
(4) In the event none of the above circumstances applies, when the patient has a serious irreversible illness or condition, and the likely risks and burdens associated with the medical intervention to be withheld or withdrawn may reasonably be judged to outweigh the likely benefits to the patient from such intervention, or imposition of the medical intervention on an unwilling patient would be inhumane. In such cases prior to implementing a decision to withhold or withdraw life-sustaining treatment, the attending physician may promptly seek consultation with an institutional or regional reviewing body in accordance with section 17 of this act, or may promptly seek approval of a public agency recognized by law for this purpose.
b. Nothing in this section shall be construed to impair the obligations of physicians, nurses and other health care professionals to provide for the care and comfort of the patient and to alleviate pain, in accordance with accepted medical and nursing standards.
c. Nothing in this section shall be construed to abridge any constitutionally-protected right to refuse treatment under either the United States Constitution or the Constitution of the State of New Jersey.
b. A do not resuscitate order shall be entered in writing in the patient's medical records prior to implementation of the order.
c. Nothing in this act shall be construed to impair any existing legal authority to issue a do not resuscitate order when the patient has not executed an advance directive.
Consultation with the institutional or regional reviewing body shall be documented in the patient's medical records.
b. Consultation with an institutional or regional reviewing body acting in accordance with subsection a. of this section is not required. Furthermore, nothing in this act shall be construed to impair the right of a patient, health care representative, physician, nurse, or other health care professional who consults with an institutional or regional reviewing body to:
(1) Seek review by a public agency recognized by law for this purpose; or
(2) Seek review by a court of competent jurisdiction.
c. Nothing in this section shall preclude the transfer of the patient to another appropriate health care professional or health care institution. In this case the health care institution responsible for the patient's care shall assure that the health care professional or health care institution to which the patient is transferred is properly informed of the advice given by the institutional or regional reviewing body.
b. The provisions of this act shall not be construed to require emergency personnel, including paid or volunteer fire fighters; paramedics; members of an ambulance team, rescue squad, or mobile intensive care unit; or emergency room personnel of a licensed health care institution, to withhold or withdraw emergency care in circumstances which do not afford reasonable opportunity for careful review and evaluation of an advance directive without endangering the life of the patient.
a. For the annual reporting by health care institutions, and the gathering of such additional data as is reasonably necessary to oversee and evaluate the implementation of this act. The department shall seek to minimize the burdens of record-keeping imposed by the rules and regulations and shall seek to assure the appropriate confidentiality of patient records.
b. Requiring health care institutions to adopt policies and practices designed to:
(1) Make routine inquiry, at the time of admission and at such other times as are appropriate under the circumstances, concerning the existence and location of an advance directive;
(2) Provide appropriate informational materials concerning advance directives to all interested patients and their families and health care representatives, and to assist patients interested in discussing and executing an advance directive;
(3) Educate patients and their families and health care representatives about the availability, benefits and burdens of rehabilitative treatment, therapy and services, as appropriate;
(4) Inform physicians, nurses, and other health care professionals of their rights and responsibilities under this act, to assure that the rights and responsibilities are understood, and to provide a forum for discussion and consultation regarding the requirements of this act; and
(5) Otherwise comply with the provisions of this act.
b. A health care professional shall not be subject to criminal or civil liability or to discipline by the health care institution or the respective State licensing board for professional misconduct for any actions performed in good faith and in accordance with the provisions of this act, any rules and regulations established by the Department of Health pursuant to this act, and accepted professional standards to carry out the terms of an advance directive.
c. A health care institution shall not be subject to criminal or civil liability for any actions performed in good faith and in accordance with the provisions of this act to carry out the terms of an advance directive.
b. To the extent any of the provisions of this act are inconsistent with P.L.1971, c.373 (C.46:2B-8 et seq.) concerning the designation of a health care representative, the provisions of this act shall have priority over those of P.L.1971, c.373 (C.46:2B-8 et seq.).
Durable powers of attorney for health care executed pursuant to P.L.1971, c.373 (C.46:2B-8 et seq.) prior to the effective date of this act shall have the same legal force and effect as if they had been executed in accordance with the provisions of this act.
c. Nothing in this act shall be construed to impair the rights of emancipated minors under existing law.
b. A health care institution that intentionally fails to act in accordance with the requirements of this act shall be subject to a fine of not more than $1,000 for each offense. For the purposes of this subsection, each violation shall constitute a separate offense. Penalties for violations of this act shall be recovered in a summary civil proceeding, brought in the name of the State in a court of competent jurisdiction pursuant to "the penalty enforcement law" (N.J.S.2A:58-1 et seq.).
c. The following acts constitute crimes:
(1) To willfully conceal, cancel, deface, obliterate or withhold personal knowledge of an advance directive or a modification or revocation thereof, without the declarant's consent, is a crime of the fourth degree.
(2) To falsify or forge an advance directive or a modification or revocation thereof of another individual is a crime of the fourth degree.
(3) To coerce or fraudulently induce the execution of an advance directive or a modification or revocation thereof is a crime of the fourth degree.
(4) To require or prohibit the execution of an advance directive or a modification or revocation thereof as a condition of coverage under any policy of health insurance, life insurance or annuity, or governmental benefits program, or as a condition of the provision of health care is a crime of the fourth degree.
d. Commission of any of the acts identified in paragraphs (1), (2), or (3) of subsection c., resulting in the involuntary earlier death of a patient, shall constitute a crime of the fourth degree.
e. The sanctions provided in this section shall not be construed to repeal any sanctions applicable under other law.
“Authorized representative” means a parent or legal guardian of a minor, an individual's guardian, or other person appointed by the individual or court to manage the individual's health care.
"Health care facility" means a physician's office, or an acute care general hospital or any other health care facility licensed pursuant to P.L.1971, c.136 (C.26:2H-1 et seq.).
"Health care professional" means a person licensed or certified to practice a health care profession pursuant to Title 45 of the Revised Statutes.
b. An individual who is 18 years of age or older, an emancipated minor, or a patient’s authorized representative may execute a voluntary nonopioid directive stating that an opioid may not be administered or prescribed to the individual. This directive shall not apply to intraoperative procedures requiring general anesthesia.
c. A voluntary nonopioid directive shall be made on a form that shall be developed by the Department of Health and published on the department’s Internet website. The form shall include information on circumstances in which the directive would not be applicable.
d. A voluntary nonopioid directive may be revoked at any time either orally or in writing by an individual or the individual’s authorized representative.
e. The Department of Health shall publicize information about voluntary nonopioid directives through various means, including social media.
f. A voluntary nonopioid directive submitted by a patient or the patient’s authorized representative to a health care professional or to a health care facility shall be entered into the patient’s electronic file in a manner that permits the patient or the patient’s authorized representative to access the directive. The Department of Health may designate a secure common repository for nonopioid directives to be accessed by licensed healthcare professionals and pharmacists in accordance with all State and federal health privacy laws and in a manner determined by the department.
g. Nothing in this act shall prevent an opioid from being prescribed or administered to a patient if deemed medically necessary.
h. (1) A health care professional, a health care facility, or an employee of a health care professional or health care facility shall be immune from disciplinary action by the Department of Health or a licensing agency or board for any act that was done to comply with the provisions of this act.
(2) A health care professional, a health care facility, or an employee of a health care professional or health care facility shall be immune from any civil or criminal liability for failure to administer, prescribe, or dispense an opioid, and for the intentional or inadvertent administration of an opioid, to an individual who has a voluntary nonopioid directive, if the act or the failure was reasonable and done in good faith.
a. Nursing care by or under the supervision of a registered professional nurse;
b. Physical, occupational, or speech or language therapy;
c. Medical social services by a certified or licensed social worker under the direction of a physician;
d. Services of a certified home health aide;
e. Medical supplies, including drugs and biologicals, and the use of medical appliances related to terminal diagnosis;
f. Physician's services;
g. Short-term inpatient care, including both palliative and respite care and procedures;
h. Spiritual and other counseling for hospice patients and hospice patients' families;
i. Services of volunteers under the direction of the provider of the hospice care program; and
j. Bereavement services for hospice patients' families.
No public agency or private organization shall assume, represent itself as or use the word "hospice" or any modification or derivative thereof, unless the agency or organization is licensed pursuant to this act.
b. Application for a license for a hospice care program shall be made upon forms prescribed by the department. The department shall charge such nonrefundable fees for the filing of an application for a license and any renewal thereof, as it shall from time to time fix in regulations, except the amount of this fee shall not exceed $2,000. The application shall contain the name of the hospice care program and such other information as the department may require.
c. The department shall only issue a license to a hospice care program that provides written documentation that it is certified for participation in the federal Medicare program established pursuant to the federal Social Security Act, Pub. L. 89-97 (42 U.S.C. s.1395 et seq.).
d. A nursing home licensed pursuant to the "Health Care Facilities Planning Act," P.L.1971, c.136 (C.26:2H-1 et al.) that does not hold itself out to be a hospice, does not hold itself out as providing a hospice care program, does not use the term hospice to describe or refer to its activities or facilities, and does not provide all of the services enumerated in section 1 of this act is not subject to the licensing provisions of this act.
e. A hospice care program licensed pursuant to this act shall not be subject to the certificate of need requirements of P.L.1971, c.136 (C.26:2H-1 et al.).
"Family member" means a hospice care patient's spouse, parent, adult sibling, adult child, or adult grandchild.
"Health care representative" means a person, including a member of the patient's family, who is authorized to make health care decisions on behalf of a hospice care patient.
"Hospice care patient" means a person currently receiving hospice care services in a private home or an assisted living facility through a licensed hospice care program.
"Third party caregiver" means a person who:
(1) is 18 years of age or older;
(2) provides care or assistance to a hospice care patient; and
(3) is not the patient's health care representative, a family member of the patient, or employed by the patient's hospice care program.
b. A hospice care program licensed pursuant to P.L.1997, c.78 (C.26:2H-79 et seq.) may choose, but shall not be required, to accept for disposal, at such time as a hospice care patient ceases to use the drug or medication or ceases to receive hospice care services through the program, the hospice care patient's unused prescription drugs and medications. A hospice care program that chooses to accept unused prescription drugs and medications for disposal pursuant to this section shall:
(1) Establish a written policy setting forth procedures for accepting and disposing of unused prescription drugs and medications;
(2) Furnish a copy of the written policy to each patient, and to the patient's health care representative, at the time the patient is enrolled in the hospice care program, and designate a program representative who shall discuss the procedures and requirements for surrendering unused prescription drugs and medications with the patient and the patient's health care representative;
(3) Accept drugs and medications prescribed and dispensed to the patient pursuant to the patient's hospice care plan, as well as any other prescription drugs and medications that the patient, or the patient's health care representative, chooses to surrender to the program;
(4) Not accept any drug or medication for surrender except at such time as the patient ceases to use the drug or medication or ceases to receive hospice care services through the program;
(5) Obtain any certifications, authorizations, or waivers as may be required under State or federal law in order to accept and dispose of unused prescription drugs and medications pursuant to this section; and
(6) (a) at the time the patient is enrolled in the hospice care program, at such time as any change is made to the patient's course of treatment that results in a change in the drugs or medications prescribed for the patient, or in the patient discontinuing the use of a prescription drug or medication, and at such time as the patient ceases to receive hospice care services through the program, provide the patient or the patient's health care representative with oral instructions and written informational materials advising that when unused, unwanted, or expired drugs and medications are not properly, safely, and promptly disposed of:
(i) there is a risk that the drug or medication can be stolen, diverted, abused, misused, or accidentally ingested, which can pose a risk to the health and safety of the patient and other members of the patient's household;
(ii) children are particularly at risk of accidentally ingesting unused, unwanted, and expired medications that have not been properly, safely, and promptly disposed of;
(iii) when drugs or medications are disposed of in the household trash or flushed down the drain, the drugs and medications can leak into the ecosystem, which can have a potentially adverse or harmful effect on the environment; and
(iv) when drugs or medications are disposed of in the household trash without the drug or medication having been rendered deactivated, inaccessible, or otherwise unusable, the drug or medication may be stolen by individuals seeking to divert, abuse, or misuse the drug or medication;
(b) make available on-site, for purchase or at no cost to the patient, at least one consumer method for individuals to dispose of unwanted or expired prescription drugs, including, but not limited to over-the-counter at-home or site-of-use solutions or secured medication collection kiosks or boxes; and
(c) provide the patient with oral and written instructions on how to properly, safely, and promptly dispose of unused, unwanted, or expired drugs and medications, which may include, but shall not be limited to, providing instructions concerning the use of an over-the-counter at-home or site-of-use solution furnished to the patient pursuant to subparagraph (b) of this paragraph, and advising the patient of the availability of secure prescription medication drop-off receptacles and prescription medication take back programs.
c. At the time a hospice care patient ceases to receive hospice care services, a program representative shall provide a written request for surrender of unused drugs and medications to the patient or the patient's health care representative, which shall:
(1) request that the patient or the patient's health care representative surrender any unused prescription drugs or medications that were prescribed and dispensed to the patient pursuant to the patient's hospice care plan;
(2) offer to accept and dispose of any other prescription drug or medication which the patient will not use; and
(3) urge that the patient or the patient's health care representative dispose of any unused prescription drug or medication that is not surrendered to the program in a safe and legal manner, so as to avoid the risk of theft, diversion, or accidental ingestion.
d. No hospice care program may accept and dispose of an unused prescription drug or medication pursuant to this section unless the patient or the patient's health care representative authorizes, in writing, the surrender of the unused prescription drug or medication to the program; except that, if the patient is unable to provide written authorization and the patient does not have a health care representative, a third party caregiver may provide written authorization for the surrender. A hospice care program shall not accept an unused prescription drug or medication unless the drug or medication is identified for inclusion in the authorization for surrender.
e. (1) Unused prescription drugs and medications surrendered to a hospice care program pursuant to this section shall be surrendered to a registered professional nurse or a licensed practical nurse employed by the program.
(2) A nurse accepting the surrender of unused prescription drugs or medications pursuant to this section shall dispose of the drugs or medications at the site where hospice care was provided; in no case shall the nurse transport the unused prescription medications off-site for disposal or for any other purpose. The nurse may dispose of the unused drugs or medications using an over-the-counter at-home or site-of-use solution that meets the requirements of paragraph (2) of subsection a. of section 1 of P.L.2019, c.509 (C.45:14-67.6).
(3) A nurse who accepts and disposes of an unused prescription drug or medication pursuant to this section shall document:
(a) the name and quantity of each drug or medication surrendered;
(b) the name of the person authorizing the surrender, and the relationship of the person to the patient;
(c) the date and method of disposal; and
(d) the quantity and type of any unused prescription drug or medication, of which the nurse is aware, that was prescribed and dispensed to the patient pursuant to the patient's hospice care plan, but was not surrendered to the program or otherwise disposed of by another person in the nurse's presence.
(4) The person authorizing the surrender of a drug or medication shall be provided with the opportunity to review, verify, and sign the documentation required under paragraph (3) of this subsection.
f. Nothing in this section shall prohibit any person from disposing of an unused prescription drug or medication by any means authorized by law, including, but not limited to, disposing of the drug or medication pursuant to subparagraph (b) of paragraph (6) of subsection b. of this section or surrendering the medication at a secure prescription medication drop-off receptacle.
g. No person shall be subject to civil or criminal liability or professional disciplinary action for any act or omission undertaken in good faith consistent with the requirements of this section.
In addition, a follow-up criminal history record background check of federal records shall be conducted at least once every two years as a condition of recertification for every certified nurse aide and personal care assistant; except that the commissioner, in lieu of conducting follow-up criminal history record background checks for purposes of recertification, may provide for an alternative means of determining whether a certified nurse aide or personal care assistant has been convicted of a crime or disorderly persons offense which would disqualify that person from certification, including, but not limited to, a match of a person's Social Security number or other identifying information with records of criminal proceedings in this and other states. If the commissioner elects to implement this alternative means of determining whether a certified nurse aide or personal care assistant has been convicted of a crime or disorderly persons offense which would disqualify that person from certification, the commissioner shall report to the Governor and the Legislature prior to its implementation on the projected costs and procedures to be followed with respect to its implementation and setting forth the rationale therefor.
A person shall be disqualified from certification if that person's criminal history record background check reveals a record of conviction of any of the following crimes and offenses:
(1) In New Jersey, any crime or disorderly persons offense:
(a) involving danger to the person, meaning those crimes and disorderly persons offenses set forth in N.J.S.2C:11-1 et seq., N.J.S.2C:12-1 et seq., N.J.S.2C:13-1 et seq., N.J.S.2C:14-1 et seq. or N.J.S.2C:15-1 et seq.; or
(b) against the family, children, or incompetents, meaning those crimes and disorderly persons offenses set forth in N.J.S.2C:24-1 et seq.; or
(c) involving theft as set forth in chapter 20 of Title 2C of the New Jersey Statutes; or
(d) involving any controlled dangerous substance or controlled substance analog as set forth in chapter 35 of Title 2C of the New Jersey Statutes except paragraph (4) of subsection a. of N.J.S.2C:35-10.
(2) In any other state or jurisdiction, of conduct which, if committed in New Jersey, would constitute any of the crimes or disorderly persons offenses described in paragraph (1) of this subsection.
b. Notwithstanding the provisions of subsection a. of this section, no person shall be disqualified from certification on the basis of any conviction disclosed by a criminal history record background check performed pursuant to sections 2 through 6 and section 14 of P.L.1997, c.100 (C.26:2H-83 through 87 and C.53:1-20.9a) if the person has affirmatively demonstrated to the Commissioner of Health clear and convincing evidence of the person's rehabilitation. In determining whether a person has affirmatively demonstrated rehabilitation, the following factors shall be considered:
(1) the nature and responsibility of the position which the convicted person would hold, has held or currently holds, as the case may be;
(2) the nature and seriousness of the offense;
(3) the circumstances under which the offense occurred;
(4) the date of the offense;
(5) the age of the person when the offense was committed;
(6) whether the offense was an isolated or repeated incident;
(7) any social conditions which may have contributed to the offense; and
(8) any evidence of rehabilitation, including good conduct in prison or in the community, counseling or psychiatric treatment received, acquisition of additional academic or vocational schooling, successful participation in correctional work-release programs, or the recommendation of those who have had the person under their supervision.
c. If a person subject to the provisions of sections 2 through 6 of P.L.1997, c.100 (C.26:2H-83 through 87) refuses to consent to, or cooperate in, the securing of a criminal history record background check, the commissioner shall, as applicable:
(1) not issue a nurse aide or personal care assistant certification and shall notify the applicant, and the applicant's employer if the applicant is conditionally employed as provided in subsection d. of section 3 of P.L.1997, c.100 (C.26:2H-84) or the applicant's prospective employer if known, of that denial; or
(2) revoke the person's current nurse aide or personal care assistant certification and notify the person, and the person's employer, if known, of that revocation.
b. Upon receipt of the criminal history record information for a person from the Federal Bureau of Investigation or the Division of State Police, the commissioner shall immediately notify, in writing, the applicant, and the applicant's employer if the applicant is conditionally employed as provided in subsection d. of this section or the applicant's prospective employer if known, or a certified nurse aide or personal care assistant who is required to undergo a criminal history record background check pursuant to section 2 of P.L.1997, c.100 (C.26:2H-83) and that person's employer, as applicable, of the person's qualification or disqualification for certification under sections 2 through 6 of P.L.1997, c.100 (C.26:2H-83 through 87). If the person is disqualified, the conviction or convictions which constitute the basis for the disqualification shall be identified in the notice to the person, but shall not be identified in the notice to the person's employer or prospective employer.
c. The person who is the subject of the background check shall have 30 days from the date of the written notice of disqualification to petition the commissioner for a hearing on the accuracy of the person's criminal history record information or to establish the person's rehabilitation under subsection b. of section 2 of P.L.1997, c.100 (C.26:2H-83). The commissioner shall notify the person's employer or prospective employer of the person's petition for a hearing within five days following the receipt of the petition from the person. Upon the issuance of a final decision upon a petition to the commissioner pursuant to this subsection, the commissioner shall notify the person and the person's employer or prospective employer as to whether the person remains disqualified from certification under sections 2 through 6 of P.L.1997, c.100 (C.26:2H-83 through 87).
d. An applicant for certification may be issued conditional certification and may be employed as a nurse aide or a personal care assistant conditionally for a period not to exceed 60 days, pending completion of a criminal history record background check required under sections 2 through 6 of P.L.1997, c.100 (C.26:2H-83 through 87) by the Division of State Police in the Department of Law and Public Safety based upon an examination of its own files in accordance with section 14 of P.L.1997, c.100 (C.53:1-20.9a), and for an additional period not to exceed 60 days pending completion of a criminal history record background check by federal authorities as arranged for by the Division of State Police pursuant to section 14 of P.L.1997, c.100 (C.53:1-20.9a), if the person submits to the commissioner a sworn statement attesting that the person has not been convicted of any crime or disorderly persons offense as described in section 2 of P.L.1997, c.100 (C.26:2H-83). A person who submits a false sworn statement shall be disqualified from certification as a nurse aide or a personal care assistant, as the case may be, and shall not have an opportunity to establish rehabilitation pursuant to subsection b. of section 2 of P.L.1997, c.100 (C.26:2H-83).
A conditionally employed person, or an employed person certified as a nurse aide or a personal care assistant, who disputes the accuracy of the criminal history record information and who files a petition requesting a hearing pursuant to subsection c. of this section may remain employed by that person's employer until the commissioner rules on the person's petition but, pending the commissioner's ruling, the employer shall not permit the person to have unsupervised contact with patients, residents, or clients, as the case may be, who are 60 years of age or older.
e. (1) A licensed health care facility or other entity that has received an application from or conditionally employs an applicant for nurse aide or personal care assistant certification, or employs a certified nurse aide or personal care assistant, and:
(a) receives notice from the Commissioner of Health that the applicant or certified nurse aide or personal care assistant, as applicable, has been determined by the commissioner to be disqualified from certification as a nurse aide or personal care assistant pursuant to sections 2 through 6 of P.L.1997, c.100 (C.26:2H-83 through 87); or
(b) terminates its employment of a conditionally employed applicant for nurse aide or personal care assistant certification or a certified nurse aide or personal care assistant because the person was disqualified from employment at the health care facility or other entity on the basis of a conviction of a crime or disorderly persons offense as described in section 2 of P.L.1997, c.100 (C.26:2H-83) after commencing employment at the health care facility or other entity;
shall be immune from liability for disclosing that disqualification or termination in good faith to another licensed health care facility or other entity that is qualified by statute or regulation to employ the person as a nurse aide or personal care assistant.
(2) A licensed health care facility or other entity which discloses information pursuant to paragraph (1) of this subsection shall be presumed to be acting in good faith unless it is shown by clear and convincing evidence that the health care facility or other entity acted with actual malice toward the person who is the subject of the information.
f. (1) A licensed health care facility or other entity, upon receiving notice from the Commissioner of Health that a person employed by it as a nurse aide or personal care assistant, including a conditionally employed person, has been convicted of a crime or disorderly persons offense as described in section 2 of P.L.1997, c.100 (C.26:2H-83) after commencing employment at the health care facility or other entity, shall:
(a) immediately terminate the person's employment as a nurse aide or personal care assistant; and
(b) report information about the termination to the Commissioner of Health in a manner prescribed by the commissioner, who shall thereupon deem the person to be disqualified from certification as a nurse aide or personal care assistant, subject to the provisions of paragraph (3) of this subsection.
(2) A licensed health care facility or other entity shall be immune from liability for any actions taken in good faith pursuant to paragraph (1) of this subsection and shall be presumed to be acting in good faith unless it is shown by clear and convincing evidence that the health care facility or other entity acted with actual malice toward the employee.
(3) The person terminated from employment pursuant to paragraph (1) of this subsection shall have 30 days from the date of the termination to petition the commissioner for a hearing on the accuracy of the information about the conviction reported to the commissioner or to establish why the person should not be terminated from employment, and disqualified from certification, as a nurse aide or personal care assistant. The commissioner shall notify the person's employer of the person's petition for a hearing within five days following the receipt of the petition from the person. Upon the issuance of a final decision upon a petition to the commissioner pursuant to this paragraph, the commissioner shall notify the person and the person's employer as to whether:
(a) the person is to be reinstated in the person's employment as a nurse aide or personal care assistant and retain the person's certification; or
(b) the person's termination from employment as a nurse aide or personal care assistant stands and the person remains disqualified from certification.
g. The commissioner shall provide for a registry of all persons who have successfully completed all training and competency evaluation requirements for certification as a nurse aide or personal care assistant and shall provide for the inclusion in the registry of information about the disqualification of any person from certification pursuant to sections 2 through 6 of P.L.1997, c.100 (C.26:2H-83 through 87); for which purposes, the commissioner may use an existing registry established pursuant to statute or regulation, subject to the requirements of federal law. The registry shall include the specific documented findings constituting the basis for that disqualification, except that the information shall indicate that the person was convicted of a crime or disorderly persons offense as described in section 2 of P.L.1997, c.100 (C.26:2H-83), but shall not identify the conviction or convictions which constitute the basis for the disqualification.
a. the Department of Health receives documentation from the other state or territory that the applicant holds a current, valid certification as a nurse aide in the state or territory;
b. the applicant has not been convicted of any crimes and has no documented findings of abuse, neglect, or misappropriation of resident property in the other state or territory;
c. the applicant complies with the criminal history record background check requirements set forth under P.L.1997, c.100 (C.26:2H-83 et al.); and
d. (1) the applicant has completed within the preceding 24 months the amount of continuing education hours required by regulation for a nurse aide; or
(2) the applicant has the equivalent of at least two years of full time employment in the other state or territory as a nurse aide and the most recent date of such employment is within the 24-month period immediately preceding the date of the application. The Department of Health shall require an individual applying for a certification to be entered on the registry on the basis of work experience pursuant to this paragraph to complete the clinical skills competency examination and the written and oral competency examination, required by the Department pursuant to regulation, to verify the individual meets New Jersey's training and competency requirements.
"Medicaid" means the program established pursuant to P.L.1968, c.413 (C.30:4D-1 et seq.).
"Medicare" means the program established pursuant to Pub.L.89-97 (42 U.S.C. s.1395 et seq.).
"PACE" means the "Program of All-Inclusive Care for the Elderly," operated by a public, private, nonprofit, or proprietary entity, as permitted by federal law. The program is a comprehensive health and social services delivery system that integrates acute and long-term care services. PACE is a capitated program which provides services to disabled and frail elderly persons who are certified by the State as nursing home eligible to maximize their autonomy and continued independence.
The program shall not be subject to the requirements of P.L.1973, c.337 (C.26:2J-1 et seq.).
a. The cash reserves, at a minimum, shall equal the sum of:
(1) One month's total capitation revenue; and
(2) One month's average payment to subcontractors.
b. The program may demonstrate cash reserves to cover expenses of insolvency with one or more of the following: reasonable and sufficient net worth, insolvency insurance, letters of credit or parental guarantees.
b. The PACE program provider shall notify and provide to each enrollee in the
PACE program, three months prior to the date on which the enrollee will be 65 years of age, contact and eligibility information for the Medicare program and any other information the PACE program provider shall deem necessary to ensure that enrollees in the PACE program have sufficient information to allow them to apply for Medicare coverage.
c. As used in this section, the definitions of section 1 of P.L.1997, c.296 (C.26:2H-88) shall apply.
a. It is in the public interest of this State for its nursing home industry to continue to provide high-quality services to those frail and vulnerable citizens who critically need nursing home care;
b. Presently, New Jersey has the lowest Medicaid reimbursement rate in the region for nursing home services provided;
c. Additional reductions in federal funding, together with the current budget crisis facing the State, are likely to deepen the nursing home industry's funding shortfall;
d. This funding crisis leads directly to caregiver staffing problems, high staff turnover, reduced staffing levels, and, in turn, a diminution in the quality of nursing care services;
e. By establishing an appropriate assessment on nursing homes, in accordance with federal regulations set forth at 42 C.F.R. s.433.68(f), additional funding will be made available to improve the quality of care by increasing Medicaid reimbursement for services delivered to those senior citizens and other persons residing in New Jersey nursing homes;
f. It is, therefore, appropriate to establish a "Nursing Home Quality of Care Improvement Fund" by using investment contributions from nursing home providers to attract federal matching funds; and
g. This innovative approach would allow New Jersey to improve nursing home services by using available federal dollars in the best manner possible.
"Commissioner" means the Commissioner of Human Services.
"Department" means the Department of Human Services.
"Director" means the Director of the Division of Taxation in the Department of the Treasury.
"Fund" means the "Nursing Home Quality of Care Improvement Fund" established pursuant to this act.
"Medicaid" means the Medicaid program established pursuant to P.L.1968, c.413 (C.30:4D-1 et seq.).
"Nursing home" means a long-term care facility licensed pursuant to P.L.1971, c.136 (C.26:2H-1 et seq.), as well as the distinct part of another health care facility or continuing care retirement community that is licensed to provide skilled nursing care services pursuant to P.L.1971, c.136 (C.26:2H-1 et seq.). For the purposes of this act, nursing home shall not include: an acute care hospital; assisted living facility; comprehensive personal care home; residential health care facility; adult day health care facility; alternate family care program; adult family care program; home health care agency; State psychiatric hospital; county health care facility, including, but not limited to, county geriatric center, county nursing home or other county long-term care facility; the New Jersey Firemen's Home; or a health care facility operated by the Department of Military and Veterans' Affairs.
a. The fund shall be comprised of:
(1) revenues from assessments paid by nursing homes pursuant to section 5 of this act;
(2) matching federal funds received pursuant to Title XIX of the federal Social Security Act (42 U.S.C. s.1396 et seq.) that result from the expenditure of revenues from assessments collected pursuant to section 5 of this act;
(3) General Fund revenues, as necessary, to allow for the per diem add-on payments pursuant to subsection d. of section 6 of this act until the revenue from the assessment has been collected. Upon collection of the revenue from the assessment, the General Fund shall be repaid within 90 days; and
(4) any interest or other income earned on monies deposited into the fund.
b. Any disbursement of monies from the fund shall be used solely for Medicaid nursing home add-ons as provided for under section 6 of this act, which shall not in any manner render the assessment mechanism set forth in section 5 of this act to be in violation of the hold harmless provisions of 42 C.F.R. s.433.68(f).
c. The State Treasurer shall provide by regulation for such measures as are required to ensure the integrity of the fund.
d. The State Treasurer shall establish separate accounts within the fund as are needed to efficiently manage and disburse fund monies.
e. Monies in the fund shall not be used to supplant appropriations from the General Fund to the department for use in securing matching federal funds not otherwise provided for in this act.
f. The Director of the Division of Taxation shall be responsible for collecting the assessments.
(1) (Deleted by amendment, P.L.2004, c.41).
(2) Notwithstanding any law to the contrary, each nursing home shall pay to the director for deposit into the fund, in accordance with the requirements set forth in this act, an amount for nursing home patient days, excluding Medicare patient days, up to the maximum limit allowed by law less any licensing or other fees which would be considered "health care-related taxes" as defined by 42 C.F.R. s.433.55, including, but not limited to, any fees established by the commissioner as permitted under law.
b. The assessment paid under subsection a. of this section shall not include Medicare patient day revenues and receipts from Medicare certified beds.
c. The director, in consultation with the commissioner, shall prescribe by regulation the method by which nursing homes shall report information necessary for the director to calculate the assessment.
d. The assessment shall not be payable by nursing homes until both the provider assessment and the plan for distribution of the proceeds of the fund are approved by the federal government. Thereafter, the assessment shall be payable after the end of each calendar quarter during which the assessment accrues. Prior written notice of the due date of the assessment shall not be issued until the per diem add-ons pursuant to subsection d. of section 6 of this act have been paid.
e. A nursing home shall submit appropriate reports to the director to facilitate the purposes of this act, on a form and in a manner prescribed by the director and within such period of time as the director may require.
a. As soon after the collection of the monies from the assessment as is practicable, the State Treasurer shall authorize the transfer to the General Fund of $12.875 million for each quarter for which the assessment has been collected, not to exceed $51.5 million on an annual basis. All of the amounts so transferred to the General Fund shall be allocated for the support of nursing home programs as the commissioner shall designate, provided that of those amounts, a sufficient amount shall be used to fund nursing home rates at State fiscal year 2003 levels or higher and the continued applicability of nursing home rebasing and bed hold payment methodologies in effect during fiscal year 2003;
b. (Deleted by amendment, P.L.2004, c.41).
c. The State Treasurer, in consultation with the commissioner, shall distribute to nursing homes all remaining monies in the fund, in accordance with the provisions of this section, including any federal Medicaid funds received pursuant to this act, in order to enhance the quality of care for the residents of those facilities, which may include training, recruitment and improvement of wages and benefits for nursing home direct care employees;
d. The monies identified in subsection c. of this section shall be allocated in the following manner:
(1) sufficient monies from these funds shall be used to recognize the assessment as an allowable cost for Medicaid reimbursement purposes; and
(2) the remaining portion of these funds not allocated under paragraph (1) of this subsection shall be made as a uniform per diem add-on for all Medicaid days provided by nursing facilities.
The Medicaid payments to nursing homes provided for under this subsection shall not violate the hold harmless provisions set forth at 42 C.F.R. s.433.50 et seq.;
e. Beginning immediately and continuing for a period of 24 months following the enactment of this act, any monies received by facilities pursuant to this act that are expended in the furtherance of increasing recruitment and retention of employees and increasing the wages of caregivers shall not be subject to the nursing screen or direct patient care screens within the routine cost limits imposed by the nursing home rate setting regulations, in accordance with federal regulations and in such a manner so as to not violate the hold harmless provisions set forth at 42 C.F.R. s.433.50 et seq.
During this 24-month period it is recommended that nursing homes increase the nursing and direct care staffing ratio to above the State minimum requirement. Within 24 months of the enactment of this act, the commissioner shall develop, with the advice of industry representatives, consumer organizations and the caregivers' union, increased mandatory State ratios for direct patient care and nursing staffing, to significantly improve nursing and patient care staffing ratios, subject to the availability of funding;
f. The commissioner or his designee shall certify the amounts to be provided to each nursing home in accordance with the formulas established by the commissioner for Medicaid reimbursement.
a. apply for: a State plan amendment to secure federal financial participation for State Medicaid expenditures under the federal Medicaid program pursuant to 42 U.S.C. s.1396b(w)(3)(B); and a waiver of the uniformity requirements contained in 42 C.F.R. s.433.68(e)(2)(i); and
b. prescribe such procedures and forms, and take such other actions, as the commissioner determines necessary to carry out the provisions of this act, including, but not limited to, such actions as are necessary to ensure that the State receives its maximum share of federal financial participation for State Medicaid expenditures under the federal Medicaid program.
(1) the assessment provided for in section 5 of this act shall beome void, no further assessment shall be collected and all funds collected to date shall be returned to nursing homes in proportion to the amounts of assessments paid by them under the provisions of this act; and
(2) thereafter, no penalty, fine or fee shall be imposed upon, or other punitive measure taken against, a nursing home that fails to pay an assessment.
b. If federal law is altered to prohibit the use of provider assessments to generate a matching amount of federal Medicaid funds as provided for in this act, the provisions of this act shall become inoperative and void upon the effective date of that prohibition.
c. Notwithstanding any other provision of this act to the contrary, the assessments imposed by section 5 of this act shall not be imposed or collected and the authorized expenditures shall not be made until the State has obtained federal approval of any related State plan amendment and verified the availability of federal financial participation for the New Jersey Medicaid expenditure funded in whole or in part by revenues collected in accordance with section 5 of this act from the assessments.
b. A nursing home that realizes a net financial loss resulting from the payment of its assessment pursuant to section 5 of this act and the distribution of monies in the fund pursuant to section 6 of this act shall not pass through, as a charge or other cost to its residents or a third party payer, any amount that exceeds the amount of that net financial loss.
b. The rules and regulations adopted by the State Treasurer pursuant to subsection a. of this section shall be adopted in consultation with the commissioner and shall include, but not be limited to: establishment of a system for the efficient collection of the assessment paid by nursing homes pursuant to section 5 of this act; the auditing of nursing home financial information relevant to the collection of the assessment; the reporting of relevant information needed to effectuate the assessment and procedures to effectuate the purposes of section 9 of this act.
c. The commissioner shall adopt rules and regulations pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.) to effectuate the applicable provisions of this act; except that, notwithstanding any provision of P.L.1968, c.410 to the contrary, the commissioner may adopt, immediately upon filing with the Office of Administrative Law, such regulations as the commissioner deems necessary to implement the applicable provisions of this act, which shall be effective for a period not to exceed six months and may thereafter be amended, adopted or readopted by the commissioner in accordance with the requirements of P.L.1968, c.410.
a. This State recognizes, in its law and public policy, a patient's right to make voluntary, informed choices to accept, reject, or choose among alternative courses of medical and surgical treatment, and specifically for an adult who has mental capacity to plan ahead for health care decisions through the execution of an advance directive for health care, otherwise known as a living will or durable power of attorney for health care, and to have the wishes expressed therein respected, subject to certain limitations;
b. Advance directives for health care provide a vehicle for adults who have mental capacity to operationalize their fundamental legal right to accept or refuse medical treatment in the event that they are rendered unable to make decisions and communicate with a health care provider about their treatment options because of serious illness, injury, or permanent loss of mental capacity;
c. The issues affecting persons with mental illness and their psychiatric needs warrant enactment of a separate statute governing advance directives for these individuals, who: find their civil rights and due process protections frequently compromised; often lack the resources, societal supports, and self-esteem needed to make advance directives for health care work for them; and are disadvantaged by the fact that many physicians and attorneys are unaware of the specific issues that typically enter into the decisions that a person with mental illness may make for himself when in crisis;
d. The provision by statute of advanced directives for mental health care will assure respect for the rights of patients with mental illness with respect to the provision of mental health services and their decision-making in regard thereto; and
e. In order to permit a person with mental illness to execute an advance directive that specifies preferences for mental health services in the event that the declarant is subsequently determined to lack decision-making capacity, the Legislature hereby enacts the "New Jersey Advance Directives for Mental Health Care Act."
"Adult" means an individual who has reached majority pursuant to section 3 of P.L.1972, c.81 (C.9:17B-3).
"Advance directive for mental health care" or "advance directive" means a writing executed in accordance with the requirements of this act. An "advance directive" may include a proxy directive or an instruction directive, or both.
"Decision-making capacity" means a patient's ability to understand and appreciate the nature and consequences of mental health care decisions, including the benefits and risks of each, and alternatives to any proposed mental health care, and to reach an informed decision. A patient's decision-making capacity is evaluated relative to the demands of a particular mental health care decision.
"Declarant" means an adult who has the mental capacity to execute an advance directive for mental health care and does so.
"Domestic partner" means a domestic partner as defined in section 3 of P.L.2003, c.246 (C.26:8A-3).
"Instruction directive" means a writing which provides instructions and direction regarding the declarant's wishes for mental health care in the event that the declarant subsequently lacks decision-making capacity.
"Mental health care decision" means a decision to accept or refuse any treatment, service, or procedure used to diagnose, treat, or care for a patient's mental condition. "Mental health care decision" also means a decision to accept or refuse the services of a particular mental health care professional or psychiatric facility, including a decision to accept or to refuse a transfer of care.
"Mental health care professional" means an individual licensed or certified by this State to provide or administer mental health care in the ordinary course of business or practice of a profession.
"Mental health care representative" means the individual designated by a declarant pursuant to the proxy directive part of an advance directive for mental health care for the purpose of making mental health care decisions on the declarant's behalf, and includes an individual designated as an alternate mental health care representative who is acting as the declarant's mental health care representative in accordance with the terms and order of priority stated in an advance directive for mental health care.
"Patient" means an individual who is under the care of a mental health care professional.
"Proxy directive" means a writing which designates a mental health care representative in the event that the declarant subsequently lacks decision-making capacity.
"Psychiatric facility" means a State psychiatric facility listed in R.S.30:1-7, a county psychiatric hospital or the psychiatric unit of a county hospital, a short-term care facility, special psychiatric hospital or psychiatric unit of a general hospital or other health care facility licensed by the Department of Health pursuant to P.L.1971, c.136 (C.26:2H-1 et seq.), or a hospital or community-based mental health center or other entity licensed or funded by the Department of Human Services to provide community-based mental health services.
"Responsible mental health care professional" means a person licensed or certified by the State to provide or administer mental health care who is selected by, or assigned to, the patient and has primary responsibility for the care and treatment of the patient.
"State" means a state, territory, or possession of the United States, the District of Columbia, or the Commonwealth of Puerto Rico.
mental health care.
(1) The advance directive shall be signed and dated by, or at the direction of, the declarant in the presence of at least one subscribing adult witness, who shall attest that the declarant is of sound mind and free of duress and undue influence.
(2) The advance directive may be supplemented by a video or audio tape recording.
b. The following persons shall not act as a witness to the execution of an advance directive for mental health care:
(1) a designated mental health care representative; and
(2) the responsible mental health care professional responsible for, or directly involved with, the patient's care at the time that the advance directive is executed.
c. A person shall not act as a sole witness to the execution of an advance directive for mental health care if that person is:
(1) related to the declarant by blood, marriage or adoption, or is the declarant's domestic partner or otherwise shares the same home with the declarant;
(2) entitled to any part of the declarant's estate by will or by operation of law at the time that the advance directive is executed; or
(3) an operator, administrator or employee of a rooming or boarding house or a residential health care facility in which the declarant resides.
(2) If an advance directive includes an expiration date that occurs during a period of time in which the declarant has been determined by the responsible mental health care professional to lack the capacity to make a particular mental health care decision, the advance directive shall remain in effect until the declarant is determined by the responsible mental health care professional to have regained the capacity to make a particular mental health care decision.
b. A declarant may state in an advance directive for mental health care, including a proxy directive or an instruction directive, or both, whether the declarant wishes to be able to modify, revoke or suspend the advance directive after it has become operative pursuant to section 7 of P.L.2005, c.233 (C.26:2H-108); however, the failure to include such a statement in the advance directive shall not be construed to prevent the declarant from modifying, revoking or suspending the advance directive under the circumstances described in this subsection.
c. A declarant may reaffirm or modify an advance directive for mental health care, including a proxy directive or an instruction directive, or both, subject to the provisions of subsection b. of this section. The reaffirmation or modification shall be made in accordance with the requirements for execution of an advance directive for mental health care pursuant to section 4 of P.L.2005, c.233 (C.26:2H-105).
d. A declarant may revoke an advance directive for mental health care, including a proxy directive or an instruction directive, or both, subject to the provisions of subsection b. of this section, by the following means:
(1) notification, orally or in writing, to the mental health care representative or mental health care professional, or other reliable witness, or by any other act evidencing an intent to revoke the document; or
(2) execution of a subsequent proxy directive or instruction directive, or both, in accordance with section 4 of P.L.2005, c.233 (C.26:2H-105).
e. Designation of the declarant's spouse as mental health care representative shall be revoked upon divorce or legal separation, and designation of the declarant's domestic partner as mental health care representative shall be revoked upon termination of the declarant's domestic partnership or designation of the declarant's civil union partner as mental health care representative shall be revoked upon termination of the declarant's civil union, unless otherwise specified in the advance directive.
f. An inpatient in a psychiatric facility may modify, revoke, or suspend an advance directive for mental health care, including a proxy directive or an instruction directive, or both, by any of the means stated in paragraph (1) of subsection d. of this section, unless a responsible mental health professional determines, in accordance with the provisions of section 8 of P.L.2005, c.233 (C.26:2H-109), that the patient lacks decision-making capacity to make the decision to modify, revoke, or suspend the advance directive. A patient who has modified, revoked, or suspended an advance directive may reinstate that advance directive by oral or written notification to the mental health care representative or mental health care professional of an intent to reinstate the advance directive.
g. Reaffirmation, modification, or revocation of an advance directive for mental health care is effective upon communication to any person capable of transmitting the information, including the mental health care representative or mental health care professional responsible for the patient's care.
(1) An adult who has mental capacity, including, but not limited to, a declarant's spouse, domestic partner, civil union partner, adult child, parent, or other family member, friend, religious or spiritual advisor, or other person of the declarant's choosing, may be designated as a mental health care representative.
(2) An operator, administrator, or employee of a psychiatric facility in which the declarant is a patient or resident shall not serve as the declarant's mental health care representative unless the operator, administrator, or employee is related to the declarant by blood, marriage, domestic partnership, civil union, or adoption.
This restriction shall not apply to a mental health care professional if that individual does not serve as the patient's responsible mental health care professional or other provider of mental health care services to the patient and the patient's mental health care representative at the same time.
(3) A declarant may designate one or more alternate mental health care representatives, listed in order of priority. In the event that the primary designee is unavailable, unable, or unwilling to serve as mental health care representative, or is disqualified from such service pursuant to this section or any other law, the next designated alternate shall serve as mental health care representative. In the event that the primary designee subsequently becomes available and able to serve as mental health care representative, the primary designee may, insofar as then practicable, serve as mental health care representative.
(4) A declarant may direct the mental health care representative to consult with specified individuals, including alternate designees, family members, and friends, in the course of the decision-making process.
(5) A declarant shall state the limitations, if any, to be placed upon the authority of the mental health care representative.
(6) If a declarant explicitly authorizes the mental health care representative to consent to the declarant's admission to a psychiatric facility, the declarant shall separately initial each paragraph in which that authorization is granted at the time that the proxy directive is signed and witnessed.
b. A declarant may execute an instruction directive, pursuant to the requirements of section 4 of P.L.2005, c.233 (C.26:2H-105), which specifies preferences for mental health services in the event that the declarant is subsequently determined to lack decision-making capacity.
(1) The instruction directive may include: a statement of the declarant's general mental health care philosophy and objectives; the declarant's specific wishes regarding the provision, withholding, or withdrawal of any form of mental health care; or both.
(2) The declarant's specific wishes regarding the provision, withholding, or withdrawal of any form of mental health care may include:
(a) the identification of mental health care professionals and programs and psychiatric facilities that the declarant would prefer to provide mental health services;
(b) consent to admission to a psychiatric facility for up to a specified number of days;
(c) a refusal to accept specific types of mental health treatment, including medications;
(d) a statement of medications preferred by the declarant for mental health treatment;
(e) a statement of the preferred means of crisis intervention or other preferences for mental health treatment; and
(f) additional instructions or information concerning mental health care.
(3) An instruction directive may, but need not, be executed contemporaneously with, or be attached to, a proxy directive.
(1) when it is transmitted to the responsible mental health care professional or the psychiatric facility; and it is determined pursuant to section 8 of this act that the patient lacks capacity to make a particular mental health care decision; or
(2) at an earlier date if stipulated by the declarant in the advance directive.
b. Treatment decisions pursuant to an advance directive for mental health care shall not be made and implemented until there has been a reasonable opportunity to establish, and where appropriate confirm, a reliable diagnosis and prognosis for the patient.
b. The responsible mental health care professional's determination of a lack of decision-making capacity shall be confirmed by one or more mental health care professionals. The opinion of the confirming mental health care professional shall be stated in writing and made a part of the patient's medical records in the same manner as that of the responsible mental health care professional.
c. A mental health care professional designated by the patient's advance directive as a mental health care representative shall not make the determination of a lack of decision-making capacity.
d. The responsible mental health care professional shall inform the patient, if the patient has any ability to comprehend that he has been determined to lack decision-making capacity, and the mental health care representative that:
(1) the patient has been determined to lack decision-making capacity to make a particular mental health care decision;
(2) each has the right to contest this determination; and
(3) each may have recourse to the dispute resolution process established by the psychiatric facility pursuant to section 14 of P.L.2005, c.223 (C.26:2H-115). Notice to the patient and the mental health care representative shall be documented in the patient's medical records.
e. A determination of lack of decision-making capacity under this act shall be solely for the purpose of implementing an advance directive for mental health care in accordance with the provisions of this act, and shall not be construed as a determination of a patient's incapacity for any other purpose.
f. For the purposes of this section, a determination that a patient lacks decision-making capacity shall be based upon, but need not be limited to, an evaluation of the patient's ability to understand and appreciate the nature and consequences of a particular mental health care decision, including the benefits and risks of, and alternatives to, the proposed mental health care, and to reach an informed decision.
g. For the purposes of this section, "mental health care decision" includes a decision to modify, revoke, or suspend an advance directive for mental health care as provided in subsection f. of section 5 of P.L.2005, c.233 (C.26:2H-106).
(1) The mental health care representative shall act in good faith and within the bounds of the authority granted by the advance directive for mental health care and by this act.
(2) The mental health care representative may consent to the patient's admission to a psychiatric facility only as authorized pursuant to paragraph (6) of subsection a. of section 6 of this act.
b. If a different individual has been appointed as the patient's legal guardian, the mental health care representative shall retain legal authority to make mental health care decisions on the patient's behalf, unless the terms of the legal guardian's court appointment or other court decree provide otherwise.
c. The conferral of legal authority on the mental health care representative shall not be construed to impose liability upon that person for any portion of the patient's health care costs.
d. An individual designated as a mental health care representative or as an alternate mental health care representative may decline to serve in that capacity.
e. The mental health care representative shall exercise the patient's right to be informed of the patient's mental health condition, prognosis and treatment options, and to give informed consent to, or refusal of, health care.
f. In the exercise of these rights and responsibilities, the mental health care representative shall seek to make the mental health care decision that the patient would have made if the patient possessed decision-making capacity under the circumstances, or, when the patient's wishes cannot adequately be determined, shall make a mental health care decision in the best interests of the patient.
g. Departure from the decisions of a mental health care representative shall be permitted only if the responsible mental health care professional determines that compliance with those decisions would:
(1) violate the accepted standard of mental health care or treatment under the circumstances of the patient's mental health condition;
(2) require the use of a form of care or treatment that is not available to the mental health care professional responsible for the provision of mental health services to the patient;
(3) violate a court order or provision of statutory law; or
(4) endanger the life or health of the patient or another person.
a. The responsible mental health care professional shall make an affirmative inquiry of the patient, the patient's family or others, as appropriate under the circumstances, concerning the existence of an advance directive for mental health care. The responsible mental health care professional shall note in the patient's medical records whether or not an advance directive exists, and the name of the patient's mental health care representative, if any, and shall attach a copy of the advance directive to the patient's medical records. The responsible mental health care professional shall document in the same manner the reaffirmation, modification, revocation or suspension of an advance directive, if he has knowledge of such action.
b. In the event of a transfer of a patient's care:
(1) The responsible mental health care professional shall assure the timely transfer of the patient's medical records, including a copy of the patient's advance directive for mental health care; and
(2) A mental health care professional other than the responsible mental health care professional, who is responsible for the patient's care, shall cooperate in effecting an appropriate, respectful and timely transfer of care, and to assure that the patient is not abandoned or treated disrespectfully.
(2) The decision-making process shall allow, as appropriate under the circumstances, adequate time for the mental health care representative to understand and deliberate about all relevant information before a treatment decision is implemented.
b. (1) The mental health care representative and the responsible mental health care professional shall seek to promote the patient's capacity for effective participation.
(2) Once decision-making authority has been conferred upon a mental health care representative pursuant to an advance directive for mental health care, if the patient is subsequently found to possess adequate decision-making capacity with respect to a particular mental health care decision, the patient shall have legal authority to make that decision. In those circumstances, the mental health care representative may continue to participate in the decision-making process in an advisory capacity, unless the patient objects.
c. If a mental health care representative is authorized to consent to the patient's admission to a psychiatric facility pursuant to paragraph (6) of subsection a. of section 6 of this act and the responsible mental health care professional has obtained informed consent for admission from the mental health care representative, the responsible mental health professional may admit the patient based upon the responsible mental health professional's:
(1) thorough investigation of the patient's psychiatric and psychological history, diagnosis and need for care or treatment, and expressed wishes;
(2) written determination that the patient is in need of an inpatient evaluation or would benefit from the care or treatment of a mental, emotional or other personality disorder in an inpatient setting, and that the evaluation, care or treatment cannot be accomplished in a less restrictive setting; and
(3) documentation in the patient's medical records of the responsible mental health professional's findings and recommendations with regard to the patient's care or treatment.
d. In acting to implement a patient's wishes pursuant to an advance directive for mental health care, the mental health care representative shall give priority to the patient's instruction directive, and may also consider, as appropriate and necessary, the following forms of evidence of the patient's wishes:
(1) the patient's contemporaneous expressions, including nonverbal expressions;
(2) other reliable sources of information, including the mental health care representative's personal knowledge of the patient's values, preferences and goals; and
(3) reliable oral or written statements previously made by the patient, including, but not limited to, statements made to other persons.
e. If the instruction directive, in conjunction with other evidence of the patient's wishes, does not provide, in the exercise of reasonable judgment, clear direction as applied to the patient's mental health condition and the treatment alternatives, the mental health care representative shall exercise reasonable discretion, in good faith, to effectuate the provisions, intent, and spirit of the instruction directive and other evidence of the patient's wishes.
f. Subject to the provisions of this act, and unless otherwise stated in the advance directive, if the patient's wishes cannot be adequately determined, then the mental health care representative shall make a mental health care decision in the patient's best interests.
b. If the instruction directive is, in the exercise of reasonable judgment, not specific to the patient's mental health condition and the treatment alternatives, the responsible mental health care professional, in consultation with a legally appointed guardian, if any, family member, or other person acting on the patient's behalf, shall exercise reasonable judgment to effectuate the wishes of the patient, giving full weight to the terms, intent and spirit of the instruction directive.
c. Departure from the specific provisions of the instruction directive shall be permitted only if the responsible mental health care professional determines that compliance with those terms or provisions would:
(1) violate the accepted standard of mental health care or treatment under the circumstances of the patient's mental health condition;
(2) require the use of a form of care or treatment that is not available to the mental health care professional responsible for the provision of mental health services to the patient;
(3) violate a court order or provision of statutory law; or
(4) endanger the life or health of the patient or another person.
a. A psychiatric facility shall adopt such policies and practices as are necessary to provide for routine inquiry, at the time of admission, and at such other times as are appropriate under the circumstances, concerning the existence and location of an advance directive for mental health care.
b. A psychiatric facility shall adopt such policies and practices as are necessary to provide appropriate informational materials concerning advance directives for mental health care to all interested patients and their families and mental health care representatives, and to assist patients interested in discussing and executing an advance directive for mental health care.
c. In situations in which a transfer of care is necessary, including a transfer for the purpose of effectuating a patient's wishes pursuant to an advance directive for mental health care, a psychiatric facility shall, in consultation with the responsible mental health care professional, take all reasonable steps to effect the appropriate, respectful and timely transfer of the patient to the care of an alternative mental health care professional or psychiatric facility, as necessary, and shall assure that the patient is not abandoned or treated disrespectfully. In those circumstances, a psychiatric facility shall assure the timely transfer of the patient's medical records, including a copy of the patient's advance directive for mental health care.
d. A psychiatric facility shall establish procedures and practices for dispute resolution in accordance with section 14 of this act.
e. A psychiatric facility shall adopt such policies and practices as are necessary to: inform mental health care professionals of their rights and responsibilities under this act; assure that those rights and responsibilities are understood; and provide a forum for discussion and consultation regarding the requirements of this act.
b. A mental health care professional involved in the patient's care, other than the responsible mental health care professional, or an administrator of a psychiatric facility may also invoke the dispute resolution process established by the psychiatric facility to seek to resolve a disagreement concerning the patient's decision-making capacity or the appropriate interpretation and application of the provisions of an advance directive for mental health care.
a. provide for the annual reporting by those psychiatric facilities to the Department of Health, and the gathering of such additional data, as is reasonably necessary to oversee and evaluate the implementation of this act; except that the commissioner shall seek to minimize the burdens of record-keeping imposed by the rules and regulations and ensure the appropriate confidentiality of patient records; and
b. require those psychiatric facilities to adopt policies and practices designed to:
(1) make routine inquiry, at the time of admission and at such other times as are appropriate under the circumstances, concerning the existence and location of an advance directive for mental health care;
(2) provide appropriate informational materials concerning advance directives for mental health care, including information about the registry of advance directives for mental health care established or designated pursuant to section 17 of this act, to all interested patients and their families and mental health care representatives, and to assist patients interested in discussing and executing an advance directive for mental health care, as well as to encourage declarants to periodically review their advance directives for mental health care as needed;
(3) inform mental health care professionals of their rights and responsibilities under this act, to assure that the rights and responsibilities are understood, and to provide a forum for discussion and consultation regarding the requirements of this act; and
(4) otherwise comply with the provisions of this act.
b. A mental health care professional shall not be subject to criminal or civil liability, or to discipline by the psychiatric facility or the respective State licensing board for professional misconduct, for any actions performed to carry out the terms of an advance directive for mental health care in good faith and in accordance with: the provisions of this act; any rules and regulations adopted by the Commissioner of Health or the Commissioner of Human Services pursuant to this act; and accepted professional standards.
c. A psychiatric facility shall not be subject to criminal or civil liability for any actions performed in good faith and in accordance with the provisions of this act to carry out the terms of an advance directive for mental health care.
(2) Durable powers of attorney for health care executed pursuant to P.L.2000, c.109 prior to the effective date of this act shall have the same legal force and effect as if they had been executed in accordance with the provisions of this act.
b. Nothing in this act shall be construed to impair the rights of emancipated minors under existing law.
b. A psychiatric facility that intentionally fails to act in accordance with the requirements of this act shall be subject to a fine of not more than $1,000 for each offense. For the purposes of this subsection, each violation shall constitute a separate offense. Penalties for violations of this act shall be recovered in a summary civil proceeding, brought in the name of the State in a court of competent jurisdiction pursuant to the "Penalty Enforcement Law of 1999," P.L.1999, c.274 (C.2A:58-10 et seq.).
c. It shall be a crime of the fourth degree for a person to:
(1) willfully conceal, cancel, deface, obliterate or withhold personal knowledge of an advance directive for mental health care, or a modification, revocation or suspension thereof, without the declarant's consent;
(2) falsify or forge an advance directive for mental health care of another person, or a modification, revocation or suspension thereof;
(3) coerce or fraudulently induce the execution of an advance directive for mental health care, or a modification, revocation or suspension, thereof; or
(4) require or prohibit the execution of an advance directive for mental health care, or a modification, revocation or suspension thereof, as a condition of coverage under any policy of health insurance, life insurance or annuity, or governmental benefits program, or as a condition of the provision of health care.
d. The sanctions provided in this section shall not be construed to repeal any sanctions applicable under other law.
b. The Commissioner of Health may waive the 60-day notice requirement in subsection a. of this section if the commissioner determines that an emergency situation warrants a more immediate closure or relocation of the nursing home or assisted living residence. In the case of such an emergency situation, the administrator of the facility shall notify, in writing, a resident, the resident's legal representative, if applicable, and the Department of Health of the closure or relocation as soon as practicable.
As used in this section, an "emergency situation" may include: the suspension or revocation of the facility license by the commissioner; decertification of the facility by the federal Medicare program established pursuant to Title XVIII of the "Social Security Act," Pub.L.89-97 (42 U.S.C. s.1395 et seq.), or the Medicaid program established pursuant to P.L.1968, c.413 (C.30:4D-1 et seq.); or any other event as prescribed by regulation of the commissioner.
b. The facility may deduct an amount not to exceed one percent per annum of the amount of the invested or deposited security deposit for the cost of servicing and processing an account containing a security deposit.
b. Every resident of an assisted living facility or comprehensive personal care home that is licensed in the State shall have the right to:
(1) receive personalized services and care in accordance with the resident's individualized general service or health service plan;
(2) receive a level of care and services that address the resident's changing physical and psychosocial status;
(3) have the resident's independence and individuality;
(4) be treated with respect, courtesy, consideration, and dignity;
(5) make choices with respect to services and lifestyle;
(6) privacy;
(7) have or not to have families' and friends' participation in resident service planning and implementation;
(8) receive pain management as needed, in accordance with Department of Health regulations;
(9) choose a physician, advanced practice nurse, or physician assistant;
(10) appeal an involuntary discharge as specified in department regulations;
(11) receive written documentation that fee increases based on a higher level of care are based on reassessment of the resident and in accordance with department regulations;
(12) receive a written explanation of fee increases that are not related to increased services, upon request by the resident;
(13) participate, to the fullest extent that the resident is able, in planning the resident's own medical treatment and care;
(14) refuse medication and treatment after the resident has been informed, in language that the resident understands, of the possible consequences of this decision;
(15) refuse to participate in experimental research, including the investigations of new drugs and medical devices, and to be included in experimental research only when the resident gives informed, written consent to such participation;
(16) be free from physical and mental abuse and neglect;
(17) be free from chemical and physical restraints, unless a physician, advanced practice nurse, or physician assistant authorizes the use for a limited period of time to protect the resident or others from injury. Under no circumstances shall a resident be confined in a locked room, or restrained, including with the use of excessive drugs, for punishment or for the convenience of staff;
(18) manage the resident's own finances, and to delegate that responsibility to a family member, assigned guardian, facility administrator, or some other individual with power of attorney. The resident's authorization delegating such authority shall be witnessed and in writing;
(19) receive prior to or at the time of admission, and afterwards through addenda, an admission agreement that complies with all applicable State and federal laws, describes the services provided and the related charges, and includes the policies for payment of fees, deposits, and refunds;
(20) receive a quarterly written account of the resident's funds, the itemized property deposited with the facility for the resident's use and safekeeping, and all financial transactions with the resident, next-of-kin, or guardian, which account shall show the amount of property in the account at the beginning and end of the accounting period, as well as a list of all deposits and withdrawals, substantiated by receipts given to the resident or the resident's guardian;
(21) have daily access during specified hours to the money and property that the resident has deposited with the facility, and to delegate, in writing, this right of access to a representative;
(22) live in safe and clean conditions that do not admit more residents than can safely be accommodated;
(23) not be arbitrarily and capriciously moved to a different bed or room;
(24) wear the resident's own clothes;
(25) keep and use the resident's personal property, unless doing so would be unsafe, impractical, or an infringement on the rights of other residents;
(26) reasonable opportunities for private and intimate physical and social interaction with other people, including the opportunity to share a room with another individual unless it is medically inadvisable;
(27) confidential treatment with regard to information about the resident, subject to the requirements of law;
(28) receive and send mail in unopened envelopes, unless the resident requests otherwise, and the right to request and receive assistance in reading and writing correspondence unless medically contraindicated;
(29) have a private telephone in the resident's living quarters at the resident's own expense;
(30) meet with any visitors of the resident's choice, at any time, in accordance with facility policies and procedures;
(31) take part in activities, and to meet with and participate in the activities of any social, religious, and community groups, as long as these activities do not disrupt the lives of other residents;
(32) refuse to perform services for the facility;
(33) request visits at any time by representatives of the religion of the resident's choice and, upon the resident's request, to attend outside religious services at the resident's own expense;
(34) participate in meals, recreation, and social activities without being subjected to discrimination based on age, race, religion, sex, marital status, nationality, or disability;
(35) organize and participate in a resident council that presents residents' concerns to the administrator of the facility;
(36) be transferred or discharged only in accordance with the terms of the admission agreement and with N.J.A.C. 8:36-5.1(d);
(37) receive written notice at least 30 days in advance when the facility requests the resident's transfer or discharge, except in an emergency, which notice shall include the name and contact information for the New Jersey Office of the Ombudsman for the Institutionalized Elderly;
(38) receive a written statement of resident rights and any regulations established by the facility involving resident rights and responsibilities;
(39) retain and exercise all constitutional, civil, and legal rights to which the resident is entitled by law;
(40) voice complaints without fear of interference, discharge, reprisal, and obtain contact information respecting government agencies to which residents can complain and ask questions, which information also shall be posted in a conspicuous place in the facility;
(41) hire a private caregiver or companion at the resident's expense and responsibility, as long as the caregiver or companion complies with the facility's policies and procedures; and
(42) obtain medications from a pharmacy of the resident's choosing, as long as the pharmacy complies with the facility's medication administration system, if applicable.
a. Pursuant to the "New Jersey Advance Directives for Health Care Act," P.L.1991, c.201 (C.26:2H-53 et seq.), this State has statutorily recognized the right of an adult with decision-making capacity to plan ahead for health care decisions through the execution of advance directives and designate a surrogate decision-maker, and to have the wishes expressed in those documents respected, subject to certain limitations, in order to ensure that the right to control decisions about one's own health care is not lost if a patient loses decision-making capacity and is no longer able to participate actively in making his own health care decisions;
b. The Physician Orders for Life-Sustaining Treatment or Practitioner Orders for Life-Sustaining Treatment, or POLST, form complements an advance directive by converting a person's wishes regarding life-sustaining treatment, such as those set forth in an advance directive, into a medical order;
c. The POLST form: contains immediately actionable, signed medical orders on a standardized form; includes medical orders that address a range of life-sustaining interventions as well as the patient's preferred intensity of treatment for each intervention; is typically a brightly colored, clearly identifiable form; and is recognized and honored across various health care settings;
d. The use of a POLST form is particularly appropriate for persons who have a compromised medical condition or a terminal illness, and the experience in other states has shown that the use of the POLST form helps these patients to have their health care preferences honored by health care providers;
e. The use of POLST forms can overcome many of the problems associated with advance directives, which in many cases are designed simply to name an individual to make health care decisions for the patient if the latter becomes incapacitated or otherwise lack specificity in regard to the patient's health care preferences, and are often locked away in file drawers or safe deposit boxes and unavailable to health care providers when the need arises to ensure that the patient's wishes are followed;
f. A completed POLST form is signed by, and more readily available than an advance directive to, the patient's attending physician, physician assistant, or advanced practice nurse, and provides a specific and detailed set of instructions for a health care professional or health care institution to follow in regard to the patient's preference for the use of various medical interventions;
g. To date, at least the following states, or communities within these states, have established programs providing for the use of the POLST form that have been endorsed by the National POLST Paradigm Task Force or are in the process of developing such programs: Alaska, California, Colorado, Florida, Georgia, Hawaii, Idaho, Indiana, Iowa, Kansas, Louisiana, Maine, Massachusetts, Michigan, Minnesota, Missouri, Montana, Nebraska, Nevada, New Hampshire, New York, North Carolina, North Dakota, Ohio, Oregon, Pennsylvania, Tennessee, Texas, Utah, Washington, West Virginia, Wisconsin, and Wyoming; and
h. The right and preference of New Jerseyans to have their health care preferences respected would be better served by the use of the POLST form in this State to augment the use of advance directives, and the enactment of this act will conduce to that end.
"Advance directive" means an advance directive for health care as defined in section 3 of P.L.1991, c.201 (C.26:2H-55).
"Advanced practice nurse" or "APN" means a person who is certified as an advanced practice nurse pursuant to P.L.1991, c.377 (C.45:11-45 et seq.).
"Commissioner" means the Commissioner of Health.
"Decision-making capacity" means a patient's ability to understand and appreciate the nature and consequences of a particular health care decision, including the benefits and risks of that decision, and alternatives to any proposed health care, and to reach an informed decision.
"Department" means the Department of Health.
"Emergency care" means the use of resuscitative measures and other immediate treatment provided in response to a sudden, acute, and unanticipated medical crisis in order to avoid injury, impairment, or death.
"Emergency care provider" means an emergency medical technician, paramedic, or member of a first aid, ambulance, or rescue squad.
"Health care decision" means a decision to accept, withdraw, or refuse a treatment, service, or procedure used to diagnose, treat, or care for a person's physical or mental condition, including life-sustaining treatment.
"Health care institution" means a health care facility licensed pursuant to P.L.1971, c.136 (C.26:2H-1 et seq.), a psychiatric facility as defined in section 2 of P.L.1987, c.116 (C.30:4-27.2), or a State developmental center listed in R.S.30:1-7.
"Health care professional" means a health care professional who is licensed or otherwise authorized to practice a health care profession pursuant to Title 45 or 52 of the Revised Statutes and is currently engaged in that practice.
"Life-sustaining treatment" means the use of any medical device or procedure, artificially provided fluids and nutrition, drugs, surgery, or therapy that uses mechanical or other artificial means to sustain, restore, or supplant a vital bodily function, and thereby increase the expected life span of a patient.
"Patient" means a person who is under the care of a physician, physician assistant, or APN.
"Patient's representative" means an individual who is designated by a patient or otherwise authorized under law to make health care decisions on the patient's behalf if the patient lacks decision-making capacity.
"Physician" means a person who is licensed to practice medicine and surgery pursuant to chapter 9 of Title 45 of the Revised Statutes.
"Physician Assistant" means a health professional who meets the qualifications under P.L.1991, c.378 (C.45:9-27.10 et seq.) and holds a current, valid license issued pursuant to section 4 of P.L.1991, c.378 (C.45:9-27.13).
" Practitioner Orders for Life-Sustaining Treatment form" or "POLST form" means a standardized printed document that is uniquely identifiable and has a uniform color, which:
a. is recommended for use on a voluntary basis by patients who have advanced chronic progressive illness or a life expectancy of less than five years, or who otherwise wish to further define their preferences for health care;
b. does not qualify as an advance directive;
c. is not valid unless it meets the requirements for a completed POLST form as set forth in this act;
d. provides a means by which to indicate whether the patient has made an anatomical gift pursuant to P.L.2008, c.50 (C.26:6-77 et al.);
e. is intended to provide direction to emergency care personnel regarding the use of emergency care, and to a health care professional regarding the use of life-sustaining treatment, with respect to the patient, by indicating the patient's preference concerning the use of specified interventions and the intensity of treatment for each intervention;
f. is intended to accompany the patient, and to be honored by all personnel attending the patient, across the full range of possible health care settings, including the patient's home, a health care institution, or otherwise at the scene of a medical emergency; and
g. may be modified or revoked at any time by a patient with decision-making capacity or the patient's representative in accordance with the provisions of section 7 of this act.
"Resuscitative measures" means cardiopulmonary resuscitation provided in the event that a patient suffers a cardiac or respiratory arrest.
b. The commissioner, in establishing the public awareness campaign, shall develop outreach efforts and provide information and educational materials to the general public on various end-of-life care topics including, but not limited to:
(1) how to effectively conduct advance care planning conversations with family members, friends, caregivers, healthcare providers, and other individuals involved in a patient's care, regarding personal goals, preferences, and the type of care desired during the final stages of the patient's life ;
(2) how community leaders and members can appropriately, and in an ethnically, culturally, and linguistically sensitive way, facilitate community-wide discussions regarding advance care planning and end-of-life care;
(3) definitions, procedures, and other information related to advance directives, established pursuant to P.L.1991, c.201 (C.26:2H-53 et seq.);
(4) the differences between the two types of advance directives, namely proxy directives and instructive directives;
(5) the importance of having an advance directive, or advance directives, and the differences between advance directives and Physician Orders for Life-Sustaining Treatment (POLST) forms;
(6) definitions, procedures, and other information related to POLST forms, established pursuant to P.L.2011, c.145 (C.26:2H-129 et seq.);
(7) standardized and approved definitions of, and differences between, palliative care, hospice care, comfort care, and other end-of-life-care terms; and
(8) any other topics or matters related to advance care planning and end-of-life care as the commissioner may deem necessary.
c. Information provided under the public awareness campaign shall be disseminated using ethnically, culturally, and linguistically appropriate means, in a manner that demonstrates respect for individual dignity and sensitivity for ethnic, cultural, and linguistic differences. Where feasible and appropriate, the information shall be made available in a variety of languages.
d. As necessary, the commissioner shall partner with, and expand upon, community-based initiatives and training programs that educate the general public on advance care planning and end-of-life care.
(1) require all administrative personnel and professional staff to complete an annual training on advance care planning, end-of-life care, and the use of advance directives and Physician Orders for Life-Sustaining Treatment (POLST) forms;
(2) provide patients and residents, and their families, as appropriate, with educational materials on POLST forms, advance directives, and hospice and palliative care; and
(3) develop and implement policies to identify and address end-of-life care issues for patients and residents upon admission to the facility.
b. The Department of Health shall:
(1) issue a training manual via regulation to establish uniform policies and procedures that a facility, at a minimum, shall follow in order to comply with the requirements outlined in subsection a. of this section. A facility may implement policies and procedures beyond those issued in the department's manual, provided that such policies and procedures do not conflict with the department's regulations; and
(2) require a facility that fails to comply with the provisions of this section to submit a plan of corrective action to the department for approval, and may impose additional penalties or administrative disciplinary action as shall be prescribed by the Commissioner of Health by regulation.
a. prescribe a POLST form and the procedures for completion, modification, and revocation of the form;
b. seek to promote awareness among health care professionals, emergency care providers, and the general public in this State about the option to complete a POLST form;
c. provide ongoing training of health care professionals and emergency care providers about the use of the POLST form, in consultation with organizations representing, and educational programs serving, health care professionals and emergency care providers, respectively, in this State;
d. prescribe additional requirements for the completion of a POLST form that may be applicable in the case of a patient with mental illness or a developmental disability in consultation with organizations that represent persons with mental illness and developmental disabilities, respectively;
e. provide for ongoing evaluation of the design and use of POLST forms through the use of such data as the PSO determines reasonably necessary for that purpose, subject to the commissioner's written approval; and
f. seek to minimize any record-keeping burden imposed on a health care institution pursuant to this act and take such actions as are necessary to ensure the confidentiality of any data furnished to the PSO that may contain patient-specific information.
b. A POLST form shall be deemed to be completed, and therefore valid for the purposes of this act if it:
(1) contains information indicating a patient's health care preferences;
(2) has been voluntarily signed by a patient with decision-making capacity, or by the patient's representative in accordance with the patient's known preferences or in the best interests of the patient;
(3) includes the signature of the patient's attending physician, physician assistant, or APN and the date of that signature; and
(4) meets any other requirements to be deemed valid for the purposes of this act.
c. A document executed in another state, which meets the requirements of this act for a POLST form, shall be deemed to be completed and valid for the purposes of this act to the same extent as a POLST form completed in this State.
b. A patient with decision-making capacity, may, at any time, modify or revoke the patient's completed POLST form or otherwise request alternative treatment to the treatment that was ordered on the form.
c. If the orders in a patient's completed POLST form regarding the use of any intervention specified therein conflict with the patient's more recent verbal or written directive to the patient's attending physician, physician assistant, or APN, then the physician, physician assistant, or APN shall honor the more recent directive from the patient in accordance with the provisions of subsection e. of this section.
d. The POLST form shall provide the patient with the choice to authorize the patient's representative to revoke or modify the patient's completed POLST form if the patient loses decision-making capacity. If the patient so authorizes the patient's representative, the patient's representative may, at any time after the patient loses decision-making capacity and after consultation with the patient's attending physician or APN, request the physician, physician assistant, or APN to modify or revoke the completed POLST form, or otherwise request alternative treatment to the treatment that was ordered on the form, as the patient's representative deems necessary to reflect the patient's health status or goals of care. If the patient does not authorize the patient's representative to revoke or modify the patient's completed POLST form, the patient's representative may not revoke or modify the patient's completed POLST form.
e. A verbal or written request by a patient or the patient's representative to modify or revoke a patient's completed POLST form, in accordance with the provisions of this section, shall be effectuated once the patient's attending physician, physician assistant, or APN has signed the POLST form attesting to that request for modification or revocation.
(1) may seek to resolve the disagreement by means of procedures and practices established by the health care institution, including, but not limited to, consultation with an institutional ethics committee, or with a person designated by the health care institution for this purpose; or
(2) may seek resolution by a court of competent jurisdiction.
b. A health care professional involved in the patient's care, other than the attending physician, physician assistant, or APN, or an administrator of a health care institution may also seek to resolve a disagreement concerning the patient's decision-making capacity or the appropriate interpretation and application of the terms of a completed POLST form to the patient's course of treatment in the same manner as set forth in subsection a. of this section.
a. abridge a patient's right to refuse treatment under either the United States Constitution or the Constitution of the State of New Jersey;
b. impair the obligations of a health care professional to provide for the care and comfort of the patient and to alleviate pain, in accordance with accepted medical and nursing standards;
c. impair the legal validity of a written order not to attempt cardiopulmonary resuscitation on a patient in the event that the patient suffers a cardiac or respiratory arrest, which is not part of a completed POLST form, if the order was signed by a physician prior to or after the effective date of this act and would be deemed valid under State law or regulation in effect prior to the date of enactment of this act;
d. require a health care professional, health care institution, or emergency care provider to participate in the beginning, continuing, withholding, or withdrawing of health care in a manner contrary to law or accepted medical standards;
e. require a private, religiously-affiliated health care institution to participate in the withholding or withdrawing of specified measures utilized to sustain life in a manner contrary to any of its written institutional policies and practices, except that the health care institution shall, with respect to a patient with a completed POLST form:
(1) properly communicate its institutional policies and practices to the patient, or to the patient's representative as applicable, prior to or upon the patient's admission, or as soon after admission as is practicable; and
(2) if its institutional policies and practices appear to conflict with the patient's legal rights, attempt to resolve the conflict and, if a mutually satisfactory accommodation cannot be reached, take all reasonable steps to effect the appropriate, timely, and respectful transfer of the patient to the care of another health care institution appropriate to the patient's needs, and assure that the patient is not abandoned or treated disrespectfully; or
f. revoke, restrict, or otherwise alter a patient's documented designation as a donor pursuant to P.L.2008, c.50 (C.26:6-77 et al.).
b. A health care professional shall not be subject to criminal or civil liability or to discipline by a health care institution or the applicable State licensing board for professional misconduct for any action taken by the health care professional to carry out the terms of a completed POLST form that is performed in good faith and in accordance with the provisions of this act.
c. A health care institution shall not be subject to criminal or civil liability for any action taken by the institution to carry out the terms of a completed POLST form that is performed in good faith and in accordance with the provisions of this act.
d. An emergency care provider shall not be subject to criminal or civil liability or to discipline by a health care institution or any other entity for professional misconduct for any action taken by the provider to carry out the terms of a completed POLST form that is performed in good faith and in accordance with the provisions of this act.
e. The withholding or withdrawing of life-sustaining treatment pursuant to a completed POLST form, when performed in good faith and in accordance with the terms of that form and the provisions of this act, shall not constitute homicide, suicide, assisted suicide, or active euthanasia.
b. A health care institution that intentionally fails to act in accordance with the requirements of this act shall be liable to a civil penalty of not more than $1,000 for each offense. For the purposes of this subsection, each violation shall constitute a separate offense. The civil penalty shall be collected in a summary proceeding, brought in the name of the State in a court of competent jurisdiction pursuant to the "Penalty Enforcement Law of 1999," P.L.1999, c.274 (C.2A:58-10 et seq.).
c. An emergency care provider subject to regulation by the Department of Health who intentionally fails to act in accordance with the requirements of this act is subject to such disciplinary measures as the commissioner deems necessary and within his statutory authority to impose.
d. A person who commits any of the following acts is guilty of a crime of the fourth degree:
(1) willfully concealing, canceling, defacing, obliterating, or withholding personal knowledge of a completed POLST form or a modification or revocation thereof, without the patient's consent;
(2) falsifying or forging a completed POLST form or a modification or revocation thereof of another person;
(3) coercing or fraudulently inducing the completion of a POLST form or a modification or revocation thereof; or
(4) requiring or prohibiting the completion of a POLST form or a modification or revocation thereof as a condition of coverage under any policy of health or life insurance or an annuity, or a public benefits program, or as a condition of the provision of health care.
e. The commission of an act identified in paragraph (1), (2), or (3) of subsection d. of this section, which results in the involuntary earlier death of a patient, shall constitute a crime of the first degree.
f. The provisions of this section shall not be construed to repeal any sanctions applicable under any other law.
a. A great deal of information is needed by schools and communities throughout New Jersey in order to improve the survival of children who experience sudden cardiac events;
b. The collection of relevant data and the documentation of sudden cardiac event outcomes are essential for policymakers and health care professionals to determine the most effective allocation of personnel, training, equipment, and resources to save the greatest number of lives; and
c. It is in the public interest to implement such measures as are necessary to provide for the collection of children's sudden cardiac event data and to establish a Statewide database that will inform the efforts of schools, families, policymakers, and health care professionals to improve children's sudden cardiac event prevention and survival.
"Child" means a child who is under 19 years of age.
"Commissioner" means the Commissioner of Health.
"Department" means the Department of Health.
"Health care professional" means a physician or registered professional nurse licensed to practice in this State.
"Registry" means the Children's Sudden Cardiac Events Registry established pursuant to this act.
"Sudden cardiac event" means a death or aborted death due to a cardiac arrhythmia resulting in loss of consciousness requiring cardiopulmonary resuscitation, defibrillation, or other advanced life support measures to regain normal heart function.
b. The report shall be in writing and shall include the name and address of the health care professional submitting the report, the name, age, and address of the child, and other pertinent information as may be required by the commissioner; except that, if the child's parent or guardian objects to the reporting of the child's condition for any reason, the report shall not include any information that could be used to identify the child.
c. The commissioner shall specify procedures for the health care professional to inform the child's parent or guardian of the requirements of subsections a. and b. of this section and the purpose served by including this information in the registry, as well as the parent's or guardian's right to refuse to permit the reporting of any information that could be used to identify the child.
b. The reports made pursuant to this act shall be used only by the department and other agencies as may be designated by the commissioner, and shall not otherwise be divulged or made public so as to disclose the identity of any person to whom they relate. To that end, the reports shall not be included under materials available to public inspections pursuant to P.L.1963, c.73 (C.47:1A-1 et seq.) or P.L.2001, c.404 (C.47:1A-5 et al.).
c. A health care professional providing information to the department pursuant to this act shall not be deemed to be, or held liable for, divulging confidential information.
d. Nothing in this act shall be construed to compel a child to submit to medical or health examination or supervision by the department.
(1) The purpose of the board shall be to review and evaluate the information reported to the department pursuant to this act, and to study any other data, which the board shall seek and as may be made available to it to supplement the reported information, with respect to children diagnosed with cardiac conditions or reported to have had a sudden cardiac event in this State.
(2) The board shall make note of such factors as the age, gender, and ethnicity of each child, and the location of each sudden cardiac event, in its review of any information received by the board.
(3) The board may share its findings with other recognized entities that collect nationwide data on sudden cardiac events, except that the board shall not disclose to any person or entity outside the department any information that could be used to identify a child.
b. The board shall consist of 11 members as follows:
(1) the commissioner and the Commissioners of Children and Families and Education, or their designees, who shall serve ex officio; and
(2) eight public members to be appointed by the commissioner as follows: one person who represents the American Heart Association; one person who represents the American Academy of Pediatrics, New Jersey Chapter; one person who represents the American College of Cardiology; one person who represents the New Jersey State School Nurses Association; one person who represents the New Jersey State Interscholastic Athletic Association; one person who represents the Hypertrophic Cardiomyopathy Association; one person who represents the Athletic Trainers' Society of New Jersey; and one person who represents the New Jersey Academy of Family Physicians.
c. The public members of the board shall serve for a term of three years, except that of the public members first appointed, four shall serve for a term of two years, and four shall serve for a term of three years. The public members shall serve without compensation but shall be eligible for reimbursement for the necessary and reasonable expenses incurred in the performance of their official duties, within the limits of funds appropriated or otherwise made available for this purpose. Vacancies in the membership of the board shall be filled in the same manner as the original appointments were made.
d. The public members shall select from among themselves an individual to serve as chairperson of the board, who shall be responsible for the coordination of all activities of the board and shall provide the technical assistance needed to execute the duties of the board.
e. The board shall be entitled to call to its assistance and avail itself of the services of employees of any State, county, or municipal department, board, bureau, commission, or agency as it may require and as may be available for the purposes of carrying out its responsibilities.
"Alzheimer's disease and related disorders" means a form of dementia characterized by a general loss of intellectual abilities of sufficient severity to interfere with social or occupational functioning.
"Commissioner" means the Commissioner of Health.
"Department" means the Department of Health.
"Dementia" means a chronic or persistent disorder of the mental processes due to organic brain disease, for which no curative treatment is available, and marked by memory disorders, changes in personality, deterioration in personal care, impaired reasoning ability, and disorientation.
"Dementia care home" means a community residential facility which: (1) provides services to residents with special needs, including, but not limited to, persons with Alzheimer's disease and related disorders or other forms of dementia; (2) is subject to the licensure authority of the Department of Health as a health care facility pursuant to P.L.1971, c.136 (C.26:2H-1 et seq.); (3) and meets the requirements of section 19 of P.L.2015, c.125 (C.26:2H-150).
(2) The department shall be empowered to exercise such authority with respect to a dementia care home as the department is granted with respect to any other health care facility licensed by the department, pursuant to P.L.1971, c.136 (C.26:2H-1 et seq.) and any rules and regulations adopted pursuant thereto, and in accordance with the provisions of P.L.2015, c.125 (C.55:13B-5.1 et al.).
b. The department shall establish and enter into an inter-agency agreement with the Department of Community Affairs as necessary for the purposes of subsection a. of this section.
c. (1) Whenever any reference is made in any law, rule, regulation, order, contract, document, or judicial or administrative proceeding to rooming and boarding houses for residents with special needs, including, but not limited to, persons with Alzheimer's disease and related disorders or other forms of dementia, the same shall be deemed to mean or refer to "dementia care homes."
(2) Whenever the term "Department of Community Affairs" appears or any reference is made thereto in any law, rule, regulation, order, contract, document, or judicial or administrative proceeding pertaining to rooming and boarding houses for residents with special needs, including, but not limited to, persons with Alzheimer's disease and related disorders or other forms of dementia, the same shall be deemed to mean or refer to the "Department of Health."
d. A dementia care home that is operating as a rooming or boarding house that provides services to residents with special needs, including, but not limited to, persons with Alzheimer's disease and related disorders or other forms of dementia, on the effective date of P.L.2015, c.125 (C.55:13B-5.1 et al.) shall be granted provisional licensure by the department for a period of one year following the effective date. At the end of that period, the department shall issue a license to the facility pursuant to P.L.1971, c.136 (C.26:2H-1 et seq.) or make continued licensure subject to such actions by the facility as the commissioner determines necessary to effectuate the purposes of P.L.1971, c.136 and P.L.2015, c.125 (C.55:13B-5.1 et al.).
b. A resident of a dementia care home shall be a person with special needs, including, but not limited to, persons with Alzheimer's disease and related disorders or other forms of dementia, as prescribed by regulation of the commissioner, who is: 18 years of age or older; ambulant with or without assistive devices; certified by a licensed physician to be free from communicable disease and not in need of skilled nursing care; and, except in the case of a person 65 years of age or over, in need of dietary services, supervision of self-administration of medications, supervision of and assistance in activities of daily living, or assistance in obtaining health care services. A resident of a dementia care home shall not be given skilled nursing care while a resident, except that the provisions of this subsection shall not be construed to prevent: care of residents in emergencies or during temporary illness for a period of one week or less; or a licensed physician from ordering nursing or other health care services for the resident.
(2) A person shall not offer, advertise, or hold out a dementia care home as another type of health care facility licensed pursuant to P.L.1971, c.136 (C.26:2H-1 et seq.).
(3) A person found to be in violation of paragraph (1) or (2) of this subsection shall be liable for a civil penalty for each building so operated in accordance with the provisions of section 25 of P.L.2015, c.125 (C.26:2H-156).
b. Notwithstanding the provisions of any municipal ordinance to the contrary, a dementia care home shall meet such requirements as the commissioner shall establish by regulation for the posting of visible signs in its local community that identify the location of the facility.
a. Safety from fire;
b. Safety from structural, mechanical, plumbing, and electrical deficiencies;
c. Adequate light and ventilation;
d. Physical security;
e. Protection from harassment, fraud, and eviction without due cause;
f. Clean and reasonably comfortable surroundings;
g. Adequate personal and financial services rendered in the facility;
h. Disclosure of owner identification information;
i. Maintenance of orderly and sufficient financial and occupancy records;
j. Referral of residents, by the operator, to social service and health care providers for needed services;
k. Assurance that no constitutional, civil, or legal right will be denied solely by reason of residence in a dementia care home;
l. Reasonable access for employees of public and private agencies, and reasonable access for other citizens upon receiving the consent of the resident to be visited by them;
m. Opportunity for each resident to live with as much independence, autonomy, and interaction with the surrounding community as the resident is capable of doing; and
n. Assurance that the needs of residents of a dementia care home will be met, which shall include, at a minimum, the following:
(1) staffing levels, which shall ensure that the ratio of direct care staff to residents in the facility is equal to or higher than that which existed on the date of enactment of P.L.2015, c.125 (C.55:13B-5.1 et al.);
(2) staff qualifications and training;
(3) special dietary needs of residents;
(4) special supervision requirements relating to the individual needs of residents;
(5) building safety requirements appropriate to the needs of residents, including the requirement to maintain the operation 24 hours a day, seven days a week, of window, door, and any other locks or security system designed to prevent the elopement of a resident;
(6) special health monitoring of residents by qualified, licensed health care professionals, including a requirement that a medical assessment by a physician be performed on a resident with special needs as described in this subsection, as determined necessary by the commissioner, prior to admission and on a quarterly basis thereafter, to ensure that the facility is appropriate to the needs of the resident; and
(7) criteria for discharging residents which shall be set forth in the admission agreement, which shall be provided to the resident or the resident's representative prior to or upon admission. The commissioner may revoke the license of any provider who violates the criteria for discharging residents.
(1) the granting of the waiver would not pose a threat to the health, safety, or welfare of its residents; and
(2) the failure to grant such a waiver would pose a serious financial hardship to the facility.
b. A dementia care home that is seeking a waiver pursuant to subsection a. of this section shall apply for the waiver on a form and in a manner prescribed by the commissioner.
(1) To manage the resident's own financial affairs;
(2) To wear the resident's own clothing;
(3) To determine the resident's own dress, hair style, or other personal effects according to individual preference;
(4) To retain and use the resident's personal property in the resident's immediate living quarters, so as to maintain individuality and personal dignity, except where the facility can demonstrate that it would be unsafe, impractical to do so, or infringe upon the rights of others, and that mere convenience is not the facility's motive to restrict this right;
(5) To receive and send unopened correspondence;
(6) To unaccompanied access to a telephone at a reasonable hour and to a private phone at the resident's expense;
(7) To privacy;
(8) To retain the services of the resident's own personal physician at the resident's own expense or under a health care plan and to confidentiality and privacy concerning the resident's medical condition and treatment;
(9) To unrestricted communication, including personal visitation with any person of the resident's choice, at any reasonable hour;
(10) To make contacts with the community and to achieve the highest level of independence, autonomy, and interaction with the community of which the resident is capable;
(11) To present grievances on behalf of the resident or others to the operator, State governmental agencies, or other persons without threat of reprisal in any form or manner;
(12) To a safe and decent living environment and considerate and respectful care that recognizes the dignity and individuality of the resident;
(13) To refuse to perform services for the facility, except as contracted for by the resident and the operator;
(14) To practice the religion of the resident's choice, or to abstain from religious practice; and
(15) To not be deprived of any constitutional, civil, or legal right solely by reason of residence in a dementia care home.
b. The operator of a dementia care home shall ensure that a written notice of the rights set forth in subsection a. of this section is given to every resident upon admittance to the facility and to each resident upon request. The operator shall also post this notice in a conspicuous public place in the facility. This notice shall include the name, address, and telephone numbers of the Office of the Ombudsman for the Institutionalized Elderly, county welfare agency, and county office on aging.
c. A person or resident whose rights as set forth in subsection a. of this section are violated shall have a cause of action against any person committing the violation. The action may be brought in any court of competent jurisdiction to enforce those rights and to recover actual and punitive damages for their violation. A plaintiff who prevails in the action shall be entitled to recover reasonable attorney's fees and costs of the action.
a. The weeks following birth are a critical period for the person who has given birth and the infant, setting the stage for long-term health and well-being;
b. During this period, the person who has given birth is adapting to multiple physical, social, and psychological changes, while simultaneously recovering from childbirth, adjusting to changing hormones, and learning to feed and care for a newborn;
c. Like prenatal care, the postpartum health care visit that typically occurs six weeks after childbirth is considered important to a new parent's health; however, for people who have given birth, the six-week postpartum visit punctuates a period devoid of formal or informal support for a parent who has recently given birth;
d. Additionally, according to the American College of Obstetricians and Gynecologists, as many as 40 percent of people who have given birth do not attend a postpartum visit in the United States;
e. During the time immediately following delivery, health care providers are uniquely qualified to enable a person who has given birth to access the clinical and social resources the person needs to successfully navigate the transition from pregnancy to parenthood;
f. Research also indicates that postpartum education and care lead to lower rates of morbidity and mortality in persons who have given birth, as many of the risk factors for post-delivery complications, such as hemorrhaging or a pulmonary embolism, may not be identifiable before a person who has given birth is discharged following the birth;
g. Such data demonstrate the wide ranging benefits to persons who have given birth, children, and families when a person who has given birth and the infant receive support from the medical community within days after delivering a child; and
h. It is, therefore, in the public interest for the Legislature to remove barriers regarding access to postpartum care and to establish the infrastructure for people who have given birth in New Jersey to receive one cost-free home nurse visit in which a registered nurse provides the necessary physical, social, and emotional support critical to recovery following childbirth.
b. In establishing the newborn home nurse visitation program, the Department of Children and Families shall:
(1) appoint an advisory group of stakeholders, which shall organize no later than 30 days after the date of enactment of P.L.2021, c.187 (C.26:2H-158 et al.) and which shall include at least one representative of each of the following entities: an insurance carrier that offers health benefit plans in the State; a hospital; a birthing facility; a local public health authority; a maternal child health consortium; an early childhood home visitation program; a home health agency; a federally qualified health center; a community-based organization; and a social service agency;
(2) consult, coordinate, and collaborate with the advisory group established pursuant to paragraph (1) of this subsection in the development of the program;
(3) have the authority to develop a plan for the managed rollout of the program throughout the State;
(4) in consultation with the Departments of Banking and Insurance and Human Services, establish criteria for the coverage of services provided under the newborn home nurse visitation program by insurance carriers offering a health benefits plan in the State; and
(5) ensure that the program meets the needs of the residents in the communities in which the program operates.
c. The newborn home nurse visitation program shall be implemented in a culturally-competent manner and shall:
(1) be voluntary and carry no negative consequences for parents with a newborn infant who decline to participate in the program when applying for other services available to pregnant persons and when applying for other services available to all parents of newborn infants;
(2) offer home nurse visitation services in every community in the State and for all newborn infants and all parents of a newborn infant residing in the community in which the program operates, including resource family parents, adoptive parents, and parents experiencing a stillbirth;
(3) include at least one home nurse visit in the participating newborn infant's home within two weeks after the birth of an infant;
(4) provide the opportunity for no more than two additional visits during the newborn infant's first three months of life, with such additional visits occurring based on the family's choice, as well as need and availability as determined by the program;
(5) require that the home nurse visit be conducted by a registered nurse or an advanced practice nurse licensed in this State pursuant to Title 45 of the Revised Statutes;
(6) improve State outcomes in areas including maternal health, infant health and development, and parenting skills;
(7) be based on criteria established by the United States Department of Health and Human Services for an evidence-based early childhood home visiting service delivery model;
(8) include an evidence-based evaluation of the physical, emotional, and social factors affecting a parent or parents and the parent's or parents' newborn infant, including, but not limited to, a health and wellness check of the newborn and an assessment of the physical and mental health of a person who has given birth;
(9) provide support services to the parent or parents of a newborn infant, including, but not limited to, breastfeeding education and assistance to a person who has recently given birth in recognizing the symptoms of, and coping with, perinatal mood disorder;
(10) coordinate with each hospital and birthing facility in the State to ensure that a person who has given birth is advised of the benefits of receiving a home nurse visit within two weeks after the birth of an infant, and to ensure that the program attempts to schedule a home nurse visit prior to the person's discharge from the hospital or facility;
(11) develop a method for providing parents, who elect to have a home birth, information about the program; and
(12) provide information on, and referrals to, services that address the specific needs of newborn infants and parents of a newborn infant, including linking a person who has given birth and the person's infant to a central intake agency for referrals to community resources, support services, community-based organizations or social service agency programs available to persons who have given birth and their infants, and medically necessary follow-up healthcare.
d. Nothing in this section shall be construed to require parents of a newborn infant to participate in the newborn home nurse visitation program.
e. The Department of Children and Families may contract with one or more third-party vendors or service providers to assist the department in administering the program established pursuant to this section, including hiring and staffing nurses and providing training on the home visiting model utilized by the program.
b. The Department of Children and Families shall work with other State departments and agencies, health insurance carriers that offer health benefit plans in the State, hospitals and birthing facilities, local public health authorities, maternal child health consortia, early childhood home visitation programs, community-based organizations, and social service providers, to develop protocols concerning the timely sharing of data collected pursuant to subsection a. of this section, including the sharing of data with the primary care providers of parents participating in the newborn home nurse visitation program.
c. The Department of Children and Families may contract with a third-party vendor with expertise in the model utilized by the program to assist with the analysis and evaluation of data collected pursuant to this section. In the event of such a contract, the department shall facilitate the sharing of data with the third party, in accordance with State and federal law.
b. The Commissioner of Banking and Insurance, in consultation with the Commissioner of the Department of Children and Families, shall have the authority to permit carriers to use an in-network provider that meets the requirements of the program, or contract with a vendor or provider selected by the program, to provide home visitation.
"Carrier," "covered person," and "health benefits plan," shall have the same meaning as provided for those terms under section 2 of P.L.1997, c.192 (C.26:2S-2).
"Department" means the Department of Health.
"Federal acute Hospital Care at Home Program" or "federal program" means the program established by the federal Centers for Medicare and Medicaid Services under 42 U.S.C. Section 1320b-5 and extended by 42 U.S.C 1395cc-7, or any successor program established by an act of Congress or the federal Centers for Medicare and Medicaid Services.
"Hospital" means an acute care hospital licensed pursuant to P.L.1971, c.136 (C.26:2H-1 et seq.).
"State program" means the hospital at home program established by the department pursuant to section 3 of this act.
b. Any hospital issued a waiver to operate, or otherwise approved to participate in, the federal Acute Hospital Care at Home Program shall be permitted to operate under the federal program to the extent permitted under the federal program for such time as the federal program remains in effect.
(a) provide a credit to the public employer toward the cost of the contract awarded by the public employer to the health care provider to manage a medical home model for health care services for the public employees and their dependents; and
(b) refer public employees and their dependents, who receive services through the medical home model to other providers with whom the health care provider has a contractual relationship.
If provided, the amount of the credit permitted toward the cost of the contract shall not exceed the amount of the payments received by the health care provider from the health benefits program or plan for claims submitted for provider services rendered to public employees and their dependents.
No such contract shall include any provision conditioning the retention, renewal, or continued validity of the contract on the ability of any party to the contract to pay or receive referral fees for services covered by the contract.
A health care provider that has entered into such a contract shall retain an independent, third-party accounting firm, at the provider's expense, to conduct an annual audit of all financial records related to billing and receipt of payments from the applicable health benefits program or plan received by the provider and credited to the public employer for compliance with this section. A certification that such an audit has been completed, and the results thereof, shall be provided to the Division of Consumer Affairs, in the Department of Law and Public Safety, within 30 days of completion.
Beginning January 1, 2024, a public employer that participates in the State Health Benefits Program, established pursuant to P.L.1961, c.49 (C.52:14-17.25 et seq.), or the School Employees' Health Benefits Program, established pursuant to sections 31 through 41 of P.L.2007, c.103 (C.52:14-17.46.1 through C.52:14-17.46.11), shall receive approval from the appropriate commission governing the program prior to entering into a new contract or an extension or renewal of an existing contract covered by this section.
Nothing in this section shall preclude the provider from billing the health benefits program or plan on a fee-for-service basis when such payments by the health benefits program or plan are used to apply a credit toward the cost of the contract.
As used in this section "medical home" means on-site physicians, nurses, and pharmacy and laboratory services, provided at no cost to public employees and their dependents, when the medical staff receive salaries and services are not provided on a fee-for-service basis and when primary care, care coordination through the use of health information technology and chronic disease registries, and referrals for specialist care are provided.
It is the purpose of this act to ensure that all health care institutions have access to financial resources to improve the health and welfare of the citizens of the State. It is hereby declared to be the policy of the State to encourage the provision of modern, well-equipped health care facilities, and such provision is hereby declared to be a public use and purpose.
It is also the purpose of this act to provide assistance in the restructuring of the health care system of the State and to aid in the termination of the provision of hospital acute care services at such locations as may no longer be useful or necessary for this purpose.
This act shall be known and may be cited as the "New Jersey Health Care Facilities Financing Authority Law."
"Authority" means the New Jersey Health Care Facilities Financing Authority created by this act or any board, body, commission, department, or officer succeeding to the principal functions thereof or to whom the powers conferred upon the authority by this act shall be given by law.
"Bond" means bonds, notes, or other evidences of indebtedness of the authority issued pursuant to this act.
"Commissioner" means the Commissioner of Health.
"Credit agreement" means a loan agreement, revolving credit agreement, agreement establishing a line of credit, letter of credit, reimbursement agreement, interest exchange agreement, insurance contract, surety bond, commitment to purchase bonds, purchase or sale agreement, or commitment or other contract or agreement authorized and approved by the authority in connection with the authorization, issuance, security or payment of bonds.
"Health care organization" means an organization located in this State which is authorized or permitted by law, whether directly or indirectly through a holding corporation, partnership, or other entity, to provide health care-related services, including, but not limited to, hospital, outpatient, public health, home health care, residential care, assisted living, hospice, health maintenance organization, blood bank, alcohol or drug abuse, half-way house, diagnostic, treatment, rehabilitation, extended care, skilled nursing care, nursing care, intermediate care, tuberculosis care, chronic disease care, maternity, mental health, boarding or sheltered care or day care, services provided by a physician in his office, or any other service offered in connection with health care services or by an entity affiliated with a health care organization or an integrated delivery system.
"Hospital asset transformation program" means the hospital asset transformation program established pursuant to subsection g. of section 7 of P.L.1972, c.29 (C.26:2I-7).
"Integrated delivery system" means a group of legally affiliated health care organizations.
"Public health care organization" means a State, county, or municipal health care organization.
"Project" or "health care organization project" means the acquisition, construction, improvement, renovation, or rehabilitation of lands, buildings, fixtures, equipment, and articles of personal property, or other tangible or intangible assets that are necessary or useful in the development, establishment, or operation of a health care organization pursuant to this act, and "project" or "health care organization project" may include: the financing, refinancing, or consolidation of secured or unsecured debt, borrowings, or obligations, or the provision of financing for any other expense incurred in the ordinary course of business, all of which lands, buildings, fixtures, equipment, and articles of personal property are to be used or occupied by any person in the health care organization; the acquisition of an entity interest, including capital stock, in a corporation; or any combination thereof; and may include any combination of the foregoing undertaken jointly by any health care organization with one or more other health care organizations.
"Project cost" or "health care organization project cost" means the sum total of all or any part of costs incurred or estimated to be incurred by the authority or by a health care organization which are reasonable and necessary for carrying out all works and undertakings and providing all necessary equipment for the development of a project, exclusive of the amount of any private or federal, State, or local financial assistance for and received by a health care organization for the payment of such project cost. Such costs shall include, but are not necessarily limited to: interest prior to, during and for a reasonable period after such development; start-up costs and costs of operation and maintenance during the construction period and for a reasonable additional period thereafter; organization, administration, operation, and other expenses of the health care organization prior to and during construction; the cost of necessary studies, surveys, plans, and specifications, architectural, engineering, legal, or other special services; the cost of acquisition of land, buildings, and improvements thereon (including payments for the relocation of persons displaced by such acquisition), site preparation and development, construction, reconstruction, equipment, including fixtures, equipment, and cost of demolition and removal, and articles of personal property required; the reasonable cost of financing incurred by a health care organization or the authority in the course of the development of the project; reserves for debt service; the fees imposed upon a health care organization by the commissioner and by the authority; other fees charged, and necessary expenses incurred in connection with the initial occupancy of the project; and the cost of such other items as may be reasonable and necessary for the development of a project; as well as provision or reserves for working capital, operating or maintenance or replacement expenses, or for payment or security of principal of, or interest on, bonds.
b. The authority shall consist of seven members, three of whom shall be the commissioner, who shall be the chairman, the Commissioner of Banking and Insurance, and the Commissioner of Human Services, who shall serve during their terms of office, or when so designated by them, their deputies or other representatives, who shall serve at their pleasure, and four public members who are citizens of the State to be appointed by the Governor, with the advice and consent of the Senate for terms of four years; provided that the four members first appointed by the Governor shall serve terms expiring on the first, second, third, and fourth, respectively, April 30 ensuing after the enactment of this act. Each member shall hold office for the term of the member's appointment and until the member's successor shall have been appointed and qualified. Any vacancy among the public members shall be filled by appointment for the unexpired term only.
c. Any member of the authority appointed by the Governor may be removed from office by the Governor for cause after a public hearing.
d. The members of the authority shall serve without compensation, but the authority may reimburse its members for necessary expenses incurred in the discharge of their official duties.
e. The authority, upon the first appointment of its members and thereafter on or after April 30 in each year, shall annually elect from among its members a vice chairman who shall hold office until April 30 next ensuing and shall continue to serve during the term of his successor and until his successor shall have been appointed and qualified. The authority may also appoint, retain, and employ, without regard to the provisions of Title 11A, Civil Service, of the New Jersey Statutes, such officers, agents, and employees as it may require, and it shall determine their qualifications, terms of office, duties, services, and compensation.
f. The powers of the authority shall be vested in the members thereof in office from time to time and a majority of the total authorized membership of the authority shall constitute a quorum at any meeting thereof. Action may be taken and motions and resolutions adopted by the authority at any meeting thereof by the affirmative vote of a majority of the members present, unless in any case the bylaws of the authority shall require a larger number. No vacancy in the membership of the authority shall impair the right of a quorum to exercise all the rights and perform all the duties of the authority.
g. Each member and the treasurer of the authority shall execute a bond to be conditioned upon the faithful performance of the duties of such member or treasurer, as the case may be, in such form and amount as may be prescribed by the Attorney General. Such bonds shall be filed in the office of the Secretary of State. At all times thereafter the members and treasurer of the authority shall maintain such bonds in full force and effect. All costs of such bonds shall be borne by the authority.
h. No trustee, director, officer, or employee of a health care organization may serve as a member of the authority.
i. At least two true copies of the minutes of every meeting of the authority shall be forthwith delivered by and under the certification of the secretary thereof, to the Governor. No action taken at such meeting by the authority shall have force or effect until 10 days, exclusive of Saturdays, Sundays, and public holidays, after such copies of the minutes shall have been so delivered or at such earlier time as the Governor shall sign a statement of approval thereof. If, in said 10-day period, the Governor returns a copy of the minutes with veto of any action taken by the authority or any member thereof at such meeting, such action shall be null and of no effect. If the Governor shall not return the minutes within said 10-day period, any action therein recited shall have force and effect according to the wording thereof. At any time prior to the expiration of the said 10-day period, the Governor may sign a statement of approval of all or any such action of the authority.
The powers conferred in this subsection upon the Governor shall be exercised with due regard for the rights of the holders of bonds of the authority at any time outstanding.
a. To adopt bylaws for the regulation of its affairs and the conduct of its business and to alter and revise such bylaws from time to time at its discretion.
b. To adopt and have an official seal and alter the same at pleasure.
c. To maintain an office at such place or places within the State as it may designate.
d. To sue and be sued in its own name.
e. To borrow money and to issue bonds of the authority and to provide for the rights of the holders thereof as provided in this act.
f. To acquire, lease as lessee or lessor, hold and dispose of real and personal property or any interest therein, in the exercise of its powers and the performance of its duties under this act.
g. To acquire in the name of the authority by purchase or otherwise, on such terms and conditions and in such manner as it may deem proper, any land or interest therein and other property which it may determine is reasonably necessary for any project; and to hold and use the same and to sell, convey, lease, or otherwise dispose of property so acquired, no longer necessary for the authority's purposes, for fair consideration after public notice.
h. To receive and accept, from any federal or other public agency or governmental entity directly or through the Department of Health or any other agency of the State or any health care organization, grants or loans for or in aid of the acquisition or construction of any project, and to receive and accept aid or contributions from any other source, of either money, property, labor or other things of value, to be held, used, and applied only for the purposes for which such grants, loans and, contributions may be made.
i. To prepare or cause to be prepared plans, specifications, designs, and estimates of costs for the construction and equipment of health care organization projects for health care organizations under the provisions of this act, and from time to time to modify such plans, specifications, designs, or estimates.
j. By contract or contracts with and for health care organizations only, to construct, acquire, reconstruct, rehabilitate and improve, and furnish and equip health care organization projects. The authority, in the exercise of its authority to make and enter into contracts and agreements necessary or incidental to the performance of its duties and the execution of its powers, shall adopt standing rules and procedures providing that, except as hereinafter provided, no contract on behalf of the authority shall be entered into for the doing of any work, or for the hiring of equipment or vehicles, where the sum to be expended exceeds the sum of $7,500 or the amount determined as provided in this subsection, unless the authority shall first publicly advertise for bids therefor, and shall award the contract to the lowest responsible bidder; provided, however, that such advertising shall not be required where the contract to be entered into is one for the furnishing or performing of services of a professional nature or for the supplying of any product or the rendering of any service by a public utility subject to the jurisdiction of the Board of Public Utilities, and tariffs and schedules of the charges, made, charged, or exacted by the public utility for any such products to be supplied or services to be rendered are filed with said board. The Governor, in consultation with the Department of the Treasury, shall, no later than March 1 of each odd-numbered year, adjust the threshold amount set forth in this subsection, or subsequent to 1985 the threshold amount resulting from any adjustment under this subsection or section 17 of P.L.1985, c.469, in direct proportion to the rise or fall of the Consumer Price Index for all urban consumers in the New York City and the Philadelphia areas as reported by the United States Department of Labor. The Governor shall, no later than June 1 of each odd-numbered year, notify the authority of the adjustment. The adjustment shall become effective July 1 of each odd-numbered year.
k. To determine the location and character of any project to be undertaken, subject to the provisions of this act, and subject to State health and environmental laws, to construct, reconstruct, maintain, repair, lease as lessee or lessor, and regulate the same and operate the same in the event of default by a health care organization of its obligations and agreements with the authority; to enter into contracts for any or all such purposes; and to enter into contracts for the management and operation of a project in the event of default as herein provided. The authority shall use its best efforts to conclude its position as an operator as herein provided as soon as is practicable.
l. To establish rules and regulations for the use of a project or any portion thereof and to designate a health care organization as its agent to establish rules and regulations for the use of a project undertaken by such a health care organization.
m. Generally to fix and revise from time to time and to charge and collect rates, rents, fees, and other charges for the use of and for the services furnished or to be furnished by a project or any portion thereof and to contract with holders of its bonds and with any other person, party, association, corporation or other body, public or private, in respect thereof.
n. To enter into agreements, credit agreements or contracts, execute any and all instruments, and do and perform any and all acts or things necessary, convenient or desirable for the purposes of the authority or to carry out any power expressly given in this act.
o. To invest any moneys held in reserve or sinking funds, or any moneys not required for immediate use or disbursement, at the discretion of the authority, in such obligations as are authorized by resolution of the authority.
p. To obtain, or aid in obtaining, from any department or agency of the United States any insurance or guarantee as to, or of, or for the payment or repayment of interest or principal, or both, or any part thereof, on any loan or any instrument evidencing or securing the same, made or entered into pursuant to the provisions of this act; and notwithstanding any other provisions of this act, to enter into agreement, contract, or any other instrument whatsoever with respect to any such insurance or guarantee, and accept payment in such manner and form as provided therein in the event of default by the borrower.
q. To obtain from any department or agency of the United States or a private insurance company any insurance or guarantee as to, or of, or for the payment or repayment of interest or principal, or both, or any part thereof, on any bonds issued by the authority pursuant to the provisions of this act; and notwithstanding any other provisions of this act, to enter into any agreement, contract, or any other instrument whatsoever with respect to any such insurance or guarantee, except to the extent that such action would in any way impair or interfere with the authority's ability to perform and fulfill the terms of any agreement made with the holders of the bonds of the authority.
r. To receive and accept, from any department or agency of the United States or of the State or from any other entity, any grant, appropriation, or other moneys to be used for or applied to any corporate purpose of the authority, including without limitation the meeting of debt service obligations of the authority in respect of its bonds.
s. Subject to the approval of the State Treasurer, to grant or loan all or any portion of the funds received pursuant to subsection g. of section 7 of P.L.1972, c.29 (C.26:2I-7) in connection with the hospital asset transformation program.
The Commissioner of Labor and Workforce Development shall determine the prevailing wage rate in the locality in which the construction or rehabilitation is to be performed for each craft, trade or classification of worker employed in the construction or rehabilitation, as if the construction or rehabilitation is "public work" as defined in section 2 of P.L.1963, c.150 (C.34:11-56.26).
b. Except as may otherwise be expressly provided by the authority, every issue of its bonds shall be general obligations of the authority payable from any revenues or moneys of the authority, subject only to any agreements with the holders of particular bonds pledging any particular revenues or moneys. Notwithstanding that bonds may be payable from a special fund, they shall be fully negotiable within the meaning of Title 12A, the Uniform Commercial Code, of the New Jersey Statutes, subject only to any provisions of the bonds for registration.
c. The bonds may be issued as serial bonds or as term bonds, or the authority, in its discretion, may issue bonds of both types. The bonds shall be authorized by resolution of the members of the authority and shall bear such date or dates, mature at such time or times, not exceeding 50 years from their respective dates, bear interest at such rate or rates, be payable at such time or times, be in such denominations, be in such form, either coupon or registered, carry such registration privileges, be executed in such manner, be payable in lawful money of the United States of America at such place or places, and be subject to such terms of redemption, as such resolution or resolutions may provide. The bonds may be sold at public or private sale for such price or prices as the authority shall determine. Pending preparation of the definitive bonds, the authority may issue interim receipts or certificates which shall be exchanged for such definitive bonds.
d. Any resolution or resolutions authorizing any bonds or any issue of bonds may contain provisions, which shall be a part of the contract with the holders of the bonds to be authorized, as to:
(i) pledging all or any part of the revenues of a project or any revenue producing contract or contracts made by the authority with any individual, partnership, corporation or association or other body, public or private, to secure the payment of the bonds or of any particular issue of bonds, subject to such agreements with bondholders as may then exist;
(ii) the rentals, fees and other charges to be charged, and the amounts to be raised in each year thereby, and the use and disposition of the revenues;
(iii) the setting aside of reserves or sinking funds, and the regulation and disposition thereof;
(iv) limitations on the right of the authority or its agent to restrict and regulate the use of a project;
(v) limitations on the purpose to which the proceeds of sale of any issue of bonds then or thereafter to be issued may be applied and pledging such proceeds to secure the payment of the bonds or any issue of the bonds;
(vi) limitations on the issuance of additional bonds, the terms upon which additional bonds may be issued and secured and the refunding of outstanding bonds;
(vii) the procedure, if any, by which the terms of any contract with bondholders may be amended or abrogated, the amount of bonds the holders of which must consent thereto, and the manner in which such consent may be given;
(viii) limitations on the amount of moneys derived from a project to be expended for operating, administrative or other expenses of the authority; and
(ix) defining the acts or omissions to act which shall constitute a default in the duties of the authority to holders of its obligations and providing the rights and remedies of such holders in the event of a default.
e. Neither the members of the authority nor any person executing the bonds shall be liable personally on the bonds or be subject to any personal liability or accountability by reason of the issuance thereof.
f. The authority shall have power out of any funds available therefor to purchase its bonds. The authority may hold, pledge, cancel or resell such bonds, subject to and in accordance with agreements with bondholders.
g. (1) (a) There is established a hospital asset transformation program in the authority for the purpose of providing financial assistance by the authority to nonprofit hospitals in this State, from funds received pursuant to and in accordance with the provisions of this subsection, in connection with the termination of the provision of hospital acute care services at a specific location that may no longer be necessary or useful for this purpose. For the purposes of this subsection, "the termination of the provision of hospital acute care services" shall include, but not be limited to, the actual closure of, or other action taken to terminate acute care services at, a nonprofit hospital and the surrender of its license to provide hospital acute care services at that specific location, which occurred after the issuance by the commissioner of, and in accordance with the provisions of, a certificate of need issued pursuant to P.L.1971, c.136 (C.26:2H-1 et seq.), without regard to any pending appeal by a third party of the issuance of the certificate of need.
(b) The termination of the provision of hospital acute care services shall not preclude the commissioner from issuing a new certificate of need with respect to the provision of hospital acute care services at that location to a party unrelated to the party to whom the certificate of need with respect to the termination of the provision of hospital acute care services was issued.
(2) Subject to the approval of the State Treasurer, the authority shall have the power to issue bonds and refunding bonds, incur indebtedness and borrow money secured, in whole or in part, by moneys received pursuant to subsection a. of section 6 of P.L.2000, c.98 (C.26:2I-7.1), in order to provide, in connection with the hospital asset transformation program, any nonprofit health care organization in the State with the funds to:
(a) satisfy the outstanding bonded indebtedness or any other outstanding indebtedness of any hospital in the State;
(b) pay the costs of transitioning a general hospital to a nonprofit, non-acute care health care-related facility, including, but not limited to, construction, renovation, equipment, information technology and working capital;
(c) pay the costs related to transitioning acute care and related services from the hospital at which inpatient acute care services are to be terminated to an existing nonprofit general hospital, including, but not limited to, construction, renovation, equipment, information technology and working capital;
(d) pay the costs associated with the closure of a general hospital;
(e) pay the costs of the acquisition of a general hospital in the State for the purpose of either (i) moving an existing general hospital's services into the acquired hospital and closing the acquirer's inpatient acute care services, or (ii) closing its inpatient acute care services;
(f) pay capitalized interest;
(g) fund a debt service reserve fund;
(h) pay the costs associated with the issuance of any bonds for any of the aforementioned purposes; or
(i) pay other costs specifically related to the closure or transition of inpatient acute care services as identified in the contract with the Treasurer.
The authority may establish reserves or other funds to further secure these bonds or refunding bonds.
(3) The authority may, in any resolution authorizing the issuance of bonds or refunding bonds issued pursuant to this subsection, pledge the contract with the State Treasurer provided for in subsection b. of section 6 of P.L.2000, c.98 (C.26:2I-7.1), or any part thereof, for the payment or redemption of the bonds or refunding bonds, and covenant as to the use and disposition of money available to the authority for payments of bonds and refunding bonds. Subject to the approval of the State Treasurer, the authority may pay the costs associated with the issuance of bonds or refunding bonds by the authority for the purposes of this subsection from amounts it receives from the proceeds of the bonds or refunding bonds and from amounts it receives pursuant to subsection a. of section 6 of P.L.2000, c.98 (C.26:2I-7.1), which costs may include, but are not limited to, any costs relating to the issuance of the bonds or refunding bonds and costs attributable to any agreements securing, or providing for the payment of, these bonds or refunding bonds. The authority is authorized to enter into any agreement necessary or desirable to effectuate the purposes of this subsection, including an agreement to sell bonds or refunding bonds to any person and to comply with the laws of any jurisdiction relating thereto.
b. The State Treasurer and the authority are authorized to enter into one or more contracts to implement the payment arrangement provided for in subsection a. of this section. The contract shall provide for payment by the State Treasurer of the amounts required to be paid pursuant to subsection a. of this section and shall set forth the procedure for the transfer of monies for the purpose of making that payment. The contract shall contain such terms as are determined by the State Treasurer and the authority and shall include, but not be limited to, terms and conditions necessary and desirable to secure any bonds or refunding bonds issued by the authority pursuant to subsection g. of section 7 of P.L.1972, c.29 (C.26:2I-7); except that, notwithstanding any provision of any law, rule or regulation to the contrary, the State Treasurer shall pay the authority only such amounts as shall be determined by the contract and the incurrence of any obligation of the State under the contract, including any payment to be made from the General Fund pursuant thereto, shall be subject to and dependent upon appropriations made by the Legislature for the purposes of this section.
In the discretion of the authority, any bonds issued under the provisions of this act may be secured by a trust agreement by and between the authority and a corporate trustee or trustees, which may be any trust company or bank having the powers of a trust company within or without the State. Such trust agreement or the resolution providing for the issuance of such bonds may pledge or assign the revenues or other moneys or securities to be received or proceeds of any contract or contracts pledged. Such trust agreement or resolution providing for the issuance of such bonds may contain such provisions for protecting and enforcing the rights and remedies of the bondholders as may be reasonable and proper and not in violation of law, including particularly such provisions as have hereinabove been specifically authorized to be included in any resolution or resolutions of the authority authorizing bonds thereof. Any bank or trust company incorporated under the laws of this State which may act as depositary of the proceeds of bonds or revenues or other moneys or securities may furnish such indemnifying bonds or pledge such securities as may be required by the authority. Any such trust agreement may set forth the rights and remedies of the bondholders and of the trustee or trustees, and may restrict the individual right of action by bondholders. In addition to the foregoing, any such trust agreement or resolution may contain such other provisions as the authority may deem reasonable and proper for the security of the bondholders. All expenses incurred in carrying out the provisions of such trust agreement or resolution may be treated as project costs.
Bonds issued under the provisions of this act shall not be deemed to constitute a debt or liability of the State or of any political subdivision thereof other than the authority, nor a pledge of the faith and credit of the State or of any such political subdivision, other than the authority, but shall be payable solely from the funds herein provided. All such bonds shall contain on the face thereof a statement to the effect that neither the State of New Jersey nor the authority shall be obligated to pay the same or the interest thereon except from revenues or other moneys of the authority and that neither the faith and credit nor the taxing power of the State of New Jersey or of any political subdivision thereof other than the authority is pledged to the payment of the principal of or the interest on such bonds. The issuance of bonds under the provisions of this act shall not directly or indirectly or contingently obligate the State or any political subdivision thereof to levy or to pledge any form of taxation whatever therefor.
a. To pay the cost of maintaining, repairing and operating the project and each and every portion thereof, to the extent that the payment of such cost has not otherwise been adequately provided for.
b. To pay the principal of and the interest on outstanding bonds of the authority issued in respect of such project as the same shall become due and payable; and
c. To create and maintain reserves required or provided for in any resolution authorizing, or trust agreement securing, such bonds of the authority.
Such rates, rents, fees and charges shall not be subject to supervision or regulation by any department, commission, board, body, bureau or agency of this State other than the authority. A sufficient amount of the revenues derived in respect of a project, except such part of such revenues as may be necessary to pay the cost of maintenance, repair and operation and to provide reserves for renewals, replacements, extensions, enlargements and improvements as may be provided for in the resolution authorizing the issuance of any bonds of the authority or in the trust agreement securing the same, shall be set aside at such regular intervals as may be provided in such resolution or trust agreement in a sinking or other similar fund which is hereby pledged to, and charged with, the payment of the principal of and the interest on such bonds as the same shall become due, and the redemption price or the purchase price of bonds retired by call or purchase as therein provided. Such pledge shall be valid and binding from the time when the pledge is made; the rates, rents, fees and charges and other revenues or other moneys or securities so pledged and thereafter received by the authority shall immediately be subject to the lien of such pledge without any physical delivery thereof or further act, and the lien of any such 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 such 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. The use and disposition of moneys to the credit of such sinking or other similar fund shall be subject to the provisions of the resolution authorizing the issuance of such bonds or of such trust agreement. Except as may otherwise be provided in such resolution or such trust agreement, such sinking or other similar fund shall be a fund for all such bonds issued to finance projects of a health care organization without distinction or priority of one over another; provided the authority in any such resolution or trust agreement may provide that such sinking or other similar fund shall be the fund for a particular project at a health care organization and for the bonds issued to finance a particular project and may, additionally, permit and provide for the issuance of bonds having a subordinate lien in respect of the security herein authorized to other bonds of the authority and, in such case, the authority may create separate sinking or other similar funds in respect to such subordinate lien bonds.
All moneys received pursuant to the authority of this act, whether as proceeds from the sale of bonds or as revenues, shall be deemed to be trust funds to be held and applied solely as provided in this act. Any officer with whom, or any bank or trust company with which, such moneys shall be deposited shall act as trustee of such moneys and shall hold and apply the same for the purposes hereof, subject to such regulations as this act and the resolution authorizing the bonds of any issue or the trust agreement securing such bonds may provide.
Any holder of bonds issued under the provisions of this act or any of the coupons appertaining thereto, and the trustee or trustees under any trust agreement, except to the extent the rights herein given may be restricted by any resolution authorizing the issuance of, or any such trust agreement securing, such bonds, may, either at law or in equity, by suit, action, proceeding in lieu of prerogative writ, or other proceedings, protect and enforce any and all rights under the laws of the state or granted hereunder or under such resolution or trust agreement, and may enforce and compel the performance of all duties required by this act or by such resolution or trust agreement to be performed by the authority or by any officer, employee or agent thereof, including the fixing, charging and collecting of the rates, rents, fees, and charges herein authorized and required by the provisions of such resolution or trust agreement to be fixed, established and collected.
a. The authority is hereby authorized to provide for the issuance of bonds of the authority for the purpose of refunding any bonds of the authority then outstanding, including the payment of any redemption premium thereon and any interest accrued or to accrue to the earliest or subsequent date of redemption, purchase or maturity of such bonds, and, if deemed advisable by the authority, for the additional purpose of paying all or any part of the cost of constructing and acquiring additions, improvements, extensions or enlargements of a project or any portion thereof and for making payments to reserve funds therefor.
b. The proceeds of any such bonds issued for the purpose of refunding outstanding bonds may, in the discretion of the authority, be applied to the purchase or retirement at maturity or redemption of such outstanding bonds either on their earliest or any subsequent redemption date or upon the purchase or at the maturity thereof and may, pending such application, be placed in escrow to be applied to such purchase or retirement at maturity or redemption on such date as may be determined by the authority.
c. Any such escrowed proceeds, pending such use, may be invested and reinvested as permitted by the applicable resolution or trust agreement. The interest, income and profits, if any, earned or realized on any such investment may also be applied to the payment of outstanding bonds to be refunded. After the terms of the escrow have been fully satisfied and carried out, any balance of such proceeds and interest, income and profits, if any, earned or realized on the investments thereof may be returned to the authority for use by it in any lawful manner.
d. All such bonds shall be subject to the provisions of this act in the same manner and to the same extent as other bonds issued pursuant to this act.
Bonds and notes issued by the authority under the provisions of this act are hereby made securities in which the State and all political subdivisions of the State, their officers, boards, commissions, departments or other agencies, all banks, bankers, savings banks, trust companies, savings and loan associations, investment companies and other persons carrying on a banking business, all insurance companies, insurance associations, and other persons carrying on an insurance business, and all administrators, executors, guardians, trustees and other fiduciaries, and all other persons whatsoever who now are or may hereafter be authorized to invest in bonds or other obligations of the State, may properly and legally invest any funds, including capital belonging to them or within their control; and said bonds, notes or other securities or obligations are hereby made securities which may properly and legally be deposited with and received by any State or municipal officers or agency of the State for any purpose for which the deposit of bonds or other obligations of the State is now or may hereafter be authorized by law.
Bonds may be issued under the provisions of this act without obtaining the consent of any department, division, commission, board, bureau, agency or officer of the State, and without any other proceedings or the happening of any other conditions or things than those proceedings, conditions and things which are specifically required by this act.
The exercise of the powers granted by the this act will be in all respects for the benefit of the people of this State, for the increase of their commerce, welfare and prosperity, and for the improvement of their health and living conditions, and as the operation and maintenance of a project by the authority or its agent will constitute the performance of an essential public function, neither the authority nor its agent shall be required to pay any taxes or assessments upon or in respect of a project or any property acquired or used by the authority or its agent under the provisions of this act or upon the income therefrom, and any bonds issued under the provisions of this act, their transfer and the income therefrom, including any profit made on the sale thereof, shall at all times be exempt from taxation except for transfer, inheritance and estate taxes.
On or before March 31 in each year, the authority shall make an annual report of its activities for the preceding calendar year to the Governor and the Legislature. Each such report shall set forth a complete operating and financial statement covering the authority's operations during the year. The authority shall cause an audit of its books and accounts to be made at least once in each year by certified public accountants and cause a copy thereof to be filed with the Secretary of State and the Comptroller of the Treasury.
Except as otherwise expressly provided in this act, any member, officer, agent or employee of the authority, or member of the immediate family thereof, who is interested, either directly or indirectly, in any contract or transaction of another with the authority, or in the purchase, sale or lease of any property, either real or personal, to or from the authority, shall be guilty of a misdemeanor.
The Comptroller of the Treasury and his legally authorized representatives are hereby authorized and empowered from time to time to examine the accounts, books and records of the authority, including its receipts, disbursements, contracts, sinking funds, investments and any other matters relating thereto and to its financial standing.
The authority shall be entitled to call to its assistance and avail itself of the services of such employees of any State department or agency as it may require and as may be available to it for said purpose.
a. The power to sell and to convey to the authority title in fee simple in any such land and any existing health care facility thereon owned by the State and held for any department thereof or of any of the institutions under the jurisdiction of the Department of Health or the power to sell and to convey to the authority such title as the State or the public health care organization, respectively, may have in any such land and any existing health care facility thereon.
b. The power to lease to the authority any land and any existing health care facility thereon so owned for a term or terms not exceeding 50 years each.
c. The power to lease or sublease from the authority, and to make available, any such land and existing health care facility conveyed or leased to the authority under subsections a. and b. of this section, and any new health care facility erected upon such land or upon any other land owned by the authority.
d. The power and duty, upon receipt of notice of any assignment by the authority of any lease or sublease made under subsection c. of this section, or of any of its rights under any such lease or sublease, to recognize and give effect to such assignment, and to pay to the assignee thereof rentals or other payments then due or which may become due under any such lease or sublease which has been so assigned by the authority.
a. The power to pledge and assign all or any part of the revenues derived from the operation of a health care organization as security for the payment of rentals due and to become due under any lease or sublease of a new health care facility as provided under subsection c. of section 23 of P.L.1972, c.29 (C.26:2I-23).
b. The power to covenant and agree in any lease or sublease of such new health care facilities made under subsection c. of section 23 of P.L.1972, c.29 (C.26:2I-23) to impose fees, rentals or other charges for the use and occupancy or other operation of such new health care facilities in an amount calculated to produce net revenues sufficient to pay the rentals due and to become due under such lease or sublease.
c. The power to apply all or any part of the revenues derived from the operation of any health care organization to the payment of rentals due and to become due under any lease or sublease made under subsection c. of section 23 of P.L.1972, c.29 (C.26:2I-23).
d. The power to pledge and assign all or any part of the revenues derived from the operation of any health care organization to the payment of rentals due and to become due under any lease or sublease made under subsection c. of section 23 of P.L.1972, c.29 (C.26:2I-23).
e. The power to covenant and agree in any lease or sublease made under subsection c. of section 23 of P.L.1972, c.29 (C.26:2I-23) to impose fees, rentals or other charges for the use and occupancy of a health care facility or for the operation of a health care organization in an amount calculated to produce net revenues sufficient to pay the rentals due and to become due under such lease or sublease.
a. Upon application of the health care organization to construct, acquire or otherwise provide projects for the use and benefit of the health care organization and the patients, employees and staff of the health care organization. The health care organization for which such a project is undertaken by the authority shall approve the plans and specifications of such project.
b. To operate and manage any project provided pursuant to this section, or the authority may lease any such project to the health care organization for which such project is provided. At such time as the liabilities of the authority incurred for any such project have been met and the bonds of the authority issued therefor have been paid, or such liabilities and bonds have otherwise been discharged, the authority shall transfer title to all the real and personal property of such project vested in the authority, to the health care organization in connection with which such project is then being operated, or to which such project is then leased; provided, however, that if at any time prior thereto the health care organization ceases to offer health services, then such title shall vest in the State of New Jersey.
Any lease of a project authorized by this section shall be a general obligation of the lessee and may contain provisions, which shall be a part of the contract with the holders of the bonds of the authority issued for such project, as to:
(i) pledging all or any part of the moneys, earnings, income and revenues derived by the lessee from such project or any part or parts thereof, or other personal property of the lessee, to secure payments required under the terms of such lease;
(ii) the rates, rentals, fees and other charges to be fixed and collected by the lessee, the amounts to be raised in each year thereby, and the use and disposition of such moneys, earning, income and revenues;
(iii) the setting aside of reserves and the creation of special funds and the regulation and disposition thereof;
(iv) the procedure, if any, by which the terms of such lease may be amended;
(v) vesting in a trustee or trustees such specified properties, rights, powers and duties as shall be deemed necessary or desirable for the security of the holders of the bonds of the authority issued for such projects;
(vi) the obligations of the lessee with respect to the replacement, reconstruction, maintenance, operation, repairs and insurance of such project;
(vii) defining the acts or omissions to act which shall constitute a default in the obligations and duties of the lessee, and providing for the rights and remedies of the authority and of its bondholders in the event of such default;
(viii) any other matters, of like or different character, which may be deemed necessary or desirable for the security or protection of the authority or the holders of its bonds.
a. To make loans to any health care organization for the construction or acquisition of projects in accordance with a loan agreement. No such loan shall exceed the total cost of such project. Each such loan shall be promised upon an agreement between the authority and the health care organization as to payment, security, maturity, redemption, interest and other appropriate matters.
b. To make loans to any health care organization to refund existing bonds, mortgages or advances given or made by the health care organization for the construction of projects to the extent that this will enable the health care organization to offer greater security for loans for new project construction.
b. Whenever the authority under section 28 of P.L.1972, c.29 (C.26:2I-28) undertakes to construct, acquire or otherwise provide a project and to lease the same to a health care organization, the lessee shall be responsible for the direct operation and maintenance costs of such project and, in addition, shall be responsible for the overall supervision of each project, for the overhead and general administrative costs of the lessee which are incurred because of such project and for the integration of each project operation into the lessee's health care program.
c. Whenever the authority under section 29 of P.L.1972, c.29 (C.26:2I-29) makes loans for the construction of a project, the health care organization at which such project is located shall be responsible for the direct operation and maintenance costs of such project and, in addition, shall be responsible for the overall supervision of each project, for the overhead and general administrative costs of the health care organization which are incurred because of such project and for the integration of each project operation into the health care organization's health care program.
b. Acquisition of health care facilities from counties or municipalities. Notwithstanding the provisions of any law to the contrary, the authority may authorize the acquisition, and any county or municipality by resolution or ordinance may authorize a private sale and conveyance or leasing to the authority, of any interest of the county or municipality in any lands and existing health care facilities which are then being operated by a health care organization upon such terms and conditions as may be agreed upon by the authority and the county and municipality. The authority may use its funds for the acquisition by providing for the retirement of obligations incurred for the acquisition of the land, and for the acquisition and construction of the existing health care facilities, provided that the amount of the purchase price shall not exceed the project costs. Upon acquisition of the lands and existing health care facilities, the authority may convey or lease the lands and existing health care facilities to a health care organization under such terms and conditions as the authority and health care organization may agree.
This act shall be liberally construed to effect the purpose thereof.
Nothing contained in this act shall be deemed or construed to create or constitute a debt, liability, or a loan or pledge of the credit, of the State.
The foregoing sections of this act shall be deemed to provide an additional and alternative method for the doing of the things authorized thereby, and shall be regarded as supplemental and additional to powers conferred by other laws, and shall not be regarded as in derogation of any powers now existing; provided, however, that the issuance of bonds or refunding bonds under the provisions of this act need not comply with the requirements of any other law applicable to the issuance of bonds.
The provisions of this act shall be severable, and if any of the provisions hereof shall be held to be unconstitutional or otherwise invalid, such decision shall not affect the validity of any of the remaining provisions of this act.
This act may be cited as the "Health Maintenance Organizations Act."
a. "Commissioner" means the State Commissioner of Health.
b. "Basic health care services" means those services, including but not limited to emergency care, inpatient hospital and physician care, and outpatient medical services, designated by regulations promulgated by the commissioner.
c. "Health care services" includes basic health care services and any additional services designated by regulations promulgated by the commissioner.
d. "Enrollee" means an individual who has been enrolled with a health maintenance organization.
e. "Evidence of coverage" means any booklet, certificate, agreement, or contract issued to an enrollee setting out the services and other benefits to which he is entitled.
f. "Health maintenance organization" means any person which directly or through contracts with providers furnishes at least basic comprehensive health care services on a prepaid basis to enrollees in a designated geographical area.
g. "Person" means any natural or artificial person including but not limited to individuals, partnerships, associations, trusts, or corporations.
h. "Provider" means any physician, hospital, or other person which is licensed or otherwise authorized in this State to furnish health care services.
i. "Health care facility" means the facility or institution whether public or private, engaged in providing services for health maintenance organizations, diagnosis or treatment of human disease, pain, injury, deformity or physical condition, including, but not limited to, a general hospital, special hospital, mental hospital, public health center, diagnostic center, treatment center, rehabilitation center, extended care facility, skilled nursing home, nursing home, intermediate care facility, tuberculosis hospital, chronic disease hospital, maternity hospital, outpatient clinic, dispensary, home health care agency, boarding home or other home for the sheltered care of adult persons and bio-analytical laboratory or central services facility serving one or more such institutions but excluding institutions that provide healing solely by prayer.
a. Notwithstanding any law of this State to the contrary, any person may apply to the commissioner for and obtain a certificate of authority to establish and operate a health maintenance organization in compliance with this act. No person shall establish or operate a health maintenance organization in this State without compliance with regulations to be promulgated by the commissioner, nor sell, offer to sell, or solicit offers to purchase or receive advance or periodic consideration in conjunction with a health maintenance organization without obtaining a certificate of authority under this act. When the establishment or operation of a health maintenance organization involves the construction of a health care facility or any change in or expansion of a health care facility or involves the institution of new health care services as defined in section 7 of the Health Care Facilities Planning Act (P.L.1971, c. 136, C. 26:2H-7), said health maintenance organization shall abide by all provisions of P.L.1971, c. 136. All health care facilities utilized by a health maintenance organization or its agents shall comply with the licensure provisions of section 12 of the Health Care Facilities Planning Act (C. 26:2H-12).
b. Every health maintenance organization as of the effective date of this act shall submit an application for a certificate of authority under subsection c. of this section within 90 days of the effective date of this act. Each such applicant may continue to operate until the commissioner acts upon the application. In the event that an application is denied under section 4, hereof, the applicant shall henceforth be treated as a health maintenance organization whose certificate of authority has been revoked.
c. Each application for a certificate of authority shall be verified by an officer or authorized representative of the applicant, shall be in a form prescribed by the commissioner, and shall set forth or be accompanied by the following:
(1) a copy of the basic organizational document of the applicant such as the articles of incorporation, articles of association, partnership agreement, trust agreement, or other applicable documents, and all amendments thereto;
(2) a copy of the bylaws, rules and regulations, or similar document regulating the conduct of the internal affairs of the applicant;
(3) a list of the names, addresses, and official positions of the persons who are to be responsible for the conduct of the affairs of the applicant;
(4) a copy of any contract made or to be made between any providers or persons listed in paragraph (3) of this subsection and the applicant;
(5) a copy of any contract made or to be made with an insurer or a hospital or medical service corporation;
(6) a statement generally describing the health maintenance organization, its facilities, and personnel;
(7) a copy of the form of evidence of coverage to be issued to the enrollees;
(8) a copy of the form of the group contract, if any, which is to be issued to employers, unions, trustees, or other organizations;
(9) recent financial statements showing the applicant's assets, liabilities, and sources of financial support;
(10) a general description of the proposed method of marketing and financing and a statement as to the sources of funding;
(11) a power of attorney duly executed by such applicant, if not domiciled in this State, appointing the commissioner and his successors in office, and duly authorized deputies, as the true and lawful attorney of such applicant in and for this State upon whom all lawful process in any legal action or proceeding against the health maintenance organization on a cause of action arising, in this State may be served;
(12) a statement reasonably describing the geographic area or areas to be served;
(13) a general description of the complaint procedures to be utilized as required under section 12, hereof;
(14) a general description of the procedures and programs to be implemented to meet the quality of health care requirements in section 4 a. (2), hereof;
(15) a general description of the mechanism by which enrollees will be afforded an opportunity to participate in matters of policy and operation under section 6 b., hereof;
(16) such other information as the commissioner may require to make the determinations required by section 4 hereof.
d. (1) a health maintenance organization shall, unless otherwise provided for in this act, file a notice describing any modification of the information required by subsection c. of this section. Such notice shall be filed with the commissioner prior to the modification. If the commissioner does not disapprove within 30 days of filing, such modification shall be deemed approved.
(2) the commissioner may promulgate rules and regulations exempting from the filing requirements of paragraph (1) of this subsection those items he deems unnecessary.
a. (1) Upon receipt of an application for issuance of a certificate of authority the commissioner shall forthwith transmit copies of such application and accompanying documents to the Commissioner of Insurance. The approval of the Commissioner of Insurance shall be required to the extent that the proposal involves the doing of an insurance business or a contract with an insurer or hospital or medical service corporation.
(2) The commissioner shall determine whether the applicant for a certificate of authority:
(a) has demonstrated the potential ability to assure that such health care services will be provided in a manner to assure both availability and accessibility of adequate personnel and facilities and in a manner enhancing availability, accessibility and continuity of service;
(b) has arrangements for an on-going quality of health care assurance program; and
(c) has a procedure to establish and maintain a uniform system of cost accounting approved by the commissioner; establish and maintain a uniform system of reports and audits meeting the requirements of the commissioner; and prepare and review annually a long range plan for the provision of health care services, which plan shall be compatible with the State Health Plan established pursuant to the "Comprehensive Health Planning and Public Health Services Amendments of 1966" (Federal Law 89-749) as related to medical health services, health care services and health manpower.
(3) Where the application has been rejected the commissioner shall specify in what respect it fails to comply and, if applicable, specifies in what respect the proposal fails to comply with the requirements of the Commissioner of Insurance.
b. Issuance of a certificate of authority shall be granted upon payment of the application fee prescribed in section 23 hereof if the commissioner and, if applicable, the Commissioner of Insurance, are satisfied that the following conditions are met:
(1) the health maintenance organization's proposed plan of operation meets the requirements of subsection a. (2) of this section;
(2) the applicant's proposal sets forth an appropriate mechanism whereby the health maintenance organization will effectively provide or arrange for the provision of health care services on a prepaid basis;
(3) the health maintenance organization is financially sound and may reasonably be expected to meet its obligations to enrollees and prospective enrollees. In making this determination, the commissioner may consider:
(a) the adequacy of working capital and funding sources;
(b) agreements if any, with an insurer, a hospital or medical service corporation, a government, or any other organization for insuring the payment of the cost of health care services or the provision for automatic applicability of an alternative coverage in the event of discontinuance of the plan;
(c) any agreement with providers for the provision of health care services;
(d) any deposit of cash or form of guaranty or security submitted in accordance with section 14 hereof to assure that the obligations will be duly performed; and
(e) The financial soundness of the health maintenance organization's arrangements for health care services and the schedule of charges used in connection therewith;
(4) the enrollees will be afforded an opportunity to participate in matters of policy and operation pursuant to section 6 hereof;
(5) nothing in the proposed method of operation, as shown by the information submitted pursuant to section 3 hereof or by independent investigation, is contrary to the public interest; and
(6) any deficiencies found by the commissioner or the Commissioner of Insurance have been corrected.
c. A certificate of authority shall be denied only after compliance with the requirements of section 22 hereof.
Notwithstanding any provision of law to the contrary, every health maintenance organization for which a certificate of authority to establish and operate a health maintenance organization in this State has been issued or continued shall provide health care services to any enrollee for the treatment of Wilm's tumor, including autologous bone marrow transplants when standard chemotherapy treatment is unsuccessful, notwithstanding that any such treatment may be deemed experimental or investigational. These health care services shall be provided to the same extent as for any other sickness.
(1) one baseline mammogram examination for women who are 40 years of age; a mammogram examination every year for women age 40 and over; and, in the case of a woman who is under 40 years of age and has a family history of breast cancer or other breast cancer risk factors, a mammogram examination at such age and intervals as deemed medically necessary by the woman's health care provider; and
(2) an ultrasound evaluation, a magnetic resonance imaging scan, a three-dimensional mammography, or other additional testing of an entire breast or breasts, after a baseline mammogram examination, if the mammogram demonstrates extremely dense breast tissue, if the mammogram is abnormal within any degree of breast density including not dense, moderately dense, heterogeneously dense, or extremely dense breast tissue, or if the patient has additional risk factors for breast cancer including but not limited to family history of breast cancer, prior personal history of breast cancer, positive genetic testing, extremely dense breast tissue based on the Breast Imaging Reporting and Data System established by the American College of Radiology, or other indications as determined by the patient's health care provider. The coverage required under this paragraph may be subject to utilization review, including periodic review, by the health maintenance organization of the medical necessity of the additional screening and diagnostic testing.
b. These health care services shall be provided to the same extent as for any other sickness under the enrollee agreement.
c. The provisions of this section shall apply to all enrollee agreements in which the health maintenance organization has reserved the right to change the schedule of charges.
(1) the American Medical Association Drug Evaluations;
(2) the American Hospital Formulary Service Drug Information;
(3) the United States Pharmacopoeia Drug Information;
or, it is recommended by a clinical study or review article in a major-peer reviewed professional journal.
b. Notwithstanding the provisions of this section, coverage shall not be required for any experimental or investigational drug or any drug which the Food and Drug Administration has determined to be contraindicated for the specific treatment for which the drug has been prescribed. Health care services provided pursuant to this section shall be determined and provided to the same extent as other services under the enrollee plan for drugs prescribed for treatments which have been approved by the Food and Drug Administration.
c. This section shall apply to health maintenance organization plans in which the right to change the enrollee charge has been reserved.
d. Any coverage of a drug required by this section shall also include medically necessary services associated with the administration of the drug.
(1) For all persons 20 years of age and older, annual tests to determine blood hemoglobin, blood pressure, blood glucose level, and blood cholesterol level or, alternatively, low-density lipoprotein (LDL) level, and blood high-density lipoprotein (HDL) level;
(2) For all persons 35 years of age or older, a glaucoma eye test every five years;
(3) For all persons 40 years of age or older, an annual stool examination for presence of blood;
(4) For all persons 45 years of age or older, a left-sided colon examination of 35 to 60 centimeters every five years;
(5) For all women 20 years of age or older, a pap smear pursuant to the provisions of section 5 of P.L.1995, c.415 (C.26:2J-4.12);
(6) For all women 40 years of age or older, a mammogram examination pursuant to the provisions of section 6 of P.L.1991, c.279 (C.26:2J-4.4);
(7) For all adults, recommended immunizations; and
(8) For all persons 20 years of age or older, an annual consultation with a health care provider to discuss lifestyle behaviors that promote health and well-being including, but not limited to, smoking control, nutrition and diet recommendations, exercise plans, lower back protection, weight control, immunization practices, breast self-examination, testicular self-examination, and seat belt usage in motor vehicles.
Notwithstanding the provisions of this subsection to the contrary, if a physician or other health care provider recommends that it would be medically appropriate for an enrollee to receive a different schedule of tests and services than that provided for under this subsection, the health maintenance organization shall provide coverage for the tests or services actually provided, within the limits of the amounts listed in subsection b. of this section.
b. A health maintenance organization shall not be required to offer services to enrollees set forth in subsection a. of this section for which the value exceeds: $125 a year for each person between the ages of 20 to 39, inclusive; $145 a year for each man age 40 and over; and $235 a year for each woman age 40 and over; except that for persons 45 years of age or older, the value of a left-sided colon examination shall not be included in the above amount; however, no health maintenance organization shall be required to provide services to enrollees for a left-sided colon examination with a value in excess of $150.
c. The Commissioner of Health, in consultation with the Department of the Treasury, shall annually adjust the threshold amounts provided by subsection b. of this section in direct proportion to the increase or decrease in the consumer price index for all urban consumers in the New York City and Philadelphia areas as reported by the United States Department of Labor. The adjustment shall become effective on July 1 of the year in which it is reported.
d. Nothing in this act shall be construed to require that a health maintenance organization take any actions which conflict with the health benefits, underwriting and rating standards established by the federal government pursuant to subchapter XI of Pub.L.93-222 (42 U.S.C. s.300e et seq.).
e. This section shall apply to all health maintenance organization contracts in which the right to change the enrollee charge has been reserved.
f. The provisions of this section shall not apply to a health benefits plan subject to the provisions of P.L.1992, c.161 (C.17B:27A-2 et seq.) or P.L.1992, c.162 (C.17B:27A-17 et seq.).
(1) Permits the enrollee, at the time of enrollment, to select benefit coverage allowing the enrollee to choose a pharmacy or pharmacist for the provision of prescription drugs or pharmacy services, provided that any pharmacist or pharmacy selected by the enrollee is registered pursuant to R.S.45:14-1 et seq.;
(2) Provides that no pharmacy or pharmacist shall be denied the right to participate as a preferred provider or as a contracting provider, under the same terms and conditions currently applicable to all other preferred or contracting providers, if the health maintenance organization provides for coverage by contracted or preferred providers for pharmaceutical services, provided the pharmacy or pharmacist is registered pursuant to R.S.45:14-1 et seq., and accepts the terms and conditions of the health maintenance organization;
(3) Provides that no copayment, fee, or other condition shall be imposed upon an enrollee selecting a participating or contracting pharmacist or pharmacy that is not also equally imposed upon all enrollees selecting a participating or contracting pharmacist or pharmacy;
(4) (a) Provides that no enrollee shall be required to obtain pharmacy services and prescription drugs from a mail service pharmacy;
(b) Provides for no differential in any copayment applicable to any prescription drug of the same strength, quantity and days' supply, whether obtained from a mail service pharmacy or a non-mail service pharmacy, provided that the non-mail service pharmacy agrees to the same terms, conditions, price and services applicable to the mail service pharmacy; and
(c) Provides that the limit on days' supply is the same whether the prescription drug is obtained from a mail service pharmacy or a non-mail service pharmacy, and that the limit shall not be less than 90 days except for any health care-related programs funded in whole or in part with State funds, including, but not limited to, the Medicaid program established pursuant to P.L.1968, c.413 (C.30:4D-1 et seq.) and the "Children's Health Care Coverage Program" established pursuant to P.L.1997, c.272 (C.30:4I-1 et seq.);
(5) Sets forth the auditing procedures to be used by the health maintenance organization and includes a provision that any audit shall take place at a time mutually agreeable to the pharmacy or pharmacist and the auditor, unless authorized by the Division of Medical Assistance and Health Services in the Department of Human Services with regard to any health care-related programs funded in whole or in part with State funds, including, but not limited to, the Medicaid program and "Children's Health Care Coverage Program". No audit by a health maintenance organization shall include a review of any document relating to any person or prescription plan other than those reimbursable by the health maintenance organization, unless authorized by the Division of Medical Assistance and Health Services in the Department of Human Services with regard to any health care-related programs funded in whole or in part with State funds, including, but not limited to, the Medicaid program and "Children's Health Care Coverage Program";
(6) Provides that the health maintenance organization, or any agent or intermediary thereof, including a third party administrator, shall not restrict or prohibit, directly or indirectly, a pharmacy from charging the enrollee for services rendered by the pharmacy that are in addition to charges for the drug, for dispensing the drug or for prescription counseling. Services rendered by the pharmacy for which additional charges are imposed shall be subject to the approval of the Board of Pharmacy. A pharmacy shall disclose to the purchaser the charges for the additional services and the purchaser's out-of-pocket cost for those services prior to dispensing the drug. A pharmacy shall not impose any additional charges for patient counseling or for other services required by the Board of Pharmacy or the Division of Medical Assistance and Health Services in the Department of Human Services or State or federal law;
(7) The provisions of P.L.1999, c.395 shall apply to all health maintenance organization contracts delivered. issued or renewed on or after the effective date of P.L.1999, c.395.
b. Nothing in this section shall be construed to operate to add any coverage for health care services, to increase the scope of any coverage for health care services, or to increase the level of any health care services provided by a health maintenance organization.
c. This section shall apply to health maintenance organization plans in which the right to change the enrollee charge has been reserved.
The offer required pursuant to this section shall apply to all contracts for health care services by health maintenance organizations under which the right to change the schedule of charges for enrollee coverage is reserved. Nothing in this section shall be construed to limit a health maintenance organization in adjusting the schedule of charges for enrollee coverage, or providing for reasonable deductibles or copayments, with respect to benefits provided pursuant to this section.
b. Notwithstanding the provisions of subsection a. of this section, an enrollee agreement that provides health care services for post-delivery care to a mother and her newly born child in the home shall not be required to provide for a minimum of 48 hours and 96 hours, respectively, of in-patient care unless such in-patient care is determined to be medically necessary by the attending physician or is requested by the mother. For the purposes of this section, attending physician shall include the attending obstetrician, pediatrician or other physician attending the mother or newly born child.
c. Every health maintenance organization shall provide notice to enrollees regarding the coverage required by this section in accordance with this subsection and regulations promulgated by the Commissioner of Health pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.). The notice shall be in writing and prominently positioned in any literature or correspondence and shall be transmitted at the earliest of: (1) the next mailing to the enrollee; (2) the yearly informational packet sent to the enrollee; or (3) January 1, 1996.
a. Screening by blood lead measurement for lead poisoning for children, including confirmatory blood lead testing as specified by the Department of Health pursuant to section 7 of P.L.1995, c.316 (C.26:2-137.1); and medical evaluation and any necessary medical follow-up and treatment for lead poisoned children.
b. All childhood immunizations as recommended by the Department of Health, which shall consider the recommendations of the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention in the federal Department of Health and Human Services and, as appropriate, the recommendations of the American Academy of Pediatrics, the American Academy of Family Physicians, the American College of Obstetricians and Gynecologists, and the American College of Physicians. A health maintenance organization shall notify its enrollees, in writing, of any change in the health care services provided with respect to childhood immunizations and any related changes in premium. The notification shall be in a form and manner to be determined by the Commissioner of Banking and Insurance.
c. Screening for newborn hearing loss by appropriate electrophysiologic screening measures and periodic monitoring of infants for delayed onset hearing loss, pursuant to P.L.2001, c.373 (C.26:2-103.1 et al.). Payment for this screening service shall be separate and distinct from payment for routine new baby care in the form of a newborn hearing screening fee as negotiated with the provider and facility.
The health care services provided pursuant to this section shall be provided to the same extent as for any other medical condition under the contract, except that a deductible shall not be applied for services provided pursuant to this section; however, with respect to a contract that qualifies as a high deductible health plan for which qualified medical expenses are paid using a health savings account established pursuant to section 223 of the federal Internal Revenue Code of 1986 (26 U.S.C. s.223), a deductible shall not be applied for any services provided pursuant to this section that represent preventive care as permitted by that federal law, and shall not be applied as provided pursuant to section 12 of P.L.2005, c.248 (C.26:2J-4.29). This section shall apply to all contracts under which the health maintenance organization has reserved the right to change the schedule of charges for enrollee coverage.
b. Each contract shall also provide health care services for diabetes self-management education to ensure that a person with diabetes is educated as to the proper self-management and treatment of their diabetic condition, including information on proper diet. Health care services provided for self-management education and education relating to diet shall be limited to visits medically necessary upon the diagnosis of diabetes; upon diagnosis by a participating physician or participating nurse practitioner/clinical nurse specialist of a significant change in the enrollee's or other covered person's symptoms or conditions which necessitate changes in that person's self-management; and upon determination of a participating physician or participating nurse practitioner/clinical nurse specialist that reeducation or refresher education is necessary. Diabetes self-management education shall be provided by a participating dietitian registered by a nationally recognized professional association of dietitians or a health care professional recognized as a Certified Diabetes Educator by the American Association of Diabetes Educators or, pursuant to section 6 of P.L.1993, c.378 (C.26:2J-4.7), a registered pharmacist in the State qualified with regard to management education for diabetes by any institution recognized by the board of pharmacy of the State of New Jersey.
c. The health care services required by this section shall be provided to the same extent as for any other sickness under the contract.
d. This section shall apply to all contracts in which the health maintenance organization has reserved the right to change the schedule of charges.
e. The provisions of this section shall not apply to a health benefits plan subject to the provisions of P.L.1992, c.161 (C.17B:27A-2 et seq.) or P.L.1992, c.162 (C.17B:27A-17 et seq.).
f. The Commissioner of Banking and Insurance may, in consultation with the Commissioner of Health, pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.), promulgate and periodically update a list of additional diabetes equipment and related supplies that are medically necessary for the treatment of diabetes and for which benefits shall be provided according to the provisions of this section.
As used in this section, and notwithstanding the provisions of this section to the contrary, "Pap smear" means an initial Pap smear and any confirmatory test when medically necessary and as ordered by the covered person's physician and includes all laboratory costs associated with the initial Pap smear and any confirmatory test.
The provisions of this section shall apply to all contracts for health care services by health maintenance organizations under which the right to change the schedule of charges for enrollee coverage is reserved.
The health care services shall be provided to the same extent as for any other medical condition under the contract.
The provisions of this section shall apply to all contracts for health care services by health maintenance organizations under which the right to change the schedule of charges for enrollee coverage is reserved.
The health care services shall be provided to the same extent as for any other medical condition under the contract for health care services.
The provisions of this section shall apply to all contracts for health care services by health maintenance organizations under which the right to change the schedule of charges for enrollee coverage is reserved.
The provisions of this section shall not be construed to: require a patient to receive inpatient care for 72 or 48 hours, as appropriate, if the patient in consultation with the patient's physician determines that a shorter length of stay is medically appropriate; or relieve a patient or a patient's physician, if appropriate, of any notification requirements to the health maintenance organization under the enrollee agreement.
The health care services shall be provided to the same extent as for any other sickness under the enrollee agreement.
The provisions of this section shall apply to enrollee agreements in which the health maintenance organization has reserved the right to change the schedule of charges.
b. The Commissioner of Banking and Insurance shall adopt regulations pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.) to implement the provisions of this section.
For the purposes of this section, "inherited metabolic disease" means a disease caused by an inherited abnormality of body chemistry for which testing is mandated pursuant to P.L.1977, c.321 (C.26:2-110 et seq.); "low protein modified food product" means a food product that is specially formulated to have less than one gram of protein per serving and is intended to be used under the direction of a physician for the dietary treatment of an inherited metabolic disease, but does not include a natural food that is naturally low in protein; and "medical food" means a food that is intended for the dietary treatment of a disease or condition for which nutritional requirements are established by medical evaluation and is formulated to be consumed or administered enterally under direction of a physician.
The health care services shall be provided to the same extent as for any other medical condition under the contract.
The provisions of this section shall apply to all contracts for health care services by health maintenance organizations under which the right to change the schedule of charges for enrollee coverage is reserved.
b. A health maintenance organization may require prior authorization of hospitalization for dental services in the same manner that prior authorization is required for hospitalization for other covered diseases or conditions.
c. This section shall apply to all contracts for health care services in which the health maintenance organization has reserved the right to change the schedule of charges.
Coverage provided pursuant to this section shall include benefits delivered through the psychiatric Collaborative Care Model.
(2) As used in this section:
"Mental health condition" means a condition defined to be consistent with generally recognized independent standards of current medical practice referenced in the current version of the Diagnostic and Statistical Manual of Mental Disorders.
"Psychiatric Collaborative Care Model" means the evidence-based, integrated behavioral health service delivery method wherein a primary care provider and a care manager collaborate with a psychiatric consultant to provide care to a patient. "Psychiatric Collaborative Care Model" shall include those benefits that are billed using the following list of Current Procedural Terminology (CPT) codes, which list shall be updated by the Commissioner of Banking and Insurance whenever the codes are altered or supplemented:
(a) 99492 - Initial psychiatric collaborative care management;
(b) 99493 - Subsequent psychiatric collaborative care management; and
(c) 99494 - Initial or subsequent psychiatric collaborative care management, additional time.
"Same terms and conditions" means that the health maintenance organization cannot apply more restrictive non-quantitative limitations, such as utilization review and other criteria or more quantitative limitations such as copayments, deductibles, aggregate or annual limits or health care services limits to mental health condition and substance use disorder services than those applied to substantially all other medical or surgical health care services.
"Substance use disorder" means a disorder defined to be consistent with generally recognized independent standards of current medical practice referenced in the most current version of the Diagnostic and Statistical Manual of Mental Disorders.
b. (Deleted by amendment, P.L.2019, c.58)
c. The provisions of this section shall apply to enrollee agreements in which the health maintenance organization has reserved the right to change the premium.
d. Nothing in this section shall reduce the requirement for a health maintenance organization to provide benefits pursuant to section 8 of P.L.2017, c.28 (C.26:2J-4.39).
b. If an enrollee is a resident of a skilled nursing facility, continuing care retirement community, or a retirement community which operates a skilled nursing facility on the premises of the community, regardless of whether the health maintenance organization is under contract with the skilled nursing facility or the skilled nursing facility at the continuing care retirement community or retirement community, the enrollee's primary care physician shall refer the enrollee to the skilled nursing facility or the community's Medicare-certified skilled nursing unit, as applicable, rather than to a skilled nursing facility separate from the facility or the community of origin, if:
(1) the skilled nursing facility or the continuing care retirement community or retirement community with a skilled nursing facility has the capacity to provide the services the enrollee needs;
(2) the primary care physician, in consultation with the enrollee or a representative of the enrollee's family, determines that the referral is in the best interest of the enrollee;
(3) the skilled nursing facility or the continuing care retirement community or retirement community with a skilled nursing facility agrees to be reimbursed at the same contract rate negotiated by the health maintenance organization with similar providers for the same services and supplies in the same geographic area; and
(4) the skilled nursing facility or the continuing care retirement community or retirement community with a skilled nursing facility meets all applicable State licensing and certification requirements.
c. For the purposes of this act, "continuing care retirement community" means a continuing care facility operating under a certificate of authority issued by the Department of Community Affairs pursuant to P.L.1986, c.103 (C.52:27D-330 et seq.), and "retirement community" means a retirement community which is registered with the Department of Community Affairs pursuant to P.L.1977, c.419 (C.45:22A-21 et seq.).
As used in this section:
"Infertility" means a disease, condition, or status characterized by any of the following:
(1) the inability to achieve a successful pregnancy based on a patient's medical, sexual, and reproductive history, age, physical findings, diagnostic testing, or any combination of those factors;
(2) the need for medical intervention, including, but not limited to, the use of donor gametes or donor embryos in order to achieve a successful pregnancy either as an individual or with a partner; or
(3) in patients having regular, unprotected intercourse and without any known etiology for either partner suggestive of impaired reproductive ability, evaluation should be initiated at 12 months when the female partner is under 35 years of age and at 6 months when the female partner is 35 years of age or older.
Nothing in this definition shall be used to deny or delay treatment to any individual, regardless of relationship status or sexual orientation.
"Treatment of infertility" means the recommended treatment plan or prescribed procedures, services, and medications directed by a licensed physician for infertility as defined in this section.
The benefits shall be provided to the same extent as for other medical conditions under the contract, except that the services provided for in this section shall be performed at facilities that conform to standards established by the American Society for Reproductive Medicine or the American College of Obstetricians and Gynecologists. The same copayments, deductibles and benefit limits shall apply to the diagnosis and treatment of infertility pursuant to this section as those applied to other medical or surgical benefits under the contract. Infertility resulting from a voluntary unreversed sterilization procedure may be excluded if the voluntary unreversed sterilization is the sole cause of infertility, provided, however, that coverage for infertility services shall not be excluded if the voluntary sterilization is successfully reversed.
b. A religious employer may request, and a health maintenance organization shall grant, an exclusion under the contract for the coverage required by this section for in vitro fertilization, embryo transfer, artificial insemination, zygote intra fallopian transfer, and intracytoplasmic sperm injection if the required coverage is contrary to the religious employer's bona fide religious tenets. The hospital service corporation that issues a contract containing such an exclusion shall provide written notice thereof to each prospective subscriber or subscriber, which shall appear in not less than 10 point type, in the contract, application and sales brochure. For the purposes of this subsection, "religious employer" means an employer that is a church, convention or association of churches, or any group or entity that is operated, supervised, or controlled by or in connection with a church or a convention or association of churches as defined in 26 U.S.C. s.3121(w)(3)(A), and that qualifies as a tax-exempt organization under 26 U.S.C. s.501(c)(3).
c. The provisions of this section shall apply to those contracts for health care services by health maintenance organizations under which the right to change the schedule of charges for enrollee coverage is reserved.
d. The provisions of this section shall not apply to a contract for health care services by a health maintenance organization which, pursuant to a contract between the health maintenance organization and the Department of Human Services, provides benefits to persons who are eligible for medical assistance under P.L.1968, c.413 (C.30:4D-1 et seq.), the NJ FamilyCare Program established pursuant to P.L.2005, c.156 (C.30:4J-8 et al.), or any other program administered by the Division of Medical Assistance and Health Services in the Department of Human Services.
e. Nothing in this section shall preclude the health maintenance organization from performing utilization review, including periodic review of the medical necessity of a particular service, provided all utilization review decisions are consistent with American Society for Reproductive Medicine guidelines.
b. No deductible, coinsurance, copayment, or any other cost-sharing requirement shall be imposed for a colonoscopy performed following a positive result on a non-colonoscopy, colorectal cancer screening test recommended by the United States Preventive Services Task Force.
c. The health care services shall be provided to the same extent as for any other medical condition under the enrollee agreement.
d. The provisions of this section shall apply to all enrollee agreements in which the health maintenance organization has reserved the right to change the schedule of charges.
The health care services shall be provided to the same extent as for any other prescribed items under the contract.
The provisions of this section shall apply to those contracts for health care services by health maintenance organizations under which the health maintenance organization has reserved the right to change the schedule of charges for enrollee coverage.
The provisions of this section shall apply to contracts in which the health maintenance organization has reserved the right to change the schedule of charges.
The services provided pursuant to this section shall be provided to the same extent as for any other medical condition under the contract, except that a deductible shall not be applied for services provided pursuant to this section. This section shall apply to all contracts under which the health maintenance organization has reserved the right to change the schedule of charges for enrollee coverage.
This section shall apply to all contracts under which the health maintenance organization has reserved the right to change the schedule of charges for enrollee coverage.
(1) Any contraceptive drug, device or product approved by the United States Food and Drug Administration, which coverage shall be subject to all of the following conditions:
(a) If there is a therapeutic equivalent of a contraceptive drug, device or product approved by the United States Food and Drug Administration, coverage shall be provided for either the requested contraceptive drug, device or product or for one or more therapeutic equivalents of the requested drug, device or product.
(b) Coverage shall be provided without a prescription for all contraceptive drugs available for over-the-counter sale that are approved by the United States Food and Drug Administration.
(c) Coverage shall be provided without any infringement upon a subscriber's choice of contraception and medical necessity shall be determined by the provider for covered contraceptive drugs, devices or other products approved by the United States Food and Drug Administration.
(2) Voluntary male and female sterilization.
(3) Patient education and counseling on contraception.
(4) Services related to the administration and monitoring of drugs, devices, products and services required under this section, including but not limited to:
(a) Management of side effects;
(b) Counseling for continued adherence to a prescribed regimen;
(c) Device insertion and removal;
(d) Provision of alternative contraceptive drugs, devices or products deemed medically appropriate in the judgment of the subscriber's health care provider; and
(e) Diagnosis and treatment services provided pursuant to, or as a follow-up to, a service required under this section.
b. The coverage provided shall include prescriptions for dispensing contraceptives for:
(1) (Deleted by amendment, P.L.2021, c.376)
(2) up to a 12-month period at one time.
c. (1) Except as provided in paragraph (2) of this subsection, the health care services shall be provided to the same extent as for any other service, drug, device, product, or procedure under the contract, except no deductible, coinsurance, copayment, or any other cost-sharing requirement on the coverage shall be imposed.
(2) In the case of a high-deductible health plan, benefits for male sterilization or male contraceptives shall be provided at the lowest deductible and other cost-sharing permitted for a high-deductible health plan under section 223(c)(2)(A) of the Internal Revenue Code (26 U.S.C. s.223).
d. The provisions of this section shall apply to those contracts for health care services by health maintenance organizations under which the right to change the schedule of charges for enrollee coverage is reserved.
e. Nothing in this section shall limit coverage of any additional preventive service for women, as identified or recommended by the United States Preventive Services Task Force or the Health Resources and Services Administration of the United States Department of Health and Human Services pursuant to the provisions of 42 U.S.C. 300gg-13.
(1) an orthotic or prosthetic appliance from any licensed orthotist or prosthetist, licensed podiatrist, or any certified pedorthist, as determined medically necessary by the covered person's physician; and
(2) an additional orthotic or prosthetic appliance from any licensed orthotist or prosthetist, licensed podiatrist, or any certified pedorthist, if the covered person's physician determines that the additional appliance is necessary to enable the covered person to engage in physical and recreational activities, including running, bicycling, swimming, climbing, skiing, snowboarding, and team and individual sports.
As used in this section, "orthotic appliance," "prosthetic appliance," "licensed orthotist" and "licensed prosthetist" have the meaning assigned to them in section 3 of P.L.1991, c.512 (C.45:12B-3), "licensed podiatrist" has the meaning assigned to it in R.S.45:5-1 et seq., and "certified pedorthist" has the meaning assigned to it in subsection j. of section 18 of P.L.1991, c.512 (C.45:12B-18).
b. On and after the effective date of P.L.2007, c.345 (C.17:48-6ff et al.), a health maintenance organization shall reimburse for orthotic and prosthetic appliances at the same rate as reimbursement for such appliances under the federal Medicare reimbursement schedule.
c. The benefits shall be provided to the same extent as for any other medical condition under the enrollee agreement.
d. The provisions of this section shall apply to all enrollee agreements in which the health maintenance organization has reserved the right to change the schedule of charges.
b. The health care services shall include the purchase of a hearing aid for each ear, when medically necessary and as prescribed or recommended by a licensed physician or audiologist. A health maintenance organization may limit the health care services provided in this section to one hearing aid for each hearing-impaired ear every 24 months.
c. A health maintenance organization contract shall provide coverage of the cost of treatment related to cochlear implants, including procedures for the implantation of cochlear devices and costs for any parts, attachments, or accessories of the device, including replacement of obsolete external cochlear implant processors.
d. The health care services shall be provided to the same extent as for any other condition under the contract.
e. This section shall apply to those contracts for health care services under which the right to change the schedule of charges for enrollee coverage is reserved.
b. For the purposes of this section, "obstetrical provider licensed in New Jersey" means:
(1) an obstetrician/gynecologist licensed by the State Board of Medical Examiners; or
(2) a midwife licensed by the State Board of Medical Examiners as a certified midwife or a certified nurse midwife.
c. This section shall apply to all enrollee agreements in which the health maintenance organization has reserved the right to change the schedule of charges.
a. The health maintenance organization shall provide coverage for health care services for screening and diagnosing autism or another developmental disability.
b. When the enrollee's primary diagnosis is autism or another developmental disability, the health maintenance organization shall provide coverage for medically necessary occupational therapy, physical therapy, and speech therapy services, as prescribed through a treatment plan. Coverage of these therapies shall not be denied on the basis that the treatment is not restorative.
c. When the enrollee is under 21 years of age and the enrollee's primary diagnosis is autism, the health maintenance organization shall provide coverage for medically necessary behavioral interventions based on the principles of applied behavioral analysis and related structured behavioral programs, as prescribed through a treatment plan, subject to the provisions of this subsection.
(1) Except as provided in paragraph (3) of this subsection, the coverage provided pursuant to this subsection shall be provided to the same extent as for any other medical condition under the contract, but shall not be subject to limits on the number of visits that an enrollee may make to a provider of behavioral interventions.
(2) The coverage provided pursuant to this subsection shall not be denied on the basis that the treatment is not restorative.
(3) (a) The maximum coverage amount for an enrollee in any calendar year through 2011 shall be $36,000.
(b) Commencing on January 1, 2012, the maximum coverage amount shall be subject to an adjustment, to be promulgated by the Commissioner of Banking and Insurance and published in the New Jersey Register no later than February 1 of each calendar year, which shall be equal to the change in the consumer price index for all urban consumers for the nation, as prepared by the United States Department of Labor, for the calendar year preceding the calendar year in which the adjustment to the maximum benefit amount is promulgated.
(c) The adjusted maximum coverage amount shall apply to a contract that is delivered, issued, executed, or renewed, or approved for issuance or renewal, in the 12-month period following the date on which the adjustment is promulgated.
(d) Notwithstanding the provisions of this paragraph to the contrary, a health maintenance organization shall not be precluded from providing a coverage amount for an enrollee in any calendar year that exceeds the coverage amounts set forth in subparagraphs (a) and (b) of this paragraph.
d. The treatment plan required pursuant to subsections b. and c. of this section shall include all elements necessary for the health maintenance organization to appropriately provide coverage for health care services, including, but not limited to: a diagnosis; proposed treatment by type, frequency, and duration; the anticipated outcomes stated as goals; the frequency by which the treatment plan will be updated; and the treating physician's signature. The health maintenance organization may only request an updated treatment plan once every six months from the treating physician to review medical necessity, unless the health maintenance organization and the treating physician agree that a more frequent review is necessary due to emerging clinical circumstances.
e. The provisions of subsections b. and c. of this section shall not be construed as limiting coverage for health care services otherwise available to an enrollee.
f. The provisions of subsections b. and c. of this section shall not be construed to require that benefits be provided to reimburse the cost of services provided under an individualized family service plan or an individualized education program, or affect any requirement to provide those services; except that the benefits provided pursuant to those subsections shall include coverage for expenses incurred by participants in an individualized family service plan through a family cost share.
g. The coverage required under this section may be subject to utilization review, including periodic review, by the health maintenance organization of the continued medical necessity of the specified therapies and interventions.
h. The provisions of this section shall apply to those enrollee agreements in which the health maintenance organization has reserved the right to change the premium.
b. Pursuant to subsection a. of this section, coverage for expenses for prescribed, orally administered anticancer medications used to kill or slow the growth of cancerous cells shall not be subject to any prior authorization, dollar limit, copayment, deductible or coinsurance provision that does not apply to intravenously administered or injected anticancer medications.
c. A health maintenance organization contract shall not achieve compliance with the provisions of this section by imposing an increase in patient cost sharing, including any copayment, deductible or coinsurance, for anticancer medications, whether intravenously administered or injected or orally administered, that are covered under the contract as of the effective date of this act.
d. This section shall apply to those contracts for health care services under which the right to change the schedule of charges for enrollee coverage is reserved.
The health care services shall be provided to the same extent as for any other medical condition under the contract.
The provisions of this section shall apply to those contracts for health care services by health maintenance organizations under which the right to change the schedule of charges for enrollee coverage is reserved.
(1) the prescribing health care practitioner indicates on the original prescription that additional quantities of the prescription eye drops are needed; and
(2) the refill requested by the enrollee or covered person does not exceed the number of additional quantities indicated on the original prescription by the prescribing health care practitioner.
b. The provisions of this section shall apply to those contracts for health care services by health maintenance organizations under which the health maintenance organization has reserved the right to change the schedule of charges.
(1) apply a prorated daily cost-sharing rate to prescriptions that are dispensed by a network pharmacy for less than a 30 days' supply if the prescriber or pharmacist indicates the fill or refill is in the best interest of the covered person or is for the purpose of synchronizing the covered person's chronic medications;
(2) provide coverage for a drug prescribed for the treatment of a chronic illness dispensed in accordance with a plan among the covered person, the prescriber and the pharmacist to synchronize the refilling of multiple prescriptions for the covered person; and
(3) determine dispensing fees based exclusively on the total number of prescriptions dispensed; dispensing fees shall not be prorated or based on the number of the days' supply of medication prescribed or dispensed.
b. This section shall apply to all enrollee agreements in which the health maintenance organization has reserved the right to change the schedule of charges.
c. This section shall not apply to prescriptions for opioid analgesics. "Opioid analgesic" means a drug in the opioid analgesic drug class prescribed to treat moderate to severe pain or other conditions, whether in immediate release or extended release form, and whether or not combined with other drug substances to form a single drug product or dosage form.
b. The benefits for the first 180 days per plan year of inpatient and outpatient treatment of substance use disorder shall be provided when determined medically necessary by the covered person's physician, psychologist or psychiatrist without the imposition of any prior authorization or other prospective utilization management requirements. The facility shall notify the health maintenance organization of both the admission and the initial treatment plan within 48 hours of the admission or initiation of treatment. If there is no in-network facility immediately available for a covered person, a health maintenance organization shall provide necessary exceptions to their network to ensure admission in a treatment facility within 24 hours.
c. Providers of treatment for substance use disorder to persons covered under a covered contract shall not require pre-payment of medical expenses during this 180 days in excess of applicable co-payment, deductible, or co-insurance under the policy.
d. The benefits for outpatient visits shall not be subject to concurrent or retrospective review of medical necessity or any other utilization management review.
e. (1) The benefits for the first 28 days of an inpatient stay during each plan year shall be provided without any retrospective review or concurrent review of medical necessity and medical necessity shall be as determined by the covered person's physician.
(2) The benefits for days 29 and thereafter of inpatient care shall be subject to concurrent review as defined in this section. A request for approval of inpatient care beyond the first 28 days shall be submitted for concurrent review before the expiration of the initial 28-day period. A request for approval of inpatient care beyond any period that is approved under concurrent review shall be submitted within the period that was previously approved. No health maintenance organization shall initiate concurrent review more frequently than at two-week intervals. If a health maintenance organization determines that continued inpatient care in a facility is no longer medically necessary, the health maintenance organization shall within 24 hours provide written notice to the covered person and the covered person's physician of its decision and the right to file an expedited internal appeal of the determination pursuant to an expedited process pursuant to sections 11 through 13 of P.L.1997, c.192 (C.26:2S-11 through 26:2S-13) and N.J.A.C.11:24A-3.5, as applicable. The health maintenance organization shall review and make a determination with respect to the internal appeal within 24 hours and communicate such determination to the covered person and the covered person's physician. If the determination is to uphold the denial, the covered person and the covered person's physician have the right to file an expedited external appeal with the Independent Health Care Appeals Program in the Department of Banking and Insurance pursuant to sections 11 through 13 of P.L.1997, c.192 (C.26:2S-11 through 26:2S-13) and N.J.A.C.11:24A-3.6, as applicable. An independent utilization review organization shall make a determination within 24 hours. If the health maintenance organization's determination is upheld and it is determined continued inpatient care is not medically necessary, the carrier shall remain responsible to provide benefits for the inpatient care through the day following the date the determination is made and the covered person shall only be responsible for any applicable co-payment, deductible and co-insurance for the stay through that date as applicable under the policy. The covered person shall not be discharged or released from the inpatient facility until all internal appeals and independent utilization review organization appeals are exhausted. For any costs incurred after the day following the date of determination until the day of discharge, the covered person shall only be responsible for any applicable cost-sharing, and any additional charges shall be paid by the facility or provider.
f. (1) The benefits for the first 28 days of intensive outpatient or partial hospitalization services shall be provided without any retrospective review of medical necessity and medical necessity shall be as determined by the covered person's physician.
(2) The benefits for days 29 and thereafter of intensive outpatient or partial hospitalization services shall be subject to a retrospective review of the medical necessity of the services.
g. Benefits for inpatient and outpatient treatment of substance use disorder after the first 180 days per plan year shall be subject to the medical necessity determination of the health maintenance organization and may be subject to prior authorization or, retrospective review and other utilization management requirements.
h. Medical necessity review shall utilize an evidence-based and peer reviewed clinical review tool to be designated through rulemaking by the Commissioner of Human Services in consultation with the Department of Health.
i. The benefits for outpatient prescription drugs to treat substance use disorder shall be provided when determined medically necessary by the covered person's physician, psychologist or psychiatrist without the imposition of any prior authorization or other prospective utilization management requirements.
j. The first 180 days per plan year of benefits shall be computed based on inpatient days. One or more unused inpatient days may be exchanged for two outpatient visits. All extended outpatient services such as partial hospitalization and intensive outpatient, shall be deemed inpatient days for the purpose of the visit to day exchange provided in this subsection.
k. Except as stated above, the benefits and cost-sharing shall be provided to the same extent as for any other medical condition covered under the contract.
l. The benefits required by this section are to be provided to all covered persons with a diagnosis of substance use disorder. The presence of additional related or unrelated diagnoses shall not be a basis to reduce or deny the benefits required by this section.
m. The provisions of this section shall apply to those contracts in which the health maintenance organization has reserved the right to change the premium.
n. The Attorney General's Office shall be responsible for overseeing any violations of law that may result from P.L.2017, c.28 (C.17:48-6nn et al.), including fraud, abuse, waste, and mistreatment of covered persons. The Attorney General's Office is authorized to adopt, pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.), rules and regulations to implement any of the provisions of P.L.2017, c.28 (C.17:48-6nn et al.).
o. The provisions of this section shall not apply to a health maintenance organization contract which, pursuant to a contract between the health maintenance organization and the Department of Human Services, provides benefits to persons who are eligible for medical assistance under P.L.1968, c.413 (C.30:4D-1 et seq.), the "Family Health Care Coverage Act," P.L.2005, c.156 (C.30:4J-8 et seq.), or any other program administered by the Division of Medical Assistance and Health Services in the Department of Human Services.
p. As used in this section:
"Concurrent review" means inpatient care is reviewed as it is provided. Medically qualified reviewers monitor appropriateness of the care, the setting, and patient progress, and as appropriate, the discharge plans.
"Substance use disorder" is as defined by the American Psychiatric Association in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition and any subsequent editions and shall include substance use withdrawal.
b. The discrimination prohibited by this section shall include:
(1) denying, cancelling, limiting or refusing to issue or renew a contract on the basis of a covered person's or prospective covered person's gender identity or expression, or for the reason that the covered person or prospective covered person is a transgender person;
(2) demanding or requiring a payment or premium that is based in whole or in part on a covered person's or prospective covered person's gender identity or expression, or for the reason that the covered person or prospective covered person is a transgender person;
(3) designating a covered person's or prospective covered person's gender identity or expression, or the fact that a covered person or prospective covered person is a transgender person, as a preexisting condition for which coverage will be denied or limited; or
(4) denying or limiting coverage, or denying a claim, for services including but not limited to the following, due to a covered person's gender identity or expression or for the reason that the covered person is a transgender person:
(a) health care services related to gender transition if coverage is available for those services under the contract when the services are not related to gender transition, including but not limited to hormone therapy, hysterectomy, mastectomy, and vocal training; or
(b) health care services that are ordinarily or exclusively available to individuals of one sex when the denial or limitation is due only to the fact that the covered person is enrolled as belonging to the other sex or has undergone, or is in the process of undergoing, gender transition.
c. For the purposes of this section:
"Gender expression" means a person's gender-related appearance and behavior, whether or not stereotypically associated with the person's assigned sex at birth.
"Gender identity" means a person's internal sense of their own gender, regardless of the sex the person was assigned at birth.
"Gender transition" means the process of changing a person's outward appearance, including physical sex characteristics, to accord with the person's actual gender identity.
"Transgender person" means a person who identifies as a gender different from the sex assigned to the person at birth.
d. The provisions of this section shall apply to those contracts for health care services under which the health maintenance organization has reserved the right to change the schedule of charges for enrollee coverage.
e. Nothing in this section shall preclude the health maintenance organization from performing utilization review, including periodic review of the medical necessity of a particular service.
b. In the case of digital tomosynthesis conducted to detect or screen for breast cancer in women 40 years of age and over, no deductible, coinsurance or other cost sharing shall be applied; and in the case of digital tomosynthesis conducted for diagnostic purposes in women of any age, the same deductibles, coinsurance, and other cost sharing as apply to similar services under the contract shall be applied.
c. This section shall apply to those contracts for health care services under which the health maintenance organization has reserved the right to change the schedule of charges for enrollee coverage.
(1) the covered person is an infant under the age of six months;
(2) the milk is obtained from a human milk bank that meets quality guidelines established by the Department of Health; and
(3) a licensed medical practitioner has issued an order for an infant who is medically or physically unable to receive maternal breast milk or participate in breast feeding or whose mother is medically or physically unable to produce maternal breast milk in sufficient quantities or participate in breast feeding despite optimal lactation support; or
(4) a licensed medical practitioner has issued an order for an infant who meets any of the following conditions:
(a) a body weight below healthy levels determined by the licensed medical practitioner;
(b) a congenital or acquired condition that places the infant at a high risk for development of necrotizing enterocolitis; or
(c) a congenital or acquired condition that may benefit from the use of donor breast milk as determined by the Department of Health.
b. The provisions of this section shall apply to those contracts for health care services by health maintenance organizations under which the health maintenance organization has reserved the right to change the schedule of charges.
c. Nothing in this section shall preclude the health maintenance organization from performing utilization review, including periodic review of the medical necessity of a particular service.
d. The benefits shall be provided to the same extent as for any other prescribed items under the contract.
e. If there is no supply of human breast milk that meets the requirements of paragraph (2) of subsection a. of this section, the health maintenance organization shall not be required to provide coverage of expenses pursuant to this section.
For the purposes of this section:
"Iatrogenic infertility" means an impairment of fertility caused by surgery, radiation, chemotherapy, or other medical treatment affecting reproductive organs or processes.
"May directly or indirectly cause" means a medical treatment with a likely side effect of iatrogenic infertility as established by the American Society for Reproductive Medicine, the American Society of Clinical Oncology, or as defined by the New Jersey Department of Health.
"Standard fertility preservation services" means procedures consistent with established medical practices and professional guidelines published by the American Society for Reproductive Medicine, the American Society of Clinical Oncology, or as defined by the New Jersey Department of Health. "Standard fertility preservation services" shall not include the storage of sperm or oocytes.
The benefits shall be provided to the same extent as for any other medical condition under the contract. The same copayments, deductibles, and benefit limits shall apply to the provision of standard fertility preservation services pursuant to this section as those applied to other medical or surgical benefits under the contract.
b. A health maintenance organization providing coverage under this section shall not determine the provision of standard fertility preservation services based on an enrollee's expected length of life, present or predicted disability, degree of medical dependency, perceived quality of life, or other health conditions, or based on personal characteristics, including age, sex, sexual orientation, marital status, or gender identity.
c. This section shall apply to those health maintenance organization contracts in which the health maintenance organization has reserved the right to change the premium.
b. Coverage of breastfeeding equipment shall include:
(1) Purchase of a single-user breast pump, subject to the following conditions:
(a) A contract shall cover the purchase of a double electric breast pump. If an enrollee requests a manual pump in lieu of the double electric breast pump, the contract shall cover the purchase of a manual pump.
(b) A double electric breast pump provided pursuant to this paragraph shall be of sufficient power and durability to establish and maintain milk supply for the duration of breastfeeding.
(c) A contract shall not require documentation of medical necessity, prior authorization, or a prescription for a breast pump provided pursuant to this paragraph.
(d) Coverage shall be available at any time during pregnancy and the postpartum period, and shall continue for the duration of breastfeeding as defined by the contract enrollee.
(e) Coverage for breast pumps shall include repair or replacement if necessary.
(2) Rental or purchase of a multi-user breast pump, on the recommendation of a licensed health care provider, subject to the following conditions:
(a) When recommended by a licensed health care provider, a contract shall provide coverage for a multi-user breast pump.
(b) A health maintenance organization may determine whether a rental or purchase is covered.
(c) Coverage for a multi-user breast pump shall be covered without regard to coverage or acquisition of a single-user breast pump.
(d) A health maintenance organization may require a letter of medical necessity from a lactation consultant or other health care provider for coverage of a multi-user pump. The letter shall not interfere with the timely acquisition of a multi-user pump.
(3) Coverage of breastfeeding equipment pursuant to this section shall include two breast pump kits per birth event, as well as appropriate size breast pump flanges, or other lactation accessories recommended by a health care provider.
(4) Breastfeeding equipment specified in paragraphs (1) and (3) of this subsection shall be furnished: within 48 hours of notification of need, if requested after the birth of the child; or by the later of two weeks before the enrollee's expected due date or 72 hours after notification, if requested prior to the birth of the child. If the health maintenance organization cannot ensure an enrollee receives breastfeeding equipment within 48 hours, an enrollee may purchase the equipment and the contract shall reimburse all out-of-pocket expenses incurred by the enrollee, including any balance billing amounts.
(5) Breastfeeding equipment specified in paragraph (2) of this subsection shall be made available within 12 hours of notification of need. If equipment is not available within 12 hours of notification of need, the health maintenance organization shall reimburse all out-of-pocket rental expenses incurred by an enrollee, including any balance billing amounts, until the enrollee receives breastfeeding equipment.
c. Coverage of comprehensive lactation counseling and lactation consultation shall include:
(1) In-person, one-on-one lactation counseling and lactation consultation, subject to the following conditions:
(a) Coverage shall include visits that occur inside and outside a hospital or office setting. In-person lactation counseling and lactation consultation shall be covered regardless of location of service provision and shall include home visits.
(b) Lactation counseling and lactation consultation shall be made available within 24 hours of notification of need.
(2) Telephonic lactation assistance shall be covered in addition to, and not as a substitute for, in-person, one-on-one lactation counseling or lactation consultation, when an enrollee requests one-on-one, in-person lactation counseling or lactation consultation. The telephonic lactation assistance shall be provided within 12 hours of notification of need.
(3) Group lactation counseling shall be covered in addition to, and not as a substitute for, one-on-one, in-person lactation counseling or lactation consultation, if an enrollee requests one-on-one, in-person lactation counseling or lactation consultation. Group counseling shall include educational classes and support groups.
(4) A contract shall not require prior authorization, prescription or referral for any lactation counseling or lactation consultation, regardless of provider type or setting.
(5) A health maintenance organization shall not impose medical management techniques not described in this section.
d. Except as otherwise authorized pursuant to this section, a health maintenance organization shall not impose restrictions on the coverage provided pursuant to this section, including, but not limited to, limitations on reimbursement to allowable amounts or reasonable and customary charges, documentation requests, or delays on the coverage provided.
e. As used in this section:
"Cost-sharing" means deductible, co-insurance or co-payments, or similar charges.
"Breast pump kit" means a collection of tubing, valves, flanges, collection bottles, or other parts required to extract human milk using a breast pump.
"Lactation consultant" means an individual who is an International Board Certified Lactation Consultant.
"Lactation consultation" means the clinical application by a lactation consultant or other licensed health care provider of scientific principles and a multidisciplinary body of evidence for evaluation, problem identification, treatment, education, and consultation to child-bearing families utilizing lactation care and services.
Lactation care and services shall include, but not be limited to:
(1) lactation assessment through the systematic collection of subjective and objective data;
(2) analysis of data and creation of a plan of care;
(3) implementation of a lactation care plan with demonstration and instruction to parents and communication to the primary health care provider;
(4) evaluation of outcomes;
(5) provision of lactation education to parents and health care providers; and
(6) the recommendation and use of assistive devices.
"Lactation counseling" means breastfeeding education and support services provided by a lactation counselor, such as:
(1) educating women, families, health care professionals, and the community about the impact of breastfeeding and human lactation on health and what to expect in the normal course of breastfeeding;
(2) acting as an advocate for breastfeeding as the norm for feeding infants and young children;
(3) providing breastfeeding support, encouragement, and care from preconception to weaning in order to help women and their families meet their breastfeeding goals;
(4) using principles of adult education when teaching clients, health care providers, and others in the community; and
(5) identifying and referring high-risk mothers and babies and those requiring clinical treatment appropriately.
"Lactation counselor" means an individual, other than an International Board Certified Lactation Consultant or a licensed health care provider, who is:
(1) licensed or certified to practice lactation counseling under any law, or who is an accredited member belonging to another profession or occupation, who provides breastfeeding education and support services for which that person is licensed, regulated, accredited, or certified; or
(2) a community-based lactation supporter who has received at least 40 hours of specialty education in breastfeeding and lactation, and who works within a lactation counselor's scope of practice.
"Telephonic lactation assistance" means lactation counseling or consultation with a lactation counselor or lactation consultant conducted remotely through live voice communication.
f. The provisions of this section shall apply to those contracts for health care services by health maintenance organizations under which the right to change the schedule of charges for enrollee coverage is reserved.
(1) evidence-based items or services that have in effect a rating of "A" or "B" in the current recommendations of the United States Preventive Services Task Force;
(2) immunizations that have in effect a recommendation from the Department of Health, which shall in making its recommendations consider the recommendations of the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention in the federal Department of Health and Human Services and, as appropriate, the recommendations of the American Academy of Pediatrics, the American Academy of Family Physicians, the American College of Obstetricians and Gynecologists, and the American College of Physicians;
(3) with respect to infants, children, and adolescents, evidence-informed preventive care and screenings provided for in the comprehensive guidelines supported by the Health Resources and Services Administration; and
(4) with respect to women, any additional preventive care and screenings not described in paragraph (1) as provided for in the comprehensive guidelines supported by the Health Resources and Services Administration.
b. (1) Except as provided in paragraph (2) of this subsection, nothing in this section shall:
(a) require a contract which has a network of providers to provide benefits for items or services described in subsection a. of this section that are delivered by an out-of-network provider; or
(b) preclude a contract which has a network of providers from imposing cost-sharing requirements for items or services described in subsection a. of this section that are delivered by an out-of-network provider.
(2) If a contract does not have in its network a provider who can provide an item or service described in subsection a. of this section, the contract shall cover the item or service when performed by an out-of-network provider and shall not impose cost sharing with respect to that item or service.
c. (1) A contract shall provide coverage for an item or service described in subsection a. of this section for plan years that begin on or after the date that is one year after the date the recommendation or guideline is issued.
(2) (a) Except as provided in subparagraph (b) of this paragraph, a contract that is required to provide coverage for an item or service described in subsection a. of this section on the first day of a plan year shall provide coverage for that item or service through the last day of the plan year.
(b) The commissioner may remove a coverage requirement for an item or service during a plan year if the recommendation or guideline changes or is no longer described in subsection a. of this section.
d. The provisions of this section shall apply to those contracts in which the health maintenance organization has reserved the right to change the premium.
e. With respect to an annual wellness visit for a covered member who is over three years of age, a carrier is required to cover only one wellness visit per plan year or calendar year, as provided for under the health benefits plan contract, but may not impose a waiting period for the wellness visit.
(1) (a) an agreement that provides a silver, gold, or platinum level of coverage, as defined in 45 C.F.R. s.156.140, shall limit a covered person's cost-sharing, including any copayment or coinsurance, for prescription drugs, including specialty drugs, to no more than $150 per month for each prescription drug for up to a 30-day supply of any single drug;
(b) an agreement that provides a bronze level of coverage, as defined in 45 C.F.R. s.156.140, shall ensure that any required covered person's cost-sharing, including any copayment or coinsurance, does not exceed $250 per month for each prescription drug for up to a 30-day supply of any single drug;
(c) an agreement that meets the requirements of a catastrophic plan, as defined in 45 C.F.R. s.156.155, shall be exempt from the requirements of subparagraphs (a) and (b) of this paragraph;
(2) except as provided in paragraph (3) of this subsection, the limits described in paragraph (1) of this subsection shall apply at any point in the benefit design, including before and after any applicable deductible is reached; and
(3) for prescription drug benefits offered in conjunction with a high-deductible health plan, the plan shall not provide prescription drug benefits until the expenditures applicable to the deductible under the plan have met the amount of the minimum annual deductibles in effect for self-only and family coverage under section 223(c)(2)(A)(i) of the federal Internal Revenue Code (26 U.S.C. s.223(c)(2)(A)(i)) for self-only and family coverage, respectively. Once the foregoing expenditure amount has been met under the plan, coverage for prescription drug benefits shall begin, and the limit on out-of-pocket expenditures for prescription drug benefits shall be as specified in paragraph (1) of this subsection.
b. The provisions of this section shall apply to all agreements in which the health maintenance organization has reserved the right to change the premium.
The health care services shall be provided to the same extent as for any other condition under the contract, except that the health maintenance organization shall not impose on covered persons receiving these services any form of cost sharing, including, but not limited to, copayments, deductibles, or coinsurance.
This section shall apply to those contracts for health care services under which the right to change the schedule of charges for enrollee coverage is reserved.
(1) provide coverage for the services provided by the newborn home nurse visitation program established pursuant to section 2 of P.L.2021, c.187 (C.26:2H-159);
(2) notify a covered person of the services provided by the newborn home nurse visitation program, upon application by the covered person for coverage of a newborn infant;
(3) ensure that the plan does not contain any provision that requires a covered person to receive the services provided by the newborn home nurse visitation program as a condition of coverage, or that denies or limits benefits to the covered person if that person declines the services provided under the program; and
(4) have the discretion to determine how best to reimburse for the expenses incurred for services provided under the newborn home nurse visitation program, including, but not limited to, utilizing:
(a) a value-based payment methodology;
(b) an invoice claim process;
(c) a capitated payment arrangement;
(d) a payment methodology that takes into account the need for an agency or organization providing services under the program to expand its capacity to provide services and address health disparities; or
(e) any other payment arrangement agreed to by the carrier and an agency or organization providing services under the program.
b. Any copayment, coinsurance, or deductible that may be required pursuant to the health benefits plan for such services shall be waived.
c. Every health maintenance organization that is subject to the provisions of this section shall submit to the Department of Banking and Insurance, in a form and manner prescribed by the department, a report on the claims submitted for services provided under the newborn home nurse visitation program.
The information contained in the report shall be shared with the Department of Children and Families and used by that department to assess the newborn home nurse visitation program pursuant to subsection a. of section 4 of P.L.2021, c.187 (C.26:2H-161).
d. (1) Except as provided in paragraphs (2) and (3) of this subsection, the contract shall specify that no deductible, coinsurance, copayment, or any other cost-sharing requirement may be imposed on the coverage required pursuant to this section.
(2) A contract offered by a health maintenance organization that qualifies as a high deductible health plan shall provide benefits for expenses incurred for services provided under the newborn home nurse visitation program established pursuant to section 2 of P.L.2021, c.187 (C.26:2H-159) at the lowest deductible and other cost-sharing requirement permitted for a high deductible health plan under section 223(c)(2)(A) of the Internal Revenue Code (26 U.S.C. s.223).
(3) A contract offered by a health maintenance organization that meets the requirements of a catastrophic plan, as defined in 45 C.F.R. s.156.155, shall provide benefits for expenses incurred for services provided under the newborn home nurse visitation program established pursuant to section 2 of P.L.2021, c.187 (C.26:2H-159) at the lowest deductible and other cost-sharing requirement to the extent permitted for a catastrophic plan under federal law.
e. The benefits shall be provided to the same extent as for any other medical condition under the contract.
Nothing in this section shall prevent a health maintenance organization from reducing an enrollee's or other covered person's cost-sharing requirement by an amount greater than the amount specified in this section.
Nothing in this section shall prevent a health maintenance organization from reducing an enrollee's or other covered person's cost-sharing requirement by an amount greater than the amount specified in this section.
b. Biomarker precision medical testing shall be covered for the purposes of diagnosis, treatment, appropriate management, or ongoing monitoring of a disease or condition, excluding asymptomatic screening, to guide treatment decisions of an enrollee when the efficacy and appropriateness of biomarker precision medical testing for the diagnosis, treatment, appropriate management, or guiding treatment decisions for an enrollee's disease or condition is recognized by:
(1) labeled indications for an FDA-approved or -cleared test;
(2) indicated tests for an FDA-approved drug;
(3) actions to address warnings and precautions on FDA-approved drug labels;
(4) Centers for Medicare and Medicaid Services National Coverage Determinations or Medicare Administrative Contractor Local Coverage Determinations; or
(5) nationally recognized clinical practice guidelines.
c. Coverage, pursuant to subsection b. of this section, shall be provided in a manner that limits disruption, including multiple biopsies or biospecimen samples, in the care of an enrollee.
d. (1) If utilization review is required, a health maintenance organization shall provide a decision pursuant to the guidelines and timeframes set forth in P.L.2023, c.296 (C.17B:30-55.1 et al.).
(2) The enrollee and the treating health care provider or treating health care entity prescribing biomarker precision medical testing for the enrollee shall have access to clear, readily accessible, and conspicuous information on the process to submit an appeal to an adverse determination.
e. The health care services shall be provided to the same extent as for any other medical condition under the contract, including determinations of clinical review criteria used for utilization review of health care services along with copayment, deductible, and coinsurance provisions.
f. The provisions of this section shall apply to those contracts for health care services by health maintenance organizations under which the right to change the schedule of charges for enrollee coverage is reserved.
g. As used in this section:
"Biomarker" means a characteristic that is objectively measured and evaluated as an indicator of normal biological processes, pathogenic processes, or pharmacologic responses to a specific therapeutic intervention, including known gene-drug interactions for medications being considered for use or already being administered. Biomarkers shall also include, but not be limited to, gene mutations, characteristics of genes, or protein expression.
"Biomarker precision medical testing" means the analysis of tissue, blood, or other biospecimen for the presence of a biomarker. Biomarker precision medical testing includes, but is not limited to, single-analyte tests, multiplex panel tests, protein expression, and whole exome, whole genome, and whole transcriptome sequencing.
"Nationally recognized clinical practice guidelines" means evidence-based clinical practice guidelines developed by independent organizations or medical professional societies utilizing a transparent methodology and reporting structure and with a conflict of interest policy. The guidelines establish standards of care informed by a systematic review of evidence and an assessment of the benefits and risks of alternative care options and include recommendations intended to optimize patient care.
(2) If the federal Food and Drug Administration has authorized or approved one or more therapeutic equivalents of a drug, device, or product for the prevention of HIV and AIDS, paragraph (1) of this subsection shall not be construed to require the plan to cover all therapeutically equivalent versions without prior authorization or step therapy, if at least one version is covered without prior authorization or step therapy.
b. Reimbursement issued under this section to a pharmacist shall be at a rate that is no less than the rate provided by the health maintenance organization to other non-physician practitioners if the reimbursement is for a service or procedure that meets the following criteria:
(1) the service or procedure is within the scope of practice of the treating pharmacist; and
(2) the service or procedure would otherwise be covered by the health maintenance organization if provided by a healthcare provider, including a physician, advanced practice nurse, or physician assistant.
c. A health maintenance organization shall grant a licensed pharmacist receiving reimbursement under this section the same rights of participation, plan admission, and registration as may be granted by the health maintenance organization to a healthcare provider, including a physician, advanced practice nurse, or physician assistant, who is reimbursed for an identical service.
d.A health maintenance organization shall not:
(1) prohibit, or permit a delegated pharmacy benefits manager to prohibit, a pharmacist from dispensing HIV preexposure prophylaxis or HIV postexposure prophylaxis; and
(2) be required to cover HIV preexposure prophylaxis that has been furnished by a pharmacist without an individual prescription pursuant to pursuant to section 2 of P.L.2025, c.196 (C.45:14-67.13) in excess of a 90-day supply for a single patient within a given two year period.
e. Nothing in this section shall be construed to require a health maintenance organization to provide coverage for HIV preexposure prophylaxis or HIV postexposure prophylaxis furnished by a pharmacist at an out-of-network pharmacy, unless the contract has an out-of-network pharmacy benefit.
f. The benefits shall be provided to the same extent as for any other medical condition under the contract.
g. As used in this section:
“HIV preexposure prophylaxis” means the same as that term is defined in section 1 of P.L.2025, c.196 (C.45:14-67.12).
“HIV postexposure prophylaxis” means the same as that term is defined in section 1 of P.L.2025, c.196 (C.45:14-67.12).
“Step therapy” means requiring that a lower-cost alternative to HIV preexposure prophylaxis or HIV postexposure prophylaxis be shown to have been ineffective as a condition of providing prescription benefits.
(1) hormonal therapies such as hormone replacement therapy and bioidentical hormone treatments;
(2) non-hormonal treatments, including medications to manage menopausal symptoms;
(3) behavioral health care services;
(4) pelvic floor physical therapy;
(5) bone health treatments, including screenings and medications due to hormonal changes related to perimenopause and menopause;
(6) preventative services that have a rating of “A” or “B” in the current recommendations of the United States Preventive Services Task Force for early detection and treatment of health conditions related to perimenopause and menopause such as osteoporosis and cancer; and
(7) counseling and education regarding menopause management.
b. A health maintenance organization shall provide clear and accessible information to enrollees regarding covered perimenopause and menopause treatments.
c. The benefits shall be provided to the same extent as for any other medical condition under the enrollee agreement.
d. The provisions of this section shall apply to all enrollee agreements in which the health maintenance organization has reserved the right to change the schedule of charges.
e. As used in this section:
“Menopause” means the permanent end of a female’s menstrual cycle, diagnosed by a licensed medical provider after 12 consecutive months without a menstrual period.
“Perimenopause” means the transitional period leading to menopause, marked by fluctuating hormone levels and changes in menstrual cycles.
a. The powers of a health maintenance organization include the following:
(1) the purchase, lease, construction, renovation, operation, or maintenance of health care facilities, and their ancillary equipment, and such property as may reasonably be required for its principal office or for such other purposes as may be necessary in the transaction of the business of the organization;
(2) the receiving of funds by loan or otherwise;
(3) the making of loans to a medical group under contract with it in furtherance of its program or the making of loans to a corporation or corporations under its control for the purpose of acquiring or constructing health care facilities or in furtherance of a program providing health care services to enrollees;
(4) the assumption of responsibility for the furnishing of health care services through providers which are under contract with or employed by the health maintenance organization to persons including but not limited to enrollees;
(5) the contracting with any person for the performance on its behalf of certain functions such as marketing, enrollment and administration;
(6) the contracting with an insurance company licensed in this State, or with a hospital or medical service corporation authorized to do business in this State, for the provision of insurance, indemnity, or reimbursement against the cost of health care services provided by the health maintenance organization which may include provisions for reasonable classifications for the purpose of establishing rates and reasonable restrictions based on underwriting consideration; and
(7) the offering, in addition to basic health care services, of:
(a) additional health care services;
(b) indemnity benefits covering out-of-area or emergency services; and
(c) indemnity benefits, in addition to those relating to out-of-area and emergency services, provided through insurers or hospital or medical service corporations.
b. (1) A health maintenance organization shall file notice, with adequate supporting information, with the commissioner prior to the exercise of any power granted in subsection a. (1) or (2) of this section. The commissioner shall disapprove such exercise of power if in his opinion it would substantially and adversely affect the financial soundness of the health maintenance organization and endanger its ability to meet its obligations. If the commissioner does not disapprove within 30 days of filing, it shall be deemed approved.
(2) The commissioner may promulgate rules and regulations exempting from the filing requirements of paragraph (1) of this subsection those activities having a de minimis effect.
a. The governing body of any health maintenance organization may include providers, other individuals, or both.
b. Such governing body shall establish a mechanism to afford the enrollees an opportunity to participate in matters of policy and operation through the establishment of advisory panels, by the use of advisory referenda on major policy decisions, or through the use of other mechanisms.
Any director, officer employee or partner of a health maintenance organization who receives, collects, disburses, or invests funds in connection with the activities of such organization shall be bonded in an amount to be determined by the commissioner.
(2) No evidence of coverage, or amendment thereto, shall be issued or delivered to any person until a copy of the form of the evidence of coverage, or amendment thereto, has been filed with the commissioner or, where applicable, with the Commissioner of Insurance.
(3) An evidence of coverage shall contain:
(a) provisions or statements which are not unjust, unfair, inequitable, misleading, deceptive, or which encourage misrepresentation, or which are untrue, misleading or deceptive as defined in subsection a. of section 15 of P.L.1973, c.337 (C.26:2J-15); and
(b) a clear and complete statement, if a contract, or a reasonably complete summary, if a certificate, of:
(i) the health care services and where applicable the insurance or other benefits, if any, to which enrollees are entitled;
(ii) any limitations on the services, kind of services, benefits, or kind of benefits, to be provided, including any deductible or co-payment feature;
(iii) where and in what manner information is available as to how services may be obtained;
(iv) a clear and understandable description of the health maintenance organization's method for resolving enrollee complaints; and
(v) the total amount of payment for health care services and the indemnity or service benefits, if any, which the enrollee is obligated to pay with respect to individual contracts, or an indication whether the plan is contributory or non-contributory with respect to group certificates.
(4) Any subsequent change may be evidenced in a separate document issued to the enrollee.
b. (1) no schedule of charges for enrollee coverage for health care services, or amendment thereto, may be used by a health maintenance organization until a copy of such schedule, or amendment thereto, has been filed with the Commissioner of Insurance for informational purposes; provided, however, that the Commissioner of Insurance may bring an enforcement action pursuant to P.L.1973, c.337 (C.26:2J-1 et seq.) if the commissioner has reason to believe that the rates are excessive, inadequate or unfairly discriminatory.
(2) such charges may be established in accordance with actuarial principles for various categories of enrollees, provided that charges applicable to an enrollee shall not be individually determined based on the status of his health. However, the charges shall not be excessive, inadequate, or unfairly discriminatory. A certification, by a qualified actuary, to the appropriateness of the charges, based on reasonable assumptions, shall accompany the filing.
c. In accordance with the provisions of section 26 of P.L.1995, c.73 (C.26:2J-44), the commissioner or, where applicable, the Commissioner of Insurance shall approve any form if the requirements of subsection a. of this section are met. It shall be unlawful to issue such form until approved. A form that is disapproved may be resubmitted for approval in accordance with subsections b., c., and d. of section 25 of P.L.1995, c.73 (C.26:2J-43) and shall be subject to review in accordance with the procedure described in the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.) and any rules adopted thereunder. Any such form which is filed by the commissioner or deemed filed may be so delivered or issued for delivery until such time as any subsequent withdrawal of the filing by the commissioner, following an opportunity for a hearing held in accordance with the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.) and any rules adopted thereunder, becomes final in accordance therewith.
d. The commissioner or Commissioner of Insurance, where applicable, may require the submission of whatever relevant information he deems necessary in determining whether to approve or disapprove a filing made pursuant to subsection a. of this section.
The Commissioner of Banking and Insurance may grant extensions or waivers of the implementation requirement when it has been demonstrated to the commissioner's satisfaction that compliance with the timetable for implementation will result in an undue hardship to a health maintenance organization, or its agent, its subsidiary or its covered persons.
b. Within 12 months of the adoption of regulations establishing standard health care enrollment and claim forms by the Commissioner of Banking and Insurance pursuant to section 1 of P.L.1999, c.154 (C.17B:30-23), a health maintenance organization or its agent or a subsidiary that processes health care benefits claims as a third party administrator shall use the standard health care enrollment and claim forms in connection with all group and individual health maintenance organization coverage for health care services issued, delivered, executed or renewed in this State.
c. Twelve months after the adoption of regulations establishing standard health care enrollment and claim forms by the Commissioner of Banking and Insurance pursuant to section 1 of P.L.1999, c.154 (C.17B:30-23), a health maintenance organization or its agent shall require that health care providers file all claims for payment for health care services. A covered person who receives health care services shall not be required to submit a claim for payment, but notwithstanding the provisions of this subsection to the contrary, a covered person shall be permitted to submit a claim on his own behalf, at the covered person's option. All claims shall be filed using the standard health care claim form applicable to the contract.
d. For the purposes of this subsection, "substantiating documentation" means any information specific to the particular health care service provided to a covered person.
(1) Effective 180 days after the effective date of P.L.1999, c.154, a health maintenance organization or its agent, hereinafter the payer, shall remit payment for every insured claim submitted by a covered person or health care provider, no later than the 30th calendar day following receipt of the claim by the payer or no later than the time limit established for the payment of claims in the Medicare program pursuant to 42 U.S.C. s.1395u(c)(2)(B), whichever is earlier, if the claim is submitted by electronic means, and no later than the 40th calendar day following receipt if the claim is submitted by other than electronic means, if:
(a) the health care provider is eligible at the date of service;
(b) the person who received the health care service was covered on the date of service;
(c) the claim is for a service or supply covered under the health benefits plan;
(d) the claim is submitted with all the information requested by the payer on the claim form or in other instructions that were distributed in advance to the health care provider or covered person in accordance with the provisions of section 5 of P.L.2023, c.296 (C.17B:30-55.4); and
(e) the payer has no reason to believe that the claim has been submitted fraudulently.
(2) If all or a portion of the claim is not paid within the time frames provided in paragraph (1) of this subsection because:
(a) the claim submission is incomplete because the required substantiating documentation has not been submitted to the payer;
(b) the diagnosis coding, procedure coding, or any other required information to be submitted with the claim is incorrect;
(c) the payer disputes the amount claimed; or
(d) there is strong evidence of fraud by the provider and the payer has initiated an investigation into the suspected fraud,
the payer shall notify the health care provider, by electronic means and the covered person in writing within 30 days of receiving an electronic claim, or notify the covered person and health care provider in writing within 40 days of receiving a claim submitted by other than electronic means, that:
(i) the claim is incomplete with a statement as to what substantiating documentation is required for adjudication of the claim;
(ii) the claim contains incorrect information with a statement as to what information must be corrected for adjudication of the claim;
(iii) the payer disputes the amount claimed in whole or in part with a statement as to the basis of that dispute; or
(iv) the payer finds there is strong evidence of fraud and has initiated an investigation into the suspected fraud in accordance with its fraud prevention plan established pursuant to section 1 of P.L.1993, c.362 (C.17:33A-15), or referred the claim, together with supporting documentation, to the Office of the Insurance Fraud Prosecutor in the Department of Law and Public Safety established pursuant to section 32 of P.L.1998, c.21 (C.17:33A-16).
(3) If all or a portion of an electronically submitted claim cannot be adjudicated because the diagnosis coding, procedure coding or any other data required to be submitted with the claim was missing, the payer shall electronically notify the health care provider or its agent within seven days of that determination and request any information required to complete adjudication of the claim.
(4) Any portion of a claim that meets the criteria established in paragraph (1) of this subsection shall be paid by the payer in accordance with the time limit established in paragraph (1) of this subsection.
(5) A payer shall acknowledge receipt of a claim submitted by electronic means from a health care provider, no later than two working days following receipt of the transmission of the claim.
(6) If a payer subject to the provisions of P.L.1983, c.320 (C.17:33A-1 et seq.) has reason to believe that a claim has been submitted fraudulently, it shall investigate the claim in accordance with its fraud prevention plan established pursuant to section 1 of P.L.1993, c.362 (C.17:33A-15), or refer the claim, together with supporting documentation, to the Office of the Insurance Fraud Prosecutor in the Department of Law and Public Safety established pursuant to section 32 of P.L.1998, c.21 (C.17:33A-16).
(7) Payment of an eligible claim pursuant to paragraphs (1) and (4) of this subsection shall be deemed to be overdue if not remitted to the claimant or his agent by the payer on or before the 30th calendar day or the time limit established by the Medicare program, whichever is earlier, following receipt by the payer of a claim submitted by electronic means and on or before the 40th calendar day following receipt of a claim submitted by other than electronic means.
If payment is withheld on all or a portion of a claim by a payer pursuant to subparagraph (a) or (b) of paragraph (2) or paragraph (3) of this subsection, the claims payment shall be overdue if not remitted to the claimant or his agent by the payer on or before the 30th calendar day or the time limit established by the Medicare program, whichever is earlier, for claims submitted by electronic means and the 40th calendar day for claims submitted by other than electronic means, following receipt by the payer of the required documentation or information or modification of an initial submission.
If payment is withheld on all or a portion of a claim by a payer pursuant to paragraph (2) or (3) of this subsection and the provider is not notified within the time frames provided for in those paragraphs, the claim shall be deemed to be overdue.
(8) (a) No payer that has reserved the right to change the premium shall deny payment on all or a portion of a claim because the payer requests documentation or information that is not specific to the health care service provided to the covered person.
(b) No payer shall deny payment on all or a portion of a claim while seeking coordination of benefits information unless good cause exists for the payer to believe that other insurance is available to the covered person. Good cause shall exist only if the payer's records indicate that other coverage exists. Routine requests to determine whether coordination of benefits exists shall not be considered good cause.
(c) In the event payment is withheld on all or a portion of a claim by a payer pursuant to subparagraph (a) or (b) of this paragraph, the claims payment shall be deemed to be overdue if not remitted to the claimant or his agent by the payer on or before the 30th calendar day or the time limit established by the Medicare program, whichever is earlier, following receipt by the payer of a claim submitted by electronic means or on or before the 40th calendar day following receipt of a claim submitted by other than electronic means.
(9) An overdue payment shall bear simple interest at the rate of 12% per annum. The interest shall be paid to the health care provider at the time the overdue payment is made. The amount of interest paid to a health care provider for an overdue claim shall be credited to any civil penalty for late payment of the claim levied by the Department of Human Services against a payer that does not reserve the right to change the premium.
(10) With the exception of claims that were submitted fraudulently or submitted by health care providers that have a pattern of inappropriate billing or claims that were subject to coordination of benefits, no payer shall seek reimbursement for overpayment of a claim previously paid pursuant to this section later than 18 months after the date the first payment on the claim was made. No payer shall seek more than one reimbursement for overpayment of a particular claim. At the time the reimbursement request is submitted to the health care provider, the payer shall provide written documentation that identifies the error made by the payer in the processing or payment of the claim that justifies the reimbursement request. No payer shall base a reimbursement request for a particular claim on extrapolation of other claims, except under the following circumstances:
(a) in judicial or quasi-judicial proceedings, including arbitration;
(b) in administrative proceedings;
(c) in which relevant records required to be maintained by the health care provider have been improperly altered or reconstructed, or a material number of the relevant records are otherwise unavailable; or
(d) in which there is clear evidence of fraud by the health care provider and the payer has investigated the claim in accordance with its fraud prevention plan established pursuant to section 1 of P.L.1993, c.362 (C.17:33A-15), and referred the claim, together with supporting documentation, to the Office of the Insurance Fraud Prosecutor in the Department of Law and Public Safety established pursuant to section 32 of P.L.1998, c.21 (C.17:33A-16).
(11) (a) In seeking reimbursement for the overpayment from the health care provider, except as provided for in subparagraph (b) of this paragraph, no payer shall collect or attempt to collect:
(i) the funds for the reimbursement on or before the 45th calendar day following the submission of the reimbursement request to the health care provider;
(ii) the funds for the reimbursement if the health care provider disputes the request and initiates an appeal on or before the 45th calendar day following the submission of the reimbursement request to the health care provider and until the health care provider's rights to appeal set forth under paragraphs (1) and (2) of subsection e. of this section are exhausted; or
(iii) a monetary penalty against the reimbursement request, including but not limited to, an interest charge or a late fee.
The payer may collect the funds for the reimbursement request by assessing them against payment of any future claims submitted by the health care provider after the 45th calendar day following the submission of the reimbursement request to the health care provider or after the health care provider's rights to appeal set forth under paragraphs (1) and (2) of subsection e. of this section have been exhausted if the payer submits an explanation in writing to the provider in sufficient detail so that the provider can reconcile each covered person's bill.
(b) If a payer has determined that the overpayment to the health care provider is a result of fraud committed by the health care provider and the payer has conducted its investigation and reported the fraud to the Office of the Insurance Fraud Prosecutor as required by law, the payer may collect an overpayment by assessing it against payment of any future claim submitted by the health care provider.
(12) No health care provider shall seek reimbursement from a payer or covered person for underpayment of a claim submitted pursuant to this section later than 18 months from the date the first payment on the claim was made, except if the claim is the subject of an appeal submitted pursuant to subsection e. of this section or the claim is subject to continual claims submission. No health care provider shall seek more than one reimbursement for underpayment of a particular claim.
e. (1) A health maintenance organization or its agent, hereinafter the payer, shall establish an internal appeal mechanism to resolve any dispute raised by a health care provider regardless of whether the health care provider is under contract with the payer regarding compliance with the requirements of this section or compliance with the requirements of sections 5 through 15 of P.L.2023, c.296 (C.17B:30-55.4 through 17B:30-55.14). No dispute pertaining to medical necessity which is eligible to be submitted to the Independent Health Care Appeals Program established pursuant to section 11 of P.L.1997, c.192 (C.26:2S-11) shall be the subject of an appeal pursuant to this subsection. The payer shall conduct the appeal at no cost to the health care provider.
A health care provider may initiate an appeal on or before the 90th calendar day following receipt by the health care provider of the payer's claims determination, which is the basis of the appeal, on a form prescribed by the Commissioner of Banking and Insurance which shall describe the type of substantiating documentation that must be submitted with the form. The payer shall conduct a review of the appeal and notify the health care provider of its determination on or before the 30th calendar day following the receipt of the appeal form. If the health care provider is not notified of the payer's determination of the appeal within 30 days, the health care provider may refer the dispute to arbitration as provided by paragraph (2) of this subsection.
If the payer issues a determination in favor of the health care provider, the payer shall comply with the provisions of this section and pay the amount of money in dispute, if applicable, with accrued interest at the rate of 12% per annum, on or before the 30th calendar day following the notification of the payer's determination on the appeal. Interest shall begin to accrue on the day the appeal was received by the payer.
If the payer issues a determination against the health care provider, the payer shall notify the health care provider of its findings on or before the 30th calendar day following the receipt of the appeal form and shall include in the notification written instructions for referring the dispute to arbitration as provided by paragraph (2) of this subsection.
The payer shall report annually to the Commissioner of Banking and Insurance the number of appeals it has received and the resolution of each appeal.
(2) Any dispute regarding the determination of an internal appeal conducted pursuant to paragraph (1) of this subsection may be referred to arbitration as provided in this paragraph. The Commissioner of Banking and Insurance shall contract with a nationally recognized, independent organization that specializes in arbitration to conduct the arbitration proceedings.
Any party may initiate an arbitration proceeding on or before the 90th calendar day following the receipt of the determination which is the basis of the appeal, on a form prescribed by the Commissioner of Banking and Insurance. No dispute shall be accepted for arbitration unless the payment amount in dispute is $1,000 or more, except that a health care provider may aggregate his own disputed claim amounts for the purposes of meeting the threshold requirements of this subsection. No dispute pertaining to medical necessity which is eligible to be submitted to the Independent Health Care Appeals Program established pursuant to section 11 of P.L.1997, c.192 (C.26:2S-11) shall be the subject of arbitration pursuant to this subsection.
(3) The arbitrator shall conduct the arbitration proceedings pursuant to the rules of the arbitration entity, including rules of discovery subject to confidentiality requirements established by State or federal law.
(4) An arbitrator's determination shall be:
(a) signed by the arbitrator;
(b) issued in writing, in a form prescribed by the Commissioner of Banking and Insurance, including a statement of the issues in dispute and the findings and conclusions on which the determination is based; and
(c) issued on or before the 30th calendar day following the receipt of the required documentation.
The arbitration shall be nonappealable and binding on all parties to the dispute.
(5) If the arbitrator determines that a payer has withheld or denied payment in violation of the provisions of this section, the arbitrator shall order the payer to make payment of the claim, together with accrued interest, on or before the 10th business day following the issuance of the determination. If the arbitrator determines that a payer has withheld or denied payment on the basis of information submitted by the health care provider and the payer requested, but did not receive, this information from the health care provider when the claim was initially processed pursuant to subsection d. of this section or reviewed under internal appeal pursuant to paragraph (1) of this subsection, the payer shall not be required to pay any accrued interest.
(6) If the arbitrator determines that a health care provider has engaged in a pattern and practice of improper billing and a refund is due to the payer, the arbitrator may award the payer a refund, including interest accrued at the rate of 12% per annum. Interest shall begin to accrue on the day the appeal was received by the payer for resolution through the internal appeals process established pursuant to paragraph (1) of this subsection.
(7) The arbitrator shall file a copy of each determination with and in the form prescribed by the Commissioner of Banking and Insurance.
f. As used in this section, "insured claim" or "claim" means a claim by a covered person for payment of benefits under an insured health maintenance organization contract for which the financial obligation for the payment of a claim under the health maintenance organization coverage for health care services rests upon the health maintenance organization.
g. Any person found in violation of this section with a pattern and practice as determined by the Commissioner of Banking and Insurance shall be liable to a civil penalty as set forth in section 17 of P.L.2005, c.352 (C.17B:30-55).
a. Every health maintenance organization shall annually, on or before March 1, file a report verified by at least two principal officers with the commissioner, with a copy to the Commissioner of Insurance covering the preceding calendar year.
b. Such report shall be on forms prescribed by the commissioner and shall include:
(1) a financial statement of the organization, including its balance sheet and receipts and disbursements for the preceding year certified by an independent public accountant;
(2) any material changes in the information submitted pursuant to section 3 c. hereof;
(3) the number of persons enrolled during the year, the number of enrollees as of the end of the year and the number of enrollments terminated during the year;
(4) a summary of information compiled pursuant to section 4 a. (2)(c) hereof in such form as required by the commissioner"; and
(5) such other information relating to the performance of the health maintenance organization as is necessary to enable the commissioner to carry out his duties under this act.
a. Every health maintenance organization shall annually provide to its enrollees:
(1) a summary of any material changes since the issuance of the last report;
(2) a description of the available health care services and information as to where and how to secure them; and
(3) a clear and understandable description of the health maintenance organization's method for resolving enrollee complaints.
b. Every health maintenance organization shall make available to its enrollees the most recent annual statement of financial condition.
(1) The child was born out of wedlock;
(2) The child is not claimed as a dependent on the enrollee's federal tax return;
(3) The child does not reside with the enrollee or in the health maintenance organization's service area, provided that the child complies with the terms and conditions of the coverage with respect to the use of specified providers;
(4) The child is married;
(5) The child has or adopts a child; or
(6) The child starts or leaves school.
b. If a child has coverage through a health maintenance organization plan of a noncustodial parent, the health maintenance organization shall:
(1) Provide such information to the custodial parent as may be necessary for the child to obtain health care services through the child's noncustodial parent's coverage;
(2) Permit the custodial parent, or the health care provider with the authorization of the custodial parent, to submit claims for health care services without the approval of the noncustodial parent; and
(3) Make payments on claims submitted in accordance with paragraph (2) of this subsection directly to the custodial parent, the health care provider or the Division of Medical Assistance and Health Services in the Department of Human Services which administers the State Medicaid program, as appropriate.
c. When a parent who is the enrollee is eligible for dependent coverage and is required by a court or administrative order to provide health insurance coverage for his child, the health maintenance organization shall:
(1) Permit the parent to enroll his child as a dependent, without regard to any open enrollment restrictions;
(2) Permit the child's other parent, or the Division of Medical Assistance and Health Services as the State Medicaid agency or the Division of Family Development as the State IV-D agency, in the Department of Human Services, to enroll the child if the parent who is the enrollee fails to enroll the child; and
(3) Not terminate coverage of the child unless the parent who is the enrollee provides the health maintenance organization with satisfactory written evidence that: the court or administrative order is no longer in effect; or the child is or will be enrolled in a comparable health benefits plan whose coverage will be effective on the date of the termination of coverage.
(1) is 30 years of age or younger;
(2) is unmarried;
(3) has no dependent of his own;
(4) is a resident of this State or is enrolled as a full-time student at an accredited public or private institution of higher education; and
(5) (a) is not actually provided coverage as a named subscriber, insured, enrollee, or covered person under any other group or individual health benefits plan, group health plan, church plan or health benefits plan, or entitled to benefits under Title XVIII of the Social Security Act, Pub.L.74-271 (42 U.S.C. s.1395 et seq.) at the time dependent coverage pursuant to this section begins or will begin; and
(b) there is evidence of prior, creditable coverage or receipt of benefits under a benefits plan or by law as set forth in subparagraph (a) of this paragraph.
b. (1) A health maintenance organization contract that provides coverage for an enrollee's dependent under which coverage of the dependent terminates at a specific age before the dependent's 30th birthday, and is delivered, issued, executed or renewed in this State pursuant to P.L.1973, c.337 (C.26:2J-1 et seq.) on or after the effective date of this section of P.L.2008, c.38, shall, upon the application of the dependent as set forth in subsection c. of this section, provide coverage to the dependent after that specific age, until the dependent's 31st birthday.
(2) Nothing herein shall be construed to require:
(a) coverage for services provided to a dependent before the effective date of this section of P.L.2008, c.38; or
(b) that an employer or other group contract holder pay all or part of the cost of coverage for a dependent as provided pursuant to this section.
c. (1) A dependent covered by an enrollee's contract, which coverage under the contract terminates at a specific age on or before the dependent's 30th birthday, may make a written election for coverage as a dependent pursuant to this section, until the dependent's 30th birthday:
(a) within 30 days prior to the termination of coverage at the specific age provided in the contract;
(b) within 30 days after meeting the requirements for dependent status as set forth in subsection a. of this section, when coverage for the dependent under the contract previously terminated; or
(c) during an open enrollment period, as provided pursuant to the contract, if the dependent meets the requirements for dependent status as set forth in subsection a. of this section during the open enrollment period.
(2) (Deleted by amendment, P.L.2008, c.38)
d. (1) Coverage for a dependent who makes a written election for coverage pursuant to subsection c. of this section shall consist of coverage which is identical to the coverage provided to that dependent prior to the termination of coverage at the specific age provided in the contract. If coverage is modified under the contract for any similarly situated dependents for coverage prior to the termination of coverage at the specific age provided in the contract, the coverage shall also be modified in the same manner for the dependent.
(2) Coverage for a dependent who makes a written election for coverage pursuant to subsection c. of this section shall not be conditioned upon, or discriminate on the basis of, lack of evidence of insurability.
e. (1) The enrollee's contract may require payment under the schedule of charges by the enrollee or dependent, as appropriate, subject to the approval of the Commissioner of Banking and Insurance, for any period of coverage relating to a dependent's written election for coverage pursuant to subsection c. of this section. The payment shall not exceed 102% of the applicable portion of the schedule of charges previously paid for that dependent's coverage under the contract prior to the termination of coverage at the specific age provided in the contract.
(2) The applicable portion of the schedule of charges previously paid for the dependent's coverage under the contract shall be determined pursuant to regulations promulgated by the Commissioner of Banking and Insurance, based upon the difference between the contract's rating tiers for adult and dependent coverage or family coverage, as appropriate, and single coverage, or based upon any other formula or dependent rating tier deemed appropriate by the commissioner which provides a substantially similar result.
(3) Payments under the schedule of charges may, at the election of the payor, be made in monthly installments.
f. Coverage for a dependent provided pursuant to this section shall be provided until the earlier of the following:
(1) the date upon which the dependent is disqualified for dependent status as set forth in subsection a. of this section;
(2) the date upon which coverage ceases under the contract by reason of a failure to make a timely payment under any schedule of charges required under the contract by the enrollee or dependent for coverage provided pursuant to this section. The payment under any schedule of charges shall be considered to be timely if made within 30 days after the due date or within a longer period as may be provided for by the contract; or
(3) the date upon which the contract, under which coverage is provided to a dependent, ceases to provide coverage to the enrollee.
Nothing herein shall be construed to permit a health maintenance organization to refuse a written election for coverage by a dependent pursuant to subsection c. of this section, based upon the dependent's prior disqualification pursuant to paragraph (1) of this subsection, other than a disqualification based on age or lack of evidence of prior, creditable coverage or receipt of benefits.
g. Notice regarding coverage for a dependent as provided pursuant to this section shall be provided to an enrollee by the health maintenance organization:
(1) in the certificate of coverage or other equivalent document prepared for enrollees and delivered on or about the date of commencement of the enrollees' coverage; and
(2) (Deleted by amendment, P.L.2008, c.38)
(3) in a notice delivered to enrollees on a quarterly basis.
h. This section shall apply to those contracts in which the health maintenance organization has reserved the right to change the schedule of charges.
a. After a health maintenance organization has been in operation 24 months, it shall have an annual open enrollment period of at least one month during which it accepts enrollees up to the limits of its capacity, as determined by the health maintenance organization, in the order in which they apply for enrollment. A health maintenance organization may apply to the commissioner for authorization to impose such underwriting restrictions upon enrollment as are necessary to preserve its financial stability, to prevent excessive adverse selection by prospective enrollees, or to avoid unreasonably high or unmarketable charges for enrollee coverage for health care services. The commissioner shall approve or deny such application within 30 days of the receipt thereof from the health maintenance organization. The Commissioner of Insurance shall certify to the commissioner the appropriateness of any requested underwriting restrictions.
b. Health maintenance organizations providing or arranging for services exclusively on a group contract basis may limit the open enrollment provided for in subsection a. to all members of the group or groups covered by such contracts.
c. A health maintenance organization shall notify its enrollees in writing at the time of enrollment, and include a notice in the promotional material which it distributes to prospective enrollees, that a person's choice of health benefits plan will determine his coverage until the next annual open enrollment period, regardless of the continued availability of a particular health care provider who contracts with that health maintenance organization, unless the enrollee moves his place of residence outside of the organization's designated service area.
If a health maintenance organization authorized to operate in this State pursuant to P.L.1973, c.337 (C.26:2J-1 et seq.) and a general hospital licensed pursuant to P.L.1971, c.136 (C.26:2H-1 et seq.) with which the health maintenance organization has a contract to provide services to its enrollees, are unable to agree on the terms of a new contract upon the expiration of the current contract, the hospital and the health maintenance organization shall continue to abide by the terms of the most current contract for a period of four months from a severance date mutually agreed upon by both parties. In that event, the health maintenance organization shall promptly notify the health care providers with which it has contracted to provide services and provide notification within the four-month extension period to those of its enrollees who reside in the county in which the hospital is located or in an adjacent county in writing as to the extension of the terms of the most current contract, and shall in the notice to its enrollees advise them of the options available to them with respect to their health care coverage.
a. (1) Every health maintenance organization shall establish and maintain a complaint system to provide reasonable procedures for the resolution of written complaints initiated by enrollees concerning health care services.
(2) Each health maintenance organization shall submit to the commissioner an annual report in a form prescribed by him which shall include:
(a) a description of the procedures of such complaint system;
(b) the total number of written complaints handled through such complaint system and a compilation of causes underlying the complaints filed; and
(c) the number, amount, and disposition of malpractice claims settled during the year by the health maintenance organization and any of the providers used by it.
b. The health maintenance organization shall maintain records of written complaints filed with it concerning other than health care services and shall submit to the commissioner a summary report at such times and in such format as the commissioner may require.
c. The commissioner may examine such complaint system.
With the exception of investments made in accordance with section 5 a. (1) and (3) hereof, the investable funds of a health maintenance organization shall be only in securities or other investments permitted by the laws of this State for the investment of assets constituting the legal reserves of life insurance companies or such other securities or investments as the commissioner may permit with the approval of the Commissioner of Insurance.
Each health maintenance organization shall deposit cash or a form of guaranty or security in such amount as will assure that the obligations to the enrollees will be performed in such amount and for such time as prescribed by the commissioner, or where applicable by the Commissioner of Insurance. The commissioner may waive this requirement whenever satisfied that the assets of the organization or its contracts with insurers, hospital or medical service corporation governments, or other organizations are sufficient to reasonably assure the performance of its obligations.
(1) a statement or item of information shall be deemed to be untrue if it does not conform to fact in any respect which is or may be significant to an enrollee of, or person considering enrollment in, a health care plan;
(2) a statement or item of information shall be deemed to be misleading, whether or not it may be literally untrue, if, in the total context in which such statement is made or such item of information is communicated, such statement or item of information may be reasonably understood by a reasonable person, not possessing special knowledge regarding health care coverage, as indicating any benefit or advantage or the absence of any exclusion, limitation, or disadvantage of possible significance to an enrollee of, or person considering enrollment in, a health care plan, if such benefit or advantage or absence of limitation, exclusion or disadvantage does not in fact exist;
(3) an evidence of coverage shall be deemed to be deceptive if the evidence of coverage taken as a whole, and with consideration given to typography and format, as well as language, shall be such as to cause a reasonable person, not possessing special knowledge regarding health care plans and evidences of coverage therefore, to expect benefits, services, charges, or other advantages which the evidence of coverage does not provide or which the health care plan issuing such evidence of coverage does not regularly make available for enrollees covered under such evidence of coverage.
b. The unfair trade practice provisions of the New Jersey insurance law (N.J.S.17B:30-1 through 22) shall be construed to apply to health maintenance organizations, health care plans and evidences of coverage except to the extent that the commissioner determines that the nature of health maintenance organizations, health care plans and evidence of coverage render such sections clearly inappropriate.
c. An enrollee may not be canceled or nonrenewed except for the failure to pay the charge for such coverage, or for such other reasons as may be promulgated by the commissioner.
d. No health maintenance organization, unless licensed as an insurer, may use in its name, evidence of coverage, or literature any of the words "insurance," "assurance," "casualty," "surety," "mutual," or any other words descriptive of the insurance, casualty, or surety business or deceptively similar to the name or description of any insurance, or surety corporation doing business in this State.
e. A health maintenance organization shall not consider a person's eligibility for medical assistance pursuant to P.L.1968, c.413 (C.30:4D-1 et seq.), or the equivalent statute in another state, when determining the person's eligibility for enrollment in, or the provision of health care services under, a contract or certificate for health care services.
The provisions of this section shall be enforced by the State Director of the Division of Consumer Affairs and, where applicable, the commissioner or the Commissioner of Insurance. Nothing in this act shall limit the powers of the Attorney General and the procedures with respect to consumer fraud in P.L.1960, c.39 (C.56:8-1 et seq.).
The commissioner may, after notice and hearing, promulgate such reasonable rules and regulations, which have been approved by the Commissioner of Insurance, as are necessary to provide for the certification of agents. An agent as used herein means a person directly or indirectly associated with a health maintenance organization who engages in solicitation or enrollment for compensation.
a. An insurance company licensed in this State, or a hospital or medical service corporation authorized to do business in this State, may either directly or through a subsidiary or affiliate organize and operate a health maintenance organization under the provisions of this act. Notwithstanding any other law which may be inconsistent herewith, any two or more such insurance companies, hospital or medical service corporations, or subsidiaries or affiliates thereof, may jointly organize and operate a health maintenance organization.
b. Notwithstanding any provision of Title 17 of the Revised Statutes and Title 17B of the New Jersey Statutes, an insurer or a hospital or medical service corporation may contract with a health maintenance organization to provide insurance or protection against the cost of care furnished through health maintenance organizations and to provide coverage in the event of the failure of health maintenance organization to meet its obligations. The enrollees of a health maintenance organization constitute a permissible group under such laws. Among other things, under such contracts, the insurer or hospital or medical service corporation may make benefit payments to health maintenance organizations for health care services rendered by providers.
a. Not less frequently than once every 3 years the commissioner may make an examination concerning the quality of health care services and other affairs of the health maintenance organization and providers with whom such organization has contracts, agreements, or other arrangements. The commissioner may make such examination at any time.
b. Every health maintenance organization and provider shall submit its books and records to such examinations. For the purpose of examinations, the commissioner may administer oaths to, and examine the officers and agents of the health maintenance organization and the principals of such providers concerning their business.
c. The expenses of examinations under this section up to $1,000.00 annually shall be assessed against the organization being examined and such amount shall be remitted to the commissioner.
d. In lieu of such examination, the commissioner may accept the report of an examination made by the Commissioner of Health or Commissioner of Insurance of another state.
"Commissioner" means the Commissioner Banking and Insurance.
"Health maintenance organization" means an entity authorized to transact business in this State pursuant to P.L.1973, c.337 (C.26:2J-1 et seq.).
a. Increases or decreases in the frequency and severity of losses under normal operating conditions, as well as increases or decreases in those values, above or below the levels contemplated by the rates that it charged for coverage and above or below those reasonably expected under normal conditions;
b. Increases or decreases in expenses under normal operating conditions, as well as increases or decreases in those values, above or below the levels contemplated by the rates it charged for coverage and above or below those reasonably expected under normal conditions;
c. Increases or decreases in the value of, or return on, invested assets under normal operating conditions, as well as increases or decreases in those values, above or below those levels anticipated under normal conditions;
d. Changes in economic, social and market conditions that could adversely or favorably affect the financial condition of the health maintenance organization, including conditions that would make liquidity more or less important than contemplated and would prevent or facilitate timely investments or force or prohibit untimely sales of assets; and
e. Any other contingencies, including reinsurance and unfunded or extra contractual obligations, which may affect the health maintenance organization's financial condition.
a. Methods and techniques used to measure risk exposure and variability;
b. The information available relating to the magnitude of the various risks described in section 2 of P.L.2005, c.65 (C.26:2J-18.3);
c. The extent to which risks described in section 2 of P.L.2005, c.65 (C.26:2J-18.3) are independent or interrelated, and whether any dependency is direct or inverse;
d. The extent to which the health maintenance organization has provided protection against contingencies in ways other than the establishment of surplus, including, but not limited to: redundancy of premiums; margin in reserves and liabilities; adjustability of contracts pursuant to the terms of the contracts; voluntary or mandatory investment valuation reserves; reinsurance; the use of conservative actuarial assumptions to provide a margin of security; reserve adjustments after rate increases for policies written at earlier and less adequate rates; contingency or catastrophe reserves; and diversification of assets and underwriting risk; and
e. Any other relevant factors, including the National Association of Insurance Commissioners' reports and independent judgments of the soundness of the health maintenance organization's financial condition, as evidenced by the rating and reports of reliable professional financial services.
a. The commissioner may suspend or revoke any certificate of authority issued to a health maintenance organization under this act if he finds that any of the following conditions exist:
(1) The health maintenance organization is operating in a manner significantly contrary to that described in section 3, hereof, unless amendments to such submissions have been filed with the commissioner;
(2) The health maintenance organization issues evidence of coverage which does not comply with the requirements of section 8 hereof;
(3) the health maintenance organization does not provide or arrange for basic health care services;
(4) the commissioner finds that:
(a) the health maintenance organization does not meet the requirements of section 4 a. (2), hereof; or
(b) the health maintenance organization is unable to fulfill its obligations to furnish health care services.
(5) the health maintenance organization is no longer financially responsible and may reasonably be expected to be unable to meet its obligations to enrollees or prospective enrollees;
(6) the health maintenance organization has failed to implement a mechanism affording the enrollees an opportunity to participate in matters of policy and operation under section 6, hereof;
(7) the health maintenance organization has failed to implement the complaint system required by section 12, hereof, in a manner to reasonably resolve valid complaints;
(8) the continued operation of the health maintenance organization would be hazardous to the health and safety of its enrollees;
(9) the health maintenance organization has otherwise failed to substantially comply with this act; or
(10) the health maintenance organization, or any person on its behalf, has advertised or merchandised its services in an untrue, misrepresentative, misleading, deceptive or unfair manner.
b. A certificate of authority shall be suspended or revoked only after compliance with the requirements of section 21, hereof.
c. When the certificate of authority of a health maintenance organization is suspended, the health maintenance organization shall not, during the period of such suspension, enroll any additional enrollees except newborn children or other newly acquired dependents of existing enrollees, and shall not engage in any advertising or solicitation whatsoever.
d. When the certificate of authority of a health maintenance organization is revoked, such organization shall proceed, immediately following the effective date of the order of revocation, to dissolve its structure, and shall conduct no further business except as may be essential to the orderly conclusion of the affairs of such organization. It shall engage in no further advertising or solicitation whatsoever. The commissioner or where applicable the Commissioner of Insurance may, by written order, permit such further operation of the organization as he may find to be in the best interest of enrollees, to the end that enrollees will be afforded the greatest practical opportunity to obtain continuing health care coverage.
The commissioner may, upon notice and hearing, promulgate reasonable rules and regulations, as are necessary or proper to carry out the provisions of this act. Where applicable, such rules and regulations shall be promulgated after consultation with the Commissioner of Insurance. Such rules and regulations shall specify those determinations in this act which are to be made by the Commissioner of Insurance and shall be subject to review in accordance with the Administrative Procedure Act, P.L.1968, c. 410 (C. 52:14B-1 et seq.).
a. When the commissioner has cause to believe that grounds for the denial of an application for a certificate of authority exist, or that grounds for the suspension or revocation of a certificate of authority exist, he shall notify the health maintenance organization and the Commissioner of Insurance in writing specifically stating the grounds for denial, suspension, or revocation and fixing a time of at least 20 days thereafter for a hearing on the matter.
b. The Commissioner of Insurance, or his designated representative, shall be in attendance at the hearing and shall participate in the proceedings. The recommendation and findings of the Commissioner of Insurance with respect to matters relating to the doing of an insurance business or contract with an insurer or hospital or medical services corporation, provided in connection with any decision regarding denial, suspension, or revocation of a certificate of authority, shall be conclusive and binding upon the commissioner. After such hearing, or upon the failure of the health maintenance organization to appear at such hearing, the commissioner shall take action as is deemed advisable on written findings which shall be mailed to the health maintenance organization with a copy thereof to the Commissioner of Insurance. The action of the commissioner and the recommendation and findings of the Commissioner of Insurance and the levy of any administrative penalty shall be subject to judicial review in accordance with chapter 34 of Title 17B of the New Jersey Statutes.
c. The provisions of the Administrative Procedure Act, P.L.1968, c. 410 (C. 52:14B-1 et seq.) of this State shall apply to proceedings under this section to the extent they are not in conflict with subsections a. and b. of this section.
a. for filing an application for a certificate of authority or amendment thereto, $100.00;
b. for filing each annual report, $10.00; and
c. for the purpose of supporting the activities of the Department of Banking and Insurance associated with the regulation of health maintenance organizations, $1.50 per life per year, with payment being made annually no later than July 15 for the preceding calendar year. Payments made by a health maintenance organization pursuant to this act shall not in any way reduce payments that may be owed by a health maintenance organization pursuant to P.L.1995, c.156 (C.17:1C-19 et seq.) and subsequent amendments thereto. No such payment shall be required for any per life per year that is funded through the Medicaid program established pursuant to P.L.1968, c.413 (C.30:4D-1 et seq.) or the NJ FamilyCare Program established pursuant to P.L.2005, c.156 (C.30:4J-8 et al.).
In accordance with the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.), the commissioner may promulgate rules and regulations directing that additional fees be paid.
From fees collected under the provisions of subsection c. of this section, the Legislature shall in each fiscal year appropriate to the community health law project the sum of $100,000 to fund a grant in support of a program to provide any senior citizen resident of this State who is covered as an enrollee in or beneficiary of a health plan administered by a health maintenance organization with information concerning the person's rights under the program and assistance with the procedures for receiving the benefits to which the person is entitled under the program.
b. Any person who violates this act is a disorderly person and shall be prosecuted and punished pursuant to the "disorderly persons law," subtitle 12 of Title 2A of the New Jersey Statutes.
c. (1) If the commissioner or the Commissioner of Banking and Insurance shall for any reason have cause to believe that any violation of this act has occurred or is threatened, the commissioner or Commissioner of Banking and Insurance may give notice to the health maintenance organization and to the representatives, or other persons who appear to be involved in such suspected violation, to arrange a conference with the alleged violators or their authorized representatives for the purpose of attempting to ascertain the facts relating to such suspected violation, and, in the event it appears that any violation has occurred or is threatened, to arrive at an adequate and effective means of correcting or preventing such violation.
(2) Proceedings under this subsection c. shall not be governed by any formal procedural requirements, and may be conducted in such manner as the commissioner or the Commissioner of Banking and Insurance may deem appropriate under the circumstances.
d. (1) The commissioner or the Commissioner of Banking and Insurance may issue an order directing a health maintenance organization or a representative of a health maintenance organization to cease and desist from engaging in any act or practice in violation of the provisions of this act.
(2) Within 20 days after service of the order of cease and desist, the respondent may request a hearing on the question of whether acts or practices in violation of this act have occurred. Such hearings shall be conducted pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.) and judicial review shall be available as provided therein.
e. In the case of any violation of the provisions of this act, if the commissioner elects not to issue a cease and desist order, or in the event of noncompliance with a cease and desist order issued pursuant to subsection d. of this section, the commissioner may institute a proceeding to obtain injunctive relief, in accordance with the applicable Court Rules.
a. Except as otherwise provided in this act, provisions of the insurance law and provisions of hospital, medical or health service corporation laws shall not be applicable to any health maintenance organization granted a certificate of authority under this act. This provision shall not apply to an insurer or hospital, medical or health service corporation licensed and regulated pursuant to the insurance laws or the hospital, medical or health service corporation laws of this State except with respect to its health maintenance organization activities authorized and regulated pursuant to this act. Charges paid by or on behalf of enrollees of a health maintenance organization with respect to health care services shall not be subject to taxation by the State or any of its political subdivisions, except as otherwise provided in section 3 of P.L.2004, c.49 (C.26:2J-47).
b. Solicitation of enrollees by a health maintenance organization granted a certificate of authority, or its representatives, shall not be construed to violate any provision of law relating to solicitation or advertising by health professionals.
c. Any health maintenance organization authorized under this act shall not be deemed to be practicing medicine and shall be exempt from the provisions of chapter 9 of Title 45, Medicine and Surgery, of the Revised Statutes relating to the practice of medicine.
d. Except as provided in P.L.2001, c.187 (C.2A:53A-30 et al.), no person participating in the arrangements of a health maintenance organization other than the actual provider of health care services or supplies directly to enrollees and their families shall be liable for negligence, misfeasance, nonfeasance or malpractice in connection with the furnishings of such services and supplies. The provisions of this subsection shall not be construed to eliminate any cause of action against a health maintenance organization otherwise provided by law.
e. A health maintenance organization shall be subject to the provisions of P.L.1970, c.22 (C.17:27A-1 et seq.), including those relating to merger or acquisition of control.
All applications, filings and reports required under this act shall be treated as public documents and, except for any examination being conducted pursuant to section 20 of P.L.1997, c.192 (C.26:2J-18.1), any matter pertaining to a change in capital or surplus pursuant to the provisions of P.L.2005, c.65 (C.26:2J-18.2 et al.) and contracts referred to in paragraphs (4) and (5) of subsection c. of section 3 of P.L.1973, c. 337 (C.26:2J-3), shall not be considered to be confidential.
Any data or information pertaining to the diagnosis, treatment, or health of any enrollee or applicant obtained from such enrollee or from any provider by any health maintenance organization shall be held in confidence and shall not be disclosed to any person except to the extent that it may be necessary to carry out the purposes of this act; or upon the express consent of the enrollee or applicant; or pursuant to statute or court order for the production of evidence or the discovery thereof; or in the event of claim or litigation between such enrollee and the health maintenance organization wherein such data or information is pertinent. A health maintenance organization shall be entitled to claim any statutory privileges against such disclosure which the provider who furnished such information to the health organization is entitled to claim.
The commissioner or where applicable the Commissioner of Insurance, in carrying out his obligations under sections 4 a. (2), and 18 a. hereof, may contract with qualified persons to make recommendations concerning the determinations required to be made by him. Such recommendations may be accepted in full or in part by the commissioner or Commissioner of Insurance.
Any employee of the State or any subdivision of the State or any institution supported in whole or in part by the State may elect to enroll in a health maintenance organization and have all deductions from his salary or wages and all contributions being paid by his employer to any health insurer paid instead to a health maintenance organization; provided, however, in no event, shall an employer under this section make a contribution to any alternative health benefits program greater than the contribution being made to any health plan pursuant to a contract in existence on the effective date of this act. Any such employee shall at least annually be allowed to choose an alternative health benefits program made available through his employer.
If any section, term, or provision of this act shall be adjudged invalid for any reason, such judgment shall not affect, impair, or invalidate any other section, term, or provision of this act, but the remaining sections, terms, and provisions shall be and remain in full force and effect.
"Applicant" means any individual who seeks enrollment with a health maintenance organization for the purpose of obtaining medicare supplement health care services.
"Commissioner" means the Commissioner of Insurance.
"Department" means the Department of Insurance.
"Enrollee" means an individual who is enrolled with a health maintenance organization.
"Evidence of coverage" means any booklet, certificate, agreement or contract issued to an enrollee setting out the services and other benefits to which he is entitled.
"Health care services" means those services, including, but not limited to, inpatient hospital and physician care, and outpatient medical services, as set forth in the evidence of coverage.
"Health maintenance organization" means any person which, directly or through contracts with providers, furnishes health care services on a prepaid basis to enrollees in a designated geographic area in this State pursuant to the provisions of P.L.1973, c.337 (C.26:2J-1 et seq.).
"Medicare" means the program established by the "Health Insurance for the Aged Act," Title XVIII of the "Social Security Act," Pub.L. 89-97, as then constituted or later amended (42 U.S.C. s.1395 et seq.).
"Medicare supplement contract" means a group or individual contract or plan which is advertised, marketed or designed primarily as providing, or is otherwise held out to provide, medicare supplement health care services and under which an individual is enrolled, other than a contract issued pursuant to a contract under 42 U.S.C. s.1395l or 42 U.S.C. s.1395mm or a contract issued under a demonstration project authorized pursuant to the "Health Insurance for the Aged Act," 42 U.S.C. s.1395 et seq. The term does not include health care services provided pursuant to a contract or plan issued to one or more employers or labor organizations, or to the trustees of a fund established by one or more employers or labor organizations, or combination thereof, for employees or former employees of the employers, or a combination thereof, or for members or former members, or a combination thereof, of the labor organizations.
"Medicare supplement evidence of coverage" means an evidence of coverage delivered to an enrollee who has medicare supplement health care services coverage under a medicare supplement contract.
"Medicare supplement health care services" means health care services which supplement medicare, provided under a medicare supplement contract as set forth in a medicare supplement evidence of coverage.
"Provider" means any physician, hospital or other person which is licensed or otherwise authorized in this State to furnish health care services.
a. This act shall apply to all medicare supplement health care services provided pursuant to a medicare supplement contract or evidence of coverage delivered or issued for delivery in this State.
b. This act shall not apply to any health maintenance organization contract or evidence of coverage, including group conversion plans, provided to medicare eligible persons that are not advertised, marketed, designed primarily as or otherwise held out to provide medicare supplement health care services.
b. The commissioner shall promulgate regulations to establish specific standards for the provisions to be contained in any medicare supplement contract or evidence of coverage, which shall be in addition to and in accordance with the applicable laws of this State. The regulations may provide, but shall not be limited to:
(1) Terms of renewability;
(2) Initial and subsequent conditions of eligibility;
(3) Non-duplication of coverage;
(4) Probationary periods;
(5) Benefit limitations, exceptions and reductions;
(6) Elimination periods;
(7) Requirements for replacement;
(8) Recurrent conditions; and
(9) Definition of terms.
c. The commissioner may promulgate regulations that specify prohibited medicare supplement contract or evidence of coverage provisions not otherwise specifically authorized by statute which, in the opinion of the commissioner, are unjust, unfair or unfairly discriminatory to any applicant for, or enrollee with, medicare supplement health care services coverage.
a. Establishment of minimum standards for benefits, claim payments, marketing and reporting practices and compensation arrangements;
b. Establishment of a uniform methodology for calculating and reporting loss ratios, and requiring refunds or credits if the medicare supplement contracts do not meet loss ratio requirements;
c. Establishment of a process for filing of all requests for premium increases and rate changes which may include public hearings as determined appropriate by the commissioner prior to approval of any premium increases;
d. Assurance of access by the public to policy, premium and loss ratio information; and
e. Establishment of standards for Medicare Select contracts at such time as this State is authorized under federal law to authorize Medicare Select contracts.
a. The number of enrollees;
b. The geographic area to be serviced;
c. The current and prospective financial condition of the health maintenance organization;
d. The anticipated impact on the health maintenance organization of providing medicare supplement health care services in addition to other services which it provides.
(1) At the expiration of 60 days after submission a form shall be deemed filed unless prior thereto it has been affirmatively filed or disapproved for filing by the commissioner.
(2) No form which is disapproved for filing by the commissioner during the 60-day period, may be delivered or issued for delivery in this State unless and until the disapproval for filing is withdrawn. Any disapproval shall be subject to review in accordance with the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.). Any form which is filed by the commissioner or deemed filed may be delivered or issued for delivery in this State until such time as any subsequent withdrawal of the filing by the commissioner, following an opportunity for a hearing held in accordance with the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.).
(3) The commissioner may extend the 60-day period provided in paragraph (1) of this subsection for not more than 60 additional days by giving written notice of extension before the expiration of the initial 60-day period. In the event of an extension, all of the provisions of this subsection, except this provision for an extension, relating to the initial 60-day period shall apply to the extended period instead of the initial 60-day period.
(4) The disapproval for filing or the withdrawal of the filing of any form by the commissioner shall state in writing the grounds therefor in such detail as is reasonable to inform the health maintenance organization of the reasons for withdrawal or disapproval.
(5) The provisions of this subsection shall not apply to documents which relate only to the manner of distribution of services or to the reservation of rights and services under the medicare supplement contract or evidence of coverage and which are used at the request of the enrollee.
(6) The disapproval by the commissioner of any form submitted for filing pursuant to the provisions of this subsection may be on the ground that the form contains provisions which are unjust, unfair, inequitable, misleading or contrary to law or to the public policy of this State.
b. Every health maintenance organization providing medicare supplement health care services to a resident of this State shall file annually with the commissioner its rates, rating schedule and supporting documentation demonstrating that it is in compliance with the applicable loss ratio standards of this State. All filings of rates and rating schedules shall be certified by a qualified actuary and shall demonstrate that the actual and expected costs in relation to services provided comply with the requirements of this act and any rule or regulation promulgated hereunder.
As used in this subsection, "qualified actuary" means a person, in good standing, who is a member of the American Academy of Actuaries, a fellow of the Casualty Actuarial Society, or a person who has otherwise demonstrated actuarial competence to the satisfaction of the commissioner.
c. Services provided under a medicare supplement contract or evidence of coverage shall be expected to return to enrollees services or other benefits which are reasonable in relation to the premium or other fee charged. The commissioner shall promulgate regulations to establish minimum standards for loss ratios under medicare supplement contracts or evidences of coverage on the basis of paid medicare supplement health care expenses and written earned premiums and fees in accordance with accepted actuarial principles and practices.
b. The commissioner shall prescribe the format and content of the outline of coverage required by subsection a. of this section. For the purposes of this section, "format" means style, arrangement and overall appearance, including the size, color and prominence of the font used, paper size and weight and the arrangement of text and captions. The outline of coverage shall include:
(1) A description of the principal medicare supplement health care services provided;
(2) A statement of any applicable exceptions, reductions and limitations in the available medicare supplement health care services;
(3) A statement of the renewal provisions, including any reservation by the health maintenance organization of the right to change premiums or other fees; and
(4) A statement that the outline of coverage is a summary of the medicare supplement contract or evidence of coverage issued or applied for and that the contract or evidence of coverage should be consulted to determine the governing contractual provisions.
c. The commissioner may require by regulation the publication of forms and an informational brochure with a standardized format and content, to serve as an aid in the selection of appropriate coverage, if any, by those eligible for medicare, and to aid the consumer in improving his understanding of medicare benefits. Except in the case of direct response solicitation for medicare supplement health care services, the commissioner may require by regulation that the informational brochure be provided, concurrently with delivery of the outline of coverage, to all prospective enrollees eligible for medicare. With respect to direct response solicitation for medicare supplement health care services, the commissioner may require by regulation that the prescribed brochure be provided upon request to any prospective enrollee eligible for medicare, but in no event later than the time the medicare supplement contract or evidence of coverage is delivered.
d. The commissioner may promulgate regulations for captions or notice requirements for all contracts and evidences of coverage delivered or issued for delivery to persons eligible for medicare to inform prospective enrollees that the particular contract or evidence of coverage does not provide medicare supplement health care services. These notice requirements shall not apply to medicare supplement contracts or evidences of coverage or to contracts issued pursuant to a contract under 42 U.S.C. s.1395l or 42 U.S.C. s.1395mm.
e. The commissioner may further promulgate regulations to govern the full and fair disclosure of information in connection with the replacement of contracts or evidences of coverage by persons eligible for medicare.
b. The commissioner may, in the public interest, promulgate regulations governing medicare supplement health care services advertising including, but not limited to, specific filing procedures, standards upon which review may be based, celebrity endorsements, unfair practices and review and disapproval procedures.
c. Notwithstanding the provisions of subsection b. of this section, the commissioner may disapprove any advertisement for use in this State at any time if he determines that the advertisement misrepresents the product, misleads the targeted consumer, uses a strategy which involves scare tactics, unnecessarily confusing data or representations, false or fraudulent statements or otherwise violates any applicable law of this State or regulation promulgated thereunder.
b. Any contract, evidence of coverage or related form filed with the Commissioner of Insurance for approval pursuant to this section shall be deemed approved upon the expiration of 60 days after the submission of the form unless disapproved in writing by the Commissioner of Insurance within that time. Any such disapproval shall be based only on the specific provisions of applicable statutes, regulations adopted by the Commissioner of Insurance, or guidelines published by the Commissioner of Insurance as of the effective date of this act, with regard to forms of that type. A disapproved contract, evidence of coverage or related form may be resubmitted.
c. Any contract, evidence of coverage or related form filed for approval pursuant to this section and disapproved by the Commissioner of Insurance before the expiration of 60 days after its submission shall be deemed withdrawn at the expiration of 60 days after the transmittal of the specific objections of the Commissioner of Insurance unless the filer submits a complete written response to all of the objections of the Commissioner of Insurance within the 60 day period.
d. A contract, evidence of coverage or related form, resubmitted in response to the objections of the Commissioner of Insurance pursuant to subsection b. of this section, shall be deemed approved upon the expiration of 30 days after its resubmission unless disapproved in writing by the Commissioner of Insurance within that time. No disapproval by the Commissioner of Insurance of a resubmission shall be based on any objection not specified by the Commissioner of Insurance in the initial disapproval of the filing, except that the Commissioner of Insurance may disapprove that form based upon any new provisions introduced in the resubmission or if in addressing the specified objections cited in the disapproval transmission of the Commissioner of Insurance, the health maintenance organization changes or modifies any substantive provisions of the form. Any form resubmitted for approval pursuant to this section and disapproved by the Commissioner of Insurance before the expiration of 30 days after its submission shall be deemed withdrawn at the expiration of 30 days after the transmittal of the specific objections of the Commissioner of Insurance, unless the filer submits a complete written response to all of the objections of the Commissioner of Insurance regarding the submission within the 30 day period.
e. With respect to all types of contracts, evidences of coverage or related forms required to be filed pursuant to this section and currently on file with and approved by the Commissioner of Insurance upon enactment of this act, the Commissioner of Insurance shall propose regulations, which may be amended or modified by the Commissioner of Insurance from time to time after adoption, concerning any actuarial or form requirements consistent with applicable statutory provisions but not specified therein, not later than 180 days after enactment of this act. Any such regulation shall be adopted not later than 180 days after it is proposed. With respect to any type of form not then on file with the Commissioner of Insurance but filed subsequent to enactment of this act, the Commissioner of Insurance shall propose regulations, which may be amended or modified by the Commissioner of Insurance from time to time after adoption, concerning any actuarial or form requirements consistent with applicable statutory provisions but not specified therein within 120 days after the form is approved or deemed approved by the Commissioner of Insurance pursuant to this section. Any such regulation shall be adopted not later than 180 days after it is proposed. The Commissioner of Insurance may issue bulletins which are interpretive of existing regulations consistent with statutory provisions, with respect to any type of contract or evidence of coverage form that may be certified pursuant to section 26 of this act. Nothing in this section shall preclude a health maintenance organization from filing a certifiable contract or evidence of coverage or related form for approval by the Commissioner of Insurance.
f. Any such form which is filed with the Commissioner of Insurance or deemed filed may be so delivered or issued for delivery until such time as any subsequent withdrawal of the filing by the Commissioner of Insurance, following an opportunity for a hearing held in accordance with the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.) and any rules adopted thereunder, becomes final in accordance therewith.
g. For purposes of this section: "days" means calendar days, except that when the last day of any specified time period is a Saturday, Sunday, or State holiday, then the time period shall end on the next following business day. With respect to any specified time period pertaining to correspondence between a health maintenance organization and the Commissioner of Insurance, the time period shall commence on the date that such correspondence is postmarked or submitted to a private delivery service.
h. The Commissioner of Insurance, in consultation with the Commissioner of Health, pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.), shall adopt rules and regulations as may be necessary to effectuate the purposes of this section.
b. Contracts and evidence of coverage forms, including related endorsements, riders and application forms, eligible for certification pursuant to this section shall include, but not be limited to, certain categories of individual and group health maintenance organization contracts and evidences of coverage which the Commissioner of Insurance shall define by regulation.
c. The certification memorandum shall be signed and acknowledged by a responsible officer of the health maintenance organization. The acknowledgment by that officer shall be done in the same manner in which documents for recording instruments conveying or affecting interests in real estate in this State must be acknowledged to be eligible for recording, or in such other manner as specified by the Commissioner of Insurance by regulation from time to time.
d. Upon receipt of an acknowledgment from the Commissioner of Insurance that the form and a certification memorandum which conforms to the requirements of this section have been received, the form so submitted may be used by the health maintenance organization.
e. (1) Improper certification shall subject a health maintenance corporation submitting such improper certification to a fine not to exceed $50,000 and, in addition, a maximum penalty of $1,000 per contract or evidence of coverage issued on a form determined to be improperly certified pursuant to the provisions of this section. The Commissioner of Insurance shall promulgate a schedule of penalties to be applied pursuant to this section. In determining the amount of any penalty to be imposed, the Commissioner of Insurance shall consider the severity of the violation based upon the potential adverse impact to the public and whether it is the filer's first violation of this section.
(2) If, after notice and a hearing pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.), a health maintenance organization is found by the Commissioner of Insurance to be in violation of this section, the form may be disapproved, and in addition to any other penalties that may be imposed pursuant to P.L.1973, c.337 (C.26:2J-1 et seq.), the Commissioner of Insurance may bar that health maintenance organization from participating in the certification process pursuant to this section for a period not to exceed one year.
f. The Commissioner of Insurance shall hold a hearing annually, or more often, for the purpose of adopting regulations to define the specific forms eligible for certification pursuant to this section. Initial regulations shall be adopted pursuant to this section no later than 180 days after enactment of this act.
g. For purposes of this section:
(1) "a responsible officer of the health maintenance organization" means a corporate officer of the level of vice president or higher, or of equivalent title within the health maintenance organization's structure, who is either the actuary of the health maintenance organization with responsibility for the type of form filed, or the individual with responsibility for managing the form filing process for the health maintenance organization with regard to the type of form filed; and
(2) "improper certification" means providing any misrepresentation or false statement material to a certification form required pursuant to subsection a. of this section.
(2) "Net written premiums received" means direct premiums as reported on the annual financial statement submitted pursuant to section 9 of P.L.1973, c.337 (C.26:2J-9), and to the commissioner on a quarterly basis.
b. The commissioner shall certify the amount of the annual assessment issued to each health maintenance organization as calculated pursuant to subsection a. of this section. Each health maintenance organization shall remit the amount so certified on a quarterly basis in each fiscal year to the Department of Banking and Insurance in accordance with the procedures established in P.L.1995, c.156 (C.17:1C-19 et seq.), and as prescribed by the commissioner, who may adjust the quarterly payments from time to time as necessary to meet the current and estimated assessment obligation of each health maintenance organization in each fiscal year.
c. Amounts collected by the commissioner shall be allocated to the Health Care Subsidy Fund established pursuant to section 8 of P.L.1992, c.160 (C.26:2H-18.58) and used solely for the purpose of providing charity care payments to hospitals in accordance with the formula used for the distribution of charity care subsidies that are provided pursuant to P.L.1992, c.160 (C.26:2H-18.51 et al.).
d. (1) A health maintenance organization shall not impose any additional premium, fee or surcharge on its premium or enrollee charge to recoup any assessment paid pursuant to this section.
(2) The provisions of paragraph (1) of this subsection shall not apply to a health maintenance organization with respect to any federally funded program underwritten by that health maintenance organization.
b. A health maintenance organization shall annually report to the Commissioner of Banking and Insurance, no later than August 1 of each year, the loss ratio calculated for all health benefits plans for the previous calendar year. In each case in which the loss ratio fails to substantially comply with the 85 percent loss ratio requirement, the health maintenance organization shall issue a dividend or credit against future premiums for all contract holders in an amount sufficient to assure that the aggregate benefits paid in the previous calendar year plus the amount of the dividends and credits shall equal 85 percent of the premiums collected. The health maintenance organization shall distribute all dividends and credits by December 31 of the year following the calendar year in which the loss ratio requirements were not satisfied. The health maintenance organization's annual report shall include the health maintenance organization's calculation of the dividends and credits applicable to all health benefits plans, as well as an explanation of the health maintenance organization's plan to issue dividends or credits.
c. The commissioner shall specify by regulation:
(1) any informational filings required to be submitted by a health maintenance organization to the commissioner in order to determine whether the health maintenance organization is in compliance with the loss ratio requirements;
(2) the instructions and format for calculating and reporting loss ratios and issuing dividends or credits;
(3) procedures for the distribution of a dividend or credit in the event of cancellation or termination by a contract holder; and
(4) the instructions and format for submitting annual reports.
d. As used in this section, "large employer" means an employer with more than 50 employees, who is not a small employer as defined in section 1 of P.L.1992, c.162 (C.17B:27A-17).
a. "Advanced life support" means an advanced level of emergency medical care, including specialty care transport, which includes basic life support functions and the use of procedures, medications, and equipment established by the National Highway Traffic Safety Administration's National EMS Scope of Practice Model for paramedics, except for any provisions of the National EMS Scope of Practice Model expressly excluded by the commissioner in rules or regulations, and any other such procedures, medications, and equipment as set forth in section 6 of P.L.1984, c.146 (C.26:2K-12) or as otherwise authorized in rules or regulations promulgated by the commissioner;
b. "Board of Medical Examiners" means the State Board of Medical Examiners;
c. "Board of Nursing" means the New Jersey Board of Nursing;
d. "Commissioner" means the Commissioner of the Department of Health;
e. "Department" means the Department of Health;
f. "Emergency department" means a program in a hospital staffed 24 hours a day by a licensed physician trained in emergency medicine;
g. "Specialty care transport" means services that are above basic life support services rendered to patients before and during transportation between licensed facilities, during retrieval from those facilities, and upon arrival within those facilities;
h. "Mobile intensive care paramedic" means a person trained in advanced life support services and licensed by the commissioner to render advanced life support services as part of a mobile intensive care unit or as otherwise provided in section 4 of P.L.1984, c.146 (C.26:2K-10);
i. "Mobile intensive care unit" means a specialized emergency medical service unit that is staffed in accordance with paragraph (2) of subsection a. of section 6 of P.L.1984, c.146 (C.26:2K-12) and operated for the provision of advanced life support services under the direction of an authorized hospital;
j. "Pre-hospital care" means those emergency medical services rendered by mobile intensive care units to emergency patients before and during transportation to emergency treatment facilities, and upon arrival within those facilities.
k. "Volunteer paramedic unit" means an operational subunit within a mobile intensive care unit that is exclusively staffed by at least two volunteer paramedics with access to any vehicle, including a personal vehicle.
l. "Agency EMS medical director" means a physician licensed in this State who is certified in emergency medicine or emergency medical services, or both, and is responsible for the medical oversight of a hospital mobile intensive care program.
m. "Mobile integrated health" means health care services delivered with the approval of the Department of Health to patients outside of a hospital setting, using mobile resources, and employing team-based and patient-centered care.
b. The commissioner with the approval of the State Board of Medical Examiners shall establish written standards which a mobile intensive care paramedic shall meet in order to obtain licensure. The commissioner shall make a determination upon applications of candidates for licensure as a mobile intensive care paramedic within 30 days of the receipt of a complete application and background check. Such determination may include a determination that the commissioner requires more time to adequately review the application. The commissioner shall license a candidate who provides satisfactory evidence of the successful completion of an educational program approved by the commissioner for the training of mobile intensive care paramedics and who passes an examination in the provision of advanced life support services, which examination shall be approved by the commissioner. The commissioner shall license a candidate as a mobile intensive care paramedic who has equivalent military training or experience in any branch of the active duty or reserve component of the Armed Forces of the United States or the National Guard of any state if the commissioner determines that the candidate's military training and experience exceed or are equivalent to the licensure standards established by the commissioner. The commissioner shall license a candidate as a mobile intensive care paramedic who is registered as a paramedic with the National Registry of Emergency Medical Technicians if the commissioner determines that the candidate's training and experience exceed or are equivalent to the licensure standards established by the commissioner.
c. The department shall maintain a register of all applicants for licensure hereunder, which register shall include but not be limited to:
(1) The name and residence of the applicant;
(2) The date of the application;
(3) Information as to whether the applicant was rejected or licensed and the date of that action.
The department shall annually compile a list of mobile intensive care paramedics. This list shall be available to the public.
b. A person shall be disqualified from licensure if that person's criminal history record background check reveals a record of conviction of any of the following crimes or offenses:
(1) In New Jersey, any crime or disorderly persons offense:
(a) involving danger to the person, meaning those crimes and disorderly persons offenses set forth in N.J.S.2C:11-1 et seq., N.J.S.2C:12-1 et seq., N.J.S.2C:13-1 et seq., N.J.S.2C:14-1 et seq., or N.J.S.2C:15-1 et seq.; or
(b) involving arson as set forth in N.J.S.2C:17-1 or causing or risking widespread injury or damage as set forth at N.J.S.2C:17-2; or
(c) involving forgery and fraudulent offenses as set forth in chapter 21 of Title 2C of the New Jersey Statutes; or
(d) against the family, children, or incompetents, meaning those crimes and disorderly persons offenses set forth in N.J.S.2C:24-1 et seq.; or
(e) involving theft as set forth in chapter 20 of Title 2C of the New Jersey Statutes; or
(f) involving any controlled dangerous substance or controlled substance analog as set forth in chapter 35 of Title 2C of the New Jersey Statutes; or
(g) that would qualify the person for registration pursuant to section 2 of P.L.1994, c.133 (C.2C:7-2).
(2) In any other state or jurisdiction, of any crime or disorderly persons offense involving conduct which, if committed in New Jersey, would constitute any of the crimes or disorderly persons offenses described in paragraph (1) of this subsection.
c. Except for a disqualification based on conviction for a crime enumerated in subparagraph (g) of paragraph (1) of subsection b. of this section or a crime in any other state or jurisdiction which, if committed in New Jersey, would constitute a crime enumerated in subparagraph (g) of paragraph (1) of subsection b. of this section, no person shall be disqualified from licensure on the basis of any conviction disclosed by a criminal history record background check performed pursuant to the requirements of this act if the person has affirmatively demonstrated to the commissioner clear and convincing evidence of the person's rehabilitation. In determining whether a person has affirmatively demonstrated rehabilitation, the following factors shall be considered:
(1) the nature and responsibility of the position which the convicted person would hold, has held or currently holds, as the case may be;
(2) the nature and seriousness of the offense;
(3) the circumstances under which the offense occurred;
(4) the date of the offense;
(5) the age of the person when the offense was committed;
(6) whether the offense was an isolated or repeated incident;
(7) any social conditions which may have contributed to the offense; and
(8) any evidence of rehabilitation, including good conduct in prison or in the community, counseling or psychiatric treatment received, acquisition of additional academic or vocational schooling, successful participation in correctional work-release programs, or the recommendation of those who have had the person under their supervision.
d. If a person subject to the provisions of sections 3 through 5 of P.L.2022, c.118 (C.26:2K-8.1 through C.26:2K-8.3) refuses to consent to, or cooperate in, the securing of a criminal history record background check, the commissioner shall, as applicable:
(1) not issue a mobile intensive care paramedic license; or
(2) revoke the person's mobile intensive care paramedic license.
b. Upon receipt of the criminal history record information for a person from the Federal Bureau of Investigation or the Division of State Police, the commissioner shall immediately notify, in writing, the applicant of the results of the criminal history record background check. If the person is disqualified, the conviction or convictions which constitute the basis for the disqualification shall be identified in the notice to the person, but shall not be identified to any other person.
c. The person who is the subject of the background check shall have 30 days from the date of the written notice of disqualification to petition the commissioner for a hearing on the accuracy of the person's criminal history record information or to establish the person's rehabilitation under subsection c. of section 3 of P.L.2022, c.118 (C.26:2K-8.1 through C.26:2K-8.3). Upon the issuance of a final decision following a petition to the commissioner pursuant to this subsection, the commissioner shall notify the person as to whether the person remains disqualified from licensure.
b. The Department of Health shall establish, in writing, criteria by which an entity may apply for and receive authorization from the department to participate in the mobile integrated health program, and criteria by which an entity may lose authorization to participate in the mobile integrated health program.
c. The Commissioner of Health shall adopt rules and regulations as are necessary to effectuate the provisions of this section, which rules and regulations shall be effective immediately upon filing with the Office of Administrative Law for a period not to exceed 18 months, and shall, thereafter, be amended, adopted, or readopted in accordance with the provisions of the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.)."
b. (1) A mobile intensive care paramedic may deliver advanced life support services, or any other services within the approved scope of practice for mobile intensive care paramedics, in a pre-hospital setting, in a mobile integrated health care setting, health care specialty setting, or any other hospital-controlled setting, through an approved mobile intensive care hospital, as determined by the commissioner and as authorized by the agency EMS medical director. A mobile intensive care paramedic shall be permitted to provide advanced life support services when operating outside of a mobile intensive care unit in situations directly related to EMS first response or mobile integrated health as determined by the commissioner and as authorized by the mobile intensive care paramedic's agency EMS medical director. A single mobile intensive care paramedic shall not be acknowledged as a mobile intensive care unit.
(2) The authorized services provided under a mobile integrated health program shall be determined by the commissioner, and may include, but need not be limited to: providing paramedicine care, chronic disease management, preventive care, and post-discharge follow-up visits; or providing referrals and transportation assistance to appropriate care and services to patients requiring health care services who do not require hospital-based treatment.
c. Nothing in this section shall be construed to alter the scope of practice of any licensed health care professional under Title 45 of the Revised Statutes or the scope or authority of any agency, board, department, or other entity in this State that is responsible for licensing health care workers.
d. The provisions of this section shall apply notwithstanding the provisions of section 12 of P.L.1984, c.146 (C.26:2K-18) and notwithstanding the provisions of any law to the contrary.
If the direct voice communications fail, a mobile intensive care paramedic may perform any advanced life support procedure for which that person is certified and which is included in a written protocol established by the mobile intensive care hospital and approved by the commissioner if, in the judgment of the nurse or paramedic, the life of the patient is in immediate danger and requires that care for his preservation.
(2) The first member of a volunteer paramedic unit to respond to an emergency may provide aid prior to the arrival of the second member of a volunteer paramedic if necessary.
(3) The first member of a volunteer paramedic unit to respond to an emergency may cancel the response of a second member of a volunteer paramedic unit to the emergency if the aid of a second member of a volunteer paramedic unit is unnecessary.
b. (1) Members of a volunteer paramedic unit shall be dressed professionally and shall wear identification identifying members as paramedics.
(2) Members of a volunteer paramedic unit shall not be required to respond to an emergency dressed in a uniform issued by the mobile intensive care unit.
(2) (a) A mobile intensive care unit, when in service, shall be staffed by a minimum of two persons, which two persons may be two mobile intensive care paramedics, two registered professional nurses trained in advanced life support nursing, or one mobile intensive care paramedic and one registered professional nurse trained in advanced life support nursing. Any individual providing advanced life support as provided in this paragraph shall be authorized to render care within that individual's scope of practice, as determined by the commissioner and based on the agency EMS medical director's determination of competency.
(b) The Department of Health shall establish criteria for and a process by which a hospital may apply to the department for permission to operate a mobile intensive care unit that is staffed by one emergency medical technician and one mobile intensive care paramedic or registered professional nurse trained in advanced life support nursing, if the hospital is experiencing a staffing shortage.
(3) Agency EMS medical directors shall have the authority to establish advanced life support protocols, within the scope of practice for advanced life support providers established by this act and the commissioner, which protocols shall include, but shall not be limited to, protocols concerning medications, equipment, procedures, and clinical practice. Such advanced life support protocols shall be submitted to the commissioner for approval. The commissioner may approve or deny advanced life support protocols submitted by an agency EMS medical director or may approve such protocols subject to amendments that the commissioner deems to be necessary. Aspects of clinical practice that exceed the scope established by commissioner shall be submitted by an agency EMS medical director to the mobile intensive care advisory council for review and recommendation to the commissioner, which shall be acted upon by the commissioner within 90 days.
(4) The commissioner with the approval of the State Board of Medical Examiners shall establish education and competency requirements which a board-certified or board-eligible emergency medicine physician, advanced practice nurse, or physician assistant who is employed by a hospital with a mobile intensive care unit shall be required to meet in order to obtain authorization from the department to deliver care within the respective scope of practice of the board-certified or board-eligible emergency medicine physician, advanced practice nurse, or physician assistant, as the case may be, in a pre-hospital setting or an interfacility setting. An authorized board-certified or board-eligible emergency medicine physician, advanced practice nurse, or physician assistant may deliver such care if and to the extent approved by the agency EMS medical director.
b. A hospital authorized by the commissioner pursuant to subsection a. of this section shall provide mobile intensive care unit services on a seven-day-a-week basis.
c. The commissioner shall establish, in writing, criteria which a hospital shall meet in order to qualify for the authorization.
d. The commissioner may withdraw his authorization if the hospital or unit violates any provision of this act or rules or regulations promulgated pursuant thereto.
e. Nothing in this section shall be construed to alter the scope of practice of any licensed health care professional under Title 45 of the Revised Statutes or the scope or authority of any agency, board, department, or other entity in this State that is responsible for licensing health care workers.
(2) A hospital that develops and maintains advanced life support services pursuant to paragraph (1) of this subsection shall be subject to the same level of oversight by the Department of Health as would apply to an entity that holds a certificate of need for advanced life support services, as provided by regulation at N.J.A.C.8:33.
b. A hospital which has been issued a certificate of need by the Department of Health to operate a Level 1 trauma center shall have the right to apply under expedited review to provide advanced life support services in additional municipalities in which an acute care hospital that, as of July 1, 2015, is part of the same health system as the Level 1 trauma center is located, provided such application for expedited review is submitted on or before December 31, 2016.
b. As used in this section, "emergency medical services provider" means any association, organization, company, department, agency, service, program, unit, or other entity that provides pre-hospital emergency care to patients in New Jersey, including, but not limited to, a basic life support ambulance service, a mobile intensive care program or mobile intensive care unit, an air medical service, or a volunteer or non-volunteer first aid, rescue and ambulance squad.
b. No person may impersonate or refer to himself or herself as a mobile intensive care paramedic unless the person is licensed or approved therefor, as appropriate.
An individual who violates the provisions of this act is subject to a penalty of $200.00 for the first offense and $500.00 for each subsequent offense. If the violation of this act is of a continuing nature, each day during which it continues shall constitute a separate offense for the purposes of this section. The penalty shall be collected and enforced by summary proceedings under "the penalty enforcement law," (N.J.S. 2A:58-1 et seq.).
(2) The State Emergency Medical Services Medical Director shall have primary responsibility for the oversight, regulation, and discipline related to clinical issues pertaining to the provision of emergency medical services in New Jersey, and the Director of Emergency Medical Services shall have primary responsibility for the oversight of non-clinical issues related to the provision of emergency medical services in New Jersey. The State Emergency Medical Services Medical Director shall additionally be responsible for aiding the commissioner in promulgating rules and regulations establishing the scope of practice for providers of emergency medical services, including new standards for basic and advanced life support based on the National Highway Traffic Safety Administration's National EMS Scope of Practice Model, the recommendations of the mobile intensive care advisory council, and standards established by the commissioner.
b. The commissioner shall establish a State mobile intensive care advisory council, which shall: advise the department on all matters of advanced life support, the Emergency Medical Service Helicopter Response Program and emergency medical transportation; annually review advanced life support scope of practice; and provide recommendations directly to the commissioner for clinical updates. The council shall annually select a chairperson and a vice-chair from among its members. The chairperson shall coordinate the activities of the advisory council. Within 60 days following the effective date of P.L.2022, c.118 (C.26:2K-8.1 et al.), the council shall create new by-laws, and select a chair and vice-chair from among its members. In the event that the chair position is vacant, the vice-chair shall act as chair of the council until the chair position is no longer vacant. The chair shall appoint subcommittees to review and recommend policy on subjects including, but not limited to, advanced life support training programs, advanced life support patient care equipment, biomedical and telecommunications equipment and procedures, treatment protocols, and helicopter equipment and procedures, as well as other medical matters.
Nothing in this act shall be interpreted to permit a mobile intensive care paramedic to perform the duties or fill the position of another health care professional employed by the hospital, except that the paramedic may perform those functions that are necessary to assure the orderly transfer of advanced life support care from the mobile intensive care unit to hospital staff upon arrival at an emergency room, and that are necessary to obtain the clinical training in the provision of advanced life support services required by the department.
Nothing in this act shall be construed as interfering with an emergency service training program authorized and operated under provisions of the "New Jersey Highway Safety Act of 1971," P.L.1971, c. 351 (C. 27:5F-1 et seq.).
Nothing in this act shall be construed to prevent a licensed and qualified member of the health care profession from performing any of the duties of a mobile intensive care paramedic if the duties are consistent with the accepted standards of the member's profession.
As used in this act:
a. "Board" means the State Board of Medical Examiners;
b. "Basic life support" means a basic level of pre-hospital care which includes patient stabilization, airway clearance, cardiopulmonary resuscitation, hemorrhage control, initial wound care and fracture stabilization and other techniques and procedures authorized by the commissioner;
c. "Commissioner" means the Commissioner of the State Department of Health;
d. "Department" means the State Department of Health;
e. "Emergency service" means a program in a hospital staffed 24 hours a day by licensed physicians trained in emergency medicine;
f. "EMT-intermediate" means a person trained in intermediate life support services and certified by the commissioner to render intermediate life support services as part of an authorized pre-hospital intermediate life support pilot program;
g. "Inter-hospital care" means those emergency medical services rendered to emergency patients in preparation for transportation and during transportation between emergency treatment facilities, and upon arrival within those facilities;
h. "Intermediate life support program" means a program authorized under this act to provide pre-hospital intermediate life support services;
i. "Intermediate life support services" means an intermediate level of pre-hospital, inter-hospital, and emergency service care which includes basic life support functions, cardiac monitoring, cardiac defibrillation, the use of the esophageal obturator airway, and the use of military anti-shock trousers and other techniques and procedures authorized by the commissioner;
j. "Pre-hospital care" means those emergency medical services rendered to emergency patients before and during transportation to emergency treatment facilities, and upon arrival within those facilities.
A hospital having an accredited emergency service may apply to the department for approval to develop and maintain a pilot intermediate life support program in cooperation with first aid, rescue or emergency squads under regulations adopted by the commissioner. The pilot program shall be limited to rural areas. A pilot program that is approved by the department shall utilize EMT-intermediates for the provision of intermediate life support services. The program shall be under the direction of a licensed physician specializing in emergency medicine, who is affiliated with a hospital certified to participate in this program by the commissioner.
An intermediate life support program shall not extend beyond three years of the effective date of this act. The commissioner shall report to the Legislature no later than January 15 of each year on the effectiveness of each intermediate life support program.
a. EMT-intermediates may perform intermediate life support services; provided they maintain direct voice communications with, and are taking orders from, a licensed physician or physician-directed registered professional nurse, both of whom are affiliated with a hospital which is approved by the commissioner to operate an intermediate life support program.
b. If the direct voice communications fail, an EMT-intermediate may perform any intermediate life support service for which he is certified that is included in written protocols established by the intermediate life support program hospital and approved by the commissioner, if, in the judgment of the EMT-intermediate, the life of the patient is in immediate danger and requires that care for his preservation.
a. An EMT-intermediate shall obtain certification from the commissioner to provide pre-hospital intermediate life support services and shall make application therefor on forms prescribed by the commissioner.
b. The commissioner, with the approval of the board, shall establish written standards which an EMT-intermediate shall meet in order to obtain certification. The commissioner shall certify a candidate who provides satisfactory completion of an educational program approved by the commissioner for the training of EMT-intermediates and who passes an examination in the provision of intermediate life support services, which shall be conducted by the department at regular intervals.
c. The commissioner shall maintain a register of all applications for approval hereunder, which shall include but not be limited to:
(1) The name and residence of the applicant;
(2) The date of the application;
(3) Whether the applicant was rejected or approved and the date of that action.
The commissioner shall annually compile a list of certified EMT-intermediates. This list shall be available to the public.
The commissioner, after notice and hearing, may revoke the certification of an EMT-intermediate for violation of any provisions of this act or of any regulations promulgated hereunder.
a. A hospital authorized by the commissioner pursuant to section 3 shall provide intermediate life support services on a seven-day-a-week basis.
b. The commissioner shall establish, in writing, criteria which a hospital shall meet in order to qualify for the authorization.
c. The commissioner may withdraw his authorization if the hospital or intermediate life support services violate any provision of this act or regulations promulgated pursuant thereto.
a. No person may advertise or disseminate information to the public that the person provides intermediate life support services, unless the person is authorized to do so pursuant to this act.
b. No person may impersonate or refer to himself as an EMT-intermediate unless he is certified pursuant to section 6 of this act.
No EMT-intermediate, licensed physician, hospital or its board of trustees, officers and members of the medical staff, nurses or other employees of the hospital, or officers and members of a first aid, ambulance or rescue squad shall be liable for any civil damages as the result of an act or the omission of an act committed while in training for or in the rendering of intermediate life support services in good faith and in accordance with this act.
Any person who violates the provisions of this act is subject to a penalty of $200.00 for the first offense and $500.00 for each subsequent offense. If the violation of this act is of a continuing nature, each day during which it continues shall constitute a separate offense for the purposes of this section. The penalty shall be collected and enforced by summary proceedings under "the penalty enforcement law" (N.J.S. 2A:58-1 et seq.).
The commissioner shall adopt such rules and regulations in accordance with the "Administrative Procedure Act," P.L. 1968, c. 410 (C. 52:14B-1 et seq.) as he deems necessary to effectuate the purpose of this act, and the board shall adopt such rules and regulations as it deems necessary to carry out its functions under this act.
Nothing in this act shall be interpreted to permit an EMT-intermediate to perform the duties or fill the position of another health professional employed by a hospital, except that the EMT-intermediate may perform those functions that are necessary to assure the orderly transfer of a patient receiving pre-hospital intermediate life support services to hospital staff upon arrival at an emergency department and that are necessary to obtain the required clinical training in the provision of intermediate life support services required by the department.
Nothing in this act shall be construed as interfering with an emergency service training program authorized and operated under provisions of the "New Jersey Highway Safety Act of 1971," P.L. 1971, c. 351 (C. 27:5F-1 et seq.).
Nothing in this act shall be construed to prevent a licensed and qualified member of the health care profession from performing any of the duties of an EMT-intermediate if the duties are consistent with the accepted standards of the member's profession.
a. "Commissioner" means the Commissioner of Health.
b. "Dispatch" means the coordinated request for and dispatch of the emergency medical service helicopter response unit by a central communications center located in the service area, following protocols developed by the mobile intensive care hospital, the regional trauma or critical care center, the commissioner, and the superintendent.
c. "Emergency medical service helicopter response unit" means a specially equipped hospital-based emergency medical service helicopter staffed by advanced life support personnel and operated for the provision of advanced life support services under the medical direction of a mobile intensive care program and the regional trauma or critical care center authorized by the commissioner.
d. "Emergency medical transportation" means the prehospital or interhospital transportation of an acutely ill or injured patient by a dedicated emergency medical service helicopter response unit operated, maintained and piloted by the Division of State Police of the Department of Law and Public Safety, pursuant to regulations adopted by the commissioner under chapter 40 of Title 8 of the New Jersey Administrative Code.
e. "Medical direction" means the medical control and medical orders transmitted from the physician of the mobile intensive care hospital or from the physician at the regional trauma or critical care center to the staff of the helicopter. The mobile intensive care unit coordinating center and regional trauma or critical care center shall have the ability to cross patch and consult with each other as approved by the commissioner.
f. "Mobile intensive care hospital" means a hospital authorized by the commissioner to develop and maintain a mobile intensive care unit to provide advanced life support services in accordance with P.L.1984, c.146 (C.26:2K-7 et al.).
g. "Regional trauma center" means a State designated level one hospital-based trauma center equipped and staffed to provide emergency medical services to an accident or trauma victim, including, but not limited to, the level one trauma centers at University Hospital in Newark, known as the "Eric Munoz Trauma Center," and at the Cooper Hospital/University Medical Center in Camden.
h. "Critical care center" means a hospital authorized by the commissioner to provide regional critical care services, such as trauma, burn, spinal cord, cardiac, poison, or neonatal care.
i. "Superintendent" means the Superintendent of the Division of State Police of the Department of Law and Public Safety.
a. There is established the New Jersey Emergency Medical Service Helicopter Response Program in the Division of Local and Community Health Services of the Department of Health. The commissioner shall designate a mobile intensive care hospital and a regional trauma or critical care center which shall develop and maintain a hospital-based emergency medical service helicopter response unit. The commissioner shall designate at least two units in the State, of which no less than one unit each shall be designated for the northern and southern portions of the State, respectively.
b. Each emergency medical service helicopter response unit shall be staffed by at least two persons trained in advanced life support and approved by the commissioner. The staff of the emergency medical service helicopter response unit shall render life support services to an accident or trauma victim, as necessary, in the course of providing emergency medical transportation.
b. From the moneys in the fund there shall be annually appropriated an amount necessary to pay the reasonable and necessary expenses of the operation of the New Jersey Emergency Medical Service Helicopter Response Program created pursuant to P.L.1986, c.106 (C.26:2K-35 et al.). Moneys remaining in the fund, and any unexpended balance of appropriations from the fund, at the end of each fiscal year, shall be reappropriated and deposited in a special capital maintenance reserve account within the fund. Moneys in the special capital maintenance reserve account shall be used exclusively for capital replacement and major maintenance of helicopter equipment.
c. Six months after the effective date of this section and every six months thereafter, the Commissioner of Health shall report to the Joint Budget Oversight Committee, or its successor, the Senate Health and Human Services Committee and the Assembly Health and Human Services Committee. The report shall contain, but not be limited to, cost analyses concerning the response program activities including the number of flights, types of accidents, hours spent waiting at accident sites, and fuel and maintenance expenses.
The Division of State Police of the Department of Law and Public Safety shall establish an emergency medical transportation service to provide medical transportation service pursuant to this amendatory and supplementary act. The superintendent shall operate and maintain at least one dedicated helicopter for each emergency medical service helicopter response unit designated by the commissioner pursuant to section 2 of this amendatory and supplementary act.
No mobile intensive care paramedic, licensed physician, hospital or its board of trustees, officers and members of the medical staff, nurses or other employees of the hospital, first aid, ambulance or rescue squad members or officers is liable for any civil damages as the result of an act or the omission of an act committed while training for or in rendering advanced life support services in good faith and in accordance with this amendatory and supplementary act.
"Commissioner" means the Commissioner of Health.
"Emergency medical service" means a program in a hospital staffed 24 hours-a-day by a licensed physician trained in emergency medicine.
"Emergency medical technician" means a person trained in basic life support services as defined in section 1 of P.L.1985, c.351 (C.26:2K-21) and who is certified by the Department of Health to perform these services.
"EMT-D" means an emergency medical technician who is certified by the commissioner to perform cardiac defibrillation.
"First Responder" means a police officer, firefighter or other person who has been trained to provide emergency medical first response services in a program recognized by the commissioner.
"First Responder-D" means a First Responder who is certified by the commissioner to perform cardiac defibrillation.
"Pre-hospital care" means those emergency medical services rendered to emergency patients at the scene of a traffic accident or other emergency and during transportation to emergency treatment facilities, and upon arrival within those facilities.
b. The commissioner shall establish written standards and application procedures which an emergency medical technician shall meet in order to obtain certification as an EMT-D, and which a person shall meet in order to obtain certification as a First Responder-D. The commissioner shall certify a candidate who provides evidence of satisfactory completion of an educational program which includes training in the performance of cardiac defibrillation and which is approved by the commissioner, and who passes an examination in the performance of cardiac defibrillation which is approved by the commissioner.
c. The commissioner shall maintain a register of all applications for certification as an EMT-D or a First Responder-D which shall include, but not be limited to:
(1) The name and residence of the applicant;
(2) The date of the application;
(3) Whether the applicant was rejected or approved and the date of that action.
d. The commissioner shall annually compile a list of certified EMT-D's and First Responder-D's which shall be available to the public.
e. A fee may be charged to a person who is enrolled in an educational program approved by the Department of Health which includes training in the performance of cardiac defibrillation, to cover the costs of training and testing for certification as an EMT-D or a First Responder-D.
b. A person shall not impersonate or refer to himself as an EMT-D or a First Responder-D unless he is certified pursuant to section 2 of this act.
A person who violates the provisions of this act is subject to a penalty of $200 for the first offense and $500 for each subsequent offense. If the violation of this act is of a continuing nature, each day during which it continues shall constitute a separate offense for the purposes of this section. The penalty shall be collected and enforced by summary proceedings under "the penalty enforcement law" (N.J.S.2A:58-1 et seq.).
Nothing in this act shall be construed as interfering with an emergency service training program authorized and operated under the provisions of the "New Jersey Highway Traffic Safety Act of 1987," P.L.1987, c.284 (C.27:5F-18 et seq.).
"Commissioner" means the Commissioner of Health;
"Emergency medical service" means a program in a hospital staffed 24 hours-a-day by a licensed physician trained in emergency medicine;
"Emergency medical technician" means a person trained in basic life support services as defined in section 1 of P.L.1985, c.351 (C.26:2K-21) and who is certified by the Department of Health to provide that level of care.
Each administration of an auto-injector device pursuant to this act shall be reported to the Department of Health in a manner determined by the commissioner.
b. The commissioner shall establish written standards and application procedures which an emergency medical technician shall meet in order to obtain certification. The commissioner shall certify a candidate who: provides evidence of satisfactory completion of an educational program which is approved by the commissioner and includes training in the administration of epinephrine auto-injector devices; and passes an examination in the administration of the devices which is approved by the commissioner.
c. The commissioner shall maintain a registry of all persons certified pursuant to this section, which shall include, but not be limited to:
(1) the person's name and residence; and
(2) the date that certification was granted.
d. The commissioner shall annually compile a list of emergency medical technicians who have obtained certification to administer an epinephrine auto-injector device pursuant to this section, which shall be available to the public.
e. A fee may be charged to a person enrolled in an educational program approved by the department which includes training in the administration of an epinephrine auto-injector device in order to cover the cost of training and testing for certification pursuant to this section, if the entity that provides the educational program is not reimbursed for the cost of that training and testing from the "Emergency Medical Technician Training Fund" established pursuant to section 3 of P.L.1992, c.143 (C.26:2K-56).
a. permit a person certified to administer an epinephrine auto-injector device pursuant to section 2 of this act to perform the duties or fill the position of another health care professional employed by a hospital;
b. interfere with an emergency service training program authorized and operated under the provisions of the "New Jersey Highway Traffic Safety Act of 1987," P.L.1987, c.284 (C.27:5F-18 et seq.);
c. prohibit the administration of an epinephrine auto-injector device by a person acting pursuant to a lawful prescription; or
d. prevent a licensed and qualified member of a health care profession from administering an epinephrine auto-injector device if the duties are consistent with the accepted standards of the member's profession.
a. Traumatic injuries, such as automobile accidents, bicycle accidents, drownings and poisonings, are the most common cause of death in children over the age of one; and children have a high death rate in these emergency situations.
b. Children react differently than adults to stress, metabolize drugs differently, and suffer different illnesses and injuries. Because of these differences, children's emergency medical needs should be recognized.
c. Emergency medical services training programs focus on adults and, therefore, offer fewer hours of pediatric training. In addition, many emergency medical services personnel have no clinical experience with children, indicating the need to improve training of these personnel in pediatric emergencies.
d. It is the public policy of this State that children are entitled to comprehensive emergency medical services, including pre-hospital, hospital and rehabilitative care.
"Advanced life support" means an advanced level of pre-hospital, interhospital, and emergency service care which includes basic life support functions, cardiac monitoring, cardiac defibrillation, telemetered electrocardiography, administration of antiarrhythmic agents, intravenous therapy, administration of specific medications, drugs and solutions, use of adjunctive ventilation devices, trauma care and other techniques and procedures authorized in writing by the commissioner pursuant to department regulations and P.L.1984, c.146 (C.26:2K-7 et seq.).
"Advisory council" means the Emergency Medical Services for Children Advisory Council established pursuant to section 5 of this act.
"Basic life support" means a basic level of pre-hospital care which includes patient stabilization, airway clearance, cardiopulmonary resuscitation, hemorrhage control, initial wound care and fracture stabilization, and other techniques and procedures authorized by the commissioner.
"Commissioner" means the Commissioner of Health.
"Coordinator" means the person coordinating the EMSC program within the Office of Emergency Medical Services in the Department of Health.
"Department" means the Department of Health.
"EMSC program" means the Emergency Medical Services for Children program established pursuant to section 3 of this act, and other relevant programmatic activities conducted by the Office of Emergency Medical Services in the Department of Health in support of appropriate treatment, transport, and triage of ill or injured children in New Jersey.
"Emergency medical services personnel" means persons trained and certified or licensed to provide emergency medical care, whether on a paid or volunteer basis, as part of a basic life support or advanced life support pre-hospital emergency care service or in an emergency department or pediatric critical care or specialty unit in a licensed hospital.
"Pre-hospital care" means the provision of emergency medical care or transportation by trained and certified or licensed emergency medical services personnel at the scene of an emergency and while transporting sick or injured persons to a medical care facility or provider.
b. The commissioner shall hire a full-time coordinator for the EMSC program in consultation with, and by the recommendation of the advisory council.
c. The coordinator shall implement the EMSC program following consultation with, and at the recommendation of, the advisory council. The coordinator shall serve as a liaison to the advisory council.
d. The coordinator may employ professional, technical, research and clerical staff as necessary within the limits of available appropriations. The provisions of Title 11A of the New Jersey Statutes shall apply to all personnel so employed.
e. The coordinator may solicit and accept grants of funds from the federal government and from other public and private sources.
a. Initial and continuing education programs for emergency medical services personnel that include training in the emergency care of infants and children;
b. Guidelines for referring children to the appropriate emergency treatment facility;
c. Pediatric equipment guidelines for pre-hospital care;
d. Guidelines for hospital-based emergency departments appropriate for pediatric care to assess, stabilize, and treat critically ill infants and children, either to resolve the problem or to prepare the child for transfer to a pediatric intensive care unit or a pediatric trauma center;
e. Guidelines for pediatric intensive care units, pediatric trauma centers and intermediate care units fully equipped and staffed by appropriately trained critical care pediatric physicians, surgeons, nurses and therapists;
f. An interhospital transfer system for critically ill or injured children; and
g. Pediatric rehabilitation units staffed by rehabilitation specialists and capable of providing any service required to assure maximum recovery from the physical, emotional, and cognitive effects of critical illness and severe trauma.
b. The advisory council shall consist of a minimum of 14 public members to be appointed by the Governor, with the advice and consent of the Senate, for a term of three years. Membership of the advisory council shall include: one practicing pediatrician, one pediatric critical care physician, one board certified pediatric emergency physician and one pediatric physiatrist, to be appointed upon the recommendation of the New Jersey chapter of the American Academy of Pediatrics; one pediatric surgeon, to be appointed upon the recommendation of the New Jersey chapter of the American College of Surgeons; one emergency physician, to be appointed upon the recommendation of the New Jersey chapter of the American College of Emergency Physicians; one emergency medical technician, to be appointed upon the recommendation of the New Jersey State First Aid Council; one paramedic, to be appointed upon the recommendation of the State mobile intensive care advisory council; one family practice physician, to be appointed upon the recommendation of the New Jersey chapter of the Academy of Family Practice; two registered emergency nurses, one to be appointed upon the recommendation of the New Jersey State Nurses Association and one to be appointed upon the recommendation of the New Jersey Chapter of the Emergency Nurses Association; and three members, each with a non-medical background, two of whom are parents with children under the age of 18, to be appointed upon the joint recommendation of the Association for Children of New Jersey and the Junior Leagues of New Jersey.
c. Vacancies on the advisory council shall be filled for the unexpired term by appointment of the Governor in the same manner as originally filled. The members of the advisory council shall serve without compensation. The advisory council shall elect a chairperson, who may select from among the members a vice-chairperson and other officers or subcommittees which are deemed necessary or appropriate. The council may further organize itself in any manner it deems appropriate and enact bylaws as deemed necessary to carry out the responsibilities of the council.
"Commissioner" means the Commissioner of Health.
"Fund" means the "Emergency Medical Technician Training Fund" established pursuant to this act.
"Council" means the State advisory council for basic and intermediate life support services training established pursuant to this act.
The State Treasurer is the custodian of the fund and all disbursements from the fund shall be made by the treasurer upon vouchers signed by the commissioner or his designee. Monies in the fund shall be used to carry out the provisions of this act, except that no more than 5% of these monies shall be used for administration of the fund in each fiscal year. The fund shall consist of monies as provided for in this act and the interest which is earned on those monies. The monies in the fund shall be invested and reinvested by the Director of the Division of Investment in the Department of the Treasury as are other trust funds in the custody of the State Treasurer in the manner provided by law.
b. All reimbursements from the fund shall be promptly paid upon receipt of a qualifying application for reimbursement, which payment shall be made to the agency, organization, or entity that provided training to the volunteer emergency medical technician.
c. (1) The head of the ambulance, first aid, and rescue squad employing or utilizing the services of an emergency medical technician, who received initial emergency medical technician training from an agency, organization, or entity that received reimbursement from the fund for providing the initial emergency medical technician training to that emergency medical technician, shall determine the emergency medical technician to be a volunteer in good standing, provided that the emergency medical technician works at least one service call per month during the initial three-year certification period as a volunteer emergency medical technician.
(2) The head of the ambulance, first aid, and rescue squad shall seek reimbursement from the emergency medical technician, if the emergency medical technician ceases to be a volunteer in good standing, for monies paid out of the fund in connection with that emergency medical technician's training, testing, certification, or recertification, as appropriate, in connection with the initial three-year certification period in which the emergency medical technician ceased to be a volunteer in good standing. However, an emergency medical technician who ceases to be a volunteer in good standing in order to attend a public or private institution of higher education shall not be responsible for reimbursing the fund. The Department of Health shall exercise oversight authority over the collection of funds pursuant to this paragraph.
d. As used in this section:
"Public or private institution of higher education" means any public university or college or any private college, university, or institute incorporated and located in New Jersey, which by virtue of law or character or license is a nonprofit educational institution authorized to grant academic degrees, provides a level of education equivalent to the education provided by the State's public institutions of higher education as attested by the receipt of and continuation of regional accreditation by the Middle States Association of Colleges and Schools, and is eligible to receive State aid under the provisions of the Constitution of the United States and the Constitution of the State of New Jersey.
"Volunteer emergency medical technician" means an emergency medical technician who provides basic life support services without receiving compensation in the form of an hourly wage, a salary, or any other form of financial remuneration provided for or in connection with the provision of basic life support services. A volunteer emergency medical technician shall not include an individual employed full-time by a general or special hospital licensed pursuant to P.L.1971, c.136 (C.26:2H-1 et seq.) as an emergency medical technician.
b. The council shall consist of 13 members, as follows: the Commissioner of Health, the Superintendent of the Division of State Police in the Department of Law and Public Safety, the Director of the Governor's Office on Volunteerism, the President of the New Jersey State First Aid Council, the chairman of the State mobile intensive care advisory council, and the President of the Medical Transport Association of New Jersey, or their designees, as ex officio members; and seven public members, of which two shall be persons with a demonstrated interest or expertise in emergency medical services who are not health care professionals and two shall be physicians who are medical specialists in areas relating to basic life support services, to be appointed by the Governor, one shall be a representative of the New Jersey Hospital Association, to be appointed by the President thereof, one shall be a representative of the Medical Society of New Jersey, to be appointed by the President thereof, and one shall be a representative of the New Jersey State Nurses Association, to be appointed by the President thereof.
c. Of the public members first appointed, three shall serve for a term of two years, three shall serve for a term of three years and one shall serve for a term of four years. Following the expiration of the original terms, the public members shall serve for a term of four years and are eligible for reappointment. Any vacancy shall be filled in the same manner as the original appointment, for the unexpired term. Public members shall continue to serve until their successors are appointed.
d. The council shall meet at its discretion, but at least quarterly. The public members of the council shall serve without compensation but shall be reimbursed for the reasonable expenses incurred in the performance of their duties, within the limits of funds available to the council.
e. The council shall organize no later than the 60th day after the effective date of this act. The members shall choose a chairman from among themselves and a secretary who need not be a member of the council. The Department of Health shall provide such technical, clerical and administrative support as the council requires to carry out its responsibilities.
The chief executive officer of the volunteer first aid, ambulance or rescue squad located in and normally serving a contiguous municipality to whom such a request for assistance is made shall, except as hereinafter otherwise set forth, provide such personnel and equipment as requested to the extent possible without endangering any person or property within the municipality in which the assisting squad is located and which it normally serves.
The members of any squad providing assistance shall have, while so acting, the same rights and immunities as they otherwise enjoy in the performance of their normal duties in the municipality, or other territorial jurisdiction, in which the squad is located and which it normally serves.
If any member of the assisting first aid, ambulance or rescue squad shall, in rendering such assistance, suffer any injury or death, the member or his designee or legal representative shall be entitled to all salary, pension rights, workers compensation and other benefits to which the member would be entitled if the casualty or death had occurred in the performance of the member's duties in the municipality, or other territorial jurisdiction, in which the squad is located and which it normally serves.
a. Terms and conditions for payment by the municipality receiving assistance to the municipality rendering assistance for each member and each equipped first aid, ambulance or rescue squad apparatus for each hour supplied;
b. The reimbursement of the municipality or municipalities rendering assistance for any damage to first aid, ambulance or rescue squad equipment or other property and for payment to any member of a first aid, ambulance or rescue squad for injuries sustained while serving pursuant to such agreements, or to a surviving spouse or other dependent if death results; and
c. A joint meeting of the municipalities entering into such agreements regarding other matters as are mutually deemed necessary.
b. A person who possesses a current EMT certification in good standing from another state, territory, or possession of the United States, the District of Columbia, or the Commonwealth of Puerto Rico may obtain an EMT certification from the commissioner to provide basic life support and may make application therefor on forms prescribed by the commissioner.
c. The commissioner shall make a determination regarding applications of candidates for certification as an EMT within 30 days of the receipt of a complete application and background check. The determination may provide that the commissioner requires more time to adequately review the application. An application may be denied if the application is incomplete, contains false or fraudulent information, or the applicant has been suspended or revoked in any other state or jurisdiction or would otherwise be ineligible for EMT certification, as determined by the commissioner.
The commissioner shall approve an application upon determining that the certification standards of the applicant's certifying jurisdiction exceed or are equivalent to the EMT certification standards established by the commissioner and the applicant is not disqualified pursuant to P.L.2023, c.229 (C.26:2K-65.1 et al.).
d. Applicants for EMT certification, who have equivalent military training or experience in any branch of the active duty or reserve component of the Armed Forces of the United States or the National Guard of any state, shall be certified by the commissioner if the commissioner determines that the applicant's military training and experience exceed or are equivalent to the certification standards established by the commissioner.
An EMT certified by the department prior to the effective date of P.L.2023, c.229 (C.26:2K-65.1 et al.) who has not undergone a criminal history record background check, shall undergo the criminal history record background check as a condition of that individual's recertification following the effective date of P.L.2023, c.229 (C.26:2K-65.1 et al.).
A follow-up criminal history record background check of federal records shall be conducted at least once every three years as a condition of recertification for every EMT.
b. An EMT candidate shall be disqualified from certification if that candidate's criminal history record background check reveals a record of conviction of any of the following crimes or offenses:
(1) In New Jersey, any crime or disorderly persons offense:
(a) involving danger to the person, meaning those crimes and disorderly persons offenses set forth in N.J.S.2C:11-1 et seq., N.J.S.2C:12-1 et seq., N.J.S.2C:13-1 et seq., N.J.S.2C:14-1 et seq., or N.J.S.2C:15-1 et seq.;
(b) involving arson as set forth in N.J.S.2C:17-1 or causing or risking widespread injury or damage as set forth in N.J.S.2C:17-2;
(c) involving forgery and fraudulent offenses as set forth in chapter 21 of Title 2C of the New Jersey Statutes;
(d) against the family, children, or incompetents, meaning those crimes and disorderly persons offenses set forth in N.J.S.2C:24-1 et seq.;
(e) involving theft as set forth in chapter 20 of Title 2C of the New Jersey Statutes;
(f) involving any controlled dangerous substance or controlled substance analog as set forth in chapter 35 of Title 2C of the New Jersey Statutes; or
(g) that would qualify the person for registration pursuant to section 2 of P.L.1994, c.133 (C.2C:7-2).
(2) In any other state or jurisdiction, of any crime or disorderly persons offense involving conduct which, if committed in this State, would constitute any of the crimes or disorderly offenses described in paragraph (1) of this subsection.
c. Except for a disqualification based on conviction for a crime enumerated in subparagraph (g)of paragraph (1) of subsection b. of this section or a crime in any other state or jurisdiction involving conduct which, if committed in this State, would constitute a crime enumerated in subparagraph (g) of paragraph (1) of subsection b. of this section, a person shall not be disqualified from licensure on the basis of any conviction disclosed by a criminal history record background check performed pursuant to the requirements of this act if the person has affirmatively demonstrated to the commissioner clear and convincing evidence of the person's rehabilitation.
In determining whether a person has affirmatively demonstrated rehabilitation, the following factors shall be considered:
(1) the nature and responsibility of the position which the convicted person would hold, has held or currently holds, as the case may be;
(2) the nature and seriousness of the offense;
(3) the circumstances under which the offense occurred;
(4) the date of the offense;
(5) the age of the person when the offense was committed;
(6) whether the offense was an isolated or repeated incident;
(7) any social conditions which may have contributed to the offense; and
(8) any evidence of rehabilitation, including good conduct in prison or in the community, counseling or psychiatric treatment received, acquisition of additional academic or vocational schooling, successful participation in correctional work-release programs, or the recommendation of those who have had the person under their supervision.
d. If a person subject to the provisions of sections 1 through 4 of P.L.2023, c.229 (C.26:2K-65 through 26:2K-65.3) refuses to consent to, or cooperate in, the securing of a criminal history background check, the commissioner shall, as applicable:
(1) not issue an EMT certification; or
(2) revoke the person's EMT certification.
b. Upon receipt of the criminal history record information for a person from the Federal Bureau of Investigation or the Division of State Police, the commissioner shall immediately notify, in writing, the applicant of the results of the criminal history record background check. If the person is disqualified, the conviction or convictions which constitute the basis for the disqualification shall be identified in the notice to the person, but shall not be identified to any other person.
c. The person who is the subject of the background check shall have 30 days from the date of the written notice of disqualification to petition the commissioner for a hearing on the accuracy of the person's criminal history record information or to establish the person's rehabilitation under subsection c. of section 2 of P.L.2023, c.229 (C.26:2K-65.1). Upon the issuance of a final decision following a petition to the commissioner pursuant to this subsection, the commissioner shall notify the person as to whether the person remains disqualified from licensure.
"Commissioner" means the Commissioner of Health.
"Department" means the Department of Health.
"Emergency Medical Services Advisory Council" means the Emergency Medical Services Council constituted in the department as of the effective date of P.L.2017, c.116 (C.26:2K-66 et seq.), which serves as the main emergency medical services advisory council to the commissioner and the Office of Emergency Medical Services, makes recommendations and advises on emergency medical services in New Jersey, monitors legislative developments at all levels and in other states, and supports Statewide public information and education for consumers regarding emergency medical services.
"Emergency Medical Services Task Force" means the Emergency Medical Services Task Force constituted in the department as of the effective date of P.L.2017, c.116 (C.26:2K-66 et seq.).
"Emergency medical services dispatch center" means any communications center which provides services in connection with the coordination of requests for emergency medical services, including, but not limited to, call intake, call processing, emergency medical dispatch, call triage, unit assignment, and dispatch and tracking of any emergency medical services provider or other first responder.
"Emergency medical services provider" means any association, organization, company, department, agency, service, program, unit, or other entity that provides pre-hospital emergency medical care to patients in this State, including, but not limited to, a basic life support ambulance service, a mobile intensive care unit, an air medical service, or a volunteer or non-volunteer first aid, rescue, and ambulance squad.
"First responder" means a police officer, firefighter, or other person who has been trained to provide emergency medical first response services in a program recognized by the commissioner.
"Opioid antidote" means naloxone hydrochloride, or any other similarly acting drug approved by the United States Food and Drug Administration for the treatment of an opioid overdose.
"Pre-hospital emergency medical care" means the provision of emergency medical care or transportation by trained and certified or licensed emergency medical services personnel at the scene of an emergency and while transporting sick or injured persons to a medical care facility or provider.
(1) The date, time, and location of the encounter;
(2) The nature of the medical emergency, including the number of persons requiring emergency medical services and the condition of each person requiring emergency medical services at the time the provider arrived at the scene of the encounter;
(3) Any emergency medical treatment or other services provided, including any specific procedures performed, any medications administered including, but not limited to, an opioid antidote, and any modalities administered;
(4) The name and certification or professional licensure of each emergency medical service professional staffing the provider unit during the encounter, regardless of whether the professional provided direct treatment or services to any person;
(5) Whether any other emergency medical services provider responded to the request for emergency medical services, and, if so, whether they provided emergency medical treatment or other services to any person;
(6) The outcome of the encounter, including whether each person receiving emergency medical services was treated, refused additional treatment, was transported to a hospital or other health care facility or transferred to another emergency medical services provider for further treatment, or died. In the case of a person who was transported by a provider other than the reporting provider, the reporting provider shall identify the transporting provider and the receiving facility, if known. In the case of a person who died, the provider shall indicate the cause of death, if known, and whether the person died before, during, or after the provision of emergency medical services; and
(7) Any other particulars of the encounter as may be relevant or as may be required by the commissioner.
b. Each emergency medical services dispatch center shall report to the department, in a standardized format as the commissioner shall prescribe by regulation, the following information concerning each request for emergency medical services received by the dispatch center:
(1) The date, time, and location of the request for emergency medical services;
(2) The nature and circumstances of the emergency, as provided to the dispatch center;
(3) The identity of each emergency medical services provider dispatched to the scene of the encounter; and
(4) Any other particulars of the request as may be relevant or as may be required by the commissioner.
b. The electronic reporting system established pursuant to this section shall, at a minimum, seek to record and track data concerning types of medical emergencies for which emergency medical services are requested, response times for emergency medical services providers, patterns in the timing and location of requests for emergency medical services, patterns in the type or nature of emergency medical services provided, and patterns in dispatch and response activity.
c. The commissioner shall, in consultation with the Emergency Medical Services Advisory Council, adopt rules and regulations, pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.), establishing quality performance metrics and pre-hospital protocols for emergency medical services providers, which shall be based on the data tracked and recorded pursuant to subsection b. of this section. The commissioner shall review and update the rules and regulations concerning quality performance metrics and pre-hospital protocols as appropriate.
d. The commissioner shall make the response times for emergency medical services providers that are tracked and recorded pursuant to subsection b. of this section available to the public on the department's Internet website.
b. The purpose of the task force shall be to support and enhance the provision of specialized response services, utilizing personnel and equipment to respond as requested, for both pre-planned and emergency events, including natural disasters, mass casualty incidents, and chemical, biological, radiological, nuclear, and explosive events, in order to reduce morbidity and mortality through appropriate triage, incident management, and coordinated pre-hospital care and transportation.
c. The membership of the task force shall represent all regions of the State and shall include first responders, emergency medical technicians, paramedics, registered nurses, physicians, communications specialists, hospitals, agencies providing emergency medical responder and other emergency medical services, and communication centers utilized for the purpose of providing emergency medical services.
"Mobile intensive care paramedic" and "mobile intensive care unit" shall have the same meaning as provided in section 1 of P.L.1984, c.146 (C.26:2K-7).
"Opioid antidote" shall have the same meaning as provided in section 1 of P.L.2017, c.116 (C.26:2K-66).
b. Subject to the requirements of federal law, a mobile intensive care paramedic in this State who has responded to an emergency as a member of a dispatched mobile intensive care unit may administer buprenorphine, under the medical direction of a licensed, supervising physician, to an individual following the emergency administration of an opioid antidote to that individual provided that the mobile intensive care paramedic administering the buprenorphine:
(1) is providing emergency medical services through a program that is registered with the United States Attorney General pursuant to subsection (j) of 21 U.S.C. s.823;
(2) administers the buprenorphine consistent with all applicable requirements of federal law; and
(3) has completed supervised comprehensive training and competency assessments within a mobile intensive care unit regarding which specific medical conditions necessitate the administration of buprenorphine, buprenorphine dosage requirements, and required medical documentation following the administration of buprenorphine.
a. There are over 6,000 public safety call centers, known as public safety answering points, in the United States.
b. Public safety communications professionals dedicate their lives to helping others by performing work that goes far beyond merely relaying information between the public and first responders.
c. In times of crises, the information collected and actions taken by public safety communications professionals form the foundation for an effective response by law enforcement agencies, fire departments, and emergency medical service professionals.
d. Public safety communications professionals are an important part of the first responder community that provides immediate assistance to crime and disaster victims.
e. Accordingly, it is altogether fitting and proper to recognize the role of public safety communications professionals, including 9-1-1 dispatchers or operators, as emergency response personnel by designating them as 9-1-1 first responder dispatchers.
"Commissioner" means the Commissioner of Health.
“Emergency glucagon” means a medication used when a person with diabetes is experiencing severe hypoglycemia, or low blood sugar, and cannot take sugar orally. Once injected the medication raises the injected person’s blood sugar.
"Emergency medical technician" means a person trained in basic life support services as defined in section 1 of P.L.1985, c.351 (C.26:2K-21) and who is certified by the Department of Health to provide that level of care.
“Glucagon” means a hormone that the human body produces to prevent low blood sugar, which comes in several forms including a nasal spray, auto-injectors, prefilled syringes, or a powder that must be mixed with a liquid before injecting.
b. An emergency medical technician who has been authorized by the commissioner pursuant to subsection a. of this section to administer emergency glucagon shall administer, maintain, and dispose of the device in accordance with rules and regulations adopted by the commissioner.
c. The commissioner may by regulation or order modify, suspend, or terminate the authorization of an individual emergency medical technician to administer glucagon or blood glucose tests, obtained pursuant to this section, if necessary for public health, safety, or welfare. The commissioner may, by written standards, protocols, or regulation, require the emergency medical technician to transfer the patient to an acute care hospital unless the patient or their legally authorized representative refuses the transfer.
d. The commissioner may maintain a registry of all persons authorized pursuant to this section, which may include, but not be limited to:
(1) the person's name and residence; and
(2) the date that authorization was granted.
e. The commissioner may annually compile a list of emergency medical technicians who have obtained authorization to administer blood glucose tests or emergency glucagon pursuant to this section, which shall be available to the public.
f. A fee may be charged to a person enrolled in an educational program approved by the department which includes training in the administration of blood glucose tests and emergency glucagon in order to cover the cost of training and testing for certification pursuant to this section, if the entity that provides the educational program is not reimbursed for the cost of that training and testing from the "Emergency Medical Technician Training Fund" established pursuant to section 3 of P.L.1992, c.143 (C.26:2K-56).
a. Injury is the leading cause of death for New Jersey citizens aged one to 44, the fourth leading cause of death for all age groups, and accounts for more than 60,000 emergency department visits in the State each year, with direct medical costs estimated to be in excess of $2 billion;
b. At the request of the Department of Health, the American College of Surgeons Trauma Systems Evaluation and Planning Committee assessed the State's trauma system and made numerous recommendations for its improvement. The committee found that, while the provision of trauma care in New Jersey has many dedicated trauma professionals, a sufficient number of ten trauma centers strategically located in the State, and 100 percent emergency medical services coverage, the trauma care system faces many challenges. Among the challenges noted by the committee are the absence of one lead State agency to oversee and ensure the coordination of a Statewide trauma system and the absence of systematic data collection concerning the various aspects of trauma care in the State;
c. Among the recommendations made by the committee to address the challenges to the State trauma system were: establishment of a statutorily authorized lead agency to oversee the development of a formal State trauma system, appointment of a designated leader to coordinate stakeholders involved in all aspects of providing trauma care in the development, maintenance, and ongoing evaluation of a formal State trauma system, the creation of an advisory body to formulate policies that address all aspects of patient care, and the development of prevention strategies to help control injury as part of a formal State trauma system;
d. While there currently exists a Trauma Center Council in New Jersey which represents multidisciplinary trauma care within the State-designated trauma centers, this Council is focused on the activities and operations of New Jersey's State-designated trauma centers, with limitations in developing an effective trauma system for the State of New Jersey; and
e. In order to more effectively prevent injury, improve the care and outcomes of individuals who are injured in New Jersey, and save lives, it is appropriate to ensure the development and implementation of a formal State trauma system to serve injured patients in the State along the continuum of their care, and establish means for ongoing data collection and input from relevant stakeholders in the State's trauma care system to inform policies concerning trauma care in the State.
b. The State Trauma Medical Director shall, in collaboration with the State Trauma System Advisory Committee (STSAC) established pursuant to section 4 of this act, oversee the development of a Statewide trauma system plan, and once the plan has been adopted through regulations promulgated by the department in compliance with the provisions of this act, shall be responsible for implementing, maintaining, and providing ongoing evaluation of the plan. The director shall additionally ensure that the development and implementation of the plan involves broad-based collaboration with stakeholders representing disciplines relevant to trauma care in the State and interested citizens, including the commissioner, the director, or any other stakeholders that the STSAC determines may inform the process.
(1) the medical director of each State-designated trauma center, provided that the trauma program managers of each State designated trauma center may serve as alternates for the medical director of each State-certified trauma center;
(2) the medical director of a State-certified burn treatment facility;
(3) the chairperson of the New Jersey Emergency Medical Services Council;
(4) the medical director of a rehabilitation facility in the State that treats patients with traumatic injuries, including traumatic brain injuries and traumatic spinal cord injuries;
(5) three representatives of pre-hospital care providers in the State, including an advanced life support provider as recommended by the State mobile intensive care advisory council, a volunteer basic life support provider as recommended by the New Jersey State First Aid Council, and a paid basic life support provider;
(6) The New Jersey licensed physician chairperson of the New Jersey Chapter of the American College of Surgeons Committee on Trauma;
(7) a New Jersey licensed physician recommended by the New Jersey Chapter of the American College of Emergency Physicians;
(8) a New Jersey licensed nurse recommended by the New Jersey Chapter of the Emergency Nurses Association;
(9) one individual with expertise in the prevention of injury; and
(10) one medical director of the emergency department of a New Jersey hospital that is not a State-designated trauma center.
b. (1) The STSAC shall have an executive committee appointed by the commissioner from among the members of the STSAC, consisting of two medical directors from State-designated Level One trauma centers; two medical directors from State designated Level Two trauma centers; one medical director of an emergency department from a New Jersey hospital that is not the site of a State-designated trauma center; one representative of pre-hospital care providers in the State; and the State Trauma Medical Director, who shall serve ex officio as chair of the executive committee of the STSAC.
(2) The executive committee of the STSAC shall set forth the times and agenda of the meetings of the STSAC, coordinate the policy recommendations of the STSAC, and draft the STSAC's initial and subsequent reports.
c. (1) Each member of the STSAC shall serve for a term of three years and may be reappointed to one or more subsequent terms, except that of the members first appointed, one third shall serve for a term of three years, one third for a term of two years, and one third for a term of one year. Vacancies in the membership of the committee shall be filled in the same manner provided for the original appointments.
(2) The STSAC shall organize as soon as practicable following the appointment of its members and shall hold its initial meeting no later than 90 days after the effective date of this act.
(3) The members of the STSAC shall select a chairperson and vice chair. The vice chair shall conduct the committee meetings when the chairperson is unable to attend.
(4) The members shall serve without compensation, but shall be reimbursed for necessary expenses incurred in the performance of their duties and within the limits of available funds.
d. (1) Consistent with the recommendations of the American College of Surgeons Committee on Trauma, and, to the extent applicable, consistent with the processes outlined in the State Trauma System Planning Guide issued by the National Association of State Emergency Medical Services Officials, the STSAC shall: analyze data related to trauma care in the State; design a formal system of trauma care in the State with system-wide standards of pre-hospital triage and hospital-based care and policies; evaluate the State trauma system on an ongoing basis, and identify strategies to ensure optimal coordination of the Statewide trauma system. In fulfilling these responsibilities, the STSAC shall seek input from stakeholders representing all aspects of trauma care in the State.
(2) Within one year following the date of enactment of this act, the STSAC shall prepare and submit a report to the commissioner and the State Trauma Medical Director, which shall include a recommended comprehensive State trauma system plan. The plan shall address:
(a) Best practices and standards for all trauma care providers;
(b) Development and implementation of protocols for the stabilization and transfer of patients;
(c) Training requirements for acute care hospital personnel with respect to identifying, stabilizing, and arranging for the transfer of a patient whose condition is beyond the scope of the hospital's capabilities;
(d) Mandatory trauma triage practices to be performed by emergency medical service providers;
(e) Any other issues that the STSAC determines to be appropriate for inclusion in the plan.
(3) Subsequent to the receipt of the initial report and recommendation submitted by the STSAC pursuant to this subsection, the commissioner shall promulgate regulations establishing and implementing a State trauma system plan.
(4) Subsequent to the preparation and issuance of its initial report pursuant to this subsection, the STSAC shall: systematically review strategies to maintain and improve the State trauma system; submit an annual report to the commissioner and the State Trauma Medical Director on its activities; and provide any recommendations it determines are necessary to improve the State trauma system.
(2) For the purposes of enforcing the provisions of this subsection, the commissioner shall establish criteria to be used in identifying municipalities that have disproportionately high rates of firearm violence or homicide, and shall develop a list of such municipalities, based on the application of identified criteria, in coordination with the Department of Law and Public Safety. The list shall be published on the department's Internet website, and shall be revised and updated as necessary, on at least an annual basis.
b. The commissioner shall adopt rules and regulations, pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.), as may be necessary to implement the provisions of this section. Such rules and regulations shall identify, at a minimum, the criteria that the department will use, pursuant to paragraph (2) of subsection a. of this section, to determine which of the State's municipalities have a disproportionately high rate of firearm violence or homicide.
c. As used in this section:
"Commissioner" means the Commissioner of Health.
"Department" means the Department of Health.
"Hospital-based or hospital-linked violence intervention program" means a program that is operated by a hospital, or by a person or entity who is contracted by the hospital, and which works to end cycles of violence through the provision of intensive counseling, case management, and social services to patients in the hospital who are recovering from gunshot wounds and other injuries resulting from violence.
This act shall be known and may be cited as the "Controlled Dangerous Substances Therapeutic Research Act."
The Legislature finds and declares that recent medical research has shown that the therapeutic use of certain Schedule I controlled dangerous substances may alleviate the nausea and ill-effects of certain medical treatment, such as cancer chemotherapy, and, additionally, may alleviate the ill-effects of certain diseases, such as glaucoma. The Legislature further recognizes that there is a need for further therapeutic research with regard to the use of such controlled dangerous substances for these purposes under strictly controlled circumstances. It is for this purpose that the "Controlled Dangerous Substances Therapeutic Research Act" is hereby enacted.
As used in this act:
a. "Board" means the Therapeutic Research Qualification Review Board established in section 5 of this act.
b. "Commissioner" means the State Commissioner of Health.
c. "Schedule I controlled dangerous substance" means a controlled dangerous substance having a high addiction liability; no accepted medical use in the United States; and listed in New Jersey Administrative Code 8:65-10.1.
d. "Drugs" means drugs as defined in section 2 of P.L.1970, c. 226 (C. 24:21-2).
e. "Practitioner" means a physician licensed to prescribe and administer drugs which are subject to the "New Jersey Controlled Dangerous Substances Act" (P.L.1970, c. 226).
f. "Program" means the controlled dangerous substances therapeutic research program established in this act.
a. There is hereby established in the State Department of Health, the controlled dangerous substances therapeutic research program. The program shall be limited to therapeutic research programs presently conducted by the Bureau of Drugs in the Food and Drug Administration of the U.S. Department of Health and Human Services or its successor and shall be administered by the commissioner who shall promulgate rules and regulations necessary for the administration of this act, including but not limited to rules and regulations which may be necessary to require patients desiring certification pursuant to section 5 of this act to release their medical records for the purposes of certification and follow-up reports. In making such promulgations, the commissioner shall take into consideration all Federal controlled dangerous substances laws and rules adopted pursuant to such laws.
b. The program shall be limited to patients who are certified to the board, established by section 5 of this act, by a practitioner as being involved in a life-threatening or sense-threatening situation and who are not responding to drugs or where the drugs administered have proven to be effective but where the patient has incurred severe side effects.
c. The names and medical records of individual patients who have either requested certification or have been certified pursuant to section 5 of this act shall not be released in any form which identifies the individual, except that the names and records of such individuals shall be made available upon request for use in the enforcement of laws regarding controlled dangerous substances (P.L.1970, c. 226; C. 24:21-1 et seq.).
a. The commissioner, after consulting with the Medical Society of New Jersey, shall appoint a Therapeutic Research Qualification Review Board to serve at his pleasure. The board shall be comprised of physicians licensed to practice medicine and surgery in New Jersey and who are well qualified in their specialties. Members of the board may be reimbursed for their attendance at meetings at the rate of $35.00 per day.
b. The board shall review all practitioners applying for participation in the program and certify their participation in the program.
c. The board shall have the authority to approve for participation in the program any patient who is certified to it by a practitioner, pursuant to the provisions of section 4b. of this act.
a. The commissioner shall enter into an agreement with the National Institute on Drug Abuse for receipt of a Schedule I controlled dangerous substance for the purposes prescribed in this act, subject to the provisions of all Federal controlled dangerous substances laws and rules adopted pursuant to such laws.
b. The commissioner shall provide for a Schedule I controlled dangerous substance received pursuant to subsection a. of this section to be transferred to those practitioners certified by the board to participate in the program.
c. Patients and practitioners receiving Schedule I controlled dangerous substances through the National Cancer Institute's Investigational Drug Branch shall not be subject to the provisions of this act.
Participating practitioners shall submit to the commissioner reports on the use of Schedule I controlled dangerous substances received by their patients pursuant to this act.
The board shall review all reports of use of Schedule I controlled dangerous substances in such cases, and the commissioner, in conjunction with the board, shall report his findings and recommendations to the Legislature and Governor on an annual basis regarding the effectiveness of the program.
Notwithstanding any laws to the contrary, nothing in the laws dealing with controlled dangerous substances shall be construed to prohibit a program of therapeutic research with regard to the use of certain Schedule I controlled dangerous substances in certain situations, as provided in section 4b. of this act.
a. The Commissioner of the Department of Health shall establish a training program for health care providers in licensed long-term health care facilities in the specialized care of patients with Alzheimer's Disease. The training program shall include methods to deal with the specific problems encountered in the care of Alzheimer's Disease patients, including communicating with patients and necessary safety measures.
b. The training program shall be made available, on a voluntary basis, to licensed long-term health care facilities which provide treatment and care to Alzheimer's Disease patients. Upon request, the commissioner shall provide the training program at the long-term health care facility.
a. compile and maintain daily records for each shift in the facility and provide to a member of the public, upon request, information that indicates for each shift, as appropriate:
(1) the number of nurses, including the aggregate total of registered professional nurses and licensed practical nurses, providing direct care to patients diagnosed with Alzheimer's disease and related disorders; and
(2) the number of certified nurse aides providing direct care to patients diagnosed with Alzheimer's disease and related disorders; and
b. provide a member of the public seeking placement of a person diagnosed with Alzheimer's disease or related disorders in the facility with a clear and concise written list that indicates:
(1) the activities that are specifically directed toward patients diagnosed with Alzheimer's disease and related disorders, including, but not limited to, those designed to maintain dignity and personal identity, enhance socialization and success, and accommodate the cognitive and functional ability of a patient;
(2) the frequency of the activities listed in paragraph (1) of this subsection; and
(3) the safety policies and procedures and any security monitoring system that is specific to patients diagnosed with Alzheimer's disease and related disorders.
b. A long-term care facility shall annually provide training, under the training program established pursuant to subsection a. of this section, to a certified nurse aide, licensed practical nurse, registered professional nurse, and other health care professionals, as appropriate, who provide direct care to a patient in the facility who is diagnosed as having Alzheimer's disease or a related disorder.
Pursuant to the "Administrative Procedure Act," P.L. 1968, c. 410 (C. 52:14B-1 et seq.), the commissioner shall adopt all rules and regulations necessary to effectuate the purposes of this act.
The legislature finds and declares:
a. There is a critical need to establish specialized programs for clients suffering from Alzheimer's disease and related disorders. Alzheimer's disease is an organic, progressive brain disorder which may result in its final stages in the complete mental and physical disability of a client.
b. There are few services specifically designed to meet the unique needs of Alzheimer's clients and their families, and it is imperative that these services be developed as soon as possible.
c. There is a further need to develop training programs for professionals and other persons providing care for Alzheimer's clients. Specialized programs for an Alzheimer's client population will provide an optimum setting for developing and implementing these training programs.
a. "Adult day care" means a community-based group program designed to meet the needs of functionally or cognitively impaired adults through an individual plan of care structured to provide a variety of health, social, and related support services in a protective setting during any part of a day but less than 24 hours.
b. "Alzheimer's Disease and related disorders" means forms of dementia characterized by a general loss of intellectual abilities of sufficient severity to interfere with social or occupational functioning.
c. "Care needs or behavioral problems" means the manifestations of dementia which may include, but need not be limited to, progressive memory loss, confusion, inability to communicate, extreme personality change, and eventual inability to perform the most basic tasks.
d. "Commissioner" means the Commissioner of Human Services.
e. "Department" means the Department of Human Services.
f. "Grantee" means a public agency, private for profit agency, or private nonprofit agency selected by the department to establish an adult day care program for participants pursuant to this act.
g. "Participant" means an individual with Alzheimer's disease or a related disorder, particularly those in the moderate to severe stages. To be eligible for services, a participant shall have documentation from a physician that the participant has Alzheimer's disease or a related disorder.
The commissioner shall establish a program for participants in specialized adult day care centers, for which purpose the department shall award grants to qualified applicants in an amount to be determined by the commissioner. A grantee shall be required to match not less than 25% of the amount granted, either in cash or in kind contributions, or both, and the in kind contributions may include the value of staffing or volunteer services, or both. The use of the grantee's matching funds shall be limited to meeting the expenses of administration, staffing, operating expenses, and the costs of necessary safety renovations.
(1) The applicant shall be able to identify the special care needs or behavioral problems of participants, and the applicant's program shall be designed to meet those needs.
(2) The applicant shall demonstrate to the satisfaction of the department that the applicant's program has adequate and appropriate staffing to meet the nursing, psychosocial and recreational needs of participants.
(3) The applicant shall provide an outline of the design of the applicant's physical facilities, and of the safeguards which shall be used to protect the participants' safety.
(4) The applicant shall submit a plan for assisting individuals who cannot afford the entire cost of the program. This may include, but need not be limited to, utilizing additional funding sources to provide supplemental aid and allowing family members to serve as volunteers at the applicant's facility.
(5) The applicant shall identify potential sources of funding for the applicant's facility and shall outline plans to seek additional funding to remain solvent. This may include private donations and foundation grants, Medicare reimbursement for specific services, and the use of adult education and public health services.
(6) The department shall establish a sliding fee scale for payments by participants based on the participant's ability to pay.
b. Each grantee shall also satisfy all of the following requirements:
(1) Establish family support groups;
(2) Encourage family members to provide transportation for participants to and from the applicant's facility;
(3) Concentrate on participants in moderate to severe ranges of disability;
(4) Provide appropriate nutrition to participants, which the grantee may arrange to have provided by an organization organized for the purpose of providing meals to the elderly or to those who are needy;
(5) Establish contact with local educational programs, including nursing and other disciplines offering gerontology programs, to provide on-site training to students; and
(6) Provide services to assist family members, including counseling and referral to other resources.
The department shall develop a training program which includes information on the symptoms and progress of the disease and appropriate techniques for dealing with the psychosocial, health and physical needs of the participants. The training program shall be developed and provided as on-going, on-site training for adult day care centers funded under this act and shall be available to other community based providers who serve this client population.
The commissioner shall report to the Governor and the Legislature one year after the effective date of this act on the grant programs established pursuant to this act. The report shall include, but not be limited to:
a. A description of the progress made in implementing the programs;
b. The number of grantees who have established adult day care programs pursuant to this act;
c. The number and characteristics of participants served by the programs;
d. An evaluation of the usefulness of the programs in delaying the placement of the participants in institutions;
e. An evaluation of the programs; and
f. An evaluation of the potential for reimbursement for care in these adult day care centers by funding sources such as Medicaid or Medicare.
The commissioner shall, pursuant to the "Administrative Procedure Act," P.L. 1968, c. 410 (C. 52:14B-1 et seq.), adopt rules and regulations necessary to implement the provisions of this act.
b. The commission shall consist of 12 members, including:
(1) the Commissioner of Health, the Commissioner of Human Services, and the New Jersey Long-Term Care Ombudsman, or their designees, who shall serve as ex officio, non-voting members;
(2) two public members to be appointed by the Governor based upon the recommendation of the President of the Senate, including one member who represents an organization that advocates for members of the Alzheimer's disease and related disorders or other forms of dementia community and one member who represents a for-profit healthcare facility that offers memory care services;
(3) two public members to be appointed by the Governor based upon the recommendation of the Speaker of the General Assembly, including one member who represents an organization that advocates for members of the Alzheimer's disease and related disorders or other forms of dementia community and one member who represents a non-profit healthcare facility that offers memory care services; and
(4) five public members to be appointed by the Governor, including: one geriatrician who is currently involved in the provision of direct services to patients with Alzheimer's disease and related disorders or other forms of dementia; one psychiatrist who provides specialized services to patients with Alzheimer's disease and related disorders or other forms of dementia; one caregiver who provides paid services to persons with Alzheimer's disease or related disorders or other forms of dementia; one unpaid caregiver of a family member who has Alzheimer's disease or a related disorder or other form of dementia; and one neurologist who provides specialized services to patients with Alzheimer's disease or a related disorder or other form of dementia.
c. Each public member of the commission shall serve for a term of four years, except that, of the public members first appointed, two shall serve an initial term of one year, three shall serve an initial term of two years, two shall serve an initial term of three years, and two shall serve an initial term of four years. Each public member shall serve for the term of the member's appointment and until a successor is appointed and qualified. Public members shall be eligible for reappointment to the commission.
d. All initial appointments to the commission shall be made within 180 days after the effective date of this act. Vacancies in the membership of the commission shall be filled in the same manner as is provided for the original appointments.
e. The commission shall organize as soon as practicable, but not later than the 30th day following the appointment of a majority of its members, and shall annually elect a chairperson and vice-chairperson from among its members. The chairperson shall appoint a secretary who need not be a member of the commission.
f. Each year, the commission shall meet pursuant to a schedule to be established at its first annual meeting. The commission shall additionally meet at the call of its chairperson or at the call of the Commissioner of Human Services. In no case shall the commission meet fewer than two times per year.
g. A majority of the total number of members currently appointed to the commission shall constitute a quorum. A vacancy in the membership of the commission shall not impair the ability of the commission to exercise its duties and effectuate its purposes. The commission may conduct business without a quorum, but may only take advisory action when a quorum is present. Recommendations shall be approved by a majority of the members present.
h. The members of the commission shall serve without compensation, but shall be reimbursed for travel and other necessary expenses incurred in the performance of their duties, within the limits of funds made available to the commission for its purposes.
i. The commission shall have the power to:
(1) adopt, amend, or repeal suitable bylaws for the management of its affairs;
(2) with the approval of the Commissioner of Human Services, solicit and receive assistance and services from any State, county, or municipal department, board, commission, or agency, as it may require and as may be available to it for its purposes; and
(3) consult with, and solicit and receive testimony from, any association, organization, department, agency, or individual having knowledge of, and experience with:
(a) the treatment and care of, or provision of caregiving and personal care services to, persons with Alzheimer's disease and related disorders or other forms of dementia;
(b) the status or quality of the State's professional workforce in relation to Alzheimer's disease and related disorders and other forms of dementia care;
(c) the emotional, physical, or financial effects of Alzheimer's disease and related disorders or other forms of dementia on individuals, families, and the State; or
(d) any other issues related to Alzheimer's disease and related disorders or other forms of dementia.
j. The Department of Human Services shall provide professional and clerical staff to the commission as may be necessary to effectuate the purposes of this act.
k. The commission shall serve in an advisory capacity to the Department of Human Services.
(1) studying the incidence, prevalence, and impact of Alzheimer's disease and related disorders or other forms of dementia in the State and in each region of the State and make projections about the future Statewide and regional incidence, prevalence, and impact of these conditions;
(2) gathering, analyzing, and disseminating to health care professionals, policymakers, and members of the public, as appropriate, data and information about: (a) the needs of persons with Alzheimer's disease and related disorders or other forms of dementia, as well as the needs of their family members and caregivers; (b) the quality and consistency of care that is provided to persons with Alzheimer's disease and related disorders or other forms of dementia in the State, including those members of the medically underserved community, the low income community, and the lesbian, gay, bisexual, transgender, questioning, queer, and intersex (LGBTQI) communities; (c) the affordability of care for Alzheimer's disease and related disorders or other forms of dementia in the State and the actual and projected Statewide costs and individual costs associated with Alzheimer's disease and related disorders or other forms of dementia in New Jersey, including, but not limited to, the costs of health care, mental health care, long-term care, and personal care, and ancillary or incidental costs such as those associated with the lost work productivity of, or the treatment of stress-related physical conditions or depression and other mental health conditions in, family caregivers; (d) the cost savings attained by the State through the provision of unpaid caregiving and personal care services by family caregivers; (e) the capacity of the State's health care and long-term care facilities to house and provide specialized services to patients with Alzheimer's disease and related disorders or other forms of dementia; (f) the status of Alzheimer's disease and related disorders or other forms of dementia care in other states, as compared to New Jersey; and (g) with the approval of the Commissioner of the Department of Human Services and subject to the availability of funds as designated by the department, any other issue deemed by the commission to be relevant to effectuate the purposes of this act;
(3) assessing the availability and affordability of existing programs, services, facilities, and agencies in the State that are used to meet the needs of persons with Alzheimer's disease and related disorders or other forms of dementia and the needs of their families and caregivers; evaluating the capacity of those existing policies, programs, services, facilities, and agencies to adapt to, and adequately address, the changing needs of dementia patients and their families and caregivers in the face of a continually increasing demand for services; and identifying and recommending improvements to existing policies, programs, services, facilities, or agencies or the institution of new policies, programs, services, facilities, or agencies to address unmet and expanding needs in this area;
(4) studying, and making recommendations to the Department of Human Services on, the appropriate roles of State government, local governments, and health care facilities and professionals in providing or ensuring the provision of appropriate services and other assistance to persons with Alzheimer's disease and related disorders or other forms of dementia, including persons in the early stages of disease, and in providing or ensuring the provision of sufficient supportive and assistive services, including training and respite services, to unpaid family caregivers; and identifying ways in which State and local governments and health care systems could increase their awareness of, and improve their ability to more effectively address, issues affecting persons with Alzheimer's disease and related disorders or other forms of dementia and their families;
(5) reviewing and analyzing the capacity of law enforcement officers and emergency medical responders in the State to compassionately and effectively interact with, diffuse conflicts involving, and provide emergency services to, persons with Alzheimer's disease and related disorders or other forms of dementia;
(6) identifying and recommending best practices and training requirements for: (a) health care and mental health care professionals, particularly geriatric specialists and primary care practitioners, who are or will be practicing on the front lines of caring for patients with Alzheimer's disease and related disorders or other forms of dementia, in order to ensure that such professionals are properly trained and are capable of accurately and timely diagnosing Alzheimer's disease and related disorders or other forms of dementia, understanding the progression of the disease, and recognizing and responding to the evolving needs of patients; (b) personal care professionals who provide services to patients with Alzheimer's disease and related disorders or other forms of dementia, in order to ensure that such professionals are capable of providing compassionate and high-quality personal care services and adapting to the evolving needs of their patients; and (c) law enforcement officers, emergency medical responders, and other public safety officers, in order to ensure that those officers understand the complexities of dealing with persons with Alzheimer's disease and related disorders or other forms of dementia and are better prepared to compassionately diffuse or resolve conflicts and respond to emergencies involving such persons;
(7) evaluating the sufficiency of the State's Alzheimer's disease and related disorders or other forms of dementia care workforce, identifying current and future workforce needs, anticipating future workforce shortages, developing innovative strategies to encourage and increase the recruitment and retention of health care, mental health care, direct support, and personal care professionals who are trained to provide care for Alzheimer's disease and related disorders or other forms of dementia, and taking any other action necessary to encourage and facilitate the development and maintenance of a robust and specialized professional Statewide workforce that is capable of delivering high-quality care for patients with Alzheimer's disease and related disorders or other forms of dementia to a rapidly growing population in the State; and
(8) studying and making recommendations on any other issue related to Alzheimer's disease and related disorders or other forms of dementia.
b. One year after the commission's organizational meeting, annually thereafter for a period of no less than five years, and thereafter upon request of the Legislature or as determined by the commission, the commission shall prepare and submit a written report to the Governor and, pursuant to section 2 of P.L.1991, c.164 (C.52:14-19.1), to the Legislature. The written report shall contain, at a minimum:
(1) the commission's annual findings on the issues described in subsection a. of this section;
(2) a description as to whether, how, and why the commission's findings have changed over time, including an indication as to the implementation status of the commission's prior recommendations, a description of actions that have been undertaken by any person or public or private entity in the State over the prior reporting period to implement those prior recommendations, and a description of the perceived or documented effects resulting from implementation of those prior recommendations;
(3) a copy of, or reference to, the statistical, demographic, testimonial, or other data or information that was used by the commission to: (a) support its current findings under paragraph (1) of this subsection; or (b) inform its analysis of the impact of the commission's prior recommendations under paragraph (2) of this subsection. The data provided pursuant to this paragraph shall be presented in aggregate form and shall not contain the personal identifying information of any patient, caregiver, or other person; and
(4) the commission's recommendations for actions that can be undertaken, or strategies that can be implemented, to: (a) improve the quality, consistency, or affordability of care for Alzheimer's disease and related disorders or other forms of dementia in the State and ensure the accessibility of care to all who need it; (b) reduce, eliminate, or mitigate the societal and individual impact of, and the Statewide, local, and individual costs or financial burdens associated with, Alzheimer's disease and related disorders or other forms of dementia; (c) ensure that the State's professional workforce is adequately trained, is capable of providing affordable, high-quality care for patients with Alzheimer's disease and related disorders or other forms of dementia throughout the State, and is sufficient in numbers and flexible enough to adapt to a rapidly increasing demand for services in the State; (d) ensure that unpaid caregivers in the State are recognized for their dedicated service and significant contributions to society and are provided with sufficient supportive and respite services, as well as financial assistance where possible and appropriate, as may be necessary for them to capably perform their caregiving tasks while avoiding unnecessary physical, mental, or financial strain; or (e) otherwise address the issues or mitigate the problems identified by the commission in its annual findings.
a. According to the National Institute of Mental Health, elderly Americans are disproportionately likely to die by suicide; individuals 65 years of age and older comprise only 13% of the United States population, but they accounted for 18% of all suicide deaths in 2000;
b. In New Jersey, individuals 65 years of age and older also comprise about 13% of the State population and they accounted for 17% of all suicide deaths in the State in 2000;
c. The national suicide rate for men is relatively constant from 25 to 64 years of age, but increases significantly after 65 years of age, with men accounting for 84% of suicides among individuals 65 years of age and older in 2000; and for women the national suicide rate peaks between 45 and 64 years of age and does so again after 75 years of age;
d. When categorized by race and gender, white men 85 years of age and older have among the highest suicide rates nationally, with 59 deaths per 100,000 persons in 2000, which is more than five times the national rate of 10.6 per 100,000, and according to "Healthy New Jersey 2010," issued by the Department of Health and Senior Services, the seventh leading cause of premature death among New Jerseyans is suicide, with the highest rates among elderly white males;
e. The risk factors for suicide among elderly Americans differ from those among younger groups; elderly persons have a higher prevalence of depression, greater use of highly lethal methods and greater social isolation;
f. The presence of mental illness (especially depression and alcohol abuse), the presence of physical illness or impairment, unrelieved pain, financial stress and social isolation (especially being widowed in males) and the availability of firearms in the home contribute to the higher incidence of suicide among elderly Americans;
g. Suicide among elderly Americans may even be underreported by 40% or more; omitted from statistics are "silent suicides," such as deaths from noncompliance with medical instructions, prescription overdosages, self-starvation or dehydration and other self-induced "accidents";
h. Most elderly patients who complete suicide saw their physicians within a few months of their deaths and more than a third did so within the week of their suicide, and warning signs which indicate a serious risk of suicide include: loss of interest in things or activities that are usually seen as enjoyable; lessening of social interactions, self-care and grooming; violating medical regimens or prescription dosages; experiencing or expecting loss of a spouse; feeling hopeless or worthless; and putting personal affairs in order, including giving things away or making changes to a will; and
i. Physicians, nurses and other health care professionals who treat and care for elderly patients need to be aware of the higher incidence of suicide among elderly Americans and recognize the risk factors associated with this age group.
"Alcohol and drug counselor" means a person who is a certified alcohol and drug counselor or a licensed clinical alcohol and drug counselor pursuant to P.L.1997, c.331 (C.45:2D-1 et seq.).
"Attempted suicide" means destructive behavior intended by the actor to result in the actor's harm or death.
"Completed suicide" means a death that is known or reasonably suspected to have resulted from an intentional act of the deceased, regardless of whether it has been ruled a suicide by a medical examiner.
"Council" means the New Jersey Elderly Person Suicide Prevention Advisory Council established pursuant to section 3 of this act.
"Department" means the Department of Human Services.
"Elderly person" means a person 65 years of age and older.
"Licensed clinical social worker" means a person who holds a current, valid license issued pursuant to subsection a. of section 6 or subsection a. or d. of section 8 of P.L.1991, c.134 (C.45:15BB-1 et seq.).
a. The purpose of the council shall be to examine existing needs of and services for elderly persons at risk of suicide and make recommendations to the department for suicide prevention and intervention strategies to help reduce the incidence of attempted and completed suicides among elderly persons.
b. The council shall consist of nine members as follows:
(1) the Commissioners of Health and Human Services and the chairman of the Community Mental Health Citizens Advisory Board established pursuant to P.L.1957, c.146 (C.30:9A-1 et seq.), or their designees, who shall serve ex officio;
(2) two public members appointed by the Governor, one of whom shall be a person with personal or family experience with suicide of an elderly person and one of whom shall be an alcohol and drug counselor;
(3) two public members appointed by the Speaker of the General Assembly, who are not members of the same political party, one of whom shall be a registered professional nurse and one of whom shall be a licensed clinical social worker; and
(4) two public members appointed by the President of the Senate, who are not members of the same political party, one of whom shall be a physician who has been specially trained in caring for elderly persons and has a certificate of added qualifications in geriatrics and one of whom shall be a geropsychiatrist.
c. The public members shall be appointed no later than 60 days after the enactment of this act.
d. The public members shall serve for a term of five years; but, of the members first appointed, two shall serve for a term of three years, two shall serve for a term of four years and two shall serve for a term of five years. Members are eligible for reappointment upon the expiration of their terms. Vacancies in the membership of the council shall be filled in the same manner provided for the original appointments.
e. The council shall organize as soon as practicable following the appointment of its members and shall select a chairperson and vice-chairperson from among the members.
The chairperson shall appoint a secretary who need not be a member of the council.
f. The public members shall serve without compensation, but shall be reimbursed for necessary expenses incurred in the performance of their duties and within the limits of funds available to the council.
g. The council shall be entitled to call to its assistance and avail itself of the services of the employees of any State, county, or municipal department, board, bureau, commission, or agency as it may require and as may be available to it for its purposes.
h. The Department of Human Services shall provide staff support to the council.
b. The department shall report, in a manner and form prescribed by the department, specific recommendations, as appropriate, to the Director of the Division of Consumer Affairs in the Department of Law and Public Safety who shall inform appropriate health care professionals, through the respective professional licensing boards, of the council's recommendations.
a. The current health care system in New Jersey does not always fully address the specific needs of people with behavioral health issues, including mental health conditions and substance use disorders.
b. Frequently, people with behavioral health issues are compelled to access care through primary care providers or hospital emergency departments, neither of which are typically equipped to handle the specialized care needed by people with behavioral health issues. Often, people are discharged from these treatment settings without receiving the care or referrals to services needed to treat the individual's particular behavioral health condition.
c. Similarly, law enforcement are frequently called upon to respond to acute behavioral health crises. In many cases, the responding law enforcement officers do not possess the specialized training needed to respond to an acute behavioral health crisis, and so are not equipped to adequately assess the situation, de-escalate and resolve the immediate crisis, and access appropriate behavioral health care services.
d. Historically, the lack of a comprehensive behavioral health crisis response system has placed marginalized communities, including those experiencing mental health crises, at disproportionate risk of poor outcomes.
e. When a behavioral health condition is not appropriately treated by a qualified behavioral health specialist, the condition may worsen over time. In some cases, such as with an individual who has a substance use disorder, the longer the person goes without appropriate treatment, the greater the risk the person will experience a fatal overdose, contract a bloodborne virus and other communicable diseases, or experience other adverse health consequences resulting from the person's continuing substance use. In cases involving a person experiencing suicide ideation, the longer the person goes without treatment, the greater the risk the person will engage in self-harm.
f. Additionally, untreated behavioral health conditions can significantly detract from the quality of life of the person with the behavioral health condition and the person's family and friends, who frequently feel helpless watching a loved one struggle with the burdens of an untreated mental health condition or substance use disorder.
g. Steps have been taken at both the State and federal level to better meet the needs of people with behavioral health conditions. At the federal level, the "National Suicide Hotline Designation Act of 2020," Pub.L.116-172, and rules adopted by the Federal Communication Commission's on July 16, 2020 take steps to improve access to crisis resources through a dedicated hotline, similar to 9-1-1, specific to behavioral health crises. At the State level, New Jersey has taken steps to improve access to behavioral health care by streamlining the process for dual licensure for primary and behavioral health care providers, issuing licenses for additional treatment beds, promoting measures to improve access to substance use disorder treatment and support services, and working to expand ready access to behavioral health treatment providers for all New Jerseyans.
h. It is now necessary for New Jersey to take the steps required to implement the new national behavioral health crisis hotline in this State.
i. It is the intent of the Legislature to support the operations of the national behavioral health crisis hotline in the State, and foster improved behavioral health treatment resources, through the establishment of a comprehensive Statewide mobile behavioral health crisis response system, the goals of which will be: improving access to, and the quality of, behavioral health crisis services through, among other measures, a "no wrong door" model of access; reducing the stigma associated with suicide, mental health conditions, and substance use disorders; improving equity in diagnosing and treating mental health conditions and substance use disorders; promoting equity in services for all individuals, regardless of cultural background, race, age, ethnicity, gender, socioeconomic status, or sexual orientation; promoting full access to behavioral health care services across rural, urban, and tribal communities; and ensuring a culturally and linguistically competent response to behavioral health crises.
b. The commissioner shall not contract with a crisis hotline center pursuant to subsection a. of this section unless the center meets the standards of the National Suicide Prevention Lifeline and participates in, or has the demonstrated ability to obtain an agreement with, the National Suicide Prevention Hotline network.
c. A contracted crisis hotline center shall be responsible for receiving 9-8-8 calls and providing crisis intervention services to 9-8-8 callers, including, as appropriate:
(1) requesting the dispatch of mobile crisis teams;
(2) coordinating crisis care responses and interventions;
(3) referring callers to crisis stabilization services; and
(4) providing, or facilitating and coordinating, the provision of appropriate follow-up services.
d. To the extent possible, and when it would not interfere with responding to an emergency, a contracted crisis hotline center shall attempt to ascertain whether a 9-8-8 caller has children. If the caller has children and the center deems it appropriate, the center shall make a referral to services offered by the Department of Children and Families such as the Children's System of Care or any other referral agency, as appropriate.
e. A contracted crisis hotline center shall comply with all standards, operational and equipment requirements, training and qualification requirements for crisis hotline center staff, requirements concerning geolocation capacity, best practices, and other standards and requirements as are established under the "National Suicide Hotline Designation Act of 2020," Pub.L.116-172, as are established under rules and regulations adopted by the Federal Communications Commission, as applicable, and by any other federal authority having jurisdiction, and as are established under rules and regulations promulgated by the Commissioner of Human Services.
f. The commissioner shall collaborate with other State executive branch departments, offices, and agencies to ensure full communication, information sharing, and coordination among crisis and emergency response systems throughout the State for the purpose of ensuring real-time crisis care coordination including, but not limited to, the deployment of linked, flexible services specific to each crisis response. Executive branch departments, offices, and agencies shall issue any waivers as shall be necessary to implement the provisions of this subsection.
g. (1) The commissioner shall collaborate with appropriate behavioral health care providers in the State, including, but not limited to, mental health and substance use disorder treatment providers, local community mental health centers, community-based and hospital emergency departments, and inpatient psychiatric settings, to ensure the coordination of service linkages with contracted hotline centers and mobile crisis response teams and the provision of crisis stabilization services and follow-up services, as appropriate, following the crisis response for a 9-8-8 caller.
(2) The commissioner shall establish agreements and information sharing procedures, as appropriate, with behavioral health care providers as shall be necessary to implement the provisions of this subsection. Such information sharing procedures shall include, but not be limited to, the sharing of information concerning the availability of services provided by a behavioral health care provider.
h. The commissioner shall develop an informational campaign to promote awareness of the nature and availability of the 9-8-8 hotline to respond to behavioral health crises. The commissioner shall consult with the National Suicide Prevention Lifeline and the Veterans Crisis Line networks to foster consistency in public messaging concerning 9-8-8 services.
(1) be capable of providing behavioral health crisis response services throughout the State 24 hours per day, seven days per week;
(2) respond to behavioral health crisis dispatch requests made by crisis hotline centers that have contracted with the Department of Human Services pursuant to subsection a. of section 2 of this act and other dispatch centers using mobile crisis response teams and other appropriate resources and services;
(3) provide behavioral health crisis stabilization services, including, but not limited to, referrals to appropriate behavioral health services providers for additional care following resolution of the immediate behavioral health crisis; and
(4) provide follow-up services for people who contact a crisis response center to ensure continuity of care and provide additional referrals or other services as may be appropriate to the person's ongoing treatment needs.
b. In establishing the Statewide mobile behavioral health crisis response system pursuant to this section, the commissioner shall hold at least two public hearings, at least one of which shall be conducted virtually via videoconferencing.
c. The Commissioner of Human Services shall adopt rules and regulations, pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.), establishing:
(1) qualification, training, and experience requirements for crisis hotline center and mobile crisis response team staff;
(2) composition requirements for mobile crisis response teams, which, at a minimum, shall include at least one licensed or certified behavioral health care professional and at least one certified peer; and
(3) the scope of practice, operational protocols, and vehicle and equipment requirements for mobile crisis response teams, which requirements may provide for the establishment of crisis response teams capable of providing specialized responses to behavioral health crises involving particular types of mental health conditions.
d. Mobile crisis response teams shall be community-based and may incorporate the use of: emergency medical technicians and other health care providers, to the extent a medical response is needed; law enforcement personnel, to the extent that the crisis cannot be resolved without the presence of law enforcement, provided that, whenever possible, the mobile crisis response team shall seek to engage the services of law enforcement personnel who have completed training in behavioral health crisis response; and other professionals as may be necessary and appropriate to provide a comprehensive response to a behavioral health crisis.
e. Notwithstanding the requirement that mobile crisis response teams be community based, nothing in this section shall be construed to prohibit the provision of crisis intervention services via telephone, video chat, or other appropriate communications media, if the use of these media are necessary to provide access to a needed service in response to a particular behavioral health crisis, and the provision of services using telephone, video chat, or other media is consistent with the needs of the person experiencing the behavioral health crisis.
b. Each mobile crisis response team shall submit a monthly report to the Department of Human Services identifying, for the preceding month: the number of dispatch calls the team received; the number of dispatch calls the team responded to; the number of dispatch calls that included a response by emergency medical services providers, law enforcement, or both; the proportion of total services that were provided in person, via telephone, via video call, and via other means; the number of mobile crisis responses that resulted in referrals for services and the types of services that were referred; the number of responses that did not result in a referral or follow-up service; to the extent possible, information regarding the nature of the mobile crisis responses that did and did not result in a referral or follow-up service; and any other information as shall be required by the Commissioner of Human Services.
c. The Commissioner of Human Services shall designate the form and manner by which the reports required under subsections a. and b. of this section shall be submitted.
d. Commencing 24 months after the effective date of this act, and annually thereafter, the Commissioner of Human Services shall prepare and submit to the Governor and, pursuant to section 2 of P.L.1991, c.164 (C.52:14-19.1), to the Legislature, a report concerning the Statewide behavioral health crisis system of care, including, for the preceding year: the total number of calls received by crisis hotline centers that have contracted with the Department of Human Services pursuant to subsection a. of section 2 of this act, including the number of direct 9-8-8 calls and the number of calls referred from a 9-1-1 call center; the total number of mobile crisis response teams dispatched; the number of crisis interventions that involved emergency medical services, law enforcement, or both; the proportion of total mobile crisis response services that were provided in person, via telephone, via video call, and via other means; the number of referrals made to services, including the number of referrals made to each type of service; the nature of behavioral health crisis stabilization services provided and an analysis of the effects of providing behavioral health crisis stabilization services in lieu of a response by law enforcement or services provided through a hospital emergency department or other medical care provider; the nature of follow-up services provided and an analysis of the effects of providing follow-up services; program operating costs of the Statewide behavioral health crisis system of care; the commissioner's assessment of the benefits and limitations of the Statewide behavioral health crisis system of care and the commissioner's recommendations for legislative or administrative action to support and improve the Statewide behavioral health crisis system of care; and any other information the commissioner deems necessary and appropriate.
(1) detailing the resources necessary to make the 9-8-8 suicide prevention and behavioral health crisis hotline available, operational, and effective Statewide, including an evaluation of available and new revenue sources to support the implementation, staffing, and ongoing activities of 9-8-8 services that are reasonably attributed to implementing the provisions of section 2 of this act; and
(2) assessing if the implementation of a fee, as permitted pursuant to the "National Suicide Hotline Designation Act of 2020," Pub.L.116-172, is necessary to support the 9-8-8 suicide prevention and behavioral health crisis hotline and, if the fee is determined to be necessary, making recommendations on the amount of the fee, the manner in which the fee will be collected, and the establishment of a special account to serve as a repository for monies dedicated to the implementation of the hotline system.
b. In conducting the study and preparing the report required pursuant to subsection a. of this section, the Commissioner of Human Services shall solicit public comments and may hold public hearings at such times and places as the commissioner deems appropriate. The Commissioner of Human Services shall submit the report required under this section to the Governor and, pursuant to section 2 of P.L.1991, c.164 (C.52:14-19.1), to the Legislature, no later than April 1, 2023.
a. implement the provisions of this act in a manner that is consistent with timeframes required by the "National Suicide Hotline Designation Act of 2020," Pub.L.166-172, and the Federal Communication Commission's rules adopted on July 16, 2020; and
b. seek out and apply for all sources of federal funding as may be available to support the Statewide behavioral health crisis system of care, including, but not limited to, applying for such State plan amendments or waivers as may be necessary to secure federal financial participation for State Medicaid expenditures under the federal Medicaid program.
For the purposes of this act:
a. "Commissioner" means the Commissioner of Health.
b. "Department" means the State Department of Health.
c. "Health care provider" means any licensed health care professional or public or private health care facility in this State that administers pertussis vaccine.
d. "Major adverse reaction" means collapse or shock, high pitched screaming, persistent crying for three or more hours, excessive somnolence (sleepiness), temperature of 105`, convulsions with or without accompanying fever or severe alterations of consciousness or any serious illness, disability or impairment of mental, emotional, behavioral or physical functioning or development, the first manifestation of which appears within 30 days of the date of administration of pertussis vaccine, and for which there is reasonable scientific or medical evidence that pertussis vaccine causes or significantly contributes to the illness, disability or impairment; or any other reaction which the department determines, by regulation, is a basis for not administering pertussis vaccine.
e. "Pertussis vaccine" means any vaccine containing a substance intended to prevent the occurrence of pertussis, which is administered separately or in conjunction with other substances intended to prevent the occurrence of other diseases.
a. A list of the immunizations required for admission to a public or private school in the State;
b. Specific information regarding the pertussis vaccine which includes:
(1) The circumstances under which pertussis vaccine should not be administered or should be delayed, including the categories of persons who are significantly more vulnerable to major adverse reactions than are members of the general population;
(2) Possible adverse reactions to pertussis vaccine and the early warning signs or symptoms that may be precursors to a major adverse reaction which, upon occurrence, should be brought to the immediate attention of the health care provider who administered the vaccine;
(3) A form that the parent or guardian may use to monitor symptoms of a possible adverse reaction and which includes places where the parent or guardian can record information about the symptoms that will assist the health care provider; and
(4) Measures that a parent or guardian should take to reduce the risk of, or to respond to, a major adverse reaction including identification of who should be notified of the reaction and when the notification should be made.
The commissioner shall prepare the pamphlet in consultation with the Medical Society of New Jersey and shall adopt by regulation the information contained in the pamphlet, pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.).
Prior to administering a pertussis vaccine to a child in this State, a health care provider shall give the child's parent or guardian a copy of the pamphlet prepared pursuant to section 2 of this act and provide the parent or guardian with a reasonable opportunity to read the contents of the pamphlet.
A child shall not be required to receive a pertussis vaccine as a condition for admission to a public or private school if the child's health care provider states in writing that the vaccine is medically contraindicated pursuant to subsection b. (1) of section 2 of this act and the reasons for the medical contradictions.
a. Upon administering a pertussis vaccine to a child in this State, a health care provider shall record and retain as part of the child's permanent health record the date the vaccine was administered, the manufacturer, a lot number and any other available identifying information of the vaccine that was administered, and the name and title of the health care provider who administered the vaccine.
b. The health care provider shall make the information concerning the vaccine available to the child's parent or guardian, upon request.
a. If the health care provider has reason to believe that the recipient of the pertussis vaccine has had a major adverse reaction, the health care provider shall immediately record all relevant information in the child's permanent medical record and shall report the information, including the manufacturer and the lot number, to the department within seven days.
b. Upon receipt of the information, the department shall immediately notify the manufacturer of the vaccine and the Center for Disease Control of the adverse reaction.
The commissioner shall periodically report information received regarding major adverse reactions to the United States Center for Disease Control.
b. The department shall require each hospital and birthing facility in the State to provide new mothers, including adoptive mothers, with the informational literature specified in subsection a. of this section. The informational literature shall be distributed to the mother and any other adult family member, including adult adoptive family members, present at the infant's birth, by the staff designated by the hospital or birthing facility, prior to the mother's discharge, as part of the hospital or birthing facility's discharge procedures.
c. As used in this section "birthing facility" means an inpatient or ambulatory health care facility licensed by the Department of Health that provides birthing and newborn care services.
"Antibody titer" means a test to measure the presence and amount of antibodies in a blood sample against a particular type of tissue, cell or substance.
"Health care provider" means any licensed health care professional or public or private health care facility in this State that administers vaccinations.
b. Documented laboratory evidence of immunity from MMR shall exempt a child from further vaccination for MMR, as may be required pursuant to Department of Health regulations.
The commissioner shall send a copy of the pamphlet to every licensed health care provider in the State who administers the MMR vaccine, with a cover letter advising the health care provider that the pamphlet was prepared in accordance with the requirements of P.L.2003, c. 257 (C.26:2N-8 et seq.), known as "Holly's Law," and how the health care provider can obtain additional copies of the pamphlet from the Department of Health.
The hotline shall receive and respond to calls from law enforcement officers and sheriff's officers who have been involved in any event or incident which has produced personal or job-related depression, anxiety, stress, or other psychological or emotional tension, trauma, or disorder for the officer and officers who have been wounded in the line of duty. The operators of the hotline shall seek to identify those officers who should be referred to further debriefing and counseling services, and to provide such referrals. In the case of wounded officers, those services may include peer counseling, diffusing, debriefing, group therapy, and individual therapy as part of a coordinated assistance program, to be known as the "Blue Heart Law Enforcement Assistance Program," designed and implemented by the University Behavioral Healthcare Unit of Rutgers, The State University.
b. The operators of the hotline shall be trained by the Department of Human Services and, to the greatest extent possible, shall be persons, who by experience or education, are: (1) familiar with post trauma disorders and the emotional and psychological tensions, depressions, and anxieties unique to law enforcement officers and sheriff's officers; or (2) trained to provide counseling services involving marriage and family life, substance use disorder, personal stress management, and other emotional or psychological disorders or conditions which may be likely to adversely affect the personal and professional well-being of a law enforcement officer and a sheriff's officer.
c. To ensure the integrity of the telephone hotline and to encourage officers to utilize it, the commissioner shall provide for the confidentiality of the names of the officers calling, the information discussed by that officer and the operator, and any referrals for further debriefing or counseling; provided, however, the commissioner may, by rule and regulation, (1) establish guidelines providing for the tracking of any officer who exhibits a severe emotional or psychological disorder or condition which the operator handling the call reasonably believes might result in harm to the officer or others and (2) establish a confidential registry of wounded New Jersey law enforcement officers.
The Legislature finds and declares that:
a. It is estimated that about 5% of the population carries the cystic fibrosis gene, which currently cannot be detected by any test, and that the number of persons born with cystic fibrosis who are living to adulthood is increasing;
b. The New Jersey State Organization of Cystic Fibrosis has identified at least 60 adults with cystic fibrosis living in New Jersey; however, there are estimates of as many as 150 to 200;
c. These adults, who are afflicted with a chronic hereditary disorder that affects the lungs and digestive system and causes difficulty in breathing and an inability to digest foods, have special needs for nutritional and pharmaceutical assistance that have not been met by previous or existing State programs which serve children with cystic fibrosis;
d. The program of medical care and treatment established pursuant to P.L.1981, c.289 (C.26:2-118), which provided pharmaceutical assistance to adults with cystic fibrosis became inoperative because of a lack of funding and was limited in its effectiveness because many potential service recipients were unaware of the program due to a lack of publicity;
e. The State should meet the special needs of adults with cystic fibrosis by helping them to purchase the supplemental foods that they need and the drugs and medical supplies and equipment that they require; and
f. A Statewide nutritional and pharmaceutical assistance program for adults with cystic fibrosis will enable these persons to stay in the workforce and continue to be productive members of the community.
The Commissioner of Health shall establish a program of financial assistance for persons with cystic fibrosis to meet the expenses of: supplemental, nutritious foods; prescription drugs and medical supplies and equipment that are necessary for the treatment of cystic fibrosis; and certain health insurance costs.
The commissioner shall contract with a nonprofit organization in New Jersey which has experience in providing financial assistance and direct services to persons with cystic fibrosis, to administer the program.
b. A person with cystic fibrosis who is 18 years of age or older who has health insurance is eligible for financial assistance under this act of up to $500 per year to help meet the cost of the deductible on the insurance policy if the person's annual income is less than $30,000. This financial assistance may be provided in addition to assistance for the purchase of supplemental, nutritious foods and pharmaceutical drugs and medical supplies and equipment.
c. Beginning in January 1995 and annually thereafter, the income eligibility limits provided in subsections a. and b. of this section shall increase in accordance with the Consumer Price Index published by the federal government. The Commissioner of Health shall annually adopt the new income eligibility limits by regulation, pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.).
The Commissioner of Health, pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.), shall adopt rules and regulations to effectuate the purposes of this act.
a. Lyme disease is a bacterial infection which is spread by certain ticks, and is one of the fastest growing public health problems in New Jersey;
b. Studies of Lyme disease treatment have shown that costs associated with long-term treatment of infected persons have often exceeded $100,000 per case and have a significant negative social impact;
c. Lyme disease, which is the most common tick-borne disease in this country, is present in 48 states and five continents and is spreading, with New Jersey being one of the states in which the disease is most prevalent. New Jersey experienced the largest percentage increase in reported cases of Lyme disease of any state between 1993 and 1994;
d. Lyme disease was not widely recognized in the United States until 1975 and was first identified in New Jersey in Monmouth county in 1978;
e. Even though Lyme disease is receiving increased public attention among both the medical community and the general public, it is often misdiagnosed or not diagnosed, which results in more serious health problems for the affected person;
f. If untreated, Lyme disease, in its later stages, can result in neurological disorders, including, but not limited to, chronic and severe fatigue, encephalitis, meningitis, memory loss, dementia and seizures; severe arthritis; cardiac dysfunction; vision loss, gastrointestinal disorders, paralysis, strokes and death;
g. Other tick-borne diseases known or suspected to occur in New Jersey include Rocky Mountain spotted fever, human monocytic ehrlichiosis, human granulocytic ehrlichiosis and human babesiosis; and
h. County mosquito control agencies throughout the State are currently staffed and equipped to control nuisance and vector species of mosquitoes. These commissions or agencies provide a central operational unit within each county with the capability to advise and assist the Department of Health and Senior Services in the development and implementation of an integrated approach to manage tick-borne disease vectors.
The public members shall serve for three-year terms or until a successor is appointed; but of the members initially appointed, five shall serve for a term of three years and five shall serve for a term of two years.
Vacancies in the membership of the council shall be filled in the same manner as the original appointments are made and a member may be eligible for reappointment. Vacancies occurring other than by expiration of a term shall be filled for the unexpired term.
The members of the council shall serve without compensation but shall be reimbursed for traveling and other miscellaneous expenses necessary to perform their duties, within the limits of funds appropriated or otherwise made available to the council for its purposes.
In the event of a public health necessity, the designated commission or agency may conduct other tick management activities in accordance with tick management protocols established by the Department of Health and Senior Services.
Lead poisoning is the most prevalent environmental health problem facing children in New Jersey today; the Department of Health estimates that over 177,000 children under the age of five in New Jersey are at high risk of lead poisoning, and the effects of lead poisoning in children include learning disabilities, mental retardation, behavioral disorders, hyper-irritability, lack of coordination, loss of appetite, vomiting, abdominal pain, convulsions, permanent brain damage and death; even low levels of lead exposure can cause subtle neurological changes, reduced concentration and attentiveness, reduced I.Q. scores, behavioral problems, and learning disabilities; these problems persist and can adversely affect the child's chances for success in school and life; lead poisoning is caused by environmental exposure to lead and the most significant sources are lead-based paint in older housing and lead-laden dust and soil; and the Department of Health estimates that approximately 65% of New Jersey's housing stock may contain lead-based paint, representing a potential public health hazard of alarming magnitude.
The Legislature further finds and declares that:
Persons performing lead evaluation and lead abatement work must receive appropriate training and certification to ensure that lead evaluations and abatements are reliable, thorough, and safe; persons performing lead evaluation, without proper training, may fail to detect lead-contaminated surfaces; an abatement work plan that is based on an improper evaluation will be inadequate to rid a dwelling of a lead hazard; persons performing lead abatement, without proper training, may cause the contamination of an entire home with dangerous levels of lead; and a certification program for lead abatement is essential to ensure the safety of the occupants and the safety of the workers and is also necessary to protect consumers from fraud, abuse, and shoddy work practices.
"Commissioner" means the Commissioner of Health.
"Department" means the Department of Health.
"Interim controls" means a set of measures designed to reduce temporarily human exposure or likely exposure to lead-based paint hazards, including specialized cleaning, repairs, maintenance, painting, temporary containment, ongoing monitoring of lead-based paint hazards or potential hazards, and the establishment and operation of management and resident education programs, or as the term is defined under 42 U.S.C.s.4851b.
"Lead abatement" means a set of measures designed to permanently eliminate lead-based paint hazards in accordance with standards established by the Commissioner of Community Affairs in compliance with standards promulgated by the appropriate federal agencies. Such term includes:
a. the removal of lead-based paint and lead-contaminated dust, the permanent containment or encapsulation of lead-based paint, the replacement of lead-painted surfaces or fixtures, and the removal or covering of lead contaminated soil; and
b. all preparation, cleanup, disposal, and post-abatement clearance testing activities associated with such measures.
"Lead evaluation" means a surface-by-surface investigation to determine the presence of lead-based paint and the provision of a report explaining the results of the investigation.
"Lead hazard control work" means work to make housing lead-safe, or to mitigate, through the use of interim controls as permitted under federal law and as defined in 42 U.S.C.s.4851b, or to eliminate permanently lead-based paint hazards by abatement on a premises by a person certified to perform lead abatement work pursuant to sections 1 through 12 of P.L.1993, c.288 (C.26:2Q-1 et seq.) and sections 14 through 24 of P.L.1993, c.288 (C.52:27D-427 et seq.).
"Lead-based paint" means paint or other surface coating material that contains lead in excess of 1.0 milligrams per centimeter squared or in excess of 0.5% by weight, or such other level as may be established by federal law.
"Lead-based paint hazard" means any condition that causes exposure to lead from lead-contaminated dust or soil or lead-contaminated paint that is deteriorated or present in surfaces, that would result in adverse human health effects.
"Lead-based paint hazard inspection" means an inspection of residential housing and the structure's interior common areas and exterior surface for the presence of lead-based paint hazards.
"Lead safe maintenance work" means those maintenance activities which are necessary to maintain surfaces in a lead safe condition and to prevent lead-based paint hazards from occurring or reoccurring.
"Surface" means an area such as an interior or exterior wall, ceiling, floor, door, door frame, window sill, window frame, porch, stair, handrail and spindle, or other abradable surface, soil, furniture, a carpet, a radiator or a water pipe.
b. The commissioner shall establish a certification program to assure the competency of persons to perform lead evaluations or lead abatement work in a safe and reliable manner. The commissioner may establish different classes of certification reflecting the different types and complexities of lead evaluation and abatement activities.
c. The commissioner shall certify a person who satisfactorily completes the certification training course required pursuant to this act, passes an examination prescribed by the department and meets any other requirements for certification that may be established by the commissioner or by federal law.
d. The certification shall be in writing with a photo identification, signed and dated by the commissioner. It shall be carried upon the person while performing evaluation or abatement services.
e. Notwithstanding the provisions of subsection a. of this section to the contrary, a person who is certified to conduct lead evaluations or perform lead abatement work in a jurisdiction outside of New Jersey is entitled to receive a New Jersey certification from the department if the person demonstrates successful completion of a training and certification program in that jurisdiction that is at least as rigorous and comprehensive as the State training and certification program.
f. Lead evaluation and lead abatement certifications shall be for a period not to exceed two years and shall be non-transferable. A person may apply for recertification during the 90-day period before the certification expiration date or the 90-day period after the certification expiration date; except that if a person applies after the certification expiration date, he shall not perform any services for which certification is required until the certification is renewed. If a certification has expired for more than 90 days, the person is required to obtain a new certification.
g. Nothing in this section shall be construed to restrict or otherwise affect the right of any person to engage in painting, woodworking, structural renovation or other indoor or outdoor contracting services that may result in the disturbance of paint, or to engage in lead safe maintenance work or lead hazard control work, but a person shall not hold himself out as certified by the department or otherwise represent that he has specialized competency to perform lead evaluation or abatement work, unless he has been certified or otherwise specifically authorized pursuant to sections 1 through 12 of P.L.1993, c.288 (C.26:2Q-1 through C.26:2Q-12).
A person for hire who seeks to engage in lead safe maintenance work or lead hazard control work shall, prior to doing so, complete such training course as may be prescribed by the Commissioner of Community Affairs and provided by a training provider accredited by the commissioner.
A person who utilizes interim controls to reduce the risk of lead-based paint exposure shall utilize only those methods approved by the appropriate federal agencies, including specialized cleaning, repairs, maintenance, painting, temporary containment, ongoing monitoring of lead-based paint hazards or potential hazards, as may be set forth under 42 U.S.C.s.4851b or those methods set forth in guidelines established by the Commissioner of Community Affairs, but shall not be required to be certified pursuant to this section unless performing lead abatement.
b. The training course for persons performing lead evaluation shall include, but not be limited to, instruction in:
(1) safe and effective techniques and methods to test for lead hazards and assess lead hazards on premises before, during and after abatement of lead hazards;
(2) risk assessment of the dangers posed by lead hazards on a premises and the effectiveness of various abatement techniques and methods and hazard reduction measures to reduce the risk posed by the presence of lead;
(3) safe work practices, including determining whether occupants must be relocated during lead abatement;
(4) practices to prevent contamination of the premises; and
(5) applicable State and federal requirements.
c. The training course for persons performing lead abatement shall include, but not be limited to, instruction concerning:
(1) safe and effective abatement techniques to remove, cover, encapsulate, or otherwise mitigate lead-based paint and lead-contaminated dust and soil;
(2) possible routes of exposure during abatement of lead hazards;
(3) safe work practices, including determining whether occupants must be relocated during lead abatement;
(4) proper cleanup of lead-contaminated waste generated on the premises during and after lead abatement;
(5) safe and lawful handling, transport and disposal of lead-contaminated waste; and
(6) applicable State and federal requirements.
d. The commissioner is authorized to adopt any applicable federal requirements or guidelines established by federal law, including any requirements or guidelines that apply to homeowners or other property owners, notwithstanding that the requirements or guidelines may be inconsistent with the provisions of sections 1 through 12 of P.L.1993, c.288 (C.26:2Q-1 through C.26:2Q-12).
e. The department may establish continuing education requirements for recertification.
f. A person shall not hold himself out as accredited by the department or otherwise represent that he is competent to offer training unless he has been accredited to provide training pursuant to this section.
(1) a person has obtained a certification based upon a misrepresentation or fraud;
(2) a person performed work without a certification as required in section 3 of P.L.1993, c.288 (C.26:2Q-3);
(3) a person engaged in unsafe work practices, violated the rules promulgated by the Department of Community Affairs pursuant to sections 14 through 24 of P.L.1993, c.288 (C.52:27D-427 through C.52:27D-437), failed to obtain a permit pursuant to the Uniform Construction Code, N.J.A.C.5:23-1.1 et seq. or acted in a manner which posed a health risk to others;
(4) the quality of the person's performance is below standards set by the department and remedial measures such as consultation and training are not accepted or do not result in improvement to a level of acceptable proficiency;
(5) a person made false reports or reports not based on work done;
(6) a person knowingly authorized or permitted the use of the name of a certified person to an uncertified person;
(7) a person falsely represented his certification credentials; or
(8) a person has violated any provision of sections 1 through 12 of P.L.1993, c.288 (C.26:2Q-1 through C.26:2Q-12).
b. An applicant or certificate holder whose application or certification is denied, suspended, conditionally issued, revoked or not renewed is entitled to a hearing pursuant to the provisions of the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.).
c. Denial of, suspension of, imposition of conditions upon, revocation of, or refusal to renew a certification shall not limit the department from pursuing against the applicant or certificate holder any other lawful remedy available to the department.
d. Any person whose certification has been revoked shall be ineligible to apply for certification for three years from the date of revocation.
a. hinders or delays the department in the enforcement of sections 1 through 12 of P.L.1993, c.288 (C.26:2Q-1 through C.26:2Q-12);
b. fails to obtain the certification required by section 3 of P.L.1993, c.288 (C.26:2Q-3) and engages in lead evaluation or lead abatement work for pecuniary gain;
c. solicits another person to engage, employ or retain him to perform a lead evaluation or lead abatement work, for pecuniary gain, when he is not certified pursuant to section 3 of P.L.1993, c.288 (C.26:2Q-3);
d. holds himself out as accredited by the department or otherwise represents that he is competent to offer training when he is not accredited to provide training pursuant to section 4 of P.L.1993, c.288 (C.26:2Q-4); or
e. otherwise violates any provision of sections 1 through 12 of P.L.1993, c.288 (C.26:2Q-1 through C.26:2Q-12); is guilty of a disorderly persons offense.
The penalty may be sued for and recovered by and in the name of the commissioner in a civil action in a court of competent jurisdiction by a summary proceeding under "the penalty enforcement law," N.J.S.2A:58-1 et seq. For the purposes of this act, the Superior Court and the municipal court shall have jurisdiction to enforce the provisions of "the penalty enforcement law."
The department may compromise and settle a claim for a penalty under this section in such amount as the department determines to be appropriate and equitable.
As used in this section, a violation shall include the:
a. obstructing, hindering, delaying or interfering by force or otherwise with the commissioner in the exercise of any power or the discharge of any function or duty pursuant to the provisions of sections 1 through 12 of P.L.1993, c.288 (C.26:2Q-1 through C.26:2Q-12);
b. preparing, uttering or rendering of any false statements, reports, documents, plans or specifications permitted or required pursuant to sections 1 through 12 of P.L.1993, c.288 (C.26:2Q-1 through C.26:2Q-12); or
c. refusal or failure to comply with a ruling, action, order or notice of the commissioner pursuant to sections 1 through 12 of P.L.1993, c.288 (C.26:2Q-1 through C.26:2Q-12).
"Commissioner" means the Commissioner of Human Services.
"Council" means the Interagency Council on Osteoporosis established pursuant to this act.
"Department" means the Department of Human Services.
"Program" means the osteoporosis prevention and education program established pursuant to this act.
b. The program shall include the following:
(1) Development of a public education and outreach campaign to promote osteoporosis prevention and education, including, but not limited to, the following subjects:
(a) The cause and nature of the disease;
(b) Risk factors;
(c) The role of hysterectomy;
(d) Prevention of osteoporosis, including nutrition, diet, and physical exercise;
(e) Diagnostic procedures and appropriate indications for their use;
(f) Hormone replacement, including the benefits and risks;
(g) Environmental safety and injury prevention; and
(h) Availability of osteoporosis diagnostic treatment services in the community.
(2) Development of educational materials to be made available for consumers, particularly targeted to high-risk groups, through local boards of health, physicians, other health care providers, including, but not limited to, health maintenance organizations, hospitals, and clinics, and women's organizations.
(3) Development of professional education programs for health care providers to assist them in understanding research findings and the subjects set forth in paragraph (1) of this subsection.
(4) Development and maintenance of a list of current providers of specialized services for the prevention and treatment of osteoporosis. Dissemination of the list shall be accompanied by a description of diagnostic procedures, appropriate indications for their use, and a cautionary statement about the current status of osteoporosis research, prevention, and treatment. The statement shall also indicate that the department does not license, certify, or in any other way approve osteoporosis programs or centers in this State.
a. Parkinson's disease is a debilitating, painful, and incurable neurological disorder of unknown origin that disrupts and can end the lives of those who suffer from it;
b. Parkinson's disease causes diverse symptoms, including rigidity, slowness of movement, poor balance, and tremors, which lead to an impaired ability to walk, speak, swallow, and even breathe, so that the end result can be a clear mind trapped inside a body that has lost its ability to function;
c. The visible symptoms of Parkinson's disease are often mistaken to be a normal part of the aging process;
d. In addition, many people with the disease encounter precarious legal and personal situations in which they are erroneously thought to be under the influence of illegal or prescription drugs or alcohol due to their movement and gait patterns;
e. Parkinson's disease takes an enormous emotional, psychological, and physical toll on caregivers and families, potentially overwhelming their lives;
f. It has been estimated that 1.5 million Americans have been diagnosed with Parkinson's disease, 50,000 more are diagnosed nationally each year, and another 1.5 million persons have the disease but have never seen a neurologist;
g. Parkinson's disease costs Americans $25 billion per year, including medical treatments, disability payments, and lost productivity;
h. Medications can only control some of the symptoms of the disease and only for uncertain periods of time;
i. New Jersey, with the largest concentration of pharmaceutical companies of any state in the nation and its top academic research facilities, is a center for Parkinson's disease research and treatment;
j. The "Morris K. Udall Parkinson's Disease Research Act of 1997," Pub.L.105-78, provides federal funding through the National Institutes of Health for Parkinson's disease, and April 11 has been proclaimed to be World Parkinson's Day in order to recognize the need for more research and help in dealing with the devastating effects of this disease;
k. This State, through the enactment of Joint Resolution No. 17 on January 7, 2000, has designated April in each year as "Parkinson's Disease Awareness Month" in New Jersey, and directs the Governor to annually issue a proclamation calling upon the public officials and citizens of the State to observe this month with appropriate activities and programs;
l. Increased public awareness and education are needed among health care, social services, judicial, law enforcement, and emergency medical services personnel in order to better respond to the needs of Parkinson's disease patients and their caregivers and families; and
m. It is imperative for New Jersey to commit itself to actively support such public awareness and education efforts throughout the State in order to better meet the needs of its citizens who are suffering from Parkinson's disease.
"Commissioner" means the Commissioner of Health.
"Department" means the Department of Health.
"Program" means the Parkinson's disease public awareness and education program established pursuant to this act.
a. The purpose of the program shall be to promote public awareness of Parkinson's disease and the value of early detection and possible treatments, including the benefits and risks of those treatments. The Department of Health may accept, for that purpose, any special grant of monies, services, or property from the federal government or any of its agencies, or from any foundation, organization, or medical school.
b. The program shall include the following:
(1) Development of a public education and outreach campaign to promote Parkinson's disease awareness and education, including, but not limited to, the following subjects:
(a) the cause and nature of the disease;
(b) diagnostic procedures and appropriate indications for their use;
(c) lifestyle issues relating to how a person copes with Parkinson's disease, including, but not limited to, nutrition, diet, and physical exercise;
(d) environmental safety and injury prevention; and
(e) availability of Parkinson's disease diagnostic and treatment services in the community;
(2) Development of educational materials to be made available to consumers through local boards of health, physicians, hospitals, and clinics;
(3) Development of professional education programs for health care providers to assist them in understanding research findings and the subjects set forth in paragraph (1) of this subsection;
(4) Development of educational programs for other personnel, including judicial staff, police officers, fire fighters, and social services and emergency medical service providers, to assist them in recognizing the symptoms of Parkinson's disease and understanding how to respond to the needs of persons with the disease in the course of performing their duties, including dissemination of the informational booklet prepared pursuant to section 5 of this act; and
(5) Development and maintenance of a list of current providers of specialized services for the diagnosis and treatment of Parkinson's disease. Dissemination of the list shall be accompanied by a description of diagnostic procedures, appropriate indications for their use, and a cautionary statement about the current status of Parkinson's disease research and treatment. The statement shall also indicate that the department does not endorse specific Parkinson's disease programs or centers in this State.
"Behavioral health care services" means procedures or services rendered by a health care provider for the treatment of mental illness, emotional disorders, or drug or alcohol abuse. "Behavioral health care services" does not include: any quality assurance or utilization management activities or treatment plan reviews conducted by a carrier, or a private entity on behalf of the carrier, pertaining to these services, whether administrative or clinical in nature; or any other administrative functions, including, but not limited to, accounting and financial reporting, billing and collection, data processing, debt or debt service, legal services, promotion and marketing, or provider credentialing.
"Carrier" means an insurance company, health service corporation, hospital service corporation, medical service corporation, or health maintenance organization authorized to issue health benefits plans in this State.
"Commissioner" means the Commissioner of Banking and Insurance.
"Contract holder" means an employer or organization that purchases a contract for services.
"Covered person" means a person on whose behalf a carrier offering the plan is obligated to pay benefits or provide services pursuant to the health benefits plan.
"Covered service" means a health care service provided to a covered person under a health benefits plan for which the carrier is obligated to pay benefits or provide services.
"Department" means the Department of Banking and Insurance.
"Health benefits plan" means a benefits plan which pays or provides hospital and medical expense benefits for covered services, and is delivered or issued for delivery in this State by or through a carrier. Health benefits plan includes, but is not limited to, Medicare supplement coverage and risk contracts to the extent not otherwise prohibited by federal law. For the purposes of this act, health benefits plan shall not include the following plans, policies, or contracts: accident only, credit, disability, long-term care, CHAMPUS supplement coverage, coverage arising out of a workers' compensation or similar law, automobile medical payment insurance, personal injury protection insurance issued pursuant to P.L.1972, c.70 (C.39:6A-1 et seq.), or hospital confinement indemnity coverage.
"Health care provider" means an individual or entity which, acting within the scope of its licensure or certification, provides a covered service defined by the health benefits plan. Health care provider includes, but is not limited to, a physician and other health care professionals licensed pursuant to Title 45 of the Revised Statutes, and a hospital and other health care facilities licensed pursuant to Title 26 of the Revised Statutes.
"Independent utilization review organization" means an independent entity comprised of physicians and other health care professionals who are representative of the active practitioners in the area in which the organization will operate and which is under contract with the department to provide medical necessity or appropriateness of services appeal reviews pursuant to this act.
"Managed behavioral health care organization" means an entity, other than a carrier, which contracts with a carrier to provide, undertake to arrange, or administer behavioral health care services to covered persons through health care providers employed by the managed behavioral health care organization or otherwise make behavioral health care services available to covered persons through contracts with health care providers.
"Managed behavioral health care organization" does not include a person or entity that, for an administrative fee only, solely arranges a panel of health care providers for a carrier for the provision of behavioral health care services on a discounted fee-for-service basis.
"Managed care plan" means a health benefits plan that integrates the financing and delivery of appropriate health care services to covered persons by arrangements with participating providers, who are selected to participate on the basis of explicit standards, to furnish a comprehensive set of health care services and financial incentives for covered persons to use the participating providers and procedures provided for in the plan.
"Subscriber" means, in the case of a group contract, a person whose employment or other status, except family status, is the basis for eligibility for enrollment by the carrier or, in the case of an individual contract, the person in whose name the contract is issued.
"Utilization management" means a system for reviewing the appropriate and efficient allocation of health care services under a health benefits plan according to specified guidelines, in order to recommend or determine whether, or to what extent, a health care service given or proposed to be given to a covered person should or will be reimbursed, covered, paid for, or otherwise provided under the health benefits plan. The system may include: preadmission certification, the application of practice guidelines, continued stay review, discharge planning, preauthorization of ambulatory care procedures, and retrospective review.
b. The commissioner shall establish a form for carriers which shall request, at a minimum:
(1) the official address and telephone number of the place of business of the carrier; and
(2) a description of the carrier's internal patient appeals process available to covered persons to contest a denial, reduction or termination of benefits, if any.
c. A health maintenance organization which holds a certificate of authority pursuant to P.L.1973, c.337 (C.26:2J-1 et seq.) shall be exempt from the filing requirements of this section but shall comply with the provisions of this act.
A health maintenance organization shall be required to comply with the provisions of P.L.1973, c.337 (C.26:2J-1 et seq.) and any rules and regulations adopted pursuant thereto, except that in the event that the provisions of this act conflict with the provisions of P.L.1973, c.337, the provisions of this act shall supersede the provisions of P.L.1973, c.337.
d. A carrier which issues health benefits plans utilizing a selective contracting arrangement pursuant to section 22 of P.L.1993, c.162 (C.17B:27A-54) shall be required to comply with the provisions of section 22 of P.L.1993, c.162 and any rules and regulations adopted pursuant thereto, except that in the event that the provisions of this act conflict with the provisions of section 22 of P.L.1993, c.162, the provisions of this act shall supersede the provisions of section 22 of P.L.1993, c.162.
“Carrier” means an insurance company, health service corporation, hospital service corporation, medical service corporation, or health maintenance organization authorized to issue health benefits plans in this State, or any other entity subject to the insurance laws and rules of insurance in this State or subject to the jurisdiction of the Department of Banking and Insurance, that contracts, or offers to contract, to provide, deliver, arrange for, pay for, or reimburse any of the costs of health care services under a health benefits plan in this State.
“Cost-sharing amount” means any copayment, coinsurance, deductible, or other similar charges required of an enrollee for a health care service covered by a health benefits plan, including a prescription drug, and paid by or on behalf of the enrollee.
“Enrollee” means any individual entitled to coverage of health care services from a carrier.
“Health benefits plan” means a policy, contract, certification, or agreement offered or issued by a carrier to provide, deliver, arrange for, pay for, or reimburse any of the costs of health care services. For the purposes of P.L.2025, c.199 (C.26:2S-3.1 et al.), “health benefits plans” shall not include the following plans, policies, or contracts: accident only; credit disability; long-term care; Medicare supplemental coverage; TRICARE supplement coverage; coverage for Medicare services pursuant to a contract with the United States government; the State Medicaid program established pursuant to P.L.1968, c.413 (C.30:4D-1 et seq.); coverage arising out of a worker’s compensation or similar law; the State Health Benefits Program; the School Employees’ Health Benefits Program; a self-insured health benefits plan governed by the provisions of the federal “Employee Retirement Income Security Act of 1974,” 29 U.S.C. s.1001 et seq.; coverage under a policy of private passenger automobile insurance issued pursuant to P.L.1972, c.70 (C.39:6A-1 et seq.); or hospital confinement indemnity coverage.
“Health care service” means an item or service furnished to any individual for the purpose of preventing, alleviating, curing, or healing human illness, injury, or disability.
“Third-party administrator” has the same meaning as defined in N.J.S.17B:27B-1.
b. When calculating an enrollee’s contribution to any applicable cost-sharing amount requirement, a carrier or third-party administrator shall give credit for the amount, or any portion thereof, of any cost-sharing amount paid by the enrollee or on behalf of the enrollee by another party. If a health benefits plan qualifies as a high-deductible health plan for which medical expenses are paid using a health savings account established pursuant to section 223 of the federal Internal Revenue Code of 1986 (26 U.S.C. s.223), this subsection shall apply to a high-deductible health plan with respect to the deductible after the enrollee has satisfied the minimum deductible required under section 223, except for with respect to items or services that are preventive care pursuant to section 223(c)(2)(C) of the federal Internal Revenue Code (26 U.S.C. s.223), in which case the requirements of this subsection shall apply regardless of whether the minimum deductible under section 223 has been satisfied.
c. A carrier or third-party administrator shall not directly or indirectly set, alter, implement, or condition the terms of health benefits plan coverage, including the benefit design, based in part or entirely on information about the availability or amount of financial or product assistance available for a prescription drug.
d. By March 31 of each year, each carrier and third-party administrator authorized to conduct business in the State shall certify to the Commissioner of Banking and Insurance, in a form and manner as determined by the commissioner, that it has fully and completely complied with the requirements of this section throughout the prior calendar year. The certification shall be signed by the chief executive officer, chief financial officer, or designee, of the carrier or third-party administrator.
e. The Commissioner of Banking and Insurance, pursuant to the “Administrative Procedure Act,” P.L.1968, c.410 (C.52:14B-1 et seq.), shall adopt rules and regulations to effectuate the purposes of this section.
a. The information required to be disclosed pursuant to this section shall include a description of:
(1) covered services and benefits to which the subscriber or other covered person is entitled;
(2) restrictions or limitations on covered services and benefits, including, but not limited to, physical and occupational therapy services, clinical laboratory tests, hospital and surgical procedures, prescription drugs and biologics, radiological examinations and behavioral health care services;
(3) financial responsibility of the covered person, including copayments and deductibles;
(4) prior authorization and any other review requirements with respect to accessing covered services;
(5) where and in what manner covered services may be obtained;
(6) changes in covered services or benefits, including any addition, reduction or elimination of specific services or benefits;
(7) the covered person's right to appeal and the procedure for initiating an appeal of a utilization management decision made by or on behalf of the carrier with respect to the denial, reduction or termination of a health care benefit or the denial of payment for a health care service;
(8) the procedure to initiate an appeal through the Independent Health Care Appeals Program established pursuant to this act; and
(9) such other information as the commissioner shall require.
b. The carrier shall file the information required pursuant to this section with the department.
c. In the case of a carrier that owns, wholly or in part, or contracts with a managed behavioral health care organization, the information required to be disclosed pursuant to this section shall include the following:
(1) the specific behavioral health care services covered and the specific exclusions that apply to the subscriber or other covered person;
(2) the covered person's responsibilities for obtaining behavioral health care services;
(3) the reimbursement methodology that the carrier and managed behavioral health care organization use to reimburse health care providers for behavioral health care services; and
(4) if the carrier offers a managed care plan that provides for both in-network and out-of-network benefits, the procedure that a covered person must utilize when attempting to obtain behavioral health care services from a health care provider who is not included in the network of providers used by the carrier or managed behavioral health care organization.
(1) A current participating provider directory providing information on a covered person's access to primary care physicians and specialists, including the number of available participating physicians, by provider category or specialty and by county. The directory shall include the professional office address of a primary care physician and any hospital affiliation the primary care physician has. The directory shall also provide information about participating hospitals.
In the case of a carrier that owns, wholly or in part, or contracts with a managed behavioral health care organization, the directory shall include a list of participating providers of behavioral health care services with the address of each provider.
The carrier shall promptly notify each covered person prior to the termination or withdrawal from the carrier's provider network of the covered person's primary care physician;
(2) General information about the financial incentives between participating physicians under contract with the carrier and other participating health care providers and facilities to which the participating physicians refer their managed care patients;
(3) The percentage of the carrier's managed care plan's network physicians who are board certified;
(4) The carrier's managed care plan's standard for customary waiting times for appointments for urgent and routine care;
(5) The availability through the department, upon request of a member of the general public, of independent consumer satisfaction survey results and an analysis of quality outcomes of health care services of managed care plans in the State;
(6) Information about the Managed Health Care Consumer Assistance Program established pursuant to P.L.2001, c.14 (C.26:2S-19 et al.) as prescribed by regulation of the commissioner, including the toll-free telephone number available to contact the program; and
(7) The carrier's preauthorization and review requirements of the health benefits plan regarding the determination of medical necessity that apply to a covered person who is admitted to an in-network health care facility, and the financial responsibility of the patient for the cost of services provided by an out-of-network admitting or attending health care practitioner.
The carrier shall provide a prospective subscriber with information about the provider network, including hospital affiliations, and other information specified in this subsection, upon request.
b. Upon request of a covered person, a carrier shall promptly inform the person:
(1) whether a particular network physician is board certified; and
(2) whether a particular network physician is currently accepting new patients.
c. The carrier shall file the information required pursuant to this section with the department.
b. For purposes of this section, "carrier," as defined in P.L.1997, c.192 (C.26:2S-1 et al.), shall also include the State Health Benefits Program and the School Employees' Health Benefits Program.
The medical director shall be responsible for treatment policies, protocols, quality assurance activities and utilization management decisions of the carrier. The treatment policies, protocols, quality assurance program and utilization management decisions of the carrier shall be based on generally accepted standards of health care practice. The quality assurance and utilization management programs shall be in accordance with standards adopted by regulation of the department pursuant to this act.
b. The medical director shall ensure that:
(1) Any utilization management decision to deny, reduce or terminate a health care benefit or to deny payment for a health care service, because that service is not medically necessary, shall be made by a physician. In the case of a health care service prescribed or provided by a dentist, the decision shall be made by a dentist;
(2) A utilization management decision shall not retrospectively deny coverage for health care services provided to a covered person when prior approval has been obtained from the carrier for those services, unless the approval was based upon fraudulent information submitted by the covered person or the participating provider;
(3) In the case of a managed care plan, a procedure is implemented whereby participating physicians and dentists have an opportunity to review and comment on all medical and surgical and dental protocols, respectively, of the carrier;
(4) The utilization management program is available on a 24-hour basis to respond to authorization requests for emergency and urgent services and is available, at a minimum, during normal working hours for inquiries and authorization requests for nonurgent health care services; and
(5) In the case of a managed care plan, a covered person is permitted to: choose or change a primary care physician from among participating providers in the provider network, and, when appropriate, choose a specialist from among participating network providers following an authorized referral, if required by the carrier, and subject to the ability of the specialist to accept new patients.
(1) a covered person is admitted by an out-of-network health care provider to an in-network health care facility for covered, medically necessary health care services; or
(2) the covered person receives covered, medically necessary health care services from an out-of-network health care provider while the covered person is a patient at an in-network health care facility and was admitted to the health care facility by an in-network provider, the carrier shall reimburse the health care facility for the services provided by the facility at the carrier's full contracted rate without any penalty for the patient's selection of an out-of-network provider, in accordance with the in-network policies and in-network copayment, coinsurance or deductible requirements of the managed care plan.
b. The provisions of subsection a. of this section shall apply only if the covered person complies with the preauthorization or review requirements of the health benefits plan regarding the determination of medical necessity to access in-network inpatient benefits, as set forth in writing pursuant to section 5 of P.L.1997, c.192 (C.26:2S-5).
c. With respect to a carrier which offers a managed care plan that provides for both in-network and out-of-network benefits, in the event that the covered person assigns, through an assignment of benefits, his right to receive reimbursement for medically necessary health care services to an out-of-network health care provider, the carrier shall remit payment for the reimbursement directly to the health care provider in the form of a check payable to the health care provider, or in the alternative, to the health care provider and the covered person as joint payees, with a signature line for each of the payees. Payment shall be made in accordance with the provisions of this section and P.L.1999, c.154 (C.17B:30-23 et al.). Any payment made only to the covered person rather than the health care provider under these circumstances shall be considered unpaid, and unless remitted to the health care provider within the time frames established by P.L.1999, c.154 (C.17B:30-23 et al.), shall be considered overdue and subject to an interest charge as provided in that act.
b. For the purposes of this section, "carrier" shall include, in addition to an insurance company, health service corporation, hospital service corporation, medical service corporation, or health maintenance organization authorized to issue health benefits plans in this State, the State Health Benefits Commission and the School Employees' Health Benefits Commission.
The commissioner, in consultation with the New Jersey Association of Health Plans, the Health Insurance Association of America, the Medical Society of New Jersey, the New Jersey Hospital Association and such other representatives of managed care plans as the commissioner deems appropriate, shall also adopt by regulation a form for renewal of credentialing, which shall be an abbreviated version of the universal application form. The renewal form shall be designed to enable a physician to indicate changes in the information provided in the application form.
The commissioner shall revise the universal application and renewal forms, as necessary, to conform with industry-wide, national standards for credentialing.
In developing the forms, the commissioner shall consult with the Commissioner of Human Services to ensure that the credentialing requirements for participation in the Medicaid program, established pursuant to P.L.1968, c.413 (C.30:4D-1 et seq.), and the NJ FamilyCare Program established pursuant to P.L.2005, c.156 (C.30:4J-8 et al.) are adequately reflected on the application and renewal forms.
Nothing in this section shall be construed to prevent a carrier from requesting additional information from an applicant that is not provided for in the universal application or renewal form, as applicable, if the requested information does not duplicate any information included in the applicable form.
a. The carrier shall inform a participating health care provider of the carrier's removal policy at the time the carrier contracts with the health care provider to participate in the provider network, and at each renewal thereof.
b. If a licensed health care professional's participation will be terminated prior to the date of the termination of the contract, the carrier shall provide the health care professional with 90 days' written notice of the termination and notice of a right to a hearing. If requested by the health care professional, the carrier shall provide the reasons for the termination in writing, and shall hold a hearing within 30 days of the date of the request. The hearing shall be conducted by a panel appointed by the carrier, which panel shall be comprised of a minimum of three persons, at least one of whom is a clinical peer in the same discipline and the same or similar specialty as the health care professional being reviewed. The panel shall make a decision that: (1) the health care professional shall be terminated, or (2) the health care professional shall be reinstated or provisionally reinstated, subject to conditions set forth by the panel. The panel's determination shall be in writing and shall be made in a timely manner. Participation in this process shall not be deemed to be an abrogation of the health care professional's legal rights.
The notice required and opportunity for a hearing pursuant to this subsection shall not apply in those cases when the contract expires and is not renewed, the termination is for breach of contract, in the opinion of the medical director, the health care professional represents an imminent danger to an individual patient or the public health, safety or welfare, or there is a determination of fraud.
c. If the carrier finds that a health care professional represents an imminent danger to an individual patient or to the public health, safety or welfare, the medical director shall promptly notify the appropriate professional State licensing board. Notification to the State Board of Medical Examiners shall be subject to the provisions of section 5 of P.L.1989, c.300 (C.45:9-19.5).
a. Shall state that the health care provider shall not be penalized or the contract terminated by the carrier because the health care provider acts as an advocate for the patient in seeking appropriate, medically necessary health care services;
b. Shall not provide financial incentives to the health care provider for withholding covered health care services that are medically necessary as determined in accordance with section 6 of this act, except that nothing in this subsection shall be construed to limit the use of capitated payment arrangements between a carrier and a health care provider; and
c. Shall protect the ability of a health care provider to communicate openly with a patient about all appropriate diagnostic testing and treatment options.
(1) for a period not to exceed six months in the case of post-operative follow-up care;
(2) for a period not to exceed one year in the case of oncological treatment and psychiatric treatment; and
(3) through the duration of a pregnancy and up to six weeks after delivery in the case of obstetrical care.
The continuation of treatment by a particular physician as provided for in this subsection shall be at the option of the covered person.
The carrier shall provide that health care benefits or services, as appropriate, shall be provided for the treatment of the conditions provided in this subsection to the same extent as such benefits or services were provided while the physician was employed by or under contract with the carrier. Reimbursement for the health care services shall be pursuant to the same fee schedule used to reimburse for the services when the physician was employed by or under contract with the carrier.
b. A carrier which offers a managed care plan shall also provide in that plan for continued coverage of other health care services by a physician who was employed by or under contract with the carrier at the time the treatment was initiated, but is no longer employed by or under contract with the carrier, for up to 120 calendar days in cases where it is medically necessary for the covered person to continue treatment with that physician.
Health care benefits or services, as applicable, shall be provided by the health benefits plan for medically necessary treatment as provided in this subsection to the same extent as such benefits or services were provided while the physician was employed by or under contract with the carrier. Reimbursement for the health care services shall be pursuant to the same fee schedule used to reimburse for the services when the physician was employed by or under contract with the carrier.
c. During the period of time a covered person is continuing to receive treatment pursuant to subsection a. or b. of this section by a physician who is no longer employed by or under contract with the carrier, the carrier shall provide in its plan for reimbursement for any treatment or services provided or delivered to the covered person in an acute care hospital, regardless of whether the acute care hospital is under contract or agreement with the carrier.
d. The carrier shall not be liable for any inappropriate treatment provided to the covered person by a physician who is no longer employed by or under contract with the carrier.
e. The provisions of this section shall not apply to health care services provided by a physician who is the subject of disciplinary action by the State Board of Medical Examiners.
The fee schedule provided to the health care provider by the carrier is proprietary and shall be confidential. Unauthorized distribution of the fee schedule may result in the health care provider's termination from the network in accordance with the provisions of N.J.A.C. 8:38-1.1 et seq.
b. The carrier shall reimburse the health care provider in accordance with the fee schedule provided to the health care provider pursuant to the contract. The carrier may revise the fee schedule upon providing the health care provider with written notice of the change and, upon request, a copy of the revised fee schedule.
c. Nothing in this section shall be construed to limit the ability of a carrier to make payments under a managed care plan based on its claims payment policies.
b. A carrier shall provide each subscriber in a plan whose contract holder elects the point-of-service plan, with the opportunity, at the time of enrollment and during the annual open enrollment period, to enroll in the point-of-service plan option. The carrier shall provide written notice of the point-of-service plan to each subscriber in a plan whose contract holder elects the point-of-service plan and shall include in that notice a detailed explanation of the financial costs to be incurred by a subscriber who selects that plan.
c. The requirements of this section shall not apply to a carrier contract which offers a managed care plan that provides health care services to Medicaid recipients pursuant to P.L.1968, c.413 (C.30:4D-1 et seq.), or a federally qualified, nonprofit health maintenance organization.
d. A carrier which offers a managed care plan utilizing a selective contracting arrangement approved in accordance with N.J.A.C.11:4-37.1 et seq. that provides benefits for out-of-network providers shall be deemed to be in compliance with this section.
e. A health maintenance organization affiliated with an insurance company authorized to issue health benefits plans in this State that offers point-of-service benefits exclusively through a point-of-service plan provided by the affiliated insurance company using a selective contracting arrangement approved in accordance with N.J.A.C.11:4-37.1 et seq., shall be deemed to be in compliance with this section if the point-of-service plan is offered pursuant to the requirements of subsections a. and b. of this section.
a. For the purpose of providing home treatment services for bleeding episodes associated with hemophilia, the carrier shall be required to contract with, and exclusively use, providers that comply with standards adopted by regulation of the Department of Banking and Insurance in consultation with the Hemophilia Association of New Jersey. At a minimum, the standards shall require that each provider:
(1) provide services pursuant to a prescription from the covered person's attending physician and not make any substitutions of blood products without prior approval of the attending physician;
(2) provide all brands of clotting factor products in low, medium and high-assay range levels to execute treatment regimens as prescribed by a covered person's attending physician, and all needed ancillary supplies for the treatment or prevention of bleeding episodes, including, but not limited to, needles, syringes, and cold compression packs;
(3) have the ability to deliver prescribed blood products, medications, and nursing services within three hours after receipt of a prescription for an emergent situation, and maintain 24-hour on-call service to accommodate this requirement;
(4) demonstrate experience with and knowledge of bleeding disorders and the management thereof;
(5) demonstrate the ability for appropriate and necessary record keeping and documentation, including the ability to expedite product recall or notification systems and the ability to assist covered persons in obtaining third party reimbursement;
(6) provide for proper removal and disposal of hazardous waste pursuant to State and federal law;
(7) provide covered persons with a written copy of the agency's policy regarding discontinuation of services related to loss of health benefits plan coverage or inability to pay; and
(8) provide covered persons, upon request, with information about the expected costs for medications and services provided by the agency that are not otherwise covered by the covered person's health benefits plan.
b. The Department of Banking and Insurance shall compile a list of providers who meet the minimum standards established pursuant to this section and shall make the list available to carriers and covered persons, upon request.
c. As used in this section: "blood product" includes, but is not limited to, Factor VIII, Factor IX and cryoprecipitate; and "blood infusion equipment" includes, but is not limited to, syringes and needles.
a. the results of laboratory tests are medically necessary immediately or sooner than the normal return time for the carrier's participating clinical laboratory; or
b. accurate test results need to be determined by closely supervised procedures in venipuncture and laboratory techniques in controlled environments that cannot be achieved by the carrier's participating clinical laboratory.
The carrier shall pay the hospital's clinical laboratory for the laboratory services at the same rate it would pay a participating clinical laboratory for comparable services.
The carrier shall retain the right to review all services provided pursuant to this section for medical necessity.
b. Nothing in this section shall be construed to prevent a carrier from entering into a contract with a vision care plan.
b. A vision care provider shall not charge more for services and materials that are noncovered services or noncovered materials to an enrollee of a vision care plan or carrier than the provider's usual and customary rate for those services and materials.
"Contractual discount" means a reduction from a vision care provider's usual and customary rate for covered services and materials required under a participating provider agreement.
"Covered materials" means materials for which reimbursement from the carrier or vision care plan is provided to a vision care provider by a covered person's plan contract, or for which a reimbursement would be available but for the application of the enrollee's contractual limitations of deductibles, copayments, or coinsurance.
"Covered services" means services for which reimbursement from the carrier or vision care plan is provided to a vision care provider by an enrollee's plan contract, or for which a reimbursement would be available but for the application of the enrollee's contractual limitations of deductibles, copayments, or coinsurance.
"Materials" means ophthalmic devices including but not limited to lenses, devices containing lenses, ophthalmic frames and other lens mounting apparatus, prisms, lens treatments and coatings contact lenses, and prosthetic devices to correct, relieve, or treat defects or abnormal conditions of the human eye or its adnexa.
"Services" means the professional work performed by a vision care provider.
"Vision care plan" means an entity that creates, promotes, sells, provides, advertises or administers, an integrated or stand-alone vision benefit plan, or a vision care insurance policy or contract which provides vision or medically necessary benefits to an enrollee pertaining to the provision of covered services or covered materials.
"Vision care provider" means a licensed doctor of optometry practicing under the authority of R.S.45:12-1 et seq. or a licensed medical or osteopathic doctor practicing under the authority of R.S.45:9-1 et seq. that has also completed a residency in ophthalmology.
"Benefit limits" includes both quantitative treatment limitations and non-quantitative treatment limitations.
"Carrier" means an insurance company, health service corporation, hospital service corporation, medical service corporation, or health maintenance organization authorized to issue health benefits plans in this State or any entity contracted to administer health benefits in connection with the State Health Benefits Program or School Employees' Health Benefits Program.
"Classification of benefits" means the classifications of benefits found at 45 C.F.R. 146.136(c)(2)(ii)(A) and 45 C.F.R. s.146.136(c)(3)(iii).
"Department" means the Department of Banking and Insurance.
"Mental health condition" means a condition defined to be consistent with generally recognized independent standards of current medical practice referenced in the current version of the Diagnostic and Statistical Manual of Mental Disorders.
"Non-quantitative treatment limitations" or "NQTL" means processes, strategies, or evidentiary standards, or other factors that are not expressed numerically, but otherwise limit the scope or duration of benefits for treatment. NQTLs shall include, but shall not be limited to:
(1) Medical management standards limiting or excluding benefits based on medical necessity or medical appropriateness, or based on whether the treatment is experimental or investigative;
(2) Formulary design for prescription drugs;
(3) For plans with multiple network tiers, such as preferred providers and participating providers, network tier design;
(4) Standards for provider admission to participate in a network, including reimbursement rates;
(5) Plan methods for determining usual, customary, and reasonable charges;
(6) Refusal to pay for higher-cost therapies until it can be shown that a lower-cost therapy is not effective, also known as fail-first policies or step therapy protocols;
(7) Exclusions based on failure to complete a course of treatment;
(8) Restrictions based on geographic location, facility type, provider specialty, and other criteria that limit the scope or duration of benefits for services provided under the plan or coverage;
(9) In and out-of-network geographic limitations;
(10) Limitations on inpatient services for situations where the participant is a threat to self or others;
(11) Exclusions for court-ordered and involuntary holds;
(12) Experimental treatment limitations;
(13) Service coding;
(14) Exclusions for services provided by a licensed professional who provides mental health condition or substance use disorder services;
(15) Network adequacy; and
(16) Provider reimbursement rates.
"Substance use disorder" means a disorder defined to be consistent with generally recognized independent standards of current medical practice referenced in the most current version of the Diagnostic and Statistical Manual of Mental Disorders.
b. A carrier shall approve a request for an in-plan exception if the carrier's network does not have any providers who are qualified, accessible and available to perform the specific medically necessary service. A carrier shall communicate the availability of in-plan exceptions:
(1) on its website where lists of network providers are displayed; and
(2) to beneficiaries when they call the carrier to inquire about network providers.
c. A carrier that provides hospital or medical expense benefits through individual or group contracts shall submit an annual report to the department on or before March 1. The annual report shall contain, to the extent that the commissioner determines practicable, the following information:
(1) A description of the process used to develop or select the medical necessity criteria for mental health benefits, the process used to develop or select the medical necessity criteria for substance use disorder benefits, and the process used to develop or select the medical necessity criteria for medical and surgical benefits;
(2) Identification of all NQTLs that are applied to mental health benefits, all NQTLs that are applied to substance use disorder benefits, and all NQTLs that are applied to medical and surgical benefits, including, but not limited to, those listed in subsection a. of this section;
(3) The results of an analysis that demonstrates that for the medical necessity criteria described in paragraph (1) of this subsection and for selected NQTLs identified in paragraph (2) of this subsection, as written and in operation, the processes, strategies, evidentiary standards, or other factors used to apply the medical necessity criteria and selected NQTLs to mental health condition and substance use disorder benefits are comparable to, and are no more stringently applied than the processes, strategies, evidentiary standards, or other factors used to apply the medical necessity criteria and selected NQTLs, as written and in operation, to medical and surgical benefits. A determination of which selected NQTLs require analysis will be determined by the department; at a minimum, the results of the analysis shall entail the following, provided that some NQTLs may not necessitate all of the steps described below:
(a) identify the factors used to determine that an NQTL will apply to a benefit, including factors that were considered but rejected;
(b) identify and define the specific evidentiary standards, if applicable, used to define the factors and any other evidentiary standards relied upon in designing each NQTL;
(c) provide the comparative analyses, including the results of the analyses, performed to determine that the processes and strategies used to design each NQTL, as written, for mental health and substance use disorder benefits are comparable to and applied no more stringently than the processes and strategies used to design each NQTL as written for medical and surgical benefits;
(d) provide the comparative analyses, including the results of the analyses, performed to determine that the processes and strategies used to apply each NQTL, in operation, for mental health and substance use disorder benefits are comparable to and applied no more stringently than the processes or strategies used to apply each NQTL in operation for medical and surgical benefits; and
(e) disclose the specific findings and conclusions reached by the carrier that the results of the analyses above indicate that the carrier is in compliance with this section and the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008, 42 U.S.C. s.18031(j), and its implementing and related regulations, which includes 45 C.F.R. s.146.136, 45 C.F.R. s.147.160, and 45 C.F.R. s.156.115(a)(3); and
(4) Any other information necessary to clarify data provided in accordance with this section requested by the Commissioner of Banking and Insurance including information that may be proprietary or have commercial value, provided that no proprietary information shall be made publicly available by the department.
d. The department shall implement and enforce applicable provisions of the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008, 42 U.S.C. 18031(j), any amendments to, and federal guidance or regulations issued under that act, including 45 C.F.R. Parts 146 and 147, 45 C.F.R. s.156.115(a)(3), P.L.1999, c.106 (C.17:48-6v et al.), and section 2 of P.L.1999, c.441 (C.52:14-17.29e), which includes:
(1) Ensuring compliance by individual and group contracts, policies, plans, or enrollee agreements delivered, issued, executed, or renewed in this State pursuant to P.L.1938, c.366 (C.17:48-1 et seq.), P.L.1940, c.74 (C.17:48A-1 et seq.), P.L.1985, c.236 (C.17:48E-1 et seq.), chapter 26 of Title 17B of the New Jersey Statutes (N.J.S.17B:26-1 et seq.), chapter 27 of Title 17B of the New Jersey Statutes (N.J.S.17B:27-26 et seq.), P.L.1992, c.161 (C.17B:27A-2 et seq.), P.L.1992, c.162 (C.17B:27A-17 et seq.), P.L.1973, c.337 (C.26:2J-1 et seq.), and P.L.1961, c.49 (C.52:14-17.25 et seq.), or approved for issuance or renewal in this State by the Commissioner of Banking and Insurance.
(2) Detecting violations of the law by individual and group contracts, policies, plans, or enrollee agreements delivered, issued, executed, or renewed in this State pursuant to P.L.1938, c.366 (C.17:48-1 et seq.), P.L.1940, c.74 (C.17:48A-1 et seq.), P.L.1985, c.236 (C.17:48E-1 et seq.), chapter 26 of Title 17B of the New Jersey Statutes (N.J.S.17B:26-1 et seq.), chapter 27 of Title 17B of the New Jersey Statutes (N.J.S.17B:27-26 et seq.), P.L.1992, c.161 (C.17B:27A-2 et seq.), P.L.1992, c.162 (C.17B:27A-17 et seq.), P.L.1973, c.337 (C.26:2J-1 et seq.), and P.L.1961, c.49 (C.52:14-17.25 et seq.), or approved for issuance or renewal in this State by the Commissioner of Banking and Insurance.
(3) Accepting, evaluating, and responding to complaints regarding violations.
(4) Maintaining and regularly reviewing for possible parity violations a publicly available consumer complaint log regarding mental health condition and substance use disorder coverage, provided that the names of specific carriers will be redacted and not disclosed on the complaint log.
(5) The commissioner shall adopt rules as may be necessary to effectuate any provisions of this section and the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 that relate to the business of insurance.
e. Not later than May 1 of each year, the department shall issue a report to the Legislature pursuant to section 2 of P.L.1991, c.164 (C.52:14-19.1). The report shall:
(1) Describe the methodology the department is using to check for compliance with the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008, 42 U.S.C s.18031(j), and any federal regulations or guidance relating to the compliance and oversight of that act.
(2) Describe the methodology the department is using to check for compliance with P.L.1999, c.106 (C.17:48-6v et al.) and section 2 of P.L.1999, c.441 (C.52:14-17.29e).
(3) Identify market conduct examinations conducted or completed during the preceding 12-month period regarding compliance with parity in mental health and substance use disorder benefits under state and federal laws and summarize the results of such market conduct examinations. This shall include:
(a) The number of market conduct examinations initiated and completed;
(b) The benefit classifications examined by each market conduct examination;
(c) The subject matters of each market conduct examination, including quantitative and non-quantitative treatment limitations;
(d) A summary of the basis for the final decision rendered in each market conduct examination; and
(e) Individually identifiable information shall be excluded from the reports consistent with state and Federal privacy protections.
(4) Detail any educational or corrective actions the department has taken to ensure compliance with Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008, 42 U.S.C s.18031(j), P.L.1999, c.106 (C.17:48-6v et al.) and section 2 of P.L.1999, c.441 (C.52:14-17.29e).
(5) Detail the department's educational approaches relating to informing the public about mental health condition and substance use disorder parity protections under State and federal law.
(6) Be written in non-technical, readily understandable language and shall be made available to the public by, among such other means as the department finds appropriate, posting the report on the department's website.
f. The department shall post on its Internet website a report disclosing the department's conclusions as to whether the analyses collected from the carriers as specified in paragraph (3) of subsection c. of this section demonstrate compliance with the Mental Health Parity and Addiction Equity Act of 2008 and its implementing regulations, specifically including whether or not there is compliance with 45 C.F.R. 146.136(c)(4). The name and identity of carriers shall be confidential, shall not be made public by the department, and shall not be subject to public inspection.
b. A carrier shall not prohibit a network pharmacy from disclosing, and shall not apply a penalty or any other type of disincentive to a network pharmacy that discloses, to a covered person lower cost prescription drug options, including those that are available to the covered person if the covered person purchases the prescription drug without using health insurance coverage.
c. Any provision of a contract that conflicts with the provisions of subsection b. of this section shall be void and unenforceable.
d. A violation of this section shall be an unlawful practice and a violation of P.L.1960, c.39 (C.56:8-1 et seq.), and shall also be subject to any enforcement action that the Commissioner of Banking and Insurance is authorized to take pursuant to section 5 of P.L.2015, c.179 (C.17B:27F-5) .
The purpose of the appeals program is to provide an independent medical necessity or appropriateness of services review of final decisions by carriers to deny, reduce, or terminate benefits in the event the final decision is contested by the covered person or any health care provider acting on behalf of the covered person, but only with the covered person's consent. The appeal review shall not include any decisions regarding benefits not covered by the covered person's health benefits plan.
a. A covered person or health care provider may apply to the Independent Health Care Appeals Program for a review of a decision to deny, reduce, or terminate a benefit if the person or health care provider has already completed the carrier's appeals process, if any, and the person or health care provider contests the final decision by the carrier. The person or health care provider shall apply to the department within 60 days of the date the final decision was issued by the carrier in a manner determined by the commissioner.
b. As part of the application, the covered person or health care provider shall provide the department with:
(1) The name and business address of the carrier;
(2) A brief description of the covered person's medical condition for which benefits were denied, reduced, or terminated;
(3) A copy of any information provided by the carrier regarding its decision to deny, reduce, or terminate the benefit; and
(4) A written consent to obtain any necessary medical records from the carrier and, in the case of a carrier which offers a managed care plan, any other out-of-network physician the person may have consulted on the matter.
c. (Deleted by amendment, P.L.2025, c.75)
d. Prior to receiving hospital services, a covered person or a person designated by the covered person may sign a consent form authorizing a health care provider acting on the covered person's behalf to appeal a determination by the carrier to deny, reduce, or terminate benefits. The consent is valid for all stages of the carrier's informal and formal appeals process and the Independent Health Care Appeals Program established pursuant to this section. A covered person shall retain the right to revoke his consent at any time.
e. A health care provider shall provide notice to the covered person whenever the health care provider initiates an appeal of a carrier's determination to deny, reduce, or terminate a benefit or deny payment for a health care service based on a medical necessity determination made by the carrier. The health care provider shall provide additional notice to the covered person each time the health care provider continues the appeal to the next stage of an appeals process, including any appeal to an independent utilization review organization pursuant to this section.
b. The commissioner shall establish procedures for transmitting the completed application for an appeal review to the independent utilization review organization.
c. The independent utilization review organization shall promptly review the pertinent medical records of the covered person to determine the appropriate, medically necessary health care services the person should receive, based on applicable, generally accepted practice guidelines developed by the federal government, national or professional medical societies, boards or associations and any applicable clinical protocols or practice guidelines developed by the carrier. The organization shall complete its review and make its determination within 90 days of receipt of a completed application for an appeal review or within less time, as prescribed by the commissioner.
Upon completion of the review, the organization shall state its findings in writing and make a determination of whether the carrier's denial, reduction or termination of benefits deprived the covered person of medically necessary services covered by the person's health benefits plan. If the organization determines that the denial, reduction or termination of benefits deprived the person of medically necessary covered services, it shall convey to the covered person or the health care provider acting on behalf of the covered person and carrier its decision regarding the appropriate, medically necessary health care services that the person should receive, which shall be binding on the carrier. If all or part of the organization's decision is in favor of the covered person, the carrier shall promptly provide coverage for the health care services found by the organization to be medically necessary covered services. If the covered person is not in agreement with the organization's decision, the person may seek the desired health care services outside of his health benefits plan, at his own expense.
d. If the commissioner determines that a carrier has failed to comply with the decision of an independent utilization review organization or is otherwise in violation of patient rights and other applicable regulations, the commissioner may impose such penalties and sanctions on the carrier, as provided by regulation, as the commissioner deems appropriate.
e. The commissioner shall require the independent utilization review organization to establish procedures to provide for an expedited review of a carrier's denial, reduction or termination of a benefit decision when a delay in receipt of the service could seriously jeopardize the health or well-being of the covered person.
f. The covered person's medical records provided to the Independent Health Care Appeals Program and the independent utilization review organization and the findings and recommendations of the organization made pursuant to this act are confidential and shall be used only by the department, the organization and the affected carrier for the purposes of this act. The medical records and findings and recommendations shall not otherwise be divulged or made public so as to disclose the identity of any person to whom they relate, and shall not be included under materials available to public inspection pursuant to P.L.1963, c.73 (C.47:1A-1 et seq.).
g. The commissioner shall establish a reasonable, per case reimbursement schedule for the independent utilization review organization.
h. The cost of the appeal review shall be borne by the carrier pursuant to a schedule of fees established by the commissioner.
b. The carrier that is the subject of a review shall not be liable in any action for damages to any person for any action taken to implement a recommendation of the independent utilization review organization pursuant to this act.
(1) post, in a conspicuous place in each of its waiting rooms for members of the general public, a notice, as prescribed pursuant to section 3 of P.L.2011, c.190 (C.26:2S-14.2), which provides information about the operation of, and how to apply for, the Independent Health Care Appeals Program established pursuant to section 11 of P.L.1997, c.192 (C.26:2S-11); and
(2) ensure that appropriate hospital staff, including direct patient care providers, staff that are concerned with billing for hospital services or provide financial counseling to patients, and staff otherwise engaged in providing patient advocacy or patient relations services, are made aware of the program and are able to provide information to patients and their family members, or other persons on the patient's behalf, about how to contact the program.
b. The department shall make available to members of the general public, upon request, the results of the independent consumer satisfaction survey and the analysis of quality outcomes measures of health care services provided by managed care plans in the State, prepared by the department.
(1) the payments made by the managed behavioral health care organization to health care providers for the provision of behavioral health care services to covered persons during the preceding calendar year, which shall be separately identified in the report from the other information that is required to be included pursuant to this subsection;
(2) the total expenses incurred by the managed behavioral health care organization for quality assurance and utilization management activities and treatment plan reviews, whether administrative or clinical in nature, during the preceding calendar year, which shall be separately identified in the report;
(3) the total expenses incurred by the managed behavioral health care organization for other administrative functions, including, but not limited to, accounting and financial reporting, billing and collection, data processing, debt or debt service, legal services, promotion and marketing, or provider credentialing, during the preceding calendar year, which shall each be separately identified in the report; and
(4) the amount of any premiums or other fees received by the managed behavioral health care organization during the preceding calendar year.
b. A carrier shall make available to a subscriber or other covered person, upon request, a copy of the report that is required pursuant to subsection a. of this section. The carrier may charge a fee, in an amount to be established by the commissioner, for furnishing a copy of the report or form to a subscriber or other covered person, which shall reasonably reflect the cost of preparation and the actual cost of postage and handling.
b. (1) The commissioner or the Commissioner of Banking and Insurance may issue an order directing a carrier or a representative of a carrier to cease and desist from engaging in any act or practice in violation of the provisions of this act.
(2) Within 20 days after service of the order of cease and desist, the respondent may request a hearing on the question of whether acts or practices in violation of this act have occurred. The hearing shall be conducted pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.) and judicial review shall be available as provided therein.
c. In the case of any violation of the provisions of this act, if the commissioner elects not to issue a cease and desist order, or in the event of noncompliance with a cease and desist order issued pursuant to subsection b. of this section, the commissioner may institute a proceeding to obtain injunctive relief in accordance with the applicable Court Rules.
The commissioners shall report their recommendations to the Senate and General Assembly standing reference committees on health and insurance and to the Governor within one year of the effective date of this act.
Within six months of the effective date of this act, in consultation with the Commissioner of Banking and Insurance, the commissioner shall adopt rules and regulations, pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.), necessary to carry out the purposes of this act. The regulations shall establish consumer protection and quality standards governing carriers which offer a managed care plan or use a utilization management system that are consistent with the standards governing health maintenance organizations in the State.
The regulations shall include standards for: a quality management program; provider participation in a network; adequacy of the provider network with respect to the scope and type of health care benefits provided by the carrier, the geographic service area covered by the provider network and access to medical specialists, when appropriate; utilization management as required in this act; a covered person complaint system; a patient appeals system as required in this act; the establishment of consumer rights of covered persons; carrier disclosure as required in this act; and outcomes and data reporting requirements as required in this act.
a. Managed health care, regardless of the form it takes, is now a major vehicle for the delivery of health care in this nation; and the rapid transition to managed health care has left consumers confused and concerned about how it affects them and how to navigate the managed health care system;
b. Despite the clear promises of reduced costs, quality service and comprehensive care made by managed care plans, many consumers are uncertain about how to obtain appropriate care and inhibited in their efforts to do so. They often lack necessary information about the benefits and referral requirements of specific plans and have no access to resources which might assist them to obtain quality care on a timely basis;
c. Consumers need help understanding their rights and responsibilities and how to access care and assert their rights in a complex managed care environment; and
d. It is, therefore, in the public interest to establish a program to provide consumers with the information and assistance they need to access the high-quality, cost-effective health care available from managed care plans and to promote the rights and interests of managed care consumers.
"Carrier" means a carrier as defined in section 2 of P.L.1997, c.192 (C.26:2S-2).
"Commissioner" means the Commissioner of Banking and Insurance.
"Department" means the Department of Banking and Insurance.
"Managed care plan" means a managed care plan as defined in section 2 of P.L.1997, c.192 (C.26:2S-2).
"Medicaid" means the Medicaid program established pursuant to P.L.1968, c.413 (C.30:4D-1 et seq.).
"Medicare" means the federal Medicare program established pursuant to the federal Social Security Act, Pub.L.89-97 (42 U.S.C. s.1395 et seq.).
"NJ FamilyCare" means the FamilyCare Health Coverage Program established pursuant to P.L.2005, c.156 (C.30:4J-8 et al.).
"Program" means the Managed Health Care Consumer Assistance Program established pursuant to this act.
b. The program shall:
(1) create and provide educational materials and training to consumers regarding their rights and responsibilities as enrollees in managed care plans, including materials and training specific to Medicaid, NJ FamilyCare, Medicare, and commercial managed care plans;
(2) assist and educate individual enrollees about the functions of the State and federal agencies that regulate managed care products, assist and educate enrollees about the various complaint, grievance, and appeal processes, including State fair hearings, provide assistance to individuals in determining which process is most appropriate for the individual to pursue when necessary, maintain and provide to individual enrollees the forms that may be necessary to submit a complaint, grievance or appeal with the State or federal agencies, and provide assistance to individual enrollees in completion of the forms, if necessary;
(3) maintain and provide information to individuals upon request about advocacy groups, including legal services programs Statewide and in each county that may be available to assist individuals, and maintain lists of State and Congressional representatives and the means by which to contact representatives, for distribution upon request;
(4) maintain a toll-free telephone number for consumers to call for information and assistance. The number shall be accessible to the deaf and hard of hearing, and staff or translation services shall be available to assist non-English proficient individuals who are members of language groups that meet population thresholds established by the department;
(5) ensure that individuals have timely access to the services of, and receive timely responses from, the program;
(6) provide feedback to managed care plans, beneficiary advisory groups and employers regarding enrollees' concerns and problems;
(7) provide nonpartisan information about federal and State activities relative to managed care, and provide assistance to individuals in obtaining copies of pending legislation, statutes, and regulations; and
(8) develop and maintain a data base monitoring the degree of each type of service provided by the program to individual enrollees, the types of concerns and complaints brought to the program and the entities about which complaints and concerns are brought.
c. In order to meet its objectives, the program shall have access to:
(1) the medical and other records of an individual enrollee maintained by a managed care plan, upon the specific written authorization of the enrollee or his legal representative;
(2) the administrative records, policies, and documents of managed care plans to which individuals or the general public have access; and
(3) all licensing, certification, and data reporting records maintained by the State or reported to the federal government by the State that are not proprietary information or otherwise protected by law, with copies thereof to be supplied to the program by the State upon the request of the program.
d. The program shall take such actions as are necessary to protect the identity and confidentiality of any complainant or other individual with respect to whom the program maintains files or records. Any medical or personally identifying information received or in the possession of the program shall be considered confidential and shall be used only by the department, the program and such other agencies as the commissioner designates and shall not be subject to public access, inspection or copying under P.L.1963, c.73 (C.47:1A-1 et seq.) or the common law concerning access to public records. This subsection shall not be construed to limit the ability of the program to compile and report non-identifying data pursuant to paragraph (8) of subsection b. of this section.
e. The program shall seek to coordinate its activities with consumer advocacy organizations, legal assistance providers serving low-income and other vulnerable health care consumers, managed care and health insurance counseling assistance programs, and relevant federal and State agencies to assure that the information and assistance provided by the program are current and accurate.
f. Until such time as the program is developed, the commissioner shall make agreements with two independent, private nonprofit consumer advocacy organizations, which shall be the Community Health Law Project and New Jersey Protection and Advocacy, Inc. to operate the program on an interim basis. The interim program shall be in effect for one year from the effective date of this act. Any appropriation in this act for the program may be allocated for the interim program.
b. (1) The program may charge fees for the provision of materials to the public consistent with P.L.1963, c.73 (C.47:1A-1 et seq.). The commissioner may establish a separate fee schedule for training and education services that may be provided by the program to for-profit organizations, and for the distribution to nongovernmental entities of statistical information that may be developed by the program.
(2) Revenues received by the department pursuant to paragraph (1) of this subsection shall be deposited into a special nonlapsing fund which the commissioner shall create in the department for the purpose of providing funding for the program, and these revenues and the interest earned therefrom shall be utilized to fund the program in addition to the amount appropriated pursuant to subsection b. of this section.
"Carrier" means an insurance company, health service corporation, hospital service corporation, medical service corporation, dental service corporation, dental plan organization, or health maintenance organization, authorized to issue dental plans in this State.
"Covered person" means a person on whose behalf a carrier offering a dental plan is obligated to pay benefits for or provide dental services pursuant to the plan.
"Covered service" means a dental care service for which a reimbursement is available under a covered person's dental plan, or for which a reimbursement would be available but for the application of contractual limitations including, but not limited to, deductibles, copayments, coinsurance, waiting periods, annual or lifetime maximums, frequency limitations, alternative benefit payments, or any other limitation, or services not reimbursable due to the dentist's failure to comply with a provision of the dentist's participating provider agreement or the dental plan.
"Dental plan" means a benefits plan which pays or provides dental expense benefits for covered services and is delivered or issued for delivery in this State by or through a carrier either on a stand-alone basis or as part of other coverage including, but not limited to, health benefits coverage.
b. A carrier may limit coverage to services that are delivered by health care providers in the health benefits plan's network, but may not charge any deductible, copayment, or coinsurance for a health care service, delivered through telemedicine or telehealth, in an amount that exceeds the deductible, copayment, or coinsurance amount that is applicable to an in-person consultation. In no case shall a carrier:
(1) impose any restrictions on the location or setting of the distant site used by a health care provider to provide services using telemedicine and telehealth or on the location or setting of the originating site where the patient is located when receiving services using telemedicine and telehealth, except to ensure that the services provided using telemedicine and telehealth meet the same standard of care as would be provided if the services were provided in person;
(2) restrict the ability of a provider to use any electronic or technological platform to provide services using telemedicine or telehealth, including, but not limited to, interactive, real-time, two-way audio, which may be used in combination with asynchronous store-and-forward technology without video capabilities, including audio-only telephone conversations, to provide services using telemedicine or telehealth, provided that the platform used:
(a) allows the provider to meet the same standard of care as would be provided if the services were provided in person; and
(b) is compliant with the requirements of the federal health privacy rule set forth at 45 CFR Parts 160 and 164;
(3) deny coverage for or refuse to provide reimbursement for routine patient monitoring performed using telemedicine and telehealth, including remote monitoring of a patient's vital signs and routine check-ins with the patient to monitor the patient's status and condition, if coverage and reimbursement would be provided if those services are provided in person, and the provider is able to meet the same standard of care as would be provided if the services were provided in person; or
(4) limit coverage only to services delivered by select third-party telemedicine or telehealth organizations.
c. Nothing in this section shall be construed to:
(1) prohibit a carrier from providing coverage for only those services that are medically necessary, subject to the terms and conditions of the covered person's health benefits plan; or
(2) allow a carrier to require a covered person to use telemedicine or telehealth in lieu of receiving an in-person service from an in-network provider.
d. The Commissioner of Banking and Insurance shall adopt rules and regulations, pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.), to implement the provisions of this section.
e. As used in this section:
"Asynchronous store-and-forward" means the same as that term is defined by section 1 of P.L.2017, c.117 (C.45:1-61).
"Carrier" means the same as that term is defined by section 2 of P.L.1997, c.192 (C.26:2S-2).
"Covered person" means the same as that term is defined by section 2 of P.L.1997, c.192 (C.26:2S-2).
"Distant site" means the same as that term is defined by section 1 of P.L.2017, c.117 (C.45:1-61).
"Health benefits plan" means the same as that term is defined by section 2 of P.L.1997, c.192 (C.26:2S-2).
"Originating site" means the same as that term is defined by section 1 of P.L.2017, c.117 (C.45:1-61).
"Telehealth" means the same as that term is defined by section 1 of P.L.2017, c.117 (C.45:1-61).
"Telemedicine" means the same as that term is defined by section 1 of P.L.2017, c.117 (C.45:1-61).
"Telemedicine or telehealth organization" means the same as that term is defined by section 1 of P.L.2017, c.117 (C.45:1-61).
"Carrier" means an insurance company, health service corporation, hospital service corporation, medical service corporation, dental service corporation, dental plan organization, or health maintenance organization, authorized to issue or act as an administrator of dental plans in this State.
"Dental plan" means a benefits plan which pays or provides dental expense benefits for covered services and is delivered or issued for delivery in this State by or through a carrier either on a stand-alone basis or as part of other coverage including, but not limited to, health benefits coverage.
b. The commissioner shall also adopt by regulation a form for renewal of credentialing, which shall be an abbreviated version of the universal application form. The renewal form shall be designed to enable a dentist to indicate changes in the information provided in the application form.
c. The commissioner shall revise the universal application and renewal forms, as necessary, to conform to industry-wide, national standards for credentialing.
d. In developing the forms, the commissioner shall consult with the Commissioner of Human Services to ensure that the credentialing requirements for participation in the Medicaid program, established pursuant to P.L.1968, c.413 (C.30:4D-1 et seq.), and the NJ FamilyCare Program established pursuant to P.L.2005, c.156 (C.30:4J-8 et al.) are adequately reflected on the application and renewal forms.
b. Nothing in this section shall be construed to prevent a carrier from requesting additional information from an applicant that is not provided for in the universal application or renewal form, as applicable, if the requested information does not duplicate any information included in the applicable form.
(1) notifies the covered person prior to performing the covered procedure or service that the dentist may not be paid by the carrier and that the covered person is responsible for payment of the covered procedure or service;
(2) provides the covered person an explanation, in writing, of the benefits and material cost differences of suitable alternative options for the covered procedure or service, and that the alternative selected may not be covered by the plan, in advance of it being performed;
(3) obtains the covered person's consent, in writing, to the performance of the covered procedure or service and the participating dentist makes the written consent available to the carrier upon request; and
(4) accepts as payment in full the amount the participating dentist would have accepted from the carrier under the covered person's dental plan, including bundling pursuant to this act.
A participating dentist that receives payment for a covered procedure or service from a covered person that exceeds the amount the participating dentist is obligated to accept under the covered person's dental plan shall refund to the covered person the difference between the amount accepted by the participating dentist from the covered person and the amount the participating dentist is obligated to accept under the covered person's dental plan.
b. Notwithstanding the provisions of subsection a. of this section, this act shall not apply in cases where the service performed by the participating dentist is required as a result of a prior service by the dentist that was inconsistent with the quality of care in the practice of dentistry as determined by a licensed dentist, and this act shall not permit billing covered persons for:
(1) equipment used by the participating dentist;
(2) overhead expenses incurred by the participating dentist;
(3) other costs of services or supplies rendered that are covered, or for which benefits are payable, under the covered person's dental plan, except for copayment, coinsurance, or deductible amounts set forth in the dental plan; or
(4) laboratory costs or other services customarily associated with the performance of covered services unless:
(a) the participating dentist receives prior written consent from the covered person in advance of the performance of the service; and
(b) the participating dentist has explained, in writing, the benefits and material cost differences of suitable alternative options for the service, and that the alternative selected may not be covered by the plan, in advance of it being performed.
c. A carrier shall not change a dentist's submitted procedure codes through down-coding or bundling unless the carrier undertakes a professional review of the submitted charges and supporting clinical information and determines that the original coding was incorrect, fragmented, or un-bundled as:
(1) provided for in the Current Dental Terminology Code of Dental Procedures and Nomenclature; or
(2) consistent with the generally acceptable standards of care in the practice of dentistry.
d. Notwithstanding any other provision of this act or any other law to the contrary, a carrier may base its benefit reimbursement on a lower acceptable cost procedure, material, or test where an alternative, and less costly, means is available and generally accepted for purposes of benefit payment, and based on the participation agreement between the carrier and the participating dentist. However, nothing in this act shall preclude a carrier from covering procedures or services that are actually performed by a participating dentist, per its network provider agreement, and are otherwise eligible for benefit.
e. Nothing in this act shall exempt or limit any dentist from the provisions of the "Insurance Fraud Prevention Act," P.L.1983, c.320 (C.17:33A-1 et seq.).
f. As used in this act:
"Bundling" means the practice of combining distinct dental procedures or components of a more extensive procedure into one procedure for billing purposes, but does not include the denial or adjustment of claims for covered services in accordance with the covered person's dental plan.
"Carrier" means an insurance company, health service corporation, hospital service corporation, medical service corporation, dental service corporation, dental plan organization or health maintenance organization authorized to issue dental contracts, policies, or plans in this State.
"Covered person" means a person on whose behalf a carrier offering a dental plan is obligated to pay benefits for or provide dental procedures or services pursuant to the plan.
"Covered procedure or service" means a dental care procedure or service that is consistent with generally acceptable standards of care in the practice of dentistry, and which the carrier has determined to be reimbursable under a covered person's dental plan, or for which a reimbursement would be available but for the application of deductibles, copayments, coinsurance, waiting periods, annual or lifetime maximums, frequency limitations, or alternative benefit payments.
"Dental plan" means a benefits plan, policy, or contract which pays or provides dental expense benefits for covered procedures or services and is delivered or issued for delivery in this State by or through a carrier either on a stand-alone basis or as part of other coverage including, but not limited to, health benefits coverage.
Dental plan shall not include the following plans, policies, or contracts: accident only, credit disability, long-term care, Medicare supplement coverage; TRICARE supplement coverage, coverage for Medicare services pursuant to a contract with the United States government, the State Medicaid program established pursuant to P.L.1968, c.413 (C.30:4D-1 et seq.), the NJ FamilyCare Program established pursuant to P.L.2005, c.156 (C.30:4J-8 et al.), coverage arising out of a worker's compensation or similar law, the State Health Benefits Program, the School Employees' Health Benefits Program, or a self-insured health benefits plan governed by the provisions of the federal "Employee Retirement Income Security Act of 1974," 29 U.S.C. s.1001 et seq., coverage under a policy of private passenger automobile insurance issued pursuant to P.L.1972, c.70 (C.39:6A-1 et seq.), or hospital confinement indemnity coverage.
"Down-coding" means the adjustment of a claim submitted to a dental plan to a less complex or lower cost procedure code. Down-coding does not include a carrier's adjustment of payment for procedures which were improperly or inaccurately billed, or the denial or adjustment of claims for covered services in accordance with the covered person's dental plan.
"Participating dentist" means a dentist who has entered into a contract with a carrier to provide dental services to covered persons for a predetermined fee or set of fees.
a. denies or limits benefits for a preexisting condition to any covered person; or
b. uses a preexisting condition as a factor in calculating a premium.
(1) any lifetime limits on the dollar value of benefits for any individual insured pursuant to the plan; or
(2) any annual limits on the dollar value of essential health benefits.
b. The provisions of this section shall be in effect if:
(1) a state of emergency or public health emergency is declared by the State or federal government, or an emergency supply of a drug is recommended by the Centers for Disease Control and Prevention; and
(2) the commissioner determines that an emergency supply of prescription drugs is necessary.
c. The coverage shall be provided on an in-network basis to the same extent as for any other refills of prescription drugs under the health benefits plan, except that:
(1) in the event of a drug shortage or access issue identified by the commissioner or the Division of Consumer Affairs, the carrier shall provide formulary flexibility for a covered alternative. The cost-sharing for any non-preferred medication shall not exceed the cost-sharing that would be imposed for the preferred medication that is unavailable due to the shortage or access issue; and
(2) no fees shall be imposed for home delivery of the drugs.
d. The Division of Consumer Affairs, in consultation with the commissioner, may develop restrictions on the filling or refilling of prescriptions by pharmacists to address shortage concerns, provided those restrictions shall exclude restricting use for existing conditions to the maximum extent practicable.
e. As used in this section, "carrier" means an insurance company, health service corporation, hospital service corporation, medical service corporation, or health maintenance organization authorized to issue health benefits plans in this State, and shall include the State Health Benefits Program and the School Employees' Health Benefits Program.
(1) prescribed or administered to the covered person by a licensed medical practitioner who is authorized to prescribe or administer that treatment pursuant to State and federal law; or
(2) dispensed to the covered person by a licensed pharmacist under a standing order to dispense an opioid antidote pursuant to section 1 of P.L.2017, c.88 (C.45:14-67.2).
b. The provisions of this section shall not be construed to limit the coverage of an opioid antidote only when administered by a medical practitioner.
c. As used in this section:
"Carrier" means an insurance company, health service corporation, hospital service corporation, medical service corporation, or health maintenance organization authorized to issue health benefits plans in this State.
"Opioid antidote" means naloxone hydrochloride, or any other similarly acting drug approved by the United States Food and Drug Administration for self-administration for the treatment of an opioid overdose.
b. For the purposes of this section, "religious employer" means an organization that is organized and operates as a nonprofit entity and is referred to in section 6033(a)(3)(A)(i) or (iii) of the Internal Revenue Code of 1986 (26 U.S.C. s.6033), as amended.
b. The benefits shall be provided to the same extent as for any other service, drug, device, product, or procedure under the contract.
c. As used in this section:
“At-risk diagnosis” means a diagnosis made after consideration of factors influencing behavioral health and child development, such as family circumstances or life challenges, that does not lead to a formal mental health diagnosis and, instead, promotes preventive care. Allowing providers to bill for an “at-risk diagnosis” authorizes providers to use an alternative code, including a Social Determinants of Health Z-code, to the codes of the American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders or the Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood when billing for services, without a formal mental health diagnosis, for children who are 18 years of age or younger.
"Carrier" means an insurance company, health service corporation, hospital service corporation, medical service corporation, or health maintenance organization authorized to issue health benefits plans in this State.
“Screening, prevention, and treatment” includes the prevention and early identification of mental health conditions without a behavioral health diagnosis. Services may include, but are not limited to, screenings and individual, group, and family psychotherapy to individuals with potential mental health disorders not yet diagnosed.
a. The health care delivery system in New Jersey needs reforms that will enhance consumer protections, create a system to resolve certain health care billing disputes, contain rising costs, and measure success with respect to these goals;
b. Despite existing State and federal laws and regulations to protect against certain surprise out-of-network charges, these charges continue to pose a problem for health care consumers in New Jersey. Many consumers find themselves with surprise bills for hospital emergency room procedures or for charges by providers that the consumer had no choice in selecting;
c. While the Patient Protection and Affordable Care Act added new patient protections requiring federally-regulated group health plans to reimburse for out-of-network emergency service by paying the greatest of three possible amounts: (1) the amount negotiated with in-network providers for the emergency service furnished; (2) the amount for the emergency service calculated using the same method the plan generally uses to determine payments for out-of-network services; or (3) the amount that would be paid under Medicare for the emergency service, patients continue to face out-of-network charges for surprise bills;
d. Out-of-network benefits are a health insurance benefit enhancement for which insureds pay an additional premium, but in recent years, out-of-network coverage has been used inappropriately as a means to diminish consumers' health insurance coverage, exposing consumers to additional costs;
e. Carriers and consumers continue to report exorbitant charges by certain health care professionals and facilities for out-of-network services, including balance billing, and in certain cases, consumers' bills are referred to collection, which contributes to the increasing costs of health care services and insurance and imposes hardships on health care consumers;
f. Health care providers and hospitals report that inadequate reimbursement from carriers and government payers is causing financial stress on safety net hospitals, deteriorating morale among providers and reduced quality of care for consumers;
g. It is, therefore, in the public interest to reform the health care delivery system in New Jersey to enhance consumer protections, create a system to resolve certain health care billing disputes, contain rising costs, and measure success with respect to these goals.
"Carrier" means an entity that contracts or offers to contract to provide, deliver, arrange for, pay for, or reimburse any of the costs of health care services under a health benefits plan, including: an insurance company authorized to issue health benefits plans; a health maintenance organization; a health, hospital, or medical service corporation; a multiple employer welfare arrangement; the State Health Benefits Program and the School Employees' Health Benefits Program; or any other entity providing a health benefits plan. Except as provided under the provisions of this act, "carrier" shall not include any other entity providing or administering a self-funded health benefits plan.
"Commissioner" means the Commissioner of Banking and Insurance.
"Covered person" means a person on whose behalf a carrier is obligated to pay health care expense benefits or provide health care services.
"Department" means the Department of Banking and Insurance.
"Emergency or urgent basis" means all emergency and urgent care services including, but not limited to, the services required pursuant to N.J.A.C.11:24-5.3.
"Health benefits plan" means a benefits plan which pays or provides hospital and medical expense benefits for covered services, and is delivered or issued for delivery in this State by or through a carrier. For the purposes of this act, "health benefits plan" shall not include the following plans, policies or contracts: Medicaid, Medicare, Medicare Advantage, accident only, credit, disability, long-term care, TRICARE supplement coverage, coverage arising out of a workers' compensation or similar law, automobile medical payment insurance, personal injury protection insurance issued pursuant to P.L.1972, c.70 (C.39:6A-1 et seq.), a dental plan as defined pursuant to section 1 of P.L.2014, c.70 (C.26:2S-26) and hospital confinement indemnity coverage.
"Health care facility" means a general acute care hospital, satellite emergency department, hospital based off-site ambulatory care facility in which ambulatory surgical cases are performed, or ambulatory surgery facility, licensed pursuant to P.L.1971, c.136 (C.26:2H-1 et seq.).
"Health care professional" means an individual, acting within the scope of his licensure or certification, who provides a covered service defined by the health benefits plan.
"Health care provider" or "provider" means a health care professional or health care facility.
"Inadvertent out-of-network services" means health care services that are: covered under a managed care health benefits plan that provides a network; and provided by an out-of-network health care provider in the event that a covered person utilizes an in-network health care facility for covered health care services and, for any reason, in-network health care services are unavailable in that facility. "Inadvertent out-of-network services" shall include laboratory testing ordered by an in-network health care provider and performed by an out-of-network bio-analytical laboratory.
"Knowingly, voluntarily, and specifically selected an out-of-network provider" means that a covered person chose the services of a specific provider, with full knowledge that the provider is out-of-network with respect to the covered person's health benefits plan, under circumstances that indicate that covered person had the opportunity to be serviced by an in-network provider, but instead selected the out-of-network provider. Disclosure by a provider of network status shall not render a covered person's decision to proceed with treatment from that provider a choice made "knowingly" pursuant to this definition.
"Medicaid" means the State Medicaid program established pursuant to P.L.1968, c.413 (C.30:4D-1 et seq.).
"Medical necessity" or "medically necessary" means or describes a health care service that a health care provider, exercising his or her prudent clinical judgment, would provide to a covered person for the purpose of evaluating, diagnosing, or treating an illness, injury, disease, or its symptoms and that is: in accordance with the generally accepted standards of medical practice; clinically appropriate, in terms of type, frequency, extent, site, and duration, and considered effective for the covered person's illness, injury, or disease; not primarily for the convenience of the covered person or the health care provider; and not more costly than an alternative service or sequence of services at least as likely to produce equivalent therapeutic or diagnostic results as to the diagnosis or treatment of that covered person's illness, injury, or disease.
"Medicare" means the federal Medicare program established pursuant to Pub.L.89-97 (42 U.S.C. s.1395 et seq.).
"Self-funded health benefits plan" or "self-funded plan" means a self-insured health benefits plan governed by the provisions of the federal "Employee Retirement Income Security Act of 1974," 29 U.S.C. s.1001 et seq.
(1) disclose to the covered person whether the health care facility is in-network or out-of-network with respect to the covered person's health benefits plan;
(2) advise the covered person to check with the physician arranging the facility services to determine whether or not that physician is in-network or out-of-network with respect to the covered person's health benefits plan and provide information about how to determine the health plans participated in by any physician who is reasonably anticipated to provide services to the covered person;
(3) advise the covered person that at a health care facility that is in-network with respect to the person's health benefits plan:
(a) the covered person will have a financial responsibility applicable to an in-network procedure and not in excess of the covered person's copayment, deductible, or coinsurance as provided in the covered person's health benefits plan;
(b) unless the covered person, at the time of the disclosure required pursuant to this subsection, has knowingly, voluntarily, and specifically selected an out-of-network provider to provide services, the covered person will not incur any out-of-pocket costs in excess of the charges applicable to an in-network procedure;
(c) any bills, charges or attempts to collect by the facility, or any health care professional involved in the procedure, in excess of the covered person's copayment, deductible, or coinsurance as provided in the covered person's health benefits plan in violation of subparagraph (b) of this paragraph should be reported to the covered person's carrier and the relevant regulatory entity; and
(d) that if the covered person's coverage is provided through an entity providing or administering a self-funded health benefits plan that does not elect to be subject to the provisions of section 9 of this act, that:
(i) certain health care services may be provided on an out-of-network basis, including those services associated with the health care facility;
(ii) the covered person may have a financial responsibility applicable to health care services provided by an out-of-network provider, in excess of the covered person's copayment, deductible, or coinsurance, and the covered person may be responsible for any costs in excess of those allowed by the person's self-funded health benefits plan; and
(iii) the covered person should contact the covered person's self-funded health benefits plan sponsor for further consultation on those costs; and
(4) advise the covered person that at a health care facility that is out-of-network with respect to the covered person's health benefits plan:
(a) certain health care services may be provided on an out-of-network basis, including those health care services associated with the health care facility;
(b) the covered person may have a financial responsibility applicable to health care services provided at an out-of-network facility, in excess of the covered person's copayment, deductible, or coinsurance, and the covered person may be responsible for any costs in excess of those allowed by their health benefits plan; and
(c) that the covered person should contact the covered person's carrier for further consultation on those costs.
b. In a form that is consistent with federal guidelines, a health care facility shall make available to the public a list of the facility's standard charges for items and services provided by the facility.
c. A health care facility shall post on the facility's website:
(1) the health benefits plans in which the facility is a participating provider;
(2) a statement that:
(a) physician services provided in the facility are not included in the facility's charges;
(b) physicians who provide services in the facility may or may not participate with the same health benefits plans as the facility;
(c) the covered person should check with the physician arranging for the facility services to determine the health benefits plans in which the physician participates; and
(d) the covered person should contact their carrier for further consultation on those costs;
(3) as applicable, the name, mailing address, and telephone number of the hospital-based physician groups that the facility has contracted with to provide services including, but not limited to, anesthesiology, pathology, and radiology; and
(4) as applicable, the name, mailing address, and telephone number of physicians employed by the facility and whose services may be provided at the facility, and the health benefits plans in which they participate.
d. If, between the time the notice required pursuant to subsection a. of this section is provided to the covered person and the time the procedure takes place, the network status of the facility changes as it relates to the covered person's health benefits plan, the facility shall notify the covered person promptly.
e. The Department of Health shall specify in further detail the content and design of the disclosure form and the manner in which the form shall be provided.
(1) Prior to scheduling a non-emergency procedure inform the covered person that the professional is out-of-network and that the amount or estimated amount the health care professional will bill the covered person for the services is available upon request;
(2) Upon receipt of a request from a covered person for the service and the Current Procedural Terminology (CPT) codes associated with that service, disclose to the covered person in writing the amount or estimated amount that the health care professional will bill the covered person for the service, and the CPT codes associated with that service, absent unforeseen medical circumstances that may arise when the health care service is provided;
(3) Inform the covered person that the covered person will have a financial responsibility applicable to health care services provided by an out-of-network professional, in excess of the covered person's copayment, deductible, or coinsurance, and the covered person may be responsible for any costs in excess of those allowed by their health benefits plan; and
(4) Advise the covered person to contact the covered person's carrier for further consultation on those costs.
b. A health care professional who is a physician shall provide the covered person, to the extent the information is available, with the name, practice name, mailing address, and telephone number of any health care provider scheduled to perform anesthesiology, laboratory, pathology, radiology, or assistant surgeon services in connection with care to be provided in the physician's office for the covered person or coordinated or referred by the physician for the covered person at the time of referral to, or coordination of, services with that provider. The physician shall provide instructions as to how to determine the health benefits plans in which the health care provider participates and recommend that the covered person should contact the covered person's carrier for further consultation on costs associated with these services.
c. A physician shall, for a covered person's scheduled facility admission or scheduled outpatient facility services, provide the covered person and the facility with the name, practice name, mailing address, and telephone number of any other physician whose services will be arranged by the physician and are scheduled at the time of the pre-admission, testing, registration, or admission at the time the non-emergency services are scheduled, and information as to how to determine the health benefits plans in which the physician participates, and recommend that the covered person should contact the covered person's carrier for further consultation on costs associated with these services.
d. The receipt or acknowledgement by any covered person of any disclosure required pursuant to this section shall not waive or otherwise affect any protection under existing statutes or regulations regarding in-network health benefits plan coverage available to the covered person or created under this act.
e. If, between the time the notice required pursuant to subsection a. of this section is provided to the covered person and the time the procedure takes place, the network status of the professional changes as it relates to the covered person's health benefits plan, the professional shall notify the covered person promptly.
f. In the case of a primary care physician or internist performing an unscheduled procedure in that provider's office, the notice required pursuant this section may be made verbally at the time of the service.
g. The appropriate professional or occupational licensing board within the Division of Consumer Affairs in the Department of Law and Public Safety shall specify in further detail the content and design of the disclosure form and the manner in which the form shall be provided.
b. With respect to out-of-network services, for each health benefits plan offered, a carrier shall, consistent with State and federal law, provide a covered person with:
(1) a clear and understandable description of the plan's out-of-network health care benefits, including the methodology used by the entity to determine the allowed amount for out-of-network services;
(2) the allowed amount the plan will reimburse under that methodology and, in situations in which a covered person requests allowed amounts associated with a specific Current Procedural Terminology code, the portion of the allowed amount the plan will reimburse and the portion of the allowed amount that the covered person will pay, including an explanation that the covered person will be required to pay the difference between the allowed amount as defined by the carrier's plan and the charges billed by an out-of-network provider;
(3) examples of anticipated out-of-pocket costs for frequently billed out-of-network services;
(4) information in writing and through an internet website that reasonably permits a covered person or prospective covered person to calculate the anticipated out-of-pocket cost for out-of-network services in a geographical region or zip code based upon the difference between the amount the carrier will reimburse for out-of-network services and the usual and customary cost of out-of-network services;
(5) information in response to a covered person's request, concerning whether a health care provider is an in-network provider;
(6) such other information as the commissioner determines appropriate and necessary to ensure that a covered person receives sufficient information necessary to estimate their out-of-pocket cost for an out-of-network service and make a well-informed health care decision; and
(7) access to a telephone hotline that shall be operated no less than 16 hours per day for consumers to call with questions about network status and out-of-pocket costs.
c. If a carrier authorizes a covered health care service to be performed by an in-network health care provider with respect to any health benefits plan, and the provider or facility status changes to out-of-network before the authorized service is performed, the carrier shall notify the covered person that the provider or facility is no longer in-network as soon as practicable. If the carrier fails to provide the notice at least 30 days prior to the authorized service being performed, the covered person's financial responsibility shall be limited to the financial responsibility the covered person would have incurred had the provider been in-network with respect to the covered person's health benefits plan.
d. A carrier shall incorporate into the Explanation of Benefits and all reimbursement correspondence to the consumer and the provider clear and concise notification that inadvertent and involuntary out-of-network charges are not subject to balance billing above and beyond the financial responsibility incurred under the terms of the contract for in-network service. Any attempt by the provider to collect, bill, or invoice funds should be promptly reported to the carrier's customer service department at the phone number that the carrier shall provide on the Explanation of Benefits and all reimbursement correspondence to the consumer.
e. A carrier, and any other entity providing or administering a self-funded health benefits plan that elects to be subject to section 9 of this act, shall issue a health insurance identification card to the primary insured under a health benefits plan. In a form and manner to be prescribed by the department, the card shall indicate whether the plan is insured or, in the case of self-funded plans that elect to be subject to section 9 of this act, whether the plan is self-funded and whether the plan elected is to be subject to this act.
f. A carrier shall include in the carrier's annual public regulatory filings, and in a manner to be determined by the Department of Banking and Insurance, the number of claims submitted by health care providers to the carrier which are denied or down coded by the carrier and the reason for the denial or down coding determination.
b. If a covered person receives medically necessary services at an out-of-network health care facility on an emergency or urgent basis as defined by the Emergency Medical Treatment and Active Labor Act, 42 U.S.C. s.1395dd et seq. and section 14 of P.L.1992, c.160 (C.26:2H-18.64), and the carrier and facility cannot agree on the final offer as a reimbursement rate for these services pursuant to section 9 of this act, the carrier, health care facility, or covered person, as applicable, may initiate binding arbitration pursuant to section 10 or 11 of this act.
c. If a health care facility is in-network with respect to any health benefits plan, the facility shall ensure that all providers providing services in the facility on an emergency or inadvertent basis are provided notification of the provisions of this act and information as to each health benefits plan with which the facility has a contract to be in-network.
d. A health care facility that contracts with a carrier to be in-network with respect to any health benefits plan shall annually report to the Department of Health the health benefits plans with which the facility has an agreement to be in-network.
e. Subsections a. and b. of this section shall only apply to providers providing services to members of entities providing or administering a self-funded health benefits plan and its plan members if the entity elects to be subject to section 9 of this act pursuant to subsection d. of that section.
f. The Department of Health shall make the information collected pursuant to subsection d. of this section available to the Department of Banking and Insurance.
(1) in the case of inadvertent out-of-network services, not bill the covered person in excess of any deductible, copayment, or coinsurance amount; and
(2) in the case of emergency and urgent services, not bill the covered person in excess of any deductible, copayment, or coinsurance amount, applicable to in-network services pursuant to the covered person's health benefits plan.
b. If the carrier and the professional cannot agree on a reimbursement rate for the services provided pursuant to subsection a. of this section, pursuant to section 9 of this act the carrier, professional, or covered person, as applicable, may initiate binding arbitration pursuant to section 10 or 11 of this act.
c. This section shall only apply to providers providing services to members of entities providing or administering a self-funded health benefits plan and its plan members if the entity elects to be subject to section 9 of this act pursuant to subsection d. of that section.
a. With respect to a carrier, if a covered person receives inadvertent out-of-network services, or services at an in-network or out-of-network health care facility on an emergency or urgent basis, the carrier shall ensure that the covered person incurs no greater out-of-pocket costs than the covered person would have incurred with an in-network health care provider for covered services. Pursuant to sections 7 and 8 of this act, the out-of-network provider shall not bill the covered person, except for applicable deductible, copayment, or coinsurance amounts that would apply if the covered person utilized an in-network health care provider for the covered services. In the case of services provided to a member of a self-funded plan that does not elect to be subject to the provisions of this section, the provider shall be permitted to bill the covered person in excess of the applicable deductible, copayment, or coinsurance amounts.
b. (1) With respect to inadvertent out-of-network services, or services at an in-network or out-of-network health care facility on an emergency or urgent basis, benefits provided by a carrier that the covered person receives for health care services shall be assigned to the out-of-network health care provider, which shall require no action on the part of the covered person. Once the benefit is assigned as provided in this subsection:
(a) any reimbursement paid by the carrier shall be paid directly to the out-of-network provider; and
(b) the carrier shall provide the out-of-network provider with a written remittance of payment that specifies the proposed reimbursement and the applicable deductible, copayment, or coinsurance amounts owed by the covered person.
(2) An entity providing or administering a self-funded health benefits plan that elects to participate in this section pursuant to subsection d. of this section, shall comply with the provisions of paragraph (1) of this subsection.
c. If inadvertent out-of-network services or services provided at an in-network or out-of-network health care facility on an emergency or urgent basis are performed in accordance with subsection a. of this section, the out-of-network provider may bill the carrier for the services rendered. The carrier may pay the billed amount or the carrier shall determine within 20 days from the date of the receipt of the claim for the services whether the carrier considers the claim to be excessive, and if so, the carrier shall notify the provider of this determination within 20 days of the receipt of the claim. If the carrier provides this notification, the carrier and the provider shall have 60 days from the date of this notification to negotiate a settlement. The carrier may attempt to negotiate a final reimbursement amount with the out-of-network health care provider which differs from the amount paid by the carrier pursuant to this subsection. If there is no settlement reached after the 60 days, the carrier shall pay the provider their final offer for the services. If the carrier and provider cannot agree on the final offer as a reimbursement rate for these services, the carrier, provider, or covered person, as applicable, may initiate binding arbitration within 60 days of the final offer, pursuant to section 10 or 11 of this act. In addition, in the event that arbitration is initiated pursuant to section 10 of this act, the payment shall be subject to the binding arbitration provisions of paragraphs (4) and (5) of subsection b. of section 10 of this act.
d. With respect to an entity providing or administering a self-funded health benefits plan and its plan members, this section shall only apply if the plan elects to be subject to the provisions of this section. To elect to be subject to the provisions of this section, the self-funded plan shall provide notice, on an annual basis, to the department, on a form and in a manner prescribed by the department, attesting to the plan's participation and agreeing to be bound by the provisions of this section. The self-funded plan shall amend the employee benefit plan, coverage policies, contracts and any other plan documents to reflect that the benefits of this section shall apply to the plan's members.
b. The binding arbitration shall adhere to the following requirements:
(1) The party requesting arbitration shall notify the other party that arbitration has been initiated and state its final offer before arbitration, which in the case of the carrier shall be the amount paid pursuant to subsection c. of section 9 of this act. In response to this notice, the out-of-network provider shall inform the carrier of its final offer before the arbitration occurs;
(2) Arbitration shall be initiated by filing a request with the department;
(3) The department shall contract, through the request for proposal process, every three years, with one or more entities that have experience in health care pricing arbitration. The department may initially utilize the entity engaged under the "Health Claims Authorization, Processing, and Payment Act," P.L.2005, c.352 (C.17B:30-48 et seq.), for arbitration under this act; however, after a period of one year from the effective date of this act, the selection of the arbitration entity shall be through the Request for Proposal process. Claims that are subject to arbitration pursuant to the provisions of this act, which previously would be subject to arbitration pursuant to the "Health Claims Authorization, Processing, and Payment Act," shall instead be subject to this act;
(4) The arbitration shall consist of a review of the written submissions by both parties, which shall include the final offer for the payment by the carrier for the out-of-network health care provider's fee made pursuant to subsection c. of section 9 of this act and the final offer by the out-of-network provider for the fee the provider will accept as payment from the carrier; and
(5) The arbitrator's decision shall be one of the two amounts submitted by the parties as their final offers and shall be binding on both parties. The decision of the arbitrator shall include detailed written findings and shall be issued within 30 days after the request is filed with the department. The detailed written findings shall be an analysis of the decision including, but not limited to, information concerning any databases, previous awards, or other documentation or arguments that contributed to the arbitrator's decision. The arbitrator's expenses and fees shall be split equally among the parties except in situations in which the arbitrator determines that the payment made by the carrier was not made in good faith, in which case the carrier shall be responsible for all of the arbitrator's expenses and fees. Each party shall be responsible for its own costs and fees, including legal fees if any.
c. (1) The amount awarded by the arbitrator that is in excess of any payment already made pursuant to subsection c. of section 9 of this act shall be paid within 20 days of the arbitrator's decision as provided in subsection b. of this section.
(2) The interest charges for overdue payments, pursuant to P.L.1999, c.154 (C.17B:30-23 et al.), shall not apply during the pendency of a decision under subsection b. of this section and any interest required to be paid a provider pursuant to P.L.1999, c.154 (C.17B:30-23 et al.) shall not accrue until after 20 days following an arbitrator's decision as provided in subsection b. of this section, but in no circumstances longer than 150 days from the date that the out-of-network provider billed the carrier for services rendered, unless both parties agree to a longer period of time.
d. This section shall apply only if the covered person complies with any applicable preauthorization or review requirements of the health benefits plan regarding the determination of medical necessity to access in-network inpatient or outpatient benefits.
e. This section shall not apply to a covered person who knowingly, voluntarily, and specifically selected an out-of-network provider for health care services.
f. In the event an entity providing or administering a self-funded health benefits plan elects to be subject to the provisions of section 9 of this act, as provided in subsection d. of that section, the provisions of this section shall apply to a self-funded plan in the same manner as the provisions of this section apply to a carrier. If a self-funded plan does not elect to be subject to the provision of section 9 of this act, a member of that plan may initiate binding arbitration as provided in section 11 of this act.
b. The binding arbitration shall adhere to the following requirements:
(1) Arbitration shall be initiated by filing a request with the department. The department shall establish a process to notify the other party that arbitration has been initiated and to inform a plan member of the process to arbitrate pursuant to this section;
(2) The arbitrator with which the department contracts pursuant to section 10 of this act shall conduct the arbitration pursuant to this section;
(3) The arbitrator shall consider information supplied by both parties; and
(4) The arbitrator's decision shall include written findings, including a final binding amount that the arbitrator determines is reasonable for the service, which shall include a non-binding recommendation to the entity providing or administering the self-funded health benefits plan of an amount that would be reasonable for the entity to contribute to payment for the service, and shall be issued within 30 days after the request is filed with the department.
c. The arbitrator's expenses and fees shall be divided equally among the parties, unless the payment would pose a financial hardship to the plan member, in which case the department shall establish an agreement with the arbitrator to waive any part or all of the cost of arbitration. Each party shall be responsible for its own costs and fees, including legal fees, if any.
d. This section shall not apply to a covered person who knowingly, voluntarily, and specifically selected an out-of-network provider for health care services.
a. A list of all arbitrations filed pursuant to sections 10 and 11 of this act between January 1 and December 31 of the previous calendar year, including the percentage of all claims that were arbitrated.
(1) For each arbitration decision, the list shall include but not be limited to:
(a) an indication of whether the decision was in favor of the carrier or the out-of-network health care provider;
(b) the arbitration bids offered by each side and the award amount;
(c) the category and practice specialty of each out-of-network health care provider involved in an arbitration decision, as applicable; and
(d) a description of the service that was provided and billed for.
(2) The list of arbitration decisions shall not include any information specifically identifying the provider, carrier, or covered person involved in each arbitration decision.
b. The percentage of facilities and hospital-based professionals, by specialty, that are in-network for each carrier in this State as reported pursuant to subsection d. of section 7 of this act.
c. The number of complaints the department receives relating to out-of-network health care charges.
d. The number of and description of claims received by the State Health Benefits Program and the School Employees' Health Benefits Program for in-State emergency out-of-network health care and inadvertent out-of-network health care.
e. Annual trends on health benefits plan premium rates, total annual amount of spending on inadvertent and emergency out-of-network costs by carriers, and medical loss ratios in the State to the extent that the information is available.
f. The number of physician specialists practicing in the State in a particular specialty and whether they are in-network or out-of-network with respect to the carriers that administer the State Health Benefits Program, the School Employees' Health Benefits Program, the qualified health plans in the federally run health exchange in the State, and other health benefits plans offered in the State.
g. The results of the network audit required pursuant to section 16 of this act.
h. A summary of the information submitted to the department pursuant to subsection f. of section 6 of this act concerning the number of claims submitted by health care providers to carriers which are denied or down coded by the carrier and the reasons for the denials or down coding determinations.
i. Any other benchmarks or information obtained pursuant to this act that the commissioner deems appropriate to make publicly available to further the goals of the act.
b. The commissioner shall provide a notice on the department's website containing information for consumers relating to the protections provided by this act, information on how consumers can report and file complaints with the department or the appropriate regulatory agency relating to any out-of-network charges, and information and guidance for consumers regarding arbitrations filed pursuant to section 11 of this act.
b. The department shall report to the Governor, and to the Legislature pursuant to section 2 of P.L.1991, c.164 (C.52:14-19.1), no later than 12 months after the effective date of this act and annually thereafter, on the savings to policyholders and the healthcare system that result from the provisions of this act. The report shall contain an analysis of the information compiled pursuant to section 12 of this act.
b. This section shall not apply to any waiver, rebate, gift, payment, or offer that falls within a safe harbor under federal laws related to fraud and abuse concerning patient cost-sharing, including, but not limited to, anti-kickback, self-referral, false claims, and civil monetary penalties, including any advisory opinions issued by the Centers for Medicare and Medicaid Services or the Office of Inspector General pertaining to those laws.
(1) A health care facility or carrier that violates any provision of this act shall be liable to a penalty of not more than $1,000 for each violation. Every day upon which a violation occurs shall be considered a separate violation, but no facility or carrier shall be liable to a penalty greater than $25,000 for each occurrence.
(2) A person or entity not covered by paragraph (1) of this subsection that violates the requirements of this act shall be liable to a penalty of not more than $100 for each violation. Every day upon which a violation occurs shall be considered a separate violation, but no person or entity shall be liable to a penalty greater than $2,500 for each occurrence.
b. Upon a finding that a person or entity has failed to comply with the requirements of this act, including the payment of a penalty as determined under subsection a. of this section, the commissioner may:
(1) in the case of a carrier, initiate such action as the commissioner determines appropriate;
(2) in the case of a health care facility, refer the matter to the Commissioner of Health for such action as the Commissioner of Health determines appropriate; or
(3) in the case of a health care professional, refer the matter to the appropriate professional or occupational licensing board within the Division of Consumer Affairs in the Department of Law and Public Safety for such action as that board determines appropriate.
(1) veterans of the United States armed forces;
(2) women who underwent a caesarian section or a premature delivery prior to 1990;
(3) persons who received blood or blood products prior to 1992;
(4) persons who received an organ or tissue transplant prior to 1990;
(5) persons who have received invasive cosmetic procedures, including body piercing and tattooing;
(6) persons who have a history of multiple sexually transmitted diseases or multiple partners;
(7) persons with a history of intravenous drug use; and
(8) such other categories of persons at high risk for hepatitis C infection as may be determined by the commissioner.
a. Hepatitis C is a silent killer, being largely asymptomatic until irreversible liver damage may have occurred;
b. Hepatitis C has been characterized by the World Health Organization as a disease of primary concern to humanity;
c. Hepatitis C currently infects approximately 4.5 million persons in the United States; and each year, there are some 30,000 new infections nationwide;
d. The federal Centers for Disease Control and Prevention estimate that approximately 12,000 persons die annually from the consequences of hepatitis C, and this number continues to grow each year;
e. It is estimated that approximately 200,000 New Jersey citizens are infected with hepatitis C;
f. The disease is considered to be such a public health threat that the United States Department of Health and Human Services has initiated a comprehensive plan to address this significant health problem, beginning with the identification of, and notification to, hundreds of thousands of persons who were inadvertently exposed to hepatitis C through blood transfusions;
g. In the absence of a vaccine for hepatitis C, emphasis must be placed on other means of awareness and prevention of this disease, including, but not limited to, education of persons at high risk for hepatitis C as defined by the federal Centers for Disease Control and Prevention, and the Occupational Safety and Health Administration in the U.S. Department of Labor, including but not limited to, police officers, correctional officers, firefighters, including volunteers, health care workers, emergency services personnel, employees of the State's developmental centers and the general public; and
h. New Jersey has established itself at the forefront of the fight against hepatitis C by becoming the first State in the nation to establish a comprehensive awareness program pursuant to P.L.1998, c.116 (C.26:2T-1 et seq.), and through the enactment of this act will ensure an optimal approach to controlling this lethal disease.
"Commissioner" means the Commissioner of Health.
"HCV" means the hepatitis C virus.
"Program" means the hepatitis C education, prevention, and screening program established pursuant to this act.
a. For the purposes of this program, the commissioner shall develop and implement the following:
(1) public education and outreach to raise awareness of hepatitis C among persons at high risk for hepatitis C as described in section 2 of P.L.1998, c.116 (C.26:2T-2), which includes police officers, firefighters, persons employed by correctional facilities, emergency response personnel, and other high-risk groups, including, but not limited to, health care professionals and persons employed in primary care settings or health care facilities, which shall include, at a minimum, information on risk factors, the value of early detection and the options available for treating hepatitis C;
(2) measures to promote public awareness about the availability of hepatitis C screening, prevention and treatment services among persons at high risk for hepatitis C as determined by the commissioner based upon data provided by the federal Centers for Disease Control and Prevention, the Surgeon General of the United States, the American Association for the Study of Liver Diseases, the National Institutes of Health and the American Liver Foundation, and any other nationally recognized liver societies;
(3) educational activities for health care professionals in regard to the epidemiology, natural history, detection, and treatment of hepatitis C, which shall include information about coinfection with HCV and HIV and the implications of coinfection for HIV or AIDS treatment;
(4) educational and informational measures targeted at specific groups, including, but not limited to, activities designed to educate youth about the long-term consequences of infection with HCV;
(5) measures to prevent further transmission of HCV and to prevent onset of chronic liver disease caused by hepatitis C through outreach to detect and treat chronic HCV infection; and
(6) a collaborative effort with the Department of Corrections to develop screening services to identify inmates at risk for hepatitis C upon admission, and to provide education and counseling about treatment options to reduce the potential health risk to the community from these persons.
b. The commissioner shall evaluate existing hepatitis C support services in the community and assess the need for improving the quality and accessibility of these services.
c. The commissioner shall seek to establish public-private partnerships to promote outreach and increase awareness for the purposes of this act among employers, organized labor, health care providers, health insurers, and community-based organizations, and coalitions.
d. The commissioner shall take such actions as are reasonably necessary to ensure that the program established pursuant to this act provides clear, complete, and accurate hepatitis C education, information, and referral services in a multiculturally competent manner that is designed to provide appropriate linkages to health care services for persons in need thereof.
e. The commissioner shall seek to secure the use of such funds or other resources from private nonprofit or for-profit sources or the federal government to effectuate the purposes of this act as may be available therefor, which shall be used to supplement and shall not supplant State funds used to carry out the purposes of this act.
f. The commissioner shall seek, to the maximum extent practicable, to coordinate the activities of the program, as applicable, with services provided separately to specific populations, including, but not limited to, veterans of the United States armed forces, persons participating in private or public substance or alcohol use disorder treatment programs, and persons with HIV.
b. The commissioner shall appoint as members of the advisory board persons with a demonstrated expertise and interest in hepatitis C, including, but not limited to, health care professionals and persons with hepatitis C, and including representation among the various geographic regions and ethnic groups within the State. The advisory board shall include four physicians who include one internist, one hematologist and two hepatologists; one clinical researcher specializing in diseases of the liver; and two members who are not physicians or clinical researchers, at least one of whom is a veteran of the United States armed forces who has hepatitis C.
c. The members of the advisory board shall serve without compensation, but shall be entitled to reimbursement for necessary expenses incurred in the performance of their duties.
d. The advisory board shall organize as soon as may be practicable after the appointment of its members and shall select a chairman from among its members and a secretary who need not be a member of the board.
b. For the purposes of this act, the commissioner shall, at a minimum:
(1) develop and implement a Statewide plan to promote public awareness among members of the public, community-based organizations, and health care providers, and encourage more referrals to breast cancer screening services;
(2) distribute promotional incentives for free or discounted items to be provided to women by local retail businesses that will encourage them to undergo mammography and become educated about breast cancer;
(3) provide for the use of public service announcements and printed materials in both English and Spanish;
(4) seek to disseminate information through a variety of entities, including, but not limited to, primary care sites, health care facilities, local health departments and clinics, county offices on the aging, pharmacies, libraries, YWCAs and YMCAs, senior centers, houses of worship, programs that serve victims of domestic violence, other community-based outreach programs and organizations, and the Internet;
(5) consult and seek to collaborate with at least the following entities to effectuate the public awareness campaign: the New Jersey Primary Care Association, the American Cancer Society, the Medical Society of New Jersey, the New Jersey Hospital Association, Planned Parenthood, AARP, the New Jersey Advisory Commission on the Status of Women, the New Jersey State Commission on Cancer Research, The Cancer Institute of New Jersey, the New Jersey Pharmacists Association, the Health Research and Educational Trust of New Jersey, and The Peer Review Organization of New Jersey, Inc.;
(6) establish and publicize the availability of a toll-free telephone number operated by the Department of Health to provide information and referral to members of the general public about breast screening services, with particular emphasis on facilitating free and reduced charge screening for low-income and uninsured women; and
(7) seek to secure the use of such funds or other resources from private nonprofit or for-profit sources or the federal government to effectuate the purposes of this act as may be available therefor, which shall be used to supplement and shall not supplant State funds used to carry out the purposes of this act.
b. The commissioner shall seek to include the following information for each firefighter included in the firefighter cancer registry:
(1) the age and demographic information of the firefighter;
(2) the status of the firefighter as either a paid or volunteer firefighter;
(3) the number of years working as a firefighter;
(4) the number of fire incidents attended to by the firefighter, including the number of incidents involving a residential house fire, the number of incidents involving a commercial fire, and the number of incidents involving any other type of fire;
(5) whether the firefighter's history includes smoking or drug use;
(6) relevant physical examination and medical history information; and
(7) any additional information that is deemed necessary by the commissioner.
c. For the purpose of developing and maintaining the firefighter registry established pursuant to this section, the commissioner shall consult experts with experience in developing and maintaining cancer registries, studying cancer incidence, diagnosing and treating cancer, and firefighting.
b. The commissioner shall periodically review the cancer registry to identify and implement improvements to registry infrastructure and Statewide monitoring of cancer incidence data, as well as to develop a strategy for increasing awareness of the firefighter cancer registry and maximizing the voluntary reporting of information to the registry.
c. Nothing in this section shall be construed to authorize the disclosure of any confidential or personal identifying information.
a. the causes, symptoms, and means of transmission of meningococcal meningitis;
b. the availability, effectiveness, and risks of the meningitis vaccine; and
c. where additional information concerning the disease can be obtained.
a. In the absence of appropriate housing with supportive services, many elders or people with physical disabilities are often subject to inappropriate, premature, or overextended institutionalization. This results in the overutilization of costly services and the negative impact of the institutional environment on the individual's emotional and physical well-being. A need exists to fill this gap in the housing continuum between independent living and institutionalization for those elders and physically disabled citizens who are in need of shelter and services to remain in the community.
b. Adult family care has proven to be a successful and cost-effective means of fulfilling basic shelter and everyday service needs of elders and physically disabled adults, thereby enabling them to preserve their independence, choice and dignity in a secure environment.
c. Therefore, it is the policy of this State to promote the health, safety and welfare of its elderly and physically disabled citizens by encouraging the development of adult family care homes for elders and physically disabled adults and to provide for the licensing of caregivers and regulation of such adult family care homes by the Department of Health.
"Activities of daily living" or "ADL" means functions and tasks for self-care which are performed either independently or with supervision or assistance, which include, but are not limited to, mobility, transferring, walking, grooming, bathing, dressing and undressing, eating, and toileting.
"Adult family care" means a 24-hour per day living arrangement for persons who, because of age or physical disability, need assistance with activities of daily living, and for whom services designed to meet their individual needs are provided by licensed caregivers in approved adult family care homes.
"Adult family care caregiver" means a person licensed to provide care and services in the daily operation of an adult family care home, but does not include the owner or lessor of the building in which the adult family care home is situated unless the owner or lessor is also the provider of care and services in the adult family care home.
"Adult family care home" means a residence regulated by the department and housing no more than three clients, in which personal care and other supportive services are provided by an individual who has been licensed by the department as an adult family care caregiver. "Adult family care home" shall not include a rooming or boarding house used and operated under license of the Department of Community Affairs pursuant to P.L.1979, c.496 (C.55:13B-1 et seq.).
"Adult family care sponsor agency" means an entity licensed by the department to administer an adult family care program within a given area, which provides essential administrative and clerical support services to two or more caregivers, and which shall not be considered to be a health care facility as defined in section 2 of P.L.1971, c.136 (C.26:2H-2).
"Client" means an elder or person with physical disabilities enrolled in adult family care.
"Commissioner" means the Commissioner of Health.
"Department" means the Department of Health.
"Elder" means a person sixty years of age or older.
b. Application for licensure as an adult family care caregiver shall be made upon forms prescribed by the department. The department shall charge a single, non-refundable fee for the filing of an application for the issuance of a license and a single, non-refundable fee for any renewal thereof, as it shall from time to time fix in rules or regulations, except that neither fee shall exceed $200.
c. The department shall issue a license as an adult family care caregiver to an applicant if it finds that:
(1) the applicant and the adult family care home identified in the application are fit and adequate, in accordance with the qualifications and standards established by regulation of the commissioner;
(2) there is reasonable assurance that care will be provided to clients in the manner required by this act and any rules or regulations adopted pursuant thereto; and
(3) there are sufficient indicia of fiscal responsibility such that the applicant will be able to maintain residence at the adult family care home with minimal likelihood of eviction or mortgage foreclosure during the term of licensure.
All licenses issued by the department shall be effective for up to two years from the date of issuance unless revoked in accordance with the provisions of this act.
d. An adult family care caregiver license shall specify both the name of the licensee and the location of the particular home in which clients will be housed. An adult family care caregiver's license is not transferable and shall apply only to the location and person indicated on the license.
e. Upon issuance of a license to an adult family care caregiver, the department shall provide a copy of the license to the municipality in which the adult family care home is located.
f. Upon receipt of a license as an adult family care caregiver, the caregiver shall provide notification of the license to the police department, fire department and ambulance corps that serve the municipality in which the adult family care home is located for their planning purposes.
g. For three years following the date of this act, a licensed caregiver shall operate under a contractual agreement with an adult family care sponsor agency to provide services to individuals enrolled in adult family care. At the end of this three-year period, the department may extend this requirement, at its discretion, by regulation.
b. A person shall be disqualified from being licensed as an adult family care caregiver or acting as a substitute caregiver if the check of his criminal history record background reveals a conviction for any of the following crimes or offenses, and a home shall be disqualified from being approved as an adult family care home if the criminal history record background check of any non-client 18 years of age or older who resides in the home reveals a conviction for any of the following crimes or offenses:
(1) In New Jersey, any crime or disorderly persons offense:
(a) involving danger to the person, meaning those crimes and disorderly persons offenses set forth in N.J.S.2C:11-1 et seq., N.J.S.2C:12-1 et seq., N.J.S.2C:13-1 et seq., N.J.S.2C:14-1 et seq., or N.J.S.2C:15-1 et seq.; or
(b) against the family, children or incompetents, meaning those crimes and disorderly persons offenses set forth in N.J.S.2C:24-1 et seq.; or
(c) involving theft as set forth in chapter 20 of Title 2C of the New Jersey Statutes; or
(d) involving any controlled dangerous substance or controlled substance analog as set forth in chapter 35 of Title 2C of the New Jersey Statutes except paragraph (4) of subsection a. of N.J.S.2C:35-10; or
(e) any other crime or disorderly persons offense substantially related to the qualifications or duties of an adult family care caregiver.
(2) In any other state or jurisdiction, conduct which, if committed in New Jersey, would constitute any of the crimes or disorderly persons offenses described in paragraph (1) of this subsection.
c. Notwithstanding the provisions of subsection b. of this section to the contrary, an applicant shall not be denied a license when the person found to have a conviction as specified in subsection b. of this section affirmatively provides evidence satisfactory to the department of the person's rehabilitation. In determining the person's rehabilitation, the department shall consider the following factors, as applicable:
(1) the nature and seriousness of the offense;
(2) the circumstances under which the offense occurred;
(3) the date of the offense;
(4) the age of the person when the offense was committed;
(5) whether the offense was an isolated or repeated incident;
(6) any social conditions which may have contributed to the offense; and
(7) any evidence of rehabilitation, including good conduct in prison or in the community, counseling or psychiatric treatment received, acquisition of additional academic or vocational schooling, successful participation in correctional work-release programs, or the recommendation of those who have had the person under their supervision.
d. Upon receipt of the criminal history record and a determination that an applicant should be disqualified from acting as a caregiver or that a home should be disqualified as an adult family care home, the department shall so notify the applicant in writing. The notice shall specify the convictions upon which the disqualification is based.
b. Application for a license as an adult family care sponsor agency shall be made upon forms prescribed by the department. The department shall charge a single, non-refundable fee for the filing of an application for the issuance of a license and a single, non-refundable fee for any renewal thereof, as it shall from time to time establish by regulations, except that neither of these fees shall exceed $4,000.
c. An applicant for licensure as an adult family care sponsor agency shall comply with all procedures and meet all standards and requirements established by regulation of the commissioner.
b. The department shall be responsible for inspecting the physical plant of each adult family care home initially and on an annual basis. In addition to any licensing fee required under this act, the department may charge an annual, non-refundable fee for inspection of any adult family care home, as shall be established from time to time by regulation of the commissioner.
c. The department's staff shall be permitted access to enter and inspect an adult family care home at any time. The department's staff shall be permitted access to the clients of the adult family care home in order to interview them privately and to inspect client records.
d. The department shall be responsible for providing to the adult family care caregiver a report of the most recent inspection of the home, written in clear, concise language readily comprehensible to the average person.
e. The adult family care caregiver shall post the inspection report in the entry to, or other equally prominent location in, the home and shall, upon request, provide a copy of the report to each client of, or person applying for admission to, the home, or the legal representative, guardian or conservator of the client or prospective client.
f. The Office of The Ombudsman for the Institutionalized Elderly shall have jurisdiction to take all actions authorized pursuant to P.L.1977, c.239 (C.52:27G-1 et seq.) with respect to adult family care homes.
b. A person, firm, partnership, corporation, limited liability company or association that, except in cases of an emergency, maintains more clients in an adult family care home than it is licensed to maintain, shall be subject to penalty, in an amount equal to the daily charge collected from those clients plus $25 for each day multiplied by the number of clients maintained over the authorized limit.
c. In addition to the authority granted to the department by this act or any other law, the department, after serving an applicant or licensee with specific charges in writing, may: assess penalties and collect the same within the limitations imposed by this act; deny a license; grant probationary or provisional status to a licensee; relocate clients; or revoke or suspend any and all licenses granted under authority of this act to a person, firm, partnership, corporation, limited liability company or association violating or failing to comply with the provisions of this act, or the rules and regulations adopted pursuant thereto.
d. A person, firm, partnership, corporation, limited liability company or association that violates any rule or regulation adopted in accordance with this act as the same pertains to the care of clients or physical plant standards shall be subject to a monetary penalty of not more than $2,500 as provided for by regulation for each day in violation of the rule or regulation.
e. Notice of the assessment of penalties, revocation, suspension, placement on probationary or provisional license status, relocation of clients or denial of a license, together with a specification of charges, shall be served on the applicant or licensee, personally or sent by certified mail to the address of record. The notice shall set forth the particular reasons for the administrative action being undertaken.
f. The commissioner or his designee shall arrange for prompt and fair hearings on all contested cases, render written decisions stating conclusions and reasons therefor upon each matter so heard, and may enter orders of denial, suspension, placement on probationary or provisional license status, relocation of clients or revocation, consistent with the circumstances in each case, and may assess penalties and collect the same within the limitations imposed by this act.
g. In the event of closure of an adult family care home, clients who are relocated by the department may be entitled to benefits pursuant to the "Relocation Assistance Act," P.L.1971, c.362 (C.20:4-1 et seq.) or the "Relocation Assistance Law of 1967," P.L.1967, c.79 (C.52:31B-1 et seq.), and any regulations adopted pursuant thereto.
(1) be treated as an adult, with respect, dignity, courtesy and consideration, and to have individual needs for privacy recognized and upheld;
(2) be informed of all client rights and house rules;
(3) make choices with respect to his care, services and lifestyle;
(4) be informed of his condition and the right to consent to or refuse care and services;
(5) participate, to the fullest extent that the client is able, in planning for his own care and services;
(6) receive appropriate care and services, as needed;
(7) a safe and secure environment;
(8) be free from abuse, exploitation and neglect;
(9) complete privacy when receiving care and services;
(10) associate and communicate privately with any person the client chooses;
(11) send and receive personal mail unopened;
(12) participate in activities of social, religious and community groups;
(13) have medical and personal information kept confidential;
(14) keep and use a reasonable amount of personal clothing and belongings, and to have a reasonable amount of private, secure storage space;
(15) manage his own money and financial affairs, unless legally restricted from doing so;
(16) receive a written agreement regarding the care and services to be provided, and the terms and conditions for termination of residency from the home;
(17) be provided with a written statement of the rates to be charged, and 30 days' written notice of any change in the rates;
(18) practice the religion of his choice, or to abstain from religious practice;
(19) be free of discrimination in regard to race, color, national origin, sex or religion; and
(20) make suggestions and complaints without fear of retaliation.
b. The adult family care caregiver shall ensure that a written notice of the rights set forth in this section is given to every client. The caregiver shall also post this notice in the entry to, or other equally prominent location in, the adult family care home. This notice shall also include the name, address and telephone number of the Office of the Ombudsman for the Institutionalized Elderly.
a. An estimated 128 million Americans suffer from the crippling economic and psychological burden of chronic, degenerative and acute diseases, including Alzheimer's disease, cancer, diabetes and Parkinson's disease;
b. The costs of treating, and lost productivity from, chronic, degenerative and acute diseases in the United States constitutes hundreds of billions of dollars annually. Estimates of the economic costs of these diseases does not account for the extreme human loss and suffering associated with these conditions;
c. Human stem cell research offers immense promise for developing new medical therapies for these debilitating diseases and a critical means to explore fundamental questions of biology. Stem cell research could lead to unprecedented treatments and potential cures for Alzheimer's disease, cancer, diabetes, Parkinson's disease and other diseases;
d. The United States has historically been a haven for open scientific inquiry and technological innovation; and this environment, combined with the commitment of public and private resources, has made this nation the preeminent world leader in biomedicine and biotechnology;
e. The biomedical industry is a critical and growing component of New Jersey's economy, and would be significantly diminished by limitations imposed on stem cell research;
f. Open scientific inquiry and publicly funded research will be essential to realizing the promise of stem cell research and maintaining this State's leadership in biomedicine and biotechnology. Publicly funded stem cell research, conducted under established standards of open scientific exchange, peer review and public oversight, offers the most efficient and responsible means of fulfilling the promise of stem cells to provide regenerative medical therapies;
g. Stem cell research, including the use of embryonic stem cells for medical research, raises significant ethical and public policy concerns; and, although not unique, the ethical and policy concerns associated with stem cell research must be carefully considered; and
h. The public policy of this State governing stem cell research must: balance ethical and medical considerations, based upon both an understanding of the science associated with stem cell research and a thorough consideration of the ethical concerns regarding this research; and be carefully crafted to ensure that researchers have the tools necessary to fulfill the promise of this research.
(1) be permitted in this State;
(2) be conducted with full consideration for the ethical and medical implications of this research; and
(3) be reviewed, in each case, by an institutional review board operating in accordance with applicable federal regulations.
b. (1) A physician or other health care provider who is treating a patient for infertility shall provide the patient with timely, relevant and appropriate information sufficient to allow that person to make an informed and voluntary choice regarding the disposition of any human embryos remaining following the infertility treatment.
(2) A person to whom information is provided pursuant to paragraph (1) of this subsection shall be presented with the option of storing any unused embryos, donating them to another person, donating the remaining embryos for research purposes, or other means of disposition.
(3) A person who elects to donate, for research purposes, any embryos remaining after receiving infertility treatment shall provide written consent to that donation.
c. (1) A person shall not knowingly, for valuable consideration, purchase or sell, or otherwise transfer or obtain, or promote the sale or transfer of, embryonic or cadaveric fetal tissue for research purposes pursuant to this act; however, embryonic or cadaveric fetal tissue may be donated for research purposes in accordance with the provisions of subsection b. of this section or other applicable State or federal law.
For the purposes of this subsection, "valuable consideration" means financial gain or advantage, but shall not include reasonable payment for the removal, processing, disposal, preservation, quality control, storage, transplantation, or implantation of embryonic or cadaveric fetal tissue.
(2) A person or entity who violates the provisions of this subsection shall be guilty of a crime of the third degree and, notwithstanding the provisions of subsection b. of N.J.S.2C:43-3, shall be subject to a fine of up to $50,000 for each violation.
a. Aphasia is a disorder of the brain, which affects a person's ability to communicate, and which most commonly occurs after a stroke or traumatic brain injury;
b. Although aphasia is most common among older people, it can be acquired by people of all ages who have suffered severe head trauma;
c. A person with aphasia typically has difficulty speaking and, sometimes, difficulty with reading, writing, and understanding what other people are saying; however, the condition does not affect a person's intellect;
d. The type and severity of language dysfunction suffered by a person with aphasia depends on the precise location and extent of damaged brain tissue;
e. Generally, there are four types of aphasia: (1) expressive aphasia, which involves difficulty in conveying thoughts through speech or writing; (2) receptive aphasia, which involves difficulty in understanding spoken or written language; (3) anomic or amnesia aphasia, the least severe form of aphasia, which involves difficulty in using the correct names for particular objects, people, places, or events; and (4) global aphasia, the most severe form of aphasia, which involves the loss of almost all language function, both comprehension and expression;
f. There is no one treatment process that is proven to be effective for all types of aphasia, and although persons with aphasia usually experience improvement over time with the aid of speech therapy, rehabilitation services, and counseling, many persons with aphasia are prone to depression, hopelessness, and isolation, and tend to avoid social situations, since communication with others may lead to mutual frustration;
g. It is estimated that one million people in the United States have aphasia, more than the number of people suffering from Parkinson's disease, muscular dystrophy, multiple sclerosis, or cerebral palsy; and
h. It is, therefore, in the public interest for the State to establish a permanent aphasia task force to ensure that there are appropriate informational resources and support systems available in the State to assist persons with aphasia, and their families.
b. The task force shall consist of 13 members as follows:
(1) the Commissioners of Health and Human Services, who shall serve ex officio;
(2) five representatives from the State's aphasia support and treatment programs, including one representative from the non-profit Adler Aphasia Center; one representative from the Kean University Institute for Adults Living with Communication Disabilities; one representative from the Comprehensive Stroke Center at Hackensack University Medical Center; one representative from the medically-based support group, JFK-Johnson Rehabilitation Institute; and one representative from the private aphasia practice, Lingraphica; and
(3) six public members to be appointed as follows: two public members to be appointed by the Senate President, one of whom shall be a person with aphasia, and one of whom shall be a professional who provides caregiving services to persons with aphasia; two public members to be appointed by the Speaker of the General Assembly, one of whom shall be a person with aphasia, and one of whom shall be a professional who provides speech-language pathology services to persons with aphasia; and two public members to be appointed by the Governor, one of whom shall be a professional who provides caregiving services to persons with aphasia, and one of whom shall be a professional who provides speech-language pathology services to persons with aphasia.
c. Each public member of the task force shall serve for a term of five years, except that, of the members first appointed, the first two appointees shall serve for terms of five years, the second two appointees shall serve for terms of four years, and the third two appointees shall serve for terms of three years. Each member shall hold office for the term of appointment, and until their successor is appointed and qualified.
d. Any vacancy in the task force membership shall be filled for the unexpired term, in the same manner provided for the original appointment. Members are eligible for reappointment to the task force.
e. The purpose of the task force shall be to: monitor the prevalence of aphasia in New Jersey; assess the unmet needs of persons with aphasia, and their families; identify, and facilitate the establishment of, aphasia support groups and other support and informational resources designed to assist in satisfying the unmet needs of residents with aphasia, and their families; and provide recommendations to the Governor and Legislature, in accordance with the provisions of subsection k. of this section, for legislation or other governmental action that would further facilitate the support of persons with aphasia, and their families. In effectuating its purposes under this act, the task force shall:
(1) establish, or encourage and facilitate the establishment of, new aphasia support groups in senior centers, Federally Qualified Health Centers, county offices for the disabled, county offices on aging, and libraries throughout the State, with a focus on improving access to aphasia support services in areas of the State that have significant senior and minority populations;
(2) provide orientation programs for speech language pathologists and caregivers who are interested in volunteering to facilitate the operation of new aphasia support groups established under paragraph (1) of this subsection;
(3) encourage all universities in the State with graduate-level programs in speech-language pathology to offer aphasia support groups to members of the public;
(4) coordinate the operations of aphasia support groups in the State, in order to facilitate the Statewide sharing of data and resources, and the adoption of collaborative efforts designed to provide support and treatment to persons with aphasia, and their families;
(5) create various focus groups that engage persons with aphasia, aphasia support group staff, and aphasia caregivers and speech-language pathologists, for the purposes of assessing and highlighting the region-by-region needs of persons with aphasia, and their families;
(6) encourage hospitals in the State to distribute information about aphasia, upon patient discharge, to patients who have had a stroke or head injury, and provide hospitals with appropriate pamphlets or other documentation, such as the informational materials that are available from the National Aphasia Association (NAA), the American Stroke Association (ASA), or the American Speech-Language-Hearing Association (ASHA), for the purposes of distribution to such patients;
(7) establish, at a publicly accessible location on the Internet website of the Department of Health, a webpage dedicated to aphasia, which shall include relevant information on aphasia, and contact information for the available aphasia support groups in the State;
(8) compile, and post on the aphasia webpage established under paragraph (7) of this subsection, a registry of counselors and psychologists in the State who are available to work with persons with aphasia, and their families;
(9) explore, document, and list on the aphasia webpage established under paragraph (7) of this subsection, any funding sources that are available for post-acute services provided to persons with aphasia in the chronic phase;
(10) create an aphasia-friendly newsletter, which shall be designed to provide persons with aphasia, caregivers, and professionals with updated information about new developments in the treatment of aphasia, and which shall be posted on the aphasia webpage established under paragraph (7) of this subsection, and disseminated to appropriate support, treatment, and educational groups, and to persons with aphasia, on a quarterly basis;
(11) coordinate with the State's county agencies on aging and county agencies for the disabled; supply each county agency with listings and descriptions of aphasia services and support groups available in their area; and encourage each agency to provide information about these services and support groups to their clients; and
(12) enlist persons with aphasia in the chronic phase to instruct first responders, medical personnel, vendors, and others in their respective communities about the needs and abilities of persons with aphasia, and the needs of their families and caregivers; and provide appropriate assistance to these instructors.
f. The task force shall organize as soon as practicable after the appointment of a majority of its members, and may meet and hold hearings at such places and times as it shall designate.
g. The members of the task force shall serve without compensation, but may be reimbursed for travel and other necessary expenses incurred in the performance of their duties, within the limits of funds appropriated or otherwise made available to the task force for its purposes.
h. The Department of Health shall provide professional and clerical staff to the task force as may be necessary for the task force's purposes, and the task force shall also be entitled to call upon the services of any State, county, or municipal department, board, commission, or agency, as may be available to it for its purposes.
i. In executing its duties under this act, the task force shall consult with associations, organizations, and individuals who are knowledgeable about the needs of persons with aphasia, and their families.
j. The task force may solicit and receive grants and other funds that are made available for the task force's purposes by any governmental, public, private, not-for-profit, or for-profit agency, including funds that are made available under any federal or State law, regulation, or program.
k. Within 12 months after the task force's organizational meeting, and at least biennially thereafter, the task force shall submit a written report to the Governor, and, pursuant to section 2 of P.L.1991, c.164 (C.52:14-19.1), to the Legislature. Each report submitted pursuant to this subsection shall contain the task force's findings on the prevalence of aphasia in the State, information as to the status and success of existing aphasia support services in the State, and any recommendations for legislative or other action that may be necessary to address the unmet needs of persons with aphasia and their families.
There shall be a board of health in every municipality in this state, which board shall consist of members appointed or designated, or both, as provided by this chapter, except that in any municipality operating under laws establishing a form of government for such municipality under which the full powers of a local board of health can not be exercised by a local board of health so appointed or designated, the respective functions of a local board of health shall be exercised by such boards, bodies, or officers as may exercise the same according to law.
A local board may adopt rules, regulations or ordinances for its government and that of its officers and employees not inconsistent with law or the state sanitary code.
a. The local board in every municipality, other than a township, which is subject to the provisions of subdivision C of this article, or a board established by a municipality that invokes the provisions of subsection b. of this section, shall be composed of not less than five nor more than seven members, except that in a city of the first class the board shall consist of 10 members, and in a city having a population of over 80,000, but not of the first class, the board shall consist of not less than five nor more than 10 members.
Upon the consent of the prospective appointee, the governing body of a municipality may appoint a school nurse or the municipal physician to the local board, notwithstanding that the nurse or physician is not a resident of the municipality.
The local board may, by ordinance, provide for the appointment of two alternate members. Notwithstanding the provisions of any other law or charter heretofore adopted, the ordinance shall provide the method of appointment of the alternate members. Alternate members shall be designated at the time of appointment by the authority appointing them as "Alternate No. 1" and "Alternate No. 2."
The terms of the alternate members shall be for two years, except that the terms of the alternate members first appointed shall be two years for Alternate No. 1 and one year for Alternate No. 2, so that the term of not more than one alternate member shall expire in any one year. A vacancy occurring otherwise than by expiration of term shall be filled by the appointing authority for the unexpired term only.
An alternate member shall not be permitted to act on any matter in which he has either directly or indirectly any personal or financial interest. An alternate member may, after public hearing if he requests one, be removed by the governing body for cause.
An alternate member may participate in discussions of the proceedings but may not vote except in the absence or disqualification of a regular member. A vote shall not be delayed in order that a regular member may vote instead of an alternate member. In the event that a choice must be made as to which alternate member is to vote, Alternate No. 1 shall vote first.
b. In the case of a municipality, other than a township, with a population of 30,000 or less, the local board may be composed of the members of the governing body of the municipality.
c. As used in this section, "governing body" means the body exercising general legislative power in the municipality, including any mayor selected by the governing body from among its own members.
In a city of the first class, only citizens of the city shall be eligible to appointment on the local board; not more than one-half of the members shall belong to the same political party; and at least one-half of the members shall be practicing physicians.
The members of the local board in every municipality, other than a township which is subject to the provisions of subdivision C of this article, or a board established by a municipality that invokes the provisions of subsection b. of R.S.26:3-3, shall be appointed in such manner as the governing body may by ordinance provide, except that in a city of the first class all the members of the board shall be appointed by the mayor and confirmed by the board or body having charge of the finances in such city.
The members of the local board in every municipality, other than a township, which is subject to the provisions of subdivision C of this article, or a board established by a municipality that invokes the provisions of subsection b. of R.S.26:3-3, shall serve for such term as the governing body may by ordinance provide, but, except in a city having a population of over 80,000 but not of the first class, no term shall exceed 4 years, and in a city of the first class the term shall be 3 years. The terms shall be so arranged that the terms of not more than three members shall expire in any 1 year, except that in a city of the first class the terms of three members shall expire in 1 year, the terms of an additional three members in the next succeeding year, and the terms of the remaining members in the second succeeding year.
If any vacancy shall occur on the local board of any municipality, other than a township which is subject to the provisions of subdivision C of this article, or a board established by a municipality that invokes the provisions of subsection b. of R.S.26:3-3, it shall be filled in the same manner in which the original appointment was made, but for the unexpired portion of the term only.
The members of the local board in a city of the first class shall receive no compensation for their services as members of the board.
The boards of health of any city in second class counties now or hereafter having a population of not less than one hundred and thirty thousand nor more than one hundred fifty thousand inhabitants, may appoint a secretary to such board of health, and said secretary shall hold his position during good behavior. Any such secretary in office on June second, one thousand nine hundred and thirty-seven, shall continue therein and his term of office is hereby extended during good behavior.
Every such secretary shall receive an annual salary of not less than one thousand seven hundred dollars. Such salary shall be paid by the municipality in the same manner as other salaries are paid, and the governing body shall provide the necessary funds for such payment.
a. The local board in every township having a population of not more than 30,000 inhabitants may be composed of the members of the township committee, the township assessor or, if the township has a board of assessors, the township clerk, and one physician or school nurse, to be appointed by the township committee for a term of three years from the time of his appointment and until the successor is appointed. Upon the consent of the prospective appointee, the township committee may appoint, as the physician or school nurse appointment, the township physician or a school nurse to the local board, notwithstanding that the physician or nurse is not a resident of the township. The township committee may by ordinance provide for the appointment of not more than two alternate members. Alternate members shall be designated at the time of appointment as "Alternate No. 1" and "Alternate No 2." The term of the alternate members shall be for two years, except that of the first two alternate members appointed, one shall be appointed for a term of one year so that the term of not more than one alternate member shall expire in any one year. A vacancy occurring otherwise than by expiration of term shall be filled by the appointing authority for the unexpired term only. Alternate members may participate in discussions of the proceedings but may not vote except in the absence or disqualification of a regular member. A vote shall not be delayed in order that a regular member may vote instead of an alternate member. In the event that a choice must be made as to which alternate member is to vote, Alternate No. 1 shall vote.
b. Any such township may by ordinance adopt the provisions of subdivision B of this article and thereafter shall be subject to the provisions thereof and shall not be subject to the provisions of this subdivision of this article.
The local board in every township having a population of more than twenty thousand inhabitants shall be composed of not less than five nor more than seven members who shall be appointed in such manner and hold their respective offices for such terms, not exceeding four years, as the township committee or other governing body may by ordinance provide, but the terms of not more than three members shall expire in any one year, but any such township may by ordinance adopt the provisions of subdivision B of this article and thereafter shall be subject to the provisions thereof and shall not be subject to the provisions of this subdivision of this article. Upon the consent of the prospective appointee, the township committee may appoint a school nurse or the township physician to the local board, notwithstanding that the nurse or physician is not a resident of the township.
In any township within whose limits any other form of local municipal government exists, the jurisdiction of the local board of the township shall extend only to such parts of the township as are outside of the territorial limits of the other local municipal government. In every other case the jurisdiction of the township board shall be coextensive with the limits of the township.
The local board in every township, which is subject to the provisions of this subdivision of this article, shall appoint, on the day of its organization, a place, day, and hour for the regular meeting of the board for the hearing of complaints, reports, and general business, and shall cause to be published in the township newspaper, or a paper circulating in the township, notice of the same. At least one regular meeting shall be held in each year. Special meetings may be called at any time by the president of the board or by the State department.
For attendance on meetings of the board, members of a township board, which is subject to the provisions of this subdivision of this article, shall each receive the sum of two dollars ($2.00) for each meeting, to be paid in the same manner as members of township committees are paid for their services.
If a township committee in a township having a population of not more than twenty thousand inhabitants, which is subject to the provisions of this subdivision of this article, shall fail to appoint a physician member within ten days after the death, removal or resignation of any physician, or after the expiration of his term, the State department may appoint a physician as a member of the local board, who shall hold his office for the term of three years from the time of his appointment by the State department and until his successor shall be appointed.
If a physician shall not be appointed either by the township committee or by the State department, the members of the township committee and the assessor shall constitute the local board of the township and shall continue to constitute the board until the appointment shall be made.
In a township having a population of not more than twenty thousand inhabitants, which is subject to the provisions of this subdivision of this article, in case of the death, removal, or resignation of an assessor before the time of electing his successor, the township clerk shall succeed the assessor as a member of the local board, and shall continue as a member until an assessor shall be elected or appointed.
If a vacancy shall occur in the board of any township having a population of more than twenty thousand inhabitants, which is subject to the provisions of this subdivision of this article, it shall be filled in the same manner in which the original appointment was made, but for the unexpired portion of the term only.
As used in this act, "public health laboratory technician" applies to every officer appointed by a board of health to perform bacteriological, serological, chemical and related technical laboratory tests in a laboratory conducted by a board of health, excepting health officers, public health nurses, sanitary inspectors, plumbing inspectors, food and drug inspectors, milk inspectors, meat inspectors, and persons performing washing or cleaning services or clerical duties in the office of the board of health.
The local board may employ such personnel as it may deem necessary, to carry into effect the powers vested in it. It shall fix the duties and compensation of every appointee and, as to local boards which shall not be operating under the provisions of Title 11A, Civil Service, of the New Jersey Statutes, fix the term of every appointee.
The appointees, agents and officers of a local board, which shall not be operating under the provisions of Title 11A, Civil Service, of the New Jersey Statutes shall hold their offices during the term for which they are severally appointed, and shall not be removed except for cause and after an opportunity has been given them for a hearing.
Any duly appointed health officer shall, subject to the superior authority of the local board appointing him, be its general agent for the enforcement of its ordinances and the sanitary laws of the State. The health officer shall provide leadership in the field of public health in the community served by the local board as required under the "Recognized Public Health Activities and Minimum Standards of Performance." In addition to being the chief executive officer of the local board, the health officer is responsible for evaluating the health problems of the community served by the local board, planning appropriate activities to meet the health problems of the citizens thereof, developing necessary budget procedures to cover these activities and directing the staff of the local board to carry out these activities efficiently and economically.
Any other duly appointed person shall be the agent of the local board appointing him for the performance of such services not inconsistent with the license held as such local board, or any officer under the authority of such board, shall assign to him. A registered environmental health specialist is authorized to make all types of inspections for a local board except plumbing inspections. A registered environmental health specialist is required to compile proper records of these inspections, inform persons of their violations, the bases thereof, and the methods of abating these violations and obtain any evidence necessary for legal action.
The licensure requirements of this section shall not apply to a person engaged in the administration and enforcement of environmental protection laws and regulations governed by the State Department of Environmental Protection.
Any person holding the position or employment of plumbing inspector under any local board of health of any municipality, which has adopted the provisions of subtitle three of Title 11 (Civil Service) of the Revised Statutes, who has held such position or employment continuously for twelve years from the date of his original appointment thereto, shall be placed in the classified service of civil service without examination, and such employee shall thereafter be subject to all the provisions of Title 11 of the Revised Statutes with respect to tenure, classification and compensation.
No local board shall appoint any person to a position for which a license is required under section 41 of P.L.1947, c.177 (C.26:1A-41) nor employ a person to do work ordinarily performed by a person required to hold a license under that section, who is not the holder of a proper license as such.
Whenever any local board shall violate any of the provisions of section 26:3-20 of this Title, the department may institute an action in the Superior Court in the name of the State at the relation of the department to enjoin such violation and for such other relief as the court deems proper.
Any holder of a license required under section 41 of P.L.1947, c.177 (C.26:1A-41) shall be eligible to appointment to the position for which the license is required by any local board.
Local boards of health of two or more adjacent municipalities may join in employing a health officer and one or more registered environmental health specialists and other personnel. In such case, the local boards of such municipalities or a regional health commission formed by them, as the case may be, shall fix the salary to be paid to these persons, arrange the duties of such persons and in the case of regional health commissions apportion the sums to be paid by each of the municipalities, which sums shall be paid from moneys appropriated to the local boards of such municipalities.
If in any township sufficient environmental inspection is not secured, the State department may, on notice to the local board, require the appointment by the local board of a registered environmental health specialist for the township who shall be paid by the local board of the township at an equitable rate of reimbursement for his services.
In every municipality containing a population of 2,000 inhabitants or more, there shall be at least one registered environmental health specialist appointed by the local board.
No health officer, inspector or employee holding a license issued in the name of the State Department of Health, after five years' consecutive service in the employ of a local board or regional health commission, shall be removed from office or reduced in pay or position except for just cause and after public hearing as provided in section 26:3-27 of this Title.
The local board or regional health commission, not operating under the provisions of Title 11A, Civil Service, of the New Jersey Statutes, employing a health officer or any other person whom it is sought to remove, shall formulate or receive charges in writing, against such person and shall fix a time and place for a hearing thereon.
A written copy of the charges and a written notice of the time and place of the hearing shall be served upon the person sought to be removed at least 20 days prior to the hearing.
At the hearing the local board or regional health commission shall hear all witnesses and receive all evidence produced, and if the charges are found to be true in fact, and just cause be shown, the local board or regional health commission may remove or reduce the pay, or position of the person against whom the charges are made.
A local board employing a health officer shall defray his necessary expenses in attending the regular meetings of the health officers' association of New Jersey.
A local board in cities of the second class may appoint and send its health officer to any medical convention meeting for the purpose of discussing the improvement of the health and sanitary condition of municipalities, and pay his necessary expenses while attending the convention.
The local board of health shall have power to pass, alter or amend ordinances and make rules and regulations in regard to the public health within its jurisdiction, for the following purposes:
a. To protect the public water supply and prevent the pollution of any stream of water or well, the water of which is used for domestic purposes, and to prevent the use of or to close any well, the water of which is polluted or detrimental to the public health.
b. (1) To prohibit the cutting, sale or delivery of ice in any municipality without obtaining a permit from the local board. No person shall cut, sell or deliver ice in any municipality without obtaining such permit.
(2) To refuse such permit or revoke any permit granted by it when in its judgment the use of any ice cut, sold or delivered under the permit would be detrimental to the public health. Upon the refusal or revocation of a permit by the local board, an appeal may be taken to the State department. Upon order of the State department a permit shall be granted or the revocation set aside.
(3) To prohibit the importation, distribution or sale of any impure ice which would be detrimental to the public health.
c. To license and regulate the sanitary conditions of hotels, restaurants, cafes, and other public eating houses and to provide for the posting of ratings or score cards setting forth the sanitary condition of any public eating house after inspection of the same and to post the rating or score card in some conspicuous or public place in such eating house.
d. To compel any owner of property along the line of any sewer to connect his house or other building therewith. This paragraph shall be enforced by the local board within its jurisdiction and it shall by ordinance provide a fine of $25 to be imposed upon any person who shall not comply with any order issued under the authority of this paragraph, within 30 days after notice by the proper officer of the board to make the required connections. An additional fine of $10 shall be provided for each day of delay, after the expiration of the 30 days, in which the provisions of the order or notice are not complied with. Such notice may be served upon the owner personally or by leaving it at his usual place of abode with a member of his family above the age of 18 years.
e. (Deleted by amendment, P.L.1987, c.442.)
f. To regulate, control, and prohibit the accumulation of offal and any decaying or vegetable substance.
g. (1) To regulate the location, construction, maintenance, method of emptying or cleaning, and the frequency of cleaning of any privy or other place used for the reception or storage of human excrement, and to prohibit the construction or maintenance of any privy or other such place until a license therefor shall have been issued by the board, which license shall continue in force for one year from the date of issue.
(2) To fix the fee, not exceeding $5, for such license, and to use the fees so collected in supervising and maintaining said privies or other places and in removing and disposing of the excrement therefrom.
(3) To revoke such license at any time if the owner or tenant of the property on which any privy or other such place is located, maintains the same in violation of law, or of the State sanitary code, or any ordinance or rule of the board.
h. To regulate, control, or prohibit the cleaning of any sewer, the dumping of garbage, the filling of any sunken lot or marsh land, and to provide for the filling up of any such lot or land, which has become filled with stagnant water and is located in any built-up area.
i. (1) To license and regulate the business of cleaning cesspools and privies, which license shall continue for the term of one year from the date of granting, and to fix the fee that shall be charged for such license, not exceeding $20 for each vehicle or conveyance.
(2) To prohibit unlicensed persons from engaging in such business.
(3) To require any vehicle or conveyance used in such business within its jurisdiction to be approved by it.
(4) To revoke such license if any licensee or his employee or agent shall violate any ordinance or rule of the board in cleaning any cesspool or privy, or in removing the contents thereof.
j. To aid in the enforcement of laws as to the adulteration of all kinds of food and drink, and to prevent the sale or exposure for sale of any meat or vegetable that is unwholesome or unfit for food.
k. To regulate, control, or prohibit the keeping or slaughtering of animals.
l. To license and regulate the keeping of boarding houses for infants and children and to fix a license fee for the same and to prevent unlicensed persons from keeping such boarding houses. This paragraph shall not apply to:
(1) The Department of Children and Families.
(2) Any children's home, orphan asylum, or children's aid society incorporated under the laws of this State.
(3) Any aid society of a properly organized and accredited church or fraternal society organized for aid and relief to its members.
(4) Any charitable society incorporated under the laws of this State having as one of its objects the prevention of cruelty to children or the care and protection of children.
m. To require in buildings, designed to be occupied, or occupied, as residences by more than two families and when the owners have agreed to supply heat, that from October 1 of each year to the next succeeding May 1, every unit of dwelling space and every habitable room therein shall be maintained at least at 68 degrees F. whenever the outside temperature falls below 55 degrees during daytime hours from 6 a.m. to 11 p.m. At times other than those specified interiors of units of dwelling space shall be maintained at least at 55 degrees F. whenever the outside temperature falls below 40 degrees.
In meeting the aforesaid standards, the owner shall not be responsible for heat loss and the consequent drop in the interior temperature arising out of action by the occupants in leaving windows or doors open to the exterior of the building. The owner shall be obligated to supply required fuel or energy and maintain the heating system in good operating condition so that it can supply heat as required herein notwithstanding any contractual provision seeking to delegate or shift responsibility to the occupant or third person, except that the owner shall not be required to supply fuel or energy for heating purposes to any unit where the occupant thereof agrees in writing to supply heat to his own unit of dwelling space and the said unit is served by its own exclusive heating equipment for which the source of heat can be separately computed and billed.
n. To regulate the practice of midwifery, but the exercise of such authority shall not conflict with the provisions of chapter 10 of Title 45 of the Revised Statutes (R.S.45:10-1 et seq.).
o. To enforce the making of returns or reports to the local board on the part of any person charged with such duty under any law and to take cognizance of any failure to make such returns and deal with the same in an effective manner.
p. To act as the agent for a landlord in the engaging of repairmen and the ordering of any parts necessary to restore to operating condition the furnace, boiler or other equipment essential to the proper heating of any residential unit rented by said landlord, provided, however, that at least 24 hours have elapsed since the tenant has lodged a complaint with the local board of health, prior to which a bona fide attempt has been made by the tenant to notify the landlord of the failure of the heating equipment, and the landlord has failed to take appropriate action, and the outside air temperature is less than 55 degrees F.
Any person who supplies material or services in accordance with this section shall bill the landlord directly and by filing a notice approved by the local board of health, with the county clerk, shall have a lien on the premises where the materials were used or services supplied.
Local boards of health may enact, amend or supplement ordinances to establish, amend or supplement rules and regulations affecting the installation, maintenance, repair and control of the plumbing, ventilation and drainage of buildings and the connection thereof with an outside sewer, cesspool or other receptacle, regulating the practice of plumbing, or dealing with the issuance of licenses to practice plumbing, by reference to such rules and regulations in any such ordinance and without the inclusion of the text thereof therein, if the rules and regulations to be adopted are printed or otherwise reproduced in book form as a code or as a part of a code of such rules and regulations; provided, that a copy of such printed code, so marked as to indicate plainly what portion thereof, if less than the whole, is intended to be adopted, is annexed to such ordinance; that said code or such portion thereof as is intended to be adopted is so described in said ordinance as to identify it and there is indicated in said description the common or trade name, if any, of such code of rules and regulations and that it is stated in the ordinance that three copies of said code, similarly marked, have been placed on file in the office of the municipal clerk, upon the introduction of said ordinance and will remain on file there until final action is taken on said ordinance, for the use and examination of the public.
It shall not be necessary to publish any such rules and regulations, so to be adopted, as part of said ordinance, notwithstanding that a printed copy thereof is annexed thereto, either before or after the final passage of such ordinance; provided, that said printed copies are filed as aforesaid, and, if said ordinance is adopted, the said copies shall remain on file in said office so long as said ordinance is in effect, and three copies shall be placed on file, and shall so remain on file, in the office of the body or department having charge of the enforcement of said ordinance, so long as said ordinance is in effect, for the use and examination of the public.
For the purpose of proof of any such ordinance or the receipt thereof in evidence in all courts and places, such copy of said code, so marked and so annexed to such ordinance, shall be construed to be part of said ordinance as fully as though it had been set forth at length therein.
This act shall be known and may be cited as "The Emergency Fuel Oil Delivery Act."
The governing body of any municipality may provide, by ordinance, that the local health officer or other officer designated in the ordinance shall, whenever necessary to protect the health and safety of residential tenants, act as an agent for a landlord in engaging a fuel oil dealer to deliver fuel oil at a reasonable price per gallon and to refire the burner to restore the proper heating of any residential property rented by said landlord; provided, however, that at least 12 hours have elapsed, if the outside air temperature is between 33 and 55 F., inclusive, or at least 4 hours have elapsed, if the outside air temperature is 32` F. or less, since the tenant has lodged a complaint with any municipal officer or agency, prior to which complaint a bona fide attempt has been made by the tenant or his representative to notify the landlord of the lack of heat, and the landlord has failed to take appropriate action. Lack of heat means maintaining less heat than required by R.S. 26:3-31.
Any fuel oil dealer who delivers fuel oil or refires the burner in accordance with section 2 of this act may bill the landlord directly, or the municipality in which the rental property is located may issue a voucher to the fuel oil dealer who delivered the fuel oil for the money amount due on the fuel oil delivered and the service charge for refiring the burner, if any. The voucher shall be paid in the manner provided for the approval and payment of claims pursuant to N.J.S. 40A:5-17.
In any penalty enforcement proceeding brought pursuant to this act the court shall also order the landlord or his agent to reimburse the municipality for the actual costs incurred for any fuel oil delivered and the service charge for refiring the burner, if any, and for reasonable attorney's fees and costs. The court shall further be empowered to issue any appropriate injunctive orders, and to authorize immediate collection of reimbursable costs due the municipality out of the goods and chattels of the landlord, including all sums due, or which may come due, as present or future rents. Any landlord who prevails in such an action shall be entitled to reimbursement by the municipality for all reasonable costs and expenses. Such landlord, however, shall still remain responsible for the cost of any fuel oil delivered and any charge for refiring the burner incurred by the municipality.
No municipality or its employees shall be liable for any damages to any person or property in enforcing this act except for the gross negligence or malfeasance of any municipal official, officer or employee, and under no circumstances shall a municipality be held liable for damages from the lack of heat in the residential property.
The provisions of this act shall not apply to owner-occupied residential rental properties containing five units or less.
Local boards of health in cities having a population of more than 80,000 inhabitants may grant and regulate licenses and permits incident to health matters and charge a reasonable fee for any such license or permit, but this provision shall not apply to any fee otherwise specifically provided for.
Local boards of health may within their respective jurisdictions:
a. Secure the sanitary condition of every building, public or private.
b. Compel, prescribe, regulate and control the plumbing, ventilation and drainage of every building, public or private, and the connection thereof with an outside sewer, cesspool or other receptacle;
c. Require plans of such plumbing, ventilation or drainage, with necessary drawings or descriptions, to be submitted to it for its inspection and approval, and may charge a fee not exceeding two dollars ($2.00), to be paid by the owner or other person filing the plans at the time of filing; and
d. Require every master and foreman plumber and every building contractor to register his name and address at the office of the board.
The local board of health in any municipality, except townships other than densely populated townships having a public water supply, may delegate by resolution any of its powers to any member of the board or to any officer thereof, to be exercised only when the board is not in session. Notice by any member or officer of the board shall be notice by the board, and the person served therewith shall be bound thereby.
The local board of health, on or before the fifteenth day of February in each year, in addition to other reports required, shall prepare and file with the director an annual report for the preceding calendar year. Such report shall state the condition of the public health within the limits of its jurisdiction, noting therein any special cause for the deterioration of health or of hazard thereto, and shall contain answers to any questions which may have been addressed to the local board by the director.
The person performing the clerical work necessary in the preparation of the annual report required by section 26:3-35 of this title, upon receiving a certificate from the director of health that such annual report has been duly prepared and received by the director at the time required, shall be entitled to receive from the proper disbursing officer of the municipality for which the report is made the sum of two dollars for such clerical services.
The body having charge of the finances of any city of the first class may by resolution, approved by the mayor, appropriate and set aside annually to the credit of the board having charge of the public health in the city a sum of money, not exceeding ten thousand dollars, to be used by such board for the establishment and maintenance of medical dispensaries for the free distribution of medicines among the poor of such city. The money so appropriated shall be annually levied and collected in the same manner as other taxes are levied and collected in the city.
The local board having charge of the public health in any city of the first class, provided the body having charge of the finances in such city shall appropriate the necessary moneys:
a. Shall establish, in suitable locations in the city, dispensaries for the free distribution of medicines among the poor, and for that purpose shall procure suitable quarters where medicines and medical attendance can be given to the poor of the city;
b. May appoint for that purpose necessary officers or employees and fix their salaries and terms of office; and
c. May provide medicines and medical attendance, and, in general, supervise and direct the affairs of such dispensaries.
The expense incurred under the provisions of this section shall not exceed ten thousand dollars in any one year.
The local board having charge of such dispensary shall annually make report of its transactions and accounts, and of the state and condition of the dispensary, to the body having charge of the finances of the city.
The local board having charge of the public health in any city of the first class may appoint and designate nurses, who shall be regularly graduated from a recognized training school of nurses, to act as nurses in such dispensary and to render such services as may be required of them in attendance upon the sick poor of such city.
The salaries of such nurses shall be fixed by the local board, but in no event shall exceed the sum of seventy-five dollars per month and shall be chargeable to the appropriation providing for such dispensary.
The local board of health of each township shall each year, before the budget of municipal taxes to be levied for the year shall be determined, present to the governing body of the municipality, an estimate of the appropriation which it believes necessary for health purposes. The governing body shall appropriate the amount of such estimate or such other amount as it may determine.
Every expenditure of money shall be presented by an itemized bill, approved by the president and secretary of the local board, to the usual disbursing officer of the township who shall pay the same.
The local board of health of every municipality other than a township, shall each year, before the budget of municipal taxes to be levied for the year shall be determined, present to the governing body of the municipality, an estimate of the appropriation which it believes necessary for health purposes. The governing body shall appropriate the amount of such estimate or such other amount as it may determine.
Whenever an epidemic of any contagious or infectious disease exists or is threatened, or any special need arises for the protection of the public health, and in the judgment of the local board of health of any municipality the expenditure of a greater sum than that already appropriated to the local board for the current year is necessary, the local board shall so certify to the body having control of the finances of the municipality. Thereupon the body having control of the finances of such municipality may appropriate such sum as the local board may certify to be necessary. If the funds at the disposal of the governing body of the municipality are not sufficient for such purpose, it may borrow the sum on the credit of the municipality. In such event the governing body shall place an amount equal to the sum borrowed with interest in the next annual tax levy, and with the money so raised shall pay the debt incurred.
The local board may pass, alter or amend ordinances and make rules and regulations to declare and define what shall constitute a nuisance in lots, streets, docks, wharves, vessels and piers, and all public or private places within its jurisdiction.
The local board, within its jurisdiction, shall examine into and prohibit any nuisance, offensive matter, foul or noxious odors, gases or vapors, water in which mosquito larvae breed, and all causes of disease which may be known to the board or brought to its attention, which, in its opinion, are injurious to the health of the inhabitants therein, and shall cause the same to be removed and abated at the expense of the owner.
The power given to the local board to remove and abate nuisances, sources of foulness, or causes of sickness hazardous to the public health, shall not depend upon whether the board has exercised its power to pass, alter, or amend ordinances in relation to the public health.
Whenever a nuisance, noxious odors, gases or vapors, water in which mosquito larvae breed, or cause of ill health or disease is found on public property or on a highway, notice shall be given by the local board to the person officially in charge thereof to remove and abate the same within such time as the board may specify. If he fails to comply with the notice, the mode of procedure shall be the same as is hereinafter provided in case of a like condition existing on private property.
Whenever any nuisance, noxious gases or vapors, water in which mosquito larvae breed, or cause of ill health or disease is found on private property, the local board shall notify the owner to remove and abate the same, at his own expense, within such time as the board may specify. A duplicate of the notice shall be left with one or more of the tenants or occupants.
If the owner resides out of the state or cannot be so notified speedily, a notice left at the house or premises with the tenant or occupant, or posted on the premises, shall suffice.
If the owner when notified, as provided in section 26:3-49 of this title, shall not comply with the notice or order of the local board within the time specified, the board shall proceed to abate the nuisance and remove the cause of such foul or noxious odors, gases or vapors, water in which mosquito larvae breed, or other thing detrimental to the public health.
No injunction shall issue out of any of the courts of this state to stay, stop, or enjoin proceedings, or to prevent any local board from proceeding with the removal and abatement of any alleged nuisance, source of foulness, or cause of sickness, hazardous to the public health, until the board has been duly notified to appear and be present at the hearing of the application, and has had an opportunity to be heard thereon.
No suit shall be maintained in any of the courts of this state to recover damages against any local board, its officers or agents, on proceedings instituted to remove and abate such nuisances and cause of disease, unless it shall be shown in the suit that the alleged nuisance and cause of disease did not exist, or was not hazardous and prejudicial to the public health, and unless it be shown that the board acted without reasonable and probable cause to believe that such nuisance did exist and that such foul or noxious odors, gases, vapors or other cause was in fact prejudicial and hazardous to the public health.
A notice by any health officer or registered environmental health specialist to remove and abate any nuisance shall be taken as a notice from the board. If the owner or persons notified fails to remove and abate the nuisance complained of, the board may cause it to be removed and abated in a summary manner, giving written directions to its representative in relation thereto, and he shall proceed according to the directions so given.
The local board may recover, by a civil action, the expenses incurred in such removal and abatement from any person who shall have caused or allowed such nuisance, source of foulness, water in which mosquito larvae breed, or cause of sickness, hazardous to the public health to exist, or from any owner, tenant, or occupant of premises who, after notice as herein provided, shall fail to remove and abate the same within the time specified in the notice.
In case the local board fails to recover an amount sufficient to defray such expenses or shall deem it inexpedient to bring action, it may present a bill, certified by the board, or by a majority thereof, for such expenses or for such part thereof as may not have been recovered, to the proper disbursing officer of the municipality, and it shall be audited and paid by the municipality in and for which the local board is organized, in the same manner as the bills for the ordinary current expenses of the municipality are paid.
The local board, instead of proceeding in a summary way to abate a nuisance hazardous to the public health, may institute an action in the Superior Court, in the name of the State, on relation of the board, for injunctive relief to prohibit the continuance of such nuisance.
The court may charge the costs of the action upon the property whereon the nuisance is found, and enforce the payment of the same by sale of the property, or any part of it; or the court may order the person who caused the nuisance, or allowed it to continue, to pay the costs.
In case no such nuisance shall be found to exist, costs shall be awarded against the local board which caused the action to be brought, but only in case it shall appear to the court that no probable cause existed for bringing the action.
The Superior Court or any municipal court may issue a warrant to search for any nuisance affecting health. Such warrant may be issued according to the practice of the court, upon the information and belief of any officer or agent of the State Department of Health, or of any local board of health that there is in any dwelling house, store, stable or any building of any kind whatsoever any nuisance affecting health or any person sick of any contagious or infectious disease, or any condition of contagion or infection which may have been caused by anyone recently sick of any such disease in any such dwelling house or other place. The warrant shall be directed to the sheriff of the county within which the search is to be made, or to any marshal, police officer, or officer or agent of the local board having jurisdiction within the place where such search is to be made.
A warrant as described in section 26:3-59 of this title shall direct the officer to search in such dwelling house, store, stable, or other building for such nuisance affecting health, or for any person affected with any contagious or infectious disease, or for any condition of contagion or infection which may have been caused by anyone recently sick of any such disease in such dwelling house or other place.
If a nuisance is found, the officer shall remove and abate it; and if a person affected with a contagious or infectious disease is found, the officer shall deal with him according to law, and the ordinances of the local board; and if a condition of contagion or infection is found to exist, the officer shall destroy the same by means of proper disinfection.
The officer to whom the search warrant shall be directed shall make return of his proceedings thereunder to the court issuing the warrant.
The sheriff of the county and any marshal or police officer of any county or municipality shall, if required by any officer to whom the search warrant may be directed, be present and assist in the execution of the warrant.
The local board of health may enact and amend health ordinances, and make and alter necessary rules and regulations in the execution of any power delegated to it or in the performance of any duty imposed upon it by law, subject to the limitations specified in section 26:2-28 of this title. An ordinance or rule of the local board shall be in force only within the jurisdiction of the board which enacts it.
In the enactment of health ordinances the local board may adopt the ordinances either in the form of a code or each ordinance may be separate and apart by itself.
No health ordinance or code shall be finally adopted unless it shall have been:
a. Given a first reading, which first reading may be by title, at a meeting held at least one week prior to final passage;
b. Published, in summary form, in a newspaper published and circulating in the municipality or county for which the local board is organized, and in the case of a municipal board of health, if there be no such newspaper, then in at least one newspaper published and circulating in the county in which the municipality is located, at least two days prior to final passage.
The publication shall contain a notice stating the time and place when and where the local board will consider the final passage of the proposed ordinance or code;
c. Posted on the bulletin board or other place upon which public notices are customarily posted in the building where the local board regularly meets prior to the meeting for final consideration. Copies of the ordinance or code shall be made available to members of the general public of the county upon request; and
d. Upon the opening of the meeting for final consideration of the ordinance or code, given a second reading, which reading may be by title. Thereafter, the ordinance may be passed with or without amendments, or rejected.
Before any health ordinance or code shall take effect, a summary of the ordinance or code, or its title, shall be published at least once in a newspaper published and circulating as prescribed in section 26:3-66 of this title.
The local board may amend or repeal any provision of a health ordinance or code, such amendment to be passed and amended in the manner prescribed in sections 26:3-66 and 26:3-67 of this title for the enactment of an original ordinance or code.
Every health ordinance, code, amendment, or repealer shall take effect in thirty days after the date of the first publication.
As used in this act, unless the context otherwise requires:
(1) "Local board of health" shall mean a county or municipal board of health, or the board of health of any regional local or special health district, having power to regulate, by ordinance, public health or sanitation.
(2) "Code" means printed code regulations or set of regulations, standards or set of standards concerning, affecting or relating to the subject matter of any such ordinance of substantially uniform character, approved by the State Department of Health.
(3) "Related document" means any printed document or part thereof adopted by reference in a code directly, or by successive adoptions by reference through other printed documents.
(4) "Printed" includes lithographing and any other method of duplicating.
Any local board of health may enact, amend or supplement ordinances establishing, amending or supplementing a code or any parts thereof by reference to such code in any such ordinance and without inclusion of the text thereof in such ordinance if the code to be adopted and any related documents are printed in book form and a copy of such printed code and related documents so marked as to indicate plainly what portion thereof, if less than the whole, is intended to be adopted, is annexed to such ordinance and if such code and related documents or such portion thereof as is intended to be adopted is so described in said ordinance as to identify them and there is indicated in said description the common or trade name, if any, of such code and related documents and it is stated in the ordinance that three copies of said code and said related documents, similarly marked, have been placed on file in the office of the secretary, clerk or other similar officer of said local board of health, upon the introduction of said ordinance and will remain on file there until final action is taken on said ordinance, for the use and examination of the public.
It shall not be necessary to publish any such code or related documents, so to be adopted, as part of any such ordinance notwithstanding that printed copies thereof are annexed thereto, either before or after the final passage of such ordinance, if said printed copies are filed as aforesaid.
In event that any such ordinance is adopted, the said copies of said code and related documents shall remain on file in said office, so long as said ordinance is in effect, and three copies shall be placed on file and shall remain on file in the office of any board, body or officer having in charge the enforcement of said ordinance, for the use and examination of the public so long as said ordinance is in effect and printed copies of said ordinance and said code and related documents shall be made available to citizens on request and for which a nominal fee may be charged.
For the purpose of proof of any such ordinance or receipt thereof in evidence in all courts and places, such copy of such code and related documents, so marked and annexed to such ordinance, shall be construed to be part of said ordinance, as fully as though it had been set forth at length therein.
This act may be cited as the Public Health and Sanitation Codes Adoption by Reference Act.
The local board may prescribe a penalty for the violation of any provision of a health ordinance or code. Such penalty shall not be more than $500.00 nor less than $5.00.
The minimum penalty permissible as prescribed by section 1 of this act, shall remain at $2.00 for those health ordinances adopted prior to the effective date of this act.
The penalty for the violation of a provision of a health ordinance or code need not be for a specific amount, but the local board may provide that the penalty shall not be less than one given sum nor greater than another given sum. The amount of the penalty between the maximum and minimum inclusive shall be left to the discretion of the court.
Every municipal court shall have jurisdiction over proceedings to enforce and collect any penalty imposed because of a violation of any provision of a health ordinance or code of a local board, if the violation occurs within the territorial jurisdiction of the court. The proceedings shall be summary and in accordance with the Penalty Enforcement Law (N.J.S. 2A:58-1 et seq.); process shall issue at the suit of such local board and shall be either in the nature of a summons or warrant.
A copy of the health ordinance or section of the code alleged to have been violated, certified to under the hand of the clerk or president of the local board, and under the seal of such board, if it has a seal, shall be taken as full and legal proof of the existence of such ordinance or code, and that all requirements of law in relation to the ordaining, publishing and making of the same, so as to make the same legal and binding, have been complied with, unless the contrary be shown.
The court may cause a defendant who refuses or neglects to pay the amount of a judgment rendered against him and all costs and charges incident thereto, to be committed to the county jail for a period not exceeding ninety days.
In case a defendant shall have been twice convicted, within the space of six months, of the violation of the same health ordinance or code and due proof of such fact is made, the court may, in addition to the imposition of the penalty prescribed by section 26:3-70 of this Title, cause the defendant to be imprisoned in the county jail or county workhouse, with or without hard labor, for any number of days not exceeding one for each dollar of the penalty.
All penalties recovered in any prosecution for a violation of a health ordinance or code of a local board shall be paid by the local board into the treasury of the municipality within which the local board has jurisdiction.
The term "municipality," when used in this act, shall mean any township or incorporated municipality in New Jersey. The term "board of health," when used in this act shall mean the board of health in any municipality or township organized under the provisions of Title 26, chapter three, article one, Revised Statutes or other body having the powers of a board of health.
Boards of health of 2 or more municipalities are hereby authorized to form an association to furnish such boards with public health services. Any board of health which desires to participate in such an association shall express its intention so to do by resolution. An association formed under the provisions of this act shall be known as a "regional health commission." Municipalities associating together to form a regional health commission may not withdraw therefrom for a period of 2 years after such municipality shall have joined such association.
A regional health commission shall consist of two members from each board of health participating therein except that when more than seven boards of health participate, the commission shall consist of one member, or a designated representative, from each board. When an independent local board of health is in place, the members or representatives to serve on a regional commission shall be appointed by the board of health. In municipalities having no independent local board of health, members of regional health commissions shall be appointed by the local governing body. Members shall serve on regional health commissions at the pleasure of the appointing authority.
b. The regional health commission shall maintain an Internet website. The purpose of the website shall be to provide increased public access to the regional health commission's operations and activities. The following information shall be posted, if applicable, on the regional health commission's website:
(1) a description of the regional health commission's mission and responsibilities;
(2) the budget once adopted for the current and immediately prior fiscal years. Commencing with the fiscal year next following the effective date of P.L.2011, c.167 (C.4:24-20.1 et al.), the budgets of at least three consecutive fiscal years shall be available on the website;
(3) the most recent Comprehensive Annual Financial Report or other similar financial information;
(4) the annual audit for the most recent and immediately prior fiscal years. Commencing with the fiscal year next following the effective date of P.L.2011, c.167 (C.4:24-20.1 et al.), the annual audits of at least three consecutive fiscal years shall be available on the website;
(5) the regional health commission's rules, regulations, and official policy statements deemed relevant by the commissioners to the interests of the residents within the jurisdiction of the commission;
(6) notice, posted pursuant to the "Senator Byron M. Baer Open Public Meetings Act," P.L.1975, c.231 (C.10:4-6 et seq.), of a meeting of the commission, setting forth the time, date, location, and agenda of the meeting;
(7) the minutes of each meeting of the commission's board including all resolutions of the board and its committees for the current fiscal year. Commencing with the fiscal year next following the effective date of P.L.2011, c.167 (C.4:24-20.1 et al.), the approved minutes of meetings for at least three consecutive fiscal years shall be available on the website;
(8) the name, mailing address, electronic mail address, if available, and phone number of every person who exercises day-to-day supervision or management over some or all of the operations of the regional health commission; and
(9) a list of attorneys, advisors, consultants, and any other person, firm, business, partnership, corporation, or other organization which received any remuneration of $17,500 or more during the preceding fiscal year for any service whatsoever rendered to the regional health commission.
A regional health commission shall have authority to receive funds from any source and expend such funds to furnish public health services to each board of health participating therein. The treasurer of a regional health commission shall be required to furnish bond in such amount and in such form as shall be approved by said commission. Said treasurer is authorized to pay from funds received by him for the use of the regional health commission bills approved by such commission. The treasurer of any municipality, the board of health of which participates in a regional health commission, is authorized to pay to the treasurer of the regional health commission such sum available for the use of the local board of health as may be approved by such board.
A regional health commission may employ a health officer, as hereinafter provided, to serve in part or all of the area in which it is rendering service who shall devote his full time to the duties of his office, and such inspectors, nurses, clerks and other employees, as may be necessary to perform the services it is authorized and has agreed to render. It shall fix the terms of office and the salaries of its employees.
A regional health commission shall be subject to the same restrictions in the appointment of employees as apply to a local board of health under the provisions of section 26:3-20 of the Revised Statutes.
Before any person employed by a regional health commission shall act as an agent of a local board of health in any municipality, he shall be so appointed by such board.
Nothing in this act shall be construed to prohibit a board of health participating in a regional health commission from retaining persons already in its employ, but the work of such persons, insofar as it relates to matters over which the health officer furnished by the regional health commission has supervision in the municipality, shall thereafter be directed by such health officer.
Each regional health commission shall have jurisdiction in matters of public health within the geographic area of the participating municipalities. It shall succeed to all powers and perform all the duties conferred and imposed upon the municipal boards of health which it shall have superseded and, in addition, shall have all the powers and perform all the duties within the geographic area of the participating municipalities which by law are conferred and imposed upon any township, city or other local board of health in this State.
The ordinances of each local board of health of each municipality participating in any regional health commission, shall remain in effect within the geographic area of such municipality, until altered or repealed by the regional health commission. Such ordinances may be enforced by and in the name of the regional health commission by proceedings instituted and prosecuted in any court having jurisdiction of such proceedings in such municipality. Ordinances of the regional health commission may be enforced by and in the name of the regional health commission by proceedings instituted and prosecuted in a court having jurisdiction of such proceeding in the region.
No regional health commission shall appoint any person as health officer, public health laboratory technician, sanitary inspector, veterinary meat inspector or plumbing inspector nor employ a person to do work ordinarily performed by a health officer, public health laboratory technician or an inspector of any of the classes named who is not the holder of a current license issued by the State Department of Health for the performance of such type and class of work. Each person who shall have been employed as a full-time employee of a local board of health or district health board, whose employment by such agency was governed by the provisions of the Civil Service law, and whose employment by such agency shall have been terminated by reason of the assumption of its activities and responsibilities by a regional health commission, shall be transferred to the regional health commission, shall be assigned duties comparable to those previously performed by him, and shall be entitled to and credited with all rights and privileges accruing to him by reason of his tenure in such previous office or position, the same as if the entire period of such previous employment had been in the position to which he shall have been transferred. His compensation shall be fixed by the board at not less than the amount received by him during the fiscal year preceding the date he shall have been transferred to the regional health commission. Each person who shall have been employed as a full-time employee, for a period of 2 years or more, of a local board of health or a district health board, whose employment by such agency was not governed by the provisions of the Civil Service law, and whose employment by such agency shall have been terminated by reason of the assumption of its activities and responsibilities by a regional health commission, shall be transferred to the regional health commission, shall be assigned duties comparable to those previously performed by him and shall be entitled to and credited with all rights and privileges accruing to him by reason of his tenure in such previous office or position, the same as if the entire period of such previous employment had been in the position to which he shall have been transferred. His compensation shall be fixed by the board at not less than the amount received by him during the fiscal year preceding the date he shall have been transferred to the regional health commission. In the event employment by the regional health commission to which a person is transferred pursuant to this act is governed by the provisions of the Civil Service law, the regional health commission shall certify to the Civil Service Commission the entitlement of such person to those rights and privileges to which he shall be entitled and which he shall be credited pursuant to this act. In such event, the Civil Service Commission shall appropriately classify such person in the competitive civil service without examination; such person shall thereafter be subject to all the provisions of the Civil Service law with regard to the terms of his employment, promotion, tenure, classification, compensation and like matters. Every person who shall have been employed as a part-time employee of a local board of health, for a period of 2 years or more and whose employment by such agency shall have been terminated by reason of the assumption of its activities and responsibilities by a regional health commission, shall be placed on a preferential re-employment list for a period of at least 2 years for positions in the regional health commission requiring the same licensure and type and class of work.
L.1970, c. 60, s. 6.
26:3A2-1. Short title
This act may be known and may be cited as the "Local Health Services Act."
L.1975, c. 329, s. 1, eff. April 1, 1976.
26:3A2-2. Policy
The Legislature declares that the policy of this State is to assure the provision of a modern and manageable array of public health services to all citizens of the State and to encourage the efficient delivery of such services by areawide health departments where such arrangements are needed to enable municipalities to meet "Standards of Performance" as determined by the Public Health Council.
L.1975, c. 329, s. 2, eff. April 1, 1976.
26:3A2-3. Definitions
a. "Local health agency" means any county, regional, municipal or other governmental agency organized for the purpose of providing health services, administered by a full-time health officer and conducting a public health program pursuant to law.
b. "County health department" means an agency established and organized pursuant to this act by a county board of health for the purpose of providing within its area of jurisdiction, health services required for the protection of the health of citizens and for the enforcement of health ordinances and statutes.
c. "County board of health" means a body established pursuant to this act by a county board of freeholders, and empowered to exercise within its area of jurisdiction all the powers of a local board of health pursuant to law.
d. "County health advisory commission" or "commission" means the body established by a county board of health pursuant to this act to advise the county health department regarding health problems and measures required to improve health and to control disease and disability in the county.
e. "Regional health commission" means an association of boards of health of two or more municipalities formed to furnish such boards with public health services pursuant to P.L.1938, c.67 (C.26:3-83 to 26:3-94).
f. "Contracting health agency" means a municipality or group of municipalities which enter into contractual agreements with approved health agencies or health agencies pending approval for the provision of public health services.
g. "Full-time health officer" means a holder of a license as a health officer issued by the State Department of Health to an individual who is a full-time employee of a local health agency or of any unit of government participating in a certified program.
h. "Area of jurisdiction" means the geographic area within each of the municipalities which contracts with a county board of health for the provision of health services meeting the "Standards of Performance".
i. "Standards of Performance" means the "Recognized Public Health Activities and Minimum Standards of Performance for Local Boards of Health in New Jersey" as prescribed by the Public Health Council of the New Jersey State Department of Health under the authority of P.L.1947, c.177 (C.26:1A-1 et seq.).
j. "Commissioner" means the State Commissioner of Health or his designee.
L.1975,c.329,s.3; amended 1993,c.64,s.1.
26:3A2-4. County board of health; establishment; procedure; counties with health agencies
a. The board of chosen freeholders of any county in this State, on its own initiative, after public hearing may, by ordinance or resolution, establish a county board of health. Notice of the public hearing shall be published at least 15 days prior to that hearing in a newspaper circulated throughout the county.
b. In any county in which the board of chosen freeholders has established a county health agency there may be established a county board of health, pursuant to this act. Said existing county health agency shall be continued as a county health department, as provided herein. In any county having a board of health and vital statistics, organized pursuant to chapter 11 of Title 26 of the Revised Statutes, that board shall be continued as a county board of health as provided herein.
L.1975, c. 329, s. 4, eff. April 1, 1976. Amended by L.1977, c. 258, s. 1, eff. Oct. 12, 1977; L.1977, c. 443, s. 4, eff. March 2, 1978.
26:3A2-5. Members; qualifications; term of office; meetings; powers
a. A county board of health shall consist of not less than five nor more than nine members appointed by the board of chosen freeholders. No more than two members of a county board of health may be members of the board of chosen freeholders. Members other than freeholders shall be selected, with due regard to their knowledge, interest in health affairs, from participating municipalities so that each of the participating municipalities, where possible, shall have at least one member on the county board of health.
b. Each member of a county board of health shall be appointed for a term of 3 years; provided, however, that of those first appointed at least two shall have terms of 1 year, at least two shall have terms of 2 years and the remaining members shall have terms of 3 years; provided that where the board consists of nine members appointments shall be made so that at least three terms shall expire each year. All appointments shall designate the date of expiration of the term. The term of office of a freeholder member shall terminate with his term of office as freeholder should this date precede the termination of his appointment to the board of health and a freeholder designated as a successor in such case shall be appointed for the unexpired term.
c. The county board of health shall meet not less than bimonthly and shall exercise within its area of jurisdiction all the powers granted to a local board of health.
L.1975, c. 329, s. 5, eff. April 1, 1976.
26:3A2-6. County health department; establishment; report by county board in counties without department; public hearing; submission to commissioners
a. The county board of health shall establish a county health department, under the administration of a full-time health officer, which provides public health activities meeting "Standards of Performance."
b. The board of chosen freeholders of any county in this State may establish a county health department.
c. In any county in which a county health department has not been established pursuant to subsections a. or b. hereof, the county board of freeholders shall prepare within 90 days of the effective date of this act, a detailed report indicating the manner in which health services meeting the standards of performance and the standards promulgated pursuant to section 10 hereof shall be provided for the territorial area of the county. Such report shall include a description of the administrative organization for providing the environmental health services and such other information as may be required by the Commissioner of Environmental Protection. Within 30 days following the completion of the report, the board of chosen freeholders shall conduct a public hearing to receive public comment concerning the contents of the report. Notice of the public hearing shall be published at least 15 days prior to that hearing in a newspaper circulated throughout the county. Within 30 days following the completion of the public hearing the board of chosen freeholders shall give due consideration to the comments presented at the public hearing and shall revise the report accordingly. A copy of the revised report shall be submitted to the Commissioners of Environmental Protection and of Health.
L.1975, c. 329, s. 6, eff. April 1, 1976. Amended by L.1977, c. 443, s. 5, eff. March 2, 1978.
26:3A2-7. County health advisory commission
The county board of health may establish a county health advisory commission and may appoint not less than nine nor more than 15 citizens to serve as members of that commission, each of whom shall be chosen with due regard to his knowledge or interest in health affairs. The commission shall include not less than three consumers of health services who are engaged in the delivery of those services.
b. Each member of the advisory commission shall be appointed for a term of 3 years; provided, however, that of those first appointed at least 1/3 (or the closest number thereto) shall have terms of 1 year, at least 1/3 shall have terms of 2 years and the remaining members shall have terms of 3 years. All appointments shall designate the date of expiration of the term.
c. The commission shall meet at least four times a year.
L.1975, c. 329, s. 7, eff. April 1, 1976.
26:3A2-8. Health ordinances; adoption; enforcement
The county board of health shall, in order to perform any power delegated to it or in the performance of any duty imposed upon it by law, adopt, amend and repeal health ordinances and provide services necessary for the appropriate control of disease and the improvement of the health of citizens. An ordinance of the county board shall be effective and enforceable only within the area of jurisdiction of the county board.
L.1975, c. 329, s. 8, eff. April 1, 1976.
26:3A2-9. Health ordinances; laws applicable to enactment and enforcement
A county board of health shall enact and enforce health ordinances in the manner prescribed by articles 4 and 5, of chapter 3 of Title 26 of the Revised Statutes (R.S. 26:3-64 through 26:3-82).
L.1975, c. 329, s. 9, eff. April 1, 1976.
26:3A2-10. Standards of performance; compliance by municipality; evaluation; certification; review by commissioner
a. Within 3 months after the Public Health Council has completed its first revision of the "Standards of Performance" pursuant to section 13 of this act, the commissioner shall provide an evaluation form to every municipal board of health for the purpose of measuring said municipal boards' compliance with said "Standards of Performance." Said evaluation form shall be completed; signed and certified as being correctly completed by the municipal health officer or by the officer designated to act in behalf of the municipal board of health and by the presiding officer of said board; and returned to the commissioner by every municipality within 60 days after issuance.
b. Within 18 months after the effective date of this act, the commissioner shall advise every municipal board of health as to whether said board meets the "Standards of Performance."
c. In every municipality not presently providing a program of public health services meeting the "Standards of Performance," as determined herein by the commissioner, the elected governing body shall, within 24 months after the effective date of this act, provide a program of public health services meeting "Standards of Performance." A municipality shall meet this requirement by use of the services of one or more of the following agencies:
(1) Individual municipal local health agency.
(2) Contracting health agency.
(3) Regional health commission.
(4) County health department.
d. The commissioner shall periodically review every municipal or county health department to determine whether said municipal or county department is meeting the "Standards of Performance."
e. This section shall not apply to services provided by volunteer first aid, rescue and ambulance squads as defined in the "New Jersey Highway Safety Act of 1971," P.L.1971, c. 351 (C. 26:5F-1 et seq.).
L.1975, c. 329, s. 10, eff. April 1, 1976. Amended by L.1979, c. 73, s. 1, eff. April 10, 1979.
26:3A2-11. Failure of municipality to comply; provision of adequate program by state; reinstatement of authority of municipality
a. In the event any municipality fails to comply with section 10 of this act:
(1) The State Commissioner of Health shall cause a public health services program meeting "Standards of Performance," to be provided in that municipality at the expense of the municipality. Expenditures for this purpose shall be adequate to provide by contract or direct employment of staff and other necessary resources, the services required in the "Standards of Performance." The staff, contracted services, or resources necessary to provide the required services in municipalities of various sizes and conditions shall be determined by the commissioner.
(2) State health aid funds to which that municipality would otherwise be entitled shall be delivered to and administered by the State Department of Health. Those funds shall be used solely for providing public health services meeting "Standards of Performance" in that municipality.
b. When a municipality submits a plan acceptable to the department which provides assurances that public health services in that municipality will meet "Standards of Performance" the department may relinquish powers granted to it under the authority of this section under such terms and conditions as may be prescribed by the department.
L.1975, c. 329, s. 11, eff. April 1, 1976.
26:3A2-12. Municipality participating in local or contracting health agency; withdrawal
a. A municipality participating in a local health agency or contracting health agency may withdraw therefrom in the following manner:
The governing body or local board of health, whichever is applicable, after participation for not less than 2 years in a local health agency or contracting health agency may by resolution declare its intention to establish its own local health agency or join with one or more municipalities in establishing a local health agency meeting "Standards of Performance." A certified copy of that resolution, setting forth the date of the municipality's intention to withdraw, shall be submitted to the agency from which it proposes to withdraw a minimum of 6 months prior to the proposed withdrawal date. The withdrawal shall be effective on the date set forth in that resolution.
b. In the event that the requirements of section 10 of this act are not met within 6 months after the time of withdrawal, the municipality shall be subject to the provisions of section 11 of this act.
L.1975, c. 329, s. 12, eff. April 1, 1976.
26:3A2-13. Standards of performance; review and revision by public health council
Within 6 months after the effective date of this act, the Public Health Council shall review and revise the present "Standards of Performance," and provide new "Standards of Performance," which shall include (1) core standards applicable to every local health agency, and (2) supplemental standards applicable to individual local health agencies which reflect specific public health needs of such local agencies. Said council shall periodically conduct a review and revision of the "Standards of Performance" as may be necessary thereafter.
L.1975, c. 329, s. 13, eff. April 1, 1976.
26:3A2-14. Appointment of health officer, other personnel
L.1975,c.329,s.14; amended 1993,c.64,s.2.
26:3A2-14.1. Public health nurse in provisional status for more than 2 years; eligibility to compete for position
Any other law, rule or regulation relating to the qualifications required for appointment to any permanent position in accordance with the provisions of Title 11 (Civil Service) of the Revised Statutes to the contrary notwithstanding, any employee of a local health agency, created pursuant to the act to which this act is a supplement, who has served in a provisional status for more than 2 years as a public health nurse and is holding such position on the effective date of this act shall be eligible to compete in appropriate examination for this position in accordance with the provisions of Title 11, Civil Service.
L.1981, c. 309, s. 1, eff. Dec. 3, 1981.
26:3A2-15. Necessity of license by employee with certain type and class of work
No local health agency shall appoint or employ any person as health officer, public health laboratory technician, sanitary inspector, veterinary meat inspector or plumbing inspector nor appoint or employ any person to do work ordinarily performed by a health officer, public health laboratory technician or an inspector of any of the classes named who is not the holder of a current license or certificate issued by the State Department of Health authorizing the performance of such type and class of work.
L.1975, c. 329, s. 15, eff. April 1, 1976.
26:3A2-16. Transfer of civil service employees of terminated local health agency to superseding agency
Each person who shall have been employed as a full-time employee of a local health agency whose employment by such agency was governed by the provisions of the Civil Service law and whose employment by such agency shall have been terminated by reason of the assumption of its activities and responsibilities by another local health agency shall be transferred to such other local agency, shall be assigned duties comparable to those previously performed by him, and shall be entitled to and credited with all rights and privileges accruing to him by reason of his tenure in such previous office or position, the same as if the entire period of such previous employment had been in the position to which he shall have been transferred. His compensation shall be fixed at not less than the amount received by him at the time of transfer.
L.1975, c. 329, s. 16, eff. April 1, 1976.
26:3A2-17. Transfer of non-civil service employees of terminated local health agency to superseding agency
Each person who shall have been employed as a full-time employee for a period of 2 years or more by a local health agency whose employment by such agency was not governed by the provisions of the Civil Service law, and whose employment by such agency shall have been terminated by reason of the assumption of its activities and responsibilities by another local health agency, shall be transferred to the local health agency and be assigned duties comparable to those previously performed by him. He shall be entitled to and credited with all rights and privileges accruing to him by reason of his tenure in such previous office or position the same as if the entire period of such employment had been in the position to which he shall have been transferred. In the event employment by the county health department to which such person shall have been transferred is subject to the provisions of the Civil Service law, the board shall forthwith certify to the Civil Service Commission, pursuant to applicable rules of said commission, the entitlement of such person to such rights and privileges. In such event, the Civil Service Commission shall appropriately classify such person in the competitive civil service without examination; a person so classified shall thereafter be subject to the provisions of the Civil Service law with regard to the terms of his employment, promotion, tenure, classification, compensation and like matters. His compensation shall be fixed at not less than the amount received by him at the time of transfer.
L.1975, c. 329, s. 17, eff. April 1, 1976.
26:3A2-18. Terminated part-time employee; placement on preferential reemployment list
Every person, who shall have been employed as a part-time employee of a local board of health for a period of 2 years or more, and whose employment by such agency shall be terminated by reason of the assumption by another local health agency of activities and responsibilities, shall be placed on a preferential reemployment list for a period of at least 2 years for positions in that local health agency requiring the same license and type and class of work.
L.1975, c. 329, s. 18, eff. April 1, 1976.
26:3A2-19. Annual budget; certification by board of chosen freeholders; apportionment to municipalities; assessment, levy and collection of tax
The county health officer shall prepare, subject to the advice of the county board of health, in each year, a budget setting forth in detail the amounts of money necessary for the operation of the county health department during the ensuing year and present that budget to the board of chosen freeholders. Such sum as approved by the board of chosen freeholders shall be certified by the board of chosen freeholders to the county board of taxation which shall apportion such amount among the municipalities participating in the county health department in accordance with the provision of R.S. 54:4-49. The amount thus apportioned to each municipality shall be assessed, levied and collected in the same manner and at the same time as other county taxes are assessed, levied and collected therein.
L.1975, c. 329, s. 19, eff. April 1, 1976.
26:3A2-20. Review by legislature; progress reports by commissioner
The Legislature, through the Senate and General Assembly Standing Committees on Institutions, Health and Welfare, shall review the implementation of this act. To facilitate this review, the commissioner shall submit annual progress reports to the committees for a period of 2 years after the effective date of this act, and any other such reports thereafter as may be deemed necessary by the committees. All such reports shall also be submitted to the Legislature's Office of Fiscal Affairs.
L.1975, c. 329, s. 20, eff. April 1, 1976.
26:3A2-20.1 Sale of tobacco to persons under age 21, prohibition, enforcement; reports.
b. The Department of the Treasury shall provide the commissioner with information about retail tobacco dealer licensees necessary to carry out the purpose of this section.
L.1995, c.320, s.2; amended 2000, c.87, s.3; 2005, c.384, s.4; 2017, c.118, s.5.
26:3A2-20.2 Authority of Cannabis Regulatory Commission.
L.2021, c.25, s.7.
26:3A2-20.3 Definitions.
"Confidential case report" means a report created by a local overdose fatality review team summarizing the data collected and analyzed regarding a confirmed fatal drug overdose.
"De-identifiable data" means data or information not containing personally identifiable information.
"Health care provider" means a physician, advanced practice nurse, or physician assistant acting within the scope of a valid license or certification issued pursuant to Title 45 of the Revised Statutes.
"Local team" means a local overdose fatality review team.
"Mental health provider" means a psychiatrist, a psychologist, an advanced practice nurse practitioner with a specialty in psychiatric mental health, a clinical social worker, a professional counselor, or a marriage and family therapist who is licensed to provide mental health services pursuant to Title 45 of the Revised Statutes.
"Overdose" means "drug overdose" as that term is defined in section 3 of P.L.2013, c.46 (C.24:6J-3).
"Personally identifiable information" means any information about an individual that can be used to distinguish or trace an individual's identity, including, but not limited to, an individual's name, address, social security number, date and place of birth, mother's maiden name, biometric records, and medical, educational, financial, and employment information.
"Public health purpose" means a purpose of protecting and improving the health of people and their communities. "Public health purpose" includes, but is not limited to, implementing educational programs, recommending policies, administering services, conducting research, and promoting healthcare equity, in an effort to protect the health of entire populations.
"Substance use disorder" shall have the same meaning prescribed by the American Psychiatric Association in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, and any subsequent editions, and shall include the symptoms of withdrawal from a substance use disorder.
"Substance use disorder treatment provider" means any individual or entity licensed, registered, or certified pursuant to the laws of this State to treat substance use disorders or who holds a current and valid waiver under the federal Drug Addiction Treatment Act of 2000 (Pub. L. 106-310) from the federal Substance Abuse and Mental Health Services Administration to treat individuals with substance use disorder using medications approved for that indication by the United States Food and Drug Administration.
L.2021, c.430, s.1.
26:3A2-20.4 Local overdose fatality review team established, county health department; membership requirements.
(2) A local drug overdose fatality review team may be established to serve one or more counties. The Office of the Chief State Medical Examiner may direct a local overdose fatality review team to establish a municipal subcommittee to focus on a municipality with a population of 100,000 persons or more; or
a municipality with a high overdose rate as determined on annual basis by the Department of Health and the Office of the Chief State Medical Examiner.
(3) A local overdose fatality review team shall be under the direction of the county health department and shall be subject to the regulation of the Department of Health. A local team shall work cooperatively with the Local Advisory Committee on Alcohol Use Disorder and Substance Use Disorder, established pursuant to section 4 of P.L.1983, c.531 (C.26:2B-33), if one exists within the local team's jurisdiction. A local team shall cooperate with and provide any information as may be requested by the Office of the Chief State Medical Examiner or the Department of Health for public health purposes.
b. A local overdose fatality review team shall consist of individuals with experience and knowledge regarding health, social services, law enforcement, education, emergency medicine, mental health, juvenile delinquency, and substance use disorders.
(1) At a minimum, each local overdose fatality review team shall include:
(a) the county health officer, or a designee;
(b) the regional or county medical examiner, or a designee;
(c) a member of the Local Advisory Committee on Alcohol Use Disorder and Substance Use Disorder, established pursuant to section 4 of P.L.1983, c.531 (C.26:2B-33), if one exists within the local team's jurisdiction;
(d) a State, county, or municipal law enforcement officer or county prosecutor;
(e) a substance use disorder health care professional; and
(f) the county or municipal director of behavioral health services, or a designee.
(2) A local overdose fatality review team may also include any of the following:
(a) the superintendent of schools, or a designee;
(b) an emergency medical services provider;
(c) a representative of a health care facility, including a hospital, health system, or federally qualified health center;
(d) a representative of a county jail, detention center, or corrections department;
(e) a representative of a county social services agency;
(f) an individual with access to the Prescription Monitoring Program established pursuant to section 25 of P.L.2007, c.244 (C.45:1-45);
(g) a representative of the local office of the Division of Child Protection and Permanency in the Department of Children and Families;
(h) a representative of a county healthcare facility;
(i) a representative of a harm reduction center, if one is located in a municipality or county over which the local team exercises jurisdiction;
(j) any individual deemed necessary for the work of the local team, as recommended by the chair and approved by a majority vote of the team members and by the Department of Health; and
(k) a representative of the office of county probation and parole services.
L.2021, c.430, s.2.
26:3A2-20.5 Duties of local overdose fatality review team.
(1) establish and implement appropriate protocols and procedures that allow the local teams to operate in accordance with applicable State and federal laws;
(2) elect, in accordance with the procedures established pursuant to paragraph (1) of this subsection and on an annual basis, a chair who shall be a member of the local team;
(3) collect, analyze, interpret, and maintain local data on overdose deaths, which information shall be maintained by the local team in accordance with all appropriate and industry-standard technical, administrative, and physical controls necessary to protect the privacy and security of the information;
(4) conduct, in accordance with Department of Health regulations and guidance, a multidisciplinary review of the information collected pursuant to this section regarding a decedent of a confirmed fatal drug overdose, as selected by the office of the county medical examiner in the county in which the overdose fatality was primarily investigated and at the direction of the Office of Chief State Medical Examiner, which review shall include, but need not be limited to:
(a) consideration of the decedent's points of contact with health care systems, social services, educational institutions, child and family services, the criminal justice system, including law enforcement, and any other systems with which the decedent had contact prior to death; and
(b) identification of the specific factors and social determinants of health that put the decedent at risk for an overdose;
(5) recommend prevention and intervention strategies to improve the coordination of services and investigations among member agencies in an effort to reduce overdose deaths;
(6) produce confidential case reports based on information received, which shall be transmitted to the Department of Health in a form and manner prescribed by the department. The reports and the data used therefor shall only be accessed by the department for public health purposes, in a form and format that is secured to prevent disclosure of personally identifiable information, in accordance with applicable State and federal laws; and
(7) submit to the Department of Health an annual report, in a manner prescribed the department, containing only de-identified data associated with the jurisdiction served by the local team, which reports may be made available to the public pursuant to P.L.1963, c.73 (C.47:1A-1 et seq.) and shall include, but need not be limited to:
(a) the total number of fatal overdoses that occurred within the jurisdiction of the local team;
(b) the number of fatal overdose cases investigated by the local overdose fatality team;
(c) any recommendations for action by State agencies, local agencies, or the Legislature for preventing fatal overdoses in this State; and
(d) any assessable results of any recommendations made by the local team, including, but not limited to, changes in local, county, or State law, policy, or funding made as a result of the local team's recommendations.
b. A local overdose fatality review team shall establish policies and procedures to ensure that all records in their possession containing personally identifiable information are properly handled and retained and are securely and permanently destroyed within one year of, or within a reasonable period of time, as determined by the Department of Health, after, the conclusion of a local team's review of a decedent's case. The annual report and other public records shall be destroyed in accordance to the requirements of P.L.1953, c.410 (C.47:3-15 et seq.).
c. A local team may only request, collect, analyze, and share information for public health purposes directly related to the review of confirmed fatal drug overdoses and, except as otherwise provided in this act, in compliance with all applicable State and federal laws or regulations.
L.2021, c.430, s.3.
26:3A2-20.6 Disclosure of relevant information.
(1) any relevant information and records maintained by a health care provider related to an individual's physical health, mental health, and substance use disorder treatment; and
(2) any relevant information and records maintained by a State or local government agency, including criminal history records and records of probation and parole if the transmission of such records does not imperil ongoing investigations, medical examiner records, social service records, and school records and educational histories.
b. The following individuals and entities may disclose, within a reasonable period of time following a request, medical records and information requested pursuant to subsection a. of this section:
(1) county medical examiners;
(2) paid fire departments or volunteer fire companies;
(3) hospitals and health systems;
(4) law enforcement agencies;
(5) State and local government agencies;
(6) mental health providers;
(7) health care practitioners;
(8) substance use disorder treatment programs and providers;
(9) public and private schools and institutions of higher education;
(10) emergency medical services providers;
(11) social services agencies and providers; and
(12) the Prescription Monitoring Program.
c. An individual or entity subject to a request for information or records by a local overdose fatality review team pursuant to this section may charge the local team a reasonable fee for the service of duplicating any records.
d. (1) The chair of a local overdose fatality review team, or the chair's designee, may request individuals authorized under 42 C.F.R. Part 2 to provide consent for the release of confidential information protected pursuant to 42 U.S.C. s.290dd-2 and 42 C.F.R. Part 2.
(2) To the extent not otherwise inconsistent with State and federal laws, and as necessary to carry out the official functions of the local team and the provisions of this act, other individuals and entities identified by a local overdose fatality review team as having relevant data for a confidential case report may also provide a local team with relevant information in their possession that may contain personally identifiable information.
e. A local overdose fatality review team shall develop a confidentiality policy and form establishing: the requirements for maintaining the confidentiality of any information disclosed during a meeting, during review, or at any other time; the responsibilities concerning those requirements; and any penalties associated with failure to maintain such confidentiality. Such requirements shall be in accordance with all applicable State and federal laws and any best practices identified by the Department of Health. An individual shall review the confidentiality policy and form, purpose, and goals of the local team prior to participating in any review. All necessary and reasonable measures shall be taken to prevent the disclosure of a decedent's name or initials at any team meeting.
f. Information received pursuant to this act may be shared with local team members at a meeting of the local team, provided that each individual present, including staff, has signed and abides by the provisions of the confidentiality policy and form developed pursuant to subsection e. of this section. Such information may be shared with any non-member attendees who meet the criteria of subsection b. of section 2 of this act and whose attendance is approved in accordance with this act, provided that such attendees also sign and abide by the provisions of the confidentiality policy and form.
g. (1) Meetings of a local team during which confidential information is discussed shall be closed to the public, except that, upon a majority vote of the local team members present, a local team may request and permit an individual who has information relevant to the exercise of the team's duties to attend a team meeting, regardless of whether the individual meets the criteria set forth in subsection b. of section 2 of this act or is a permanent member of the local team. Notice concerning the individual's attendance shall be provided to members of the local team not later than 10 days prior to the meeting at which the individual will be present.
(2) A representative from the Department of Health, as designated by the Deputy Commissioner for Public Health Services, and a representative from the Office of the Chief State Medical Examiner may attend any meeting of a local overdose fatality review team. Notice concerning a representative's attendance shall be provided to members of the local team not later than 10 days prior to the meeting at which the representative will be present.
h. Meetings of a local overdose fatality review team shall be exempt from the "Senator Byron M. Baer Open Public Meetings Act," P.L.1975, c.231 (C.10:4-6 et seq.).
i. A member of the local overdose fatality review team may contact, interview, or obtain information by request from a family member or friend of an individual whose death is being reviewed by the local team.
j. To the extent not otherwise inconsistent with State and federal laws, an entity that provides, in good faith, information or records to a local overdose fatality review team shall not be subject to civil or criminal liability or any professional disciplinary action as a result of providing the information or records.
L.2021, c.430, s.4.
26:3A2-20.7 Unspecified information kept confidential.
b. Information and records created by a local overdose fatality review team shall be considered confidential and shall not be disclosed to the public or considered a government record pursuant to P.L.1963, c.73 (C.47:1A-1 et seq.).
c. Substance use disorder treatment records requested by or provided to a local overdose fatality review team shall be subject to any additional limitations on the redisclosure of a medical record developed in connection with the provision of substance use disorder treatment services under State or federal law, including, but not limited to, 42 U.S.C. s.290dd-2 and 42 C.F.R. Part 2.
d. Local overdose fatality review team members, and any individual who presents or provides information to a local team, may not be questioned in any civil or criminal proceeding or disciplinary action regarding the information presented or provided, except in an action contesting the validity of the disclosure itself. This subsection shall not prevent an individual from testifying regarding information obtained independently of the local team, public information, or publicly available information.
e. The county health department shall ensure the privacy, confidentiality, and security of the information provided to a local overdose fatality review team shall be maintained as required by State and federal laws and any local ordinances.
f. An individual damaged by the negligent or knowing and willful disclosure of confidential information by a local team or its members may bring an action for damages, costs, and attorney fees consistent with State law. Additionally, the Department of Health may establish penalties for the negligent or knowing and willful disclosure of confidential information by a local team or its members.
g. Nothing in this act shall be construed to require the disclosure of any private or confidential health information in violation of State or federal privacy laws.
L.2021, c.430, s.5.
26:3A2-20.8 Pursuit of available funds for implementation.
b. The Department of Health, the Office of the Chief State Medical Examiner, county medical examiner offices, and local overdose fatality review teams may accept such gifts, grants, and endowments, from public or private sources, as may be made, in trust or otherwise, or any income derived according to the terms of a gift, grant, or endowment, to implement the provisions of this act.
L.2021, c.430, s.6.
26:3A2-20.9 Report to Governor, Legislature.
b. The Office of the Chief State Medical Examiner may direct all local teams to assist with the coordination of all the relevant information necessary to review a specific decedent case.
c. The Department of Health may share data containing de-identified data at any time. The department may only share data containing personally identifiable information if the data is being shared for public health purposes, the sharing of the data is permitted by this act and other applicable laws, and the data is in a form and format that is secured to prevent the disclosure of personally identifiable information. Any publication made available to the public shall be in a format that does not identify any individual or decedent and does not contain personally identifiable information.
L.2021, c.430, s.7.
26:3A2-20.10 Compliance deadline.
L.2021, c.430, s.8.
26:3A2-21. Short title
This act shall be known and may be cited as the "County Environmental Health Act."
L.1977, c. 443, s. 1, eff. March 2, 1978.
26:3A2-22 Findings, declarations relative to hazardous materials emergency response.
The Legislature declares that it is the policy of this State to provide for the administration of environmental health services by county departments of health throughout the State in a manner which is consistent with certain overall performance standards to be promulgated by the Department of Environmental Protection. The environmental health services shall include the monitoring and enforcement of environmental health standards, the operation of a technical resource center and the enactment and enforcement of environmental health ordinances to control air pollution, solid waste, hazardous waste, noise, pesticides, radiation, and water pollution, to protect workers and the public from hazardous substances and toxic catastrophes, and to protect against other threats to environmental health.
The Legislature further declares that the burdens placed upon the existing system of emergency and hazardous materials response programs require the implementation of measures to improve the coordination between the Department of Environmental Protection, the Department of Health and Senior Services, the State Office of Emergency Management in the Division of State Police in the Department of Law and Public Safety, and county health departments in order to provide comprehensive Statewide planning and supervision of all emergency management emergency response activities by these departments, and to provide for the Statewide standardization of the necessary and appropriate levels of planning, training, exercising, and equipment availability and usage for each county for the protection of the public health and the environment, and to properly prepare to respond to a terrorist incident involving chemical, biological, radiological, nuclear, or explosive weapons.
L.1977,c.443,s.2; amended 1991, c.99, s.1; 2005, c.3, s.1.
26:3A2-23. Definitions
a. "Air pollution" means the presence in the outdoor atmosphere of one or more air contaminants in such quantities and duration as are, or tend to be, injurious to the human health or welfare, animal or plant life, or property, or would unreasonably interfere with the enjoyment of life or property anywhere in the State as may be affected thereby, but excludes all aspects of employer-employee relationships with respect to health and safety hazards within the confines of a place of employment.
b. "County board" means a county board of health established pursuant to P.L.1975, c.329 (C.26:3A2-1 et seq.) and having all the powers of a county board of health provided pursuant to law.
c. "County department" means a county department of health established pursuant to P.L.1975, c.329 (C.26:3A2-1 et seq.) with the purpose of providing environmental health programs throughout the county and other local health programs in any municipality which contracts therefor with the county board.
d. "Environmental health" means those health and environmental programs relating to the control of air pollution, solid waste, hazardous waste, noise, pesticides, radiation, and water pollution and to protect workers and the public from hazardous substances and toxic catastrophes, or to such other health and environmental programs as may be designated by the commissioner.
e. "Monitor" means check, test, observe, survey or inspect to determine compliance with environmental health standards.
f. "Noise" means any sounds of such level and duration as to be or tend to be injurious to human health or welfare, or which would unreasonably interfere with the enjoyment of life or property throughout the State or in any portions thereof, but excludes all aspects of the employer-employee relationship concerning health and safety hazards within the confines of a place of employment.
g. "Solid waste" means garbage, refuse, and other discarded materials resulting from industrial, commercial and agricultural operations, and from domestic and community activities, and shall include all other waste materials including liquids, except for solid animal and vegetable wastes collected by swine producers licensed by the State Department of Agriculture to collect, prepare and feed such wastes to swine on their own farms.
h. "Water pollution" means the presence in or upon the surface or ground waters of this State of one or more contaminants, including any form of solid or liquid waste of any composition whatsoever, in such quantities and duration as are, or tend to be, injurious to the human health or welfare, animal or plant life, or property, or would unreasonably interfere with the enjoyment of life or property within any portion of the State.
i. "Certified local health agency" means a local health agency satisfying the performance and administrative standards authorized in section 15 of P.L.1977, c.443 (C.26:3A2-33).
j. "Commissioner" means the Commissioner of Environmental Protection.
k. "Department" means the Department of Environmental Protection.
l. "Local health agency" means a county department, or regional or municipal health agency responsible, pursuant to law, for the conduct, within its area of jurisdiction, of a public health program administered by a full-time health officer.
m. "Pesticides" means "pesticides" as defined in section 3 of P.L.1971, c.176 (C.13:1F-3).
n. "Radiation" means "unnecessary radiation" as defined in section 2 of P.L.1958, c.116 (C.26:2D-2); radon gas and radon progeny; "low-level radioactive waste" as defined in section 3 of P.L.1987, c.333 (C.13:1E-179), or as defined by the Commissioner of Environmental Protection pursuant to regulation.
o. "State statutes concerning environmental health" or "environmental health laws" means the "Solid Waste Management Act," P.L.1970, c.39 (C.13:1E-1 et seq.), the "Pesticide Control Act of 1971," P.L.1971, c.176 (C.13:1F-1 et seq.), the "Noise Control Act of 1971," P.L.1971, c.418 (C.13:1G-1 et seq.), the "Radiation Protection Act," P.L.1958, c.116 (C.26:2D-1 et seq.), the "Environmental Cleanup Responsibility Act," P.L.1983, c.330 (C.13:1K-6 et seq.), the "Toxic Catastrophe Prevention Act," P.L.1985, c.403 (C.13:1K-19 et seq.), the "Air Pollution Control Act (1954)," P.L.1954, c.212 (C.26:2C-1 et seq.), the "Worker and Community Right to Know Act," P.L.1983, c.315 (C.34:5A-1 et seq.), the "Water Pollution Control Act," P.L.1977, c.74 (C.58:10A-1 et seq.), P.L.1986, c.102 (C.58:10A-21 et seq.), and any other State environmental health law that the commissioner deems appropriate.
L.1977,c.443,s.3; amended 1991,c.99,s.2.
26:3A2-24. Provision of environmental health services by department
The county department shall provide environmental health services, which meet the performance and administrative standards authorized in section 10 of this act, for the territorial area of the county, under the direction of a full-time employee trained and experienced in managing environmental health programs, provided, however, that such environmental health services shall be provided by any municipal or regional health agency certified by the Commissioner of Environmental Protection pursuant to section 15 within its area of jurisdiction.
L.1977, c. 443, s. 6, eff. March 2, 1978.
26:3A2-25. Powers and duties of certified local health agency
A certified local health agency may initiate legal proceedings for a violation of any environmental health law, rule, regulation, or ordinance, including the making and issuing of complaints and summonses by serving the summons upon the violator and filing the complaint promptly with a court having jurisdiction. The county counsel or the prosecutor of the municipality in which a violation has occurred shall be authorized to act as counsel to the certified local health agency for prosecution of the violation, and any penalties collected from the prosecution shall be deposited in the "Environmental Quality and Enforcement Fund" established pursuant to section 8 of P.L.1991, c.99 (C.26:3A2-35) for use by the certified local health agency of the county or municipality prosecuting such violations.
Unless specifically precluded by State statute, penalties for a violation prosecuted under this section shall be collected pursuant to the "penalty enforcement law," N.J.S.2A:58-1 et seq.
L.1977,c.443,s.7, amended 1983,c.38,s.2; 1991,c.99,s.3.
26:3A2-25.1 Enforcement by certified local health agency.
L.2012, c.79, s.10.
26:3A2-26. Technical resource center
The county department may operate a technical resource center for environmental health services to provide: a. training programs for public and private persons or groups concerned with environmental health; b. laboratory services for analyzing materials to determine compliance with environmental health standards; c. technical assistance; d. library services; e. data collection and exchange services, concerning the results of all monitoring activities within the county; and, f. any other function or service deemed necessary to effectuate the purposes of this act. The technical resource center may be established at the county college, if any, within the county.
L.1977, c. 443, s. 8, eff. March 2, 1978.
26:3A2-27. Environmental health ordinances; formulation, adoption and enforcement
A board of health of a county or municipality, or a regional health commission with, or that is, a certified local health agency, or the governing body of any such county or municipality without a board of health or that is not a member of a regional health commission may adopt an environmental health ordinance that is more stringent than the federal or State statute, rule, regulation, or management plan upon which it is based provided that the federal or State statute, rule, regulation, or management plan allows for the adoption of more stringent ordinances.
Notwithstanding any law, rule, or regulation to the contrary, an environmental health ordinance may provide for penalties for its violation consistent with the penalties established therefor in the applicable environmental health law, or any penalty schedule adopted by the department in accordance therewith.
L.1977,c.443,s.9; amended 1991,c.99,s.4.
26:3A2-28. Promulgation of environmental health performance standards and standards of administrative procedure; delegation of powers; comprehensive model ordinances
b. The commissioner may, in the same manner, delegate the administration of one or more aspects of the environmental health laws of this State or of the rules and regulations adopted thereto, which are administered by the department, to a, certified local health agency, after he has adopted specific standards and guidelines for the administration of such programs by certified local health agencies, for so long as he determines that a certified local health agency, has the capability and determination to adhere to those specific standards and guidelines. In determining whether to delegate authority to administer all or a portion of any program, or whether a certified local health agency has the capability or determination to assume or retain delegation of program administration, the commissioner shall consider:
(1) The consistency of the delegation with applicable federal or State law;
(2) The probable effects of the delegation on the effectiveness and efficiency of program administration, and the need for uniform program administration;
(3) The availability of technical expertise, adequate staff levels and other resources needed to adequately perform program administration.
Under a delegation of program administration for the "Toxic Catastrophe Prevention Act," P.L.1985, c.403 (C.13:1K-19 et seq.) and the "Worker and Community Right to Know Act," P.L.1983, c.315 (C.34:5A-1 et seq.), delegation may not include authority to require documentation that is in addition to that required to be retained by an employer under those laws.
c. The commissioner shall develop one or more comprehensive model ordinances dealing with the control of air pollution, solid waste, hazardous waste, noise, pesticides, radiation, and water pollution, the protection of workers and the public from hazardous substances and toxic catastrophes, or other threats to environmental health for which authority has been delegated, for use by the appropriate local governmental entity, and to provide technical assistance to the certified local health agencies.
L.1977,c.443,s.10; amended 1991,c.99,s.5.
26:3A2-29. Authorization to make grants to county departments; State's contribution amount
b. There is established in the department a non-lapsing environmental health fund that shall consist of all revenues appropriated or otherwise made available for the purpose of making grants on a non-matching basis to certified local health agencies, including such monies from fees, fines and penalties collected by the department in implementing environmental health laws as the department may deposit in the fund. Non-matching grants shall be used by certified local health agencies in the administration or implementation of environmental health laws, or rules or regulations adopted pursuant thereto, for which delegation of program administration has been received, or for implementation of local ordinances adopted in accordance therewith. Non-matching grant monies may be used only for new or for expanding programs, or for development of technical and administrative procedures and protocols, training and personnel development, special projects and equipment, or other similar purposes approved by the commissioner. Non-matching grants made pursuant to this subsection shall be in addition to grants made pursuant to subsection a. of this section.
c. Monies in the fund may be used by the commissioner to provide training, equipment or other services to certified local health agencies for the purpose of assisting them in carrying out their responsibilities under P.L.1977, c.443 (C.26:3A2-21 et seq.).
L.1977,c.443,s.11; amended 1991,c.99,s.6.
26:3A2-30. Employees of local health agency; transfer to county department
Each person, who shall have been employed by a local health agency, including a regional health commission formed for the provisions of air pollution services, and whose employment by such agency shall have been terminated by reason of the assumption of its activities and responsibilities by a county department pursuant to this act, shall be transferred to such county department pursuant to the conditions contained in sections 16, 17 and 18 of P.L.1975, c. 329 (C. 26:3A2-16 to 26:3A2-18).
L.1977, c. 443, s. 12, eff. March 2, 1978.
26:3A2-31. Annual budget; submission by county health officer; tax levy; determination by board of chosen freeholders
The county health officer shall prepare and submit annually to the board of chosen freeholders, subject to the advice of the county board, in each year, a budget setting forth in detail the amounts of money necessary for the operation of the county department of health for environmental health purposes, during the ensuing year. The board of chosen freeholders shall include annually in the tax levy the amount of money which it believes will best meet the environmental health needs of the county.
L.1977, c. 443, s. 13, eff. March 2, 1978.
26:3A2-32. Severability
If any provision of this act or the application thereof to any person or circumstance is held invalid, the remainder of the act and the application of such provision to persons or circumstances other than those to which it is held invalid, shall not be affected thereby.
L.1977, c. 443, s. 14, eff. March 2, 1978.
26:3A2-33. Work program to meet standards; certification of municipal or regional health agency as authorized local government for performance of environmental health services within its jurisdiction
A county department shall, within 15 months of the promulgation of environmental health performance standards and standards of administrative procedure for county departments of health by the Commissioner of Environmental Protection, prepare a work program for meeting the standards throughout the county and shall submit it to the Commissioner of Environmental Protection and to each municipality located therein for review. The work program shall provide a detailed description of program objectives, shall delineate responsibilities for its implementation within the county, shall identify the personnel and resources required to meet the program objectives and shall provide a time schedule for achieving full program implementation.
Any municipal or regional health agency authorized by P.L.1975, c. 329 (C. 26:3A2-1 et seq.), which is presently providing environmental health services which meet the standards of performance and of procedure and which is willing to coordinate its environmental health programs with those of its neighbors by implementing the work program of the county department, may petition the Commissioner of Environmental Protection for certification and upon certification become the authorized local government for the performance of environmental health services within its jurisdiction.
The Commissioner of Environmental Protection shall certify any municipal or regional health agency as the authorized local government for the performance of environmental health services within its jurisdiction, when he finds that the petitioning health agency provides and will continue to provide a complete program of environmental health services which meet the standards of performance and of procedure as indicated in the work program of the county department. The Commissioner of Environmental Protection shall periodically review the certification of each such health agency to determine whether or not it should be continued.
L.1977, c. 443, s. 15, eff. March 2, 1978.
26:3A2-34. Certified local health agency may charge fee
L.1991,c.99,s.7.
26:3A2-35. County, municipality to establish Environmental Quality and Enforcement Fund
L.1991,c.99,s.8.
26:3A2-36 Plan for standardization, coordination of hazardous materials emergency response programs.
The plan shall include procedures for State, county, and local response to incidents involving hazardous materials, including, but not limited to, chemical, biological, radiological, nuclear, or explosive incidents, and planning, training, exercising, and equipment requirements designed to assure that local responders have the capacity, competency and capability to protect the public from exposure to those materials, and shall include the adoption of environmental health performance standards and standards of administrative procedures for county hazardous materials response.
b. The certified local health agency in each county shall develop, in consultation with their county office of emergency management, a comprehensive, coordinated county-wide emergency response program for incidents involving hazardous materials, including, but not limited to, chemical, biological, radiological, nuclear, or explosive incidents for the county that is consistent with the plan developed by the department pursuant to subsection a. of this section.
c. In any county in which there is no certified local health agency, the board of chosen freeholders shall designate a local health agency from the county to develop, in consultation with the county office of emergency management and the Department of Health, a comprehensive, coordinated county-wide emergency response program for incidents involving hazardous materials, including, but not limited to, chemical, biological, radiological, nuclear, or explosive incidents for the county that is consistent with the plan developed by the department pursuant to subsection a. of this section.
L.2005, c.3, s.2; amended 2012, c.17, s.329.
26:3A2-37 Grants to local health agencies for hazardous materials emergency response programs.
L.2005,c.3,s.3.
26:3A2-38 Rules, regulations relative to grant awards, performance standards, interlocal agreements.
(1) establish criteria and procedures for the award of grants to certified local health agencies, or local health agencies, as appropriate, pursuant to section 3 of P.L.2005, c.3 (C.26:3A2-37);
(2) establish environmental health performance standards and standards of administrative procedures for county hazardous materials response for incidents involving hazardous materials, including, but not limited to, chemical, biological, radiological, nuclear, or explosive incidents; and
(3) establish criteria and procedures for the development of inter-local agreements to facilitate the creation of a Statewide mutual aid network for responding to incidents involving hazardous materials, including, but not limited to, chemical, biological, radiological, nuclear, or explosive incidents.
b. Prior to the adoption of rules and regulations pursuant to subsection a. of this section, and notwithstanding the provisions of the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.) to the contrary, the Commissioner of Environmental Protection may, immediately upon filing the proper notice with the Office of Administrative Law, adopt such temporary rules and regulations as the commissioner determines are necessary to implement the provisions of P.L.2005, c.3 (C.26:3A2-36 et al.). The temporary rules and regulations shall be in effect for a period not to exceed 270 days after the date of the filing, except that in no case shall the temporary rules and regulations be in effect one year after the effective date of P.L.2005, c.3 (C.26:3A2-36 et al.). The temporary rules and regulations shall thereafter be amended, adopted or readopted by the commissioner as the commissioner determines is necessary in accordance with the requirements of the "Administrative Procedure Act."
No person, corporation or municipality shall maintain, use or permit to be used any privy, privy vault, cesspool, septic tank, title disposal field or other means of disposal of human excrement which allows flies to gain access to the excremental matter contained therein, or from which excremental matter or liquid containing excremental matter flows over or upon the surface of the ground or gains access to the source of any public water supply or to any well or spring, used as a private potable water supply.
No person, corporation or municipality shall deposit or permit to be deposited or to remain on the surface of the ground any human excrement or material containing human excrement or dispose of or place any such material where it can gain access to the source of any public water supply or to any well or spring, used as a private potable water supply.
No person, corporation or municipality knowingly shall maintain or permit to be maintained any accumulation of animal or vegetable matter in which fly larvae exist.
No person, corporation or municipality knowingly shall maintain or permit to be maintained any pool, ditch, stream, or other body of water, or any cistern, privy vault, cesspool or other receptacle, containing liquid in which mosquitoes are breeding.
No person, corporation or municipality knowingly shall maintain or permit to be maintained any accumulation of filth or source of foulness which is hazardous to the health or comfort of any of the inhabitants of this State.
The provisions of sections two, three and four of this act shall not apply to the effluents from sewage treatment plants, or industrial waste treatment plants heretofore or hereafter installed in accordance with the requirements of the law and operated in accordance with the rules and regulations of the State Department of Health or the Passaic Valley Sewerage Commission.
Nothing in this act shall be construed to prohibit or limit the authority otherwise granted by statute to any local board of health or other body to regulate or control objects or conditions described or referred to in this act, nor shall the provisions of this act apply to vehicles operated by interstate carriers.
Any person or private or municipal corporation or their agents violating any of the provisions of this act shall be liable to a penalty for each first offense of not less than ten dollars ($10.00) nor more than fifty dollars ($50.00), and for each second and every subsequent offense to a penalty of not less than twenty-five dollars ($25.00) nor more than one hundred dollars ($100.00) to be recovered by and in the name of the Department of Health of the State of New Jersey or by or in the name of the director of health of the State of New Jersey, or by and in the name of the local board of health, or such board, body or officers exercising the functions of a local board of health according to law.
Each day that a violation of the provisions of this act exists shall be deemed to be a separate violation for which a penalty may be recovered.
Every municipal court shall have jurisdiction over proceedings to enforce and collect any penalty imposed because of a violation of any provision of this act, if the violation has occurred within the territorial jurisdiction of the court. The proceedings shall be summary and in accordance with the Penalty Enforcement Law (N.J.S. 2A:58-1 et seq.). Process shall be in the nature of a summons or warrant and shall issue only at the suit of the Department of Health of the State of New Jersey or of the State Commissioner of Health, or of the local board of health, or of such board, body or officers exercising the functions of a local board of health according to law, as the case may be, as plaintiff.
The court shall cause a defendant, other than a body corporate, who refuses or neglects to pay forthwith the amount of a judgment rendered against him and the costs and charges incident thereto, to be committed to the county jail for a period not exceeding ten days in the case of a first conviction, and in the case of a conviction for a second or subsequent violations for a period of not less than ten days nor more than thirty days.
Payment of a penalty for any alleged violation of this act, either before or after the institution of proceedings for the collection thereof, shall be deemed equivalent to a conviction of the violation for which such penalty was claimed.
Any penalty recovered in an action brought under the provisions of this act shall be paid to the plaintiff therein. When the plaintiff is the Department of Health of the State of New Jersey or the director of health of the State of New Jersey, the penalty shall be paid by said department or director into the treasury of the State. When the plaintiff is a local board of health or board, body or officers exercising the functions of a local board of health, the penalty shall be paid by such plaintiff into the treasury of the municipality within which the plaintiff has jurisdiction.
a. Tobacco is the leading cause of preventable disease and death in the State and the nation;
b. Tobacco smoke constitutes a substantial health hazard to the nonsmoking majority of the public;
c. Electronic smoking devices have not been approved as to safety and efficacy by the federal Food and Drug Administration, and their use may pose a health risk to persons exposed to their smoke or vapor because of a known irritant contained therein and other substances that may, upon evaluation by that agency, be identified as potentially toxic to those inhaling the smoke or vapor;
d. The separation of smoking and nonsmoking areas in indoor public places and workplaces does not eliminate the hazard to nonsmokers if these areas share a common ventilation system;
e. The prohibition of smoking at public parks and beaches would better preserve and maintain the natural assets of this State by reducing litter and increasing fire safety in those areas, while lessening exposure to secondhand tobacco smoke and providing for a more pleasant park or beach experience for the public; and
f. Therefore, subject to certain specified exceptions, it is clearly in the public interest to prohibit the smoking of tobacco products and the use of electronic smoking devices in all enclosed indoor places of public access and workplaces and at all public parks and beaches.
"Bar" means a business establishment or any portion of a nonprofit entity, which is devoted to the selling and serving of alcoholic beverages for consumption by the public, guests, patrons or members on the premises and in which the serving of food, if served at all, is only incidental to the sale or consumption of such beverages.
"Cigar bar" means any bar, or area within a bar, designated specifically for the smoking of tobacco products, purchased on the premises or elsewhere; except that a cigar bar that is in an area within a bar shall be an area enclosed by solid walls or windows, a ceiling and a solid door and equipped with a ventilation system which is separately exhausted from the nonsmoking areas of the bar so that air from the smoking area is not recirculated to the nonsmoking areas and smoke is not backstreamed into the nonsmoking areas.
"Cigar lounge" means any establishment, or area within an establishment, designated specifically for the smoking of tobacco products, purchased on the premises or elsewhere; except that a cigar lounge that is in an area within an establishment shall be an area enclosed by solid walls or windows, a ceiling and a solid door and equipped with a ventilation system which is separately exhausted from the nonsmoking areas of the establishment so that air from the smoking area is not recirculated to the nonsmoking areas and smoke is not backstreamed into the nonsmoking areas.
"Electronic smoking device" means an electronic device that can be used to deliver nicotine or other substances to the person inhaling from the device, including, but not limited to, an electronic cigarette, cigar, cigarillo, or pipe.
"Indoor public place" means a structurally enclosed place of business, commerce or other service-related activity, whether publicly or privately owned or operated on a for-profit or nonprofit basis, which is generally accessible to the public, including, but not limited to: a commercial or other office building; office or building owned, leased or rented by the State or by a county or municipal government; public and nonpublic elementary or secondary school building; board of education building; theater or concert hall; public library; museum or art gallery; bar; restaurant or other establishment where the principal business is the sale of food for consumption on the premises, including the bar area of the establishment; garage or parking facility; any public conveyance operated on land or water, or in the air, and passenger waiting rooms and platform areas in any stations or terminals thereof; health care facility licensed pursuant to P.L.1971, c.136 (C.26:2H-1 et seq.); patient waiting room of the office of a health care provider licensed pursuant to Title 45 of the Revised Statutes; child care center licensed pursuant to P.L.1983, c.492 (C.30:5B-1 et seq.); race track facility; facility used for the holding of sporting events; ambulatory recreational facility; shopping mall or retail store; hotel, motel or other lodging establishment; apartment building lobby or other public area in an otherwise private building; or a passenger elevator in a building other than a single-family dwelling.
"Person having control of an indoor public place or workplace" means the owner or operator of a commercial or other office building or other indoor public place from whom a workplace or space within the building or indoor public place is leased.
"Person having control of a public park or beach" means the person having supervisory authority over a public park or beach or that person's designee, as applicable.
"Public park or beach" means a State park or forest, a county or municipal park, or a State, county, or municipal beach, but does not include any parking lot that is adjacent to, but outside of, the public park or beach.
"Smoking" means the burning of, inhaling from, exhaling the smoke from, or the possession of a lighted cigar, cigarette, pipe or any other matter or substance which contains tobacco or any other matter that can be smoked, or the inhaling or exhaling of smoke or vapor from an electronic smoking device.
"State park or forest" means any State owned or leased land, water or facility administered by the Department of Environmental Protection, including, but not limited to, a park, forest, recreational area, marina, historic site, burial site, or natural area, but not including a wildlife management area or reservoir land.
"Tobacco retail establishment" means an establishment in which at least 51% of retail business is the sale of tobacco products and accessories, and in which the sale of other products is merely incidental.
"Workplace" means a structurally enclosed location or portion thereof at which a person performs any type of service or labor.
b. Smoking is prohibited in any area of any building of, or on the grounds of, any public or nonpublic elementary or secondary school, regardless of whether the area is an indoor public place or is outdoors.
b. The smoking cessation program shall be developed in consultation with the Commissioners of Health and Senior Services and Personnel, and shall be initiated one year prior to prohibiting smoking on its grounds and continue to be offered as long as smoking is prohibited. If a smoking cessation program required pursuant to this section was initiated prior to, and is in effect on, the effective date of this act, smoking may be prohibited one year from the date of initiation of the program.
c. The Commissioner of Human Services may, by regulation, prohibit smoking on the grounds of other Human Services facilities, subject to the requirements of subsection b. of this section.
a. any cigar bar or cigar lounge that, in the calendar year ending December 31, 2004, generated 15 percent or more of its total annual gross income from the on-site sale of tobacco products and the rental of on-site humidors, not including any sales from vending machines, and is registered with the local board of health in the municipality in which the bar or lounge is located. The registration shall remain in effect for one year and shall be renewable only if: (1) in the preceding calendar year, the cigar bar or lounge generated 15 percent or more of its total annual gross income from the on-site sale of tobacco products and the rental of on-site humidors, and (2) the cigar bar or cigar lounge has not expanded its size or changed its location since December 31, 2004;
b. any tobacco retail establishment, or any area the tobacco retail establishment provides for the purposes of smoking;
c. any tobacco business when the testing of a cigar or pipe tobacco by heating, burning or smoking is a necessary and integral part of the process of making, manufacturing, importing, or distributing cigars or pipe tobacco;
d. private homes, private residences and private automobiles;
e. the area within the perimeter of:
(1) any casino as defined in section 6 of P.L.1977, c.110 (C.5:12-6) approved by the Casino Control Commission that contains at least 150 stand-alone slot machines, 10 table games, or some combination thereof approved by the commission, which machines and games are available to the public for wagering; and
(2) any casino simulcasting facility approved by the Casino Control Commission pursuant to section 4 of P.L.1992, c.19 (C.5:12-194) that contains a simulcast counter and dedicated seating for at least 50 simulcast patrons or a simulcast operation and at least 10 table games, which simulcast facilities and games are available to the public for wagering;
f. research laboratories and other facilities that have been approved by the Department of Health to permit smoking for the purpose of medical research related to the health effects of smoking, in an indoor facility that is separately ventilated for the purpose of medical or scientific research that is conducted under physician supervision and has been approved by an Investigational Review Board (IRB), if the facility is used solely and exclusively for clinical research activities;
g. a golf course;
h. an area of a municipal or county beach, not to exceed 15 percent of the total area of the beach, which is designated by the municipality or county by ordinance or resolution as a smoking area; and
i. any cigar bar or lounge previously registered with the local board of health pursuant to subsection a. of this section that has, in accordance with the requirements of this subsection, renewed that registration following a period of lapse. A cigar bar or cigar lounge registration which has lapsed may be renewed under this subsection if: (1) no more than 10 years have elapsed since the date the registration lapsed; (2) in the calendar year immediately preceding the lapse, the cigar bar or lounge generated 15 percent or more of its total annual gross income from the on-site sale of tobacco products and the rental of on-site humidors; and (3) the cigar bar or lounge has not expanded its size or changed its location since December 31, 2004. A registration renewed pursuant to this subsection shall remain in effect for one year, and shall be renewable thereafter only if it meets the requirements for renewal as set forth in this subsection or subsection a. of this section.
b. Nothing in this section shall be construed to require a hotel, motel or other lodging establishment to provide a nonsmoking room to a guest if all the designated nonsmoking rooms are occupied.
b. The provisions of this section shall not be construed to prevent a lessee of the workplace, or space within the building or indoor public place, from enforcing the smoking restrictions imposed by the owner or operator of a commercial or other office building or other indoor public place.
b. The Department of Health or the local board of health or the board, body, or officers exercising the functions of the local board of health according to law, upon written complaint or having reason to suspect that an indoor public place or workplace covered by the provisions of this act is or may be in violation of the provisions of this act, shall, by written notification, advise the person having control of the place accordingly, and order appropriate action to be taken. A person receiving that notice who fails or refuses to comply with the order is subject to a fine of not less than $250 for the first offense, $500 for the second offense, and $1,000 for each subsequent offense. In addition to the penalty provided herein, the court may order immediate compliance with the provisions of this act.
c. A penalty recovered under the provisions of this act shall be recovered by and in the name of the Commissioner of Health or by and in the name of the local board of health. When the plaintiff is the Commissioner of Health, the penalty recovered shall be paid by the commissioner into the treasury of the State. When the plaintiff is a local board of health, the penalty recovered shall be paid by the local board into the treasury of the municipality where the violation occurred.
d. The Superior Court or a municipal court shall have jurisdiction over proceedings to enforce and collect any penalty imposed because of a violation of this act if the violation has occurred within the territorial jurisdiction of the court, except that the Superior Court shall have exclusive jurisdiction over violations that occur in an indoor public place or public park or beach that may be issued against a State or local government entity pursuant to subsection b. of this section. The proceedings shall be summary and in accordance with the "Penalty Enforcement Law of 1999," P.L.1999, c.274 (C.2A:58-10 et seq.). Process shall be in the nature of a summons and shall issue only at the suit of the Commissioner of Health, or the local board of health, as the case may be, as plaintiff.
e. The penalties provided in subsections a. and b. of this section shall be the only civil remedy for a violation of this act, and there shall be no private right of action against a party for failure to comply with the provisions of this act.
f. A penalty may be imposed and recovered for a violation at a public park or beach and, if so imposed and recovered, it shall be done in accordance with the provisions of this section, and shall involve the person having control of a public park or beach, the Department of Health or the local board of health or the board, body, or officers exercising the functions of the local board of health according to law, and the courts, as provided in this section, except that any penalty recovered for a violation at a public park or beach that is recovered by and in the name of the Commissioner of Health or by and in the name of the local board of health shall be paid 50 percent to the Treasury of the State and be dedicated to smoking cessation programs administered by the State Department of Health, and 50 percent shall be paid to the treasury of the municipality where the violation occurred.
b. The governing body of a municipality may adopt a municipal ordinance to impose a civil penalty, as provided for under subsection a. of this section, as an alternative to the liability for the offense provided for under N.J.S.2C:33-13.
As used in this section, "use of smokeless tobacco" means the inhalation, chewing, or placement in the oral cavity of snuff, chewing tobacco, or any other matter or substance which contains tobacco.
b. The board of education of each school district shall ensure the placement, in every public entrance to a public school building in its district, of a sign which shall be located so as to be clearly visible to the public and shall contain letters which contrast in color with the sign, indicating that the use of smokeless tobacco is prohibited therein.
c. (1) The board of education of each school district shall order any person using smokeless tobacco in violation of this section to comply with the provisions of this section. Except as otherwise provided pursuant to subsection d. of this section, a person, after being so ordered, who uses smokeless tobacco in violation of this section is subject to a fine of not less than $250 for the first offense, $500 for the second offense, and $1,000 for each subsequent offense. A penalty shall be recovered in accordance with the provisions of paragraphs (3) and (4) of this subsection.
(2) The department, the local board of health, or the board, body, or officers exercising the functions of the local board of health according to law, upon written complaint or having reason to suspect that a public school is or may be in violation of the provisions of this section, shall, by written notification, advise the board of education of the school district accordingly and order appropriate action to be taken. A board of education that receives that notice and fails or refuses to comply with the order is subject to a fine of not less than $250 for the first offense, $500 for the second offense, and $1,000 for each subsequent offense. In addition to the penalty provided herein, a court may order immediate compliance with the provisions of this section.
(3) A penalty recovered under the provisions of this section shall be recovered by, and in the name of, the Commissioner of Health or by, and in the name of, the local board of health. When the plaintiff is the commissioner, the penalty recovered shall be paid by the commissioner into the treasury of the State. When the plaintiff is a local board of health, the penalty recovered shall be paid by the local board into the treasury of the municipality where the violation occurred.
(4) A municipal court shall have jurisdiction over proceedings to enforce and collect any penalty imposed because of a violation of this section if the violation has occurred within the territorial jurisdiction of the court. The proceedings shall be summary and in accordance with the "Penalty Enforcement Law of 1999," P.L.1999, c.274 (C.2A:58-10 et seq.). Process shall be in the nature of a summons or warrant and shall issue only at the suit of the commissioner or the local board of health, as the case may be, as plaintiff.
(5) The penalties provided in paragraphs (1) and (2) of this subsection shall be the only civil remedy for a violation of this section. There shall be no private right of action against a party for failure to comply with the provisions of this section.
d. A student who violates the provisions of this section after being ordered by the board of education of the district to comply with the provisions of this section, shall not be subject to the fines established pursuant to paragraph (1) of subsection c. of this section, but rather shall be prohibited by the board of education of the district from participation in all extracurricular activities, including interscholastic athletics, and the revocation of any student parking permit that the student may possess. The board of education shall adopt a policy that establishes the length of a suspension or revocation to be imposed on a student for an initial or subsequent violation of the provisions of this section.
As used in this act "restaurant" means any facility or part thereof in which food is prepared and provided or served for consumption on the premises but shall not include mobile food establishments or any temporary food establishment which operates at a fixed location for a limited period of time in connection with a fair, carnival, public exhibition or similar transitory gathering or charitable fund raising event.
The proprietor, or in the case of a public or nonprofit restaurant, the manager or administrator of a restaurant shall:
a. Ensure that posters prepared by the State Department of Health which illustrate choke prevention techniques are prominently displayed in food preparation and service areas of the restaurant; and
b. Have pamphlets illustrating choke prevention techniques available for free distribution to customers or patrons of the restaurant.
The Department of Health shall prepare instructional posters and pamphlets which illustrate choke prevention techniques such as the "Heimlich Maneuver" and distribute the posters and pamphlets to local boards of health for distribution to restaurants.
The Department of Health, through local boards of health, shall make available to school districts, instructional posters and pamphlets prepared pursuant to P.L.1983, c.488 (C.26:3E-1 et seq.).
Except as otherwise provided by law, no person shall be obligated to remove or assist in removing or attempting to remove food which may become lodged in a person's throat.
Any restaurant proprietor, or in the case of a public or nonprofit restaurant, manager or administrator who violates the provisions of this act shall be subject to a penalty of not less than $50.00 or more than $100.00 to be sued for and recovered in a civil action commenced by the State in a summary proceeding in the Superior Court pursuant to "the penalty enforcement law" (N.J.S. 2A:58-1 et seq.).
The Commissioner of Health shall promulgate all necessary regulations to carry out this act.
b. The commissioner, in consultation with the New Jersey Restaurant and Hospitality Association and in consideration of food allergy information published by the federal Food and Drug Administration, shall prepare an informational sign promoting food allergen awareness, which shall include information about the most common food allergens, the health-related consequences of allergic reactions to food, best practices for food storage and preparation to prevent cross-contamination with food allergens, the symptoms of and appropriate responses to an allergic reaction to food, and such other information as the commissioner deems appropriate. The commissioner shall additionally prepare a sign for restaurant customers advising them to notify their server if they have any food allergies. The commissioner shall make the food allergen awareness sign and the customer advisory sign available to restaurants, the New Jersey Restaurant and Hospitality Association, and local boards of health. Each restaurant in the State shall acquire a food allergen awareness sign and prominently display the sign in the restaurant kitchen or another area of the restaurant that is frequently used by, and is generally accessible to, restaurant staff, and shall acquire an appropriate number of customer advisory signs to ensure one sign is placed at each location in the restaurant where customers may place food or drink orders, including, as appropriate, but not limited to, dining tables, dining counters, drive-through menu boards, and walk-up ordering stations ; provided that nothing in this subsection shall be construed to require any restaurant to place customer advisory signs on the tops of dining tables in the restaurant if the restaurant does not routinely place any other signage on its dining tables. If a restaurant with dining tables does not place customer advisory notice signs on the tops of its dining tables, the restaurant shall ensure that an equivalent advisory notice is provided to customers by another means, which may include prominently printing the notice in customer menus. In the case of restaurants in operation on the date the food allergen awareness sign or the customer advisory sign is first made available, the restaurant shall acquire and display the sign or equivalent customer advisory notice no later than one month after it is made available; in the case of restaurants that commence operations after one or both signs are made available, the restaurant shall acquire and display the available signs or equivalent customer advisory notice as a condition of commencing restaurant operations.
c. Each restaurant manager in the State shall be required to complete an allergen awareness training course approved by the commissioner and provide documentation demonstrating course completion as part of any inspection of the restaurant conducted by the Department of Health or a local board of health.
d. The provisions of this section shall preempt any law, ordinance, resolution, or regulation adopted by the governing body of a county or municipality concerning food allergen awareness, training, or signage that is in addition to, or is inconsistent with, the provisions of this section.
e. As used in this section:
"Nut" means peanuts and tree nuts, including, but not limited to, almonds, brazil nuts, cashews, hazelnuts, filberts, macadamia nuts, pecans, pistachios, and walnuts; and
"Restaurant" means an establishment in which the principal business is the sale of food for consumption on the premises.
a. Research continues to demonstrate that there is a strong link between diet and health; in 2004, an estimated 65% of adults in the United States were overweight or obese and 18% of children and adolescents were overweight; today there are nearly twice as many overweight children and almost three times as many overweight adolescents as there were in 1980; while the rates of overweight and obesity are rising, Americans are increasingly eating meals away from home, and the food industry spends millions of dollars every year encouraging families to eat in restaurants and other food establishments; in 1970, Americans spent just 26% of their food budget eating away from home, but currently, Americans spend almost half of their food dollars dining out; furthermore, portion sizes in restaurants have been increasing and it is not uncommon for a restaurant entree to provide half of an individual's total recommended daily allowance of calories, fat and sodium;
b. Surveys conducted by academicians from the University of Arkansas and Villanova University, and reported in the American Journal of Public Health article entitled "Attacking the Obesity Epidemic: The Potential Health Benefits of Providing Nutrition Information in Restaurants," showed that levels of calories and saturated fats in less-healthful restaurant items were significantly underestimated by consumers; actual fat and saturated fat levels were twice consumers' estimates and calories approached two times more than what consumers expected; based on these findings, the authors of the article conducted an experiment demonstrating that for food items for which levels of calories, fat and saturated fats substantially exceeded consumers' expectations, the provision of nutrition information had a significant influence on product attitude, purchase intention, and choice;
c. A recent report of the Surgeon General of the United States on overweight and obesity recommended that the food industry provide reasonable food and beverage portions and increase the availability of nutrition information on foods prepared and eaten away from home; and
d. Therefore, it is in the public's interest to enable families to make more informed choices about a significant part of their diets and help reduce the problem of overweight and obesity in the State.
a. (1) A retail food establishment using a standard printed menu shall list next to each food or beverage item on the menu, the total number of calories for that item as usually prepared and offered for sale;
(2) A retail food establishment using a menu board system or similar signage shall list next to each food or beverage item on the board or sign, the total number of calories for that item as usually prepared and offered for sale;
(3) A retail food establishment that has a drive-through window shall display calorie content values either on the drive-through menu board or on an adjacent stanchion visible at the point of ordering, and the calorie content values shall be posted adjacent to their respective menu item names as clearly and conspicuously as the price or menu item is on the drive-through menu board; and
(4) A retail food establishment which offers alcoholic beverages for sale may, as an alternative to listing calorie information for each individual alcoholic beverage, list the average caloric value for beers, wines, and spirits as established by the United States Department of Agriculture, Agriculture Research Service in the National Nutrient Database for Standard Reference.
A retail food establishment that lists the average caloric values for alcoholic beverages pursuant to this paragraph shall add to the labeling the following statement: "Signature drinks or liqueurs with added ingredients may increase calorie content."
b. The calorie information listed pursuant to paragraphs (1) and (2) of subsection a. of this section shall be posted clearly and conspicuously adjacent or in close proximity to the applicable menu item using a font and format that is at least as prominent, in size and appearance, as that used to post either the name or price of the menu item.
The calorie content values required by this act shall be based upon a verifiable analysis of the menu item, which may include the use of nutrient databases, laboratory testing, or other reliable methods of analysis, and shall be rounded to the nearest 10 calories for calorie content values above 50 calories and to the nearest five calories for calorie content values 50 calories and below.
c. The provisions of this section shall apply to each menu item that is served in portions the size and content of which are standardized.
d. For menu items that come in different flavors and varieties but that are listed as a single menu item, the minimum to maximum numbers of calories for all flavors and varieties of that item shall be listed on the menu, menu board, or stanchion, as applicable, for each size offered for sale.
e. (1) The disclosure of calorie information on a menu, menu board, or stanchion next to a standard menu item that is a combination of at least two standard menu items on the menu, menu board, or stanchion, shall, based upon all possible combinations for that standard menu item, include both the minimum and the maximum amount of calories. If there is only one possible total amount of calories, that total shall be disclosed.
(2) The disclosure of calorie information on a menu, menu board, or stanchion next to a standard menu item that is not an appetizer or dessert, but is intended to serve more than one individual, shall include both:
(a) the number of individuals intended to be served by the standard menu item; and
(b) the calorie information per individual serving.
If the standard menu item is a combination of at least two standard menu items, the disclosure shall, based upon all possible combinations for that standard menu item, include both the minimum and the maximum amount of calories. If there is only one possible total amount of calories, that total shall be disclosed.
f. Nothing in this section shall prohibit a retail food establishment from providing additional nutrition information to its customers for each food or beverage item listed on its menu.
g. The provisions of this section shall not apply to any:
(1) item not listed on a standard printed menu or menu board system or similar signage, including, but not limited to, condiments or other products placed on a table or counter for general use; or
(2) daily specials, temporary menu items appearing on the menu for less than 60 days per calendar year, customized orders, or food or beverage items from a consumer self-serve salad bar or buffet.
h. (1) The Department of Health or the local board of health or the board, body, or officers exercising the functions of the local board of health according to law, upon written complaint or having reason to suspect that a violation of this act has occurred, shall, by written notification, advise the proprietor of the retail food establishment accordingly and order appropriate action to be taken.
(2) A proprietor of a retail food establishment who violates the provisions of this section by failing to provide the information about food and beverage items as required in this section, or knowingly misstating the number of calories in a food or beverage item, shall be subject to a penalty of not less than $50 or more than $100 for the first offense, and not less than $250 or more than $500 for the second or any subsequent offense. A municipal court shall have jurisdiction over proceedings to enforce and collect any penalty imposed because of a violation of this act, if the violation has occurred within the territorial jurisdiction of the court. The proceedings shall be summary and in accordance with the "Penalty Enforcement Law of 1999," P.L.1999, c.274 (C.2A:58-10 et seq.). Process shall be in the nature of a summons or warrant and shall issue only at the suit of the Commissioner of Health, or the local board of health, as the case may be, as plaintiff.
When the plaintiff is the Commissioner of Health, the penalty recovered shall be paid by the commissioner into the treasury of the State. When the plaintiff is a local board of health, the penalty recovered shall be paid by the local board into the treasury of the municipality where the violation occurred.
i. The provisions of this section shall not be construed to create or enhance any claim, right of action, or civil liability that did not previously exist under State law or limit any claim, right of action, or civil liability that otherwise exists under State law.
j. There shall be no private right of action against the proprietor of a retail food establishment for failure to comply with the provisions of this section.
k. To the extent consistent with federal law, the provisions of this section, as well as any other State law that regulates the disclosure of caloric information, shall be a matter of Statewide concern and shall occupy the entire field of regulation regarding the disclosure of caloric information by a retail food establishment, as well as content required to be posted on menus, menu board systems or similar signage, or stanchions, as applicable. No ordinance or regulation of a local government or local board of health shall regulate the dissemination of caloric information or the content required to be placed on menus, menu board systems or similar signage, or stanchions by a retail food establishment. Any local government or local board of health ordinance or regulation that violates this prohibition is void and shall have no force or effect.
l. As used in this section, "retail food establishment" means a fixed restaurant or any similar place that is part of a chain with 20 or more locations nationally and doing business
(1) under the same trade name or under common ownership or control or
(2) as franchised outlets of a parent business,
the principal activity of which consists of preparing for consumption within the establishment a meal or food to be eaten on the premises or picked up at a drive-through window.
As used in this chapter, "communicable disease" means any infectious or contagious disease so declared or defined by law or which has been or may hereafter be declared a "communicable disease" by the state department of health.
In order to prevent the spread of disease affecting humans, the Department of Health, and the local boards of health within their respective jurisdictions and subject to the State sanitary code, shall have power to:
a. Declare what diseases are communicable.
b. Declare when any communicable disease has become epidemic.
c. Require the reporting of communicable diseases.
d. Maintain and enforce proper and sufficient quarantine, wherever deemed necessary.
e. Remove any person infected with a communicable disease to a suitable place, if in its judgment removal is necessary and can be accomplished without any undue risk to the person infected.
f. Disinfect any premises when deemed necessary.
g. Remove to a proper place to be designated by it all articles within its jurisdiction, which, in its opinion, shall be infected with any matter likely to communicate disease and to destroy such articles, when in its opinion the safety of the public health requires it.
In the event the Governor declares a public health emergency, the department shall oversee the uniform exercise of these powers in the State and the local board of health shall be subject to the department's exercise of authority under this section.
Whenever the state department or a local board, in order to prevent the spread of communicable disease, destroys any goods, it shall make an inventory of the goods, and immediately certify the value of them. The certification shall be made to the state treasurer, in case the goods were destroyed by the state department, and to the treasurer of the proper municipality, in case of destruction by the local board.
The state treasurer or local treasurer, as the case may be, shall pay to the owner of the goods, or his legal representatives, the sum so certified.
Whenever within the jurisdiction of a local board there is a person infected with any communicable disease, the State department may cause a notice in writing, signed by the Commissioner of Health, to be sent to the local board requiring it to take action for the restriction of the spread of the communicable disease within the time specified in the notice.
If no action is taken by the local board within the time specified in the notice, the State department may bring a proceeding in lieu of prerogative writ to compel the local board to take the action ordered in the notice.
Each local board may declare any epidemic or cause of ill health to be so injurious or hazardous as to make it necessary to close any or all of the public or private schools within the jurisdiction of the board.
No public school shall be closed except by the direction of the body having the control or direction of such school. Any such body may cause any school under its control to be closed, if, in its judgment, such closing is necessary because of the injurious or hazardous nature of an epidemic or cause of ill health.
Any body having control of a school may, on account of the prevalence of any communicable disease, or to prevent the spread of communicable diseases, prohibit the attendance of any teacher or pupil of any school under their control and specify the time during which the teacher or scholar shall remain away from school.
a. (Deleted by amendment.)
b. (Deleted by amendment.)
c. (Deleted by amendment.)
The State Department of Health and Local Boards of Health may provide at public expense, the necessary equipment, materials and services for immunizing people from the diseases which pupils are required to be immunized against by the State Sanitary Code or for diseases against which immunization may be recommended by the State Department of Health.
Whenever an epidemic shall occur in an institution maintained in whole or in part by the state, the state department shall immediately take all necessary measures to check and control the epidemic.
When the state department shall have reason to believe that any milk, cream, skimmed milk, or other dairy product has been contaminated by the emanations, exhalations or discharges of any person affected with any communicable disease, or that any such dairy product has been or is produced, stored or kept on any premises upon which any source of a communicable disease exists, the department may issue an order in writing prohibiting the transportation or sale of such dairy product.
Every person upon whom any such order may be served shall obey it. The prohibition shall continue until the state department shall have had an opportunity to examine the matter, and shall have removed the prohibition by the service of another order in writing signed by the proper representative of the department.
Any person upon whom any such order of prohibition has been served who shall, prior to the removal of the prohibition, transport or sell any milk, cream, skimmed milk or other dairy product contrary to such prohibition, shall be liable to a penalty of one hundred dollars; and any other person who shall knowingly transport or sell any such dairy product so prohibited shall be liable to a penalty of one hundred dollars.
Every physician shall, within 12 hours after his diagnosis that a person is ill or infected with a communicable disease or other disease required by any law of this State, the State Sanitary Code, or ordinance, to be reported, report such diagnosis and such related information as may be required by the State Department of Health.
In cases of venereal diseases, the report shall be made to the State Department of Health, and in other cases to the health officer or other officer or employee designated to receive such reports by the local board of health having jurisdiction of the area wherein the diagnosis was made, which officer or employee the local board of health is hereby authorized to designate.
The report shall be in writing, and shall include the name of the reporting physician, the name of the disease, the name, age and precise location of the person ill or infected with the disease and such other information as may be required by regulation of the State Department of Health.
Every house owner or householder who has reason to believe that any person living, dwelling or being in any building under his control is ill or infected with any disease required by law or the State Sanitary Code to be reported shall, when no physician has professionally attended the ill or infected person, within 12 hours after discovering the same, report the fact in person, by telephone or in writing to the health officer or other officer or employee designated to receive such reports by the local board of health having jurisdiction of the area.
Every physician who shall attend any person ill or infected with any communicable disease required by law or the State Sanitary Code to be reported, on any premises where milk is produced for sale or distribution, shall report such fact to the State Department of Health within 12 hours after he has first ascertained that any such person is ill or infected with any of said diseases.
The report shall be in writing and shall state the nature of the disease, the name of the person who is ill or infected with the disease, the location of the place where the person is ill or infected, the name of the owner or manager of the dairy premises if the same can be ascertained and such other information as may be required by regulation of the State Department of Health.
Every physician who shall attend any person ill or infected with any of the communicable diseases required by law or the State Sanitary Code to be reported, having knowledge that a member of the family of, or any person living in the same family with, the ill or infected person is employed on any dairy premises where milk is produced for sale or distribution, shall report such fact to the State Department of Health in writing, within 12 hours after the physician has ascertained that such person is ill or infected or within 12 hours after gaining the information above mentioned.
The report shall state the name of the person who is ill or infected, the nature of the disease, the location of the place where such person is ill or infected, the name of the member of the family or person living in the same family who is employed on the dairy premises, the name of the owner or manager thereof if it can be ascertained, the location of the dairy premises where such person is employed and such other information as may be required by regulation of the State Department of Health.
Every physician, superintendent or other person having control or supervision over a State, county or municipal hospital, sanatorium or other public or private institution in which any person ill or infected with any disease required by law or the State Sanitary Code to be reported is received for care or treatment shall, within 24 hours after any such patient has been received into the institution, report the fact to the health officer or other officer or employee designated to receive such reports by the local board of health having jurisdiction over the territory in which the institution is located.
The report shall be in writing in the name of the physician, superintendent or other person having charge over the institution and shall set forth the name and age of the ill or infected person and the exact place of his residence or the name of the place from which he was received into the institution, together with the date upon which he was received and such other information as may be required by regulation of the State Department of Health.
Every person designated by any local board of health to receive reports of communicable diseases who shall receive any report of sickness from a physician, superintendent or other person having charge over any institution referred to in section 26:4-19 of this title shall, when the sick person referred to in the report resides in some municipality other than that in which the institution is located, make a duplicate of any such report received by him and transmit the same, within twenty-four hours after the receipt of the original, by mail, to the officer designated to receive the reports in the locality in which the sick person resided before being admitted into the institution.
On the thirtieth day of June and the thirty-first day of December in each year every physician, house owner or householder making any report of a communicable disease shall receive from the officer to whom the report was made during the preceding six months a certificate in writing under the hand of the officer setting forth the number of names reported.
The certificate, when presented to the proper disbursing officer of the municipality within which the affected person may have been, shall entitle the person making the report to receive the sum of ten cents for each name certified to have been reported, unless the report shall be found to have been erroneous.
The facts contained in the report of a communicable disease shall be entered by the officer to whom the report is delivered in a register kept for that purpose.
The register shall be subject to the inspection of the local board and its proper officers and to the state department and its officers only.
The officer to whom the report of a communicable disease is delivered and whose duty it is to make a record of the same, shall, at least once each week, and daily when required by the state department, transmit by mail the facts stated therein to the state department and shall upon request by the state department give full information concerning the measures employed by the local board to prevent the spread of the diseases mentioned in the reports, which facts and information shall be conveyed to the state department in writing.
Proof that the state department has not received the report of such facts and information from any officer shall be prima facie evidence that the same has not been transmitted to the department by the officer.
Upon presentation of a certificate of the number of cases reported to the State Department pursuant to section 26:4-24 of the Revised Statutes at least once per year the officer shall be entitled to receive from the proper disbursing officer of the municipality within the limits of which the sickness reported occurred, the sum of ten cents ($0.10) for each case certified as having been reported.
As used in this article:
"Venereal disease" includes syphilis, gonorrhea, chancroid, lymphogranuloma venereum and granuloma inguinale.
"Treating a venereal disease" includes the treatment of or attempt to treat a venereal disease by prescription, formula, patented or proprietary medicine or compound or otherwise, or the sale or gift, for the purpose of treating or attempting to treat such a disease, of any prescription, formula, patented or proprietary medicine or compound which either by itself or in connection with any other treatment, medicine, or compound is claimed to be useful, or to cure, relieve, or arrest in any way any venereal disease.
"Licensed health officer" shall mean and include only a person holding office as a local health officer who holds a valid health officer's license issued by the State Department of Health.
Syphilis, gonorrhea, chancroid, lymphogranuloma venereum and granuloma inguinale are hereby declared to be infectious and communicable diseases, dangerous to the public health.
A case of venereal disease shall be regarded as infectious until a physician licensed to practice medicine has examined the case and reported to the local board that the case is not infectious, but if in the opinion of the local board of the jurisdiction the protection of the public health requires it, the board may review the case and cause a medical examination of any such case to be made by a physician designated by the board, and the opinion of such physician as to the infectiousness or noninfectiousness of the case shall be final.
When a local board or health officer receives a report from the director or from any person authorized by the director to make such report, that a person within the jurisdiction of the local board or health officer is, or is suspected to be, a person with a sexually transmitted infection, the board or health officer may cause a medical examination to be made of the person for the purpose of ascertaining whether or not such person is in fact a person with a sexually transmitted infection.
Any person requested by the local board or health officer to be examined under the authority of section 26:4-30 of this title shall submit to examination and permit necessary specimens of blood or bodily discharges to be taken for laboratory examination.
The examination shall be made by a physician of the same sex as the person being examined if the latter so requests.
A prostitute or other lewd person shall be considered a suspected person within the meaning of section 26:4-30 of this title and may be required to submit to examination at any time.
No certificate of freedom from venereal disease shall be issued to any prostitute under any circumstances whatever.
The local board shall use all reasonable means to ascertain the existence of any case of venereal disease within its jurisdiction. It shall investigate any case or suspected case that is not under the care of a reputable physician, and shall ascertain so far as is possible every source of infection and every exposure to infection.
The physician in attendance upon a person having an infectious venereal disease, or suspected of having such disease, shall instruct the person in the precautionary measures for preventing the spread of the disease and the necessity for systematic and prolonged treatment. He also shall furnish to the person printed instructions for preventing infection, to be supplied to the physician by the state department on request.
If a person in the infectious stage of a sexually transmitted infection shall fail to report as directed to the physician in attendance for treatment, the physician shall report such failure to the local board, or to the Department of Health, which shall forward the information to the local board.
The local board may require such person to be examined as provided in sections 26:4-30 and 26:4-31 of this title. If upon examination the person is found to have a sexually transmitted infection in its infectious stage and does not present evidence to show that the person is being regularly treated by a licensed physician for the disease, the person shall be quarantined as described in sections 26:4-36 and 26:4-37 of this title.
Quarantine for venereal disease has the purpose of preventing transmission of venereal diseases and shall mean and include, restriction of the actions, behavior and movements of a person or confinement to a defined place and area.
A local board or health officer or any physician shall report to the State department, and any licensed health officer or the State Director of Health or the authorized representative of either may quarantine for venereal disease the following persons:
a. Any person who has or who is believed upon reasonable grounds to have a venereal disease in its infectious stage, if he is likely to spread the disease to others by reason of his failure or refusal to submit to treatment or by reason of his habits, or for any other reason.
b. Any person who refuses or neglects to submit to a medical examination for venereal disease required under authority of any section of this article.
c. Any person who refuses or neglects to supply, or to permit to be taken, the specimens required or requested under authority of any section of this article.
d. Any person who refuses or neglects to submit to treatment for a venereal disease in an infectious stage.
Such quarantine shall continue until the infected person is free from the disease or until such time as in the judgment of the health officer or his authorized representative who established the quarantine or by the State director or his authorized representative, it shall be safe for such infected person to be released from quarantine.
Any person included in paragraphs b, c or d of this section shall be liable to the penalty provided for in section 26:4-49 in addition to the imposition of the penalty prescribed by section 26:4-129.
In establishing quarantine for venereal disease, the licensed health officer or the State Commissioner of Health, or the authorized representative of either shall by notice in writing define the restriction of the actions, behavior and movements of the person or the place and the limits of the area within which the person is to be quarantined. Such person while so quarantined shall observe and obey said notice restricting his actions, behavior and movements or remain within the place and area defined by said health officer, director or representative in said notice. The custodian, if any, of such person shall safely keep and confine said person and said notice shall be sufficient warrant and authorization therefor.
Whenever a licensed health officer or the State Commissioner of Health or the authorized representative of either shall quarantine any person for venereal disease under authority of this article, he may also order the removal of such person to the place and area within which the person is to be quarantined for venereal disease, and the person shall proceed to such place at the time and in the manner specified.
A licensed health officer or the State Commissioner of Health or the authorized representative of either one of them may file a complaint with any municipal court in the county or with the Superior Court against the following persons:
a. Any person, who while quarantined for venereal disease fails, refuses or neglects to observe and obey said notice restricting his actions, behavior and movements, or to remain within the place and area defined by said health officer, director or representative or to proceed to a place for quarantine for venereal disease at the time and in the manner specified by said health officer, director or representative.
b. Any person who fails, refuses or neglects to submit to, observe or obey the conditions of any commitment or to comply with any order made by any court under authority of this article.
c. Any of the persons included in section 26:4-36 of this article.
If a warrant issues, it shall be directed to the sheriff in the county, or any police officer.
The court shall determine the matter without a jury. If the court finds that the person is one of those listed in this section against whom a complaint may be filed, it may commit such person to a State, county, or municipal hospital which will receive the person, or to any other place or institution suitable for and willing to receive the person for detention, examination, care and treatment, whether the hospital, place or institution be located within or without the county, or to the county jail or may make any order for the examination, care or treatment of said person which may be deemed proper under the circumstances.
The complaint, commitment, and all other papers relating to the case shall be impounded and shall not be open to public inspection, and hearings shall not be open to the public.
Any person committed under the provisions of this statute shall be held in the place to which committed until discharged by the court which heard the case or by the Superior Court or by order of the Commissioner of the State Department of Health.
The local health officer having jurisdiction shall report to the State department any person quarantined for venereal disease, or upon whom a summons is served or against whom a warrant is issued under authority of this article except where the action is initiated by the State Commissioner of Health or his authorized representative.
The physician, nurse, or other person treating a venereal disease shall report the case immediately to the state department.
The physician, superintendent, or other person having control or supervision over any State, county, or municipal hospital, or other public or private institution shall report the following cases to the Department of Health immediately after they are received into the institution:
a. A person with a sexually transmitted infection, who enters the institution to receive care or treatment for the infection.
b. A person with any other disease, who enters the institution to receive care or treatment for that disease, but who is found also to be a person with a sexually transmitted infection.
The report required by sections 26:4-38 and 26:4-39 of this title shall contain the following information:
a. Name, address, color, sex, nationality, and the age as nearly as practicable, of the person so infected with a venereal disease;
b. Character of the disease;
c. Probable source of infection; and
d. Whether the case has been previously reported or not; and if it has been reported, when, where, and by whom it was reported.
No person shall disclose the name or address or the identity of any person known or suspected to have a venereal disease except to the person's physician or to a health authority, or, in the event of a prosecution under this article or under the criminal law of this State, to a prosecuting officer or to the court; provided, however, that the person's physician or a health authority may disclose the name, address or identity of such person when and only when the physician or health authority shall deem such disclosure necessary in order to protect the health or welfare of the person or of his family or of the public; and provided further, that nothing herein shall be construed as in any way restricting such disclosures to the State Department of Health.
Documents, records or reports which contain or would reveal the name, address or identity of a person known or suspected to have a venereal disease or treated for such a disease shall not be open to inspection except by an authorized representative of the State Department of Health or, in the event of a prosecution under this article or under the criminal laws of this State, by a prosecuting officer or the court; provided, however, that the custodian of any such documents, records or reports may permit inspection of them by a licensed physician or a health official whenever said custodian shall deem such inspection necessary in order to protect the health or welfare of the person or of his family or of the public and the custodian of any hospital record shall permit examination of such record in connection with any claim for compensation or damages for personal injury or death resulting therefrom by any person authorized by any other law to make such examination.
Any person suffering from a venereal disease in the infectious stage and who is unable to pay for treatment may apply for care and treatment to the local board having jurisdiction of the place in which he resides. If the board after investigation finds that the person is in fact unable to pay for treatment, it shall be provided without cost.
The State Department of Health may:
a. Provide appropriate laboratory services for the diagnosis of sexually-transmitted diseases;
b. Provide antibiotics and other appropriate drugs and biologicals for the treatment and prevention of sexually-transmitted diseases.
c. (Deleted by amendment.)
d. (Deleted by amendment.)
The Commissioner of Health may promulgate rules and regulations pertaining to payment for services and materials provided by the department hereunder, including a schedule of fees for such services and materials, consistent with the promotion of public health and the prevention of disease within the State.
The State Department shall make and enforce any rule or regulation for the quarantining and treatment of a venereal disease which it may deem necessary for the protection of the public health.
The State Department of Health shall by rule and regulation define the stages of venereal diseases to be regarded as infectious within the meaning of this article.
The State Director of Health or any person or official authorized by him in writing for that purpose shall have the same power and authority as that conferred by any section or sections of this article upon any local board of health or health officer for the purposes of isolation or quarantine or to require or request examinations or submissions of specimens or treatment, observation or care for venereal diseases.
In any quarantine for venereal disease or any commitment or court order imposed by authority of this act upon any person who, since immediately prior to the onset of the person's infection with a venereal disease, has been continuously a member of a well-recognized church, the principles of which are opposed to medical treatment for disease, any requirement to follow a course of medical treatment shall be optional, but in such case the termination of the period of quarantine, commitment or applicability of the court order shall be determined by the duration of the infectious stage of the disease, as defined by the State Department of Health; provided, however, that nothing herein shall be construed as exempting any such person from any other provision of this act, including the requirements to submit to medical examination and to supply specimens or permit such specimens to be taken, where such person has or there are reasonable grounds to believe such person may have a venereal disease in an infectious stage.
b. Expedited partner therapy shall consist of the health care professional:
(1) prescribing or dispensing medication for the treatment of the sexually transmitted disease. The medication shall be prescribed or dispensed in the sexual partner's name or, if not known, in the name of "Expedited Partner Therapy," and provided to the patient to give to the sexual partner;
(2) providing the patient with printed informational materials, which have been distributed by the department pursuant to subsection a. of section 2 of this act, for the patient to give to the sexual partner; and
(3) requesting that the patient advise the sexual partner of the importance of seeking clinical treatment for the sexually transmitted disease from a health care professional.
The health care professional shall not be required to perform a clinical examination of the sexual partner as a condition of providing expedited partner therapy.
c. A health care professional may provide expedited partner therapy to any sexual partner of the patient, provided that:
(1) the patient indicates with reasonable certainty that the patient has had sexual contact with the sexual partner within the past 60 days under circumstances in which there was a risk of transmission of a sexually transmitted disease;
(2) the patient indicates with reasonable certainty that the sexual partner is unable or unwilling to seek clinical services in a timely manner; and
(3) the patient indicates with reasonable certainty that the patient will be able to contact the sexual partner for the purposes of providing expedited partner therapy.
d. As used in this act:
"Commissioner" means the Commissioner of Health.
"Department" means the Department of Health.
"Health care professional" means a physician, advanced practice nurse, certified nurse midwife, or physician assistant who is authorized to issue prescriptions for the medications used in expedited partner therapy and for whom the treatment of sexually transmitted disease is within the physician's, advanced practice nurse's, certified nurse midwife's, or physician assistant's scope of training and practice.
b. The written informational materials that are developed and distributed by the department pursuant to subsection a. of this section shall be made available in English, Spanish, and any other language that the commissioner determines is the first language of a significant number of people who use or are likely to use expedited partner therapy, and shall include the following:
(1) Information about any medication prescribed or dispensed, including clear and explicit allergy and side effect warnings and a statement that a person who has a history of allergy to the medication, or medications in the same pharmaceutical class as the medication, should not take the medication and should immediately contact a health care professional for a clinical examination;
(2) A warning that a woman who is pregnant or who might be pregnant should not take certain antibiotics and should immediately contact a health care professional for a clinical examination;
(3) Information about the treatment and prevention of sexually transmitted diseases, including the necessity of practicing abstinence for a certain period of time during and after treatment to prevent the risk of exposing others to infection;
(4) Notice concerning the risk to the person, the person's sexual partners, and others, as well as the risk to the public health, if the sexually transmitted disease is not completely and successfully treated;
(5) A recommendation that the person contact a health care professional for a clinical examination that includes testing for sexually transmitted diseases, including the human immunodeficiency virus, and information concerning available testing and clinical resources;
(6) Information concerning the person's responsibility to inform the person's sexual partners of the risk of infection with a sexually transmitted disease, and the importance of urging those partners to seek prompt clinical examination and treatment;
(7) Advice to all women and symptomatic persons, and, in particular, women with symptoms suggestive of pelvic inflammatory disease, to seek medical attention;
(8) Notice that the person may contact a health care professional, the local board of health, or the department with questions concerning the information contained in the materials;
(9) Notice that the person will be liable for the cost of the medication prescribed, unless the person has prescription benefits coverage or the medication was dispensed or otherwise furnished by a health care professional without charge; and
(10) Any other information as may be required by the department, including any additional information or materials the department recommends be provided to persons who are repeatedly diagnosed with a sexually transmitted disease.
c. In consideration of the recommendations and guidelines issued by the federal Centers for Disease Control and Prevention, the department shall develop and make available to health care professionals informational materials and guidance concerning the safe and effective provision of expedited partner therapy. The department may also offer educational programs about expedited partner therapy for health care professionals and licensed pharmacists.
d. The commissioner shall, pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.), and in consideration of recommendations and guidelines issued by the federal Centers for Disease Control and Prevention, adopt rules and regulations to effectuate the provisions of this act, including, but not limited to, establishing a list of sexually transmitted diseases that may be treated through expedited partner therapy.
b. Nothing in this act shall be construed to require a patient's health benefits plan or prescription benefits plan to pay for or provide reimbursement for anyone other than the patient who is provided expedited partner therapy pursuant to this act unless the person to whom expedited partner therapy is being provided is listed as a beneficiary under the patient's health benefits plan or prescription benefits plan.
In case a defendant shall have been twice convicted, within the space of six months, of the violation of the same provision of this article and due proof of such fact is made, the court may, in addition to the imposition of the penalty prescribed by section 26:4-129 of this Title, cause the defendant to be imprisoned, with or without hard labor, for any number of days not exceeding one for each dollar of the penalty.
For the purpose of this act a standard serological test shall be a test for syphilis approved by the State Department of Health, and shall be made at a laboratory licensed in syphilis serology by the department, or by a laboratory in this State approved to make such tests by said department, or at a laboratory outside this State approved by said department, or the health department of the state or territory of the United States or District of Columbia wherein it is located, or at a laboratory of the Armed Forces of the United States or the United States Public Health Services. Such laboratory tests as are required by this act may, at the option of the department, be performed in the laboratories of the State Department of Health without charge.
This act shall take effect January first, one thousand nine hundred and thirty-nine.
For the purposes of this act "migrant laborer" shall mean any seasonal, temporary or migrant worker entering New Jersey and living in a tent, vehicle, building or structure used as living quarters directly or indirectly in connection with any work or place where work is being performed, whether or not rent is paid or reserved in connection with the use or occupancy of such premises.
Any migrant laborer who cannot show satisfactory evidence of examination for syphilis, gonorrhea and other venereal diseases having been performed by a health department or licensed physician within ninety days prior to entry into New Jersey shall submit to such examination as prescribed by the State Department of Health within thirty days after such entry. Said examination shall be performed by a duly licensed physician chosen by the migrant laborer or provided by the State Department of Health.
Any person who shall employ one or more migrant laborers shall notify the State Department of Health within five days of the commencement of such employment whether such person or persons have been examined as required by this section.
The warden or other person in charge of any jail, house of correction, or other penal or correctional institution shall require and cause a medical examination for venereal diseases to be made of any person therein confined for a period of seven days or longer and such warden or other person in charge may require such examination to be made of any person therein confined for a shorter period of time. The superintendent or other person in charge of any detention or contagious disease hospital, or any State, county or city charitable institution shall require and cause a medical examination for venereal diseases to be made of all persons admitted as soon as practicable after admission. Any board or agency operating such jail or institution shall provide a physician licensed to practice medicine and suitable facilities, equipment and supplies to examine inmates for venereal disease and to treat any inmate who is known or found to have a venereal disease and who is in need of treatment. The warden, superintendent or other person in charge of such jail or institution may isolate any inmate who refuses to submit to such examination or who refuses to permit the taking of specimens or any inmate with an infectious venereal disease. If a person has a venereal disease or if any person has refused to submit to examination or to allow specimens to be taken, the warden, superintendent or other person in charge shall notify the State department and may also notify the local health officer of the expected date of release of such person and the facts of the case. Such notification shall be made, if possible, at least five days prior to the actual date of release, and shall be made not later than the day following the date of release in any case.
Any person declared by the department of health to be a carrier of the causative agent of typhoid fever, paratyphoid fever or other disease the infective agent of which is transmissible through food to other persons may apply to the director of health for financial aid for medical or surgical treatment for such carrier condition and for hospital care and maintenance. In the case of a minor the parent or guardian of such person may make such application on his behalf.
Upon receipt of any such application the director shall inquire into the circumstances for the purpose of determining whether such person should properly receive medical or surgical treatment and hospital care as a result of the carrier condition and is unable to pay for such treatment and care, and whether such person is in need of aid for maintenance as a result of inability to earn a livelihood for himself or dependents because of restrictions placed upon such a carrier by the laws of this state or by regulations enacted by the state department of health to protect the public health.
If, after such inquiry, the director is satisfied that financial aid for any or all the purposes set forth above should be granted such person, he shall so report to the department of health setting forth facts found in said inquiry. If the department shall decide that financial aid for any or all the purposes set forth above should be granted such person, the department shall determine the kind and amount of such aid which shall be given and such aid shall then be given from state funds in such amounts, for such purpose or purposes and at such intervals as the director in conformity with the decision of the department shall certify; provided, that the total amount of such aid granted in any one fiscal year to any such carrier shall not exceed the sum of six hundred dollars.
The local board shall cause all reports of cases of tuberculosis, and the results of any examination showing the presence of the bacilli of tuberculosis to be recorded in a register of which it shall be the custodian.
Such register shall not be open to inspection by any person other than the State department and the local board. The local board shall not permit any such report or record to be divulged so as to disclose the identity of the person to whom it relates, except as may be necessary to carry into effect the provisions of this article.
The State department shall expend such sums as shall be annually appropriated for the study, treatment and prevention of tuberculosis.
The State department shall make rules and regulations for the care of persons suffering with tuberculosis, and for preventing the spread of the disease.
The State department shall enforce the rules and regulations and see that they are enforced, for which purpose it may issue orders to local boards and practicing physicians. Every local board shall also enforce said rules and regulations.
When cases of tuberculosis are reported to the state department as required by law, the state department and the local boards shall investigate such cases for the purpose of ascertaining whether the rules and regulations of the state department are being complied with.
Whenever one or both eyes of an infant become inflamed, swollen or reddened, or show any unnatural discharge at any time within two weeks after its birth, and no licensed practitioner of medicine is in attendance upon the infant at the time, the midwife, nurse, attendant or relative having charge of such infant shall report the fact in writing, within six hours, to the local board of health having jurisdiction over the locality in which the parents of the infant reside.
Upon receipt of such report the local board shall direct the parents or persons having charge of such infant to place the infant immediately under the care of a licensed physician, or under the care of the physician of the local municipal government of the locality over which the local board has jurisdiction, if the parents are unable to pay for medical services.
The local board shall furnish a copy of this article to every licensed physician, nurse, and midwife, and any other person deemed proper by the local board in the locality over which the board has jurisdiction, and the state department shall cause a sufficient number of such copies to be printed to supply each local board with the necessary quantity.
The state department shall furnish, free of cost, to a licensed physician or midwife, any prophylactic remedy which it deems best for the prevention of ophthalmia neonatorum, together with instructions which it considers necessary for the proper administration of the same.
Any person who violates any of the provisions of this article shall be liable to a penalty of fifty dollars ($50.00) to be recovered in a civil action by the local board of the municipality in which the violation occurs.
Whenever a dog, cat or other animal is affected by rabies or suspected of being affected by rabies or has been bitten by an animal known or suspected to be affected by rabies, the owner or person in charge of the animal or any person having knowledge thereof, shall forthwith notify the local board having jurisdiction of the place where the animal is located. The notification shall be in writing, signed by the person making the same and shall state where the animal may be found.
Every physician shall, within twelve hours after his first professional attendance upon any person bitten by a dog, cat or other animal, report to the person designated by law or by the local board, under authority of law, to receive reports of reportable communicable diseases in the municipality in which the person so bitten may be, the name, age, sex, color and the precise location of the person so bitten.
The parent or guardian of a child bitten by a dog, cat or other animal, when no physician attends such child, shall within twelve hours after first having knowledge that the child was so bitten, report to the person designated by law or by the local board, under authority of law, to receive reports of reportable communicable diseases in the municipality in which the child so bitten may be, the name, age, sex, color and the precise location of the child.
If an adult is bitten by a dog, cat or other animal and no physician attends him, the adult, or if he is incapacitated, the person caring for him, shall report to the person designated by law or by the local board of health to receive reports of communicable diseases in the municipality in which the adult so bitten may be, the name, age, sex, color and the precise location of the adult.
The report shall be made within twelve hours after the adult was so bitten, or if he is incapacitated, the report shall be made within twelve hours after the person caring for him shall first have knowledge that the adult was so bitten.
The local board, within its jurisdiction, may serve notice upon the owner or person in charge of a dog, cat or other animal which has attacked or bitten a person, to confine the animal at the expense of the owner or person in charge of it upon the premises of the owner or person in charge or at some other place designated in the notice, for at least ten days after the animal has attacked or bitten a person.
The local board, within its jurisdiction, shall serve a notice, in writing, upon the owner or person in charge of a dog, cat or other animal known or suspected to have been bitten by an animal known or suspected of being affected by rabies, requiring the owner or person in charge of the animal to kill it or confine it for a period of not less than six months.
Whenever the local board or any officer or inspector thereof has reason to believe or has been notified by the State Department that there is danger that rabies may spread within the jurisdiction of such board, such board, officer or inspector shall serve a notice, in writing, upon all persons within the jurisdiction of such board, so far as the same may be known to the board or to such officer or inspector thereof, owning or having charge of any dog, requiring such person to confine such dog, or such board, officer or inspector in lieu of serving such notice, in writing, may cause a notice to be published in the official newspaper of such municipality. Other animals may be included in the order whenever, in the opinion of such board, this is necessary.
Whenever the State Department has knowledge that any case of rabies exists among dogs or other domestic animals, within the State, and in its judgment the disease is liable to spread, the department may issue an order requiring any local board to order animals confined as provided in this section, and to cause its provisions to be enforced, by appropriate proceedings either in law or in equity.
An animal confined under order of the local board shall not be released until a certificate of release has been issued by the board.
The local board or the duly authorized agent of the board, within its jurisdiction, shall be permitted by the owner or person in charge of a dog, cat or other animal which has attacked or bitten a person, to examine the animal at any time, and daily if desired, within a period of 10 days after the animal has attacked or bitten a person, to determine whether the animal shows symptoms of rabies.
If the animal dies within the 10-day confinement period or if the owner or person in charge of the animal chooses to euthanize the animal at any time during the confinement period, the local board may order a laboratory examination for rabies to be performed on the dead animal, in compliance with section 2 of P.L.2021, c.436 (C.26:4-86.2).
Except as provided for in section 2 of P.L.2021, c.436 (C.26:4-86.2), no person shall refuse, obstruct, or interfere with the local board in making any examination authorized pursuant to this section.
The Legislature therefore determines that it is the public policy of the State to require those caring for an animal, including veterinarians and staff at animal hospitals, to: (1) clearly communicate to the owner the tests and procedures required and how the tests and procedures may affect the condition of the animal's body after death; and (2) disclose whether the remains of the animal can be returned to the owner, and the condition of the those remains. The Legislature further determines that the importance of the connection between domestic companion animals and their owners needs to be recognized and addressed by those who treat animals, euthanize them, and handle their remains after death.
b. Whenever it is necessary to test a dead domestic companion animal for rabies, prior to commencing any testing procedure, the health official requiring the rabies testing, or the veterinarian preparing and submitting the specimen for rabies testing, as applicable, shall notify at the first opportunity the owner of the animal, if known, verbally and in writing, of:
(1) the necessity of the rabies testing and the reasons therefor;
(2) the rabies testing protocol to be followed;
(3) the protocol to be followed with regard to the handling of the animal's body;
(4) the protocol to be followed with regard to the disposal of the animal's body or its return to the owner; and
(5) the protocol of decapitation.
c. Upon receiving the notification required in subsection b. of this section, the owner of the animal shall immediately provide, in writing, in the manner prescribed by the department pursuant to subsection d. of this section:
(1) release of the animal to the health official or veterinarian, as applicable, for the rabies testing, in accordance with the protocols to be followed pursuant to subsection b. of this section; and
(2) the owner's signature to acknowledge notification about the protocols and procedures to be followed pursuant to this section.
d. The Department of Health shall develop and provide on its website forms for use in providing the notification required pursuant to subsection b. of this section, and the release, and acknowledgement of notification required pursuant to subsection c. of this section.
e. This section shall not apply to rabies testing required pursuant to section 10 of P.L.1989, c.307 (C.4:19-26) or to the handling of an impounded animal that is suspected of being rabid pursuant to section 16 of P.L.1941, c.151 (C.4:19-15.16). In cases where a veterinarian or health official has made reasonable attempts to contact the owner to comply with this section and the owner is unable to be contacted or refuses to provide a signature, rabies testing can proceed. When contact is made but a written signature or acknowledgement by the owner cannot be obtained, the veterinarian or health official shall document the date and time that verbal notification was made to the owner and keep this information on file for six months.
f. Nothing in this section shall be construed to interfere with the powers of any municipality to control rabies consistent with R.S.26:4-95.
g. As used in this section, "domestic companion animal" means any animal commonly referred to as a pet that was bought, bred, raised, or otherwise acquired, in accordance with local ordinances and State and federal law, for the primary purpose of providing companionship to the owner, rather than for business or agricultural purposes. "Domestic companion animal" shall not include "domestic livestock" as defined in subsection c. of section 1 of P.L.1995, c.311 (C.4:22-16.1).
Each local board shall furnish information to the state department concerning the prevalence of rabies within its jurisdiction whenever or as often as requested to do so by the state department.
The state department shall prepare a circular containing a description of the symptoms, the methods of transmission, the treatment, and the preventive measures to be taken against the spread of rabies, and, upon application, shall provide sufficient copies of the circular for distribution.
The circulars shall be furnished to the person empowered under the law to license dogs, and if there is no provision for such person within the jurisdiction of the local board of health, the local board is empowered to act. Such person or board shall apply to the state department for a sufficient number of such circulars, and shall, at the time of licensing, furnish a copy of the circular to each person who may obtain a dog license.
Each local board may furnish without charge the Pasteur treatment for any indigent person, residing within its jurisdiction, who has been bitten by an animal known or suspected to be affected by rabies.
Any expense thus incurred shall be provided for by the governing body having charge of the finances of the municipality in which the indigent person resides in the same manner as the regular funds of the board are provided for.
Any person who violates any of the provisions of this article, or any notice served thereunder, shall be liable to a penalty of $50 for the first offense, and not less than $50 nor more than $250 for each subsequent offense, to be recovered in a civil action brought by and in the name of the Department of Health or a local board. Penalties hereunder shall be enforced and collected pursuant to R.S.26:3-72, R.S.26:3-77 and R.S.26:3-78.
Nothing in this article shall be construed to change or affect the provisions of any law authorizing the mayor or governing body of a municipality to enforce measures for the restriction and control of rabies.
The State Department of Health is hereby directed to establish and conduct a virology program having as its objectives:
(a) the furnishing of services as may be necessary to establish the presence of virus diseases, and to establish epidemiological control of virus diseases as well as those services necessary to determine the effectiveness of control measures.
(b) development of improved techniques or methodologies in establishing the presence of virus diseases and the control thereof.
The virology program shall be financed during the current fiscal year from any moneys available to the department.
a. The human papillomavirus (HPV) is the most common sexually transmitted infection in the United States, and can be transmitted without intercourse;
b. Although most HPV infections are benign and many strains clear on their own, certain strains have serious consequences, including cervical cancer and genital warts;
c. HPV has been detected in over 90% of cervical cancer cases, and the American Cancer Society estimates that over 9,700 new cases of HPV-related cervical cancer will occur in the United States this year; and
d. It is appropriate to take measures through education to significantly reduce medical problems and deaths attributable to HPV.
b. The commissioner shall prepare a patient information brochure regarding the human papillomavirus, including its causes and the most effective means of prevention and treatment. The department shall distribute the pamphlet, at no charge, to all pediatricians in the State. The department shall update the pamphlet as necessary, and shall make additional copies of the pamphlet available to other health care providers upon request.
The state department may prepare in the state bacteriological laboratory culture media, stains, solutions, cultures, cultural products, and other laboratory supplies which may be useful to the county or municipal laboratories, physicians, or pharmacists in this state.
Such materials may be sold at prices fixed by the state department to county and municipal laboratories, physicians, and pharmacists in this state under rules and regulations adopted by the department.
All moneys received from the sale of such laboratory supplies shall be paid by the state department to the state treasurer and shall be added to the amount appropriated for the support of the bacteriological laboratory, and shall be expended by the state department for the maintenance of the laboratory.
If the state department ascertains that any vaccine virus, antitoxin, or other biological product sold, or offered for sale, or held for sale or use for prophylactic or remedial purposes is dangerous to human health, or so impure or inert as to be inefficacious in rendering immune or less susceptible to disease any person in whom the product may be used, the department may prohibit the further sale or use of such product or any other biological product manufactured or produced by the same party.
No person shall knowingly sell or offer for sale, or use, or offer for use, any such prohibited product.
The state department may purchase and distribute free, in accordance with rules of the department, diphtheria toxoid or toxin-antitoxin, or both, and smallpox vaccine.
For the purchase and distribution of such materials and for expenses incident to such distribution and the keeping of records of the use of such materials, the department may expend such sum as shall be appropriated in any annual or supplemental appropriation act.
The local board of health of any city which is engaged in the production of diphtheria antitoxin may sell any surplus antitoxin at a price determined by it.
The Department of Health of the State of New Jersey is hereby authorized to purchase and to distribute free, anti-pneumococcic serum for the treatment of persons affected with pneumonia and for determining the type of pneumococci from persons suspected or known to have the disease.
Anti-pneumococcic serum may be supplied free by the said department to a physician licensed to practice in the State of New Jersey only after he has signed an application which shall contain a statement that the person to be treated is affected with pneumonia and is financially unable to purchase the serum, and such other facts as the State Department of Health may require, including the name and address of the patient, the type of pneumococci present, the duration of the disease and the amount of serum requested.
The said department may review any such application for serum and if it finds a false or misleading statement as to the ability of the person to pay for the serum, a bill therefor shall be presented to said person.
The State Department of Health shall be and is hereby empowered to make necessary rules and regulations for the purpose of administering this act.
The Department of Health of the State of New Jersey is hereby authorized, within the limits of available appropriations therefor, to purchase and to distribute free, in accordance with rules of said department, typhoid vaccine, other biologicals, and antibiotics, for use in preventing or treating communicable diseases.
For the purchase and distribution of the said materials, and for expenses incident to such distribution and the keeping of records of the use of said material, the said department is hereby authorized to expend such sum as shall be appropriated by any law, or such amount as may be available to the department for other biological products, or which may otherwise be available.
It is hereby declared to be the policy of the State that no child shall be denied vaccination against poliomyelitis because of inability to pay the cost thereof. It is hereby found that there exists a shortage of poliomyelitis vaccine (hereinafter referred to as "the vaccine") and that the public interest requires that the purchase, sale, distribution and use of the vaccine shall, so long as the shortage shall exist, be controlled and regulated as herein provided, to the end that fair and equitable distribution may be had and the vaccine be administered to children and others in accordance with priority groups based on the relative susceptibility of various age groups of children and others to poliomyelitis.
The State Commissioner of Health (hereinafter referred to as "the commissioner") is authorized and directed, without compliance with chapter 48 of the laws of 1954, to purchase poliomyelitis vaccine supplementing that which may be made available pursuant to conditions of Federal grants in sufficient quantities to inoculate children of this State who shall not have attained the age of 20 years and for whom free vaccine is not available through the auspices of the National Foundation for Infantile Paralysis or because of inability to pay the cost thereof. The commissioner shall distribute the vaccine so purchased or acquired under such plan, procedures and regulations as to him shall appear necessary or appropriate to accomplish the objective of providing the vaccine without cost for such children, fairly and equitably, according to priority groups based upon the relative susceptibility of various age groups of children to poliomyelitis as determined by the commissioner and upon such evidence or assurances of use for such children as to the commissioner shall appear to be adequate and consistent with expeditious distribution of the vaccine.
The commissioner on behalf of the State is authorized and directed to apply for and receive Federal grants of the vaccine or funds therefor and to use such funds for the purchase of the vaccine in accordance with the conditions of such grants and for distribution as provided in section 2 of this act, and to make such reports and establish such methods and procedures as may be required for such Federal grants.
In carrying out the purposes of this act the commissioner is authorized to enlist the participation and co-operation of the State Department of Education, the Division of Purchase and Property, the Division of Civil Defense and any other department or division which in his opinion may be of assistance to him, and every such department or division, so enlisted, is authorized and directed so to assist the commissioner.
(a) The commissioner shall have the power and authority, upon a finding that the vaccine continues to be in short supply, to make, promulgate, suspend, repeal and enforce rules and regulations concerning the purchase, sale, distribution, and use of the vaccine, to the end that the vaccine, whether distributed by an agency of the State or through private channels, shall be fairly and equitably available to all children and others in accordance with priority groups based on the relative susceptibility of various age groups of children and others to poliomyelitis, as found and determined by the commissioner and prohibiting the sale, offer to sell, purchase, distribution and use of the vaccine in contravention of such rules and regulations. No person shall buy, sell, offer to sell, distribute or use the vaccine except in accordance with such rules and regulations.
(b) Such rules and regulations and all amendments thereof may be adopted with or without public hearing; shall be filed with the Secretary of State; and shall become effective immediately upon the filing thereof, unless otherwise therein provided.
(c) Any person who knowingly violates any provision of this act or of any rule or regulation adopted thereunder, or who conspires with or knowingly aids, abets or assists another to do so, is a disorderly person.
(d) The expiration or other termination of a rule or regulation shall not terminate or affect the liability of a person for violation thereof or of this act.
In addition to the sums appropriated to the State Department of Health during the fiscal year 1955-56, there is hereby appropriated out of the general treasury for the period between the date of the enactment of this act and June 30, 1956, the sum of $570,000.00 for the purchase of the vaccine and for no other purpose.
For carrying out the provisions of this act in the fiscal year beginning July 1, 1956, there shall be appropriated to the State Department of Health any unexpended balances remaining from the appropriation contained in section 6 of this act.
(1) volunteer emergency medical technicians-ambulance and volunteer firefighters;
(2) all other emergency medical technicians-ambulance, firefighters and police officers in squads or departments with less than 100 members; and
(3) all other emergency medical technicians-ambulance, firefighters and police officers.
The Director of the Division of Epidemiology and Communicable Disease Control shall promulgate rules and regulations in order to effectuate the purposes of this fund.
b. A person whose medical insurance policy pays for the full cost of the hepatitis inoculation shall not receive payment for an inoculation administered pursuant to subsection a. of this section. A person whose medical insurance policy pays for a portion of the cost of hepatitis inoculation may be reimbursed for the unpaid portion from the Hepatitis Inoculation Fund.
No vessel infected with a communicable disease, and no vessel on board of which there is any person, baggage, merchandise or materials infected with such disease, shall be brought to any wharf, nor shall any person or cargo so infected, or person, baggage, merchandise or materials on any vessel so infected, land or be landed at any place until a permit to do so has been obtained from the local board having jurisdiction of the place where it is intended to bring the vessel to wharf, or to land the person, baggage, merchandise or materials.
A permit shall not be granted until after the vessel, and every person and the baggage, merchandise or materials on it, has been examined, cleansed, ventilated, and purified, and a quarantine period has been observed. The state department is authorized to make regulations or to issue special orders with respect to the examination, cleansing, ventilation, purification, and the quarantine period required preliminary to the issuance of a permit.
The local board may, whenever in its judgment the protection of the public health requires it, order the master or commander of any vessel within its jurisdiction to remove the vessel to a place of safety to be designated by the board, and to order any person, baggage, merchandise or materials which have been landed from the vessel to be seized and returned to the vessel or taken to some other place of safety to be designated by the board.
If the master or commander cannot be found, or if he fails to obey any such order, the local board may employ any necessary assistance to make the order effective.
The master or commander shall not, after the issuance of an order under the provisions of section 26:4-103 of this title, bring his vessel to any landing place within the jurisdiction of the local board, or land any person, baggage, merchandise or materials from the vessel at any place within that jurisdiction, until a permit has been granted by the local board as required in section 26:4-101 of this title.
No vessel coming from any foreign or domestic port, which shall pass any quarantine station, located in Long Island sound, or in New York bay, whose master or commander has obtained a written permit from the proper quarantine officer at any of these quarantine stations to proceed with his vessel to any place in the state of New Jersey, shall be brought to any wharf, and no passenger, baggage, merchandise or materials on board of any such vessel shall land or be landed at any place until the master or commander shall deposit his permit at the office of the local board of health of the place of destination named in the permit. Such deposit shall be made within twenty-four hours after receiving the permit. In addition to the deposit of such permit, the master or commander shall obtain a permit to land as required by section 26:4-101 of this title.
If the local board, or the officer acting for it, shall have no reason to believe that such vessel, or any person, baggage, merchandise or materials on the vessel, is infected with a communicable disease, a permit to land shall be granted upon the deposit of the permit issued by the quarantine officer as required in section 26:4-106 of this title.
If the local board, or the officer acting for it, has reason to believe that the vessel, or any person, baggage, merchandise or materials on it, is infected with any communicable disease, no permit to land shall be granted, except subject to any regulation or special order prescribed by the state department.
The following vessels shall come to anchor at some place designated by the Perth Amboy port health officer for the purpose of inspection:
a. Every vessel which, between the first day of March and the first day of December in any year, or within any other time in any year designated by resolution of the state department, shall come into that portion of the waters of this state known as Raritan bay or Sandy Hook bay south of a straight line extending from Ward's point to the northerly extremity of Sandy Hook and comes from:
Any port in the United States south of Cape Henlopen;
Any West India, Bahama, or Bermuda island port; or
Any port or place where any communicable disease exists.
b. Every vessel which, at any time during the year, comes into the waters enumerated in paragraph "a" of this section on board of which:
Any person shall have died while at any port in the United States south of Cape Henlopen or at any foreign port, or while between any such port and Raritan bay or Sandy Hook bay;
There is any baggage, merchandise or materials by which any communicable disease may be introduced into this state; or
The Perth Amboy port health officer shall have reason to believe that any person may be sick with any communicable disease or that there may be any baggage, merchandise or materials by which any communicable disease may be introduced into this state.
The anchorage place described in section 26:4-109 of this title shall be southward of a straight line extending from the south ferry wharf in Perth Amboy to the house on Staten Island formerly of Caleb Ward, as well as southward and eastward of a straight line extending from the south ferry wharf to the most easterly wharf of South Amboy.
Whenever any such vessel shall arrive at the designated anchorage place, the Perth Amboy port health officer shall, subject to any regulation or special order of the state department:
a. Visit the vessel and examine the sanitary conditions of the vessel, and of any person, baggage, merchandise or materials on board;
b. Order the vessel, and any baggage, merchandise or materials on board, to be cleansed, ventilated, and purified under his supervision and direction, and for that purpose to require the vessel to be unloaded if necessary;
c. Order the vessel to be detained at quarantine for any period after the vessel, and baggage, merchandise or materials on board shall have been so cleansed, ventilated, and purified, which any regulation or special instruction of the state department may require;
d. Prescribe a quarantine station for such vessel;
e. Prohibit and prevent communication with any infected vessel; and
f. Detain and isolate any infected person.
The Perth Amboy port health officer also shall have power with reference to such vessel, subject to any regulation or special order of the state department:
a. To grant a permit to land any passenger, baggage, merchandise or materials;
b. To grant a permit to discharge any baggage, merchandise or materials into lighters or otherwise;
c. To release such vessel from quarantine; and
d. To give any other orders which he may think necessary for the prevention of the introduction into this state of any communicable disease.
Whenever, in time of threatened epidemic or injury to the public health, the state department shall consider that a health officer should be appointed for any port or maritime place other than Perth Amboy, the state department may appoint a competent person as temporary port health officer for such place, who shall hold office during the pleasure of the department and shall receive as compensation for his services the fees which he collects under this article.
A temporary port health officer shall exercise all the powers conferred upon, and perform all the duties required of, the local board of health by this article. He shall wholly supersede the local board having jurisdiction of the place for which he may be appointed in the exercise of such powers and the performance of such duties.
The following fees shall be paid to the local board or port health officer:
a. For examination of every vessel from a foreign port, five dollars.
b. For examination of every vessel from any port in the United States south of Cape Henlopen, if a steamer, three dollars, and if other than a steamer, one dollar.
c. For medical examination of every one hundred, or fraction of one hundred, steerage passengers upon transatlantic vessels, two dollars.
d. For each permit granted for the landing of persons, or discharging of baggage, merchandise or materials, and for every release of a vessel from quarantine, twenty-five cents.
e. For sanitary inspection of every vessel after the discharge of cargo or ballast, ten dollars.
f. For disinfection of every vessel from an infected port, and of every vessel that shall require disinfection by reason of exposure to infection or contagion, fifty dollars.
g. For vaccination of persons on board of any vessel on which smallpox has developed during the voyage, twenty-five cents each.
The port health officer shall keep a record of all fees received by him under this article.
All fees collected by the Perth Amboy port health officer or by his deputy, under the provisions of this article, shall be paid monthly to the state treasurer. Such health officer shall also give to the state treasurer a full account of all fees collected during the preceding calendar month.
All expenses incurred by, and all fees becoming due to, any port health officer or local board, or any of their employees, for services rendered or duties performed under the provisions of this article or under any regulation prescribed by the state department shall be paid by the master, commander, or owner of the vessel in relation to which the duties shall be performed or services rendered.
The port health officer or local board to whom any moneys shall be due on account of any expense or fees shall have a lien for the amount of the expenses or fees, and for all costs of suit and such counsel fee for the plaintiff as the court may allow, upon the vessel, its tackle, apparel and furniture.
If payment is not made on demand, the lien may be enforced by a suit in admiralty, or other proper suit, in any court of competent jurisdiction.
The state department may issue any necessary order revoking, modifying, supplementing, or superseding any order given, or act done, under the provisions of this article, by the local board or the port health officer.
The master, commander, or other person in charge of any vessel concerning which, or concerning any person, baggage, merchandise or materials on board of which, any order may be given by the local board or port health officer, or by the state department, shall cause the order to be obeyed.
The state department may require from the local board and the port health officer any necessary reports relating to their duties under this article.
The state department shall have the power, from time to time, to adopt, alter, and amend regulations prescribing the manner and form in which the local board and the port health officer shall exercise the powers conferred upon and perform the duties required of them by this article.
Any person who shall violate any of the provisions of this article shall be guilty of a misdemeanor. On conviction he shall be punished for each offense by a fine not exceeding three thousand dollars, or by imprisonment for a term not exceeding one year, or both.
Except as otherwise specifically provided in this chapter, a person who violates any of the provisions of this chapter, or fails to perform any duty imposed by this chapter at the time and in the manner provided, shall be liable to a penalty of not less than ten nor more than one hundred dollars for each offense.
Except as otherwise specifically provided in this chapter, any penalty incurred for a violation of any of the provisions of this chapter shall be sued for and recovered by the State department, or by the local board of the municipality within which the violation occurred.
Every municipal court shall have jurisdiction over proceedings to enforce and collect any such penalty, if the violation has occurred within the territorial jurisdiction of the court. The proceedings shall be summary and in accordance with the Penalty Enforcement Law (N.J.S. 2A:58-1 et seq.). Process shall be either in the nature of a summons or warrant.
The court may cause any defendant who shall fail to pay forthwith the amount of the judgment rendered against him, and all costs and charges incident thereto, to be committed to the county jail for any period not exceeding ninety days.
All moneys recovered in any such proceedings shall be paid to the plaintiff therein and applied by such plaintiff to any purpose for which it may be legally authorized to expend money.
a. ensure the greatest possible protection to the public from morbidity and death related to infectious diseases preventable by appropriate and timely immunizations;
b. establish the public health infrastructure necessary:
(1) to assist individuals and families to maximize their personal protection from vaccine-preventable diseases in as efficient and efficacious a manner as possible;
(2) for community-wide and population-specific surveillance of potential susceptibility to outbreaks of vaccine-preventable diseases; and
(3) for an effective response to a bio-terrorism event utilizing a potentially vaccine-preventable disease organism or to an epidemic or pandemic outbreak of a novel influenza virus of unusual virulence;
c. ensure that a registrant, or the registrant's parent or legal guardian if the registrant is a minor, can more easily obtain from his health care provider or local health authority, or by other means as determined by the Commissioner of Health and Senior Services, the registrant's full immunization history if the registrant changes health care providers or requires documentation of immunization;
d. provide health care providers, licensed child care centers, schools, colleges, and other public agencies and private organizations authorized to access the immunization registry with information concerning immunizations and other preventive health screenings, and the ability to determine relevant immunization and other preventive health screening histories of the individuals whom they serve;
e. provide the State with greatly improved accuracy in its records concerning immunization rates among the State's residents;
f. improve the State's ability to respond to outbreaks of communicable and vaccine-preventable diseases in a manner that reduces the risk of unnecessary additional immunizations;
g. enable the efficient allocation of public health resources to provide the widest possible protection of the general population from vaccine-preventable diseases;
h. ensure that all vulnerable children can be brought to completed immunization status as quickly as possible following manufacturing or distribution delays that may occur; and
i. establish the legal and administrative framework necessary to ensure a properly functioning, universal, Statewide immunization registry inclusive of both public and private partners working cooperatively to share immunization data in a timely manner.
"Commissioner" means the Commissioner of Health.
"Department" means the Department of Health.
"Health care provider" means a health care facility licensed pursuant to P.L.1971, c.136 (C.26:2H-1 et seq.) or a health care professional whose practice is regulated pursuant to Title 45 of the Revised Statutes.
"Registry" means the New Jersey Immunization Information System established pursuant to this act.
b. A newborn infant in New Jersey, who is born on or after January 1, 1998, shall be enrolled in the registry immediately following birth unless the parent or legal guardian of the infant provides a written request to not participate in the registry.
A child born prior to January 1, 1998 may be enrolled in the registry at the parent's or legal guardian's written request.
c. Access to the information in the registry shall be limited to: health care providers, schools, colleges, licensed child care centers, and public agencies, and private organizations as determined by regulation of the commissioner. A registrant, or the registrant's parent or legal guardian if the registrant is a minor, shall have access to the registrant's immunization and other preventive health screening information in the registry.
d. The information contained in the registry shall be used for the following purposes:
(1) to help ensure that registrants receive all recommended immunizations in a timely manner by providing access to the registrants' immunization records;
(2) to help improve immunization rates by providing notice to registrants of overdue or upcoming immunizations; and
(3) to help control communicable diseases by assisting in the identification of persons who require immediate immunization in the event of a vaccine-preventable disease outbreak.
e. The authentic immunization and other preventive health screening record of a child, which shall consist of a paper or electronic copy of the registry entry that is a true and accurate representation of the information contained therein, obtained from the registry shall be accepted as a valid immunization and preventive health screening record of the registrant for the purpose of meeting immunization and preventive health screening documentation requirements for admission to a school, college, or licensed child care center.
f. A health care provider shall not discriminate in any way against a person solely because the person elects not to participate in the registry.
g. An authorized user granted access as provided in subsection c. of this section shall only access information in the registry on a specific patient or client who is presently receiving services, is under the user's care or is within the applicable governmental health authority's jurisdiction.
h. An agency, organization, or other entity authorized to access information in the registry shall not use any report made by a health care provider pursuant to this act in any punitive manner against the provider.
i. The commissioner, in consultation with the Public Health Council, shall adopt rules and regulations, pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.), to effectuate the purposes of this act, including, but not limited to:
(1) the establishment and maintenance of the registry;
(2) the methods for submitting, and the content of, reports of immunizations to the registry, for which purpose the commissioner shall provide, to the maximum extent practicable, for reporting options to facilitate compliance with the requirements of subsection b. of this section;
(3) procedures for the birth hospital of a newborn infant or health care provider, as applicable, to inform the parent or legal guardian of a newborn infant or minor of the purpose of the registry and its potential uses by parties having authorized access to registry information, and the content of that information;
(4) procedures for a registrant, or the registrant's parent or legal guardian if the registrant is a minor, to review and correct information contained in the registry;
(5) procedures for the parent or legal guardian of a newborn infant or minor, or a person over 18 years of age, to request to not participate in the registry at any time and to remove or inactivate information from the registry;
(6) limits on, and methods of, access to the registry by those authorized pursuant to subsection c. of this section;
(7) procedures for health insurers to obtain immunization information from the registry concerning only their covered persons, as well as summary statistics, which information or statistics shall not be used or disclosed for any other purpose than to:
(a) improve patient care;
(b) provide quality assurance to employers purchasing group coverage and to health care providers;
(c) improve outreach and education efforts with respect to their covered persons and health care providers; and
(d) monitor and improve quality of care standards as developed by professional organizations, accreditation agencies and government agencies in collaboration with the department; and
(8) procedures for the department to disseminate statistical information and supporting commentary.
a. reporting information to, receiving information from, or disclosing information received from, the registry in accordance with the provisions of this act or any regulation adopted pursuant thereto; and
b. any error or inaccuracy in the information that is reported to, received from, or disclosed after receipt from, the registry in accordance with the provisions of this act or any regulation adopted pursuant thereto, and any consequence of that error or inaccuracy.
b. A person who is aggrieved as a result of a violation of this act may commence a civil action against the person or entity committing the violation to obtain appropriate relief, including actual damages, equitable relief and reasonable attorney's fees and court costs. Punitive damages may be awarded when the violation evidences wantonly reckless or intentionally malicious conduct by the person or entity who committed the violation.
c. A person who discloses information in violation of this act is guilty of a disorderly persons offense. Each disclosure made in violation of this act is a separate and actionable offense.
"Campground" means a plot of ground upon which two or more campsites are located, established or maintained for occupancy by camping units of the general public as temporary living quarters for children or adults, or both, for a total of 15 days or more in any calendar year, for recreation, education, or vacation purposes.
"Common interest community" means:
a. property subject to the "Condominium Act," P.L.1969, c.257 (C.46:8B-1 et seq.) or the "Horizontal Property Act," P.L.1963, c.168 (C.46:8A-1 et seq.);
b. a housing corporation or association, commonly known as a cooperative, which entitles the holder of a share or membership interest thereof to possess and occupy for dwelling purposes a house, apartment, manufactured or mobile home or other unit of housing owned or leased by the corporation or association, or to lease or purchase a unit of housing constructed or to be constructed by the corporation or association; or
c. real estate with respect to which a person, by virtue of his ownership of a unit, is obligated to pay for real estate taxes, insurance premiums, maintenance or improvement of other real estate described in the instrument, however denominated, which creates the common interest community. Ownership of a unit does not include holding a leasehold interest of less than 20 years in a unit, including renewal options.
"Health club" means a health club that is registered with the Director of the Division of Consumer Affairs in the Department of Law and Public Safety pursuant to P.L.1987, c.238 (C.56:8-39 et seq.).
"Hotel" or "motel" means a commercial establishment with a building of four or more dwelling units or rooms used for rental and lodging by guests.
"Mobile home park" means a parcel of land, or two or more contiguous parcels of land, containing at least 10 sites equipped for the installation of mobile or manufactured homes, where these sites are under common ownership and control, other than as a cooperative, for the purpose of leasing each site to the owner of a mobile or manufactured home for the installation thereof, and where
the owner provides services, which are provided by the municipality in which the park is located for property owners outside the park, which services may include, but shall not be limited to:
a. Construction and maintenance of streets;
b. Lighting of streets and other common areas;
c. Garbage removal;
d. Snow removal; and
e. Provision for the drainage of surface water from home sites and common areas.
"Private lake, river or bay or private community lake, river or bay association" means an organization of property owners within a fixed or defined geographical area with deeded or other rights to utilize, with similarly situated owners, various lakefront, riverfront or bayfront properties, which properties are not open to the general public, other than bona fide guests of a member of the private lake, river or bay or private community lake, river or bay association.
"Private marina" means a privately-owned water dependent facility for the docking, servicing or storage of private boats, at which services are provided on an annual, seasonal or per diem basis, and which facility is not open to the general public, other than bona fide guests of boat owners eligible to use the marina and which has a private swimming pool that is not open to the general public, other than bona fide guests of boat owners eligible to use the marina.
"Retirement community" means a retirement community which is registered with the Division of Housing and Development in the Department of Community Affairs pursuant to "The Planned Real Estate Development Full Disclosure Act," P.L.1977, c.419 (C.45:22A-21 et seq.).
"Specially exempt facility" means a private lake, river or bay or private community lake, river or bay association, or private nonprofit common interest community which restricts the use of its lake, river, bay or pool, as appropriate, to the owners of units thereof and their invited guests. Specially exempt facility also includes a campground, hotel, motel, mobile home park, or retirement community which restricts the use of its pool to renters of the lodging units or owners of the dwelling units, as appropriate, and their invited guests, or day-use visitors, or a private marina which restricts the use of its swimming pool to owners of boats eligible to use the facilities and their invited guests. Specially exempt facility also includes a privately-owned campground which restricts the use of a swimming area other than its swimming pool to renters of the lodging units or owners of the dwelling units, as appropriate, and their invited guests, or day-use visitors. Specially exempt facility also includes a health club which restricts the use of its pool to the health club's members and their invited guests; does not permit the use of its pool by persons under 16 years of age; and in which the maximum depth of the water in the pool does not exceed five feet, but does not include a health club which shares the use of its pool with another entity.
a. A campground, private marina with a swimming pool, hotel, motel, mobile home park or retirement community which does not voluntarily comply with these requirements shall have a manager or owner on the premises when its swimming area or, in the case of a private marina, when its swimming pool is open for use;
b. A health club which does not voluntarily comply with these requirements shall have an owner or manager on the premises when its swimming pool is open for use. The provisions of this section shall not be construed to exempt a health club from the provisions of P.L.2005, c.346 (C.2A:62A-30 et seq.); and
c. A health club which would ordinarily qualify as a specially exempt facility, but no longer satisfies all of the requirements for exemption because it has elected to provide swimming lessons, classes, or instruction, either directly or through a third-party entity, to persons who are not members of the health club, or to persons who are under 16 years of age, shall continue to be deemed a specially exempt facility for the purposes of P.L.1991, c.135 (C.26:4A-4 et seq.), provided that the health club complies with the first aid personnel and lifeguard requirements of N.J.A.C.8:26-5 et seq. while the swimming lessons, classes or instruction are taking place.
No specially exempt facility shall be deemed ineligible for an exemption from mandatory compliance with the first aid personnel and lifeguard requirements of N.J.A.C.8:26-5 et seq., as provided in this section, solely on the basis that the facility has a functional diving board, water slide, or similar recreational appurtenance.
b. Lifeguards who are on duty at a swimming pool shall not have duties or perform any activities that would distract them or intrude upon their attention from proper observation of persons in the swimming pool area or that prevent immediate assistance to persons in distress in the water; except that nothing in this subsection shall be construed to prevent any lifeguard from performing minor administrative tasks, such as checking pool passes, or from performing any routine testing required by the Department of Health by regulation, including, but not limited to, testing disinfectant levels and measuring the pH of the water during operational hours, provided that the lifeguard can perform these tasks and tests without causing an imminent, significant risk to bather safety.
c. No seasonal or year-round swimming pool that was in existence on January 1, 2018 shall be required to take any steps to comply with any new requirements concerning swimming pool circulation systems established by the Department of Health by regulation on or after January 1, 2018, until such time as alterations are made to any part of that swimming pool's circulation system. As used in this subsection, "alteration" means any modification or relocation of any structure or equipment, or change of water flow patterns in an existing swimming pool, such that the design, configuration, or operating characteristics of the circulation system are different from the original design, configuration, or operating characteristics of the circulation system. The term does not include normal maintenance, repair, or replacement of equipment with the same or a newer model.
b. A health club which is a specially exempt facility and does not voluntarily comply with the first aid and lifeguard requirements of N.J.A.C.8:26-5 et seq., shall post a sign not less than three feet by four feet, which shall be prominently displayed at the entrance to its swimming pool, stating: "No lifeguard on duty. Persons under the age of 16 are not permitted to use this pool." The sign shall also state: "This pool shall be closed when the owner or manager is not on the premises." This information shall also be posted on a sign not less than eight inches by 10 inches at the member service desk of the health club.
Notwithstanding any provisions of this act to the contrary, the Department of Health may adopt rules and regulations pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.), requiring that first aid personnel or a lifeguard, or both, be on the premises of a specially exempt facility in those cases in which the facility has a functional diving board, water slide or other recreational appurtenance that may present an increased safety risk or hazard.
Any place of employment or of public accommodation which maintains public restrooms shall make available at least one-half of the units in each such restroom without charge and shall charge equally for the use of the remaining units designated for men and women. Where a public restroom has only one unit, that unit shall be made available without charge. For the purpose of this act "unit" shall include only toilets and "one-half" means the number of units divided by two, but where such division results in a whole number and a fraction, "one-half" means said whole number.
Whenever restroom entry doors are secured by a lock, admission keys shall be provided without charge upon request and notice as to the availability of such keys shall be posted on the entry door.
Any person owning or operating a place of employment or public accommodation which violates this act is a petty disorderly person.
b. Any penalty recovered under the provisions of this act shall be recovered by and in the name of the Commissioner of Health and Senior Services or by and in the name of the local board of health. When the plaintiff is the Commissioner of Health and Senior Services, the penalty recovered shall be paid by the commissioner into the treasury of the State. When the plaintiff is a local board of health, the penalty recovered shall be paid by the local board into the treasury of the municipality where the violation occurred.
c. Every municipal court shall have jurisdiction over proceedings to enforce and collect any penalty imposed because of a violation of any provision of this act, if the violation has occurred within the territorial jurisdiction of the court. The proceedings shall be summary and in accordance with "the penalty enforcement law," N.J.S.2A:58-1 et seq. Process shall be in the nature of a summons or warrant and shall issue only at the suit of the Commissioner of Health and Senior Services, or the local board of health, as the case may be, as plaintiff.
"Department" means the Department of Health.
"Health care facility" means a health care facility that is licensed by the department pursuant to the "Health Care Facilities Planning Act," P.L.1971, c.136 (C.26:2H-1 et seq.).
"Lactation room" means a sanitary room, other than a restroom, which can be used by a mother to breast feed her baby or express milk in private, and which includes an electrical outlet, a chair, and nearby access to running water.
"Medical Assistance Customer Center" means a community-based office that is operated by the Division of Medical Assistance and Health Services in the Department of Human Services.
"One-Stop Career Center" means the same as that term is defined by section 3 of P.L.1992, c.43 (C.34:15D-3).
b. The department shall create signage that: (1) contains information about breast feeding; (2) affirms a mother's right to nurse in public, as provided by section 2 of P.L.1997, c.101 (C.26:4B-4); and (3) indicates that lactation rooms are being made available for the privacy and comfort of nursing mothers, pursuant to this act. Such signage shall be distributed directly to the various facilities identified in subsection a. of this section, and shall additionally be posted, in a printable format, on the department's Internet website. A facility that is required to provide a lactation room pursuant to subsection a. of this section shall display the signage prepared under this subsection in a clear and conspicuous manner in the facility's public waiting room, as well as in any lactation room that is made available pursuant to this act.
c. No later than one year after the effective date of this act, the department shall establish, and shall post at a publicly accessible location on its Internet website, a list of all facilities that have made lactation rooms available pursuant to this section. Thereafter, the department shall make regular updates to the list, as may be necessary to ensure that it reflects the most up-to-date information on the availability of lactation rooms in the State. The list established pursuant to this subsection shall additionally include a hyperlink to the reports on school lactation-related policies that have been posted on the Department of Education website in accordance with the provisions of section 3 of this act.
d. The department may adopt rules and regulations, pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.), to implement the provisions of this section, including rules and regulations that establish guidelines for the location and placement of lactation rooms within a facility, and rules and regulations that establish training requirements for staff who are employed at a facility where a lactation room is required.
b. Each report submitted pursuant to this section shall: (1) summarize the applicable policies in this area; (2) indicate the number and percentage of policies that authorize access to a designated lactation room; and (3) indicate the manner in which such policies were communicated to students, parents, and guardians during the preceding school year.
c. Each report submitted pursuant to this section shall be posted at a publicly-accessible location on the Department of Education's Internet website.
Every physician shall report each case of cerebral palsy now under his care, if his patient is under eighteen years of age, and all new cases of cerebral palsy, regardless of the age of the patient. The said reports shall be made to the local boards of health having jurisdiction over the territory within which the patients reside or are being treated.
The State Department of Health shall prescribe and furnish the forms on which the reports shall be made, and shall make and promulgate regulations pertaining thereto.
This act shall be known and may be cited as the "Hereditary Disorders Act."
The Legislature finds and declares: that hereditary disorders such as Cooley's anemia, cystic fibrosis, sickle cell anemia, hemophilia, Huntington's Disease, galactosemia and phenylketonuria often present a costly and tragic hardship for citizens of this State; that early detection of the disorders can alleviate some potentially harmful and disabling conditions; that hereditary disorders vary in their severity, with some having little effect and others having significant negative effect upon the normal functioning of individuals; that hereditary disorders also vary in their treatability, with some being subject to total or partial alleviation through medical intervention and treatment and others, currently, not being subject to any more than minimal alleviation; that medical knowledge concerning early identification and treatment of certain hereditary disorders is rapidly expanding; and that it is the policy of this State that in order to insure that standards for detection and treatment comply with the most recent medical knowledge and that the public is kept informed about these standards and the availability of treatment, it is necessary to establish an hereditary disorders program.
As used in this act "hereditary disorder" means any human ailment, disease or deformity resulting from a specific genetic condition and for which treatment is available, and includes Cooley's anemia, cystic fibrosis, sickle cell anemia, hemophilia, Huntington's Disease, and inborn errors of metabolism such as galactosemia and phenylketonuria.
The Department of Health, in consultation with appropriate professional advisory groups, shall:
a. Establish guidelines for the early identification of persons born with hereditary disorders and standards for testing for hereditary disorders in newborn infants;
b. Establish guidelines for the education and treatment of persons born with hereditary disorders;
c. Establish procedures for referral of persons with hereditary disorders and their families to medical treatment and financial assistance;
d. Institute and carry out an educational program among physicians, hospitals, public health departments and the public concerning hereditary disorders;
e. Consult with the Commissioner of Insurance in identifying arbitrary and unreasonable discrimination against persons with hereditary disorders and their families in insurance coverages;
f. Evaluate on a continuous basis the need for and efficacy of State programs for the treatment of persons with hereditary disorders;
g. Promulgate all rules and regulations necessary to carry out the purposes of this act.
a. Sickle cell anemia is an inherited blood disorder characterized primarily by chronic anemia and periodic episodes of pain;
b. The clinical course of sickle cell anemia does not follow a single pattern, for the symptoms can range from mild to very severe;
c. Sickle cell anemia affects millions of people throughout the world but in this country affects approximately 72,000 people, according to the National Heart, Lung, and Blood Institute, most of whom are African-Americans and Hispanic-Americans of Caribbean ancestry;
d. Approximately two million Americans, or one in 12 African-Americans, carry the sickle cell trait; and the disease occurs in approximately one in 500 African-Americans and one in every 1,000-1,400 Hispanic-Americans;
e. All newborn infants born in New Jersey and in most other states are screened for sickle cell anemia; however, there is currently no known means of prevention or cure for the disease, although promising new methods of treatment have emerged from clinical studies in recent years, including drug therapy, bone marrow transplants from matched siblings, and umbilical cord blood transplants; and
f. There is a widespread need for information among those populations who are at greatest risk for carrying the sickle cell trait about the genetic risk factors associated with sickle cell anemia and the symptoms and treatment of the disease.
b. The department shall prepare an informational booklet in English and Spanish that contains the information posted on its website pursuant to subsection a. of this section, as funds become available for that purpose. The department shall make a supply of booklets available to all licensed health care facilities engaged in the diagnosis or treatment of sickle cell anemia, as well as to health care professionals, community health centers, members of the public, and social services agencies upon their request.
“Amyotrophic lateral sclerosis” means a progressive neurodegenerative disease that affects nerve cells in the brain and the spinal cord.
"Health care professional" means a person licensed to practice a health care profession pursuant to Title 45 of the Revised Statutes.
"Motor neuron disease" means a group of progressive neurological conditions that destroy motor neurons, which are the cells that control skeletal muscle activity such as walking, breathing, speaking, and swallowing, and include amyotrophic lateral sclerosis, progressive bulbar palsy, primary lateral sclerosis, progressive muscular atrophy, spinal muscular atrophy, Kennedy’s disease, and post-polio syndrome.
b. (1) Consistent with federal and State privacy laws, the Department of Health shall require health care professionals, who screen for, diagnose, or provide therapeutic services to patients with amyotrophic lateral sclerosis or motor neuron disease, to confidentially report to the department all known cases of amyotrophic lateral sclerosis and motor neuron disease in a manner to be specified by the department no later than six months following a patient’s amyotrophic lateral sclerosis or motor neuron disease diagnosis.
(2) Any information reported to the department for display on the New Jersey State Health Assessment Data System pursuant to this subsection shall be reported in a manner to protect against the disclosure of any confidential or personal identifying information of any patient or health care professional.
(3) The department may enter into agreements to provide the data reported to it pursuant to this subsection with the federal Centers for Disease Control and Prevention and any other successor agency, local health officers, or researchers of the study of amyotrophic lateral sclerosis or motor neuron disease for public health and research purposes. Any data provided to the federal Centers for Disease Control and Prevention and any other successor agency, local health officers, or researchers of the study of amyotrophic lateral sclerosis or motor neuron disease pursuant to this paragraph shall be reported in a manner to protect against the disclosure of any confidential or personal identifying information of any patient or health care professional. The department shall use the New Jersey Integrated Population Health Data Project (iPHD) protocols or a successor program to share data to researchers.
c. The New Jersey State Health Assessment Data System shall record and compile information received pursuant to this section for research and statistical purposes only.
d. Nothing in this act shall be construed to authorize the disclosure of any confidential or personal identifying information.
e. No later than 12 months following the effective date of this act, the Commissioner of Health shall develop and make available on its Internet website written educational materials that provide information about the New Jersey State Health Assessment Data System, including information on how to access the datasets, statistics, and information regarding amyotrophic lateral sclerosis and motor neuron disease reported to the New Jersey State Health Assessment Data System pursuant to subsection b. of this section.
This act shall be known and may be cited as the "AIDS Assistance Act."
The Legislature finds that:
a. The effective identification, diagnosis, care and treatment of persons who have contracted acquired immune deficiency syndrome, commonly known as "AIDS," is of paramount public importance;
b. AIDS is thought to be the result of a virus or other highly infectious agent which may be spread through bodily secretions, especially blood and semen, or through an as yet unidentified method of transmission;
c. The AIDS organism is responsible for the near total collapse of the body's immune system, resulting in the susceptibility to cancer and other fatal infections;
d. AIDS although first diagnosed in homosexual men is now striking so many groups such as drug users, hemophiliacs, persons who have received blood transfusions and Haitians, that its course is currently unpredictable;
e. The spread of AIDS may be impossible to stop because the AIDS organism can be dormant for months before it manifests symptoms and because the incubation period ranges from six months to two years;
f. People who have already been infected might not be aware of their exposure and may unknowingly infect hundreds more individuals;
g. Resultantly, the outbreak of AIDS has reached alarming proportions because of its highly contagious nature with New Jersey ranking fourth in the nation of the number of reported cases.
The Legislature further finds that researchers have no conclusive evidence regarding the detection, treatment, cure or prevention of AIDS; that many health care professionals are not yet familiar with the symptoms or treatment techniques of AIDS; that most victims are not aware that they have been exposed to AIDS and therefore infect others; that accordingly, the magnitude of the AIDS outbreak has not yet been realized.
Therefore, the Legislature declares that it is imperative that programs be established for diagnosing and treating persons who have been exposed to AIDS, referring AIDS victims and their families to sources of treatment and counseling, and providing an educational program to health care professionals to heighten their awareness of the latest diagnostic procedures and treatment. The Legislature further declares that a task force be established to coordinate the medical and social services needed by AIDS victims.
The Commissioner of the State Department of Health shall establish:
a. A program to educate the public, which shall include a public information campaign encouraging persons who suspect exposure to AIDS to seek medical testing and counseling, and a Statewide telephone hotline to answer requests for information and referrals;
b. A program to educate health care professionals and others who are required to have contact with people who have contracted AIDS about the diagnosis and treatment of AIDS; and
c. Departmental and local support programs to provide early detection, counseling, social services, and referrals for those who suspect exposure to AIDS.
As used in this act:
"AIDS" means acquired immune deficiency syndrome as defined by the Centers for Disease Control of the United States Public Health Service.
"Commissioner" means the Commissioner of Health.
"Department" means the Department of Health.
"Diagnosis and treatment" means services or activities carried out for the purpose of, or as an incident to, diagnosis, prevention and treatment of AIDS and HIV infection and includes interviewing and counseling.
"HIV infection" means infection with the human immunodeficiency virus or any other related virus identified as a probable causative agent of AIDS.
"HIV related illness" means an illness that may result from, or may be associated with, HIV infection.
"HIV related test" means any laboratory test or series of tests for any virus, antibody, antigen or etiologic agent thought to cause or to indicate the presence of AIDS.
"Identifying information" means the name, address, Social Security number, or similar information by which the identity of a person who has or is suspected of having AIDS or HIV infection may be determined with reasonable accuracy either directly or by reference to other publicly available information.
"Informed consent" means consent obtained pursuant to policies and procedures prescribed in 42 C.F.R. s. 2.31.
"Minor" means a person under the age of 12.
"Program" means either an individual or an organization furnishing diagnosis and treatment of AIDS and conditions related to HIV infection.
All diagnosed cases of AIDS and all diagnosed cases of HIV infection shall be reported to the department along with the identifying information for the person diagnosed. However, the department may select up to six counseling and testing sites throughout the State to offer anonymous testing. These sites shall be required to report all diagnosed cases of AIDS and all diagnosed cases of HIV infection but shall not be required to request or report identifying information. The commissioner shall determine those individuals who shall be required to make the reports and the manner in which the report shall be made to the department.
A record maintained by:
a. the department;
b. a local health department;
c. an organization pursuant to a contract with, grant from, or regulation by the department in connection with this act;
d. a provider of health care or a health care facility as defined by section 2 of P.L.1971, c.136 (C.26:2H-2);
e. a laboratory;
f. a blood bank;
g. a third-party payor; or
h. any other institution or person;
which contains identifying information about a person who has or is suspected of having AIDS or HIV infection is confidential and shall be disclosed only for the purposes authorized by this act.
b. If the prior written consent of the person who is the subject of the record is not obtained, the person's records shall be disclosed only under the following conditions:
(1) To qualified personnel for the purpose of conducting scientific research, but a record shall be released for research only following review of the research protocol by an Institutional Review Board constituted pursuant to federal regulation 45 C.F.R. s. 46.101 et seq. The person who is the subject of the record shall not be identified, directly or indirectly, in any report of the research and research personnel shall not disclose the person's identity in any manner.
(2) To qualified personnel for the purpose of conducting management audits, financial audits, or program evaluation, but the personnel shall not identify, directly or indirectly, the person who is the subject of the record in a report of an audit or evaluation, or otherwise disclose the person's identity in any manner. Identifying information shall not be released to the personnel unless it is vital to the audit or evaluation.
(3) To qualified personnel involved in medical education or in the diagnosis and treatment of the person who is the subject of the record. Disclosure is limited to only personnel directly involved in medical education or in the diagnosis and treatment of the person.
(4) To the department as required by State or federal law.
(5) As permitted by rules and regulations adopted by the commissioner for the purposes of disease prevention and control.
(6) In all other instances authorized by State or federal law.
a. The record of a person who has or is suspected of having AIDS or HIV infection may be disclosed by an order of a court of competent jurisdiction which is granted pursuant to an application showing good cause therefor. At a good cause hearing the court shall weigh the public interest and need for disclosure against the injury to the person who is the subject of the record, to the physician-patient relationship, and to the services offered by the program. Upon the granting of the order, the court, in determining the extent to which a disclosure of all or any part of a record is necessary, shall impose appropriate safeguards to prevent an unauthorized disclosure.
b. A court may authorize disclosure of a person's record for the purpose of conducting an investigation of or a prosecution for a crime of which the person is suspected, only if the crime is a first degree crime and there is a reasonable likelihood that the record in question will disclose material information or evidence of substantial value in connection with the investigation or prosecution.
c. Except as provided in subsections a. and b. of this section, a record shall not be used to initiate or substantiate any criminal or civil charges against the person who is the subject of the record or to conduct any investigation of that person.
d. The court shall deny an application for disclosure of a person's record unless the court makes a specific finding that the program was afforded the opportunity to be represented at the hearing. A program operated by a federal, State or local government agency or department shall be represented at the hearing.
e. Nothing in this section shall be construed to authorize disclosure of any confidential communication which is otherwise protected by statute, court rule or common law.
The limits on disclosure set forth in this act shall continue to apply to a record relating to AIDS and HIV infection concerning a person who has been a patient or a participant in a program, whether that person remains a patient or participant or ceases to be a patient or participant.
Any record disclosed under this act shall be held confidential by the recipient of the record and shall not be released by said recipient unless the conditions of this act are met.
a. From an executor, administrator of the estate, or authorized representative of the legally incapacitated or deceased person;
b. From the person's spouse, domestic partner as defined in section 3 of P.L.2003, c.246 (C.26:8A-3), primary caretaking partner or, if none, by another member of the person's family; and
c. From the commissioner in the event that a deceased person has neither an authorized representative or next-of-kin.
When consent is required for disclosure of the record of a minor who has or is suspected of having AIDS or HIV infection, consent shall be obtained from the parent, guardian, or other individual authorized under State law to act in the minor's behalf.
a. A person who has or is suspected of having AIDS or HIV infection who is aggrieved as a result of a violation of this act may commence a civil action against the individual or institution who committed the violation to obtain appropriate relief, including actual damages, equitable relief and reasonable attorney's fees and court costs. Punitive damages may be awarded when the violation evidences wantonly reckless or intentionally malicious conduct by the person or institution who committed the violation.
b. Each disclosure made in violation of this act is a separate and actionable offense.
"AIDS" means acquired immune deficiency syndrome as defined by the Centers for Disease Control and Prevention of the United States Public Health Service.
"Commissioner" means the Commissioner of Health.
"Department" means the Department of Health.
"HIV" means the human immunodeficiency virus or any other related virus identified as a probable causative agent of AIDS.
a. (1) A physician or other health care practitioner who is the primary caregiver for a pregnant woman shall, in accordance with guidelines developed by the commissioner, provide the woman with information about HIV and AIDS, including an explanation of HIV infection and the meanings of positive and negative test results, and also inform the woman of the benefits of being tested for HIV as early as possible in the course of her pregnancy and a second time during the third trimester, the medical treatment available to treat HIV infection if diagnosed early, the reduced rate of transmission of HIV to a fetus if an HIV-infected pregnant woman receives treatment for HIV, and the interventions that are available to reduce the risk of transmission of HIV to the fetus and newborn. The information shall be provided orally or in writing, and the woman shall be offered an opportunity to ask questions.
The physician or other health care practitioner shall also advise the woman that HIV testing is recommended for all pregnant women both early in their pregnancy and during the third trimester, and that she will receive HIV tests as part of the routine panel of prenatal tests unless she specifically declines to be tested for HIV.
If a woman declines to be tested for HIV, the declination shall be documented in her medical record. A woman shall not be denied appropriate prenatal or other medical care because she declines to be tested for HIV.
(2) A pregnant woman, who presents herself for delivery and has not been tested for HIV during the course of her pregnancy, shall be given the information specified in paragraph (1) of this subsection as soon as may be medically appropriate and, unless she declines to be tested for HIV after receiving that information, shall be tested for HIV as soon as may be medically appropriate.
b. The commissioner shall establish guidelines regarding notification to a woman whose test result is positive, and to provide, to the maximum extent possible, for counseling about the significance of the test result.
c. Information about a woman which is obtained pursuant to this section shall be held confidential in accordance with the provisions of P.L.1989, c.303 (C.26:5C-5 et seq.).
"HIV" means the human immunodeficiency virus which has been identified as the probable causative agent of acquired immune deficiency syndrome, or AIDS.
"HIV test" means a laboratory test designed to detect the presence of HIV, its related antigens, or antibodies to HIV.
"Semen bank" means a commercial or noncommercial activity involving the handling of human semen which participates in the collection, processing, storage or distribution of semen.
b. A semen bank shall perform the HIV test only after the donor has provided written informed consent according to standards adopted by the Commissioner of Health. A donor who refuses to provide written informed consent to an HIV test or tests positive for HIV shall not be permitted to donate semen.
c. The cost of the HIV test shall be borne by the recipient of the donation.
d. The Commissioner of Health shall establish procedures for notification by a semen bank to donors of screening results and referrals to appropriate counseling and health care services as necessary.
a. Injection drug use is one of the most common methods of transmission of HIV, hepatitis C, and other bloodborne pathogens;
b. (deleted by amendment, P.L.2021, c.396)
c. More than a million people in the United States use drugs at a cost to society in health care, lost productivity, accidents, and crime of more than $50 billion annually;
d. Harm reduction services have been proven effective in reducing the spread of HIV, hepatitis C, and other bloodborne pathogens, and in reducing overdoses and overdose deaths without increasing rates of substance use or causing other adverse social impacts;
e. Every scientific, medical, and professional agency or organization that has studied this issue, including the federal Centers for Disease Control and Prevention, the American Medical Association, the American Public Health Association, the National Academy of Sciences, the National Institutes of Health Consensus Panel, the American Academy of Pediatrics, and the United States Conference of Mayors, has found harm reduction services to be effective in reducing the transmission of HIV;
f. Harm reduction programs are designed to prevent the spread of HIV, hepatitis C, and other bloodborne pathogens, prevent overdoses and overdose deaths, and to provide a bridge to substance use disorder treatment, healthcare services, and social support services sought out by persons who use drugs intravenously; and it is in the public interest that such services be provided in this State in accordance with statutory guidelines designed to ensure the safety of consumers who use these programs, the health care workers who operate them, and the members of the general public;
g. Despite the attention that substance use disorders and overdose deaths are receiving Statewide, the number of overdose deaths in New Jersey has remained unacceptably high, with 2,914 confirmed overdose deaths in 2019, and over 70,000 overdose deaths nationwide;
h. The COVID-19 pandemic has increased the urgency of maintaining and expanding harm reduction services. Now more than ever, harm reduction expansion is critical. According to the federal Centers for Disease Control and Prevention's June 24-30, 2020 Morbidity and Mortality Weekly Report, 13 percent of U.S. residents began substance use or increased substance use during the pandemic. New Jersey has already started to see the consequences of the intersecting opioid and COVID-19 crises. There were 3,046 suspected overdose deaths in 2020. If confirmed, this will be New Jersey's highest drug-related fatality count in the past decade;
i. The opioid epidemic is part of a syndemic and is associated with increased rates of HIV and viral hepatitis infection, as well as other social complexities;
j. New Jersey enacted the "Bloodborne Disease Harm Reduction Act" P.L.2006, c.99 (C.26:5C-25 et al.) in 2006 to allow for the establishment of sterile syringe access programs. There are currently seven such programs operating throughout the State, which shall hereafter be referred to as harm reduction services;
k. The federal Centers for Disease Control and Prevention describe harm reduction services as an effective component of a comprehensive and integrated approach to HIV prevention. Such services include providing consumers with sterile syringes, fentanyl test strips, resources for critical services such as HIV care, treatment, pre- and post-exposure prophylaxis services, screening for other sexually transmitted diseases, hepatitis C testing and treatment, hepatitis A and B vaccinations, and other medical, social, and mental health services. In addition, harm reduction services include education concerning safe injection practices, wound care, and overdose prevention;
l. The U.S. Department of Health and Human Services has stated that there is conclusive scientific evidence that harm reduction services, as part of a comprehensive HIV prevention strategy, are an effective public health intervention that reduces the transmission of HIV and does not encourage the use of illegal drugs;
m. Harm reduction services do not promote drug use and do not minimize the harm and danger associated with lawful and unlawful drug use. Individuals utilizing harm reduction services are often ill, in pain, and have experienced trauma. Harm reduction services are offered to these individuals by professionals who treat the individuals with compassion and who provide these necessary services without judgment;
n. There is evidence demonstrating that crime does not increase in areas in which harm reduction services locations are situated;
o. Harm reduction services do not interfere with substance use disorder treatment efforts. The services provide a bridge to substance use disorder treatment and other social services for individuals with substance use disorders;
p. For individuals who inject drugs, the best way to reduce the risk of acquiring and transmitting infectious disease through injection drug use is to stop injecting drugs, but for individuals who do not stop injecting drugs, the use of sterile injection equipment can reduce the risk of acquiring and transmitting infectious diseases and prevent outbreaks;
q. Research shows that the provision of sterile syringes is associated with an estimated 50 percent reduction in the incidence of HIV and hepatitis C, a greater likelihood that individuals will seek treatment, and decreased overdose rates; and
r. Entities offering harm reduction services in New Jersey provide sterile syringes and operate under a philosophy of harm reduction, which honors the dignity of those who use drugs or are living with a substance use disorder, reduces the negative consequences of injection drug use, and provides a stigma-free environment for people who use drugs by providing the care they desire and need.
"Authorized harm reduction services" means a suite of harm reduction services, approved by the Department of Health and provided in a manner that is consistent with State and federal law, which services shall include, but shall not be limited to: syringe access, syringe disposal, referrals to health and social services, harm reduction counseling and supplies including, but not limited to, fentanyl test strips, and HIV and hepatitis C testing.
"Eligible entity" means a federally qualified health center, a public health agency, a substance use disorder treatment program, an AIDS service organization, or another entity with the capacity to provide harm reduction services as determined by the Department of Health.
"Harm reduction supplies" means any materials or equipment used or intended for use in preventing, reducing, or mitigating the adverse effects associated with the personal use of controlled dangerous substances, controlled substance analogs, or toxic chemicals, which adverse effects may include, but are not limited to, disease transmission and overdose. "Harm reduction supplies" include, but shall not be limited to: naloxone hydrochloride and other opioid antidotes; test strips and other supplies or equipment designed to identify or analyze the presence, strength, effectiveness, or purity of controlled dangerous substances, controlled substance analogs, toxic chemicals, or other substances used to potentiate or enhance the effects of controlled dangerous substances, controlled substance analogs, or toxic chemicals; and supplies or equipment provided by an authorized harm reduction services program in accordance with the provisions of P.L.2006, c.99 (C.26:5C-25 et al.) and any rules promulgated pursuant to P.L.2006, c.99 (C.26:5C-25 et al.) by the Commissioner of Health.
a. The department shall:
(1) permit a registration form, to be submitted in a manner prescribed by the department, from any entity that seeks to provide harm reduction services in New Jersey, which shall be a prerequisite to so doing;
(2) approve or deny a registration request based upon the requirements established by regulation of the department;
(3) support and facilitate, to the maximum extent practicable, the linkage of harm reduction services to: (a) health care facilities and programs that may provide appropriate health care services, including mental health services, medication-assisted treatment services, and other substance use disorder treatment services to consumers receiving harm reduction services; and (b) housing assistance programs, career and employment-related counseling programs, and education counseling programs that may provide appropriate ancillary support services to consumers receiving harm reduction services;
(4) provide for the adoption of a uniform membership card or other uniform Statewide means of identification for consumers, staff, and volunteers of entities offering authorized harm reduction services pursuant to paragraph (9) of subsection b. of section 4 of P.L.2006, c.99 (C.26:5C-28); and
(5) maintain a record of de-identified statistical aggregate data reported to the department by entities offering authorized harm reduction services pursuant to paragraph (11) of subsection b. of section 4 of P.L.2006, c.99 (C.26:5C-28).
b. The department shall be authorized to accept funding as may be made available from the private sector to effectuate the purposes of P.L.2006, c.99 (C.26:5C-25 et al.).
(1) An entity authorized to provide harm reduction services may provide the services at a fixed location or through a mobile access component, and may operate the program directly or contract with one or more of the following entities to operate the program: a hospital or other health care facility licensed pursuant to P.L.1971, c.136 (C.26:2H-1 et seq.), a federally qualified health center, a public health agency, a substance use disorder treatment program, an AIDS service organization, or another nonprofit entity designated by the department. An entity authorized to provide harm reduction services shall be managed in accordance with standards or guidance issued by the Division of HIV, STD, and TB Services in the Department of Health and in a manner that is consistent with national best practices for the provision of harm reduction services and all applicable State laws and regulations that are not otherwise to the contrary.
(2) (deleted by amendment, P.L.2021, c.396)
(3) (deleted by amendment, P.L.2021, c.396)
(4) To the extent permitted under federal law, and subject to the requirements of federal law, notwithstanding any provision of State law to the contrary, an authorized entity may deliver harm reduction services or other related supplies, as determined by the commissioner, to consumers via postal mail or other delivery service.
b. An entity authorized to provide harm reduction services shall comply with the following requirements:
(1) Sterile syringes and needles shall be provided at no cost to consumers 18 years of age and older, provided that the department may authorize sterile syringes and needles to be provided at no cost to consumers under 18 years of age in limited circumstances, at the department's discretion;
(2) An entity authorized to provide harm reduction services shall be responsible for training program staff in the following subjects: harm reduction; substance use disorder; medical and social service referrals; infection control procedures, including universal precautions and needle stick injury protocol; and other subjects as determined by the entity authorized to provide harm reduction services and the department. Entities authorized to provide harm reduction services shall maintain records of staff and volunteer training;
(3) Entities authorized to provide harm reduction services shall offer information about HIV, hepatitis C and other bloodborne pathogens and information concerning the safe use of drugs by intravenous injection at no cost to consumers, and shall seek to educate all consumers about safe and proper disposal of needles and syringes;
(4) Entities authorized to provide harm reduction services shall provide information and referrals to consumers, including HIV, hepatitis C, and sexually transmitted infection testing options, access to medication-assisted substance use disorder treatment programs and other substance use disorder treatment programs, and available health and social service options relevant to the needs of consumers. The entity shall encourage consumers to receive HIV, hepatitis C, and sexually transmitted infection tests;
(5) Except as may otherwise be authorized by the department pursuant to paragraph (1) of this subsection, entities authorized to provide harm reduction services shall screen out consumers under 18 years of age from access to syringes and needles, and shall refer them to substance use disorder treatment and other appropriate programs for youth;
(6) Entities authorized to provide harm reduction services shall develop a plan for the handling and disposal of used syringes and needles in accordance with requirements set forth at N.J.A.C.7:26-3A.1 et seq. for regulated medical waste disposal pursuant to the "Comprehensive Regulated Medical Waste Management Act," P.L.1989, c.34 (C.13:1E-48.1 et al.), and shall also develop and maintain protocols for post-exposure treatment;
(7) (a) Entities authorized to provide harm reduction services may obtain and distribute naloxone hydrochloride or another opioid antidote to consumers, to family members and friends of consumers, and to any member of the general public, in accordance with the "Overdose Prevention Act," P.L.2013, c.46 (C.24:6J-1 et al.) and P.L.2021, c.152;
(b) Entities authorized to provide harm reduction services shall provide overdose prevention information to consumers and to family members and friends of consumers, and to members of the general public, in accordance with the provisions of section 5 of the "Overdose Prevention Act," P.L.2013, c.46 (C.24:6J-5);
(8) Entities authorized to provide harm reduction services shall maintain the confidentiality and security of information about consumers receiving harm reduction services through appropriate administrative, technical, and physical controls and safeguards that protect the confidentiality, integrity, and availability of individually identifiable information about consumers;
(9) Entities authorized to provide harm reduction services shall provide a uniform membership card that has been approved by the department to consumers and to staff and volunteers involved in transporting, exchanging or possessing syringes and needles, or shall provide for such other uniform Statewide means of identification as may be approved by the department for this purpose;
(10) Entities authorized to provide harm reduction services shall provide consumers at the time of enrollment with a schedule of the entity's operation hours and locations, in addition to information about prevention and harm reduction and substance use disorder treatment services; and
(11) Entities authorized to provide harm reduction services shall establish and implement accurate data collection methods and procedures as required by the department for the purpose of evaluating the provision of harm reduction services.
(a) (deleted by amendment, P.L.2021, c.396)
(b) (deleted by amendment, P.L.2021, c.396)
(c) (deleted by amendment, P.L.2021, c.396).
c. The department shall have sole authority to terminate authorization for an entity to provide harm reduction services that was approved by the department, without the need for application or approval by the host municipality.
d. The provisions of P.L.2006, c.99 (C.26:5C-25 et al.) shall not be construed as preempting the powers and the authority granted to municipalities under the "Municipal Land Use Law," P.L.1975, c.291 (C.40:55D-1 et seq.), nor as requiring a determination that the provision of harm reduction services is an inherently beneficial use thereunder.
(2) For the purpose of each biennial report pursuant to paragraph (1) of this subsection, the department shall:
(a) collaborate with local stakeholders, including healthcare providers, healthcare systems, social services providers, and law enforcement, to provide education and collect data on the value of providing harm reduction services in municipalities in which the services are provided; and
(b) determine the type of data to be reported and shared, which may include the number of consumers served, the number of syringes distributed, the number of referrals made to social support services and healthcare providers, overall crime statistics, and the incidence and locations of needle stick injuries.
b. (Deleted by amendment, P.L.2016, c.36)
c. The department shall prepare a detailed analysis of harm reduction services provided pursuant to P.L.2006, c.99 (C.26:5C-25 et al.), and report on the results of that analysis to the Governor, the Governor's Advisory Council on HIV/AIDS and Related Blood-Borne Pathogens, and, pursuant to section 2 of P.L.1991, c.164 (C.52:14-19.1), the Legislature annually. The analysis shall include, but not be limited to:
(1) any increase or decrease in the spread of HIV, hepatitis C and other bloodborne pathogens that may be transmitted by the use of contaminated syringes and needles;
(2) the number of exchanged syringes and needles and an evaluation of the disposal of syringes and needles that are not returned by consumers;
(3) the number of consumers receiving harm reduction services and an assessment of their reasons for accessing those services;
(4) the number of consumers receiving harm reduction services who participated in substance use disorder treatment programs; and
(5) the number of consumers receiving harm reduction services who benefited from counseling and referrals to programs and entities that are relevant to their health, housing, social service, employment and other needs.
d. (Deleted by amendment, P.L.2016, c.36)
b. The commissioner shall submit the plan to the Governor and, pursuant to section 2 of P.L.1991, c.164 (C.52:14-19.1), the Legislature no later than the 120th day after the effective date of this act, and shall report biannually thereafter to the Governor and, pursuant to section 2 of P.L.1991, c.164 (C.52:14-19.1), the Legislature on the implementation of the plan.
b. Notwithstanding any provision of P.L.1968, c.410 (C.52:14B-1 et seq.) to the contrary, the commissioner shall adopt, immediately upon filing with the Office of Administrative Law and no later than the 90th day after the effective date of P.L.2006, c.99 (C.26:2C-25 et al.), such regulations as the commissioner deems necessary to implement the provisions of sections 3 and 4 of P.L.2006, c.99 (C.26:5C-27 and C.26:5C-28), which shall be effective until the adoption of rules and regulations pursuant to subsection a. of this section and may be amended, adopted or readopted by the commissioner in accordance with the requirements of P.L.1968, c.410 (C.52:14B-1 et seq.).
c. Notwithstanding any provision of P.L.1968, c.410 (C.52:14B-1 et seq.) to the contrary, the commissioner may adopt, immediately upon filing with the Office of Administrative Law, such regulations as the commissioner deems necessary to implement the provisions of P.L.2021, c.396 (C.26:5C-26.1 et al.), which shall be effective for a period not to exceed 180 days and thereafter may be amended, adopted or readopted by the commissioner in accordance with the requirements of P.L.1968, c.410 (C.52:14B-1 et seq.).
This act shall be known and may be cited as the "SIDS Assistance Act."
The Legislature finds and declares that:
a. Sudden Infant Death Syndrome, the sudden and unexpected death of apparently healthy babies, commonly known as "SIDS" or "Crib Death," is the major cause of death of infants between the ages of one month and one year and is responsible for the deaths of approximately 7,000 infants in the United States each year.
b. Although the cause of SIDS is not known, there is evidence that it may be caused by an infectious agent, hypoglycemia, a neuroendocrine defect, or poor socioeconomic conditions. SIDS has also been associated with apnea, the temporary stoppage of breathing; however, there are no data firmly linking SIDS to apnea, and preliminary data suggest that the number of infants who have had a history of apneic episodes may account for not more than 5% of SIDS fatalities.
c. Because of the nature of SIDS and the inability to discover the cause of death, parents of victims of SIDS often experience trauma and shock and have a need for counseling and other support services.
d. Research regarding the detection, treatment, cure or prevention of SIDS has not been afforded the attention given to other areas of medicine, and many health care professionals are not familiar with the symptoms, diagnosis or treatment of SIDS; and
e. Therefore, it is imperative that a program be established for identifying and treating infants who are potential victims of SIDS, referring potential SIDS victims and their families to sources of treatment and counseling, referring families whose children have been victims of SIDS to counseling and other support services and providing an educational program to health care professionals to heighten their awareness in detecting potential SIDS victims and in preventing SIDS.
The Commissioner of the Department of Health shall establish a program to educate the public and health care professionals about SIDS. The program shall include a referral service for the public and health care professionals on SIDS related services and a 24-hour telephone hotline to provide needed information and referrals. The commissioner shall also encourage the development of local support programs to provide early detection, counseling, and referrals for infants who may be at risk of SIDS.
The Commissioner of the Department of Health shall establish a "SIDS Resource Center" within a State medical school. The SIDS Resource Center shall, in coordination with the Department of Health, serve as a technical advisory center and may offer diagnostic procedures, medical treatment and counseling, as well as any other services that may be necessary to assist potential SIDS victims and their families.
As used in this chapter: "Local registrar" or "registrar" means the local registrar of vital statistics. "State registrar" means the State Registrar of Vital Statistics.
"Registration district" or "district" means the district established by law for the registration of vital events.
"Fetal death" or "stillbirth" means death prior to the complete expulsion or extraction from its mother of a product of conception, irrespective of the duration of pregnancy; the death is indicated by the fact that after such separation, 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 voluntary muscles.
"Dead body" means the dead body of a human being.
The definition of the term "communicable disease" as contained in R.S.26:4-1 shall also apply to this chapter.
"Authentication" means the entry by the Chief State Medical Examiner, Deputy Chief State Medical Examiner, or a county or intercounty medical examiner or assistant county or intercounty medical examiner, funeral director or physician into the New Jersey Electronic Death Registration System of a personal identification code, digital signature or other identifier unique to that user, by which the information entered into the system by the user is authenticated by the user who assumes responsibility for its accuracy. "Authentication" also means the process by which the State registrar or a local registrar, deputy registrar, alternate deputy registrar or subregistrar indicates that person's review and approval of information entered into the system by the Chief State Medical Examiner, Deputy Chief State Medical Examiner, or a county or intercounty medical examiner or assistant county or intercounty medical examiner, funeral director or physician.
"Electronic registration system" means any electronic method, including, but not limited to, one based on Internet technology, of collecting, transmitting, recording and authenticating information from one or more responsible parties, which is necessary to complete a vital record, and is designed to replace a manual, paper-based data collection, recordation and signature system.
"New Jersey Electronic Death Registration System" or "NJ-EDRS" is an electronic registration system for completing a certification of death or fetal death record that is authorized, designed and maintained by the State registrar.
The local board shall have power to pass, alter or amend ordinances and make rules and regulations within its jurisdiction to regulate the burial and disinterment of human bodies.
The local board may specify any communicable disease or diseases in case of death from which no public funeral shall be had, and prohibit such public funeral under a penalty to be imposed, not to exceed fifty dollars, and in case of the threatening or prevalence of an epidemic, may prohibit such public funeral of persons dying with the particular disease or diseases then prevalent. The board may also prohibit such public funeral in any case in which the attending physician shall by writing so advise, or in any case in which two reputable physicians in the same district or municipality certify that they believe that the interests of the public health require such restriction.
In computing the death rate of any municipality or health district in which there is located a hospital or other institution, any death which shall take place at such hospital or institution shall not be included among deaths occurring in said municipality or health district unless the death is of a person whose last place of residence was in said municipality or health district.
Any death occurring at any such hospital or institution, of any person whose last place of residence as shown on the death certificate was outside of the limits of said municipality or health district, shall, for the purpose of computing the death rate, be included among the deaths occurring in the municipality or health district named in the certificate as the last place of residence of the decedent.
Except where a death record is created on the NJ-EDRS, it shall be the duty of the registrar of the district in which such a death occurred promptly to notify the registrar of the district which was the last place of residence of the decedent.
On or before the tenth day of each month the person in charge of any such premises, or if the interment is made in a cemetery or burial ground having no person in charge, then the undertaker who made any such interment, shall certify to the supervisor of veterans' interment in the county in which such interment or cremation was made, the name of each deceased veteran who has been interred or cremated in said premises during the preceding month, together with the date and place of burial or cremation of such deceased veteran, and the war in which said deceased veteran served.
Any failure so to do on the part of the officers of any cemetery association or the undertaker shall subject the violator to a penalty of fifty dollars ($50.00) to be recovered in a civil action in the name of the supervisor of veterans' interment of any county wherein the violation occurs.
When a cemetery or burial ground or part thereof for any reason has become dangerous to the public health and it shall be deemed inadvisable that any further interments be made therein, any municipal authority within whose limits the cemetery or burial ground is situate, or the State department or any local board, may institute an action in the Superior Court, either in the name of the State on the relation of the plaintiff or otherwise.
If the court shall determine that the cemetery or burial ground or any part thereof is dangerous to the public health for any reason, or that further interments therein would be inadvisable, the court may, by injunction or otherwise, grant such relief as may be proper and necessary for the protection of the public health.
If the court shall determine that the plaintiff is not entitled to any relief, costs shall be awarded against the plaintiff, but only if it appears to the court that no probable cause existed for bringing the action.
No person, without securing a proper death certificate and a burial or removal permit, shall:
a. Remove a dead body from this State; or
b. Bury or make other final disposition of such body in this State.
The State Registrar of Vital Statistics shall, upon proper proof received from an appropriate agency of the National Military Establishment, or from the United States Department of Commerce, record the death of any person who died while in the military or naval or maritime or merchant marine service of the United States, and who at the time of entering said service was a resident of the State of New Jersey.
Proper proof as required by this section shall be the official letter from an appropriate agency of the National Military Establishment or the United States Department of Commerce, to the next of kin of such deceased person.
The State Registrar shall, upon request, certify such deaths in the same manner as in the case of deaths occurring and recorded in New Jersey.
No fees shall be charged or collected for the recording of such deaths as provided in section one, nor shall any fee be required or paid under section two when certification is made at the request of any of the next of kin or the legal representatives of such deceased person.
a. The funeral director in charge of the funeral or disposition of the body of any person dying in this State shall be responsible for the proper execution of a death certificate in a legible manner, or by means of the NJ-EDRS, and filed in exchange for a burial or removal or transit permit with the local registrar of the district in which the death occurred or the body was found or with the registrar of the district in which the funeral director has his funeral home or where the burial or other disposition is to take place. In the event the death certificate is filed with the registrar of a district other than that in which the death took place or the body was found, that registrar shall, within 24 hours after issuing the permit, sign and forward the certificate of death to the registrar of the district where the death took place or the body was found, with a statement that the permit was issued. In case the death certificate is filed with the deputy registrar, alternate deputy registrar or subregistrar, he shall within 12 hours forward the certificate to his own registrar, who in turn shall forward the certificate as heretofore directed. A record created on the NJ-EDRS shall be deemed to have been transmitted to the other local registrar, or by the deputy registrar, alternate deputy registrar or subregistrar, as applicable, in accordance with the requirements of this subsection.
b. Any funeral director filing a death certificate in a registration district other than that in which the death occurred or the body was found shall immediately send the State registrar written notice by first class mail, except that a record created on the NJ-EDRS shall be deemed to have been transmitted to the State registrar in accordance with the requirements of this subsection. The notice shall contain the name of the deceased, the place and date of death, the date the certificate was filed, the name and address of the registrar with whom the certificate was filed, and the name and address of the funeral director. Failure of the State registrar to receive the notice shall be considered as failure of the funeral director to have sent it. In that case, the funeral director shall be subject to a penalty of $25, and the State registrar shall notify the State Board of Mortuary Science of the facts in the matter.
a. The certificate of death shall contain such items as shall be listed on death certificate forms or in the NJ-EDRS provided or approved by the department under the authority of subsection c. of R.S.26:8-24. The death certificate forms or the record in the NJ-EDRS shall include, but not be limited to, the following items:
(1) name of the decedent;
(2) county or municipality in which the death occurred;
(3) date of death;
(4) sex of the decedent, as provided for in subsection b. of this section;
(5) date of birth; and
(6) date of issuance and manner of death, provided this information is available.
b. The sex of the decedent shall be recorded to reflect the decedent's gender identity, as reported by the person or persons with the right to control the funeral and disposition as established by section 22 of P.L.2003, c.261 (C.45:27-22), unless the person completing the death certificate is presented with a document that memorializes the decedent's gender transition. In the event that these sources provide conflicting information concerning the sex of the decedent, the death certificate shall be based on documentation that memorializes the decedent's gender transition. If documentation is not available, it shall be based on information provided by the person or persons with the right to control the funeral and disposition as established by section 22 of P.L.2003, c.261 (C.45:27-22). Documents that may memorialize a gender transition may include, but shall not be limited to: written instructions from the decedent; a court order approving a name or gender change; an advance health care directive; proof of clinical treatment for gender transition; or documentation of a change to the gender marker on a birth certificate or a state or federally issued identification card.
c. If a document specified in subsection b. of this section is not present and the person named executor of the decedent's will does not agree with the gender identity of the decedent as reported by the person or persons with the rights to control the funeral and disposition, that person may file a petition in the Superior Court naming as a party to the action the person or persons with the rights to control the funeral and disposition and seeking an order of the court determining, as appropriate, who among those parties shall determine the gender identity of the decedent.
d. A person or persons with the right to control the funeral and disposition and the responsibility to provide the funeral director with the decedent's gender identity warrants the truth of the facts stated and of their authority to provide the funeral director with the necessary information to complete the death certificate. A funeral director shall not be liable for any damages or costs arising from a claim related to a decedent's gender identity or expression on the death certificate unless the funeral director had reasonable notice that the representations were untrue or notice that the person or persons providing the decedent's gender identity lacked the right to control disposition.
In the execution of a death certificate, the personal particulars shall be obtained by the funeral director from the person best qualified to supply them. The death and last sickness particulars shall be supplied by the attending, covering, or resident physician; or if there is no attending, covering, or resident physician, by an attending registered professional nurse licensed by the New Jersey Board of Nursing under P.L.1947, c.262 (C.45:11-23 et seq.); or if there is no attending, covering, or resident physician or attending registered professional nurse, by the county or intercounty medical examiner or assistant county or intercounty medical examiner.
Within a reasonable time, not to exceed 24 hours after the pronouncement of death, the attending, covering, or resident physician, the attending advanced practice nurse pursuant to section 10 of P.L.1991, c.377 (C.45:11-49), or the county or intercounty medical examiner or the assistant county or intercounty medical examiner shall execute the death certification. The burial particulars shall be supplied by the funeral director. The attending, covering, or resident physician, the attending advanced practice nurse, the attending registered professional nurse, or the county or intercounty medical examiner or the assistant county or intercounty medical examiner and the funeral director shall certify to the particulars supplied by them by signing their names below the list of items furnished, or by otherwise authenticating their identities and the information that they have provided through the NJ-EDRS. If a person acting under the direct supervision of the Chief State Medical Examiner, Deputy Chief State Medical Examiner, a county or intercounty medical examiner or the assistant county or intercounty medical examiner, funeral director, attending, covering, or resident physician, attending advanced practice nurse, or licensed health care facility or other public or private institution providing medical care, treatment, or confinement to persons, which is registered with the NJ-EDRS, is not authorized to authenticate the information required on a certificate of death or fetal death, that person may enter that information into the NJ-EDRS in anticipation of its authentication by the Chief State Medical Examiner, Deputy Chief State Medical Examiner, or a county or intercounty medical examiner or the assistant county or intercounty medical examiner, funeral director, attending, covering, or resident physician, attending advanced practice nurse, local registrar, deputy registrar, alternate deputy registrar or subregistrar, as applicable.
b. (Deleted by amendment, P.L.2006, c.86).
Within 180 days of the effective date of this act, the Commissioner of the Department of Health shall provide to all county and local health departments, hospitals and long-term care facilities in this State for distribution to appropriate personnel a list of all diseases that the commissioner determines are contagious, infectious or communicable diseases for the purposes of this act. The commissioner shall periodically update the list, as appropriate.
a. A person who violates the provisions of this act is subject to a penalty of up to $1,000.00 for each offense. These penalties shall be recovered in a civil action in the name of the Department of Health in a court of competent jurisdiction. The action may be brought in a summary manner pursuant to "the penalty enforcement law," N.J.S. 2A:58-1 et seq.
b. Any person who in good faith complies with the provisions of this act shall be free from any civil or criminal liability for so acting, provided the skill and care exercised are that ordinarily required and exercised by others in the profession.
(1) the deceased person is diagnosed as having Alzheimer's disease or a related disorder; and
(2) it is determined, in accordance with currently accepted medical standards and with a reasonable degree of medical certainty, that Alzheimer's disease or a related disorder was a significant contributing cause of the person's death.
b. Nothing in this section shall be construed to require any person to list Alzheimer's disease or a related disorder as a secondary cause of death, and no person shall be subject to any criminal or civil liability or any professional disciplinary action under Title 45 of the Revised Statutes for listing or failing to list Alzheimer's disease or a related disorder as a secondary cause of death on a certification of death.
c. As used in this section, "Alzheimer's disease and related disorders" means forms of dementia characterized by a general loss of intellectual abilities of sufficient severity to interfere with social or occupational functioning.
In case of any death occurring without medical attendance, the funeral director shall notify the Office of the Chief State Medical Examiner or the office of the county or intercounty medical examiner, or the local registrar. In case the local registrar shall be notified, he shall immediately inform the county or intercounty medical examiner and refer the case to him for investigation. The county or intercounty medical examiner or assistant county or intercounty medical examiner shall furnish the funeral director with the necessary data and last sickness particulars to make the death certificate, or shall enter the information directly into the NJ-EDRS.
In case the physician or the advanced practice nurse who last attended the deceased is unavailable, so that a certificate of death cannot be obtained from the physician or nurse in time for burial or removal:
a. the designated covering physician shall have the primary responsibility, after examining the dead body, and being satisfied that death did not result from some unlawful means, to issue a death certificate; and
b. in the absence of the designated covering physician, any other physician, after examining the dead body, and being satisfied that death did not result from some unlawful means, may issue a death certificate.
A certificate of fetal death containing such items as shall be listed on fetal death certificate forms provided or approved by the department under the authority of subsection c. of R.S.26:8-24, and a burial or removal permit, shall be required for every fetal death; provided that 20 or more weeks of gestation have elapsed before the delivery.
No midwife shall sign a certificate for a fetal death; but any fetal death occurring without attendance of a physician or an advanced practice nurse shall be treated as a death without medical attendance, as provided in R.S.26:6-9.
The department shall take appropriate action to ensure that any certificate of fetal death required by this section is prepared in accordance with, and contains information that satisfies, the provisions of P.L.2013, c.217 (C.26:8-40.27 et seq.), designated as the "Autumn Joy Stillbirth Research and Dignity Act," and the current federal standards for fetal death certification and fetal death reporting, as adopted, amended, and supplemented by the federal Centers for Disease Control and Prevention.
No certificate of death shall be held to be complete and correct that does not supply all of the items of information called for therein, or satisfactorily account for their omission.
Upon receipt of a death certificate, the local registrar shall:
a. If the certificate is properly executed and complete, issue a burial or removal permit when requested; and
b. If the certificate of death is incomplete and unsatisfactory, call attention to the defects in the return, and withhold the burial or removal permit until the defects are corrected. Any person certifying to any of the particulars in the certificate shall complete the same as directed by the local registrar in accordance with such terms as may be defined by the State registrar.
For the purposes of the NJ-EDRS, the death certificate shall be complete when the attending, covering or resident physician or the county medical examiner, and the funeral director in charge, have completed their respective portions of the death registration record.
The burial or removal permit shall be issued upon a form or through the NJ-EDRS as prescribed by the department, signed or authenticated through the NJ-EDRS by the local registrar, and shall state:
a. The name, age, sex, cause of death, and other necessary details required by the department;
b. That a satisfactory certificate of death has been filed as required by law; and
c. That permission is granted to inter, remove, or otherwise dispose of the body.
The State registrar shall be entitled to receive a fee of $5 for each burial or removal, or transit permit issued; except that, on or after the effective date of P.L.2007, c.98 but before the first day of the thirty-seventh month following the effective date of P.L.2007, c.98, the State registrar shall be entitled to receive a fee of $15. The State registrar shall deposit the proceeds from the fees into the New Jersey Electronic Death Registration Support Fund established pursuant to section 17 of P.L.2003, c.221 (C.26:8-24.2), and shall provide such amount from the fee, as the Commissioner of Health and Senior Services determines appropriate, to the local registrar who issued the permit.
No burial permit shall be required from the local registrar of the district in which a burial is to be made, when a body is removed upon a proper removal permit from one district to another district in this state, for purpose of final disposition.
If through the absence of the local registrar, or for other sufficient reason, it is impossible to obtain from the registrar a burial or removal permit in time for burial or removal, a judge of the Superior Court or of a municipal court in the county in which the death occurred, if he is satisfied that the death certificate is genuine, and that no permit can be obtained in time for burial or removal, shall issue an emergency burial or removal permit.
The emergency burial or removal permit shall be issued in the following form:
"It being impossible to obtain a burial or removal permit from the registrar of vital statistics on account of (state here the reason), I, a judge of the Superior Court (or a judge of a municipal court of the .................. of ............. ), do hereby grant this emergency permit for the burial or removal of ....................... , whose death has been duly certified to me."
The permit shall be dated and signed by the judge and shall be given to the person delivering the certificate of death. The judge shall, within five days thereafter, transmit the certificate to the State registrar. The judge shall be entitled to $1.00 for the issuance of an emergency permit.
No person shall convey or aid in conveying to a common carrier to be transported across or within this state, nor shall a common carrier accept for transportation or transport across or within this state, the dead body of a person who has died of smallpox, Asiatic cholera, yellow fever, typhus fever or bubonic plague, unless the body is inclosed in a hermetically sealed casket and a license for such transportation has been first obtained in writing from the state department.
The State Department may make any rule prescribing the manner in which a dead body, intended to be transported by any common carrier across or within this State, shall be disinfected, embalmed, or incased. Any such rule shall be referred to in the blank form of the transit permit required for the transportation of a dead body.
No person shall ship or receive for shipment within this state or to any point outside the state, by any common carrier, a dead body until a transit permit has been issued by the local registrar of the district in which the death occurred.
The transit permit shall be issued upon a form prescribed by the State Department, signed by the local registrar, and shall set forth:
a. That the body has been prepared for transportation in every particular as required by law and the rules of the State Department;
b. The places from which and to which the body will be transported; and
c. The name of the person, if any, authorized to accompany the body in its transit.
The funeral director shall attach such portion of the transit permit as is directed thereon to the box containing the corpse when shipped by any transportation company. The remaining portion of the transit permit shall be delivered to the passenger in charge of the corpse. This portion of the transit permit shall be delivered to the person in charge of the place of burial or other disposition.
When a dead body is transported from outside this state into the state for burial or other final disposition, the transit or removal permit, issued in accordance with the law and health regulations of the place where the death occurred, shall be given the same force and effect as a local burial or removal permit.
If no such permit shall be brought with the body, or if the body be shipped by express and no permit is attached to the box in which the body is incased, then any common carrier may refuse to transport or to receive for transportation any such body until the permit has been obtained.
The funeral director shall deliver the burial or removal permit or the detachable portion of the transit permit, if any, to the person in charge or the place of burial or of final disposition before interring or otherwise disposing of the body.
The person in charge of any premises on which an interment is to be made shall see that the requirements of this chapter relative to a burial or removal permit, or transit permit shall have been complied with before any burial or other disposal is made thereon.
The person in charge of any premises on which an interment is made shall indorse, over his signature upon the burial or removal permit, or transit permit, the date of interment and shall return the permit so indorsed or the detachable portion of the transit permit, if any, to the local registrar of his district within 10 days from the date of interment, or within the time fixed by the local board.
The person in charge of any premises on which an interment is made shall keep a permanent record of any burial or other disposal made on such premises, which record shall at all times be open to official inspection. This record shall in each case state the name of the deceased person, place of death, date of burial or other disposal, and the name and address of the funeral director.
The funeral director when burying a body in a cemetery or burial ground having no person in charge shall sign the burial or removal permit, or transit permit, giving the date of burial, and shall write across the face of the permit or transit permit the words, "No person in charge," and file the permit or transit permit within 10 days with the registrar of the district in which the place of burial is located.
Every dead body interred in any burial ground or cemetery in this state shall be buried so that the top of the outside coffin or box shall be at least four feet below the natural surface of the ground, and shall be immediately covered with at least four feet of earth, soil or sand.
Bodies of infants in coffins or boxes not more than four feet in length shall be buried so that the top of the outside coffin or box shall be at least three feet and six inches below the natural surface of the ground, and shall be immediately covered with at least three feet and six inches of earth, soil or sand.
This section shall not apply where bodies are placed or buried in properly constructed private vaults so as to prevent the escape of noxious or unhealthy gases therefrom.
No dead body shall be disinterred or removed from any grave, tomb or burial place within this State except by direction of a competent court of this State for the purpose of criminal investigation or upon permit being given therefor by the local board in the locality where the body is interred or entombed.
No dead body of a person who has died of smallpox, cholera, yellow fever, typhus fever, plague, or from any disease publicly declared by the State department to be communicable, shall be disinterred or removed from any grave, tomb, vault or place within this State unless the body was originally interred in a metallic case, hermetically sealed, and then only by the order of and under the direction of the local board within whose jurisdiction the body was buried.
The requirement as to the use of a metallic case shall not apply where the body has been embalmed prior to burial and buried or interred 3 years or more.
No unembalmed dead body shall be permitted to remain longer than 48 hours in a receiving vault in this State, the depth of which is less than 5 feet below the natural surface of the ground. This section shall not apply to properly constructed receiving vaults which prevent the escape of noxious and unhealthy gases.
The municipal authorities or local board or their properly authorized agents may at all times enter any cemetery or burial ground within the limits of their jurisdiction, examine into the condition of the same, and ascertain whether the laws regulating it are duly observed.
Any person violating any of the provisions of this article or the person in charge of or exercising control over any cemetery or burial ground in this State who knowingly permits or suffers such violation, shall be punished by a fine not exceeding $300.00 or by imprisonment for 6 months, or both.
Except as otherwise specifically provided in this chapter, any person violating any provision of this chapter, or falsifying any certificate or record established by this chapter, or failing or refusing to perform any duty required by this chapter, shall be subject to a penalty of not less than $50.00 nor more than $100.00 for each offense.
Such penalties shall be recovered in a civil action in the name of the State department or local board in any court of competent jurisdiction including the municipal court.
a. For over three decades, the State of New Jersey has supported organ and tissue donation as a public policy, because one individual can save up to eight lives by donating his or her vital organs and enhance more than 50 lives by donating tissue;
b. Although 95% of the national population indicates support for donation, a far smaller percentage have actually made a legally binding decision to be organ and tissue donors, the result of which has been the deaths of over 74,186 people nationally and 2,470 New Jersey residents since 1997 because life-saving organs were not available to them for transplant;
c. A public policy supporting organ donation is no longer adequate, given the health crisis faced by more than 98,000 people awaiting life saving organ transplants nationally, of whom more than 4,000 are New Jersey residents;
d. A new public policy of advocacy which encourages positive donation decisions is now imperative in order to save more lives;
e. The health and welfare of New Jersey's residents requires a more dynamic, comprehensive framework regarding organ donation, one with mandated educational and decisional components;
f. This comprehensive framework must incorporate the federal government's charge to organ procurement organizations to work with states in educating the public so that more individuals make positive donation decisions and document those decisions;
g. In order to insure that more New Jersey residents become donors, it is necessary to provide curriculum in both secondary schools and institutions of higher education, as well as establish educational requirements for physicians and nurses, to dispel myths associated with organ donation, provide accurate information about the donation and recovery process, and emphasize the fundamental responsibility of individuals to take appropriate action, when able to do so, to help save another person's life;
h. It is further necessary to provide residents with an accessible, secure means using the Internet, to register as organ donors in a way that ties the donation decision to a routine but necessary function, such as the receipt of a driver's license or personal identification card, so that an interaction on the issue of organ donation occurs at or around the time New Jersey residents reach the age of majority; and
i. The combined initiatives provided for in this act will effectively achieve the State's public policy goal to increase the number of organ and tissue donors in the State so that more lives can be saved or enhanced.
"Anatomical research recovery organization" means a nonprofit corporation engaged in the recovery of a human body or part donated for education, research, or the advancement of medical, dental, or mortuary science pursuant to P.L.1969, c.161 (C.26:6-57 et seq.) or any subsequent statute adopted pursuant thereto, where part or all of the recovery takes place in this State. Anatomical research recovery organization shall not include an accredited institution of higher education in this State that uses an anatomical gift for its own educational or research purposes and is not engaged in the distribution of a human body or part to another person or entity.
"Commissioner" means the Commissioner of Health.
"Department" means the Department of Health.
"Distribution" means the removal of a human body or part from a storage location to any other location for educational or research use, or the advancement of medical, dental, or mortuary science.
"Education" means the use of the whole body or parts for purposes of teaching or training individuals, including medical or dental professionals and students, with regard to the anatomy and characteristics of the human body.
"Human body part" or "part" means organs, tissues, eyes, bones, blood vessels, and any other portions of a deceased human body which are subject to an anatomical gift pursuant to P.L.1969, c.161 (C.26:6-57) or any subsequent statute adopted pursuant thereto, but does not include blood collected pursuant to P.L.1945, c.301 (C.26:2A-1).
"Recovery" means the obtaining of a human body or part, including, but not limited to, determining or obtaining consent or authorization for donation of the human body or part, performing surgical or other technical procedures for recovering the body or part, and processing the body or part. Recovery does not include actions taken by a medical examiner or coroner as part of his professional duties.
"Research" means the conduct of scientific testing and observation designed to result in the acquisition of generalizable knowledge. Research does not include an autopsy or other investigation conducted for the purpose of obtaining information related to the decedent.
The registration required pursuant to this act shall be in addition to any license or permit required by a local board of health, other local health agency, or any State or federal agency.
b. The registration shall be valid for a one-year period and may be renewed subject to compliance with the requirements of this act. The commissioner shall establish such registration and renewal fees as may be reasonable and necessary to carry out the purposes of this act.
c. The commissioner may enter and inspect the premises of any anatomical research recovery organization and the books and records as is reasonably necessary to carry out the provisions of this act.
a. A physician licensed in this State or the state in which the organization is incorporated shall serve as medical director, and shall be responsible for ensuring compliance with the provisions of this act, the hiring of qualified personnel, and the maintenance of records required under this act.
b. The organization shall be a federally tax-exempt nonprofit corporation.
c. The organization shall create, compile, or maintain a complete record on each donor from which it recovers a human body or part for educational or research purposes or the advancement of medical, dental or mortuary science, which shall include, at a minimum:
(1) documentation that the donor has designated the anatomical gift for educational or research purposes or for the advancement of medical, dental, or mortuary science, as specified in section 3 of P.L.1969, c.161 (C.26:6-59) or any subsequent statute adopted pursuant thereto. The documentation may be in the form of a signed document of gift, or verifiable documentation that taped telephonic consent has been obtained;
(2) documentation of the identity and address of each entity which has been in possession of the human body or part prior to the organization, such as a funeral home, coroner, hospital, organ procurement organization, or tissue bank; and
(3) documentation of the use and disposition of each human body or part, including the name and address of each person who receives a human body or part directly from the organization.
b. In addition to any civil penalties provided under this section, the commissioner may suspend or revoke a registration made pursuant to this act for a violation of any provision of this act.
c. Except as provided in section 7 of this act, before denying to grant or renew a registration, or suspending or revoking a registration, pursuant to this act, the commissioner shall provide notice of the denial, revocation, or suspension, together with a specification of charges to the applicant or registrant, personally or by certified mail to the address of record, and the notice shall set forth the particular reasons for the denial, suspension, or revocation. The denial, suspension, or revocation shall become effective 30 days after mailing, unless the applicant or registrant, within the 30-day period, meets the requirements of the department or files with the department a written answer to the charges and gives written notice to the department of its desire for a hearing, in which case the denial, suspension, or revocation may be held in abeyance until the hearing has been concluded and a final decision rendered by the commissioner.
The commissioner shall afford the applicant or registrant an opportunity for a prompt hearing on the question of the granting, suspension, or revocation of the registration. The procedure governing the hearing shall be in accordance with the rules and regulations of the department. Either party may be represented by counsel of its own choosing, and has the right to subpoena witnesses and to compel their attendance on forms furnished by the department. The commissioner shall render a written decision stating conclusions and reasons therefor.
b. Whenever the term "Uniform Anatomical Gift Act" occurs or any reference is made thereto in any law, contract or document, the same shall be deemed to mean or refer to the "Revised Uniform Anatomical Gift Act."
"Adult" means a person who is at least 18 years of age.
"Advance directive for health care" means an advance directive for health care that is executed pursuant to P.L.1991, c.201 (C.26:2H-53 et seq.).
"Agent" means a person who is authorized to act as a health care representative by an advance directive for health care or is expressly authorized to make an anatomical gift on a donor's behalf by any other record signed by the donor.
"Anatomical gift" means a donation of all or part of a human body to take effect after the donor's death for the purpose of transplantation, therapy, research, or education.
"Civil union partner" means one partner in a civil union couple as defined in section 2 of P.L.2006, c.103 (C.37:1-29).
"Decedent" means a deceased person whose body or part is or may be the source of an anatomical gift, and includes a stillborn infant or fetus.
"Designated requester" means a hospital employee who has completed a course offered or approved by an organ procurement organization.
"Disinterested witness" means a witness other than: the spouse, civil union partner, domestic partner, child, parent, sibling, grandchild, grandparent, or guardian of the person who makes, amends, revokes, or refuses to make an anatomical gift; another adult who exhibited special care and concern for the decedent; or a person to whom an anatomical gift may pass pursuant to section 10 of P.L.2008, c.50 (C.26:6-86).
"Document of gift" means a donor card or other record used to make an anatomical gift, and includes a statement or symbol on a driver's license, identification card, or donor registry.
"Domestic partner" means a domestic partner as defined in section 3 of P.L.2003, c.246 (C.26:8A-3).
"Donor" means a person whose body or part is the subject of an anatomical gift.
"Donor registry" means a database that contains records of anatomical gifts.
"Driver's license" means a license or permit issued by the New Jersey Motor Vehicle Commission to operate a vehicle, whether or not conditions are attached to the license or permit.
"Eye bank" means an entity that is licensed, accredited, or regulated under federal or State law to engage in the recovery, screening, testing, processing, storage, or distribution of human eyes or portions of human eyes.
"Guardian" means a person appointed by a court to make decisions regarding the support, care, education, health, or welfare of another individual, but does not include a guardian ad litem.
"Hospital" means an institution, whether operated for profit or not, whether maintained, supervised, or controlled by an agency of State government or a county or municipality or not, which maintains and operates facilities for the diagnosis, treatment, or care of two or more non-related individuals with an illness, injury, or disability, and where emergency, outpatient, surgical, obstetrical, convalescent, or other medical and nursing care is rendered for periods exceeding 24 hours.
"Identification card" means an identification card issued by the New Jersey Motor Vehicle Commission.
"Medical examiner" means the Chief State Medical Examiner, Deputy Chief State Medical Examiner, a county or intercounty medical examiner or assistant county or intercounty medical examiner, performing their duties pursuant to P.L.2018, c.62 (C.26:6B-1 et al.).
"Minor" means a person who is under 18 years of age.
"Organ procurement organization" means an entity designated by the United States Secretary of Health and Human Services as an organ procurement organization.
"Parent" means a parent whose parental rights have not been terminated.
"Part" means an organ, eye, or tissue of a human being, but does not include the whole body.
"Physician" means a person authorized to practice medicine or osteopathy under the laws of any state.
"Procurement organization" means an eye bank, organ procurement organization, or tissue bank.
"Prospective donor" means a person who is dead or whose death is imminent and has been determined by a procurement organization to have a part that could be medically suitable for transplantation, therapy, research, or education, but does not include an individual who has made a refusal.
"Reasonably available" means able to be contacted by a procurement organization without undue effort and willing and able to act in a timely manner consistent with existing medical criteria necessary for the making of an anatomical gift.
"Recipient" means a person into whose body a decedent's part has been or is intended to be transplanted.
"Record" means information that is inscribed on a tangible medium or stored in an electronic or other medium and is retrievable in perceivable form.
"Refusal" means a record created pursuant to P.L.2008, c.50 (C.26:6-77 et seq.) that expressly states an intent to bar other persons from making an anatomical gift of a person's body or part.
"Sign" means, with the present intent to authenticate or adopt a record, to execute or adopt a tangible symbol, or to attach to or logically associate with the record an electronic symbol, sound, or process.
"State" means a state of the United States, the District of Columbia, Puerto Rico, the United States Virgin Islands, or any territory or insular possession subject to the jurisdiction of the United States.
"Technician" means a person who is determined to be qualified to remove or process parts by an appropriate organization that is licensed, accredited, or regulated under federal or State law, and includes an enucleator.
"Tissue" means a portion of the human body other than an organ or an eye, but does not include blood unless it is needed to facilitate the use of other parts or is donated for the purpose of research or education.
"Tissue bank" means an entity that is licensed, accredited, or regulated under federal or State law to engage in the recovery, screening, testing, processing, storage, or distribution of tissue.
"Transplant hospital" means a hospital that furnishes organ transplants and other medical and surgical specialty services required for the care of transplant patients.
a. the donor, if the donor is an adult, or if the donor is a minor 14 years of age or older, whether or not the minor is emancipated;
b. an agent of the donor, unless the advance directive for health care or other record prohibits the agent from making an anatomical gift;
c. a parent of the donor, if the donor is an unemancipated minor; or
d. the donor's guardian.
An anatomical gift made by a minor donor shall remain valid when the minor reaches 18 years of age.
(1) by authorizing a statement or symbol indicating that the donor has made an anatomical gift to be imprinted on the donor's driver's license or identification card;
(2) in a will;
(3) during a terminal illness or injury of the donor, by any form of communication addressed to at least two adults, at least one of whom shall be a disinterested witness; or
(4) as provided in subsection b. of this section.
b. A donor or other person authorized to make an anatomical gift pursuant to section 4 of this act may make a gift by a donor card or other record signed by the donor or other person making the gift or by authorizing that a statement or symbol indicating that the donor has made an anatomical gift be included on a donor registry.
If the donor or other person is physically unable to sign a record, the record may be signed by another individual at the direction of the donor or other person and shall:
(1) be witnessed by at least two adults, at least one of whom shall be a disinterested witness, who have signed at the request of the donor or other person; and
(2) state that it has been signed and witnessed as provided in paragraph (1) of this subsection.
c. The revocation, suspension, expiration, or cancellation of a driver's license or identification card upon which an anatomical gift is indicated shall not invalidate the gift.
d. An anatomical gift made by will shall take effect upon the donor's death, whether or not the will is probated. Invalidation of the will after the donor's death shall not invalidate the gift.
(1) a record signed by:
(a) the donor or other person; or
(b) subject to the provisions of subsection b. of this section, another individual acting at the direction of the donor or the other person if the donor or other person is physically unable to sign; or
(2) a later-executed document of gift that amends or revokes a previous anatomical gift or portion of an anatomical gift, either expressly or by inconsistency.
b. A record signed pursuant to subparagraph (b) of paragraph (1) of subsection a. of this section shall:
(1) be witnessed by at least two adults, at least one of whom shall be a disinterested witness, who have signed at the request of the donor or other person; and
(2) state that it has been signed and witnessed as provided in paragraph (1) of this subsection.
c. Subject to the provisions of section 8 of this act, a donor or other person authorized to make an anatomical gift pursuant to section 4 of this act may revoke an anatomical gift by the destruction or cancellation of the document of gift, or the portion of the document of gift used to make the gift, with the intent to revoke the gift.
d. A donor may amend or revoke an anatomical gift that was not made in a will by any form of communication during a terminal illness or injury addressed to at least two adults, at least one of whom shall be a disinterested witness.
e. A donor who makes an anatomical gift in a will may amend or revoke the gift in the manner provided for amendment or revocation of wills or as provided in subsection a. of this section.
(1) a record signed by:
(a) the person; or
(b) subject to subsection b. of this section, another individual acting at the person's direction if the person is physically unable to sign;
(2) the person's will, whether or not the will is admitted to probate or invalidated after the person's death; or
(3) any form of communication made by the person during the person's terminal illness or injury addressed to at least two adults, at least one of whom shall be a disinterested witness.
b. A record signed pursuant to subparagraph (b) of paragraph (1) of subsection a. of this section shall:
(1) be witnessed by at least two adults, at least one of whom shall be a disinterested witness, who have signed at the request of the person who is making a refusal; and
(2) state that it has been signed and witnessed as provided in paragraph (1) of this subsection.
c. A person who has made a refusal may amend or revoke the refusal:
(1) in the manner provided in subsection a. of this section for making a refusal;
(2) by subsequently making an anatomical gift that is inconsistent with the refusal; or
(3) by destroying or canceling the record evidencing the refusal, or the portion of the record used to make the refusal, with the intent to revoke the refusal.
d. Except as otherwise provided in subsection h. of section 8 of this act, in the absence of an express, contrary indication by the person set forth in the refusal, a person's unrevoked refusal to make an anatomical gift of the person's body or part shall preclude another individual from making an anatomical gift of the person's body or part.
b. A donor's revocation of an anatomical gift pursuant to section 6 of this act shall not be deemed to be a refusal and shall not preclude another person as specified in section 4 or section 9 of this act from making an anatomical gift of the donor's body or part.
c. If a person other than the donor makes an unrevoked anatomical gift of the donor's body or part pursuant to section 5 of this act or an amendment to an anatomical gift of the donor's body or part pursuant to section 6 of this act, another person shall not make, amend, or revoke the gift of the donor's body or part.
d. A revocation of an anatomical gift by a person other than the donor pursuant to section 6 of this act shall not preclude another person from making an anatomical gift of the body or part.
e. In the absence of an express, contrary indication by a donor or other person authorized to make an anatomical gift under this act, an anatomical gift of a part shall not be deemed to be a refusal to give another part nor a limitation on the making of an anatomical gift of another part at a later time by the donor or other person.
f. In the absence of an express, contrary indication by the donor or other person authorized to make an anatomical gift under this act, an anatomical gift of a part for any of the purposes set forth in section 4 of this act shall not be deemed to limit the making of an anatomical gift of the part for any of those other purposes by the donor or other person.
g. Notwithstanding the provisions of this section to the contrary, in the event of the death of a donor who is an unemancipated minor, a parent of the donor who is reasonably available may revoke or amend an anatomical gift of the donor's body or part.
h. In the event of the death of an unemancipated minor who has signed a refusal, a parent of the minor who is reasonably available may revoke the minor's refusal.
(a) an agent of the decedent at the time of the decedent's death who could have made an anatomical gift immediately before the decedent's death pursuant to section 4 of this act;
(b) the spouse, civil union partner, or domestic partner of the decedent;
(c) an adult child of the decedent;
(d) either parent of the decedent;
(e) an adult sibling of the decedent;
(f) another adult who is related to the decedent by blood, marriage, or adoption, or exhibited special care and concern for the decedent;
(g) a person who was acting as the guardian of the person of the decedent at the time of the decedent's death; and
(h) any other person having the authority to dispose of the decedent's body, including the administrator of a hospital in which the decedent was a patient or resident immediately preceding death. In the absence of actual notice of contrary indication by the decedent, the administrator shall make an anatomical gift of a decedent's body or part.
(2) If there is more than one member of a class as specified in subparagraphs (a) through (g) of paragraph (1) of this subsection who is entitled to make an anatomical gift, a member of the class may make an anatomical gift unless that member or a person to whom the gift may pass pursuant to section 10 of this act knows of an objection by another member of the class. If an objection is known, the gift shall be made only by a majority of the members of the class who are reasonably available. Nothing in this subsection shall be construed to require that all members of the class authorize the making of the gift or participate in the decision to make the gift.
(3) A person may not make an anatomical gift if, at the time of the decedent's death, a person in a prior class as specified in paragraph (1) of this subsection is reasonably available to make or object to the making of an anatomical gift.
b. (1) A person authorized to make an anatomical gift pursuant to subsection a. of this section may make an anatomical gift by a document of gift signed by the person making the gift or by that person's oral communication that is electronically recorded or is contemporaneously reduced to a record and signed by the individual receiving the oral communication.
(2) Subject to the provisions of paragraph (3) of this subsection, an anatomical gift by a person authorized to make the gift pursuant to subsection a. of this section may be amended or revoked orally or in a record by any member of a prior class who is reasonably available. If more than one member of the prior class is reasonably available, the gift made by the authorized person may be:
(a) amended only if a majority of the reasonably available members agree to amending the gift; or
(b) revoked only if a majority of the reasonably available members agree to revoking the gift or if they are equally divided as to whether to revoke the gift.
(3) A revocation made pursuant to paragraph (2) of this subsection shall be effective only if, before an incision has been made to remove a part from the donor's body or before invasive procedures have begun to prepare the recipient, the procurement organization, transplant hospital, or physician or technician knows of the revocation. A procurement organization, transplant hospital, or physician or technician with knowledge of a revocation shall make a best effort to communicate that information to the other parties involved in order to stop the anatomical gift recovery process.
(1) a hospital; accredited medical school, dental school, college, or university; organ procurement organization; or other appropriate person, for research or education;
(2) subject to the provisions of subsection b. of this section, an individual designated by the person making the anatomical gift if the individual is the recipient of the part; or
(3) an eye bank or tissue bank.
b. If an anatomical gift to an individual cannot be transplanted into the individual, the part shall pass in accordance with subsection f. of this section in the absence of an express, contrary indication by the person making the anatomical gift.
c. If there is more than one purpose of an anatomical gift set forth in the document of gift but the purposes are not set forth in any priority, the gift shall be used for transplantation or therapy, if suitable. If the gift cannot be used for transplantation or therapy, the gift may be used for research or education.
d. If an anatomical gift of one or more specific parts is made in a document of gift that does not name a person or entity as described in subsection a. of this section and does not identify the purpose of the gift, the gift shall be used only for transplantation or therapy, and shall pass in accordance with subsection f. of this section.
e. If a document of gift specifies only a general intent to make an anatomical gift by words such as "donor," "organ donor," or "body donor," or by a symbol or statement of similar import, the gift shall include all parts, may be used only for transplantation or therapy, and shall pass in accordance with subsection f. of this section.
f. For the purposes of subsections b., d., and e. of this section, the following shall apply:
(1) if the part is an eye, the gift shall pass to the appropriate eye bank;
(2) if the part is tissue, the gift shall pass to the appropriate tissue bank; and
(3) if the part is an organ, the gift shall pass to the appropriate organ procurement organization as custodian of the organ.
g. An anatomical gift of an organ for transplantation or therapy, other than an anatomical gift under paragraph (2) of subsection a. of this section, shall pass to the organ procurement organization as custodian of the organ.
h. If an anatomical gift does not pass pursuant to subsections a. through g. of this section or the decedent's body or part is not used for transplantation, therapy, research, or education, custody of the body or part shall pass to the person or entity under obligation to dispose of the body or part.
i. A person or entity shall not accept an anatomical gift if the person or entity knows that the gift was not effectively made pursuant to this act or that the decedent made a refusal pursuant to this act that was not revoked. For the purposes of the subsection, if a person or entity knows that an anatomical gift was made on a document of gift, the person or entity shall be deemed to know of any amendment or revocation of the gift or any refusal to make an anatomical gift on the same document of gift.
j. Except as otherwise provided in paragraph (2) of subsection a. of this section, nothing in this act shall be construed to affect the allocation of organs for transplantation or therapy.
a. A mental or physical disability does not diminish a person's right to health care;
b. The "Americans with Disabilities Act of 1990" prohibits discrimination against persons with disabilities, yet many individuals with disabilities still experience discrimination in accessing critical health care services;
c. Individuals with mental and physical disabilities have been denied life-saving organ transplants based on assumptions that their lives are less worthy, that they are incapable of complying with complex post-transplant medical regimens, or that they lack adequate support systems to ensure such compliance;
d. Although organ transplant centers must consider medical and psychosocial criteria when determining if a patient is suitable to receive an organ transplant, transplant centers that participate in the Medicare and Medicaid programs are required to use patient selection criteria that result in a fair and non-discriminatory distribution of organs; and
e. New Jersey residents in need of organ transplants are entitled to assurances that they will not encounter discrimination on the basis of a disability.
b. The court shall accord priority on its calendar and expeditiously proceed with an action brought to seek any remedy authorized by law for purposes of enforcing compliance with the provisions of this section.
c. The provisions of this section shall not be deemed to require referrals or recommendations for, or the performance of, medically inappropriate organ transplants.
d. As used in this section, "disability" has the same meaning as in the federal "Americans with Disabilities Act of 1990," Pub. L.101-336 (42 U.S.C. 12101 et seq.).
(1) a law enforcement officer, firefighter, paramedic, or other emergency rescuer finding the individual; and
(2) if no other source of the information is immediately available, a hospital, as soon as practical after the individual's arrival at the hospital.
b. If a document of gift or a refusal to make an anatomical gift is located by the search required pursuant to subsection a. of this section, the person responsible for conducting the search shall make the document of gift or refusal immediately available to the organ procurement organization.
c. A person shall not be subject to criminal or civil liability, but may be subject to administrative sanctions, for a failure to discharge the duties imposed pursuant to this section.
b. Upon or after an individual's death, a person in possession of a document of gift or a refusal to make an anatomical gift with respect to the individual shall allow examination and copying of the document of gift or refusal by a person authorized to make or object to the making of an anatomical gift with respect to the individual or by a person to whom the gift may pass pursuant to section 10 of this act.
b. When a hospital refers a person who is dead or whose death is imminent to an organ procurement organization, the organization shall make a reasonable search of the records of the New Jersey Motor Vehicle Commission and any donor registry that it knows exists for the geographical area in which the person resides in order to ascertain whether the person has made an anatomical gift.
c. (1) If the patient has a validly executed donor card, donor designation on a driver's license, advance directive for health care, will, other document of gift, or registration with a Statewide organ and tissue donor registry, the procurement organization representative or the designated requester shall attempt to notify a person listed in section 9 of this act of the gift.
If no document of gift is known to the procurement organization representative or the designated requester, one of those two individuals shall ask the persons listed in section 9 of this act whether the decedent had a validly executed document of gift. If there is no evidence of an anatomical gift or refusal by the decedent, the procurement organization representative or the designated requester shall attempt to notify a person listed in section 9 of this act of the option to donate organs or tissues.
(2) The person in charge of the hospital or that person's designated representative shall indicate in the medical record of the decedent whether or not a document of gift is known to exist, or otherwise whether consent was granted, the name of the person granting or refusing the consent, and that person's relationship to the decedent.
d. When a hospital refers an individual who is dead or whose death is imminent to a procurement organization, and the organization has determined based upon a medical record review that the individual may be a prospective donor, then the organization may conduct any blood or tissue test or minimally invasive examination that is reasonably necessary to evaluate the medical suitability of a part that is or may be the subject of an anatomical gift for transplantation, therapy, research, or education from a donor or a prospective donor. The hospital shall not withdraw any measures that are necessary to maintain the medical suitability of the part until the procurement organization has had the opportunity to advise the applicable persons as set forth in section 9 of this act of the option to make an anatomical gift or has ascertained that the individual expressed a contrary intent. The results of such tests and examinations shall be used or disclosed only for purposes of evaluating medical suitability for donation and to facilitate the donation process, and as required or permitted by existing law.
e. At any time after a donor's death, the person to whom an anatomical gift may pass pursuant to section 10 of this act may conduct any test or examination that is reasonably necessary to evaluate the medical suitability of the body or part for its intended purpose.
f. An examination conducted pursuant to this section may include an examination of all medical and dental records of the donor or prospective donor.
g. Upon the death of a minor who was a donor or had signed a refusal, the procurement organization shall, unless it knows the minor is emancipated, conduct a reasonable search for the parents of the minor and provide the parents with an opportunity to revoke or amend the anatomical gift or revoke the refusal.
h. Subject to the provisions of this act, the rights of a person or entity to whom a part passes pursuant to section 10 of this act shall be superior to the rights of all others with respect to that part. The person or entity may accept or reject an anatomical gift in whole or in part. Subject to the terms of the document of gift and the provisions of this act, a person or entity who accepts an anatomical gift of an entire body may allow embalming, burial or cremation, and the use of remains in a funeral service. If the gift is of a part, the person or entity to which the part passes pursuant to section 10 of this act, upon the death of the donor and before embalming, burial or cremation, shall cause the part to be removed without unnecessary mutilation.
i. Neither the physician or registered professional nurse who attends the decedent at death nor the physician or registered professional nurse who determines the time of the decedent's death may participate in the procedures for removing or transplanting a part from the decedent.
j. A physician or technician may remove a donated part from the body of a donor that the physician or technician is qualified to remove.
k. Each hospital or other licensed health care facility in this State shall be authorized to enter into such agreements or affiliations with procurement organizations as are necessary for the coordination of procurement and use of anatomical gifts.
b. Neither the person making an anatomical gift nor the donor's estate shall be liable for any injury or damage that results from the making or use of the gift.
c. In determining whether an anatomical gift has been made, amended, or revoked pursuant to this act, a person or entity shall rely upon representations made by an individual as specified in section 9 of this act relating to the individual's relationship to the donor or prospective donor unless the person knows that the representation is untrue.
(1) the provisions of this act;
(2) the laws of the state or country in which it is executed; or
(3) the laws of the state or country in which the person making the anatomical gift is domiciled, has a place of residence, or is a citizen at the time that the document of gift is executed.
b. The law of this State shall govern the interpretation of a valid document of gift to which the provisions of this act apply.
c. A person shall presume that a document of gift or amendment of an anatomical gift is valid unless the person knows that it was not validly executed or was revoked.
a. If the patient is determined to have decision making capacity pursuant to the provisions of P.L.1991, c.201 (C.26:2H-53 et seq.), then the patient shall, after consultation with the patient's attending physician about the donor option and all other relevant factors in end-of-life decision making, make a determination concerning the withholding or withdrawing of treatment pursuant to existing law;
b. If the patient is determined to lack decision making capacity pursuant to section 8 of P.L.1991, c.201 (C.26:2H-60), then an agent acting pursuant to the patient's advance directive or other record or, if no such agent has been designated by the patient or the agent is not reasonably available, another person authorized by law other than this act to make decisions on behalf of the patient with regard to the patient's health care shall act for the patient to resolve the conflict.
The parties specified in this subsection shall seek to resolve the conflict as set forth therein as expeditiously as possible. Information relevant to the resolution of the conflict shall be obtained from the appropriate procurement organization and any other person authorized to make an anatomical gift for the patient pursuant to section 9 of this act.
Measures necessary to ensure the medical suitability of the part shall not be withheld or withdrawn from the patient prior to resolution of the conflict if the withholding or withdrawing is not contraindicated by the requirements of providing appropriate end-of-life care.
b. A part shall not be removed from the body of a decedent under a medical examiner's jurisdiction for transplantation, therapy, research, or education, nor delivered to a person for research or education, unless the part is the subject of an anatomical gift. The provisions of this section shall not be construed to preclude a medical examiner from performing an investigation as provided in P.L.2018, c.62 (C.26:6B-1 et al.) of a decedent under the medical examiner's jurisdiction.
c. Upon the request of a procurement organization, the medical examiner shall release to the procurement organization the name, contact information, and available medical and social history of a decedent whose body is under the medical examiner's jurisdiction. If the decedent's body or part is medically suitable for transplantation, therapy, research, or education, the medical examiner shall release the post-mortem examination results to the procurement organization. The procurement organization shall make a subsequent disclosure of the post-mortem examination results or other information received from the medical examiner only if relevant to transplantation, therapy, research, or education.
a. This act shall be known and may be cited as the "New Jersey Declaration of Death Act."
b. The death of an individual shall be declared in accordance with the provisions of this act.
An individual who has sustained irreversible cessation of all circulatory and respiratory functions, as determined in accordance with currently accepted medical standards, shall be declared dead.
Subject to the standards and procedures established in accordance with this act, an individual whose circulatory and respiratory functions can be maintained solely by artificial means, and who has sustained irreversible cessation of all functions of the entire brain, including the brain stem, shall be declared dead.
b. Subject to the provisions of this act, the Department of Health, jointly with the State Board of Medical Examiners, shall adopt, and from time to time revise, regulations setting forth requirements, by specialty or expertise, for physicians authorized to declare death upon the basis of neurological criteria. The regulations shall not require the use of any specific test or procedure in the declaration of death upon the basis of neurological criteria.
c. If the individual to be declared dead upon the basis of neurological criteria is or may be an organ donor, the physician who makes the declaration that death has occurred shall not be the organ transplant surgeon, the attending physician of the organ recipient, or otherwise an individual subject to a potentially significant conflict of interest relating to procedures for organ procurement.
d. If death is to be declared upon the basis of neurological criteria, the time of death shall be upon the conclusion of definitive clinical examinations and any confirmation necessary to determine the irreversible cessation of all functions of the entire brain, including the brain stem.
The death of an individual shall not be declared upon the basis of neurological criteria pursuant to sections 3 and 4 of this act when the licensed physician authorized to declare death, has reason to believe, on the basis of information in the individual's available medical records, or information provided by a member of the individual's family or any other person knowledgeable about the individual's personal religious beliefs that such a declaration would violate the personal religious beliefs of the individual. In these cases, death shall be declared, and the time of death fixed, solely upon the basis of cardio-respiratory criteria pursuant to section 2 of this act.
A licensed health care practitioner, hospital, or the health care provider who acts in good faith and in accordance with currently accepted medical standards to execute the provisions of this act and any rules or regulations issued by the Department of Health or the Board of Medical Examiners pursuant to this act, shall not be subject to criminal or civil liability or to discipline for unprofessional conduct with respect to those actions. These immunities shall extend to conduct in conformity with the provisions of this act following enactment of this act but prior to its effective date.
Changes in pre-existing criteria for the declaration of death effectuated by the legal recognition of modern neurological criteria shall not in any manner affect, impair or modify the terms of, or rights or obligations created under, any existing policy of health insurance, life insurance or annuity, or governmental benefits program. No health care practitioner or other health care provider, and no health service plan, insurer, or governmental authority, shall deny coverage or exclude from the benefits of service any individual solely because of that individual's personal religious beliefs regarding the application of neurological criteria for declaring death.
a. The enactment of a "Revised State Medical Examiner Act" is necessary in order to reform the current decentralized and fragmented medical examiner system in this State;
b. The linchpin of this reform is to be the establishment of a new Office of the Chief State Medical Examiner, to be led by a single officer known as the Chief State Medical Examiner, with significant statutory authority and operational oversight to ensure the effective and efficient operation of the entire medical examiner system in New Jersey;
c. This new office is to be established in, but not of, the Department of Health in order to ensure its independent status, and the Chief State Medical Examiner is to exercise explicit supervisory authority over the entire medical examiner system, with the power to intervene at his discretion in any medicolegal death investigation in this State;
d. The Chief State Medical Examiner is to be responsible for ensuring that the entire medical examiner system is adequately equipped to effectively deliver medicolegal death investigation services throughout the State, including appropriate funding for staff, equipment, and facilities for all medical examiner offices;
e. The Chief State Medical Examiner is to establish operating and performance standards for every medical examiner office in New Jersey, including uniform procedures for medicolegal death investigations; and
f. The reforms entailed in this act will result in a more efficient and effective medical examiner system that will better meet the needs of this State and thereby serve the public interest.
"Commissioner" means the Commissioner of Health.
"Compelling public necessity" means one or more of the following:
a. that a dissection or autopsy is essential to the criminal investigation of a homicide of which the decedent is the victim;
b. that the discovery of the cause of death is necessary to meet an immediate and substantial threat to the public health, and that a dissection or autopsy is essential to ascertain the cause of death;
c. that the death was that of an inmate of a prison, jail, or other correctional facility;
d. that the death was that of a child under the age of 12 years suspected of having been abused or neglected or suspected of being a threat to public health, and the cause of whose death is not apparent after diligent investigation by the medical examiner; or
e. that the need for a dissection or autopsy is established pursuant to the provisions of this act.
"Department" means the Department of Health.
"Friend" means any person who, prior to the decedent's death, maintained close contact with the decedent sufficient to render that person knowledgeable of the decedent's activities, health, and religious beliefs, and who presents an affidavit stating the facts and circumstances upon which the claim that the person is a friend is based, and stating that the person will assume responsibility for the lawful disposition of the body of the deceased.
"Medicolegal death investigator" means a person, other than a medical examiner, who is not a physician, but who is authorized to investigate a death that falls under the jurisdiction of the medical examiner, including all suspicious, violent, unexplained, and unexpected deaths.
"Person in interest" means the spouse, civil union partner, domestic partner, adult child, parent, adult sibling, grandparent, or guardian of the person of the deceased at the time of the deceased's death.
b. All appropriations and other monies available, and to become available, to the Office of the State Medical Examiner in the Department of Law and Public Safety, established pursuant to section 2 of P.L.1967, c.234 (C.52:17B-79) and abolished pursuant to this act, are continued in the Office of the Chief State Medical Examiner in the Department of Health established hereunder and shall be available for the objects and purposes for which these monies are appropriated, subject to the provisions of this act and any other terms, restrictions, limitations, or other requirements imposed by law.
c. All contracts or agreements that have been executed, as of the effective date of this act, between the Office of the Attorney General and the Northern or Southern Regional Offices of the State Medical Examiner shall be transferred to the Office of the Chief State Medical Examiner in the Department of Health, and continued as if the Office of the Chief State Medical Examiner was the original party to the contract or agreement.
d. Whenever the term "State Medical Examiner" occurs or any reference is made thereto in any law, rule, regulation, order, contract, document, judicial or administrative proceeding, or otherwise, the same shall be deemed to mean or refer to: the "Chief State Medical Examiner" designated as the head of the Office of the Chief State Medical Examiner in the Department of Health established hereunder; or any person appointed to the position of "Deputy Chief State Medical Examiner" and acting on behalf of the Chief State Medical Examiner.
b. The Chief State Medical Examiner shall be a physician licensed and in good standing in the State of New Jersey, a graduate of a regularly chartered and legally constituted medical school or college or osteopathic medical school or college, and certified in forensic pathology by the American Board of Pathology or by the American Osteopathic Board of Pathology.
c. The Chief State Medical Examiner shall be appointed by the Governor, with the advice and consent of the Senate, and shall serve for a term of five years and until a successor is appointed and has qualified. In the case of the death, removal, resignation, or permanent incapacity of the Chief State Medical Examiner, the Governor shall appoint a new Chief State Medical Examiner, in the same manner as the original appointment, within six months.
d. The Chief State Medical Examiner shall receive a salary, which shall be within a salary range established by the Civil Service Commission with the approval of the Director of the Division of Budget and Accounting, as provided by section 2 of P.L.1974, c.55 (C.52:14-15.108), and as approved by the Governor.
e. The Chief State Medical Examiner shall report directly to the Commissioner of Health and shall function independently within the department with respect to the supervision of the medical examiner system and the conducting of medicolegal death investigations.
f. During the term of office set forth in this subsection, the Chief State Medical Examiner may be removed by the Governor only for cause as set forth in this act, upon notice and opportunity to be heard.
a. The Chief State Medical Examiner shall have the authority to enforce the provisions of this act.
b. The Chief State Medical Examiner shall, to the best of his ability, ensure that the medical examiner system is adequately equipped and staffed to effectively deliver medicolegal death investigation services throughout the State, for which purpose the Chief State Medical Examiner shall:
(1) establish standards of funding for the operations and staffing of the Office of the Chief State Medical Examiner;
(2) establish recommended standards of funding for the operations, staffing, capital equipment, laboratories, and facilities of the county and intercounty medical examiner offices;
(3) oversee the deployment of State funds designated for the medical examiner system;
(4) maintain and supervise the New Jersey State Medical Examiner Toxicology Laboratory as set forth in this act; and
(5) have the authority to apply for and accept funds, including grants and awarded federal appropriations, for the improvement of the system of medicolegal death investigation services.
c. The Chief State Medical Examiner shall:
(1) appoint such persons to the position of Deputy Chief State Medical Examiner, and such other employees, as may be needed for the Office of the Chief State Medical Examiner to meet its responsibilities, and prescribe their duties;
(2) pursuant to the provisions of this act, provide advice concerning the appointment, by the governing body of a county or the governing bodies of two or more counties, of county or intercounty medical examiners, as applicable, to conduct medicolegal death investigations within the jurisdiction in which they may be appointed to serve;
(3) provide advice to the governing bodies of two or more counties seeking to maintain an intercounty medical examiner office, in accordance with the provisions of this act;
(4) establish minimum training and experiential requirements of eligibility for those persons appointed as Deputy Chief State Medical Examiner or as a county or intercounty medical examiner, in addition to the other qualifications set forth in this act;
(5) retain direct supervisory power over all operations and personnel employed by the Office of the Chief State Medical Examiner;
(6) have direct supervision and oversight of any county or intercounty medical examiner facility that the Chief State Medical Examiner reasonably determines is experiencing problems that preclude its effective functioning, except that such direct supervision and oversight shall not be authorized in the case of a county or intercounty medical examiner facility that is accredited and subject to inspection by the National Association of Medical Examiners (NAME);
(7) provide professional oversight concerning the operations of the county and intercounty medical examiner offices as they relate specifically to the conduct of medicolegal death investigations and the performance of autopsies;
(8) require county and intercounty medical examiners to timely enter case information into the Case Management System maintained by the Chief State Medical Examiner, and to complete any training offered by the Office of the Chief State Medical Examiner on the proper use of the Case Management System; and
(9) establish a forensic pathology fellowship program that is designed to increase the pool of medical examiners in the State, and collaborate with, and encourage collaboration between, the State's educational institutions for the purposes of implementing the fellowship program.
d. The Chief State Medical Examiner, pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.), shall adopt rules and regulations as necessary to effectuate the provisions of this act, including, but not limited to, establishing:
(1) uniform procedures for conducting medicolegal death investigations as determined to be necessary to determine identity, cause of death, and manner of death, and to resolve any issues or potential issues of public health and legal concern;
(2) minimum performance and operating standards for the Office of the Chief State Medical Examiner and each county or intercounty medical examiner office; and
(3) standards of professional conduct to be followed by the personnel of the Office of the Chief State Medical Examiner and the personnel of county and intercounty medical examiner offices.
e. The Chief State Medical Examiner shall have direct supervision and oversight of any medical examiner facility operating under the jurisdiction of this State.
f. The Chief State Medical Examiner is authorized to intervene in, and to assume control over, any ongoing medicolegal death investigation taking place in the State, at any time and at his discretion, regardless of whether the Chief State Medical Examiner has received permission from, or a request for intervention by, the county or intercounty medical examiner performing the investigation.
g. The Chief State Medical Examiner is authorized to enter into agreements with the State Department of Health, the Attorney General, or any State-operated college or school of medicine, or any public hospital, for the use of certain of its laboratories, morgues, and other technical facilities, and space in its buildings as offices and laboratories for the Chief State Medical Examiner and his staff, and may make assistant medical examiners available to such educational institutions for the teaching of legal medicine and other subjects closely related to their duties.
b. The Chief State Medical Examiner may appoint one or more persons to the position of Deputy Chief State Medical Examiner, as he determines is needed to provide for appropriate supervision of the medical examiner system in this State. If the Chief State Medical Examiner appoints more than one person as Deputy Chief State Medical Examiner, the Chief State Medical Examiner shall name one Deputy Chief Medical Examiner as the "First Deputy Chief State Medical Examiner."
c. The Deputy Chief State Medical Examiner, or the First Deputy Chief State Medical Examiner if one has been named pursuant to subsection b. of this section, shall perform all of the duties of the Chief State Medical Examiner in the case of the incapacity, prolonged absence, permanent resignation, or removal of the Chief State Medical Examiner.
d. The Deputy Chief State Medical Examiner shall: be a physician licensed and in good standing in the State; be a graduate of a regularly chartered and legally constituted medical school or college or osteopathic medical school or college, and certified in forensic pathology by the American Board of Pathology or the American Osteopathic Board of Pathology; and possess such minimum training and experiential requirements as are established by the Chief State Medical Examiner.
e. Nothing shall preclude an appointed county or intercounty medical examiner from also serving as Deputy Chief State Medical Examiner, provided that person meets the eligibility requirements set forth in this section.
f. The Deputy Chief State Medical Examiner shall ensure compliance with the rules and regulations adopted by the Chief State Medical Examiner, and shall perform such duties as are assigned by the Chief State Medical Examiner.
g. The Deputy Chief State Medical Examiner may be removed from office by the Chief State Medical Examiner with or without cause. The removal shall be independent of any position that the Deputy Chief State Medical Examiner holds as a county or intercounty medical examiner.
h. If the Deputy Chief State Medical Examiner appointed pursuant to this section assumes the duties of a county or intercounty medical examiner, the Deputy Chief State Medical Examiner shall have all the authority conferred by law upon a county or intercounty medical examiner and may appoint such assistants, aides, investigators, or other personnel as the Deputy Chief State Medical Examiner deems necessary. In that event, the treasurer of the county or the treasurers of the counties, as the case may be, shall reimburse the Office of the Chief State Medical Examiner or its designated representative for all costs incurred in properly conducting death investigations on behalf of the county or counties and performing all other functions of the county or intercounty medical examiner.
b. (1) The governing body of a county or the governing bodies of two or more counties shall seek the advice of the Chief State Medical Examiner concerning the appointment of a county medical examiner or intercounty medical examiner, as applicable, by forwarding the nomination of the governing body for county medical examiner or the nomination of the governing bodies for intercounty medical examiner to the Chief State Medical Examiner for review.
(2) Two or more counties may jointly establish and maintain a medical examiner office on a cooperative or regional basis, to be designated as an intercounty medical examiner office, and shall seek the advice of the Chief State Medical Examiner concerning such an arrangement before doing so.
c. The office of the county medical examiner shall be directed by a county medical examiner or, in the instances when counties jointly maintain an office on a cooperative or regional basis, an intercounty medical examiner, who shall be appointed by the governing body of the county or the governing bodies of the counties maintaining such an office, as applicable, in accordance with the provisions of subsection b. of this section, for a term of five years and until a successor is appointed and has qualified; except that any person holding the office of county or intercounty medical examiner on the effective date of this act shall continue as county or intercounty medical examiner until the expiration of the term for which that person was appointed.
d. If the county governing body of a county fails, or the governing bodies of two or more counties fail, to appoint a county or intercounty medical examiner, as applicable, or if the office of the county or intercounty medical examiner becomes vacant, upon the written request of an assignment judge of the Superior Court, or of the governing body of the county or the governing bodies of two or more counties that made the original appointment or nomination, the Chief State Medical Examiner shall designate a qualified representative to perform the duties of the office until a new county or intercounty medical examiner is appointed. If the Chief State Medical Examiner assumes the duties of a county or intercounty medical examiner, the Chief State Medical Examiner shall have all the authority conferred by law upon a county or intercounty medical examiner and may appoint such assistants, aides, investigators, or other personnel as the Chief State Medical Examiner deems necessary. In that event, the treasurer of the county or the treasurers of the counties, as the case may be, shall reimburse the Office of the Chief State Medical Examiner or its designated representative for all costs incurred in properly conducting death investigations on behalf of the county or counties and performing all other functions of the county or intercounty medical examiner.
e. The office of county or intercounty medical examiner shall have at least one New Jersey licensed physician certified in forensic pathology by the American Board of Pathology or the American Osteopathic Board of Pathology on staff, serving as either the county or intercounty medical examiner, or as the assistant county or assistant intercounty medical examiner. Any additional person appointed as a county or intercounty medical examiner or an assistant county or intercounty medical examiner shall not be required to be certified in forensic pathology by the American Board of Pathology or the American Osteopathic Board of Pathology.
f. Each county medical examiner, intercounty medical examiner, assistant county medical examiner, and assistant intercounty medical examiner shall: be a licensed physician of recognized ability and in good standing in the State; be a graduate of a regularly chartered and legally constituted medical school or college or osteopathic medical school or college; and possess such minimum training and experience requirements as are established by the Chief State Medical Examiner. Either: the county medical examiner or intercounty medical examiner, as the case may be; or the assistant county medical examiner or intercounty medical examiner, as the case may be, shall additionally be certified in forensic pathology by the American Board of Pathology or the American Osteopathic Board of Pathology.
g. The county or intercounty medical examiner, subject to the approval of the governing body of the county or the governing bodies of the counties, as applicable, may appoint and prescribe the duties of any assistant county or intercounty medical examiners and other personnel as the county or intercounty medical examiner deems necessary for the proper performance of the duties of the office. An assistant county or assistant intercounty medical examiner shall meet the qualifications for that position as provided for in this section.
h. The salaries and expenses incurred by the office of the county or intercounty medical examiner shall be included in the annual budget of the county or counties served by that office, and the governing body of the county or the governing bodies of the counties shall fix the compensation to be paid to the county or intercounty medical examiner and assistant medical examiners and other personnel of the office. The governing body of the county or the governing bodies of the counties shall provide suitable quarters and equipment necessary for the performance of the duties of the county or intercounty medical examiner, and shall consult recommended standards adopted by the Chief State Medical Examiner with regard to funding for the staff, quarters, and equipment necessary for the performance of the duties of the office of the county or intercounty medical examiner. The budget for, and spending by, the office of the county or intercounty medical examiner shall: be available for review by the Chief State Medical Examiner; be published and available to the public as part of the budget approved by the governing body of the county or the governing bodies of the counties; and include all direct and indirect costs associated with the operation of the medical examiner office.
i. Each county and intercounty medical examiner shall ensure compliance with the rules and regulations adopted by the Chief State Medical Examiner.
j. The Chief State Medical Examiner may remove a county or intercounty medical examiner from office for cause, as set forth in this act, pending a hearing and final resolution, and in consultation with the governing body of the county or the governing bodies of the counties that appointed the county or intercounty medical examiner, as applicable. The Chief State Medical Examiner shall provide written notice of the removal to the governing body of the county or the governing bodies of the counties that appointed the county or intercounty medical examiner, as applicable, and to the county or intercounty medical examiner, immediately after making the removal official. A county or intercounty medical examiner removed under this provision shall be provided with notice of the charges against that person and afforded an opportunity for a hearing before an administrative law judge to contest the removal, which shall conform with the provisions applicable to such contested cases in this State as set forth in statute and regulation.
(1) death where criminal violence appears to have taken place, regardless of the time interval between the incident and death, and regardless of whether the violence appears to have been the immediate cause of death, or a contributory factor thereto;
(2) death by accident or unintentional injury, regardless of the time interval between the incident and death, and regardless of whether the injury appears to have been the immediate cause of death, or a contributory factor thereto;
(3) death under suspicious or unusual circumstances;
(4) death from causes that might constitute a threat to public health or safety;
(5) death not caused by readily recognizable diseases, disability, or infirmity;
(6) sudden death when the decedent was in apparent good health;
(7) suicide;
(8) death of a child under 18 years of age from any cause;
(9) sudden or unexpected death of an infant or child under three years of age or a fetal death occurring without medical attendance;
(10) death where suspicion of abuse of a child, family or household member, or elderly or disabled person exists;
(11) death within 24 hours of admission to a hospital or a nursing home;
(12) death in custody, in a jail or correctional facility, or in a State or county psychiatric hospital, State developmental center, or other public or private institution or facility for persons with mental illness, developmental disabilities, or brain injury;
(13) death related to occupational illness or injury;
(14) death due to thermal, chemical, electrical, or radiation injury;
(15) death due to toxins, poisons, medicinal or recreational drugs, or a combination thereof;
(16) known or suspected non-natural death;
(17) any person found dead under unexplained circumstances;
(18) the discovery of skeletal remains;
(19) death for which investigation is in the public interest; or
(20) a death occurring under such other circumstances as prescribed by regulation of the Chief State Medical Examiner.
b. For a death that occurs, or appears to have occurred, for any of the reasons specified in subsection a. of this section:
(1) It shall be the duty of any member of the general public having knowledge of the death to notify immediately the local law enforcement agency of the known facts concerning the time, place, manner, and circumstances of that death;
(2) It shall be the duty of any attending physician, licensed nurse, hospital administrator, law enforcement officer, Department of Children and Families staff member, or funeral director to notify immediately the county or intercounty medical examiner of the known facts concerning the time, place, manner, and circumstances of that death; and
(3) A person who willfully neglects or refuses to report the death, or who, without an order from the office of the county or intercounty medical examiner or the Office of the Chief State Medical Examiner, willfully touches, removes, or disturbs the decedent's body or touches, removes, or disturbs the clothing upon or near the body, is guilty of a crime of the fourth degree.
c. In addition to the rules and regulations adopted by the Chief State Medical Examiner establishing uniform procedures for conducting medicolegal death investigations, the procedures concerning the death investigation process as set forth in this subsection shall be followed by the persons specified herein.
(1) Upon the death of a person from any of the causes specified in subsection a. of this section, it shall be the duty of the physician in attendance, a law enforcement officer having knowledge of the death, the funeral director, or any other person present, to immediately notify the county or intercounty medical examiner and the county prosecutor of the county in which the death occurred of the known facts concerning the time, place, manner, and circumstances of that death. Upon receipt of that notification, the county or intercounty medical examiner, or an assistant county or intercounty medical examiner, or a medicolegal death investigator shall immediately proceed to the place where the dead body is located and take charge of the body. A medicolegal death investigator who engages in the investigation of deaths pursuant to this subsection shall obtain certification from the American Board of Medicolegal Death Investigators within three years after the effective date of this act, or within three years after the person first takes action under this paragraph, whichever is later.
(2) In cases of apparent homicide or suicide, or of accidental death, the cause of which is obscure, the scene of the event shall not be disturbed until the medical examiner or medicolegal death investigator in charge provides authorization to do so.
(3) (a) The medical examiner or medicolegal death investigator, as the case may be, shall: fully investigate the essential facts concerning the medical causes of death and take the names and addresses of as many witnesses thereto as may be practicable to obtain; before leaving the premises, reduce those facts, as the medical examiner may deem necessary, to writing; file those facts in the office of the county or intercounty medical examiner; and make the facts available to the county prosecutor and the Chief State Medical Examiner at their request.
(b) The law enforcement officer present at the investigation, or the medical examiner or medicolegal death investigator if no officer is present, shall, in the absence of the next-of-kin of the deceased person: take possession of all property of value found on the decedent; make an exact inventory thereof on his report; and deliver the property to the law enforcement agency for the municipality in which the death occurred, which shall surrender the property to the person entitled to its custody or possession.
(c) The medical examiner or medicolegal death investigator, as the case may be, shall take possession of any objects or articles that, in his opinion, may be useful in establishing the cause or manner of death, or which constitute evidence of criminal behavior, and, after cataloging each item, deliver them to the county prosecutor.
(4) The Chief State Medical Examiner, Deputy Chief State Medical Examiner, county or intercounty medical examiner, assistant county or intercounty medical examiner, or medicolegal death investigator shall consult with law enforcement officers and agencies, county prosecutors, public health agencies, or other appropriate entities in matters within their expertise, when conducting a medicolegal death investigation. The medical examiner or medicolegal death investigator, as the case may be, shall be provided with an Originating Agency Identification Number, and access to the State's motor vehicle registries and fingerprint registries, for the purposes of identifying the remains of a deceased individual under this section.
(5) If the cause of death is established within a reasonable degree of medical certainty and no autopsy is deemed necessary, the county or intercounty medical examiner, assistant county or intercounty medical examiner, or medicolegal death investigator, as the case may be, shall reduce the findings to writing and promptly make a full report thereof to the Chief State Medical Examiner and to the county prosecutor in a format to be prescribed by the Chief State Medical Examiner for that purpose.
(6) If, in the opinion of the county or intercounty medical examiner, the Chief State Medical Examiner, an assignment judge of the Superior Court, the county prosecutor, the Attorney General, or the commissioner, an autopsy is deemed necessary, the autopsy shall be performed by:
(a) the county or intercounty medical examiner or assistant county or intercounty medical examiner, provided the individual performing the autopsy is under the supervision of a pathologist certified by the American Board of Pathology or the American Osteopathic Board of Pathology;
(b) the Chief State Medical Examiner, at his discretion, or the Deputy Chief State Medical Examiner; or
(c) such competent forensic pathologists as may be authorized by the Chief State Medical Examiner.
(7) If, in any case in which the suspected cause of death of a child under one year of age is sudden infant death syndrome, or the child is between one and three years of age and the death is sudden and unexpected, and an investigation has been conducted in accordance with the provisions of this section, and a parent or legal guardian of the child requests an autopsy, an autopsy shall be performed by: the county or intercounty medical examiner or assistant county or intercounty medical examiner, provided the individual performing the autopsy is under the supervision of a pathologist certified by the American Board of Pathology or the American Osteopathic Board of Pathology; or the Chief State Medical Examiner, at his discretion, or the Deputy Chief State Medical Examiner.
(a) The medical examiner performing the autopsy shall file a detailed description of the findings and conclusions of the autopsy with the Office of the Chief State Medical Examiner, and with the appropriate county or intercounty medical examiner office and the county prosecutor.
(b) Upon the request of a parent or legal guardian of the child, a pediatric pathologist, if available, shall assist in the performance of the autopsy under the direction of a forensic pathologist. The Chief State Medical Examiner or county or intercounty medical examiner shall notify the parent or legal guardian of the child that they may request that a pediatric pathologist assist in the performance of the autopsy. The medical examiner shall include any findings and conclusions by the pathologist from the autopsy with the information filed with the Office of the Chief State Medical Examiner, and with the appropriate county or intercounty medical examiner office and the county prosecutor, pursuant to subparagraph (a) of this paragraph. The Chief State Medical Examiner or the county or intercounty medical examiner shall make available a copy of these findings and conclusions to the closest surviving relative of the decedent within 120 days of the receipt of a request therefor, unless the death is under active investigation by a law enforcement agency.
(c) The medical examiner with jurisdiction for the investigation shall make the preliminary findings and conclusions of the autopsy available to the child's parent or legal guardian and the department within 48 hours after the medical examiner is notified of the death of the child. The medical examiner shall provide his findings and conclusions for each reported case to the department upon completion of the investigation.
(8) Notwithstanding the provisions of this act to the contrary, a county or intercounty medical examiner may request the Chief State Medical Examiner or Deputy Chief State Medical Examiner, or other person authorized and designated by the Chief State Medical Examiner, to conduct an examination or perform an autopsy whenever it is deemed necessary or desirable.
(9) In the case of the death of a resident of a long-term care facility licensed by the Department of Health pursuant to P.L.1971, c.136 (C.26:2H-1 et seq.), a State psychiatric hospital operated by the Department of Health and listed in R.S.30:1-7, a county psychiatric hospital, a facility for persons with developmental disabilities as defined in section 3 of P.L.1977, c.82 (C.30:6D-3), or a facility for persons with traumatic brain injury as defined in 42 U.S.C. s.280b-1c that is operated by or under contract with the Department of Human Services, the psychiatric hospital or facility, as the case may be, shall, in addition to notifying the next-of-kin of the resident's death, so notify the county or intercounty medical examiner and provide that individual with contact information for the resident's next-of-kin. The county or intercounty medical examiner, or assistant county or intercounty medical examiner on his behalf, shall make every practicable effort to contact the resident's next-of-kin to offer that person the opportunity to provide the medical examiner with information that the person deems relevant to: the circumstances of the resident's death; and whether there is a need to perform a dissection or autopsy of the decedent.
d. Upon the request of a decedent's legal representative, or upon the request of the person who, pursuant to section 22 of P.L.2003, c.261 (C.45:27-22), is in control of the decedent's funeral, the Chief State Medical Examiner shall provide the legal representative or person in control of the funeral with all available documentation related to the decedent's autopsy and the medical investigation of the decedent's death.
b. Notwithstanding any other provision of law to the contrary, no dissection or autopsy shall be performed, in the absence of a compelling public necessity, if a member of the decedent's immediate family or, in the absence thereof, a friend of the decedent objects to the procedure on the grounds that it is contrary to the religious belief of the decedent, or if there is an obvious reason to believe that a dissection or autopsy is contrary to the decedent's religious beliefs.
c. If, in the opinion of a medical examiner, there is a compelling public necessity to perform a dissection or autopsy, and a member of the decedent's immediate family or, in the absence thereof, a friend of the decedent objects to the procedure on the grounds that it is contrary to the religious beliefs of the decedent, or if there is an obvious reason to believe that the dissection or autopsy is contrary to the religious beliefs of the decedent, no dissection or autopsy shall be performed until 48 hours after notice thereof is given by the medical examiner to the objecting party, or, if there is no objecting party, to such other party as the court may name. During that 48-hour period, the objecting party or the party named by the court may institute action in the Superior Court to determine the propriety of the dissection or autopsy; however, the court may dispense with the waiting period upon ex parte motion if it determines that the delay may prejudice the accuracy of the dissection or autopsy, or may precipitate or prolong an immediate and substantial threat to public health or safety.
d. (1) If, in the opinion of a medical examiner, there is a compelling public necessity to perform a dissection or autopsy for reasons not otherwise provided in this act, and a member of the decedent's immediate family or, in the absence thereof, a friend of the decedent objects that the dissection or autopsy is contrary to the religious beliefs of the decedent, or there is an obvious reason to believe that the dissection or autopsy is contrary to the religious beliefs of the decedent, the medical examiner may institute an action in the Superior Court for an order authorizing the dissection or autopsy. The action shall be instituted by an order to show cause on notice to the member of the decedent's immediate family or friend of the decedent, or, if no such individual is known, to such other party as the court may direct.
(2) An action brought pursuant to paragraph (1) of this subsection shall have preference over all other cases and shall be determined summarily upon the petition and oral or written proof, if any, offered by the parties. The court shall permit the dissection or autopsy to be performed if it finds that the medical examiner established a compelling public necessity, for reasons not otherwise provided for in this act, for the autopsy or dissection under all of the circumstances of the case, or if the objecting party or party named by the court fails to swear or affirm that an autopsy or dissection would be contrary to the decedent's religious beliefs. If permission to perform a dissection or autopsy is denied and no stay is granted by the court or by the appellate division, the decedent's body shall be immediately released for burial.
e. Bodies shall be treated with dignity and respect commensurate with the goals of this act.
b. A health care professional, who is authorized to remove an anatomical gift from a donor whose death is under investigation pursuant to this act, may remove the donated part from the donor's body for acceptance by a person authorized to become a donee, after giving notice to the Chief State Medical Examiner, Deputy Chief State Medical Examiner, county or intercounty medical examiner, or assistant county or intercounty medical examiner, as applicable, if the examination, autopsy, or analysis has not been undertaken in the manner and within the time provided for in this act. The Chief State Medical Examiner, Deputy Chief State Medical Examiner, county or intercounty medical examiner, or assistant county or intercounty medical examiner, as applicable, shall be present during removal of the anatomical gift if, in that medical examiner's judgment, those tissues or organs may be involved in the cause of death. In that case, the applicable medical examiner may request a biopsy of those tissues or organs or deny removal of the anatomical gift. The applicable medical examiner shall explain in writing the reasons for determining that those tissues or organs may be involved in the cause of death, and shall include that explanation in the records maintained pursuant to this act.
c. A health care professional, who is performing a transplant from a donor whose death is under investigation pursuant to this act, shall file with the Chief State Medical Examiner a report detailing the condition of the part of the body that is the anatomical gift and its relationship to the cause of death. If appropriate, the report shall include a biopsy or medically approved sample from the anatomical gift. The health care professional's report shall become part of the Chief State Medical Examiner's report.
b. The Chief State Medical Examiner shall establish a Sudden Child Death Autopsy Protocol Committee to assist in developing and reviewing the protocols. The committee shall include, but not be limited to: the Chief State Medical Examiner, the Assistant Commissioner of the Division of Family Health Services in the Department of Health, and the Director of the Division of Child Protection and Permanency in the Department of Children and Families, or their designees; the director of the SIDS Resource Center established pursuant to section 4 of P.L.1987, c.331 (C.26:5D-4); an epidemiologist; a forensic pathologist; a pediatric pathologist, a county or intercounty medical examiner; a pediatrician who is knowledgeable about sudden infant death syndrome and child abuse; a law enforcement officer; an emergency medical technician or paramedic; a family member of a sudden infant death syndrome victim; and a family member of a sudden unexpected death victim who was between one and three years of age at the time of death. The committee shall annually review the protocol and make recommendations to the Chief State Medical Examiner to revise the protocol, as appropriate.
c. The protocols shall include requirements and standards for scene investigation, criteria for ascertaining the cause of death based on autopsy, criteria for specific tissue sampling, and such other requirements as the committee deems appropriate. The protocols shall take into account nationally recognized standards for pediatric autopsies.
d. The Chief State Medical Examiner shall be responsible for ensuring that the protocols are followed by all medical examiners and other persons authorized to conduct autopsies in those cases in which the suspected cause of death is sudden infant death syndrome or in which the child is between one and three years of age and the death is sudden and unexpected.
e. The protocols shall authorize the medical examiner or other authorized person to take tissue samples for research purposes if the parent or legal guardian of the deceased child provides written consent for the taking of tissue samples for research purposes pursuant to subsection b. of this section.
f. The sudden infant death syndrome autopsy protocol shall provide that if the findings in the autopsy are consistent with the definition of sudden infant death syndrome specified in the protocol, the person who conducts the autopsy shall state on the death certificate that sudden infant death syndrome is the cause of death.
b. The Chief State Medical Examiner shall establish a Research Oversight Committee to assist in developing and reviewing the research protocols required by this section. The committee shall include five members, as follows: the Chief State Medical Examiner; the commissioner; a person with expertise in ethics, who may also be a member of the department's Institutional Review Board; an attorney; and an epidemiologist.
c. The Chief State Medical Examiner, in consultation with the commissioner and the Research Oversight Committee established pursuant to this section, shall establish, and periodically revise as necessary, protocols for participation by medical examiners in research activities concerning deaths, including, but not limited to, the deaths of children three years of age and younger, and sudden, unexpected deaths in epilepsy. The research shall include all autopsies in which the suspected cause of death is not considered a violent death that is subject to the provisions of subsection a. of section 10 of this act.
(1) The research protocols developed pursuant to this section shall authorize the Chief State Medical Examiner, Deputy Chief State Medical Examiner, county or intercounty medical examiner, or other authorized person to take and transfer tissue samples to an approved research project prior to obtaining the ordinary consent necessary to engage in such taking and transfer, but the research project shall not be permitted to use the tissue before appropriate consent is obtained.
(2) Notwithstanding the provisions of this section to the contrary, the protocols developed pursuant to this section shall provide that no tissue sample shall be taken from a deceased person who has objected, or from a deceased minor whose parent or legal guardian has objected, to an autopsy because it is contrary to the religious beliefs of the decedent in accordance with the provisions of this act.
(3) The protocols developed pursuant to this section shall stipulate, at a minimum, that:
(a) the research project is to first be approved by the institutional review board of the facility at which the research is to be conducted, and then by the Research Oversight Committee established pursuant to this section, and finally by the Institutional Review Board of the department; except that, if a research project is submitted by the department, the final review of the project is to be conducted by an independent review board;
(b) the research project is to delineate the information, other than the tissue sample, that will be required from the investigation of the death;
(c) the research project is to develop a plan for the release by the Chief State Medical Examiner or county or intercounty medical examiner, as applicable, of a decedent's tissue, as well as the obtaining of written consent for the use of the tissue and the decedent's other identifying information;
(d) the research project is to develop a plan that provides for the disposal of a decedent's tissue in the event that consent is not obtained for use of the tissue, and for disposal of the decedent's tissue upon completion of the research in those cases in which consent is obtained; and further, which incorporates accepted procedures for disposal of surgical biopsies and biohazardous materials, and procedures to inform the deceased's family members, as well as the Research Oversight Committee, of the disposal plan;
(e) the research project is to reimburse the Chief State Medical Examiner, Deputy Chief State Medical Examiner, county or intercounty medical examiner, or other authorized person participating in the research for any reasonable costs incurred in taking, storing, and providing tissue samples for the project; and estimated costs subject to reimbursement are to be reviewed and approved by the Chief State Medical Examiner;
(f) the research project is to provide the Chief State Medical Examiner and the Research Oversight Committee with periodic updates on the status of the project; and
(g) the Research Oversight Committee may terminate a research project that is not in compliance with either the provisions of this subsection or the provisions of the proposal for that research project that was approved pursuant thereto.
(4) Upon receiving notification from the research project that the research project has obtained written consent for the use of tissue samples and identifying information, the Chief State Medical Examiner, Deputy Chief State Medical Examiner, county or intercounty medical examiner, or other authorized person, as applicable, shall provide the research project with copies of the autopsy reports and any reports generated by the Chief State Medical Examiner, Deputy Chief State Medical Examiner, or county or intercounty medical examiner concerning the subject of the research.
(5) The information and tissue samples provided to the research project by the Chief State Medical Examiner, Deputy Chief State Medical Examiner, county or intercounty medical examiner, or other authorized person, shall be used by the research project only for the purposes approved by the Research Oversight Committee and as specified in the protocol, and shall not otherwise be divulged or made public so as to disclose the identity of any person to whom they relate. The information provided to the research project shall not be considered a public or government record pursuant to P.L.1963, c.73 (C.47:1A-1 et seq.) or P.L.2001, c.404 (C.47:1A-5 et al.).
(6) The Research Oversight Committee shall oversee each research project approved pursuant to this subsection.
d. The Chief State Medical Examiner, in consultation with the commissioner and the State Board of Medical Examiners, shall, as deemed appropriate, establish awareness programs to educate medical examiners in the State about various types of death, including, but not limited to, sudden infant death syndrome, and sudden, unexpected deaths in epilepsy.
b. It shall be the duty of each county or intercounty medical examiner to fully cooperate with the Chief State Medical Examiner when the latter chooses to intervene in an ongoing medicolegal death investigation.
(2) The Superior Court, upon the application of a proper party, may order the disinterment of a dead body, when an investigation of the cause of death is authorized, under the supervision and direction of the Chief State Medical Examiner or his designee, and authorize the Chief State Medical Examiner or his designee to remove the body to a public morgue for the purpose of examination or autopsy. The court shall direct the giving of or dispensing with notice.
b. The Chief State Medical Examiner and a county or intercounty medical examiner may order, at his discretion, an inquest in any case under his jurisdiction for the purpose of vetting an unclear or controversial case or issue.
c. The Chief State Medical Examiner, Deputy Chief State Medical Examiner, county and intercounty medical examiner, and assistant county and intercounty medical examiner shall have the power to administer oaths and affirmations, and take affidavits and make examinations, as to any matter within the jurisdiction of their respective offices.
d. (1) The Chief State Medical Examiner and a county or intercounty medical examiner shall be authorized to, and shall, issue a subpoena to compel the attendance of any witness that the medical examiner deems necessary to interrogate in a death under investigation, returnable forthwith or at such place and time as is directed by the medical examiner.
(2) The Chief State Medical Examiner and a county or intercounty medical examiner shall be authorized to, and shall, issue a subpoena duces tecum to require a witness to bring any books, records, documents, files, or things under the control of the person served as the medical examiner deems necessary for the purpose of a medicolegal death investigation.
(3) The Chief State Medical Examiner and a county or intercounty medical examiner shall be authorized to, and shall, issue a subpoena for the production of confidential medical records, mental health records, drug and alcohol abuse records, and other relevant information from a physician, health care facility, or other health care provider as the medical examiner deems necessary for the purpose of a medicolegal death investigation.
(4) A subpoena issued pursuant to this subsection may be enforced by order of a court of competent jurisdiction under threat of contempt of court.
b. The original reports of the Chief State Medical Examiner, Deputy Chief State Medical Examiner, county or intercounty medical examiner, and assistant county or intercounty medical examiner, and the detailed findings of the autopsy, if any, along with the records of death notification, postmortem inspections and examinations, personal effects taken into possession, and any other information deemed necessary by the Chief State Medical Examiner, shall be attached to the case record for each medicolegal death investigation.
c. The Office of the Chief State Medical Examiner and the office of each county or intercounty medical examiner shall promptly deliver to the county prosecutor of the county in which the death occurred and to the Attorney General, copies of all records and other information relating to every death in which, in the applicable medical examiner's judgment, further investigation may be deemed advisable. The county prosecutor or the Attorney General may obtain copies of such records or other information from those offices as the county prosecutor or the Attorney General deems necessary for his investigation.
d. The records maintained by the Office of the Chief State Medical Examiner and the office of each county or intercounty medical examiner, including those made by the applicable medical examiner or anyone under his direction or supervision, or transcripts thereof certified by the medical examiner, shall be received as competent evidence in any court in this State of the matters and facts therein contained.
e. The Office of the Chief State Medical Examiner and the office of each county or intercounty medical examiner may charge a reasonable fee to private persons for copies of such records and upon such conditions as may be prescribed by the Chief State Medical Examiner; provided, however, that no person with a proper interest in such records shall be denied access thereto. All such fees collected by the Office of the Chief State Medical Examiner and by the office of each county or intercounty medical examiner shall be paid into the State Treasury or county treasury, as applicable, on or before the 10th day of each month.
b. The Medical Examiner Review Team shall include nine members, as follows:
(1) the commissioner, the Commissioner of Human Services, the Attorney General, and the Chief State Medical Examiner, or their designees, who shall serve ex officio;
(2) the Chair of the Department of Pathology from one of the medical schools or colleges or osteopathic medical schools or colleges in New Jersey, to be appointed by the Governor; and
(3) one public member, to be appointed by the Governor, who shall be certified in forensic pathology by the American Board of Pathology or the American Osteopathic Board of Pathology; and
(4) three public members, to be appointed by the Governor, who shall be representatives of the public health, hospital, and medical communities, respectively.
c. The Medical Examiner Review Team shall review the following matters, and shall issue a recommendation for further action or resolution in each case upon completion of its review:
(1) disputed medicolegal death investigation findings that are the subject of a dispute between the Chief State Medical Examiner and any county or intercounty medical examiner, when referred by any such medical examiner to the commissioner with a complete statement as to the basis of the referral; and
(2) any removal of the Chief State Medical Examiner by the Governor, as well as any removal of a county or intercounty medical examiner by the Chief State Medical Examiner, except that the Chief State Medical Examiner shall be required to recuse himself from any deliberations or other actions by the Medical Examiner Review Team concerning any removal of him by the Governor.
d. The Medical Examiner Review Team shall meet at least once annually and shall meet within 45 days after receiving a report of a dispute, or after receiving notification of a removal from office, as provided in this section.
e. The Medical Examiner Review Team shall elect one of its members as chairman, who shall serve for a term of two years.
f. Of the public members of the Medical Examiner Review Team first appointed, two shall be appointed for a term of three years and one for a term of two years. Thereafter, members shall be appointed for terms of three years. The public members shall be eligible for reappointment and shall serve until the appointment and qualification of their successors.
g. Vacancies in the Medical Examiner Review Team shall be filled for the unexpired terms in the same manner as the original appointments were made.
h. The members of the Medical Examiner Review Team shall not receive any compensation, but shall be reimbursed for expenses incurred in the performance of their duties, within the limits of funds appropriated or otherwise made available to the team for its purpose.
i. The department shall provide such staff and other support as the Medical Examiner Review Team deems necessary to perform its duties.
b. The annual report shall contain, at a minimum:
(1) the budget and expenditures for each medical examiner office in this State, including its direct and indirect expenses, including a summary of the terms and conditions of each contract for the professional services of the Office of the Chief State Medical Examiner and the office of each county or intercounty medical examiner;
(2) the total number of cases received, reviewed, accepted, and investigated by each medical examiner office;
(3) statistics of determined causes of death; and
(4) an evaluation of the overall performance of each medical examiner office and the medical examiner system as a whole.
a. engaging in illegal activity;
b. intentional substantive noncompliance with rules and regulations;
c. willful misconduct;
d. professional incompetence and neglect of duty;
e. insubordination; or
f. excessive inefficiency in the performance of his duties.
b. The Chief State Medical Examiner, Deputy Chief State Medical Examiner, county or intercounty medical examiner, and assistant county or assistant intercounty medical examiner requiring the services of a toxicology laboratory are encouraged to enlist the services of the New Jersey State Medical Examiner Toxicology Laboratory. Use of another lab is permitted, provided that the laboratory meets national accreditation standards.
c. The Chief State Medical Examiner shall ensure that the Attorney General and each county prosecutor, as applicable, promptly receive copies of all final toxicology laboratory testing results from the New Jersey State Medical Examiner Toxicology Laboratory or another lab as permitted by subsection b. of this section for toxicology specimens submitted from the Office of the Chief State Medical Examiner or any county or intercounty medical examiner's office. The Attorney General or county prosecutor may obtain copies of the final toxicology testing results as the Attorney General or county prosecutor deems necessary for the fulfillment of his or her official duties.
d. The Chief State Medical Examiner shall adopt such rules and regulations as may be necessary concerning the operations and use of the New Jersey State Medical Examiner Toxicology Laboratory.
b. The request to correct the findings and conclusions on a death certificate shall:
(1) be made in writing to the Chief State Medical Examiner, regardless of which medical examiner made the initial filing;
(2) describe the requested change precisely; and
(3) state the reasons for the change.
c. Within 60 days after receiving the request, the Chief State Medical Examiner shall notify the person in interest in writing of the action taken.
d. If the Chief State Medical Examiner denies the request to change findings and conclusions on the cause of death, the person in interest may appeal the denial in writing within 15 days of the denial to the commissioner; and the commissioner, within 15 days of receipt of the appeal, shall refer the matter to the Office of Administrative Law.
e. An administrative law judge shall conduct a hearing both on the denial and the establishment of the findings and conclusions on the cause of death. Upon reviewing the findings of fact submitted by an administrative law judge, the commissioner, or the commissioner's designee, shall issue an order within 60 days to:
(1) adopt the findings of the administrative law judge; or
(2) reject the findings of the administrative law judge and affirm the findings of the medical examiner.
f. If the commissioner, or the commissioner's designee, rejects the findings of an administrative law judge, the person in interest may appeal that rejection to a court of competent jurisdiction under State law.
g. If the final decision of the commissioner, or the commissioner's designee, or of a court of competent jurisdiction on appeal, establishes findings or conclusions on the cause or manner of death of a decedent other than that recorded on the certificate of death, the medical examiner responsible for the initial filing, or if unavailable, another medical examiner with jurisdiction in this State, shall amend the certificate to reflect the different findings or conclusions.
h. The Chief State Medical Examiner shall send a change letter to the Bureau of Vital Statistics and Registration in the department to amend the certificate of death, to reflect the final decision of the commissioner, or the commissioner's designee, or a court of competent jurisdiction.
i. The final decision of the commissioner, or the commissioner's designee, or of a court in an appeal under this section, shall not give rise to any presumption concerning the application of any provision, or the resolution, of any claim concerning an insurance policy or contract relating to the decedent.
j. If the findings of the medical examiner are upheld by the commissioner, or the commissioner's designee, the appellant shall be responsible for the cost of the contested case hearing, based on the billing rate established by the Office of Administrative Law. Otherwise, the department shall be responsible for the costs.
Any person who cremates any dead human body without first having received a permit for burial or other final disposition issued according to the laws or regulations of this or any other State shall be guilty of a misdemeanor.
No person shall cremate a dead human body unless at least 24 hours have elapsed from the time of death as recorded on the death certificate to the time of cremation.
As used in this section, "cremains" means that substance which remains after the cremation of a dead human body.
b. (1) A funeral director, licensed pursuant to P.L.1952, c.340 (C.45:7-32 et seq.), shall grant a qualified veterans' organization the right to receive the cremains of a veteran, or the cremains of an eligible spouse or eligible dependent of a veteran, which have not been claimed by a relative or friend of the deceased within one year after cremation upon certification, to the commissioner's satisfaction, that a diligent effort, as defined in subsection a. of this section, has been made to identify, locate, and notify a relative or friend of the deceased within that one-year period.
A qualified veterans' organization which takes possession of cremains pursuant to this section shall dispose of the cremains by scattering them at sea or by interring them on land in a dignified manner at the State-operated Brigadier General William C. Doyle Veterans' Memorial Cemetery, a State-operated veterans' memorial cemetery, a national veterans' memorial cemetery, or a local veterans' memorial cemetery if the individual is eligible for interment at those facilities.
As used in this section, "qualified veterans' organization" means a veterans' organization that qualifies as a section 501(c)(3) or 501(c)(19) tax exempt organization under the Internal Revenue Code or a federally chartered Veterans' Service Organization.
(2) Each funeral director shall promptly respond to a request from the Commissioner of the Department of Veterans Affairs for information as to whether the cremains of a veteran, or the cremains of an eligible spouse or eligible dependent of a veteran, have been claimed.
c. A funeral home or mortuary, or an agent of the funeral home or mortuary, or a funeral director, or qualified veterans' organization, shall not be liable for damages in any civil action arising out of the disposal of cremains pursuant to this section unless the damages are the result of gross negligence or willful misconduct.
The Commissioner of the Department of Health may promulgate the rules and regulations necessary to effectuate the purposes of this act, pursuant to the "Administrative Procedure Act," P.L.1968, c. 410 (C. 52:14B-1 et seq.).
Any person who violates any of the provisions of this act except section six, or who violates any rule or regulation of the State Department made pursuant to this act, or who shall refuse to comply with any lawful order or direction of the department, shall be liable to the following penalties:
a. For each first offense a penalty of fifty dollars ($50.00);
b. For each second offense a penalty of one hundred dollars ($100.00);
c. For each third and every subsequent offense a penalty of two hundred dollars ($200.00).
Payment of a penalty for any alleged violation of this act or any rule or regulation of the State Department made pursuant thereto, either before or after the institution of proceedings for the collection thereof, shall be deemed equivalent to a conviction of the violation for which such penalty was claimed.
(a) The following courts shall have jurisdiction of such proceeding in addition to those prescribed in said law, namely: the Superior Court and municipal courts;
(b) The complaint in such proceeding may be made on information and belief by any employee of the State Department of Health;
(c) A warrant may issue in lieu of summons in such proceeding;
(d) The hearing in such proceeding shall be without a jury;
(e) If the defendant in such proceeding shall fail to pay forthwith the amount of any money judgment rendered against him, the said defendant may be committed as provided in said law;
(f) Such proceeding may be instituted on any day of the week or on a Sunday or a holiday;
(g) Any sums received in payment of a money judgment entered in such proceeding shall be remitted to the State Department of Health;
(h) An appeal from any judgment entered in such proceeding may be taken in the manner provided by law.
The Superior Court of this State is hereby vested with jurisdiction and discretionary power in an action in the court brought at the suit of the Attorney-General or of the State Department to prevent and restrain the cremation of dead human bodies by any person who has not first obtained the license required by this act, or to prevent and restrain the violation by any person of the provisions of this act, or of any rule or regulation promulgated hereunder.
Chapter seven of Title 26 of the Revised Statutes is repealed.
As used in this chapter:
"Vital statistics" means statistics concerning births, deaths, fetal deaths, marriages, civil unions and domestic partnerships established pursuant to P.L.2003, c.246 (C.26:8A-1 et al.).
"Vital records" means the birth, death, fetal death, marriage, civil union and domestic partnership records from which vital statistics are produced.
"State registrar" means the State registrar of vital statistics; "Local registrar" or "registrar" means the local registrar of vital statistics of any district; and "registration district" or "district" means a registration district as constituted by this article.
"Live birth" or "birth" means the complete expulsion or extraction from its mother of a product of conception, irrespective of the duration of pregnancy, which, after such separation, breathes or shows any other evidence of life such as beating of the heart, pulsation of the umbilical cord, or definite movement of voluntary muscles, whether or not the umbilical cord has been cut or the placenta attached.
"Authentication" means the entry by the Chief State Medical Examiner, Deputy Chief State Medical Examiner, or a county or intercounty medical examiner or assistant county or intercounty medical examiner, funeral director or physician into the New Jersey Electronic Death Registration System of a personal identification code, digital signature or other identifier unique to that user, by which the information entered into the system by the user is authenticated by the user who assumes responsibility for its accuracy. "Authentication" also means the process by which the State registrar or a local registrar, deputy registrar, alternate deputy registrar or subregistrar indicates that person's review and approval of information entered into the system by the Chief State Medical Examiner, Deputy Chief State Medical Examiner, or a county or intercounty medical examiner or assistant county or intercounty medical examiner, funeral director or physician.
"Electronic registration system" means any electronic method, including, but not limited to, one based on Internet technology, of collecting, transmitting, recording and authenticating information from one or more responsible parties, which is necessary to complete a vital record, and is designed to replace a manual, paper-based data collection, recordation and signature system.
"New Jersey Electronic Death Registration System" or "NJ-EDRS" is an electronic registration system for completing a certification of death or fetal death record that is authorized, designed and maintained by the State registrar.
Every incorporated political subdivision, including a county, but not a school district, shall constitute a registration district.
The state department, or the local boards having jurisdiction of the territory in question, may combine two or more registration districts when desirable to facilitate registration.
Upon demand of the State registrar in person, by mail, by means of the NJ-EDRS, or through the local registrar, every physician, midwife, informant, funeral director, or other person having knowledge of the facts relative to any birth, death, fetal death, marriage, civil union or domestic partnership, shall supply such information as he may possess, upon a form provided by the State registrar, or through the NJ-EDRS, or upon the original birth, death, fetal death, marriage, civil union or domestic partnership certificate or its electronic facsimile or digitized form thereof.
The person in charge of a hospital, almshouse, lying-in, penal, or other institution, public or private, to which any person resorts for treatment of disease or for confinement, or is committed by process of law, shall make a record of all the personal and statistical particulars relative to each inmate in such institution, at the time of admission, and shall make a complete medical record covering the period of such person's confinement in such institution.
The medical records provided for herein or photographic reproductions thereof shall be retained by the custodian of records of such institution for a period of 10 years following the most recent discharge of the patient, or until the person confined therein reaches the age of 23 years, whichever is the longer period of time. In addition, a discharge summary sheet shall be retained by such custodian of records for a period of 20 years following the most recent discharge of the patient. The discharge summary sheet shall contain the patient's name, address, dates of admission and discharge and a summary of the treatment and medication rendered during the patient's stay. Any X-ray films related to such confinement, or any size reproductions thereof which maintain the clarity of the original shall be retained by such custodian of records for a period of 5 years.
In case of any person admitted or committed for treatment of disease, the physician in charge shall specify, for entry in the record, the nature of the disease and where, in his opinion, it was contracted.
The personal particulars and information required by this section shall be obtained from the individual himself if practicable; and when not, they shall be obtained in as complete a manner as possible from relatives, friends, or other persons acquainted with the facts.
a. Every midwife and funeral director shall register annually his name, address and occupation, and his license number, with the local registrar of the district in which he resides and shall register that information with the local registrar immediately upon moving to another registration district.
b. The provisions of subsection a. of this section, with respect to funeral directors, shall be satisfied by the implementation of periodic data exchanges between the State Board of Mortuary Science and the State registrar, which shall begin no later than 18 months after the date of enactment of P.L.2003, c.221, in a manner to be prescribed by the State registrar.
The State department shall provide for registration of vital records.
Suitable quarters shall be provided for the registration of vital records, which quarters shall be properly equipped with fire resistant area and filing cases for the permanent and safe preservation of all official records made and retained under this chapter and chapter 6 of this Title (s. 26:6-1 et seq.) as well as Chapter 1 of Title 37 of the Revised Statutes.
The State department shall appoint a competent vital statistician, who shall be known as the State registrar of vital statistics.
a. (1) The county governing body, by resolution, subject to the provisions of paragraph (2) of this subsection, may permit the county clerk to act as the local registrar for any registration district within the county that designates the county clerk as its local registrar pursuant to subsection b. of this section. The resolution may limit the districts eligible to use the county clerk as the local registrar by population.
(2) Whenever a county governing body adopts a resolution permitting the county clerk to act as the local registrar for any registration district within the county, the resolution shall not take effect until 30 days after the governing body has:
(a) published the resolution, together with a notice of the date of passage or approval, or both, at least once in a newspaper published in the county, or, if there is no newspaper published in the county, then in a newspaper of general circulation within the county,
(b) prepared operations plans clearly delineating the responsibilities of the local registrar and the county clerk and filed those operations plans with the State Registrar, and
(c) prepared a plan to ensure the security of the vital records, related indices, safety papers and other materials of the county including the planned method of secure storage and transfer of the vital records from a municipality to the county, and filed the security plan with the State Registrar.
b. The local board having jurisdiction over an eligible registration district, within a county that permits the county clerk to act as local registrar, may designate the county clerk as its local registrar by adopting a resolution for that purpose and filing the resolution with the county clerk.
c. The local board having jurisdiction over each registration district shall appoint a local registrar for that district, which shall be the county clerk in the case of a registration district that has designated the county clerk pursuant to this section. In those districts which by governmental organization structure have no separate board of health, the appointment shall be made by the governing body.
In any district having a population of less than 5,000 persons in which the county clerk does not act as the local registrar the municipal clerk shall be appointed as local registrar at a salary to be determined by the appointing authority.
The appointment of a local registrar shall be immediately certified to the state department, but shall not become effective until thirty days from the date of filing of the certificate, unless sooner approved in writing by the department. If within the thirty days the department shall disapprove of the appointment, the office shall be deemed vacant.
The term of office of a local registrar shall be 3 years and he shall serve until his successor has been appointed and qualified. If the local registrar is the municipal clerk, his term of office shall be concurrent with his term of office as clerk, and he shall be subject to all rules and regulations of the State registrar.
At least 10 days before the expiration of the term of office of a local registrar his successor shall be appointed by the appointing authority.
Any vacancy occurring in the office of local registrar shall be filled in the same manner as an original appointment but for the unexpired term only. If in case of such vacancy, the appointing authority shall not within 10 days thereafter fill such vacancy and certify the same to the State department, the department may make such appointment, and in the meantime the clerk or executive officer of the appointing authority shall act as local registrar.
No physician, midwife or funeral director shall be appointed as local registrar, but in any registration district where full time health officers or other full time health officials will, in the judgment of the State department, properly conduct registration of vital records such officials or one or more of them may be appointed as local registrars in and for such registration district and they shall be subject to the rules and regulations of the State registrar and to all the provisions of this chapter and chapter 6 of this Title (s. 26:6-1 et seq.) as well as chapter 1 of Title 37 of the Revised Statutes. The prohibition against appointment of a physician as registrar shall not apply where the physician is also a full time health officer.
The local registrar, immediately upon acceptance of the appointment, shall appoint a deputy to assist in the normal, day-to-day operation of the office and whose duty shall be to act in the registrar's stead in case of absence, disability or death of the registrar. In case of death of the local registrar the deputy shall act as local registrar until a new local registrar has been appointed and qualified.
Except as otherwise provided in this section, the local registrar may appoint one or two alternate deputy registrars if the local registrar deems such an appointment to be necessary for the office to function efficiently and to provide quality service to the public. If the local registrar determines that the appointment of more than two alternate deputy registrars is necessary for the office to function efficiently and to provide quality services to the public, the local registrar may submit a request to the governing body of the municipality to appoint a specific number of additional alternate deputy registrars based upon the specific needs of the municipality. The governing body of the municipality may, by resolution, permit the local registrar to appoint more than two alternate deputy registrars if the appointments are necessary for the office to function efficiently and to provide quality service to the public. The local registrar shall file a copy of an approved resolution with the State registrar to allow for appropriate oversight. The deputy registrar and alternate deputy registrar shall have the authority to receive birth certificates and death certificates; to issue burial permits, and copies of birth, death, marriage, civil union and domestic partnership certificates; to take the oath on marriage and civil union license applications; and to issue marriage and civil union licenses and register domestic partnerships. The deputy registrar and alternate deputy registrar shall receive instructions from and perform their duties under the direct supervision of the registrar, who shall be the final authority with the responsibility of fulfilling the duties of the local registrar outlined in R.S.26:8-25. The deputy registrar and any alternate deputy registrar shall serve at the pleasure of the local registrar.
When it appears necessary for the convenience of the people in any registration district, the local registrar may, with the approval of the State registrar, appoint one or more suitable persons to act as subregistrars, who shall be authorized to receive certificates of births and deaths and to issue burial or removal permits and transit permits in or for such portions of the district as may be designated.
Any local registrar, deputy registrar, alternate deputy registrar, or subregistrar, who in the judgment of the State department fails or neglects to discharge efficiently the duties of his office as set forth in this chapter or chapter 6 of this Title (R.S.26:6-1 et seq.), as well as chapter 1 of Title 37 of the Revised Statutes, may be removed by the State department, and he shall also be subject to such penalties as are provided by this chapter. Upon such removal the office shall be deemed vacant.
The provisions of this chapter fixing the terms of office and providing methods of appointment and removal shall not apply to the positions of local registrar, deputy registrar, alternate deputy registrar, or subregistrar in municipalities operating under the provisions of the "Civil Service Act," Title 11A of the New Jersey Statutes.
Every provision of this chapter, of chapter 6 of this Title (R.S.26:6-1 et seq.), as well as chapter 1 of Title 37 of the Revised Statutes, and of the rules and regulations of the State department applicable to local registrars in the registration of vital records, and the issuance of burial or removal, and transit permits, shall apply to deputy registrars, alternate deputy registrars, and subregistrars with the exception that the prohibitions in section 26:6-16 against appointment of physicians or funeral directors need not apply to subregistrars if their appointment would be advantageous for efficient registration of vital records.
Before entering upon their respective duties the state registrar, local registrar, deputy local registrar, alternate deputy registrar, and subregistrar shall take an oath to perform faithfully and impartially the duties of his office. The oath of the state registrar shall be filed with the state department and the oaths of the local registrar, deputy local registrar, alternate deputy registrar, and subregistrar shall be filed with the local board. If any such oath is not filed within ten days after the appointment, the office shall be deemed vacant.
The Department of Health shall have charge of the registration of births, deaths, fetal deaths, marriages, civil unions, and domestic partnerships and shall procure the prompt and accurate registration of the same in each registration district and in the department. The department may promulgate any rule or regulation which it deems necessary for the uniform and thorough enforcement of this section.
The department may decline permission to examine any record except in the presence of an officer or employee of the department.
The State registrar shall:
a. Have general supervision throughout the State of the registration of vital records;
b. Have supervisory power over local registrars, deputy local registrars, alternate deputy local registrars, and subregistrars, in the enforcement of the law relative to the disposal of dead bodies and the registration of vital records;
c. Prepare, print, and supply to all registrars, upon request therefor, all blanks and forms used in registering the records required by said law, and provide for and prescribe the use of the NJ-EDRS or any successor vital reporting system. The blanks and forms supplied under this subsection, and any electronic blanks and forms that are used in the NJ-EDRS, shall require the person registering a birth or death record, at a minimum, to provide the same information as is required by the National Center for Vital Health Statistics in its standardized U.S. certificates of live birth, death, and fetal death. No blanks, forms, or methods of registration shall be used, other than those that satisfy the requirements of this subsection, and which are supplied or approved by the State registrar;
d. Carefully examine the certificates or electronic files received periodically from the local registrars or originating from their jurisdiction; and, if any are incomplete or unsatisfactory, require such further information to be supplied as may be necessary to make the record complete and satisfactory;
e. Arrange or bind, and permanently preserve the certificates of vital records, or the information comprising those records, in a systematic manner and in a form that is deemed most consistent with contemporary and developing standards of vital statistical archival record keeping;
f. Prepare and maintain a comprehensive and continuous index of all vital records registered, the index to be arranged alphabetically:
In the case of deaths, by the name of the decedent;
In the case of births, by the name of child, if given, and if not, then by the name of father or mother;
In the case of marriages, by the surname of the husband and also by the maiden name of the wife;
In the case of civil unions, by the surname of each of the parties to the civil union;
In the case of domestic partnerships, by the surname of each of the partners;
g. Mark the birth certificate of a missing child when notified by the Missing Persons Unit in the Department of Law and Public Safety pursuant to section 3 of P.L.1995, c.395 (C.52:17B-9.8c);
h. Develop and provide to local registrars an education and training program, which the State registrar may require each local registrar to complete as a condition of retaining that position, and which may be offered to deputy local registrars, alternate deputy local registrars and subregistrars at the discretion of the State registrar, that includes material designed to implement the NJ-EDRS and to familiarize local registrars with the statutory requirements applicable to their duties and any rules and regulations adopted pursuant thereto, as deemed appropriate by the State registrar;
i. Facilitate the electronic notification, upon completion of the death record and issuance of a burial permit, of the decedent's name, Social Security number and last known address to the Department of Labor and Workforce Development and the Department of Human Services to safeguard public benefit programs and diminish the criminal use of a decedent's name and other identifying information; and
j. Facilitate the provision of relevant statistical data on maternal deaths to the Maternal Mortality Review Committee, in accordance with the provisions of section 12 of P.L.2019, c.75 (C.26:6C-12).
(1) The system shall be fully implemented no later than 18 months after the date of enactment of P.L.2003, c.221 and shall be the required means of death registration and certification for any death or fetal death occurring in this State, subject to any exception that may be approved by the State registrar in the case of a specific death or fetal death. All participants in the death registration process, including, but not limited to, the State registrar, local registrars, deputy registrars, alternate deputy registrars, subregistrars, the Chief State Medical Examiner, Deputy Chief State Medical Examiner, county or intercounty medical examiners, assistant county or intercounty medical examiners, funeral directors, attending physicians and resident physicians, licensed health care facilities, and other public or private institutions providing medical care, treatment, or confinement to persons, shall be required to utilize the NJ-EDRS to provide the information that is required of them by statute or regulation.
(2) The State registrar may provide for a phased implementation of the system, beginning seven months after the date of enactment of P.L.2003, c.221, by requiring certain users, who are designated by the State registrar on a geographic or other basis for this purpose, to commence utilization of the system.
(3) Beginning no later than six months after the date of enactment of P.L.2003, c.221, the State registrar shall authorize and provide material support, in the form of system access, curriculum guidelines, and user registration capability and authority, to the principal trade associations or professional organizations representing persons affected by implementation of the NJ-EDRS for the purposes of providing training and education with regard to the NJ-EDRS. The State registrar may conduct such education and training, or authorize other entities to do so on his behalf; however, these activities shall not be construed as restricting the training and education activities of any affected trade association or professional organization, including the location, manner, fees, or other means of conducting those activities on the part of the association or organization.
b. The NJ-EDRS shall, at a minimum, provide for:
(1) the direct transmission of burial permit documentation to the originating funeral home in an electronic form capable of output to a local printer;
(2) an overnight mail system for the delivery of NJ-EDRS-generated death certificates by the State registrar and local registrars, the cost of which shall be chargeable to the funeral director of record;
(3) an automated notification system to alert other responsible parties to pending cases, including notification to or from alternate local registrars;
(4) a systematic electronic payment method by which all fees are taken from accounts for which funeral homes are financially responsible and distributed, as appropriate, to the State registrar or local registrars as payment for the issuance of permits, the recording of records, the making of certified copies of death certificates, or for other charges that may be incurred;
(5) a legally binding system of digital authentication in lieu of signatures for the responsible parties and a means of assuring database security that permits users to enter the system from multiple sites and includes contemporaneous and remote data security methods to protect the system from catastrophic loss or intrusions, as well as a method of data encryption for transmission;
(6) the capacity for authorized users to retrieve data comprising the death certification record;
(7) the capacity to electronically amend and correct death records;
(8) electronic notification, upon completion of the death record and issuance of a burial permit, of the decedent's name, Social Security number, and last known address and the informant to: the federal Social Security Administration, the U.S. Citizenship and Immigration Services, the Division of Medical Assistance and Health Services in the Department of Human Services, the Department of Labor and Workforce Development, and such other governmental agencies as the State registrar determines will substantially contribute to safeguarding public benefit programs and diminish the criminal use of a decedent's name and other identifying information; and the New Jersey State Funeral Directors Association, in the case of a decedent participating in one of its funeral expense payment programs, in such a manner as to enable it to fulfill its fiduciary obligations for the payment of the decedent's final funeral and burial expenses;
(9) sufficient data documentation to meet contemporary and emerging standards and expectations of vital record archiving;
(10) continuous 24-hour-a-day technical support for all authorized users of the system; and
(11) when information submitted to the NJ-EDRS identifies a decedent as a veteran, or an eligible spouse or eligible dependent of a veteran, whose remains are cremated, electronic notification to the Department of Veterans Affairs, upon completion of the death record and issuance of the cremation permit, which electronic notification shall include, to the extent available, the decedent’s: name; last known address; dates of service, including active duty, reservist, and national guard dates of service, as appropriate; date of death; and date on which the cremation permit was issued.
c. A provider of information that is required to complete a death certificate, or who is subject to the provisions of law governing the NJ-EDRS, shall not be deemed to be acting as a local registrar, deputy registrar, alternate deputy registrar, or subregistrar solely by virtue of permitting other providers of information to gain access to the NJ-EDRS by using those other providers' identifying information.
b. The State Treasurer is the custodian of the fund and all disbursements from the fund shall be made by the treasurer upon vouchers signed by the commissioner. The monies in the fund shall be invested and reinvested by the Director of the Division of Investment in the Department of the Treasury as are other trust funds in the custody of the State Treasurer in the manner provided by law. Interest received on the monies in the fund shall be credited to the fund.
c. The monies in the fund and the interest earned thereon shall be used to meet the development and operational costs of the NJ-EDRS, including, but not limited to, costs associated with: personnel; hardware purchases and maintenance; software and communications infrastructure; website hosting; and licensing fees, royalties and transaction expenses incurred in the development, installation, maintenance and operation of electronic payment security, authentication and encryption systems, and user training and education.
d. The Commissioner of Health shall, no later than 30 months after the date of enactment of P.L.2003, c.221, report to the chairs of the Senate Health, Human Services and Senior Citizens Committee, the Senate Budget and Appropriations Committee, the Assembly Health and Human Services Committee and the Assembly Appropriations Committee, or their successors, concerning the sources and uses of monies in the fund. The report shall include a description of the methodology used by the State registrar to set the fee imposed pursuant to subsection c. of R.S.26:8-62, a summary of the monies credited to the fund, and a summary of expenditures by category from the fund pursuant to the authority of this section and the requirements of section 16 of P.L.2003, c.221 (C.26:8-24.1), together with any recommendations by the State registrar or the commissioner for changes that either considers should be made in the law concerning the implementation of the NJ-EDRS or the fees imposed pursuant to subsection c. of R.S.26:8-62.
The Chief State Medical Examiner, the Commissioner of Labor and Workforce Development or his designee, and each county or intercounty medical examiner, health care facility, institution, funeral home or physician's office shall employ at least one person who is qualified to use the NJ-EDRS, and is registered with the State registrar as an authorized user of the system, by virtue of completing a course of instruction on the NJ-EDRS provided by the State registrar or an authorized agent thereof, or satisfying such other requirements as may be established by the State registrar for this purpose.
The local registrar, under the supervision and direction of the State registrar, shall:
a. Strictly and thoroughly enforce the law relative to the disposal of dead bodies and the registration of vital records in his registration district;
b. Supply blank forms of certificates to such persons as require them;
c. Supply to every physician, midwife, and funeral director a copy of the law relative to the registration of vital records and the disposal of dead bodies, together with such rules and regulations as may be prepared by the State registrar relative to their enforcement;
d. Sign his name and insert the date of filing on each certificate of birth, marriage, civil union, domestic partnership and death or otherwise authenticate the local registrar's identity through the NJ-EDRS as prescribed by the State registrar;
e. Examine each certificate of birth, marriage, civil union, domestic partnership or death when presented for record in order to ascertain whether or not it has been made in accordance with law and the instructions of the State registrar; and if incomplete and unsatisfactory, have the same corrected;
f. At the expense of the municipality make a complete and accurate copy of each birth, marriage, civil union, domestic partnership and death certificate registered by him on a form or in a manner prescribed by the State registrar, to be preserved in his office as the local record or in the NJ-EDRS as prescribed by the State registrar;
g. On the tenth day of each month or sooner if requested by the department, transmit to the State registrar all original birth, marriage, civil union, domestic partnership and death certificates received by him for the preceding month, except that a record created on the NJ-EDRS as prescribed by the State registrar shall be deemed to have been transmitted. If no births, marriages, civil unions, domestic partnerships or deaths occurred in any month, he shall, on or before the tenth day of the following month, report that fact to the State registrar on a card provided for such purpose;
h. Make an immediate report to the State registrar of any violation of R.S.26:6-1 et seq., R.S.26:8-1 et seq., R.S.37:1-1 et seq. or P.L.2006, c.103 (C.37:1-28 et al.) coming to his knowledge;
i. In the case of any birth in his registration district to parents who are residents of another registration district or of the marriage or civil union in his registration district of any couple who obtained the marriage or civil union license in another registration district, or of the death in his registration district of any person who at the time of death was a resident of another registration district notify the registrar of the other registration district, within five days of the birth, marriage, civil union, or death, on forms prescribed by the State registrar. All entries relating to cause of death on the original certificate shall be entered on the death form sent to the registrar of the other registration district. A record created on the NJ-EDRS as prescribed by the State registrar shall be deemed to have been transmitted to the registrar of the other registration district;
j. Mark the birth certificate of a missing child born in his registration district when notified by the State registrar pursuant to section 3 of P.L.1995, c.395 (C.52:17B-9.8c); and
k. Make computer facilities with access to the NJ-EDRS available to funeral directors and physicians registered with the NJ-EDRS, within the regular established business hours of the local registrar, for the purpose of providing information necessary to complete a death record.
Each subregistrar shall note, on each certificate of birth or death, over his signature, the date of filing, and shall forward all certificates to the local registrar of the district within five days, with the exception that in any instance where the subregistrar accepts a certificate for a death not occurring in his district, as permitted by R.S.26:6-6, he shall forward the certificate within 12 hours to the local registrar of his district. A record created on the NJ-EDRS as prescribed by the State registrar shall be deemed to have been forwarded as required by this section.
The department shall issue to each local registrar and to city clerks of cities of the first class, the form and substance of the several inquiries to be made of applicants for a marriage license or a civil union license and their witnesses for the purpose of ascertaining whether any legal impediment to any proposed marriage or civil union exists.
The form shall not contain any inquiries or information which concerns the race of an applicant for a marriage or civil union license.
a. (1) Except as provided by subsection e. of this section, within five days after each birth, there shall be filed with the local registrar of the district in which the birth occurred a certificate of the birth filled out with durable black or blue ink in a legible manner.
(2) The name of the father shall be included on the record of birth of the child of unmarried parents only if the father and mother have signed a voluntary acknowledgment of paternity; or a court or an administrative agency of competent jurisdiction has issued an adjudication of paternity.
(3) In the case of a child born in connection with a gestational carrier agreement executed in accordance with the provisions of P.L.2018, c.18 (C.9:17-60 et al.), the name of the intended parent shall be included on the record of birth as the child's parent.
(4) Nothing in this section shall preclude the State IV-D agency from obtaining an admission of paternity from the father for submission in a judicial or administrative proceeding, or prohibit the issuance of an order in a judicial or administrative proceeding which bases a legal finding of paternity on an admission of paternity by the father and any other additional showing required by State law.
b. As part of the birth record, all information required by the State IV-D agency pursuant to section 7 of P.L.1994, c.164 (C.26:8-28.1) shall be recorded on a separate form provided or approved by the State registrar pursuant to subsection c. of R.S.26:8-24, and filed with the State IV-D agency pursuant to R.S.26:8-30 and R.S.26:8-31 for the establishment and enforcement of child support matters in the State. For the purposes of this subsection, "State IV-D agency" means the agency in the Department of Human Services designated to administer the Title IV-D Child Support Program.
c. The State registrar shall require each parent to provide his Social Security number in accordance with procedures established by the State registrar. The Social Security numbers furnished pursuant to this section shall be used exclusively for child support enforcement purposes.
d. The certificate of birth shall include the blood type of the child.
e. Notwithstanding the provisions of subsection a. of this section to the contrary, the filing of a child's birth certificate may be delayed, based on the parent's religious beliefs, until such time as the child is named; however, no such delay shall result in the filing of the birth certificate more than 15 days after the child's date of birth. Any parent whose religious beliefs necessitate a delay in the filing of a birth certificate pursuant to this subsection, shall: (1) provide notice of the religious need for a filing delay, within five days after the child's date of birth, to the person who is responsible for filing the birth certificate, as provided by R.S.26:8-30 or R.S.26:8-31, except that, if the parent is responsible for such filing, no such notice shall be required; and (2) file the child's birth certificate, or authorize such filing by the person responsible therefor, as soon as possible after the child is named, but in no case more than 15 days after the child's birth. If a child is not named within the 15-day extended timeframe provided by this subsection, the child's birth certificate shall be filed, and the naming procedure outlined in R.S.26:8-34 shall be applied.
a. a sworn statement by the father that he is the natural father of the child;
b. the Social Security numbers, except in those cases in which a person is ineligible to apply for one, and addresses of the father and mother;
c. the signature of the mother and father authenticated by a witness or notary; and
d. instructions for filing the Certificate of Parentage with the agency designated by the State IV-D agency.
In addition, the State IV-D agency, in cooperation with birthing centers and hospitals providing maternity services and social services or health care providers as designated by the Commissioner of Human Services that may provide voluntary acknowledgment or paternity services, shall provide information orally, or through the use of video or audio equipment, and in writing to the father and mother of the child explaining the implications of signing a Certificate of Parentage, including the parental rights, responsibilities and financial obligations, as well as the availability of paternity establishment services and child support enforcement services.
The certificate of birth shall contain such items as shall be listed on birth certificate forms provided or approved by the State registrar under authority of section 26:8-24(c) of the Revised Statutes.
The attending physician, midwife or person acting as the agent of the physician or midwife, who was in attendance upon the birth shall be responsible for the proper execution and return of a certificate of birth, which certificate shall be upon the form provided or approved by the State department, and for making available to the mother and biological father a Certificate of Parentage along with related information as required by the State IV-D agency and pursuant to section 452(a)(F) of the federal Social Security Act (42 U.S.C.s.652(a)(F). It shall be the responsibility of personnel at the hospital or birthing facility to offer an opportunity to the child's biological father to execute a Certificate of Parentage. Failure of the biological father or mother to execute the Certificate of Parentage and the date of the request shall be noted on the Certificate of Parentage. The Certificate of Parentage shall be filed with the State IV-D agency or its designee. Establishment and enforcement of child support matters shall not be permitted when a legal action is pending in the case, such as adoption, or State law prohibits such intervention.
For the purposes of this section, "State IV-D agency" means the agency in the Department of Human Services designated to administer the Title IV-D Child Support Program.
A signed voluntary acknowledgment of paternity may be challenged in court within 60 days from the date of the signing of the Certificate of Parentage or by the date of the establishment of a support order to which the signatory is a party, whichever date is earlier. The challenge may be made only on the basis of fraud, duress, or material mistake of fact, with the burden of proof upon the challenger, and the legal responsibilities of any signatory arising from the acknowledgment may not be suspended during the challenge, except for good cause shown. A signed voluntary acknowledgment of paternity shall be considered a legal finding of paternity with the same force and effect as a court order or judgment establishing paternity. No judicial or administrative proceedings are required to ratify an unchallenged acknowledgment of paternity.
In case there is no physician, midwife, or person acting as the agent of the physician or midwife, in attendance upon the birth, it shall be the duty of one of the following persons in the order named to file the birth certificate with the local registrar and file the Certificate of Parentage with the State IV-D agency or its designee:
a. The father or mother of the child;
b. The manager or superintendent of the public or private institution in which the birth occurred.
In case the person filing a certificate of birth is unable, by diligent inquiry, to obtain any item or items contemplated in section 26:8-29 of this Title, the local registrar shall secure from the person so reporting, or any other person having the required knowledge, such information as will enable said person to complete the certificate.
In case the father or mother of the child does not, within one month after the date of birth, receive a notice from the local registrar that the birth of the child has been recorded, as provided in this chapter, the father or mother of the child, in the order named, shall within five days thereafter, report to the local registrar the fact of such birth.
When a certificate of birth of a living child is presented without the statement of the given name, the local registrar shall make out and deliver to the parents of the child a special blank for the supplemental report of the given name of the child, which shall be filled out as directed, and returned to the local registrar as soon as the child shall have been named.
No certificate of birth shall be held to be complete and correct that does not supply all of the items of information called for therein, or satisfactorily account for their omission.
Any person reporting a birth, or who may be interrogated in relation thereto, shall answer correctly and to the best of his knowledge all questions put to him by the local registrar which may be calculated to elicit any information needed to make a complete record of the birth as contemplated by this chapter, and the informant as to any statement made in accordance herewith shall verify the statement by his signature, when requested so to do by the local registrar.
a. A stillborn child shall be registered as a fetal death as required by R.S.26:6-11.
b. (1) The State registrar shall establish a certificate of birth resulting in stillbirth, subject to the provisions of paragraph (2) of this subsection, which shall contain such items as shall be listed on a form provided or approved by the State registrar pursuant to subsection c. of R.S.26:8-24, for an unintended, intrauterine fetal death occurring in this State after a gestational period of 20 or more weeks. This certificate shall be offered to the parent of a stillborn child.
(2) The certificate shall be provided by the State Registrar upon the parent's written request, which may be transmitted to the State registrar directly by the parent or, at the parent's option, by a licensed health care professional on the parent's behalf.
(3) The person who prepares a certificate pursuant to this subsection shall leave blank any references to the stillborn child's name if the stillborn child's parent does not wish to provide a name for the stillborn child.
(4) The certificate of birth resulting in stillbirth shall be filed with the local registrar of the district in which the birth resulting in stillbirth occurred within three days following receipt by the State registrar of the parent's request for the certificate.
(5) When a birth resulting in stillbirth occurring in this State has not been registered within one year after the date of delivery, a certificate marked "delayed" may be filed and registered.
The birth of any child which has occurred or which may hereafter occur and which is not recorded with the State registrar as required by this chapter, may be recorded by filing a certificate with the State registrar.
a. Over the signature of the physician or midwife who attended the birth or over the signature of the father or mother of the child, or
b. When it is impossible to secure the signature of any of the persons named, the certificate may be signed by any person who has definite knowledge of the facts concerning the birth or by the person whose birth is being reported; provided, substantiating documentary proof is submitted and noted upon the certificate by the person before whom the affidavit is taken.
In every case the certificate shall be accompanied by an affidavit attesting the correctness of the information given therein, which affidavit shall be a part of the record of the birth. A copy of the affidavit shall accompany each certified copy of any record of the birth issued by the State registrar.
The affidavit (1) if taken in New Jersey, shall be taken before a Superior Court judge, the State registrar or assistant State registrar of vital statistics, an attorney at law, a county clerk or a deputy county clerk of the county where the birth occurred or where the person making the affidavit resides, or (2) if taken in some other state of the United States or territory thereof or in the District of Columbia shall be taken before a judge of any of the United States courts, a judge of any court of record having jurisdiction in the place where the affidavit is taken or any attorney at law of New Jersey, or (3) if taken in any foreign kingdom, state, nation or colony shall be taken before a public ambassador, minister, consul, vice-consul, consular agent, charge d'affaires or other representative of the United States for the time being, to or at any such foreign kingdom, state, nation or colony or any attorney at law of New Jersey; provided, however, that the affidavit may be taken in New Jersey by any employee of the Superior Court, if prior thereto, the Superior Court judge shall have filed with the State registrar of vital statistics a certificate setting forth that such employee has been designated by him to take such affidavits, and all oaths, affirmations and affidavits required to be made or taken by this section or necessary or proper to be made or taken by this section may be made and taken before any such employee when so designated.
The State registrar or any local registrar may require proof of the correctness of the information in a certificate and may refuse to accept a certificate if said proof is not submitted.
Any person knowingly submitting a certificate pursuant to this section containing incorrect particulars regarding a birth shall be subject to a penalty of not more than $500.00 to be recovered with costs in a summary proceeding in accordance with "the penalty enforcement law" (N.J.S.2A:58-1 et seq.) in the name of the State department.
No official in this state shall issue a birth certificate revealing or disclosing illegitimacy; provided, that a certificate may be issued disclosing such information in response to court process or subpoena or in response to the request of the illegitimate, his or her guardian or legal counsel.
a. The State registrar shall amend the original birth record of a child born out of wedlock to change its surname on the request of both natural parents or the child who is 18 years of age or older and on proof under oath of the marriage of its natural parents. If one of the parents of the child is deceased, the State registrar shall amend the record on proof under oath by the surviving parent or guardian or the child who is 18 years of age or older: (1) of the death of the other parent and (2) that the male parent was presumed to be the child's natural father pursuant to the "New Jersey Parentage Act," P.L.1983, c.17 (C.9:17-38 et seq.).
b. When parentage is adjudicated by any court, the State registrar shall amend the birth record to conform it to the court decree or make any other necessary changes pursuant to a request by the parent to whom custody has been awarded, the child's guardian or the child who is 18 years of age or older. A request for amendment shall be made under oath by the parent, guardian or child and shall be accompanied by a copy of the court decree.
a. When any person is adopted pursuant to provisions of the laws of any state or country, and the adoption has been certified to the State Registrar as required by subsection b. of section 16 of P.L.1977, c.367 (C.9:3-52) or there is submitted a certification or a certified copy of the decree or judgment of the court in the adoption proceedings, the State Registrar shall establish, in lieu of the original birth record, a certificate of birth showing: (1) the name of the adopted person as changed by the decree of adoption, if changed; (2) the date and place of birth; (3) the names of the adopting parents or parent, including the maiden name of the female adopting parent if that name is given in the certification or certified copy of the decree or judgment of the court; and (4) the date of filing. In any instance where the child has been adopted by the spouse of the natural parent, the name of the parent shall also be entered on the new certificate of birth. The certificate of birth shall be of the same general type as is used in making a birth certificate for a person who has not been adopted.
Upon receipt of a certification or certified copy of the decree or judgment of a court in an adoption proceeding, the State Registrar shall make a new certificate of birth containing the information referred to in the preceding paragraph. The fee for this service shall be established by the Commissioner of Health, by regulation.
b. The State Registrar may file the new certificate:
(1) for any foundling, for any child born in any state, and for any child for whom an original birth report cannot be located, who has been adopted in New Jersey; provided that there is attached to the decree or judgment of the court in such adoption proceeding or is submitted to the State Registrar a certified copy of the original birth record or acceptable evidence of birth. In the case of a foundling, the date and place of birth shall be decided by a court of competent jurisdiction; and
(2) for any child born in a foreign country who was not a citizen of the United States at the time of the child's birth, whose adopting parent is a resident of this State, and who is adopted: (a) through a court of competent jurisdiction in this State; or (b) under the laws of a jurisdiction or country other than the United States and has been granted an IR-3 immigrant visa, or a successor immigrant visa, by the United States Citizenship and Immigration Services. The new certificate shall be filed upon receipt of: a request for the certificate from the court, the adopting parent, or the adopted person if that person is 18 years of age or older; proof that the adopting parent is a resident of this State; an official copy of the judgment from the jurisdiction or country in which the child was adopted; a certified translation of the foreign adoption; proof of the date and place of the child's birth; and proof of IR-3 immigrant visa status, or a successor immigrant visa status.
When applicable, the State Registrar may file a new certificate for any child who is not a citizen of the United States and who is adopted by a resident of this State, which certificate shall bear the notation "certificate of foreign birth," which shall also be shown upon any copy of the certificate issued; the notation may be removed at any subsequent date upon submission of acceptable proof that the child has become a citizen of the United States.
When a new certificate of birth is made, the State Registrar shall notify the local registrar of vital statistics of the place in which the birth occurred, if applicable, who shall enter the new certificate in the local registrar's local record and forward the copy of the original record to the State Registrar for disposition.
c. The State Registrar shall cause to be placed under seal the original certificate of birth and all papers pertaining to the new certificate of birth. Such seal shall not be broken except:
(1) by order of a court of competent jurisdiction; or
(2) upon a request for an uncertified, long-form copy of the adopted person's original certificate of birth by a person 18 years of age or older who can establish himself as one of the following:
(a) the adopted person;
(b) a direct descendant, sibling, or spouse of the adopted person;
(c) an adoptive parent, legal guardian, or other legal representative of the adopted person; or
(d) an agency of the State or federal government for official purposes.
The State Registrar shall authenticate the identity of the requester and the requester's relationship with the subject adopted person.
d. Thereafter, whenever a certification or certified copy of a certificate of birth of the adopted person is issued, it shall be made from the new certificate of birth except when an order of a court of competent jurisdiction shall require the issuance of an uncertified, long-form copy of the original certificate of birth, or upon a request for an uncertified, long-form copy of the adopted person's original certificate of birth by an authorized requester, as provided in subsection c. of this section, excluding any statistical data gathered solely for the use of the State.
Any person who, as a child of unknown parentage, heretofore was or hereafter shall be found in this State and whose parentage and the place and time of whose birth remain unknown, shall be presumed to have been born in this State until shown not to have been born herein but only upon compliance with the provisions of this act.
No order shall be made under this act as to any person--
(a) Who advises, advocates, or teaches, or who is a member of or affiliated with any organization, association, society, or group that advises, advocates, or teaches opposition to all organized government; or
(b) Who believes in, advises, advocates, or teaches, or who is a member of or affiliated with any organization, association, society, or group that believes in, advises, advocates, or teaches--
(1) the overthrow by force or violence of the government of this State or of the United States or of all forms of law; or
(2) the duty, necessity, or propriety of the unlawful assaulting or killing of any officer or officers (either of specific individuals or of officers generally) of the government of this State or of the United States or any other organized government, because of his or their official character; or
(3) the unlawful damage, injury, or destruction of property; or
(4) sabotage.
(c) Who writes, publishes, or causes to be written or published, or who knowingly circulates, distributes, prints, or displays, or knowingly causes to be circulated, distributed, printed, published, or displayed, or who knowingly has in his possession for the purpose of circulation, distribution, publication, or display any written or printed matter advising, advocating, or teaching opposition to all organized government, or advising, advocating, or teaching--
(1) the overthrow by force or violence of the government of this State or of the United States or of all forms of law; or
(2) the duty, necessity, or propriety of the unlawful assaulting or killing of any officer or officers (either of specific individuals or of officers generally) of the government of this State or of the United States or of any other organized government; or
(3) the unlawful damage, injury, or destruction of property; or
(4) sabotage.
(d) Who is a member of or affiliated with any organization, association, society, or group that writes, circulates, distributes, prints, publishes, or displays, or causes to be written, circulated, distributed, printed, published, or displayed, or that has in its possession for the purpose of circulation, distribution, publication, issue, or display, any written or printed matter of the character described in subdivision (c).
For the purpose of this section--
(1) the giving, loaning, or promising of money or anything of value to be used for the advising, advocacy or teaching of any doctrine above enumerated shall constitute the advising, advocacy, or teaching of such doctrine; and
(2) the giving, loaning, or promising of money or anything of value to any organization, association, society, or group of the character above described shall constitute affiliation therewith; but nothing in this paragraph shall be taken as an exclusive definition of advising, advocacy, teaching or affiliation.
The provisions of this section shall be applicable to any applicant for an order fixing the time and place of his birth who at any time within a period of ten years immediately preceding the filing of the petition therefor, is or has been found to be within any of the classes enumerated within this section notwithstanding that at the time petition is filed he may not be included in such classes.
On the filing of a certified copy of said order with the State Registrar of Vital Statistics, the birth of said person shall be recorded by said registrar as of the date and place named in the said order, which said record shall be evidence of said person's birth as of said time and place.
For the purposes of this act "employer" includes any individual, partnership, association, corporation, business trust, legal representative or any organized group of persons acting directly or indirectly in the interest of an employer in its relations to employees.
Every employer who shall require as a condition of employment, continuance of employment, or promotions or advancements in employment, a birth certificate from any employee, shall accept in lieu thereof from all employees who are veterans as defined by section 11:27-1 of the Revised Statutes the honorable discharge of such veteran from the armed services of the United States.
Any employer violating any of the provisions of this act shall be adjudged a disorderly person and shall be proceeded against and punished pursuant to the provisions of the disorderly persons law.
The birth of any child which has occurred or which may hereafter occur outside of the United States, where such child is a citizen of the United States by reason of the citizenship of a parent or the parents of such child, and which is not recorded with the State registrar under the provisions of chapter 8 of Title 26 of the Revised Statutes or with the appropriate State official in any other state within the United States, may be recorded by filing a certificate of the birth of such child issued by a public official of the place where such child was born, accompanied by an affidavit setting forth the facts showing such citizenship and, in the case of a child adopted outside of this State or the United States, the decree or certificate of adoption of such child, which affidavit and decree or certificate shall be a part of the record of the birth. In case any such foreign birth certificate is or shall be in a foreign language, there shall be attached to it the translation into the English language of the same, verified by the affidavit of the person making the translation. Any such birth certificate may be recorded as herein provided upon the request of a parent of such child or by any person on behalf of such child, provided that the parent or other person is a New Jersey resident, where the child is or shall become a resident of this State. The State registrar shall, upon the request of a parent of any such child who is adopted outside of this State or the United States or the request of any person on behalf of such child, issue a new certificate of birth for such child, showing (a) the name of such child as changed by the decree or certificate of adoption, if changed, (b) the date and place of birth, (c) the names of the adopting parents or parent, and (d) the date of recording of the foreign birth certificate.
Whenever the mother of a child born out of wedlock, who has the same surname as the mother, and who has no presumed natural father pursuant to the "New Jersey Parentage Act," P.L.1983, c.17 (C.9:17-38 et seq.), or the presumed father does not oppose the name change, marries a person who is not the father of said child, the surname of said child may be changed to the surname of the husband of the mother by submitting proof of such marriage to the State Registrar of Vital Statistics or to any local registrar of vital statistics, accompanied by a declaration, signed by said mother and her husband and acknowledged or proved in the manner required by law for deeds to real estate, setting forth that they desire the surname of said child to be changed to that of the husband of said mother and a declaration signed by the presumed father setting forth his approval of the name change. Upon the receipt of such proof and declarations, the surname of said child shall be so changed and the State Registrar and any local registrar of vital statistics is authorized to accept from the said mother and her husband a correction or amendment to the original birth record, giving the child the said husband's surname. Any declaration submitted to the State Registrar or to any local registrar pursuant to this section shall be filed with the original birth record of said child.
a. The State registrar shall issue the amended certificate of birth upon receipt of: (1) a certified copy of an order from a court of competent jurisdiction which indicates that the name of the person has been changed, if the person has changed his or her name; and (2) a form provided by the State registrar and completed by the person, or the person's guardian, which affirms the following language: "I, (petitioner's full name), hereby attest under penalty of perjury that the request for a change in gender to (female, male, or undesignated/non-binary) is to conform my legal gender to my gender identity and is not for any fraudulent purpose."
b. The amended certificate of birth shall be of the same general type as the original certificate of birth, and shall not be marked as amended.
c. When an amended certificate of birth is issued, the State registrar shall notify the appropriate local registrar of vital statistics who shall enter the amended certificate in his local record and place his copy of the original certificate under seal.
d. The State registrar shall place the original certificate of birth and all papers pertaining to the amended certificate of birth under seal. The seal shall not be broken except by order of a court of competent jurisdiction, or upon the request of the person who is the subject of the certificate of birth, or the parent or guardian, if the person is a minor.
Thereafter, whenever a certified copy of the certificate of birth is prepared, it shall be made from the amended certificate of birth except when an order of a court of competent jurisdiction requires that a certified copy be made of the original certificate of birth.
e. In the case of a resident of this State who was born in another state or in a foreign jurisdiction, if such other state or foreign jurisdiction requires a court order in order to amend a certificate of birth to reflect a change in gender, a court in this State shall have jurisdiction to issue an order declaring a person's gender upon receipt of a statement affirming under penalty of perjury that the request for a declaration of female, male, or undesignated/non-binary gender is to conform with gender identity and not for any fraudulent purpose.
f. The fee for issuing the amended certificate of birth is $6.00.
b. The department shall make available electronically on its Internet website, in English and Spanish, information on the characteristics and effects of severe neonatal jaundice.
b. The Commissioner of Health shall determine the health care providers and facilities which shall be required to report all birth defects and all cases of severe hyperbilirubinemia, the types of conditions or defects that shall be reported, the type of information that shall be contained in the confidential report and the method for making the report. In reports concerning all fetuses with anomalies, the name of the mother shall not be submitted.
The confidential reports made pursuant to this act are to be used only by the Department of Health and other agencies that may be designated by the Commissioner of Health and shall not otherwise be divulged or made public so as to disclose the identity of any person to whom they relate; and to that end, such reports shall not be included under materials available to public inspection pursuant to P.L. 1963, c. 73 (C. 47:1A-1 et seq.).
No individual or organization providing information to the Department of Health in accordance with this act shall be deemed to be or held liable for divulging confidential information.
Nothing in this act shall be construed to compel any individual to submit to a medical examination or to Department of Health supervision.
The Commissioner of Health shall promulgate rules and regulations necessary to effectuate the purposes of this act.
a. Stillbirths are unintended fetal deaths and are traditionally identified as those which occur after 20 weeks of pregnancy or involve the unintended death of fetuses weighing 350 or more grams;
b. Approximately one in every 160 pregnancies in the United States ends in stillbirth each year, a rate which is high compared with other developed countries;
c. Families experiencing a stillbirth suffer severe anguish, and many health care facilities in the State do not adequately ensure that grieving families are treated with sensitivity and informed about what to expect when a stillbirth occurs, nor are families who have experienced a stillbirth always advised of the importance of an autopsy and thorough evaluation of the stillborn child;
d. While studies have identified many factors that may cause stillbirths, researchers still do not know the causes of a majority of stillbirths, in part due to a lack of uniform protocols for evaluating and classifying stillbirths, and to decreasing autopsy rates;
e. The State currently collects some data related to fetal deaths, but full autopsy and laboratory data related to stillbirths could be more consistently collected and more effectively used to better understand risk factors and causes of stillbirths, and thus more effectively inform strategies for their prevention; and
f. It is in the public interest to establish mandatory protocols for health care facilities in the State, so that each child who is stillborn and each family experiencing a stillbirth in the State is treated with dignity, each family experiencing a stillbirth receives appropriate follow-up care provided in a sensitive manner, and comprehensive data related to stillbirths are consistently collected by the State and made available to researchers seeking to prevent and reduce the incidence of stillbirths.
b. The Commissioner of Health shall require as a condition of licensure that each health care facility in the State that provides birthing and newborn care services adhere to the policies and procedures prescribed in this section. The policies and procedures shall include, at a minimum:
(1) protocols for assigning primary responsibility to one physician, who shall communicate the condition of the fetus to the mother and family, and inform and coordinate staff to assist with labor, delivery, and postmortem procedures;
(2) guidelines to assess a family's level of awareness and knowledge regarding the stillbirth;
(3) the establishment of a bereavement checklist, and an informational pamphlet to be given to a family experiencing a stillbirth that includes information about funeral and cremation options;
(4) provision of one-on-one nursing care for the duration of the mother's stay at the facility;
(5) training of physicians, nurses, psychologists, and social workers to ensure that information is provided to the mother and family experiencing a stillbirth in a sensitive manner, including information about what to expect, the availability of grief counseling, the opportunity to develop a plan of care that meets the family's social, religious, and cultural needs, and the importance of an autopsy and thorough evaluation of the stillborn child;
(6) best practices to provide psychological and emotional support to the mother and family following a stillbirth, including referring to the stillborn child by name, and offering the family the opportunity to cut the umbilical cord, hold the stillborn child with privacy and without time restrictions, and prepare a memory box with keepsakes, such as a handprint, footprint, blanket, bracelet, lock of hair, and photographs, and provisions for retaining the keepsakes for one year if the family chooses not to take them at discharge;
(7) protocols to ensure that the physician assigned primary responsibility for communicating with the family discusses the importance of an autopsy for the family, including the significance of autopsy findings on future pregnancies and the significance that data from the autopsy may have for other families;
(8) protocols to ensure coordinated visits to the family by a hospital staff trained to address the psychosocial needs of a family experiencing a stillbirth, provide guidance in the bereavement process, assist with completing any forms required in connection with the stillbirth and autopsy, and offer the family the opportunity to meet with the hospital chaplain or other individual from the family's religious community; and
(9) guidelines for educating health care professionals and hospital staff on caring for families after stillbirth.
c. The State Board of Medical Examiners and the New Jersey Board of Nursing shall require physicians and nurses, respectively, to adhere to the policies and procedures prescribed in subsection a. of this section.
a. the race, age of the mother, maternal and paternal family history, comorbidities, prenatal care history, antepartum findings, history of past obstetric complications, exposure to viral infections, smoking, drug and alcohol use, fetal growth restriction, placental abruption, chromosomal and genetic abnormalities obtained pre-delivery, infection in premature fetus, cord accident, including evidence of obstruction or circulatory compromise, history of thromboembolism, and whether the mother gave birth before;
b. if consent is obtained from the parents of the stillborn child: documentation of the evaluation of a stillborn child, placenta, and cytologic specimen that conform to the standards established by the American College of Obstetricians and Gynecologists and meet any other requirements deemed by the Commissioner of Health as necessary, including, but not limited to, the following components:
(1) if the parents consent to a complete autopsy: the weight of the stillborn child and placenta, head circumference, length of stillborn child, foot length if stillbirth occurred before 23 weeks of gestation, and notation of any dysmorphic feature; photograph of the whole body, frontal and profile of face, extremities and palms, close-up of any specific abnormalities; examination of the placenta and umbilical cord; and gross and microscopic examination of membranes and umbilical cord; or
(2) if the parents do not consent to a complete autopsy as set forth in paragraph (1) of this subsection, but provide consent to an alternative, limited autopsy: a placental examination, external examination, selected biopsies, X-rays, MRI, and / or ultrasound consistent with the scope of the consent; and
c. any other relevant information, which is consistent with the current federal standards for fetal death certification and fetal death reporting, as adopted, amended, and supplemented by the federal Centers for Disease Control and Prevention.
b. The data shall be made available to the public through the department website, except that no data shall identify any person to whom the data relate.
b. No later than five years after the effective date of this section, the Commissioner of Health shall report to the Governor, and to the Legislature pursuant to section 2 of P.L.1991, c.164 (C.52:14-19.1), on the findings of the evaluation required pursuant to this section, and shall include in the report any recommendations for legislative action that the commissioner deems appropriate.
b. The fee for the uncertified, original long-form certificate of birth preceding an adoption shall be established, by regulation, by the Commissioner of Health.
b. The State Registrar shall require a birth parent who submits a document of contact preference pursuant to this section to simultaneously submit a completed form providing updated family history information, which shall include medical, cultural, and social history information regarding the birth parent.
c. The form of the contact preference document and the form of the family history information document shall be established by the State Registrar, who shall provide a copy of each document to a birth parent, upon request. The State Registrar shall also make the documents available for downloading from the Department of Health website.
d. The document of contact preference shall provide the birth parent with the following options, from which the parent may select one:
(1) "I would like to be contacted directly. I have completed a document of contact preference and an updated family history information document and am submitting them to the State Registrar as set forth in this document";
(2) "I would prefer to be contacted only through an intermediary. I have completed a document of contact preference and an updated family history information document and am submitting them to the State Registrar as set forth in this document. I would like the following named individual to act as an intermediary __________"; or
(3) "I would prefer not to be contacted at this time. If I decide later that I would like to be contacted, I will submit a revised document of contact preference to the State Registrar. I have completed a document of contact preference and an updated family history information document and am submitting them to the State Registrar as set forth in this document."
e. The State Registrar shall request a birth parent who indicates a preference for no contact by the adopted person to update the family history information every 10 years until the birth parent reaches the age of 40, and every five years thereafter.
f. The State Registrar shall maintain a file of documents of contact preference and family history information submitted by birth parents. Upon request for an original certificate of birth pursuant to subsection c. of R.S.26:8-40.1, the State Registrar shall determine whether there is on file a document of contact preference and a family history information document regarding the adopted person, and if those documents exist, shall place and retain them in the adopted person's original certificate of birth file.
g. Upon a request for an uncertified, long-form copy of an adopted person's original certificate of birth pursuant to subsection c. of R.S.26:8-40.1, the State Registrar shall also provide the authorized requester with a copy of the birth parent's document of contact preference and the updated family history information document if those documents have been submitted to the State Registrar pursuant to this section.
h. The State Registrar shall provide to an authorized requester, upon request, any information subsequently added to an adopted person's certificate of birth file. The State Registrar may establish a system to inform authorized requesters in the event that new information is added to an adopted person's certificate of birth file.
i. Notwithstanding the provisions of this section, in the case of a person adopted prior to August 1, 2015, a birth parent may submit a request for redaction of name and other identifying information of the birth parent to the State Registrar on or before December 31, 2016 that provides that the name and other identifying information of the birth parent shall be redacted in response to a request pursuant to R.S.26:8-40.1, section 4 of P.L.2014, c.9 (C.26:8-40.33), or this section. At any time following the request for redaction, the birth parent may rescind the redaction request and the State Registrar shall provide the identifying information concerning the birth parent. The State Registrar shall retain a copy of the revised request for redaction and share the information based on the revised request for redaction document in accordance with the provisions of this section.
b. The Division of Child Protection and Permanency in the Department of Children and Families shall notify the State Registrar when a child is surrendered pursuant to P.L.2000, c.58 (C.30:4C-15.5 et seq.) to enable the State Registrar to identify the certificate of birth of the child who was so surrendered and deem that the uncertified, long-form copy of the original certificate of birth shall not be provided to the authorized requester.
c. Nothing in this act shall be construed to require the Division of Child Protection and Permanency in the Department of Children and Families to provide any identifying information about the birth parents of a child who was surrendered pursuant to the provisions of P.L.2000, c.58 (C.30:4C-15.5 et seq.).
Transmission of marriage and civil union licenses and certificates. Every person or religious society, institution or organization solemnizing a marriage or civil union shall, within 5 days thereafter, transmit the certificate of marriage or civil union and the marriage or civil union license to the local registrar of the registration district in which the marriage or civil union occurs or to the clerk of the county board of health. In the case of marriages or civil unions performed pursuant to section 7 of P.L.2011, c.179 (C.37:1-17.3), the person or religious society, institution or organization solemnizing the marriage or civil union, in addition to transmitting the certificate of marriage or civil union and the marriage or civil union license, shall also transmit the power of attorney.
The local registrar or clerk of the county board of health shall stamp every certificate of marriage or civil union so received with the date of its receipt and the name of the registration district in which it is filed.
The local registrar who receives the certificate of a marriage or the certificate of a civil union within the district under his jurisdiction, the license for which was issued in another registration district, shall, within 5 days after receipt of the marriage or civil union certificate, copy the names of the persons married or the partners in a civil union couple; the date of marriage or civil union; the place of marriage or the civil union and the marriage or civil union license number upon a form provided by the State registrar and transmit it by mail to the officer legally designated to receive certificates of marriage or civil union in the registration district in which the license was issued.
Each local registrar and the clerk of the county board of health shall, on or before the tenth of each calendar month, or sooner if requested by the department, transmit by mail, express or messenger to the State registrar in an envelope or package marked "vital statistics" all the certificates of marriages and civil unions, marriage and civil union licenses and consents to the marriage or civil union of minors received by them.
The State registrar shall cause all certificates of marriages and civil unions and marriage and civil union licenses received to be alphabetically indexed and shall cause to be transcribed or otherwise recorded from the certificates such of the vital facts appearing thereon as the department may deem necessary or useful.
The certificates of marriage and civil union shall be so tabulated as to present in separate and distinct classes the record of each county or registration district of over 5,000 inhabitants, which record shall be preserved as a public record and the original certificates shall be preserved in the archives of the department.
If a marriage or a civil union has been declared void by the Superior Court in an action instituted for that purpose and the court is satisfied by the proof taken before the final judgment or by affidavit or otherwise after the final judgment that a record of the marriage or civil union is filed with the State registrar, it may order the record to be canceled.
It shall not be necessary to make the custodian of the record a party to the cause.
The order need only recite that there was a ceremony of marriage or civil union between parties to the cause (naming them), performed on (date) by (naming the officer) and that by a final judgment entered on (date), the marriage or civil union was declared void and may then direct that the said record be canceled.
Upon presenting a certified copy of said order to the State Registrar, he shall indorse on the return of the marriage or civil union the following words: "This marriage or civil union declared void by the Superior Court. See order hereto annexed" and shall annex the certified copy to the return.
The department shall cause to be prepared blank forms of certificates of marriages or civil unions and marriage or civil union licenses corresponding to the requirements of R.S.37:1-7 and R.S.37:1-17. The forms, together with such sections of the laws concerning marriages or civil unions and such instructions and explanations thereof as the department may deem useful to persons having duties to perform under such laws shall be printed and supplied upon request therefor to the local registrars and to the city clerks of cities of the first class.
All certificates of marriages or civil unions and marriage or civil union licenses shall be written upon the said blanks or blanks approved by the department and shall not contain any inquiries or information which concerns the race of an applicant for a marriage or civil union license.
A certificate of birth, fetal death, marriage, civil union, domestic partnership or death heretofore or hereafter filed with the State registrar shall not be altered or changed otherwise than by amendments properly signed, dated and witnessed, or as otherwise recorded and authenticated on the NJ-EDRS as prescribed by the State registrar.
shall be signed by the person who made the original report or by either of the parents of the child or by any other person having personal knowledge of the matters sought to be corrected which other person shall state such matters on his oath.
Corrections may also be signed by any person whose birth report is in error provided substantiating documentary proof, satisfactory to the State registrar or any local registrar, is submitted therewith and noted by said State registrar or local registrar upon the written request for correction. In the case of a correction to the birth record of a member of one of the three New Jersey tribes of American Indians, the Powhatan-Renape Nation, the Ramapough Mountain Indians, or the Nanticoke-Lenni-Lenape Indians, the substantiating documentary proof may include, but shall not be limited to, an affidavit, satisfactory to the State registrar or any local registrar and signed by the chief of the tribe that according to tribal records the person whose certificate is to be amended is a member of the tribe of the chief whose signature appears on the affidavit.
Correction to marriage or civil union licenses shall be signed by the person who issued the license or his successor in office.
Corrections to marriage, civil union or domestic partnership certificates shall be signed by the person who signed the certificate or by any other person having personal knowledge of the matters sought to be corrected which other person shall state such matters on his oath.
Corrections to death certificates shall be signed by the physician, registered professional nurse, county or intercounty medical examiner or assistant county or intercounty medical examiner, Chief State Medical Examiner, Deputy Chief State Medical Examiner, funeral director or informant, whose name appears upon the certificate, or shall be otherwise recorded and authenticated on the NJ-EDRS as prescribed by the State registrar; however, any individual having personal knowledge and substantiating documentary proof of the matters sought to be corrected may apply under oath to the county or intercounty medical examiner or the Chief State Medical Examiner in a case in which the certificate was signed by the Chief State Medical Examiner or Deputy Chief State Medical Examiner, to have the certificate corrected. The authority to sign or otherwise authenticate corrections or amendments to causes or duration of causes of death is restricted to the physician, Chief State Medical Examiner, Deputy Chief State Medical Examiner, or county or intercounty medical examiner or assistant county or intercounty medical examiner. Upon denial of an application for correction or amendment of a death certificate, a person who has applied to a county or intercounty medical examiner may apply to the Chief State Medical Examiner, who shall exercise discretion to review the matter and amend the certificate or to defer to the decision of the county or intercounty medical examiner. The decision of the county or intercounty medical examiner shall be deemed the final decision by a public officer in the matter unless the Chief State Medical Examiner amends or corrects the death certificate.
The State department or local registrars may refuse to accept corrections or amendments unless supported by adequate documentary evidence presented at the time the request for correction or amendment is made.
For all important changes to certificates, the certified copies issued by the state department, state registrar or a local registrar shall show the information as originally given and the corrected data.
Any person knowingly submitting a certificate pursuant to this article containing incorrect particulars relating to any birth, marriage, civil union, domestic partnership or death shall be subject to a penalty of not more than $500, which shall be recovered with costs in a summary proceeding in the name of the department.
The local registrar shall be paid $1 for each birth or death certificate properly executed, registered, recorded, and promptly returned, or otherwise transmitted through the NJ-EDRS, to the State Registrar. In the case of a death registration, the fee shall be credited to the account within the NJ-EDRS of the political subdivision comprising the registration district. A local registrar shall not receive the fee if compensated by a fixed salary as provided in R.S.26:8-59.
In case no birth or death is registered during any month, the local registrar shall be paid the sum of twenty-five cents for each report to that effect, if such report be made promptly as required by this chapter.
The treasurer of each incorporated political subdivision comprising a registration district shall upon certification from a local registrar of the number of certificates or reports issued by him during the preceding quarter pursuant to sections 26:8-56, 26:8-57 and 26:8-60 of this Title, make quarterly payments to the local registrar of the fees to which he may be entitled thereunder. The board of health of such political subdivision may, in lieu of such fees, provide that the local registrar shall receive a fixed compensation, to be determined by such body.
b. Any fee charged, by a local registrar, deputy registrar, alternate deputy registrar, subregistrar, or an incorporated political subdivision comprising a registration district, to a funeral home as the legal representative for a person in securing a certified copy of a death certificate shall be in the form of a debit against the account of the funeral home and a credit to the applicable political subdivision within the NJ-EDRS.
Each local registrar shall be entitled to receive from the proper disbursing officer of the municipality or county the sum of $1 for each marriage, civil union or domestic partnership certificate properly transmitted to the State Registrar.
In any registration district, the body appointing local registrars may, in lieu of fees, provide that officers performing the above service shall receive a fixed compensation to be determined by such body.
The person procuring the cancellation of a marriage or civil union record pursuant to R.S.26:8-45 and R.S.26:8-46 shall first pay to the State Registrar the sum of $2.00 and the State Registrar shall pay the same over to the State Treasurer. Such fee may be included in the taxable costs in the annulment suit.
a. The State registrar or local registrar shall, upon request, supply to a person who establishes himself as one of the following: the subject of the record of a birth, death, fetal death, certificate of birth resulting in stillbirth, domestic partnership, civil union or marriage, as applicable; the subject's parent, legal guardian or other legal representative; the subject's spouse, one partner in a civil union couple, child, grandchild or sibling, if of legal age, or the subject's legal representative; an agency of State or federal government for official purposes; a person possessing an order of a court of competent jurisdiction; or a person who is authorized under other emergent circumstances as determined by the commissioner, a certified copy, or release of the data and information of that record registered under the provisions of R.S.26:8-1 et seq., or P.L.2006, c.103 (C.37:1-28 et al.) or any domestic partnership registered under the provisions of P.L.2003, c.246 (C.26:8A-1 et al.), for any of which, except as provided by R.S.26:8-63, the State registrar shall be entitled to a search fee, if any, as provided by R.S.26:8-64, to be paid by the person. A certification may be issued in other circumstances and shall state that it is for informational purposes only, and is not to be used for identification purposes. The registrar shall authenticate the identity of the requestor and the requestor's relationship with the subject of the vital record. For the purposes of this subsection, any employee of a mortuary registered pursuant to P.L.1952, c.340 (C.45:7-32 et seq.), or a funeral director licensed pursuant to that act who is affiliated with a registered mortuary, if the mortuary was recorded on the original certificate of death, shall be construed to be the subject's legal representative and entitled to obtain full and complete copies of death certificates or certifications thereof.
b. The State registrar shall, upon request, supply to any applicant a certified transcript of any entry contained in the records of the New Jersey State census for which, except as provided by R.S.26:8-63, he shall be entitled to a search fee as provided by R.S.26:8-64, to be paid by the applicant.
c. For each death registration initiated on the NJ-EDRS on or after the first day of the first month following the date of enactment of P.L.2003, c.221 but before the first day of the thirty-seventh month following the date of enactment of P.L.2003, c.221, the State registrar shall be paid a recording fee for each record filed, whether by means of the current paper process or electronically, in an amount to be determined by the State registrar but not exceeding $10, from the account of the funeral home, which may include this amount in the funeral expenses charged to the estate or person accepting responsibility for the disposition of the deceased's human remains and the costs associated therewith; provided however, this fee shall not apply to the death registration of a person who died while in the military or naval or maritime or merchant marine service of the United States whose death is recorded pursuant to section 1 of P.L.1950, c.299 (C.26:6-5.2). The State registrar shall deposit the proceeds from the recording fee into the New Jersey Electronic Death Registration Support Fund established pursuant to section 17 of P.L.2003, c.221 (C.26:8-24.2).
d. Notwithstanding any other provision of this section to the contrary, the Commissioner of Health and Senior Services shall designate specifications for uniform forms for the issuance of all vital records, which shall be used by registrars beginning on a date established by the commissioner. The form designated for certified copies of vital records shall contain safety features for authentication purposes and to deter forgery, and shall be readily distinguishable from the form designated for certifications of vital records. Local registrars may include in the fee for a certified copy the additional cost of the form containing such safety features.
The commissioner may issue and enforce orders to implement the provisions of this subsection.
The State registrar shall:
a. Furnish a certification or certified copy of a birth, marriage, civil union, domestic partnership, fetal death or death certificate without fee in the prosecution of any claim for public pension or for military or naval enlistment purposes; and
b. Furnish the United States Public Health Service without expense to the State, microfilm or photocopy images of birth, marriage, civil union, domestic partnership, fetal death and death certificates without payment of the fees prescribed in this article; and
c. Furnish a certified transcript of any entry in the records of the New Jersey State census without fee for certification in the prosecution of any claim for public pension, for military or naval enlistment purposes; and
d. Furnish without fee upon request for administrative use by any city, State or federal agency a certified transcript of any New Jersey State census entry, or a certification or certified copy of a birth, death, fetal death, marriage, civil union or domestic partnership certificate; and
e. Furnish without fee upon request a certified copy of a veteran's death certificate to the veteran's legal representative, the executor or administrator of the veteran's estate, to a family member authorized to obtain a copy of the death certificate pursuant to subsection a. of R.S.26:8-62, or to a qualified veterans' organization which takes possession of a veteran's cremains with the intention of properly disposing of them pursuant to section 2 of P.L.1983, c.385 (C.26:7-18.2). No more than one copy of a veteran's death certificate may be provided without fee pursuant to this subsection; all other copies of the death certificate shall be subject to the statutory fee; and
f. Furnish without fee upon request by a person who is homeless a certified copy of the person's birth certificate, provided that the person submits the request through a social worker or the coordinator of the emergency shelter for the homeless where the person is temporarily residing. The request shall be transmitted on the emergency shelter's letterhead and shall include the shelter's employer identification number and an attestation by the coordinator that the person requesting the certificate is currently homeless and residing at the shelter or the request shall be submitted on the social worker's agency or professional practice letterhead and shall include the agency's or the professional practice's employer identification number and an attestation by the social worker that the person requesting the certificate is currently homeless. A certified copy of a birth certificate furnished pursuant to this subsection shall be transmitted to the social worker or coordinator who transmitted the request. No more than one certified copy of a birth certificate furnished to a person who is homeless pursuant to this subsection shall be provided without fee; all other copies of the birth certificate shall be subject to the statutory fee. On or before December 31 of each year, the State Registrar shall report to the Office of Homelessness Prevention in the Department of Community Affairs an accounting of each instance in which the State Registrar furnished without fee a certified copy of a person's birth certificate pursuant to this subsection.
As used in this section:
"Fee" includes, but is not limited to, any search, certification, processing, authentication, standard shipping, or other fees that would ordinarily be assessed to furnish a certified copy of a certificate or transcript; and
"Person who is homeless" means a person without a domicile who is unable to secure permanent and stable housing as determined by a social worker or the coordinator of an emergency shelter for the homeless established pursuant to P.L.1985, c.48 (C.55:13C-1 et seq.).
a. For any genealogical search of the files and records of births, deaths, marriages, civil unions or domestic partnerships when information required on the application for a certification or certified copy of a vital record, and the correct year only is supplied by the applicant, whether or not a certification or a certified copy is made, the State registrar shall be entitled to a minimum fee of $4, plus a fee of $1 for each additional year searched, which fee shall be paid by the applicant, except as provided by R.S.26:8-63. The fee for each additional copy of the same record ordered at the same time shall be $2.
b. For any non-genealogical search of the files and records of births, deaths, marriages, civil unions or domestic partnerships when the exact date of the event is supplied, along with all other information required on the application for a certification or certified copy of a vital record, whether or not a certification or certified copy is made, the State Registrar shall be entitled to a minimum fee of $4, which shall be paid by the applicant, except as provided by R.S.26:8-63. The fee for each additional copy of the same record ordered at the same time shall be $2.
c. Conduct without fee upon request for administrative use by any city, state, or federal agency, a search for any New Jersey State census entry.
The state registrar shall keep a true and correct account of all fees received by him and turn the same over to the state treasurer.
The State registrar either personally or by accredited representative, may investigate any case of irregularity or violation of R.S.26:6-1 et seq., R.S.26:8-1 et seq., R.S.37:1-1 et seq., or P.L.2006, c.103 (C.37:1-28 et al.), and every local registrar shall aid him in such investigation.
When the State registrar shall deem it necessary, he shall report any violation of any provision of R.S.26:6-1 et seq., R.S.26:8-1 et seq., R.S.37:1-1 et seq. or P.L.2006, c.103 (C.37:1-28 et al.), to the county prosecutor, with a statement of the facts and circumstances. Upon such report, the county prosecutor shall forthwith institute and prosecute the necessary proceedings for such alleged violation.
Upon request of the State registrar, the Attorney General shall assist in the enforcement of the provisions of R.S.26:6-1 et seq., R.S.26:8-1 et seq., R.S.37:1-1 et seq. or P.L.2006, c.103 (C.37:1-28 et al.), or the State registrar may direct that local registrars institute proceedings or civil actions in the name of the State department. Such a proceeding or action may be instituted in any court of competent jurisdiction.
Except as otherwise specifically provided in this chapter and R.S.37:1-1 et seq., any person who shall:
a. Fail or refuse to furnish correctly any information in the person's possession; or
b. Willfully and knowingly furnish false information affecting any certificate or record required by this chapter; or
c. Willfully alter, otherwise than is provided by R.S.26:8-48 et seq., or willfully or knowingly falsify, any certificate or record established by this chapter; or
d. Fail to fill out and transmit any certificate or record in the manner required by this chapter; or
e. Being a local registrar, deputy registrar, alternate deputy registrar or subregistrar, shall fail to perform the person's duty as required by this chapter and by the directions of the State registrar thereunder; or
f. Violate any of the provisions of this chapter or fail to discharge any duty required by this chapter-
Shall be subject to a penalty of not less than $100 nor more than $250 for each first offense and not less than $250 nor more than $500 for each subsequent offense.
The penalties shall be recovered in a civil action in the name of the Department of Health or local board in any court of competent jurisdiction.
The Superior Court or municipal court shall have jurisdiction over proceedings to enforce and collect any such penalty, if the violation has occurred within the territorial jurisdiction of the court. The proceedings shall be summary and in accordance with the "Penalty Enforcement Law of 1999," P.L.1999, c.274 (C.2A:58-10 et seq.).
Notwithstanding the provisions of this section to the contrary, the State registrar may refer a violation of this chapter by a physician, nurse, or funeral director who is licensed pursuant to Title 45 of the Revised Statutes to the appropriate professional board in the Division of Consumer Affairs in the Department of Law and Public Safety, which shall, in accordance with the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.), assess the penalty provided for in this subsection and assume enforcement responsibility on the same basis as it would for a violation of the statute or regulations governing the practice of those persons regulated by that board.
a. There are a significant number of individuals in this State who choose to live together in important personal, emotional and economic committed relationships with another individual;
b. These familial relationships, which are known as domestic partnerships, assist the State by their establishment of a private network of support for the financial, physical and emotional health of their participants;
c. Because of the material and other support that these familial relationships provide to their participants, the Legislature believes that these mutually supportive relationships should be formally recognized by statute, and that certain rights and benefits should be made available to individuals participating in them, including: statutory protection against various forms of discrimination against domestic partners; certain visitation and decision-making rights in a health care setting; and certain tax-related benefits; and, in some cases, health and pension benefits that are provided in the same manner as for spouses;
d All persons in domestic partnerships should be entitled to certain rights and benefits that are accorded to married couples under the laws of New Jersey, including: statutory protection through the "Law Against Discrimination," P.L.1945, c.169 (C.10:5-1 et seq.) against various forms of discrimination based on domestic partnership status, such as employment, housing and credit discrimination; visitation rights for a hospitalized domestic partner and the right to make medical or legal decisions for an incapacitated partner; and an additional exemption from the personal income tax and the transfer inheritance tax on the same basis as a spouse. The need for all persons who are in domestic partnerships, regardless of their sex, to have access to these rights and benefits is paramount in view of their essential relationship to any reasonable conception of basic human dignity and autonomy, and the extent to which they will play an integral role in enabling these persons to enjoy their familial relationships as domestic partners and to cope with adversity when a medical emergency arises that affects a domestic partnership, as was painfully but graphically illustrated on a large scale in the aftermath of the tragic events that befell the people of our State and region on September 11, 2001;
e. The Legislature, however, discerns a clear and rational basis for making certain health and pension benefits available to dependent domestic partners only in the case of domestic partnerships in which both persons are of the same sex and are therefore unable to enter into a marriage with each other that is recognized by New Jersey law, unlike persons of the opposite sex who are in a domestic partnership but have the right to enter into a marriage that is recognized by State law and thereby have access to these health and pension benefits; and
f. Therefore, it is the public policy of this State to hereby establish and define the rights and responsibilities of domestic partners.
"Affidavit of Domestic Partnership" means an affidavit that sets forth each party's name and age, the parties' common mailing address, and a statement that, at the time the affidavit is signed, both parties meet the requirements of this act for entering into a domestic partnership and wish to enter into a domestic partnership with each other.
"Basic living expenses" means the cost of basic food and shelter, and any other cost, including, but not limited to, the cost of health care, if some or all of the cost is paid as a benefit because a person is another person's domestic partner.
"Certificate of Domestic Partnership" means a certificate that includes: the full names of the domestic partners, a statement that the two individuals are members of a registered domestic partnership recognized by the State of New Jersey, the date that the domestic partnership was entered into, and a statement that the partners are entitled to all the rights, privileges and responsibilities accorded to domestic partners under the law. The certificate shall bear the seal of the State of New Jersey.
"Commissioner" means the Commissioner of Health.
"Domestic partner" or "partner" means a person who is in a relationship that satisfies the definition of a domestic partnership as set forth in this act.
"Have a common residence" means that two persons share the same place to live in this State, or share the same place to live in another jurisdiction when at least one of the persons is a member of a State-administered retirement system, regardless of whether or not: the legal right to possess the place is in both of their names; one or both persons have additional places to live; or one person temporarily leaves the shared place of residence to reside elsewhere, on either a short-term or long-term basis, for reasons that include, but are not limited to, medical care, incarceration, education, a sabbatical, or employment, but intends to return to the shared place of residence.
"Jointly responsible" means that each domestic partner agrees to provide for the other partner's basic living expenses if the other partner is unable to provide for himself.
"Notice of Rights and Obligations of Domestic Partners" means a form that advises domestic partners, or persons seeking to become domestic partners, of the procedural requirements for establishing, maintaining, and terminating a domestic partnership, and includes information about the rights and responsibilities of the partners.
b. A domestic partnership shall be established when all of the following requirements are met:
(1) Both persons have a common residence and are otherwise jointly responsible for each other's common welfare as evidenced by joint financial arrangements or joint ownership of real or personal property, which shall be demonstrated by at least one of the following:
(a) a joint deed, mortgage agreement or lease;
(b) a joint bank account;
(c) designation of one of the persons as a primary beneficiary in the other person's will;
(d) designation of one of the persons as a primary beneficiary in the other person's life insurance policy or retirement plan; or
(e) joint ownership of a motor vehicle;
(2) Both persons agree to be jointly responsible for each other's basic living expenses during the domestic partnership;
(3) Neither person is in a marriage recognized by New Jersey law or a member of another domestic partnership;
(4) Neither person is related to the other by blood or affinity up to and including the fourth degree of consanguinity;
(5) Both persons are of the same sex and therefore unable to enter into a marriage with each other that is recognized by New Jersey law, except that two persons who are each 62 years of age or older and not of the same sex may establish a domestic partnership if they meet the requirements set forth in this section;
(6) Both persons have chosen to share each other's lives in a committed relationship of mutual caring;
(7) Both persons are at least 18 years of age;
(8) Both persons file jointly an Affidavit of Domestic Partnership; and
(9) Neither person has been a partner in a domestic partnership that was terminated less than 180 days prior to the filing of the current Affidavit of Domestic Partnership, except that this prohibition shall not apply if one of the partners died; and, in all cases in which a person registered a prior domestic partnership, the domestic partnership shall have been terminated in accordance with the provisions of section 10 of P.L.2003, c.246 (C.26:8A-10).
c. A person who executes an Affidavit of Domestic Partnership in violation of the provisions of subsection b. of this section shall be liable to a civil penalty in an amount not to exceed $1,000. The penalty shall be sued for and collected pursuant to the "Penalty Enforcement Law of 1999," P.L.1999, c.274 (C.2A:58-10 et seq.).
b. Failure to provide notice to a third party, as required pursuant to this section, shall not delay or prevent the termination of the domestic partnership.
b. Upon the termination of a domestic partnership, the domestic partners, from that time forward, shall incur none of the obligations to each other as domestic partners that are created by this or any other act.
c. A domestic partnership, civil union or reciprocal beneficiary relationship entered into outside of this State, which is valid under the laws of the jurisdiction under which the partnership was created, shall be valid in this State.
d. Any health care or social services provider, employer, operator of a place of public accommodation, property owner or administrator, or other individual or entity may treat a person as a member of a domestic partnership, notwithstanding the absence of an Affidavit of Domestic Partnership filed pursuant to this act.
e. Domestic partners may modify the rights and obligations to each other that are granted by this act in any valid contract between themselves, except for the requirements for a domestic partnership as set forth in section 4 of P.L.2003, c.246 (C.26:8A-4).
f. Two adults who have not filed an Affidavit of Domestic Partnership shall be treated as domestic partners in an emergency medical situation for the purposes of allowing one adult to accompany the other adult who is ill or injured while the latter is being transported to a hospital, or to visit the other adult who is a hospital patient, on the same basis as a member of the latter's immediate family, if both persons, or one of the persons in the event that the other person is legally or medically incapacitated, advise the emergency care provider that the two persons have met the other requirements for establishing a domestic partnership as set forth in section 4 of P.L.2003, c.246 (C.26:8A-4); however, the provisions of this section shall not be construed to permit the two adults to be treated as domestic partners for any other purpose as provided in P.L.2003, c.246 (C.26:8A-1 et al.) prior to their having filed an Affidavit of Domestic Partnership.
g. A domestic partner shall not be liable for the debts of the other partner contracted before establishment of the domestic partnership, or contracted by the other partner in his own name during the domestic partnership. The partner who contracts for the debt in his own name shall be liable to be sued separately in his own name, and any property belonging to that partner shall be liable to satisfy that debt in the same manner as if the partner had not entered into a domestic partnership.
(1) blank forms, in quadruplicate, of Affidavits of Domestic Partnership and Certificates of Domestic Partnership corresponding to the requirements of this act; and
(2) copies of the Notice of the Rights and Obligations of Domestic Partners.
b. The commissioner shall ensure that these forms and notices, along with such sections of the laws concerning domestic partnership and explanations thereof as the commissioner may deem useful to persons having duties to recognize domestic partners under those laws, are printed and supplied to each local registrar, and made available to the public upon request.
(1) stamp each completed Affidavit of Domestic Partnership received with the date of its receipt and the name of the registration district in which it is filed; and
(2) immediately provide two copies of the stamped Affidavit of Domestic Partnership to the person who files that document.
b. Upon the filing of an Affidavit of Domestic Partnership and payment of the appropriate filing fee, the local registrar shall immediately complete a Certificate of Domestic Partnership with the domestic partners' relevant information and the date that the domestic partnership was established. The local registrar shall then issue to the domestic partners two copies of the certificate and two copies of the Notice of the Rights and Obligations of Domestic Partners. Copies of the Certificate of Domestic Partnership shall be prepared and recorded in the local registrar's records and with the State registrar.
c. Each local registrar shall, on or before the 10th day of each calendar month, or sooner if requested by the Department of Health and Senior Services, transmit to the State registrar the original of all the Affidavits of Domestic Partnership and Certificates of Domestic Partnership received or prepared by the local registrar for the preceding month.
(2) The termination of a domestic partnership may be adjudged for the following causes:
(a) voluntary sexual intercourse between a person who is in a domestic partnership and an individual other than the person's domestic partner as defined in section 3 of P.L.2003, c.246 (C.26:8A-3);
(b) willful and continued desertion for a period of 12 or more consecutive months, which may be established by satisfactory proof that the parties have ceased to cohabit as domestic partners;
(c) extreme cruelty, which is defined as including any physical or mental cruelty that endangers the safety or health of the plaintiff or makes it improper or unreasonable to expect the plaintiff to continue to cohabit with the defendant; except that no complaint for termination shall be filed until after three months from the date of the last act of cruelty complained of in the complaint, but this provision shall not be held to apply to any counterclaim;
(d) separation, provided that the domestic partners have lived separate and apart in different habitations for a period of at least 18 or more consecutive months and there is no reasonable prospect of reconciliation; and provided further that, after the 18-month period, there shall be a presumption that there is no reasonable prospect of reconciliation;
(e) voluntarily induced addiction or habituation to any narcotic drug, as defined in the "New Jersey Controlled Dangerous Substances Act," P.L.1970, c. 226 (C.24:21-2) or the "Comprehensive Drug Reform Act of 1987," N.J.S.2C:35-1 et al., or habitual drunkenness for a period of 12 or more consecutive months subsequent to establishment of the domestic partnership and next preceding the filing of the complaint;
(f) institutionalization for mental illness for a period of 24 or more consecutive months subsequent to establishment of the domestic partnership and next preceding the filing of the complaint; or
(g) imprisonment of the defendant for 18 or more consecutive months after establishment of the domestic partnership, provided that where the action is not commenced until after the defendant's release, the parties have not resumed cohabitation following the imprisonment.
(3) In all such proceedings, the court shall in no event be required to effect an equitable distribution of property, either real or personal, which was legally and beneficially acquired by both domestic partners or either domestic partner during the domestic partnership.
(4) The court shall notify the State registrar of the termination of a domestic partnership pursuant to this subsection.
b. In the case of two persons who are each 62 years of age or older and not of the same sex and have established a domestic partnership pursuant to section 4 of P.L.2003, c.246 (C.26:8A-4), the domestic partnership shall be deemed terminated if the two persons enter into a marriage with each other that is recognized by New Jersey law.
c. The State registrar shall revise the records of domestic partnership provided for in section 9 of P.L.2003, c.246 (C.26:8A-9) to reflect the termination of a domestic partnership pursuant to this section.
b. Notwithstanding any other provisions of law to the contrary, the provisions of subsection a. of this section shall not be deemed to be an unlawful discrimination under the "Law Against Discrimination," P.L.1945, c.169 (C.10:5-1 et seq.).
b. The Commissioner of Banking and Insurance, pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.), shall adopt rules and regulations to effectuate the purposes of sections 47 through 52, 55 and 56 of this act.
c. The New Jersey Individual Health Coverage Program Board, pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.), shall adopt rules and regulations to effectuate the purposes of section 53 of this act.
d. The New Jersey Small Employer Health Benefits Program Board, pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.), shall adopt rules and regulations to effectuate the purposes of section 54 of this act.
As used in this chapter:
"Director" means the director of the state experiment station.
"Commission", "county commission", or "county mosquito commission" means the county mosquito extermination commission.
The director of the state experiment station, or an executive officer appointed by him, shall:
a. Survey, in the order he deems desirable and to the extent that he deems necessary, all salt marsh, fresh-water swamps, or flooded areas within the state for the location of mosquito breeding areas;
b. Map each section so surveyed and indicate all mosquito breeding areas, the method adapted to their extermination, and the probable cost;
c. Investigate the mosquito life history, habits, and control, as will, in his judgment, furnish information necessary to successful mosquito extermination by any agency within the state; and
d. Distribute among the people of the state information concerning the nature and results of mosquito extermination.
The director, or his executive officer, shall survey, at the request of the local board of health or the county mosquito commission, any territory suspected of breeding mosquitoes, within the jurisdiction of such board or commission.
The director shall prepare a map of such suspected area, locating upon it such mosquito breeding areas as have been discovered, and shall report the same to the local board of health or county mosquito commission requesting the survey.
A request for such survey may be made by the local board, or the county commission, upon its own motion, and must be made upon the petition, in writing, of ten or more freeholders residing within the jurisdiction of such board or commission.
Whenever, in the course of a survey, it is found that mosquitoes breed at any place within the state, the director through his executive officer, shall notify in writing the local board or the county commission, by personal service upon an officer or member thereof, of the extent and location of such place, and furnish a map indicating the character of the work to be done and its probable cost.
The local board or the county commission shall, within twenty days from the time such notice is served, investigate the ownership, so far as ascertainable, of the territory on which the breeding places occur, and notify the owner of such lands, if he can be found or ascertained, in the manner provided in section 26:3-49 of this title, to abate such breeding place.
The notice to the landowner shall include:
a. The facts contained in the communication from the director;
b. A statement that any water in which mosquito larvae breed is a nuisance and subject to abatement under article 3 of chapter 3 of this title (s. 26:3-45 et seq.); and
c. An order that unless the nuisance is abated within a stated period, not more than sixty days from the date of the notice, the same will be abated as provided in said article 3 of chapter 3 of this title.
In case the landowner fails to comply with such order, the local board or county commission shall abate such nuisance in the manner provided in article 3 of chapter 3 of this title (s. 26:3-45 et seq.).
The commission shall have all the powers of a local board in so far as the same pertain to a mosquito breeding nuisance artificially created and water in which mosquito larvae breed, but such power shall not extend over any lands owned by a municipality, county, or the state. The powers granted by this article shall not be construed as to limit the powers conferred on county mosquito extermination commissions by sections 26:9-13 to 26:9-26 of this title.
The director of the state experiment station may expend annually for mosquito extermination such amount of money as may be appropriated by the legislature.
All moneys so appropriated shall be paid out by the state comptroller upon the certificates of the director that the conditions and requirements of this article have been complied with.
The state comptroller shall draw his warrant in payment of all bills approved by the director and the state treasurer shall pay all warrants so drawn to the extent of the amount appropriated.
The director may, if in his judgment public interests will be served, set aside out of the moneys appropriated for such purposes such an amount as may be necessary to abate the mosquito breeding areas found in any municipality. In such case, payment shall be made to the contractor upon a statement by the person in charge of the work, attested by the director, showing the amount due and that the work has been completed in accordance with the specifications of the contract.
The amount annually appropriated as State aid for mosquito extermination and control in counties bordering on the Atlantic ocean to the State Department of Health shall be used by the State Commissioner of Health in airplane spraying for mosquito extermination in each of such counties in accordance with the health needs of the respective counties as determined by the State Commissioner of Health, said work to be done in conjunction with the work of the Mosquito Extermination Commission in said county.
This act shall take effect July first, one thousand nine hundred and forty-nine.
There is hereby created in the Department of Environmental Protection a permanent commission to be known as the State Mosquito Control Commission, which shall consist of 10 members, six of whom shall be appointed by the Governor with the advice and consent of the Senate and four of whom shall be the Commissioner of the Department of Environmental Protection, the Commissioner of the Department of Health, the Secretary of Agriculture, or their designated representatives, and the Director of the New Jersey State Agricultural Experiment Station, ex officio.
The appointed members of the commission shall serve for terms of 4 years, except that of the first appointed members of the commission 1 shall be appointed for a term of 1 year, 1 for a term of 2 years, and 2 for terms of 3 years. Vacancies in the membership of the commission shall be filled in the same manner as the appointments were made but for the unexpired terms only. All members of the commission shall serve without compensation but shall be reimbursed for all expenses incurred in connection with the commission's work.
The commission shall meet at the call of the Director of the New Jersey State Agricultural Experiment Station and shall organize as soon as may be after the appointment of its members and shall select a chairman from among its members and a secretary who need not be a member of the commission.
It shall be the duty of the commission to carry on a continuous study of mosquito control and extermination in the State, to recommend to the Governor and the Legislature, from time to time, changes in legislation which in its judgment may be necessary or desirable to be enacted in order to enforce and carry out mosquito extermination and control work throughout the State, to recommend to the Legislature the amount of money which in its judgment it shall deem necessary and desirable to be appropriated each year by the State for mosquito control purposes and to allocate funds appropriated for State aid to counties in the performance of such work among the various counties through the New Jersey State Agricultural Experiment Station, to act in an advisory capacity in all matters pertaining to mosquito extermination and control and to co-operate with the agencies of other States and the Federal Government in the elimination of mosquito breeding areas under their control.
The commission shall have power to call to the attention of the director any mosquito breeding places in the State which may come to its attention and in cases in which any recommendations made by the experiment station to abate mosquito breeding places in any particular areas of the State are being disregarded, to call to his attention the fact that the same are being disregarded and to order him to take such measures as will cause abatement of said mosquito breeding places or compliance with his recommendations as are provided by law.
The New Jersey State Agricultural Experiment Station and the several county mosquito extermination commissions shall cooperate with the commission in the furnishing of information and the performance of any services which may be requested of them by the commission in the carrying out of the purposes of this act.
The commission may meet and hold hearings at such place or places as it shall designate from time to time and shall report annually its findings and recommendations to the Governor and the Legislature, accompanying the same with any legislative bills which it may desire to recommend for adoption by the Legislature.
The board of chosen freeholders of each county shall appoint a board of commissioners to be known as "the (here insert name of county) county mosquito extermination commission" for the county.
The members of the county mosquito extermination commissions of the several counties, in office when this act takes effect, shall continue in office until the expiration of their respective terms of office.
Each county mosquito extermination commission shall be composed of six members in addition to the Director of the State Experiment Station and the Commissioner of Health, who shall be ex-officio members and who shall cooperate with them for the effective carrying out of their plans and work. At least three of the appointive members shall be persons who are or have been members or employees of boards of health, and one appointive member shall be a member of the board of chosen freeholders of the county.
Notwithstanding the provisions of any other law, a county mosquito extermination commission shall be composed of the members appointed pursuant to R.S. 26:9-14 plus one additional member appointed for a term of 3 years.
The commissioners first appointed in any county shall hold office respectively for a term of one, two, and three years, as fixed in the order of appointment; thereafter, each commissioner who succeeds an original appointee shall be appointed for a term of three years.
Any vacancy occurring in the membership of the commission shall be filled in the same manner as an original appointment and for the unexpired term only.
Each appointive commissioner, before entering upon the duties of his office, shall take and subscribe an oath, before the clerk of the county in and for which he is appointed, to perform faithfully and impartially the duties of his office. The oath shall be filed with such clerk.
No member of the commission while sitting as such shall receive any compensation except for necessary expenses for actual attendance on meetings.
The commission shall choose annually from among its members a president and treasurer, appoint a clerk or secretary and such other officers and employees as it may deem necessary, but it shall not employ any of its own members. The commission shall also make rules and regulations governing the duties and compensation of its employees.
The board of freeholders of the county shall provide the commission with a suitable office where its maps, plans, documents, records, and accounts shall be kept, subject to public inspection at such times and under such reasonable regulations as the commission may determine.
The commission shall constitute a body politic, with power:
a. To sue and be sued;
b. To use a common seal;
c. To make by-laws; and
d. To perform all acts which in its opinion may be necessary for the elimination of mosquito breeding areas, or which will tend to exterminate mosquitoes within the county.
The commission shall, on or before the first of November in each year, file with the director a detailed estimate of the moneys required for the ensuing year, and a plan of the work to be done. The director shall approve or modify such estimate and plan, and when finally approved by him shall forward them, on or before the first of December each year, to the board of freeholders of the county.
The board of freeholders of the county or other body having control of the finances thereof, shall include annually in the tax levy the amount of money needed for mosquito control; but in no year shall the amount so raised exceed the following amounts:
a. In counties where the assessed valuations are not more than $25,000,000.00, a sum not greater than one mill on every dollar of assessed valuations.
b. In counties where the assessed valuations are not more than $50,000,000.00, a sum not more than one-half of one mill on every dollar of assessed valuations.
c. In counties in which the assessed valuations are in excess of $50,000,000.00, a sum of not more than one-quarter of one mill on every dollar of assessed valuations.
The commission may draw the money so appropriated on requisition duly signed and approved by its president and secretary.
The commission shall, on or before the first of November in each year, submit to the director and to the board of freeholders a report setting forth the amount of moneys expended during the previous year, the methods employed, the work accomplished, and any other information which in its judgment may seem pertinent.
Nothing in sections 26:9-13 to 26:9-25 of this title shall be construed to alter, amend, modify or repeal the provisions of article 1 of this chapter (s. 26:9-1 et seq.), or to alter, amend, modify or repeal any law conferring upon the state department or local boards of health any powers or duties in connection with the extermination of mosquitoes, but shall be construed to be supplementary thereto.
The board of freeholders in any county may:
a. Eliminate all breeding places of mosquitoes within the county;
b. Adopt and execute such plans as in its judgment will tend to exterminate mosquitoes; and
c. Purchase such material and equipment as may be necessary or proper for said purpose.
When the board of freeholders of any county, by resolution approved by a majority of the members of the board, shall declare that it is expedient or necessary to eliminate breeding places of mosquitoes within the county, the board may issue bonds, in the corporate name and under the corporate seal of the county, to provide moneys for such work. Such bond issue shall not exceed three hundred thousand dollars.
Any such bonds shall be issued under and in accordance with the provisions of article 1 of chapter 1 of the title Municipalities and Counties (s. 40:1-1 et seq.).
The board of freeholders of any county in which there is a county mosquito extermination commission may authorize, designate, and employ such commission to submit plans and to perform the work and furnish the material which, in the judgment of the board, may exterminate mosquitoes or eliminate their breeding places.
Nothing in sections 26:9-27 to 26:9-30 of this title shall be construed to alter, amend, modify or repeal the provisions of sections 26:9-13 to 26:9-26 of this title.
No cotton, wool or other material which has been used in, or has formed part of, any mattress, bed spring, cot, lounge, or sofa used in or about a public or private hospital, or about any person having a contagious or infectious disease shall be used, in whole or in part, in the manufacture of any bed spring, cot, lounge or sofa.
No bed spring, cot, lounge, or sofa which is not labeled as provided in sections 26:10-3 and 26:10-4 of this title, or which is falsely labeled, shall be sold, or offered for sale, delivered, or held in possession with intent to sell or deliver.
The label required by R.S.26:10-2 shall:
a. If the materials used in the manufacture of the article to which it is to be attached are entirely new, contain the following statement:
"The materials used in the manufacture of this bed spring" (or other article as the case may be) "are entirely new".
b. If the materials used are in whole or in part secondhand, the label shall be yellow in color, and shall contain the following statement:
"The materials used in the manufacture of this bed spring" (or other article as the case may be) "are in whole or in part secondhand"; which statement must be followed by a specific enumeration and description of the secondhand materials used.
The term "secondhand" as here used shall include any material which has been used before in any of the articles above enumerated or in any article of household or wearing apparel, however afterwards treated.
The label shall be in the form of a cloth tag, not less than two and one-half by three inches, which shall be sewed or otherwise securely attached to the article. The statements required by section 26:10-3 of this title shall be in plain print, in the English language, and in large type.
Any person violating any of the provisions of this article shall be guilty of a misdemeanor.
The term "mattress" as used in this article shall be construed to mean any quilted pad, mattress, mattress pad, bunk quilt, or cushion stuffed or filled with wool, hair, or other soft material, except feathers, to be used on a couch or other bed for sleeping or reclining purposes.
The term "box spring" as used in this article shall be construed to mean any bed base, typically consisting of a wooden frame, covered in cloth and containing springs.
No person shall use in the making, remaking, or renovating of any mattress:
a. Any material of any kind that has been used in, or has formed a part of, any mattress, bed spring, cot, lounge, or sofa, used in or about a public or private hospital or for or about any person having a contagious or infectious disease;
b. Any material known as "shoddy", and made in whole or in part from old or worn clothing, carpets or other fabric, or material previously used, or any other fabric or material from which shoddy is constructed; or
c. Any material, not otherwise prohibited by this article, of which prior use has been made, unless the material has been thoroughly sterilized and disinfected by a reasonable process approved by the state department.
No person shall sell, lease, offer to sell, lease or deliver, or consign in sale or lease, or have in his possession with intent to sell, lease, deliver, or consign in sale or lease:
a. Any mattress that has been used for or about any person having a contagious or infectious disease;
b. Any mattress made, remade, or renovated in violation of section 26:10-7 of this title; or
c. Any mattress, not otherwise prohibited by this article, of which prior use has been made, unless since last used it has been thoroughly sterilized and disinfected by a reasonable process approved by the state department.
No person shall, directly or indirectly, at wholesale or retail, or otherwise, sell, lease, offer to sell or lease, or consign in sale or lease, or have in possession with intent to sell or lease, or consign in sale or lease, any mattress that shall not have plainly and indelibly written or printed thereon, or upon a plain muslin or linen label securely sewed to the covering thereof, a statement in the English language containing the items required by R.S.26:10-10 to R.S.26:10-12. This label shall not be less than three by four and a half inches in size and shall be yellow in color if the label is for a mattress which was used in whole or in part or contains any material which was used prior to any sale, lease, or consignment.
The label provided for in section 26:10-9 of this title shall contain the items specified below and be in substantially the following form:
"Official Statement
Material used in filling
Made by
Address
Vendor (or successive vendors)
Address
This article is made in compliance with article 2 of chapter 10 of the title Health and Vital Statistics of the Revised Statutes (s. 26:10-6 et seq.)."
In addition to the requirements of section 26:10-10 of this title every mattress made from new material or from secondhand material, in whole or in part, shall have printed on the label in the manner prescribed therein the following:
"The materials used in the manufacture of this mattress are entirely new (or in whole or in part secondhand, as the case may be)."
In addition to the requirements of R.S.26:10-10, every secondhand mattress and box spring shall have printed on the yellow label in the manner prescribed in R.S.26:10-10 the following:
a. Date of sterilization and disinfection for bedbugs and other contaminants.
b. Name of person performing same.
c. Address of person performing same.
No information other than that specified in this article shall be contained in the statement on the label.
The word "felt", or words of like import, shall not be used in the description of materials on the label if there has been used in filling the mattress any material which is not felted and filled in layers, unless the statement shall plainly set forth all the different materials so used.
The description on the label shall not contain any term or designation which is misleading or likely to mislead.
No person shall remove, deface, alter, or in any manner attempt the same, or shall cause to be removed, defaced, or altered, any label placed upon any mattress in accordance with the provisions of this article.
The unit for a separate and distinct offense in violation of this article shall be each and every mattress and box spring made, remade, renovated, sold, offered for sale, delivered, consigned, or possessed with intent to sell, deliver or consign, contrary to the provisions of this article.
Any person violating any of the provisions of this article shall be liable to a penalty of not more than one hundred dollars ($100.00) for each offense, to be recovered in a civil action before the Superior Court or a municipal court; provided, the violation occurs within the territorial jurisdiction of the court.
a. Bedbugs are small insects with flat bodies, antennae and small eyes; adult bedbugs are oval, wingless and rusty-red in color and are visible to the naked eye, and often hide in cracks and crevices; in homes, bedbugs are commonly found in areas where people sleep, concentrating in mattresses, box springs, and bed frames; bedbugs feed primarily on the blood of humans, usually at night when people are sleeping;
b. According to a joint statement issued by the United States Centers for Disease Control and Prevention and the United States Environmental Protection Agency, bedbugs have been common throughout United States history; although bedbug populations dropped dramatically during the mid-20th century, the United States is one of many countries now experiencing an alarming resurgence in the population of bedbugs, and public health agencies across the country have been overwhelmed by complaints about bedbugs;
c. According to the New Jersey Department of Health, in most cases, bedbugs are transported from infested areas to non-infested areas when they cling onto a person's clothing, or crawl into luggage, furniture, or bedding that is then brought into the home; if a mattress is contaminated with bedbugs, it is easy for bedbugs to spread to non-contaminated items that are within close proximity;
d. Although bedbugs are not known to transmit disease, they are considered to be an extreme nuisance to the general public and can cause a variety of negative physical and mental health concerns and economic consequences; and
e. To help curtail widespread infestation of bedbugs, it is necessary to take measures to prevent cross-contamination of bedbugs from used mattresses and box springs to other furniture or bedding.
b. No person shall sell a used mattress or box spring unless that mattress or box spring has been cleaned and disinfected using a reasonable process approved by the Commissioner of Health.
This act shall be known and may be cited as the "New Jersey Youth Camp Safety Act."
It is the purpose of this act to promote, protect and safeguard the health and well-being of the youth of the State attending day camps and resident camps by providing for establishment of standards for the safe operation of such camps, thereby providing assurance to parents and interested citizens that youth camps meet minimum safety standards.
As used in this act:
a. "Youth camp" means any parcel or parcels of land having the general characteristics and features of a camp as the term is generally understood, used wholly or in part for recreational or educational purposes and accommodating five or more children under 18 years of age for a period of, or portions of, 2 days or more, and includes a site that is operated as a day camp or as a resident camp, except that a day program which offers only a minimal recreational component shall not be considered a youth camp; however, no such program shall include any hazardous recreational activity such as but not limited to aquatics, archery, horseback riding and riflery without first obtaining the prior written approval of the Department of Health. Failure to obtain such approval or comply with the regulations established for the activity involved shall subject the program to penalties in accordance with sections 10 and 11 of P.L.1973, c. 375 (C. 26:12-10 and 26:12-11).
b. "Youth camp safety standards" means criteria directed toward safe operations of youth camps, in such areas as, but not limited to, personnel qualifications for director and staff, ratio of staff to campers, sanitation and public health, personal health, first aid and medical services, food handling, mass feeding and cleanliness, water supply and waste disposal, water safety including use of lakes and rivers, swimming and boating equipment and practices, vehicle condition and operation, building and site design, equipment, condition and density of use, emergency evacuation procedures and fire safety.
c. "Youth camp operator" means any private agency, organization, or person, and any individual, who operates, controls or supervises a youth camp, whether such camp is operated for profit or not for profit.
d. "Commissioner" means the Commissioner of Health or any of his authorized deputies, representatives, agents or employees.
Every youth camp operator shall provide to each camper safe and healthful conditions, facilities and equipment which are free from hazards that are causing, or may reasonably be expected to cause, death, serious illness, or serious physical harm, as well as adequate and qualified instruction and supervision at all times, wherever or however such camp activities are conducted and with due consideration of conditions existing in nature.
The commissioner shall develop, and shall by rule and regulation promulgate, modify or revoke youth camp safety standards. In developing such standards, the commissioner shall consult with other State and local officials and with representatives of appropriate public and private organizations, and shall consider existing State and local regulations and standards and standards developed by private organizations which are applicable to youth camp health and safety. The commissioner shall make the initial promulgation of standards required by this act within 6 months of the effective date of this act.
No youth camp which is now or hereafter shall be established shall be operated or conducted, except by authority of a valid certificate of approval issued by the commissioner under the rules and regulations prescribed by him. Application for the issuance or renewal of certificate shall be made upon a form prescribed by the commissioner, shall set forth the location of the camp and the operator thereof, and shall be accompanied by a fee to be set in the discretion of the commissioner but not to exceed $50.00 for day camps and $100.00 for resident camps which fee shall be returned if the application is denied.
Each certificate of approval shall be valid for a period of 1 year from the date of issue. The commissioner may issue a provisional certificate subject to later approval by the commissioner, after inspection of the youth camp during the period when the camp is operational.
The commissioner shall be responsible for the enforcement of youth camp safety standards in this State and the commissioner is empowered to hold hearings and otherwise to investigate charges of any violation of this act.
a. In order to carry out his duties under this act, the commissioner may enter and inspect any youth camp and its records, may question employees, and may investigate facts, conditions, practices or other matters to the extent he deems it necessary or appropriate.
b. The commissioner shall have the power to administer oaths and examine witnesses under oath, issue subpenas, compel the attendance of witnesses and the production of papers, books, accounts, records, payrolls, documents and testimony and to take depositions and affidavits in any proceeding before the commissioner.
c. To determine the areas in which safety standards are necessary and to aid in promulgating meaningful regulations, camps subject to the provisions of this act shall be required to report annually, on the date prescribed by the commissioner, all accidents resulting in death, injury and illness, other than minor injuries which require only first aid treatment and which do not involve medical treatment, loss of consciousness, restriction of activity or motion, or premature termination of the camper's term at the camp. The commissioner shall compile the statistics reported and include summaries thereof in his annual report to the Governor and the Legislature.
The commissioner, upon notice and hearing, may revoke the certificate of approval and may impose a penalty not exceeding $1,000.00 for any violation of this act or of any rule or regulation duly issued hereunder or order issued pursuant thereto. If any penalty imposed pursuant to this act is not paid, then the penalty shall be sued for and recovered by and in the name of the commissioner in a summary proceeding under the Penalty Enforcement Law (N.J.S.2A:58-1 et seq.). In such summary proceeding, the commissioner need only prove that notice was given, a hearing held, a decision rendered and a penalty imposed which has not been paid.
Where any violation of this act or of any rule or regulation duly issued hereunder is of a continuing nature, each day during which such violation continues after the date fixed by the commissioner in any order or notice for the correction or termination of such violation or each day the camp operates without a valid certificate of approval or continues to operate after notification of revocation of its certificate of approval, shall constitute an additional, separate and distinct violation, except during the time an appeal from said order or notice may be taken or is pending.
Upon a violation of this act or of any rules and regulations promulgated hereunder, the commissioner shall be entitled to institute a civil action in a court of competent jurisdiction for injunctive relief to restrain such violation and for such other relief as the court shall deem proper, and the court may proceed in a summary manner in such action. Neither the institution of such action, nor any of the proceedings therein shall relieve any party to such proceedings from the penalty prescribed for a violation of this act.
The commissioner, upon application by a camp owner showing extraordinary circumstances or undue hardship, and upon the determination by a field inspector, after inspection of the affected premises and facilities, that the conditions, practices, or activities proposed to be used are as safe and healthful as those which would prevail if the camp owner complied with the standard, may exempt such camp or activity from specific requirements of this act, but the terms of such exemption shall require appropriate notice thereof to parents or other relatives of affected campers.
a. The commissioner shall prepare and submit to the Governor and the Legislature at least once during each fiscal year a comprehensive report on the administration of this act, which report may be contained in the general annual report of the department.
b. The commissioner is authorized to request directly from any other department or agency of State Government information, suggestions and other data that may be needed to carry out his functions under this act; and such department or agency is authorized to furnish the information, suggestions or other data requested.
Nothing in this act shall authorize the commissioner or any other official acting under this act to restrict, determine, or influence the curriculum, program or ministry of any youth camp.
Nothing in this act shall be deemed to authorize or require medical examination, immunization or treatment for those who object thereto on religious grounds, except where such is necessary for the protection of the health or safety of others.
a. Insect and food allergies are the leading cause of anaphylaxis, a life-threatening condition that is easily treatable with epinephrine, a medication only available via prescription;
b. Individuals who are known to be at risk of anaphylaxis may carry emergency doses of epinephrine with them at all times. However, many individuals may not be aware of their allergy and therefore do not carry epinephrine medication;
c. New Jersey's youth camps offer a broad array of outdoor educational and recreational opportunities to youth campers, which may expose campers and staff members to various different kinds of insects and foods for the first time;
d. Youth camps are often located in remote settings where medical professionals or first responders are not available to provide emergency care for anaphylaxis;
e. The State of New Jersey, at P.L.1997, c.368 (C.18A:40-12.5 et seq.) and P.L.2013, c.211 (C.18A:61D-11 et seq.), has already recognized the value of training non-medical professionals to administer this life-saving drug in K-12 educational settings and institutions of higher education when a medical professional is not physically present at the scene; and
f. It is prudent to similarly provide youth camp staff members, who are responsible for the safety of one or more campers, with the tools necessary to respond to emergency anaphylaxis situations, particularly where exposure to unfamiliar insects or foods is likely, and where assistance from medical professionals and first responders is not readily available.
"Commissioner" means the Commissioner of Health.
"Member of the youth camp community" means a person who is a camper at, or a staff member of, a youth camp.
"Professionally qualified health care provider" means a licensed health care professional whose authorized scope of practice includes the administration of medication, whether independently, or through a joint protocol or standing order from a physician.
"Trained designee" means a youth camp staff member who has been trained by the youth camp health director or, if the youth camp health director is not professionally qualified to administer epinephrine, by a professionally qualified health care provider, in the detection of anaphylaxis and the emergency administration of epinephrine using a pre-filled auto-injector mechanism.
"Youth camp" means the same as that term is defined by section 3 of P.L.1973, c.375 (C.26:12-3).
"Youth camp health director" means and includes a person, 18 years of age or older, who meets the qualifications required by N.J.A.C.8:25-5.2 and who is responsible for the proper medical recordkeeping, care, and treatment of campers at a youth camp. Youth camps that do not have a health director who is a medical professional may use one of the following options: a youth camp health director trained in the emergency administration of epinephrine via a pre-filled auto-injector mechanism by the professionally qualified health care provider responsible for writing the prescription with documentation; an emergency medical technician certified in emergency epinephrine auto-injector administration; or an individual trained in the detection of anaphylaxis and the emergency administration of epinephrine using a pre-filled auto-injector device.
"Youth camp operator" means the same as that term is defined by section 3 of P.L.1973, c.375 (C.26:12-3).
(1) permit the youth camp health director and trained designees to administer epinephrine via a pre-filled auto-injector mechanism to a member of the youth camp community for whom the youth camp health director or trained designee is responsible, when the youth camp health director or trained designee believes, in good faith, that the member of the youth camp community is having an anaphylactic reaction; and
(2) permit the youth camp health director and trained designees, when responsible for the safety of one or more members of the youth camp community, to carry, in a secure but easily accessible location, a supply of pre-filled epinephrine auto-injectors that is prescribed under a standing protocol from a licensed physician or other authorized prescriber.
b. If a youth camp develops a policy for the emergency administration of epinephrine via a pre-filled auto-injector mechanism, the youth camp operator, in cooperation with the youth camp health director, shall:
(1) maintain and adhere to a standardized training protocol for the emergency administration of epinephrine by trained designees under the youth camp medical program, which training protocol shall be established and administered by a professionally qualified health care provider;
(2) ensure that trained designees have satisfactorily completed the training protocol;
(3) obtain and maintain a supply of pre-filled epinephrine auto-injectors, pursuant to a standing protocol from a licensed physician or other authorized prescriber, for use by the youth camp health director and trained designees in emergency anaphylaxis situations; and
(4) establish protocols and one or more secure locations for the safe and accessible storage of the youth camp's supply of pre-filled epinephrine auto-injectors.
a. permit a trained designee to perform the duties or fill the position of a licensed medical professional;
b. prohibit the administration of a pre-filled epinephrine auto-injector mechanism by a person acting pursuant to a lawful prescription;
c. prevent a licensed and qualified member of a health care profession from administering a pre-filled epinephrine auto-injector mechanism if the duties are consistent with the accepted standards of practice applicable to the member's profession;
d. violate the "Athletic Training Licensure Act," P.L.1984, c.203 (C.45:9-37.35 et seq.) in the event that a licensed athletic trainer administers epinephrine to a member of the youth camp community as a trained designee pursuant to this act; or
e. require written authorization from a camper's parent or guardian, or from any youth camp staff member, prior to the emergency administration of epinephrine when:
(1) there is no identified medical diagnosis involving risk of anaphylaxis on record with the youth camp health director; or
(2) there is a medical diagnosis involving risk of anaphylaxis recorded with the youth camp health director, but the pre-filled epinephrine auto-injector was not provided to the youth camp by the camper or by the camper's parent or authorized guardian.
"Biological agent" means any microorganism, virus, bacterium, rickettsiae, fungus, toxin, infectious substance, or biological product that may be naturally occurring or engineered as a result of biotechnology, or any naturally occurring or bioengineered component of any such microorganism, virus, bacterium, rickettsiae, fungus, infectious substance, or biological product, capable of causing death, disease, or other biological malfunction in a human, an animal, a plant, or another living organism.
"Bioterrorism" means the intentional use or threat of use of any biological agent, to cause death, disease, or other biological malfunction in a human, animal, plant, or other living organism, or degrade the quality and safety of the food, air, or water supply.
"Chemical weapon" means a toxic chemical and its precursors, except where intended for a lawful purpose as long as the type and quantity is consistent with such a purpose. Chemical weapon includes, but is not limited to: nerve agents, choking agents, blood agents, and incapacitating agents.
"Commissioner" means the Commissioner of Health, or the commissioner's designee.
"Contagious disease" means an infectious disease that can be transmitted from person to person.
"Department" means the Department of Health.
"Health care facility" means any non-federal institution, building or agency, or portion thereof whether public or private for profit or nonprofit that is used, operated or designed to provide health services, medical or dental treatment or nursing, rehabilitative, or preventive care to any person. Health care facility includes, but is not limited to: an ambulatory surgical facility, home health agency, hospice, hospital, infirmary, intermediate care facility, dialysis center, long-term care facility, medical assistance facility, mental health center, paid and volunteer emergency medical services, outpatient facility, public health center, rehabilitation facility, residential treatment facility, skilled nursing facility, and adult day care center. Health care facility also includes, but is not limited to, the following related property when used for or in connection with the foregoing: a laboratory, research facility, pharmacy, laundry facility, health personnel training and lodging facility, patient, guest and health personnel food service facility, and the portion of an office or office building used by persons engaged in health care professions or services.
"Health care provider" means any person or entity who provides health care services including, but not limited to: a health care facility, bioanalytical laboratory director, perfusionist, physician, physician assistant, pharmacist, dentist, nurse, paramedic, respiratory care practitioner, medical or laboratory technician, and ambulance and emergency medical workers.
"Infectious disease" means a disease caused by a living organism or other pathogen, including a fungus, bacteria, parasite, protozoan, virus, or prion. An infectious disease may, or may not, be transmissible from person to person, animal to person, or insect to person.
"Isolation" means the physical separation and confinement of an individual or groups of individuals who are infected or reasonably believed to be infected, on the basis of signs, symptoms or laboratory analysis, with a contagious or possibly contagious disease from non-isolated individuals, to prevent or limit the transmission of the disease to non-isolated individuals.
"Local health agency" means a county, regional, municipal, or other governmental agency organized for the purpose of providing health services, administered by a full-time health officer and conducting a public health program pursuant to law.
"Local Information Network and Communications System Agency" or "LINCS agency" means the lead local public health agency in each county or identified city, as designated and determined by the commissioner pursuant to section 21 of this act, responsible for providing central planning, coordination, and delivery of specialized services within the designated county or city, in partnership with the other local health agencies within that jurisdiction, in order to prepare for and respond to acts of bioterrorism and other forms of terrorism or other public health emergencies or threats, and to discharge the activities as specified under this act.
"Microorganism" includes, but is not limited to, bacteria, viruses, fungi, rickettsiae, or protozoa.
"Nuclear or radiological device" means: any nuclear device which is an explosive device designed to cause a nuclear yield; an explosive radiological dispersal device used directly or indirectly to spread radioactive material; or a simple radiological dispersal device which is any act, container or any other device used to release radiological material for use as a weapon.
"Overlap agent or toxin" means: any microorganism or toxin that poses a risk to both human and animal health and includes:
Anthrax - Bacillus anthracis
Botulism - Clostridium botulinum toxin, Botulinum neurotoxins, Botulinum neurotoxin producing species of Clostridium
Plague - Yersinia pestis
Tularemia - Francisella tularensis
Viral Hemorrhagic Fevers - Ebola, Marburg, Lassa, Machupo
Brucellosis- Brucellosis species
Glanders - Burkholderia mallei
Melioidosis - Burkholderia pseudomallei
Psittacosis - Chlamydophila psittaci
Coccidiodomycosis - Coccidiodes immitis
Q Fever - Coxiella burnetii
Typhus Fever - Rickettsia prowazekii
Viral Encephalitis - VEE (Venezuelan equine encephalitis virus), EEE (Eastern equine encephalitis), WEE (Western equine encephalitis)
Toxins - Ricinus communis, Clostridium perfringens, Staph. Aureus, Staphylococcal enterotoxins, T-2 toxin, Shigatoxin
Nipah - Nipah virus
Hantavirus - Hantavirus
West Nile Fever - West Nile virus
Hendra - Hendra virus
Rift Valley Fever - Rift Valley Fever virus
Highly Pathogenic Avian Influenza
"Public health emergency" means an occurrence or imminent threat of an occurrence that:
a. is caused or is reasonably believed to be caused by any of the following: (1) bioterrorism or an accidental release of one or more biological agents; (2) the appearance of a novel or previously controlled or eradicated biological agent; (3) a natural disaster; (4) a chemical attack or accidental release of toxic chemicals; or (5) a nuclear attack or nuclear accident; and
b. poses a high probability of any of the following harms: (1) a large number of deaths, illness, or injury in the affected population; (2) a large number of serious or long-term impairments in the affected population; or (3) exposure to a biological agent or chemical that poses a significant risk of substantial future harm to a large number of people in the affected population.
"Quarantine" means the physical separation and confinement of an individual or groups of individuals, who are or may have been exposed to a contagious or possibly contagious disease and who do not show signs or symptoms of a contagious disease, from non-quarantined individuals, to prevent or limit the transmission of the disease to non-quarantined individuals.
"Toxin" means the toxic material of plants, animals, microorganisms, viruses, fungi, or infectious substances, or a recombinant molecule, whatever its origin or method of production, including:
a. any poisonous substance or biological product that may be engineered as a result of biotechnology or produced by a living organism; or
b. any poisonous isomer or biological product, homolog, or derivative of such a substance.
(1) the nature of the public health emergency;
(2) the geographic area subject to the declaration;
(3) the conditions that have brought about the public health emergency to the extent known; and
(4) the expected duration of the state of public health emergency, if less than 30 days. Such order may also prescribe necessary actions or countermeasures to protect the public's health.
b. Any public health emergency declared pursuant to this act shall be terminated automatically after 30 days unless renewed by the Governor under the same standards and procedures set forth in subsection a. of this section.
c. The commissioner shall coordinate all matters pertaining to the public health response to a public health emergency, and shall have primary jurisdiction, responsibility and authority for:
(1) planning and executing public health emergency assessment, prevention, preparedness, response and recovery for the State;
(2) coordinating public health emergency response between State and local authorities;
(3) collaborating with relevant federal government authorities, elected officials and relevant agencies of other states, private organizations or companies;
(4) coordinating recovery operations and prevention initiatives subsequent to public health emergencies; and
(5) organizing public information activities regarding public health emergency response operations.
All such activities shall be taken in coordination with the State Office of Emergency Management and shall be executed in accordance with the State Emergency Operations Plan. The State Office of Emergency Management shall provide the commissioner with all required assistance.
d. In instances involving an overlap agent or toxin that causes or has the potential to cause a public health emergency, if the Commissioner of Health and Senior Services suspects or detects conditions that could potentially affect animals, plants or crops under the jurisdiction of the Department of Agriculture pursuant to the provisions of Title 4 of the Revised Statutes, he shall immediately notify the Secretary of Agriculture. If the Secretary of Agriculture suspects or detects conditions that could potentially affect humans, he shall immediately notify the commissioner. Information shared by each department shall be held confidential by the departments and their employees and their designees, and shall not be released without the approval of the department that was the source of the information.
e. To the fullest extent practicable, the commissioner shall also promptly notify the elected municipal officials and applicable health care facilities of the jurisdiction affected by the public health emergency of the nature and extent of the emergency.
f. All orders of the commissioner shall remain in effect during the period of the public health emergency until superseded by order of the Governor pursuant to P.L.1942, c.251 (C.App.A:9-33 et seq.). Upon the issuance of an order by the Governor pursuant to P.L.1942, c.251, the commissioner shall coordinate the public health emergency in accordance with the State Emergency Operations Plan. Upon declaration of a disaster pursuant to P.L.1942, c.251, the Governor may exercise the powers granted to the commissioner pursuant to this act.
In instances involving an overlap agent or toxin, the Department of Agriculture shall be the lead agency with respect to surveillance, testing, sampling, detection and investigation related to animals, plants or crops under the jurisdiction of the Department of Agriculture pursuant to the provisions of Title 4 of the Revised Statutes, and shall coordinate its activities with all appropriate local, State and federal agencies.
b. A health care provider or medical examiner shall report to the department and to the local health official all cases of persons who harbor or are suspected of harboring any illness or health condition that may be reasonably believed to be potential causes of a public health emergency. Reportable illnesses and health conditions include, but are not limited to, any illnesses or health conditions identified by the commissioner.
c. In addition to the foregoing requirements for health care providers, a pharmacist shall, at the direction of the commissioner, report:
(1) an unusual increase in the number or type of prescriptions to treat conditions that the commissioner identifies by regulation;
(2) an unusual increase in the number of prescriptions for antibiotics; and
(3) any prescription identified by the commissioner that treats a disease that is relatively uncommon or may be associated with terrorism.
d. The reports shall be made to such State and local officials in accordance with the method and time frame as specified by the commissioner. The reports shall include the specific illness or health condition that is the subject of the report and a case number assigned to the report that is linked to the patient file in possession of the health care provider or medical examiner, along with the name and address of the health care provider or medical examiner. Based on any such report, where the commissioner has reasonable grounds to believe that a public health emergency exists, the health care provider or medical examiner shall provide a supplemental report including the following information: the patient's name, date of birth, sex, race, occupation, current home and work addresses, including city and county, and relevant telephone contact numbers; the name and address of the health care provider or medical examiner and of the reporting individual, if different; designated emergency contact; and any other information needed to locate the patient for follow-up.
e. The provisions of this section shall not be deemed or construed to limit, alter or impair in any way the authority of the Department of Environmental Protection pursuant to "The Radiation Accident Response Act," P.L.1981, c.302 (C. 26:2D-37 et seq.), or of the State Office of Emergency Management in the Division of State Police, Department of Law and Public Safety. Any powers of inspection of buildings and conveyances for sources of radiation that are granted to the commissioner shall only be exercised upon the concurrence of the Commissioner of Environmental Protection.
f. The provisions of this section shall not be deemed or construed to limit, alter or impair in any way the authority of the Department of Agriculture pursuant to its jurisdiction under the laws and policies governing that department.
a. The commissioner shall identify individuals thought to have been exposed to an illness or health condition that may be a potential cause of a public health emergency.
b. The commissioner shall counsel and interview such individuals where needed to assist in the positive identification of exposed individuals and develop information relating to the source and spread of the illness or health condition. The information shall include the name and address, including city and county, of any person from whom the illness or health condition may have been contracted and to whom the illness or health condition may have spread.
The commissioner may require training related to the provision of health care, public health services and support services in an emergency or crisis as a condition of registration.
a. The commissioner may issue identification cards to health care workers, public health workers and support services personnel included in the registry established under this section that:
(1) Identify the health care worker, public health worker or support services personnel;
(2) Indicate that the individual is registered as a New Jersey emergency health care worker, public health worker or support services personnel;
(3) Identify the professional license or certification held by the individual; and
(4) Identify the individual's usual area of practice if that information is available and the commissioner determines that it is appropriate to provide that information.
b. The commissioner shall establish a form for identification cards issued under this section.
c. The commissioner may identify all or part of a health care facility or other location as an emergency health care center. Upon the declaration of a public health emergency, an emergency health care center may be used for:
(1) Evaluation and referral of individuals affected by the emergency or crisis;
(2) Provision of health care services, including vaccination, mass prophylaxis, isolation and quarantine; and
(3) Preparation of patients for transportation.
The commissioner may direct designated LINCS agencies, or their successors, and local public health authorities to identify emergency health care centers under this subsection.
d. In the event the Governor declares a public health emergency, the commissioner may direct health care workers, public health workers and support services personnel registered under this section who are willing to provide health care services on a voluntary basis to proceed to any place in this State where health care services or public health services are required by reason of the public health emergency.
e. An emergency health care worker, public health worker and support services personnel registered under this section may volunteer to perform health care or public health services at any emergency health care center.
f. In the event the Governor declares a public health emergency, the commissioner may waive health care facility medical staff privileging requirements for individuals registered as emergency health care workers, and hospitals shall permit registered emergency health care workers to exercise privileges at the hospital for the duration of the public health emergency.
g. An emergency health care worker, public health worker and support services personnel registered under this section who provides health care services on a voluntary basis shall not be liable for any civil damages as a result of the person's acts or omissions in providing medical care or treatment related to the public health emergency in good faith and in accordance with the provisions of this act.
a. The commissioner, Chief State Medical Examiner, and Commissioner of Environmental Protection shall coordinate and consult with each other on the performance of their respective functions regarding the safe disposition of human remains, to devise and implement measures which may include, but are not limited to, the following:
(1) To take actions or issue and enforce orders to provide for the safe disposition of human remains as may be reasonable and necessary to respond to the public health emergency. Such measures may include, but are not limited to, the temporary mass burial or other interment, cremation, disinterment, transportation, and disposition of human remains. To the extent possible, religious, cultural, family, and individual beliefs of the deceased person or his family shall be considered when determining disposition of any human remains;
(2) To determine whether there is a need to investigate any human deaths related to the public health emergency, and take such steps as may be appropriate to enable the Chief State Medical Examiner, or his designee, to take possession or control of any human remains and perform an autopsy of the body under protocols of the Chief State Medical Examiner consistent with safety as the public health emergency may dictate;
(3) To direct or issue and enforce orders requiring any business or facility, including, but not limited to, a mortuary or funeral director, authorized to hold, embalm, bury, cremate, inter, disinter, transport, and dispose of human remains under the laws of this State to accept any human remains or provide the use of its business or facility if such actions are reasonable and necessary to respond to the public health emergency and are within the safety precaution capabilities of the business or facility; and
(4) To direct or issue and enforce orders requiring that every human remains prior to disposition be clearly labeled with all available information to identify the decedent, which shall include the requirement that any human remains of a deceased person with a contagious disease shall have an external, clearly visible tag indicating that the human remains are infected and, if known, the contagious disease.
b. The person in charge of disposition of any human remains shall maintain a written or electronic record of each human remains and all available information to identify the decedent and the circumstances of death and disposition. If human remains cannot be identified prior to disposition, a person authorized by the Chief State Medical Examiner shall, to the extent possible, take fingerprints and photographs of the human remains, obtain identifying dental information, and collect a DNA specimen, under protocols of the Chief State Medical Examiner consistent with safety as the public health emergency may dictate. All information gathered under this subsection shall be promptly forwarded to the Chief State Medical Examiner, who shall forward relevant information to the commissioner.
c. The commissioner and Chief State Medical Examiner shall coordinate with the appropriate law enforcement agencies in any case where human remains may constitute evidence in a criminal investigation.
a. Facilities. To close, direct and compel the evacuation of, or to decontaminate or cause to be decontaminated, any facility of which there is reasonable cause to believe that it may endanger the public health.
(1) Concurrent with or within 24 hours of decontamination or closure of a facility, the commissioner shall provide the facility with a written order notifying the facility of:
(a) the premises designated for decontamination or closure;
(b) the date and time at which the decontamination or closure will commence;
(c) a statement of the terms and conditions of the decontamination or closure;
(d) a statement of the basis upon which the decontamination or closure is justified; and
(e) the availability of a hearing to contest a closure order of a health care facility, as provided in paragraph (2) of this subsection.
(2) A health care facility subject to a closure order pursuant to this section may request a hearing in the Superior Court to contest the order.
Upon receiving a request for a hearing, the court shall fix a date for a hearing. The hearing shall be held within 72 hours of receipt of the request by the court, excluding Saturdays, Sundays and legal holidays. The court may proceed in a summary manner. At the hearing, the burden of proof shall be on the commissioner to prove by a preponderance of the evidence that the health care facility poses a threat to the public health and the closure order issued by the commissioner is warranted to address the threat.
(3) If, upon a hearing, the court finds that the closure of the health care facility is not warranted, the facility shall be released immediately from the closure order and reopened.
(4) The manner in which the request for a hearing pursuant to this subsection is filed and acted upon shall be in accordance with the Rules of Court.
b. Property. To decontaminate or cause to be decontaminated, or destroy, subject to the payment of reasonable costs as provided for in sections 24 and 25 of this act, any material of which there is reasonable cause to believe that it may endanger the public health.
c. In instances involving an overlap agent or toxin that causes a public health emergency, the department and the Department of Agriculture shall be responsible for their roles under their respective jurisdictions.
a. Use of property and facilities. To procure, by condemnation or otherwise, subject to the payment of reasonable costs as provided for in sections 24 and 25 of this act, construct, lease, transport, store, maintain, renovate or distribute property and facilities as may be reasonable and necessary to respond to the public health emergency, with the right to take immediate possession thereof. Such property and facilities include, but are not limited to, communication devices, carriers, real estate, food and clothing. This authority shall also include the ability to accept and manage those goods and services donated for the purpose of responding to a public health emergency. The authority provided to the commissioner pursuant to this section shall not affect the existing authority or emergency response of other State agencies.
b. Use of health care facilities.
(1) To require, subject to the payment of reasonable costs as provided for in sections 24 and 25 of this act, a health care facility to provide services or the use of its facility if such services or use are reasonable and necessary to respond to the public health emergency, as a condition of licensure, authorization or the ability to continue doing business in the State as a health care facility. After consultation with the management of the health care facility, the commissioner may determine that the use of the facility may include transferring the management and supervision of the facility to the commissioner for a limited or unlimited period of time, but shall not exceed the duration of the public health emergency. In the event of such a transfer, the commissioner shall use the existing management of the health care facility.
(2) Concurrent with or within 24 hours of the transfer of the management and supervision of a health care facility, the commissioner shall provide the facility with a written order notifying the facility of:
(a) the premises designated for transfer;
(b) the date and time at which the transfer will commence;
(c) a statement of the terms and condition of the transfer;
(d) a statement of the basis upon which the transfer is justified; and
(e) the availability of a hearing to contest the order, as provided in paragraph (3) of this subsection.
(3) A health care facility subject to an order to transfer management and supervision to the commissioner pursuant to this section may request a hearing in the Superior Court to contest the order.
(a) Upon receiving a request for a hearing, the court shall fix a date for a hearing. The hearing shall be held within 72 hours of receipt of the request by the court, excluding Saturdays, Sundays and legal holidays. The court may proceed in a summary manner. At the hearing, the burden of proof shall be on the commissioner to prove by a preponderance of the evidence that transfer of the management and supervision of the health care facility is reasonable and necessary to respond to the public health emergency and the order issued by the commissioner is warranted to address the need.
(b) If, upon a hearing, the court finds that the transfer of the management and supervision of the health care facility is not warranted, the facility shall be released immediately from the transfer order.
(c) The manner in which the request for a hearing pursuant to this subsection is filed and acted upon shall be in accordance with the Rules of Court.
(4) A health care facility which provides services or the use of its facility or whose management or supervision is transferred to the commissioner pursuant to this subsection shall not be liable for any civil damages as a result of the commissioner's acts or omissions in providing medical care or treatment or any other services related to the public health emergency.
(5) For the duration of a state of public health emergency, the commissioner shall confer with the Commissioner of Banking and Insurance to request that the Department of Banking and Insurance waive regulations requiring compliance by a health care provider or health care facility with a managed care plan's administrative protocols, including but not limited to, prior authorization and pre-certification.
(6) The commissioner may waive any staffing ratio requirements for any health care facility for the duration of a state of public health emergency.
c. Control of property. To inspect, control, restrict, and regulate by rationing and using quotas, prohibitions on shipments, allocation or other means, the use, sale, dispensing, distribution or transportation of food, clothing and other commodities, as may be reasonable and necessary to respond to the public health emergency.
d. To identify areas that are or may be dangerous to the public health and to recommend to the Governor and the Attorney General that movement of persons within that area be restricted, if such action is reasonable and necessary to respond to the public health emergency.
a. To issue and enforce orders to provide for the safe disposal of infectious waste as may be reasonable and necessary to respond to the public health emergency. Such orders may include, but are not limited to, the collection, storage, handling, destruction, treatment, transportation, and disposal of infectious waste, including specific wastes generated in a home setting or in isolation or quarantine facilities.
b. To require any business or facility authorized to collect, store, handle, destroy, treat, transport and dispose of infectious waste under the laws of this State, and any landfill business or other such property, to accept infectious waste, or provide services or the use of the business, facility or property if such action is reasonable and necessary to respond to the public health emergency, as a condition of licensure, authorization or the ability to continue doing business in the State as such a business or facility. The use of the business, facility or property may include transferring the management and supervision of such business, facility or property to the department for a limited or unlimited period of time, but shall not exceed the duration of the public health emergency.
c. To procure, by condemnation or otherwise, subject to the payment of reasonable costs as provided for in sections 24 and 25 of this act, any business or facility authorized to collect, store, handle, destroy, treat, transport and dispose of infectious waste under the laws of this State and any landfill business or other such property as may be reasonable and necessary to respond to the public health emergency, with the right to take immediate possession thereof.
d. To require that all bags, boxes or other containers for infectious waste shall be clearly identified as containing infectious waste, and if known, the type of infectious waste.
b. If a state of public health emergency results in a Statewide or regional shortage or threatened shortage of any product under subsection a. of this section, the commissioner may issue and enforce orders to control, restrict and regulate by rationing and using quotas, prohibitions on shipments, allocation or other means, the use, sale, dispensing, distribution or transportation of the relevant product necessary to protect the public health, safety and welfare of the people of the State.
c. In making rationing or other supply and distribution decisions, the commissioner may give preference to health care providers, disaster response personnel, mortuary staff and such other persons as the commissioner deems appropriate in order to respond to the public health emergency.
b. Any person subject to an order to submit a specimen or for physical examination may request a hearing in the Superior Court to contest such order. The commissioner shall provide notice of the right to contest the order. The court may proceed in a summary manner. At the hearing, the burden of proof shall be on the commissioner to prove by a preponderance of the evidence that the person poses a threat to the public health and that the order issued by the commissioner is warranted to address such threat.
c. The commissioner may issue and enforce orders for the isolation or quarantine, pursuant to section 15 of this act, of any person whose refusal of medical examination or testing, or the inability to conduct such medical examination or testing due to the reasonable likelihood of serious harm caused to the person thereby, results in uncertainty regarding whether the person has been exposed to or is infected with a contagious or possibly contagious disease or otherwise poses a danger to public health.
a. Require the vaccination of persons as protection against infectious disease and to prevent the spread of a contagious or possibly contagious disease, except as provided in paragraph (3) of this subsection.
(1) Vaccination may be performed by any person authorized to do so under State law.
(2) No vaccine shall be administered without obtaining the informed consent of the person to be vaccinated.
(3) To prevent the spread of a contagious or possibly contagious disease, the commissioner may issue and enforce orders for the isolation or quarantine, pursuant to section 15 of this act, of persons who are unable or unwilling to undergo vaccination pursuant to this section.
b. Require and specify in consultation with and upon the concurrence of the Department of Environmental Protection and the State Office of Emergency Management, the procedures for the decontamination of persons, personal property, property and facilities exposed to or contaminated with biological agents, chemical weapons or release of nuclear or radiological devices.
c. Require, direct, provide, specify or arrange for the treatment of persons exposed to or infected with disease.
(1) Treatment may be administered by any person authorized to do so under State law.
(2) To prevent the spread of a contagious or possibly contagious disease, the commissioner may issue and enforce orders for the isolation or quarantine, pursuant to section 15 of this act, of persons who are unable or unwilling for reasons of health, religion or conscience to undergo treatment pursuant to this section.
a. The commissioner may exercise, for such period as the state of public health emergency exists, the following emergency powers over persons:
(1) to designate, including an individual's home when appropriate, and establish and maintain suitable places of isolation and quarantine;
(2) to issue and enforce orders for the isolation or quarantine of individuals subject to the procedures specified in this section; and
(3) to require isolation or quarantine of any person by the least restrictive means necessary to protect the public health, subject to the other provisions of this section. All reasonable means shall be taken to prevent the transmission of infection among the isolated or quarantined individuals, as well as among the personnel maintaining and caring for individuals in isolation or quarantine.
b. The following standards shall apply for quarantine or isolation.
(1) Persons shall be isolated or quarantined if it is determined by a preponderance of the evidence that the person to be isolated or quarantined poses a risk of transmitting an infectious disease to others. A person's refusal to accept medical examination, vaccination, or treatment pursuant to section 13 or 14 of this act shall constitute prima facie evidence that the person should be quarantined or isolated.
(2) Isolation or quarantine of any person shall be terminated by the commissioner when the person no longer poses a risk of transmitting an infectious disease to others.
c. (1) To the extent possible, the premises in which persons are isolated or quarantined shall be maintained in a safe and hygienic manner, designed to minimize the likelihood of further transmission of infection or other harm to persons subject to isolation or quarantine. Adequate food, clothing, medication, means of communication, other necessities and competent medical care shall be provided.
(2) An isolated person shall be confined separately from a quarantined person, unless otherwise determined by the commissioner.
(3) The health status of isolated and quarantined persons shall be monitored regularly to determine if their status should change. If a quarantined person subsequently becomes infected or is reasonably believed to have become infected with a contagious or possibly contagious disease, the person shall promptly be moved to isolation.
d. (1) A person subject to isolation or quarantine shall obey the commissioner's orders, shall not go beyond the isolation or quarantine premises, and shall not put himself in contact with any person not subject to isolation or quarantine other than a physician or other health care provider, or person authorized to enter the isolation or quarantine premises by the commissioner.
(2) No person, other than a person authorized by the commissioner, may enter the isolation or quarantine premises. Any person entering an isolation or quarantine premises may be isolated or quarantined.
e. (1) Except as provided in paragraph (4) of this subsection, the commissioner shall petition the Superior Court for an order authorizing the isolation or quarantine of a person or groups of persons.
(2) A petition pursuant to paragraph (1) of this subsection shall specify the following:
(a) the identity of the person or group of persons, by name or shared characteristics, subject to isolation or quarantine;
(b) the premises designated for isolation or quarantine;
(c) the date and time at which the commissioner requests isolation or quarantine to commence;
(d) the suspected contagious disease, if known;
(e) a statement of the terms and conditions of isolation and quarantine;
(f) a statement of the basis upon which isolation or quarantine is justified; and
(g) a statement of what effort, if any, has been made to give notice of the hearing to the person or group of persons to be isolated or quarantined, or the reason supporting the claim that notice should not be required.
(3) Except as provided in paragraph (4) of this subsection, before isolating or quarantining a person, the commissioner shall obtain a written order, which may be an ex parte order, from the Superior Court authorizing such action. The order shall be requested as part of a petition filed in compliance with paragraphs (1) and (2) of this subsection. The court shall grant an order upon finding by a preponderance of the evidence that isolation or quarantine is warranted pursuant to the provisions of this section. A copy of the authorizing order shall be provided to the person ordered to be isolated or quarantined, along with notification that the person has a right to a hearing pursuant to paragraph (5) of this subsection.
(4) Notwithstanding the provisions of paragraphs (1) through (3) of this subsection to the contrary, the commissioner may issue a verbal order, to be followed by a written order requiring the immediate, temporary isolation or quarantine of a person or group of persons, including those persons who have entered an isolation or quarantine premises, without first obtaining an order from the court if the commissioner determines that any delay in the isolation or quarantine of the person would significantly jeopardize the ability to prevent or limit the transmission of infectious or possibly infectious disease to others. The commissioner's written order shall specify:
(a) the identity of the person or group of persons, by name or shared characteristics, subject to isolation or quarantine;
(b) the premises designated for isolation or quarantine;
(c) the date and time at which the isolation or quarantine commences;
(d) the suspected contagious disease, if known;
(e) a statement of the terms and conditions of isolation and quarantine;
(f) a statement of the basis upon which isolation or quarantine is justified; and
(g) the availability of a hearing to contest the order.
The commissioner shall provide notice of the order for isolation or quarantine upon the person or group of persons specified in the order. If the commissioner determines that service of the notice required is impractical because of the number of persons or geographical areas affected, or other good cause, the commissioner shall ensure that the affected persons are fully informed of the order using the best possible means available. A copy of the order shall also be posted in a conspicuous place in the isolation or quarantine premises.
Following the issuance of the commissioner's order directing isolation or quarantine, the commissioner shall file a petition pursuant to paragraphs (1) through (3) of this subsection as soon as possible, but not later than 72 hours thereafter.
(5) The court shall grant a hearing within 72 hours of the filing of a petition when a person has been isolated or quarantined pursuant to paragraph (3) or (4) of this subsection. In any proceedings brought for relief under this subsection, the court may extend the time for a hearing upon a showing by the commissioner that extraordinary circumstances exist that justify the extension.
(6) The court may order consolidation of individual claims into a group of claims where:
(a) the number of persons involved or to be affected is so large as to render individual participation impractical;
(b) there are questions of law or fact common to the individual claims or rights to be determined;
(c) the group claims or rights to be determined are typical of the affected individuals' claims or rights; and
(d) the entire group will be adequately represented in the consolidation, giving due regard to the rights of affected individuals.
f. (1) Following a hearing as provided for in paragraph (5) of subsection e. of this section, on or after a period of time of no less than 10 days but not more than 21 days, as determined by the commissioner based on the generally recognized incubation period of the infectious disease warranting the isolation or quarantine, a person isolated or quarantined pursuant to the provisions of this section may request a court hearing to contest his continued isolation or quarantine. The court may proceed in a summary manner.
The hearing shall be held within 72 hours of receipt of the request, excluding Saturdays, Sundays and legal holidays. A request for a hearing shall not act to stay the order of isolation or quarantine. At the hearing, the commissioner must show by a preponderance of the evidence that continuation of the isolation or quarantine is warranted because the person poses a significant risk of transmitting a disease to others with serious consequences.
(2) A person isolated or quarantined pursuant to the provisions of this section may request at any time a hearing in the Superior Court for injunctive relief regarding his treatment and the terms and conditions of the quarantine or isolation. Upon receiving a request for either type of hearing described in this paragraph, the court shall fix a date for a hearing. The court may proceed in a summary manner. The hearing shall be held no later than 10 days after the receipt of the request by the court. A request for a hearing shall not act to stay the order of isolation or quarantine.
(3) If, upon a hearing, the court finds that the isolation or quarantine of the individual is not warranted under the provisions of this section, then the person shall be immediately released from isolation or quarantine. If the court finds that the isolation or quarantine of the person is not in compliance with the provisions of subsection c. of this section, the court may fashion remedies appropriate to the circumstances of the state of public health emergency and in keeping with the provisions of this section.
g. (1) The petitioner shall have the right to be represented by counsel.
(2) The manner in which the request for a hearing under this section is filed and acted upon shall be in accordance with the Rules of Court.
(1) receives a certificate of completion of isolation or quarantine issued by the department or the authorized local health department;
(2) is still qualified to perform the duties of such position; and
(3) makes application for reemployment within 90 days after being released from isolation or quarantine.
b. If a public or private employer fails or refuses to comply with the provisions of this section, the Superior Court may, upon the filing of a complaint by the person entitled to the benefits of this section, specifically require the employer to comply with the provisions of this section, and may, as an incident thereto, order the employer to compensate the person for any loss of wages or benefits suffered by reason of the employer's unlawful action. A person claiming to be entitled to the benefits of this section may appear and be represented by counsel, or, upon application to the Attorney General, request that the Attorney General appear and act on his behalf. If the Attorney General is reasonably satisfied that the person so applying is entitled to the benefits, he shall appear and act as attorney for the person in the amicable adjustment of the claim, or in the filing of any complaint and the prosecution thereof. No fees or court costs shall be assessed against a person so applying for the benefits under this section. Attorney fees shall be awarded to the Attorney General or to the counsel for a person entitled to benefits under this section, who prevails in the proceeding.
c. The Attorney General may apply to the Superior Court and the court may grant additional relief to persons placed in isolation or quarantine under section 15 of this act, which relief may include, but is not limited to, relief similar to that accorded to military personnel under P.L.1979, c.317 (C.38:23C-1 et seq.).
a. Access to medical information of individuals who have participated in medical testing, treatment, vaccination, isolation or quarantine programs or efforts by the commissioner pursuant to this act shall be limited to those persons having a legitimate need to acquire or use the information to:
(1) provide treatment to the individual who is the subject of the health information;
(2) conduct epidemiologic research;
(3) investigate the causes of the transmission;
(4) assist law enforcement agencies in the identification and location of victims of the public health emergency; or
(5) provide payment by a responsible party for treatment or services rendered.
b. Medical information held by the commissioner shall not be disclosed to others without individual written, specific informed consent, except for disclosures made:
(1) directly to the individual;
(2) to the individual's immediate family members or personal representative;
(3) to appropriate federal agencies or authorities pursuant to federal law;
(4) to local health departments assisting in the epidemiological investigation or disease containment countermeasures;
(5) to law enforcement agencies, including the State Medical Examiner, investigating the circumstances giving rise to the public health emergency, or in the identification and location of victims of the public health emergency;
(6) pursuant to a court order to avert a clear danger to an individual or the public health; or
(7) to identify a deceased individual or determine the manner or cause of death.
c. Strictly for the purposes of controlling and containing the public health emergency, the commissioner may provide medical information to a health care facility about an employee who has participated in medical treatment or testing which may impact upon the public health emergency. This information may include, but is not limited to, medical testing, treatment, vaccination, isolation or quarantine programs or efforts by the commission pursuant to this act when the commissioner deems that the health care facility should be advised of such medical information in order to take actions necessary to protect the health and well being of its patients, residents or other health care employees.
Nothing in this subsection shall be construed to allow for the release of medical information that is not related to the public health emergency or is protected under federal or State law.
a. To require in-State health care providers to assist in the performance of vaccination, treatment, examination or testing of any individual;
b. To appoint and prescribe the duties of such out-of-State emergency health care providers as may be reasonable and necessary to respond to the public health emergency, as provided in this subsection.
(1) The appointment of out-of-State emergency health care providers may be for such period of time as the commissioner deems appropriate, but shall not exceed the duration of the public health emergency. The commissioner may terminate the out-of-State appointments at any time or for any reason if the termination will not jeopardize the health, safety and welfare of the people of this State.
(2) The commissioner may waive any State licensing requirements, permits, fees, applicable orders, rules, and regulations concerning professional practice in this State by health care providers from other jurisdictions; and
c. To authorize the Chief State Medical Examiner, during the public health emergency, to appoint and prescribe the duties of county or intercounty medical examiners and assistant county or intercounty medical examiners, designated forensic pathologists, their assistants, out-of-State medical examiners, and others as may be required for the proper performance of the duties of the office.
(1) The appointment of persons pursuant to this subsection may be for a limited or unlimited time, but shall not exceed the duration of the public health emergency. The Chief State Medical Examiner may terminate the out-of-State appointments at any time or for any reason.
(2) The Chief State Medical Examiner may waive any licensing requirements, permits or fees otherwise required for the performance of these duties, so long as the appointed emergency assistant medical examiner is competent to properly perform the duties of the office. In addition, if from another jurisdiction, the appointee shall possess the licensing, permit or fee requirement for medical examiners or assistant medical examiners in that jurisdiction.
d. (1) An in-State health care provider required to assist pursuant to subsection a. of this section and an out-of-State emergency health care provider appointed pursuant to subsection b. of this section shall not be liable for any civil damages as a result of the provider's acts or omissions in providing medical care or treatment related to the public health emergency in good faith and in accordance with the provisions of this act.
(2) An in-State health care provider required to assist pursuant to subsection a. of this section and an out-of-State emergency health care provider appointed pursuant to subsection b. of this section shall not be liable for any civil damages as a result of the provider's acts or omissions in undertaking public health preparedness activities, which activities shall include but not be limited to pre-event planning, drills and other public health preparedness efforts, in good faith and in accordance with the provisions of this act.
"Injury" means death, injury to a person or damage to or loss of property.
"Public entity" includes the State, and any county, municipality, district, public authority, public agency, and any other political subdivision or public body in the State. Public entity also includes any foreign governmental body, which is acting in this State under the authority of this act.
"State" means the State and any office, department, division, bureau, board, commission or agency of the State.
b. (1) A public entity and the agents, officers, employees, servants or representatives of a public entity, including volunteers, shall not be liable for an injury caused by any act or omission in connection with a public health emergency, or preparatory activities, that is within the scope of the authority granted under this act, including any order, rule or regulation adopted pursuant thereto. An agent, officer, employee, servant, representative or volunteer is not immune under this section, however, for an injury that results from an act that is outside the scope of the authority granted by this act or for conduct that constitutes a crime, actual fraud, actual malice, gross negligence or willful misconduct.
(2) A public entity or agent, officer, employee, servant or representative or volunteer, shall not be liable for an injury arising out of property of any kind that is donated or acquired according to the provisions of this or any other act for use in connection with a public health emergency. An agent, officer, employee, servant, representative or volunteer is not immune under this section, however, for an injury that results from an act that is outside the scope of the authority granted by this act or for conduct that constitutes a crime, actual fraud, actual malice, gross negligence or willful misconduct.
c. (1) A person or private entity who:
(a) owns, manages or controls property that is used in connection with a public health emergency shall not be liable for an injury with respect to the property, unless the injury is a result of gross negligence or willful misconduct. The immunity applies whether the person or entity owning, managing or controlling the property permits the use of the property voluntarily, with or without compensation, or the State or another public entity exercises the condemnation powers in this or any other act with respect to the use of the property;
(b) is acting in the performance of a contract with a public entity in connection with a public health emergency shall not be liable for an injury caused by the person or entity's negligence in the course of performing the contract, unless the injury is a result of gross negligence or willful misconduct; and
(c) in connection with a public health emergency, renders assistance or advice to a public entity or public employee or donates goods and services shall not be liable for an injury arising out of the person or entity's assistance, advice or services, or associated with the donated goods, unless the injury is a result of gross negligence or willful misconduct.
(2) A person or private entity and the employees of the entity shall not be liable for an injury caused by any act or omission in connection with a public health emergency, or preparatory activities, provided that the action of the person or entity is undertaken pursuant to the exercise of the authority provided pursuant to this act, including any order, rule or regulation adopted pursuant thereto. A person, entity or employee of the entity is not immune under this section, however, for an injury that results from an act that is outside the scope of the authority granted by this act or for conduct that constitutes a crime, actual fraud, actual malice, gross negligence or willful misconduct.
(3) The immunities established under this subsection shall not apply to a person or private entity whose act or omission caused or contributed to the public health emergency.
(4) As used in this subsection, "private entity" includes, but is not limited to, a health care provider.
d. The immunities established under this section shall be liberally construed to carry out the purposes of this act and shall apply to all public health preparedness activities, including pre-event planning, drills or other public health preparedness efforts. The immunities are in addition to, and shall not limit or abrogate in any way, other statutory immunities, common law immunities, statutory conditions on maintaining a lawsuit such as the notice provisions of the "New Jersey Tort Claims Act," N.J.S.59:1-1 et seq., or other defenses available to those who participate in responding to, or preparing for, a public health emergency.
a. prior written permission has been obtained from each resident or representative of a resident, staff member, or parent or guardian of a minor for providing the potassium iodide; and
b. each person providing permission has been advised, in writing: (1) that the ingestion of potassium iodide is voluntary only, (2) about the contraindications of taking potassium iodide and (3) about the potential side effects of taking potassium iodide.
b. The commissioner, either directly or through the LINCS agencies, shall coordinate the activities of all local health agencies in the county with regard to public health protection related to preparing for and responding to public health emergencies. The LINCS agency shall notify each local health agency in its jurisdiction of the nature and extent of the emergency, except that nothing in this subsection shall be construed to prevent the commissioner from notifying a local health agency directly.
c. The LINCS agency and all other local health agencies within the county shall be subject to the direction and authority of the commissioner, and shall perform such activities as are directed by the commissioner, in accordance with the provisions of this act.
d. The LINCS agencies shall be responsible for performing human disease surveillance, terrorism response and public health emergency response-related activities in such a manner as the commissioner may direct, and for reporting to the commissioner on the conduct of these activities as performed in the county or city, as applicable.
e. The commissioner may utilize the LINCS agencies to disseminate such information to the other local health agencies in the county, and to collect such information from those agencies, as the commissioner deems necessary; and the LINCS agencies shall transmit the information to the commissioner or the other local health agencies as directed by the commissioner.
f. The commissioner is authorized to use available federal funds received by the State to offset the costs incurred by LINCS agencies in implementing the provisions of this act, and shall reimburse local health agencies, subject to the approval of the State Treasurer and in accordance with the provisions of this act.
"Biological Agent" means:
(1) any select agent that is a microorganism, virus, bacterium, fungus, rickettsia or toxin listed in Appendix A of Part 72 of Title 42 of the Code of Federal Regulations;
(2) any genetically modified microorganism or genetic element from an organism listed in Appendix A of Part 72 of Title 42 of the Code of Federal Regulations, shown to produce or encode for a factor associated with a disease;
(3) any genetically modified microorganism or genetic element that contains nucleic acid sequences coding for any of the toxins listed in Appendix A of Part 72 of Title 42 of the Code of Federal Regulations, or their toxic subunits;
(4) high consequence livestock pathogens and toxins as determined by the U.S. Department of Agriculture and the New Jersey Department of Agriculture;
(5) any agents defined pursuant to R.S. 4:5-107 et seq. and N.J.A.C. 2:6-1.1 et seq. and the Secretary of Agriculture;
(6) any other agent as determined by the commissioner to represent a significant risk to human and animal health.
"Possess or maintain" includes, but is not limited to, any of the following: development, production, acquisition, transfer, receipt, stockpiling, retention, ownership or use of a biological agent.
"Registry" means the Biological Agent Registry established pursuant to this section.
b. The commissioner, in coordination with the Secretary of Agriculture, shall establish a Biological Agent Registry and administer a program for the registration of biological agents. The registry shall identify the biological agents possessed or maintained by any person in this State and shall contain such other information as required by regulation of the commissioner pursuant to this section.
c. A person who possesses or maintains any biological agent required to be registered under this section shall report the information to the department by submitting a duplicate of the form required under Part 331 of Title 7, Part 121 of Title 9, and Parts 72 and 73 of Title 42 of the Code of Federal Regulations. Forms submitted pursuant to these provisions shall not be reproduced by photographic, electronic or other means, and shall be stored in a manner that is both confidential and secure.
d. Except as otherwise provided in this section, information prepared for or maintained in the registry shall be confidential.
(1) The commissioner may, in accordance with rules adopted by the commissioner, utilize information contained in the registry for the purpose of conducting or aiding in a communicable disease investigation.
(2) The commissioner shall cooperate, and may share information contained in the registry, with the United States Centers for Disease Control and Prevention, the Department of Homeland Security, the New Jersey Department of Agriculture, and State and federal law enforcement agencies pursuant to a communicable disease investigation commenced or conducted by the department, the New Jersey Domestic Security Preparedness Task Force established pursuant to P.L.2001, c.246 (C.App. A:9-64 et seq.), or other State or federal law enforcement agency having investigatory authority, or in connection with any investigation involving the release, theft or loss of a registered biological agent. Access to this information shall terminate upon the completion of the investigation.
(3) Release of information from the registry as authorized under this section shall not render the information released or information prepared for or maintained in the registry a public or government record under P.L.1963, c.73 (C. 47:1A-1 et seq.) and P.L.2001, c.404 (C.47:1A-5 et al.).
e. Any person who willfully or knowingly violates any provision of this section is liable for a penalty not to exceed $10,000 per day of the violation, and each day the violation continues shall constitute a separate and distinct violation. A penalty imposed under this section may be recovered with costs in a summary proceeding before the Superior Court pursuant to the "Penalty Enforcement Law of 1999," P.L.1999, c.274 (C.2A:58-10 et seq.).
f. The commissioner shall adopt rules and regulations pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.) that are consistent with Part 331 of Title 7, Part 121 of Title 9, and Parts 72 and 73 of Title 42 of the Code of Federal Regulations, to carry out the purposes of this section; except that, notwithstanding any provision of P.L.1968, c.410 to the contrary, the commissioner may adopt, immediately upon filing with the Office of Administrative Law, such regulations as he deems necessary to implement the provisions of this section, which shall be effective for a period not to exceed six months and thereafter be amended, adopted or readopted by the commissioner in accordance with the requirements of P.L.1968, c.410.
The regulations shall include, but not be limited to:
(1) a list of the biological agents required to be registered pursuant to this section;
(2) designation of the persons required to make reports, the specific information required to be reported, time limits for reporting, the form of the reports, and the person to whom the report shall be submitted;
(3) provisions for the release of information in the registry to State and federal law enforcement agencies, the Centers for Disease Control and Prevention, the Department of Homeland Security and the New Jersey Department of Agriculture pursuant to paragraph (2) of subsection d. of this section;
(4) establishment of a system of safeguards that requires a person who possesses or maintains a biological agent required to be registered under this section to comply with the federal standards that apply to a person registered to possess or maintain the agent under federal law;
(5) establishment of a process for a person that possesses or maintains a registered biological agent to alert appropriate authorities of unauthorized possession or attempted possession of a registered biological agent, and designation of appropriate authorities for receipt of the alerts; and
(6) establishment of criteria and procedures for the commissioner to grant exemptions to the requirements if it is determined that the public benefit of such exemption outweighs the need for regulation.
b. To protect the public health during a vaccine shortage, the commissioner shall issue an order to implement a New Jersey Vaccine Education and Prioritization Plan, which shall comprise:
(1) procedures for the assessment of available vaccine Statewide;
(2) procedures for the distribution and administration of vaccines that shall apply to physicians, nurses, health care facilities, pharmacies and others that dispense vaccines. The procedures shall include, but not be limited to, a definition of high-risk groups for priority protection or treatment in the event a vaccine shortage is imminent or existent; and
(3) procedures for: (a) mobilizing public and private health resources to assist in vaccine distribution and administration; and
(b) reallocating available supplies of vaccine to most effectively meet the needs of the State's high-risk groups, if necessary.
c. As used in this section, "vaccine" includes vaccines, immune products and chemoprophylactic and treatment medications.
d. A person who willfully or knowingly violates the New Jersey Vaccine Education and Prioritization Plan or any procedures contained therein shall be liable for a civil penalty of $500 for each violation. The penalty shall be sued for and collected by the commissioner in a summary proceeding before the Superior Court pursuant to the "Penalty Enforcement Law of 1999," P.L.1999, c.274 (C.2A:58-10 et seq.).
e. The commissioner shall notify the appropriate professional or occupational licensing board or licensing authority, in the case of a facility, of repeated violations of the procedures by a health care professional or licensed facility.
b. The board shall meet at such times as may be necessary to fulfill the requirements set forth herein. The Commissioner of Health shall convene the board within 45 days of the filing of a complete petition. The concurrence of six members of the board shall be necessary for the validity of all acts of the board.
c. Subject to available appropriations, the board shall have the authority to award reasonable reimbursement, as determined by the board, for any services required of any person under the provisions of this act, which shall be paid at the prevailing established rate for services of a like or similar nature as determined by the board. Subject to available appropriations, the board shall have the authority to award reasonable reimbursement, as determined by the board, for any property employed, taken, or used under the provisions of this act.
d. All awards shall be paid from any funds appropriated by the State, any political subdivision of the State, or the federal government, for such purpose. In awarding reimbursement under this section, the board shall take into account any funds, or any other thing of value, received by a claimant from any other source, including but not limited to private donations, contributions, and insurance proceeds. The board shall not award reimbursement unless the claimant has demonstrated, to the satisfaction of the board, that the claimant has first sought reimbursement for any loss incurred due to the declaration of a public health emergency from any and all appropriate third party payers.
(1) a description of the services or property employed, taken, or used;
(2) the dates of the employment, taking, or usage;
(3) the person or entity ordering the employment, taking, or usage;
(4) such additional information as the petitioner deems relevant to a full consideration of the claim; and
(5) any additional information that the board may require.
b. The board may establish such forms, documents, and procedures as may be necessary to expedite the processing of claims, and all claimants shall utilize and follow the forms, documents, and procedures, if so established. Subsequent to the filing of an initial petition, the board may request such additional information as it deems necessary from any claimant and may require the claimant, and any other person with knowledge of facts and circumstances relevant to the claim, to appear before the board for a hearing. No petition shall be filed with the board more than 180 days from the last date the services or property were employed, taken or used, except that this deadline may be extended by the board as is necessary to further the purposes of this act.
c. The board's determination concerning a claimant's petition for reimbursement shall be transmitted to the claimant in writing. The claimant may appeal the decision to the Superior Court subject to the Rules of Court regarding the review of State agency actions.
d. Any person seeking reimbursement under this act shall proceed in accordance with the provisions of this section unless the declaration of public health emergency which gives rise to the claim or petition for reimbursement is superseded by order of the Governor pursuant to P.L.1942, c.251 (C.App.A:9-33 et seq.). Upon the declaration of an emergency by the Governor pursuant to P.L.1942, c.251 which supersedes the declaration of a public health emergency, the person shall proceed in accordance with the provisions of P.L.1942, c.251 and the person's rights, remedies and entitlement to reimbursement shall be limited to that which is afforded in that act.
e. Notwithstanding the provisions of this section to the contrary, in the event funds are otherwise made available for reimbursement, a person shall not be required to file a petition for an award with the board pursuant to this section.
a. Health care resources offered pursuant to this section may include, but shall not be limited to:
(1) information regarding health care coverage and enrollment options, including, but not limited to, information related to coverage provided through NJ FamilyCare and the "Patient Protection and Affordable Care Act," Pub.L.111-148, as amended by the federal "Health Care and Education Reconciliation Act of 2010," Pub.L.111-152;
(2) information regarding Federally Qualified Health Centers (FQHCs), including the locations and hours of operation of any FQHC that is located in the same county as, or in a neighboring county of, the warming center;
(3) information regarding health care services available for veterans;
(4) information regarding the REACHNJ hotline, which can be used to connect individuals to assessment and treatment referral services for substance use disorders; and
(5) information regarding available mental health care services.
b. Social service resources offered pursuant to this section may include, but shall not be limited to:
(1) information regarding municipal and county social service agencies for the municipality and county in which the warming center is located; and
(2) information regarding community-based assistance organizations in the municipality, county, or region of the State in which the warming center is located.
c. The Department of Human Services shall compile and make available on its Internet website health and social service resource materials corresponding to the guidelines established pursuant to subsection a. of this section.
(1) Executive Order No. 106 (2020)
(2) Executive Order No. 111 (2020)
(3) Executive Order No. 112 (2020)
(4) Executive Order No. 123 (2020)
(5) Executive Order No. 127 (2020)
(6) Executive Order No. 150 (2020)
(7) Executive Order No. 159 (2020)
(8) Executive Order No. 170 (2020)
(9) Executive Order No. 178 (2020)
(10) Executive Order No. 207 (2020)
(11) Executive Order No. 229 (2021)
(12) Executive Order No. 233 (2021)
(13) Executive Order No. 237 (2021)
(14) The most recent executive order containing general coronavirus disease 2019 (COVID-19) mitigation measures regarding face coverings, social distancing, and gatherings prior to the effective date of this act, and this executive order shall not be more restrictive than the recommendations provided in the federal Centers for Disease Control and Prevention guidelines on social distancing and face coverings in response to the coronavirus disease 2019 (COVID-19) pandemic, unless a substantial increase in hospitalizations, substantially increased spot positivity, or rate of transmission above 1 necessitates a modification that would be more restrictive.
b. Notwithstanding subsection a. of this section, the Governor shall notify the Legislature by January 1, 2022 if the Governor determines that it is necessary or appropriate to continue for an additional 90 days beyond January 11, 2022 any administrative order, directive, or waiver issued by the head of a State agency that relied on the existence of the public health emergency declared by the Governor in Executive Order No. 103 of 2020, as extended. The administrative orders, directives, or waivers shall be extended for an additional 90 days if each House of the Legislature passes a concurrent resolution to continue any such administrative order, directive, or waiver. Any administrative order, directive, or waiver as to which the Governor does not provide notification to the Legislature or as to which both Houses of the Legislature do not pass a concurrent resolution to continue shall expire on January 11, 2022.
c. Notwithstanding subsection a. of this section, the provisions of any administrative order, directive, or waiver issued by the Department of Health that relied on the existence of the public health emergency declared by the Governor in Executive Order No. 103 of 2020, as extended, governing staffing ratios, overtime, shifts, and vacation time shall remain in force and effect until September 1, 2021, at which time all such provisions of administrative orders, directives, and waivers governing staffing ratios, overtime, shifts, and vacation time shall be superseded by relevant provisions of laws, regulations, or collective bargaining agreements in effect on that date.
While the state of emergency declared in Executive Order No. 103 of 2020 shall remain in effect, the deadlines in paragraph (1) of subsection i. of section 6 of P.L.2001, c.404 (C.47:1A-5) shall apply to any request made under the open public records act after the effective date of this act, with the exception of requests made for records related to the COVID-19 response, which shall continue to be governed by paragraph (2) of subsection i. of section 6 of P.L.2001, c.404 (C.47:1A-5).
The authority granted by this section shall last until January 11, 2022, unless the Governor notifies the Legislature by January 1, 2022 that the authority granted by this section is necessary to combat the continuing threat posed by COVID-19 and should last for another 90 days. In the event of such notification, the Legislature shall have the authority to pass a concurrent resolution to concur with the Governor's notice. If such a concurrent resolution passes both Houses of the Legislature, then the authority granted by this section shall continue for an additional 90 days. If such a concurrent resolution does not pass both Houses of the Legislature, then the authority granted by this section shall expire on January 11, 2022.
a. Access to the latest treatments developed through medical research is essential to provide the citizens of this State with the best health care services available;
b. The advancement of the scientific understanding of health, behavior, disease, and treatment is a vital endeavor for the benefit of humankind;
c. Ground-breaking research is currently being conducted in New Jersey by a wide variety of health professionals in the diagnosis, intervention and monitoring of all aspects of health and medical care; and
d. All research involving human participants, regardless of the setting, must be conducted with profound respect for their health, safety, and dignity.
a. offers the prospect of direct benefit to the individual subject, provided that the institutional review board has determined that the risk is justified by the anticipated benefits to the subject and that the relation of the anticipated benefit to the risk is at least as favorable to the subject as that presented by available alternative approaches. If a currently recognized treatment exists, the subject or his guardian or authorized representative, as applicable, shall be presented with the choice of the recognized treatment and the research protocol; or
b. does not offer the prospect of direct benefit to the individual subject, provided that the institutional review board has determined that it: (1) is likely to yield generalizable knowledge about the subject's disorder or condition; (2) by its very nature cannot be conducted without the participation of decisionally incapacitated persons as subjects; and (3) involves no more than a minor increase over minimal risk.
For purposes of this section, "minimal risk" means that the probability and magnitude of harm or discomfort anticipated in the research are not greater than those ordinarily encountered in daily life or during the performance of routine physical or psychological exams or tests.
a. The subject or his guardian, or authorized representative as provided in section 5 of this act, as applicable, is informed both verbally and within the written consent form, in nontechnical terms and in a language in which the subject or the subject's guardian or authorized representative is fluent, of the following facts that include:
(1) an explanation of the procedures to be followed in the research and any drugs or devices to be utilized, including the purposes of the procedures, drugs, or devices and, when applicable, the use of placebo controls and the process by which persons will be assigned to control groups;
(2) a description of any attendant discomfort and reasonably foreseeable risks to the subject;
(3) an explanation of any potential direct benefits to the subject. If no such direct benefits are reasonably expected, that fact should be made clear;
(4) a disclosure of any appropriate alternative procedures, drugs
or devices that might be advantageous to the subject, and their relative risks and benefits;
(5) an estimate of the expected duration of the research procedure or study;
(6) an offer to answer any inquiries concerning the research or the procedures involved and an explanation of whom to contact for answers to pertinent questions about the research and the research subject's rights, and whom to contact in the event of a research-related injury;
(7) an instruction to the subject or his guardian or authorized representative, as applicable, that he is free to withdraw his prior consent to the medical experiment and discontinue participation in the research at any time, without prejudice to the subject;
(8) the name, institutional affiliation, if any, and address of the person or persons actually performing and primarily responsible for the conduct of the research;
(9) the name of the sponsor or funding source, if any, or manufacturer if the research involves a drug or device, and the organization, if any, under whose general aegis the research is being conducted;
(10) the name, address, and phone number of an impartial third party, not associated with the research, to whom the subject may address complaints about the research and the contact information for the institutional review board connected with the research; and
(11) the material financial stake or interest, if any, that the investigator or research institution has in the research. For purposes of this section, "material" means $10,000 or more in securities or other assets valued at the date of disclosure, or in relevant cumulative salary or other income, regardless of when it is earned or expected to be earned or as otherwise determined by the research institution.
b. The subject or his guardian or authorized representative, as applicable, has signed and dated a written consent form.
c. The written consent form is signed and dated by a person, who is not the subject, his guardian or authorized representative, or the researcher, and who can attest that the requirements for informed consent to the medical research have been satisfied.
d. Consent is given voluntarily and freely by the subject or his guardian or authorized representative without the intervention of force, fraud, deceit, duress, coercion or undue influence.
(1) the guardian of the subject who has the authority to make health care decisions for the subject;
(2) the health care representative of the subject pursuant to an advance directive for health care;
(3) the spouse or civil union partner, as applicable, of the subject;
(4) the domestic partner, as defined in section 3 of P.L.2003, c.246 (C.26:8A-3), of the subject;
(5) an adult son or daughter of the subject;
(6) a custodial parent of the subject;
(7) an adult brother or sister of the subject;
(8) an adult grandchild of the subject;
(9) an available adult relative with the closest degree of kinship to the subject.
b. For purposes of this section, inability to consent shall mean that a subject is unable to consent if he is unable to voluntarily reason, understand, and appreciate the nature and consequences of proposed health research interventions, including the subject's diagnosis and prognosis, the burdens, benefits, and risks of, and alternatives to, any such research, and to reach an informed decision.
All adults are presumed to have the ability to consent unless determined otherwise pursuant to this section or other provisions of State law.
A determination that a subject is unable to consent, as well as the extent of his incapacity and the likelihood that he will regain decision-making capacity, shall be made by an attending physician with no connection to the proposed research and shall be made to a reasonable degree of medical certainty.
A determination of incapacity shall promptly be given to the subject and to at least one person at the highest level reasonably available on the list of surrogates contained in subsection a. of this section.
Notwithstanding a determination of incapacity made pursuant to this section, a subject's objection to a determination of incapacity or objection to the proposed research intervention shall be binding, unless a court of competent jurisdiction determines that the subject lacks decision-making capacity.
c. For the purposes of this section:
(1) when there are two or more available persons who may give surrogate informed consent and who are in the same order of priority, if any of those persons expresses dissent as to the participation of the person in the research, consent shall not be considered as having been given; and
(2) when there are two or more available persons who are in different orders of priority, refusal to consent by a person who is a higher priority authorized representative shall not be superseded by the consent of a person who is a lower priority authorized representative.
d. An authorized representative described in this section shall make decisions about participation in accordance with the subject's individual health care instructions, if any, and other wishes, to the extent known to the authorized representative. If the authorized representative does not have knowledge of any health care instructions or other wishes of the subject, or if the instructions or wishes do not clearly indicate what decision should be made, he shall make the decision in accordance with the subject's personal values and his best estimation of what the subject would have chosen if he were capable of making a decision.
e. The requirement for obtaining informed consent for medical research pursuant to this act shall not apply to any medical research with respect to a person who is subject to a life-threatening emergency in accordance with the conditions set forth in 21 C.F.R.s.50.24.
f. The requirements for obtaining informed consent for medical research pursuant to this act may be altered or waived in accordance with the conditions set forth in 45 C.F.R.s.46.116(d).
g. A person who provides surrogate consent pursuant to this section may not receive financial compensation for providing the consent.
h. Except as otherwise provided by law, the provisions of this section shall not override an advance directive for health care executed pursuant to P.L.1991, c.201 (C.26:2H-53 et seq.).
a. There are an estimated 1.25 million residents of the State who have no health insurance coverage, of which over 240,000 are children, and the number of uninsured residents is increasing each year;
b. While employer-sponsored health care coverage in the State is well above the national average and has been a major factor in keeping the number of uninsured lower than in many states, because of the rising cost of the coverage, increasing numbers of employers are considering dropping coverage for their employees and dependents, or are requiring employees to share in a greater percentage of premium costs and to bear larger copayments and coinsurance, which is making health care coverage increasingly unaffordable to low and moderate income working families;
c. Persons without health insurance coverage receive less preventive care, poorer treatment for both minor and serious chronic and acute illnesses, and in many cases live shorter lives than comparable insured populations;
d. Many uninsured are forced to seek health care in inappropriate settings such as hospital emergency rooms because they cannot obtain needed health care services in a convenient and more cost-effective setting such as a primary care provider's office or clinic, which contributes to higher health care costs;
e. The uninsured are commonly billed at higher rates than those who have health care coverage. Health care costs have become a leading cause of bankruptcy in this country, and those without insurance are most at risk;
f. The State has recognized the importance of increasing access to health care coverage and, over the last several years, has enacted several reforms to make health care coverage more affordable and accessible to residents of the State. Among these reforms are the expansions of coverage under the State Medicaid and NJ FamilyCare programs. Despite these efforts, too many low income parents and children lack access to health care coverage;
g. In order to ensure that more low income parents in the State have access to health care coverage and all children in the State are covered under a health plan, thus moving closer to providing universal coverage for all residents of this State, it is necessary to further expand coverage for parents under the NJ FamilyCare Program, and mandate that all children in the State have health care coverage, either through public programs or private coverage; and
h. In order to make insurance coverage more affordable to residents and small businesses in this State, and to stabilize enrollment in, and the costs of, individual and small employer health benefits plans, it is also necessary to adopt comprehensive reform measures to the insurance marketplace.
b. As used in this section:
"Medicaid" means the New Jersey Medical Assistance and Health Services Program established pursuant to P.L.1968, c.413 (C.30:4D-1 et seq.).
"NJ FamilyCare" means the NJ FamilyCare Program established pursuant to P.L.2005, c.156 (C.30:4J-8 et al.).
"NJ FamilyCare Advantage" means the buy-in program established pursuant to subsection j. of section 5 of P.L.2005, c.156 (C.30:4J-12).
a. Recognizing New Jersey's long-standing commitment to individual dignity, informed consent, and the fundamental right of competent adults to make health care decisions about whether to have life-prolonging medical or surgical means or procedures provided, withheld, or withdrawn, this State affirms the right of a qualified terminally ill patient, protected by appropriate safeguards, to obtain medication that the patient may choose to self-administer in order to bring about the patient's humane and dignified death.
b. Statistics from other states that have enacted laws to provide compassionate medical aid in dying for terminally ill patients indicate that the great majority of patients who requested medication under the laws of those states, including more than 90 percent of patients in Oregon since 1998 and between 72 percent and 86 percent of patients in Washington in each year since 2009, were enrolled in hospice care at the time of death, suggesting that those patients had availed themselves of available treatment and comfort care options available to them at the time they requested compassionate medical aid in dying.
c. The public welfare requires a defined and safeguarded process in order to effectuate the purposes of this act, which will:
(1) guide health care providers and patient advocates who provide support to dying patients;
(2) assist capable, terminally ill patients who request compassionate medical aid in dying;
(3) protect vulnerable adults from abuse; and
(4) ensure that the process is entirely voluntary on the part of all participants, including patients and those health care providers that are providing care to dying patients.
d. This act is in the public interest and is necessary for the welfare of the State and its residents.
"Adult" means an individual who is 18 years of age or older.
"Attending physician" means a physician licensed pursuant to Title 45 of the Revised Statutes who has primary responsibility for the treatment and care of a qualified terminally ill patient and treatment of the patient's illness, disease, or condition.
"Capable" means having the capacity to make health care decisions and to communicate them to a health care provider, including communication through persons familiar with the patient's manner of communicating if those persons are available.
"Consulting physician" means a physician licensed pursuant to Title 45 of the Revised Statutes who is qualified by specialty or experience to make a professional diagnosis and prognosis regarding a patient's illness, disease, or condition.
"Health care facility" means a health care facility licensed pursuant to P.L.1971, c.136 (C.26:2H-1 et seq.).
"Health care professional" means a person licensed to practice a health care profession pursuant to Title 45 of the Revised Statutes.
"Health care provider" means a health care professional or health care facility.
"Informed decision" means a decision by a qualified terminally ill patient to request and obtain a prescription for medication that the patient may choose to self-administer to end the patient's life in a humane and dignified manner, which is based on an appreciation of the relevant facts and after being fully informed by the attending physician of:
(1) the patient's medical diagnosis;
(2) the patient's prognosis;
(3) the potential risks associated with taking the medication to be prescribed;
(4) the probable result of taking the medication to be prescribed; and
(5) the feasible alternatives to taking the medication, including, but not limited to, concurrent or additional treatment opportunities, palliative care, comfort care, hospice care, and pain control.
"Long-term care facility" means a nursing home, assisted living residence, comprehensive personal care home, residential health care facility, or dementia care home licensed pursuant to P.L.1971, c.136 (C.26:2H-1 et seq.).
"Medically confirmed" means that the medical opinion of the attending physician has been confirmed pursuant to section 7 of P.L.2019, c.59 (C.26:16-7) by a consulting physician who has examined the patient and the patient's relevant medical records.
"Mental health care professional" means a psychiatrist, psychologist, or clinical social worker licensed pursuant to Title 45 of the Revised Statutes.
"Participate in this act" means to perform the duties of a health care provider in accordance with the provisions of P.L.2019, c.59 (C.26:16-1 et al.), but does not include: making an initial determination that a patient is terminally ill and informing the patient of the medical prognosis; providing information about the provisions of P.L.2019, c.59 (C.26:16-1 et al.) to a patient upon the patient's request; or providing a patient, upon the patient's request, with a referral to another health care provider.
"Patient" means a person who is under the care of a physician.
"Qualified terminally ill patient" means a capable adult who is a resident of New Jersey and has satisfied the requirements to obtain a prescription for medication pursuant to P.L.2019, c.59 (C.26:16-1 et al.). A person shall not be considered to be a qualified terminally ill patient solely because of the person's age or disability or a diagnosis of any specific illness, disease, or condition.
"Self-administer" means a qualified terminally ill patient's act of physically administering, to the patient's own self, medication that has been prescribed pursuant to P.L.2019, c.59 (C.26:16-1 et al.).
"Terminally ill" means that the patient is in the terminal stage of an irreversibly fatal illness, disease, or condition with a prognosis, based upon reasonable medical certainty, of a life expectancy of six months or less.
a. is an adult resident of New Jersey as demonstrated pursuant to section 11 of P.L.2019, c.59 (C.26:16-11);
b. is capable and has been determined by the patient's attending physician and a consulting physician to be terminally ill; and
c. has voluntarily expressed a wish to receive a prescription for medication pursuant to P.L.2019, c.59 (C.26:16-1 et al.).
b. At least one of the witnesses shall be a person who is not:
(1) a relative of the patient by blood, marriage, or adoption;
(2) at the time the request is signed, entitled to any portion of the patient's estate upon the patient's death under any will or by operation of law; and
(3) an owner, operator, or employee of a health care facility, other than a long term care facility, where the patient is receiving medical treatment or is a resident.
c. The patient's attending physician at the time the request is signed shall not serve as a witness.
(1) make the initial determination of whether a patient is terminally ill, is capable, and has voluntarily made the request for medication pursuant to P.L.2019, c.59 (C.26:16-1 et al.);
(2) require that the patient demonstrate New Jersey residency pursuant to section 11 of P.L.2019, c.59 (C.26:16-11);
(3) inform the patient of: the patient's medical diagnosis and prognosis; the potential risks associated with taking the medication to be prescribed; the probable result of taking the medication to be prescribed; and the feasible alternatives to taking the medication, including, but not limited to, concurrent or additional treatment opportunities, palliative care, comfort care, hospice care, and pain control;
(4) refer the patient to a consulting physician for medical confirmation of the diagnosis and prognosis, and for a determination that the patient is capable and acting voluntarily;
(5) refer the patient to a mental health care professional, if appropriate, pursuant to section 8 of P.L.2019, c.59 (C.26:16-8);
(6) recommend that the patient participate in a consultation concerning concurrent or additional treatment opportunities, palliative care, comfort care, hospice care, and pain control options for the patient, and provide the patient with a referral to a health care professional qualified to discuss these options with the patient;
(7) advise the patient about the importance of having another person present if and when the patient chooses to self-administer medication prescribed under P.L.2019, c.59 (C.26:16-1 et al.) and of not taking the medication in a public place;
(8) inform the patient of the patient's opportunity to rescind the request at any time and in any manner, and offer the patient an opportunity to rescind the request at the time the patient makes a second oral request as provided in section 10 of P.L.2019, c.59 (C.26:16-10); and
(9) fulfill the medical record documentation requirements of P.L.2019, c.59 (C.26:16-1 et al.).
b. The attending physician shall:
(1) dispense medication directly, including ancillary medication intended to facilitate the desired effect to minimize the patient's discomfort, if the attending physician is authorized under law to dispense and has a current federal Drug Enforcement Administration certificate of registration; or
(2) contact a pharmacist to inform the latter of the prescription, and transmit the written prescription personally, by mail, or by permissible electronic communication to the pharmacist, who shall dispense the medication directly to either the patient, the attending physician, or an expressly identified agent of the patient.
Medication dispensed pursuant to this subsection shall not be dispensed to the patient by mail or other form of courier.
a. examined that patient and the patient's relevant medical records;
b. confirmed, in writing, the attending physician's diagnosis that the patient is terminally ill; and
c. verified that the patient is capable, is acting voluntarily, and has made an informed decision to request medication that, if prescribed, the patient may choose to self-administer pursuant to P.L.2019, c.59 (C.26:16-1 et al.).
b. If a patient has been referred to a mental health care professional pursuant to subsection a. of this section, the attending physician shall not write a prescription for medication that the patient may choose to self-administer pursuant to P.L.2019, c.59 (C.26:16-1 et al.) unless the attending physician has been notified in writing by the mental health care professional of that individual's determination that the patient is capable.
(1) at least 15 days shall elapse between the initial oral request and the second oral request;
(2) at the time the patient makes a second oral request, the attending physician shall offer the patient an opportunity to rescind the request;
(3) the patient may submit the written request to the attending physician when the patient makes the initial oral request or at any time thereafter;
(4) the written request shall meet the requirements of section 5 of P.L.2019, c.59 (C.26:16-5);
(5) at least 15 days shall elapse between the patient's initial oral request and the writing of a prescription pursuant to P.L.2019, c.59 (C.26:16-1 et al.); and
(6) at least 48 hours shall elapse between the attending physician's receipt of the patient's written request and the writing of a prescription pursuant to P.L.2019, c.59 (C.26:16-1 et al.).
b. A qualified terminally ill patient may rescind the request at any time and in any manner without regard to the patient's mental state.
c. At the time the patient makes an initial oral request for medication that the patient may choose to self-administer pursuant to P.L.2019, c.59 (C.26:16-1 et al.), the patient's attending physician shall recommend to the patient that the patient participate in a consultation concerning concurrent or additional treatment opportunities, palliative care, comfort care, hospice care, and pain control options, and provide the patient with a referral to a health care professional qualified to discuss these options with the patient. If the patient chooses to participate in such consultation, the consultation shall include, to the extent the patient consents to share such information, consideration of: the patient's terminal illness; the patient's prognosis; current and past courses of treatment prescribed for the patient in connection with the patient's terminal illness, including the results of any such treatment; and any palliative care, comfort care, hospice care, and pain control treatment the patient is currently receiving or has received in the past.
d. The attending physician shall ensure that the following items are included in the patient's medical record:
(1) the determination that the patient is a qualified terminally ill patient and the basis for that determination;
(2) all oral and written requests by the patient to the attending physician for medication that the patient may choose to self-administer pursuant to P.L.2019, c.59 (C.26:16-1 et al.);
(3) the attending physician's diagnosis and prognosis, and determination that the patient is capable, is acting voluntarily, and has made an informed decision;
(4) the consulting physician's diagnosis and prognosis, and verification that the patient is capable, is acting voluntarily, and has made an informed decision;
(5) if applicable, a report of the determination made by a mental health care professional as to whether the patient is capable pursuant to section 8 of P.L.2019, c.59 (C.26:16-8);
(6) the attending physician's recommendation that the patient participate in a consultation concerning concurrent or additional treatment opportunities, palliative care, comfort care, hospice care, and pain control options; the referral provided to the patient with a referral to a health care professional qualified to discuss these options with the patient; an indication as to whether the patient participated in the consultation; and an indication as to whether the patient is currently receiving palliative care, comfort care, hospice care, or pain control treatments;
(7) the attending physician's offer to the patient to rescind the patient's request at the time of the patient's second oral request; and
(8) a note by the attending physician indicating that all requirements under P.L.2019, c.59 (C.26:16-1 et al.) have been met and indicating the steps taken to carry out the patient's request for medication, including a notation of the medication prescribed.
a. a driver's license or non-driver identification card issued by the New Jersey Motor Vehicle Commission;
b. proof that the person is registered to vote in New Jersey;
c. a New Jersey resident gross income tax return filed for the most recent tax year; or
d. any other government record that the attending physician reasonably believes to demonstrate the individual's current residency in this State.
(1) No later than 30 days after the dispensing of medication pursuant to P.L.2019, c.59 (C.26:16-1 et al.), the physician or pharmacist who dispensed the medication shall file a copy of the dispensing record with the department, and shall otherwise facilitate the collection of such information as the director may require regarding compliance with P.L.2019, c.59 (C.26:16-1 et al.).
(2) No later than 30 days after the date of the qualified terminally ill patient's death, the attending physician shall transmit to the department such documentation of the patient's death as the director shall require.
(3) In the event that anyone required to report information to the department pursuant to P.L.2019, c.59 (C.26:16-1 et al.) provides an inadequate or incomplete report, the department shall contact the person to request a complete report.
(4) To the maximum extent practicable and consistent with the purposes of this section, the department shall seek to coordinate the process for reporting information pursuant to this subsection with the process for reporting prescription monitoring information by a pharmacy permit holder pursuant to sections 25 through 30 of P.L.2007, c.244 (C.45:1-45 through C.45:1-50).
b. Any information collected pursuant to subsection a. of this section that contains material or data that could be used to identify an individual patient or health care professional shall not be included under materials available to public inspection pursuant to P.L.1963, c.73 (C.47:1A-1 et seq.) and P.L.2001, c.404 (C.47:1A-5 et al.).
c. The department shall prepare and make available to the public on its Internet website an annual statistical report of information collected pursuant to subsection a. of this section.
b. An obligation owing under a contract, will, insurance policy, annuity, or other agreement, made before the effective date of P.L.2019, c.59 (C.26:16-1 et al.), shall not be affected by: the provisions of P.L.2019, c.59 (C.26:16-1 et al.); a person's making or rescinding a request for medication pursuant to P.L.2019, c.59 (C.26:16-1 et al.); or any other action taken pursuant to P.L.2019, c.59 (C.26:16-1 et al.).
c. On or after the effective date of P.L.2019, c.59 (C.26:16-1 et al.), procurement or issuance of a life, health, or accident insurance policy or annuity, or the premium or rate charged for the policy or annuity, shall not be conditioned upon or otherwise take into account the making or rescinding of a request for medication pursuant to P.L.2019, c.59 (C.26:16-1 et al.) by any person.
a. authorize a physician or any other person to end a patient's life by lethal injection, active euthanasia, or mercy killing, or any act that constitutes assisted suicide under any law of this State; or
b. lower the applicable standard of care to be provided by a health care professional who participates in P.L.2019, c.59 (C.26:16-1 et al.).
(2) Any action taken in accordance with the provisions of P.L.2019, c.59 (C.26:16-1 et al.) shall not constitute patient abuse or neglect, suicide, assisted suicide, mercy killing, euthanasia, or homicide under any law of this State.
(3) A patient's request for, or the provision of, medication in compliance with the provisions of P.L.2019, c.59 (C.26:16-1 et al.) shall not constitute abuse or neglect of an elderly person or provide the sole basis for the appointment of a guardian or conservator.
b. The provisions of subsection a. of this section shall not apply to acts or omissions constituting gross negligence, recklessness, or willful misconduct.
c. Any action taken by a health care professional to participate in P.L.2019, c.59 (C.26:16-1 et al.) shall be voluntary on the part of that individual. If a health care professional is unable or unwilling to carry out a patient's request under P.L.2019, c.59 (C.26:16-1 et al.), and the patient transfers the patient's care to a new health care professional or health care facility, the prior health care professional shall transfer, upon request, a copy of the patient's relevant records to the new health care professional or health care facility.
b. A person who coerces or exerts undue influence on a patient to request medication pursuant to P.L.2019, c.59 (C.26:16-1 et al.) or to destroy a rescission of a request is guilty of a crime of the third degree.
c. Theft of medication prescribed to a qualified terminally ill patient pursuant to P.L.2019, c.59 (C.26:16-1 et al.) shall constitute an offense involving theft of a controlled dangerous substance as set forth in N.J.S.2C:20-2.
d. Nothing in P.L.2019, c.59 (C.26:16-1 et al.) shall limit liability for civil damages resulting from the negligence or intentional misconduct of any person.
e. The penalties set forth in this section shall not preclude the imposition of any other criminal penalty applicable under law for conduct that is inconsistent with the provisions of P.L.2019, c.59 (C.26:16-1 et al.).
REQUEST FOR MEDICATION TO END MY LIFE IN A
HUMANE AND DIGNIFIED MANNER
I, . . . . . . . . . . . . . . . , am an adult of sound mind and a resident of New Jersey.
I am suffering from . . . . . . . . . . . . . . . , which my attending physician has determined is a terminal illness, disease, or condition and which has been medically confirmed by a consulting physician.
I have been fully informed of my diagnosis, prognosis, the nature of medication to be prescribed and potential associated risks, the expected result, and the feasible alternatives, including concurrent or additional treatment opportunities, palliative care, comfort care, hospice care, and pain control.
I request that my attending physician prescribe medication that I may self-administer to end my life in a humane and dignified manner and to contact any pharmacist as necessary to fill the prescription.
INITIAL ONE:
. . . . I have informed my family of my decision and taken their opinions into consideration.
. . . . . I have decided not to inform my family of my decision.
. . . . . I have no family to inform of my decision.
INITIAL ALL THAT APPLY:
. . . . .My attending physician has recommended that I participate in a consultation concerning concurrent or additional treatment opportunities, palliative care, comfort care, hospice care, and pain control options, and provided me with a referral to a health care professional qualified to discuss these options with me.
. . . . .I have participated in a consultation concerning concurrent or additional treatment opportunities, palliative care, comfort care, hospice care, and pain control options.
. . . I am currently receiving palliative care, comfort care, or hospice care.
I understand that I have the right to rescind this request at any time.
I understand the full import of this request, and I expect to die if and when I take the medication to be prescribed. I further understand that, although most deaths occur within three hours, my death may take longer and my physician has counseled me about this possibility.
I make this request voluntarily and without reservation, and I accept full responsibility for my decision.
Signed:. . . . . . . . . . . . . . .
Dated:. . . . . . . . . . . . . . .
DECLARATION OF WITNESSES
By initialing and signing below on or after the date the person named above signs, we declare that the person making and signing the above request:
Witness 1 Witness 2
Initials Initials
. . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . .
Printed Name of Witness 1: . . . . . . . . . . . . .
Signature of Witness 1/Date: . . . . . . . . . . . .
Printed Name of Witness 2: . . . . . . . . . . . . .
Signature of Witness 2/Date: . . . . . . . . . . . .
NOTE: At least one witness shall not be a relative by blood, marriage, or adoption of the person signing this request, shall not be entitled to any portion of the person's estate upon death, and shall not own, operate, or be employed at a health care facility, other than a long term care facility, where the person is a patient or resident.
a. The New Jersey Statewide 2-1-1 telephone system is the national abbreviated dialing code for free access to health and human services information and referral;
b. New Jersey's current Statewide 2-1-1 telephone system is out of date with regards to information relating to current available modes of public transit, that mainly directs people with disabilities to use private transit services that are expensive and not feasible for routine travel;
c. New Jersey's Statewide 2-1-1 system should include all pertinent transportation information, especially information pertaining to Access Link, county paratransit, voluntary drivers, or agencies that cater to the transportation needs of persons with disabilities; and
d. The Statewide 2-1-1 telephone system needs to be updated to include all current modes of public transit available in New Jersey, as well as updated to provide information on how to access and use the various services.
a. prominently displayed on the websites of both the New Jersey Transit Corporation and the Department of Human Services;
b. made available to the public through the Statewide 2-1-1 telephone system; and
c. made available using any other means that the Executive Director of the New Jersey Transit Corporation or the Commissioner of Human Services deems appropriate.
In addition, to the extent practicable, the Statewide 2-1-1 telephone system, the corporation, and the department shall disseminate information concerning public transit availability and resources using social media and any other means deemed appropriate to reach as many individuals and population groups in the State as possible.
a. Most nations across the globe have successfully reduced their maternal mortality rates over the past two and a half decades, in response to a United Nations' call to action; however, the U.S. is one of only a handful of countries where maternal mortality rates have continued to rise (increasing by 27 percent between 2000 and 2014);
b. The U.S. is currently ranked 50th in the world in maternal mortality, with a rate of maternal death that is nearly three times the rate that exists in the United Kingdom, and about six times the rate that exists in the Netherlands, Norway, and Sweden;
c. In New Jersey, there is currently a Maternal Mortality Case Review Team that operates out of the Department of Health (DOH), and periodically reviews and provides statistics on maternal deaths occurring in the State;
d. A document produced by Every Mother Counts shows that New Jersey is ranked 46th of the 50 states in total maternal mortality, with a rate of 37.3 maternal deaths per every 100,000 live births, and that African-American women in New Jersey are five times more likely than Caucasian women to die from pregnancy-related complications;
e. Although the DOH Maternal Mortality Case Review Team produces important statistical data, the team is not permanently established by statute, does not meet regularly, produces only periodic reports on maternal mortality, and uses varying datasets in those periodic reports, making the aggregation and comparison of data by interested parties more difficult;
f. There is a need to coordinate and expand the multiple, fractionalized maternal mortality and morbidity reduction efforts being conducted by caring and committed individuals and organizations across the State. Further, it is essential to house these myriad efforts in the DOH, the State-designated agency responsible for public health protection and services. The DOH can uniquely leverage the weight and power of the State to effectuate critical changes in the delivery of care and the implementation of Statewide strategies to reduce maternal mortality and morbidity and to eliminate the racial and ethnic disparities in maternal outcomes;
g. To coordinate and support a Statewide strategy to reduce maternal morbidity and mortality, the State hereby establishes a New Jersey Maternal Care Quality Collaborative (NJMCQC);
h. To improve data collection and to improve and assist quality improvement efforts by health care facilities and the State, a Maternal Data Center is hereby established within the Healthcare Quality and Informatics Unit in the DOH;
i. (Deleted by amendment, P.L.2023, c.109); and
j. In order to ensure that the entity reviewing maternal deaths in the State may operate permanently and sustainably, with full statutory authority, in adherence to certain specified powers and responsibilities, it is both reasonable and necessary for the Legislature to replace the existing informal DOH Maternal Mortality Case Review Team with a statutorily established Maternal Mortality Review Committee situated in the Department of Health, which committee will incorporate the membership of the current Maternal Mortality Case Review Team, but will have formal statutory authority, broader powers, and specific goals and directives, as necessary to ensure that it is able to continuously engage in the comprehensive, regular, and uniform review and reporting of maternal deaths throughout the State.
"Authority" means the New Jersey Maternal and Infant Health Innovation Authority established pursuant to section 4 of P.L.2023, c.109 (C.26:18-20).
"Board" means the board of the New Jersey Maternal and Infant Health Innovation Authority established pursuant to section 5 of P.L.2023, c.109 (C.26:18-21).
"Committee" means the Maternal Mortality Review Committee, established pursuant to section 4 of P.L.2019, c.75 (C.26:18-4), which is responsible for annually reviewing and reporting on maternal death rates and the causes of maternal death in the State, and which is further responsible for providing recommendations to improve maternal care and reduce adverse maternal outcomes.
"Department" means the Department of Health.
"Maternal death" means a pregnancy-associated death.
"Maternal Mortality Case Review Team" means the interdisciplinary team of experts that is operating in the Department of Health as of the effective date of this act, and which is being replaced by the committee established pursuant to this act.
"NJMCQC" means the New Jersey Maternal Care Quality Collaborative, established pursuant to section 3 of P.L.2019, c.75 (C.26:18-3).
"Pregnancy-associated death" means the death of a woman, which occurs while the woman is pregnant, or during the one-year period following the date of the end of the pregnancy, irrespective of the cause of death.
"Pregnancy-related death" means the death of a woman, which occurs while the woman is pregnant, or during the one-year period following the date of the end of the pregnancy, regardless of the duration of the pregnancy, and which results from any cause related to, or aggravated by, the pregnancy or its management, but excluding any accidental or incidental cause.
"Regional Health Hub" means an entity designated as a Regional Health Hub as provided in P.L.2019, c.517 (C.30:4D-8.16 et seq.).
"Report of maternal death" means a report of a suspected maternal death, which is filed with the department, pursuant to the processes established under subsection a. of section 7 of P.L.2019, c.75 (C.26:18-7), and which is to be forwarded to the committee for the purposes of investigation, as provided by subsection b. of that section.
"Severe maternal morbidity" means the physical and psychological conditions that result from, or are aggravated by, pregnancy, and which have an adverse effect on the health of a woman.
"State registrar" means the State registrar of vital statistics, who is responsible for supervising the registration of, and maintaining, death records in the State, in accordance with the provisions of R.S.26:8-1 et seq.
b. The NJMCQC shall work collaboratively with current organizations that are developing and implementing maternal mortality and morbidity reduction strategies, including the New Jersey Hospital Association's Perinatal Quality Care Collaborative.
c. The NJMCQC shall be composed of 39 members, including eight ex-officio members and 31 public members appointed by the Governor.
(1) The ex officio members shall include the following persons or their designees:
the Deputy Commissioner of Health Systems in the Department of Health;
the Deputy Commissioner of Public Health Services in the Department of Health;
the Director of the Office of Minority and Multicultural Health in the Department of Health;
the Director of the Division of Medical Assistance and Health Services in the Department of Human Services;
the Assistant Commissioner of Health and Life Insurance Plans in the Department of Banking and Insurance;
the Director of the Division of Consumer Affairs in the Department of Law and Public Safety;
the Director of the New Jersey Maternal Data Center in the Department of Health; and
the president and chief executive officer of the authority, who shall serve as chairperson of the NJMCQC.
(2) The public members appointed by the Governor shall include members representing each of the following groups:
the New Jersey Hospital Association;
the New Jersey Health Care Quality Institute;
the Catholic HealthCare Partnership of New Jersey;
the Hospital Alliance of New Jersey;
the Fair Share Hospitals Collaborative;
the New Jersey section of the American College of Obstetricians and Gynecologists;
the New Jersey Affiliate of the American College of Nurse Midwives;
the New Jersey Medical Society;
two medical directors of health plans in the State, as recommended to the commissioner by the President of the New Jersey Association of Health Plans;
the New Jersey Section of the Association of Women's Health Obstetric and Neonatal Nurses;
the New Jersey Chapter of the American College of Emergency Physicians;
a New Jersey affiliate of Planned Parenthood;
the New Jersey Association of Osteopathic Physicians and Surgeons;
the New Jersey Primary Care Association;
the Partnership for Maternal and Child Health of Northern New Jersey;
the Central Jersey Family Health Consortium;
the Southern New Jersey Perinatal Cooperative;
each of the four existing Regional Health Hubs or any successor organization to that Regional Health Hub;
the Perinatal Health Equity Initiative; and
eight additional public members appointed on the recommendation of the Governor, including: one member who is engaged in maternal health advocacy; one member who is engaged in health equity advocacy; one member who has personal experience in receiving perinatal services in one of the 10 New Jersey municipalities with the highest infant mortality rates in the State; one member who has expertise in maternal or infant health workforce development or graduate health education; one member who has expertise in behavioral health; one member who has expertise in providing doula services; one member who expertise in providing lactation services as an international board certified lactation consultant; and one member who is engaged in healthcare consumer advocacy.
d. The public members of the NJMCQC shall serve without compensation and shall each serve for a term of three years. Each public member shall serve for the term of appointment and shall serve until a successor is appointed and qualified, except that a public member may be reappointed to the NJMCQC upon the expiration of the member's term. Any vacancy in the membership shall be filled, for the unexpired term, in the same manner as the original appointment.
e. The board, in consultation with the NJMCQC, shall adopt and implement the strategic plan for the State of New Jersey to reduce maternal mortality, morbidity, and racial and ethnic disparities. The NJMCQC shall meet quarterly to develop recommendations to submit to the board for review and approval, which recommendations shall include, but shall not be limited to, proposed activities that forward the strategic plan, strategies on future activities, funding opportunities, action items based on the data generated and collected by the Maternal Data Center, the Healthcare Quality and Informatics Unit, the Maternal Mortality Review Committee, the Department of Health, and its partners, and strategies to communicate goals and achievement of these goals with stakeholders.
f. The board, in consultation with the NJMCQC, shall:
(1) (Deleted by amendment, P.L.2023, c.109)
(2) Apply for and accept any grant of money from the federal government, private foundations or other sources, which may be available for programs related to maternal mortality, morbidity, and racial and ethnic disparities;
(3) Coordinate with the Department of Health to receive federal funds specifically designated for programs concerning maternal mortality, morbidity, and racial and ethnic disparities;
(4) Enter into contracts with individuals, organizations, and institutions necessary for the performance of its duties under P.L.2019, c.75 (C.26:18-1 et al.); and
(5) Establish and coordinate among subcommittees as necessary to achieve the purposes of the NJMCQC.
g. (Deleted by amendment, P.L.2023, c.109)
b. The ex officio members of the committee shall include the following persons, or their designees:
the State Medical Examiner;
the Director of the Office of Emergency Medical Services in the Department of Health;
the Director of the Maternal Data Center established by section 14 of P.L.2019, c.75 (C.26:2C-13); and
the Medical Director of the Division of Medical Assistance and Health Services in the Department of Human Services;
c. (1) Seven of the public members shall be appointed by the Governor to represent the following groups:
the New Jersey section of the American College of Obstetricians and Gynecologists (ACOG);
the New Jersey Affiliate of the American College of Nurse Midwives;
the New Jersey Section of the Association of Women's Health Obstetric and Neonatal Nurses (AWHONN);
the New Jersey Chapter of the American College of Emergency Physicians;
the Partnership for Maternal and Child Health of Northern New Jersey;
the Central Jersey Family Health Consortium; and
the Southern New Jersey Perinatal Cooperative.
(2) The additional 13 public members of the committee shall be appointed by the Commissioner of Health, to reflect the diversity in the state's geographic regions and perinatal designations and shall include:
seven licensed and practicing health care practitioners, one of whom specializes in obstetrics or gynecology, one of whom specializes in maternal and fetal medicine, one of whom specializes in critical care medicine, one of whom specializes in perinatal pathology, two of whom serve in clinical roles providing pre or post-natal care at Federally Qualified Health Centers operating in the State, and one anesthesiologist;
one licensed and practicing health care practitioner or mental health care practitioner;
one substance use disorder treatment professional who specializes in perinatal addiction;
one certified nurse midwife;
one registered professional nurse or advanced practice nurse who specializes in hospital-based obstetric nursing;
one licensed practical nurse, registered professional nurse, or advanced practice nurse who participates in, and represents, the Nurse-Family Partnership operating in New Jersey; and
one Certified Midwife or Certified Professional Midwife.
d. Of the 13 public members appointed to the committee by the Commissioner of Health, not more than seven shall be of the same political party.
e. Each public member of the committee shall serve for a term of four years; however, of the public members first appointed, four shall serve an initial term of two years, four shall serve an initial term of three years, and five shall serve an initial term of four years. Each public member shall serve for the term of their appointment, and until a successor is appointed and qualified, except that a public member may be reappointed to the committee upon the expiration of their term. Any vacancy in the membership shall be filled, for the unexpired term, in the same manner as the original appointment.
f. All initial appointments to the committee shall be made within 60 days after the effective date of this act. Upon the appointment of a majority of the committee members, the Maternal Mortality Case Review Team, which is constituted in the Department of Health as of the effective date of this act, shall be disbanded.
g. Any member of the committee may be removed by the Commissioner of Health, for cause, after a public hearing.
b. The committee shall meet pursuant to a schedule to be established at its first meeting, and it shall additionally meet at the call of its chairperson or the Commissioner of Health; however, in no case shall the committee meet less than four times a year.
c. A majority of the total number of members appointed to the committee shall constitute a quorum for the conducting of official committee business. A vacancy in the membership of the committee shall not impair the right of the committee to exercise its powers and duties, provided that a majority of the currently appointed members are available to conduct business. Any recommendations of the committee shall be approved by a majority of the members present.
d. The members of the committee shall serve without compensation, but shall be reimbursed for travel and other necessary expenses incurred in the discharge of their official duties, within the limits of funds appropriated or otherwise made available for such purposes.
e. The Department of Health shall employ, at a minimum, the following support staff for the committee: a program manager, a clinical nurse case abstractor; two maternal child health epidemiologists, a case abstraction manager, and any other staff the Commissioner of Health shall deem necessary. The Department of Health shall also provide such administrative staff support to the committee as shall be necessary for the committee to carry out its duties.
(1) carry out any power, duty, or responsibility expressly granted by this act;
(2) adopt, amend, or repeal suitable bylaws for the management of its affairs;
(3) maintain an office at such place or places as it may designate;
(4) apply for, receive, and accept, from any federal, State, or other public or private source, grants, loans, or other moneys that are made available for, or in aid of, the committee's authorized purposes, or that are made available to assist the committee in carrying out its powers, duties, and responsibilities under this act;
(5) enter into any and all agreements or contracts, execute any and all instruments, and do and perform any and all acts or things necessary, convenient, or desirable to further the purposes of the committee;
(6) call to its assistance, and avail itself of the services of, such employees of any State entity or local government unit as may be required and available for the committee's purposes;
(7) review and investigate reports of maternal death; conduct witness interviews, and hear testimony provided under oath at public or private hearings, on any material matter; and request, or compel through the issuance of a subpoena, the attendance of relevant witnesses and the production of relevant documents, records, and papers;
(8) solicit and consider public input and comment on the committee's activities by periodically holding public hearings or conferences, and by providing other opportunities for such input and comment by interested parties; and
(9) identify, and promote the use of, best practices in maternal care, and encourage and facilitate cooperation and collaboration among health care facilities, health care professionals, administrative agencies, and local government units for the purposes of ensuring the provision of the highest quality maternal care throughout the State.
b. The Maternal Mortality Review Committee shall have the duty and responsibility to:
(1) develop mandatory and voluntary maternal death reporting processes, in accordance with the provisions of section 7 of this act and, at a minimum meet or exceed current federal Centers for Disease Control and Prevention reporting methodologies;
(2) conduct an investigation of each reported case of maternal death, and prepare a de-identified case summary for each such case, in accordance with the provisions of section 8 of this act;
(3) review the statistical data on maternal deaths that is forwarded by the Maternal Data Center pursuant to section 14 of this act, and the reports of maternal death that are forwarded by the department, pursuant to subsection b. of section 7 of this act, in order to identify Statewide and regional maternal death rates; trends, patterns, and disparities in adverse maternal outcomes; and medical, non-medical, and system-related factors that may have contributed to maternal deaths and treatment disparities; and
(4) annually report its findings and recommendations on maternal mortality to the department, the Governor, and the Legislature, in accordance with section 9of this act.
(1) develop a mandatory maternal death reporting process, pursuant to which health care practitioners, medical examiners, hospitals, birthing centers, and other relevant professional actors and health care facilities will be required to confidentially report to the Department of Health on individual cases of maternal death. In developing a mandatory maternal death reporting process pursuant to this paragraph, the committee may, as deemed to be appropriate, review and incorporate elements of the maternal death reporting process that is used by the Maternal Mortality Case Review Team as of the effective date of this act; and
(2) develop a voluntary maternal death reporting process, pursuant to which the family members of a deceased woman, and any other interested members of the public, will be permitted, but not required, to confidentially report to the Department of Health on individual cases of perceived maternal death. At a minimum, the process developed pursuant to this paragraph shall require the department to: (a) post on its Internet website a hyperlink, a toll-free telephone number, and an email address, which may each be used for the voluntary submission of public reports of maternal death; and (b) publicize the availability of these resources to professional organizations, community organizations, social service agencies, and members of the public.
b. The department shall keep a record of all reports of maternal death that are submitted thereto through the reporting processes that are established by the committee pursuant to paragraphs (1) and (2) of subsection a. of this section. The department shall also ensure that a copy of each such report of maternal death is promptly forwarded to the committee, so that the committee may properly execute its investigatory functions and other duties and responsibilities under this act.
(1) the information contained in the forwarded report of maternal death;
(2) any relevant information contained in the deceased woman's autopsy report or death record, or in a certificate of live birth or fetal death for the woman's child, or in any other vital records pertaining to the woman;
(3) any relevant information contained in the deceased woman's medical records, including: (a) records related to the health care that was provided to the woman prior to her pregnancy; (b) records related to the woman's prenatal and postnatal care, labor and delivery care, emergency room care, and any other care delivered up until the time of the woman's death; and (c) the woman's hospital discharge records and all hospital records including all emergency room and outpatient records from the one-year period following the end of the pregnancy;
(4) information obtained through the oral and written interviews of individuals who were directly involved in the care of the woman either during, or immediately following, her pregnancy, including interviews with relevant health care practitioners, mental health care practitioners, and social service providers, and, as deemed to be appropriate and necessary, interviews with the woman's family members;
(5) background information about the deceased woman, including, but not limited to, information regarding the woman's age, race, and socioeconomic status; and
(6) any other information that may shed light on the maternal death, including, but not limited to, reports from social service or child welfare agencies.
b. At the conclusion of an investigation conducted pursuant to this section, the committee shall prepare a case summary, which shall include the committee's findings with regard to the cause of, or the factors that contributed to, the maternal death, and recommendations for actions that should be undertaken, or policies that should be implemented, to mitigate or eliminate those factors and causes in the future. Any case summary prepared pursuant to this subsection shall omit the identifying information of the deceased woman and her family members, the health care providers who provided care, and the hospitals where care was provided.
c. The committee may present its findings and recommendations on each individual case, or on groups of individual cases, as deemed appropriate, to the health care facility or facilities where relevant care was provided in the case or group of cases, and to the individual health care practitioners who provided such care, or to any relevant professional organization, for the purposes of instituting or facilitating policy changes, educational activities, or improvements in the quality of care provided; or for the purposes of exploring, facilitating, or establishing regional projects or other collaborative projects that are designed to reduce instances of maternal death.
b. The report that is annually prepared pursuant to this section shall be based on:
(1) the case summaries that were prepared by the committee over the preceding year, pursuant to subsection b. of section 8 of this act;
(2) the statistical data that was forwarded to the committee, during the preceding year, by the Maternal Data Center, pursuant to section 14 of this act; and
(3) any other relevant information, including information from the committee's prior annual reports, or information on any collaborative maternal health arrangements that have been established by health care providers, professional organizations, local government units, or other relevant actors or entities in the preceding year, in response to the committee outreach authorized by subsection c. of section 8 of this act, or by paragraph (9) of subsection a. of section 6, of this act.
c. Upon receipt of the committee's annual report pursuant to this section, the department shall post a copy of the report at a publicly accessible location on its Internet website, and shall take appropriate steps to otherwise broadly publicize the committee's findings and recommendations. The Commissioner of Health shall also adopt rules and regulations, pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.), to implement the recommendations contained in the report, to the extent that such recommendations can be implemented through administrative rule-making action.
b. Each hospital and birthing facility in the State shall require its health care practitioners involved in labor, delivery, and postpartum care to complete a standardized maternal patient discharge education module, pursuant to which such health care practitioners will be educated in the complications of childbirth, and the warning signs of complications in women who have just given birth. This educational module may be implemented in each facility before the department finalizes the Statewide educational program that is to be established under subsection a. of this section; however, after the Statewide educational program is finalized under subsection a. of this section, the educational modules implemented pursuant to this subsection shall be modified as necessary to conform to the department's educational program. Any modules implemented before the department's Statewide educational program is finalized shall address the most frequent causes of maternal mortality, including but not limited to, hemorrhage, hypertension, preeclampsia, heart failure and chest pain, infection, embolism, and postpartum depression. Each facility shall additionally provide this information, both orally and in writing, to any woman who has given birth at the facility, prior to discharge. The educational module implemented under this subsection shall be completed by all relevant health care practitioners at the facility, as a condition of their practice or employment in the facility, and may be used to satisfy relevant continuing education requirements applicable to each such health care practitioner.
c. Within 90 days after the effective date of this act, the Commissioner of Health shall adopt rules and regulations, pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.), as necessary to implement the provisions of this section.
(2) In no case shall the committee disclose any personally identifiable information to the public, or include any personally identifiable information in a case summary that is prepared pursuant to subsection b. of section 8 of this act, or in an annual report that is prepared pursuant to section 9 of this act.
(3) Members of the committee shall not be questioned in any civil, criminal, legislative, or other proceeding regarding information that has been presented in, or opinions that have been formed as a result of, a meeting or communication of the committee; however, nothing in this paragraph shall prohibit a committee member from being questioned, or from testifying, in relation to publicly available information or information that was obtained independent of the member's participation on the committee.
b. Nothing in this section shall be deemed to prohibit the committee from publishing, or from otherwise making available for public inspection, statistical compilations or reports that are based on confidential information, provided that those compilations and reports do not contain personally identifying information or other information that could be used to ultimately identify the individuals concerned.
(2) The results of the annual analysis that is conducted pursuant to this subsection shall be posted at a publicly accessible location on the Internet website of the Department of Health, and shall also be promptly forwarded to the New Jersey Maternal and Infant Health Innovation Authority and the NJMCQC.
b. In order to accomplish its duties under this section, the Maternal Mortality Review Committee shall:
(1) for the purposes of determining the total number of pregnancy-associated deaths, review each woman's death record, and match the death record with a certificate of live birth, or with a fetal or infant death record, for the woman's child, in order to confirm whether the woman died during pregnancy, or within one year after the end of pregnancy; and
(2) for the purposes of determining the total number of pregnancy-related deaths, review each woman's death record, and identify each such death record in which the death is reported to have resulted from an underlying or contributing cause related to pregnancy, regardless of the amount of time that has passed between the end of the pregnancy and the death.
The Maternal Mortality Review Committee may also use any other appropriate means or methods to identify maternal deaths. Such means or methods may include, but need not be limited to, use of the case ascertainment system devised by the federal Centers for Disease Control and Prevention.
b. The Maternal Data Center shall employ a director, three research scientists, a technical assistant, and other staff as necessary to implement the requirements set forth in subsection a. of this section.
b. The Commissioner of Health shall deposit all membership fees and other funds collected pursuant to section 15 of this act into the fund. Monies credited to the fund may be invested in the same manner as assets of the General Fund, and any investment earnings on the fund shall accrue to the fund and shall be available subject to the same terms and conditions as other monies in the fund.
c. Commencing July 1, 2019, and annually thereafter, monies in the fund shall be appropriated by the Legislature to the Department of Health for the purposes of operating and maintaining the Maternal Data Center pursuant to section 14 of this act.
a. In 2019, New Jersey Governor Philip D. Murphy and First Lady Tammy Snyder Murphy launched Nurture NJ, a Statewide campaign committed to both reducing maternal and infant mortality and morbidity and ensuring equitable access to and provision of care among women and children of all races and ethnicities.
b. At the time, New Jersey was ranked as low as 47th in the United States for maternal deaths and had one of the widest racial disparities for both maternal and infant mortality.
c. Such inequities are particularly evident in our capital city of Trenton, which experiences the highest maternal and infant health disparities among our Black and Hispanic communities. The City of Trenton is among the cities with the highest rates of Black and Hispanic infant mortality; and only 47 percent of mothers in Trenton receive prenatal care in their first trimester.
d. In January 2021, the Nurture NJ Strategic Plan included a recommendation to establish a center in the State capital, Trenton, that focuses on innovation and research in maternal and infant health through collaboration with the State's academic, philanthropic, business, and faith communities in partnership with the New Jersey Economic Development Authority, the Departments of Health, Human Services, and Children and Families, and the Office of the Secretary of Higher Education.
e. In order to create, fund, and sustain such a facility, to ensure that substantial commitments are made to its related activities, and to position New Jersey to acknowledge and act upon the health disparities and harm wrought by racism and other forms of systemic oppression that have created a public health crisis for Black and Hispanic mothers and their babies, it is necessary to create an authority independent of any supervision or control by the principal departments of the Executive Branch of the State Government.
f. The authority will operate a Trenton-based New Jersey Maternal and Infant Health Innovation Center, and will collaborate with other State departments and agencies to advance maternal and infant health care and clinical services throughout the State, and lead the State's coordination, promotion, and implementation of, among other things, education, policymaking, research, innovation, and perinatal workforce development, with a particular focus on eliminating racial disparities in maternal and infant health outcomes.
g. The New Jersey Maternal and Infant Health Innovation Center will serve as the first-of-its kind central hub to coordinate among national, State, and local agencies, as well as private organizations, to: promote equitable maternal and infant health care services; implement strategies related to health care and social service delivery, perinatal workforce development, community engagement, data collection, research, and analysis; and serve as an incubator of new enterprises, therapeutics, and technological innovations leading to better health outcomes and reduced mortality and morbidity rates for women and children.
h. The New Jersey Maternal and Infant Health Innovation Center will be at the forefront of serving maternal and infant health care needs, not only for families residing in the City of Trenton, but also for families throughout the State of New Jersey and the nation, and will enable collaborative partnerships for research and knowledge transfer within the global maternal and infant health communities.
"Authority" means the New Jersey Maternal and Infant Health Innovation Authority established pursuant to section 4 of P.L.2023, c.109 (C.26:18-20).
"Board" means the board of the New Jersey Maternal and Infant Health Innovation Authority established pursuant to section 5 of P.L.2023, c.109 (C.26:18-21).
"Center" means the premises located in the City of Trenton used by the authority pursuant to the provisions of P.L.2023, c.109 (C.26:18-17 et al.).
"Community advisory committee" means the community advisory committee established pursuant to section 8 of P.L.2023, c.109 (C.26:18-24).
"New Jersey Maternal Care Quality Collaborative" or "NJMCQC" means the New Jersey Maternal Care Quality Collaborative, established pursuant to section 3 of P.L.2019, c.75 (C.26:18-3).
b. The authority shall:
(1) establish and oversee the New Jersey Maternal and Infant Health Innovation Center, which shall serve as a central hub to coordinate among national, State, and local agencies, as well as private organizations, to:
(a) provide perinatal, infant care, related health services, and other services as outlined in P.L.2023, c.109 (C.26:18-17 et al.) to the residents of the City of Trenton and others who are in need of such services;
(b) promote equitable maternal and infant health care services;
(c) implement strategies related to health care and social service delivery, perinatal workforce development, community engagement, data collection, research, and analysis; and
(d) serve as an incubator of new enterprises, therapeutics, and technological innovations leading to better health outcomes and reduced mortality and morbidity rates for women and children; and
(2) be responsible for overseeing the design and implementation of programs and services to improve the State's maternal and infant health outcomes, address racial disparities in maternal and infant mortality rates, ensure infant and perinatal care is provided on an equitable basis, and eliminate disparities in access to care, including, but not limited to, health care and social service delivery, research and innovation, perinatal workforce development, education and public awareness, and other initiatives as may be undertaken by the authority.
c. The authority shall become the agency primarily responsible for coordinating efforts and strategies to reduce maternal mortality, morbidity, and racial and ethnic disparities in the State at such time as the members of the board are appointed pursuant to section 5 of P.L.2023, c.109 (C.26:18-21) and the board first organizes. At that time, and except as otherwise provided by this act, all powers, duties, and responsibilities authorized pursuant to P.L.2019, c.75 (C.26:18-1 et al.) shall be transferred from the NJMCQC to the authority. Thereafter, the NJMCQC shall be reorganized within the authority and shall operate under the supervision and oversight of the board as provided in section 5 of P.L.2023, c.109 (C.26:18-21). The provisions of this subsection shall be carried out in accordance with the "State Agency Transfer Act," P.L.1971, c.375 (C.52:14D-1 et seq.), and the transfer of oversight over the NJMCQC shall include transfer of all files, books, papers, records, equipment, and other property or resources held by the NJMCQC, including, but not limited to, any State funds that have been appropriated to the Department of Health for the exclusive use of the NJMCQC, which shall be deposited in accounts as may be permitted or required by law.
(1) the person-centered and supportive services provided for birthing persons and infants during the prenatal, birthing, and postpartum periods by doulas and midwives;
(2) the culturally competent nature of the care and services provided by doulas and midwives to birthing persons;
(3) the health benefits and improved maternal and infant health outcomes that may result from doula and midwives; and
(4) any free or low-cost resources made available by the State for doula and midwife services, including, but not limited to, information concerning NJ FamilyCare coverage of doula and midwife services for pregnant, birthing, and postpartum enrollees.
b. Notwithstanding any provisions of P.L.2023, c.263 (C.52:14-40 et seq.) to the contrary, the President and Chief Executive Officer of the New Jersey Maternal Infant Health Innovation Authority shall, at a minimum:
(1) provide for the development of printed and electronic educational materials related to the public awareness campaign established pursuant to subsection a. of this section in additional languages to those all State government entities are required to use pursuant to P.L.2023, c.263 (C.52:14-40 et seq.); and
(2) make those materials available for download online and encourage the distribution of the materials to the public through a variety of entities, including, but not limited to: local health agencies and clinics; local health care providers and facilities; reproductive health service providers, including, but not limited to, Planned Parenthood health clinics; local WIC agencies and clinic offices; county human services offices; pharmacies; and other community-based outreach programs and organizations in the State.
c. As used in this section:
"Doula services" shall have the same meaning as provided in in section 1 of P.L.2023, c.286 (C.26:2H-12.6i).
"Midwife" means a certified midwife, a certified professional midwife, or a certified nurse midwife pursuant to R.S.45:10-1 et seq.
"Reproductive health service provider" means a hospital, clinic, physician's office, or other facility that provides reproductive health services, including an employee, a volunteer, or a contractor of the provider.
"Reproductive health services" means medical, surgical, counseling, or referral services relating to the human reproductive system, including services relating to pregnancy or the termination of a pregnancy.
“WIC” means the Special Supplemental Nutrition Program for Women, Infants and Children, established pursuant to the federal "Child Nutrition Act of 1966," Pub.L.89-642 (42 U.S.C. s.1771 et seq.).
(1) the Commissioner of Health, the Chief Executive Officer of the New Jersey Economic Development Authority, the Commissioner of Human Services, the Commissioner of Banking and Insurance, the Commissioner of Children and Families, the Secretary of Higher Education, and the Commissioner of Labor, or their designees, who shall serve ex officio; and
(2) eight public members to be appointed by the Governor as follows:
(a) one public member appointed upon the recommendation of the Mayor of Trenton;
(b) one public member appointed upon the recommendation of the Senate President in consultation with the New Jersey Black, Latino, and Asian-American Legislative Caucuses;
(c) one public member appointed upon the recommendation of the Speaker of the General Assembly in consultation with the New Jersey Black, Latino, and Asian-American Legislative Caucuses;
(d) five additional public members. Subject to the requirements of subsection d. of section 8 of P.L.2023, c.109 (C.26:18-24), the Governor shall select one of the public members appointed pursuant to this subparagraph to serve as the chairperson of the community advisory committee established pursuant to section 8 of P.L.2023, c.109 (C.26:18-24) and one of the public members appointed pursuant to this subparagraph to serve as the vice-chairperson of the community advisory committee.
b. In appointing public members to the board, the Governor shall seek to ensure that, to the extent possible, a majority of the public members have relevant experience in one or more of the following areas related to maternal, infant, and childhood health care, with the goal of ensuring the board includes representative experience in as many of these areas as is possible: obstetrics; neonatal care; perinatal clinical services; family planning; perinatal workforce development; education; research and innovation; community health work; social services; public health awareness; leadership; doula care; midwifery care; and other relevant experience, including lived experience, related to racial disparities affecting delivery of health care services and mortality and morbidity rates.
In addition, when appointing public members to the board, the Governor shall seek to appoint women and minorities who have been most acutely impacted by maternal and infant health disparities, with a particular focus on Black and Latina women and on women residing in Trenton, and with additional focus on Black and Latina women who have given birth within the last three years.
c. The public members initially appointed to the board shall be appointed no later than 120 days after the effective date of P.L.2023, c.109 (C.26:18-17 et al.). The public members shall serve for a term of five years or until their successors are appointed, except that, of the public members first appointed to the board, two shall serve for one year, three shall serve for two years, and three shall serve for five years. Vacancies in the public membership shall be filled for the duration of the unexpired term. Public members shall be eligible for reappointment to the board. The public members of the board shall receive an annual salary of $20,000. The ex officio members of the board and their designees, if any, shall serve without compensation but shall be reimbursed for reasonable expenses incurred in the performance of their official duties, within the limits of funds appropriated or otherwise made available to the authority for this purpose. The public members appointed to serve as chairperson and vice-chairperson of the community advisory committee pursuant to subparagraph (d) of paragraph (2) of subsection a. of this section shall be entitled to receive the stipend authorized pursuant to subsection e. of section 8 of P.L.2023, c.109 (C.26:18-24).
d. Public members appointed by the Governor may be removed from the board by the Governor. Each member, before entering upon the member's duties, shall take and subscribe an oath to perform the duties of the office faithfully, impartially, and justly to the best of the member's ability. A record of these oaths shall be filed in the office of the Secretary of State.
e. The Governor shall annually select a chairperson and vice-chairperson from among the members of the board, at least one of whom shall be the Commissioner of Health, the Commissioner of Human Services, or a designee. The chairperson shall coordinate the activities of the board. In the event that the chairperson position is vacant or the chairperson is absent from a meeting of the board, the vice-chairperson shall act as chairperson of the board.
f. No member of the board, or officer, employee, or agent of the authority, shall take any official action on any matter in which such person has a direct or indirect personal financial interest.
g. A majority of the board members shall constitute a quorum for the purposes of conducting official business. The board may take action upon the affirmative vote of a majority of the members present. No vacancy in the membership of the board shall impair the right of a quorum to exercise all the rights and perform all the duties of the board. A true copy of the minutes of every meeting of the board shall be delivered to the Governor. No action taken at such meeting by the board shall have force or effect until approved by the Governor or until 10 days after such copy of the minutes shall have been delivered. If, in this 10-day period, the Governor returns the copy of the minutes with a veto of any action taken by the board or any member thereof at the meeting, such action shall be null and of no effect. The Governor may approve all or part of the action taken at such meeting prior to the expiration of the 10-day period.
h. The board shall meet on a monthly basis and at the call of the chair, and shall additionally meet on a quarterly basis with the community advisory committee established pursuant to section 8 of P.L.2023, c.109 (C.26:18-24) for the purpose of receiving guidance and feedback related to the purposes of the authority and this act.
i. The board shall have the power to:
(1) engage with, collaborate, and coordinate efforts among maternal and infant health care stakeholders, including, but not limited to, State and federal agencies and public and private organizations, to advance the purposes of the authority and any of its programs and services, foster collective action, and review progress on improving health outcomes;
(2) promote, support, and fund perinatal workforce development, trainings, certifications, education, research, and innovation efforts, including, but not limited to, issuing requests for proposals or requests for qualifications for projects that advance the purposes of P.L.2023, c.109 (C.26:18-17 et al.); providing grants or extending credit, including, but not limited to, loans, to private companies, private and public organizations, or individuals for projects that advance the purposes of P.L.2023, c.109 (C.26:18-17 et al.); entering into agreements and contracts; and establishing a workforce hub to host research, trainings, and guidance;
(3) commission, publish, and collaborate on research studies within the State, national, and international maternal and infant health communities;
(4) collect, analyze, and disseminate data related to maternal and infant health, in collaboration with the New Jersey Maternal Data Center in the Department of Health, with a particular focus on racial disparities in outcomes, perinatal workforce needs, and development of resources;
(5) provide grants or competition prizes and host an innovation incubation space to encourage the development of solutions to problems facing the maternal and infant health care services industry;
(6) enter into the membership of other organizations or coalitions;
(7) oversee the community advisory committee established pursuant to section 8 of P.L.2023, c.109 (C.26:18-24) and to establish and oversee any other committees, which may include, but shall not be limited to, an executive committee or a nominating committee, as the board deems necessary;
(8) adopt, amend, and repeal bylaws for the regulation of its affairs and the conduct of its business, including, but not limited to, protections against undue influence or quid pro quo transactions relating to the receipt of contributions from private sources;
(9) adopt rules and regulations pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.), to effectuate the provisions of P.L.2023, c.109 (C.26:18-17 et al.);
(10) adopt and have a seal and alter the same at its pleasure;
(11) sue and be sued;
(12) conduct meetings and public hearings in connection with the purposes of P.L.2023, c.109 (C.26:18-17 et al.);
(13) enter into contracts upon those terms and conditions as the authority determines to be reasonable to effectuate the purposes of P.L.2023, c.109 (C.26:18-17 et al.);
(14) hire staff as necessary to support the authority's operations;
(15) employ consultants, contractors and specialists in the perinatal workforce development, education, research, and innovation, and other fields as may be required in the judgment of the board to effectuate the purposes of P.L.2023, c.109 (C.26:18-17 et al.), and to fix and pay their compensation from funds available therefor, all without regard to the provisions of Title 11A of the New Jersey Statutes;
(16) contract for and to accept any gifts or grants or loans of funds or property or financial or other aid in any form from the United States of America or any agency or instrumentality thereof, or from the State or any agency, instrumentality, or political subdivision thereof, or from any beneficiary of a State or federal grant, or from any other public or private source, including private companies and individuals, and to comply with the terms and conditions thereof;
(17) solicit contributions from public and private entities for any of its corporate purposes;
(18) maintain an office located in the City of Trenton for the operations of the center, and any other satellite offices at such places within the State as the board may designate;
(19) acquire, purchase, develop, manage and operate, handle, and dispose of real and personal property or interests therein, acquire an equity interest in any corporation, and take assignments of rentals and leases and make and enter into all contracts, leases, agreements and arrangements necessary or incidental to the performance of its duties, including, but not limited to, the leasing of premises to tenants within the center's offices to licensed health care facilities and providers that offer maternal, infant and pediatric health care services, childbirth education, lactation education and support services, parenting and early childhood education institutions, county colleges, independent New Jersey-based public-mission institutions that receive State operating aid, food and nutrition consultants and support programs, family planning services, behavioral health and other social service providers, and such other entities as the board deems appropriate;
(20) procure insurance against any losses in connection with its property, operations, or assets in such amounts and from such insurers as it deems desirable;
(21) enter into any agreements necessary to provide for its establishment, operation, and financial support, including memoranda of understanding with other State entities;
(22) establish or assume control over a nonprofit entity as authorized under section 9 of P.L.2023, c.109 (C.26:18-25); and
(23) do any and all things necessary or convenient to carry out its purposes and exercise the powers granted in P.L.2023, c.109 (C.26:18-17 et al.).
6 a. The authority shall employ a president and chief executive officer, who shall be responsible for the selection of properly qualified staff of the authority, without regard to the provisions of Title 11A of the New Jersey Statutes. In selecting staff for the authority, the president and chief executive officer shall seek to recruit women and minorities to serve as the authority's staff. Staff members shall receive compensation and be appointed and employed as provided by the president and chief executive officer, without regard to the provisions of Title 11A of the New Jersey Statutes. The president and chief executive officer and all staff members of the center and of the authority shall be deemed confidential employees for the purposes of the "New Jersey Employer-Employee Relations Act," P.L.1941, c.100 (C.34:13A-1 et seq.).
b. The president and chief executive officer of the authority shall be an individual selected by a majority vote of the members of the board; except that the Governor shall select the initial president and chief executive officer of the authority. The president and chief executive officer shall receive an annual salary as provided by the board. The board shall have the authority to consider, investigate, and evaluate any and all matters or issues relevant to the performance of the president and chief executive officer.
b. A purchase, contract, or agreement may be made, negotiated, or awarded by the authority without public bid or advertising under the following circumstances:
(1) When the aggregate amount involved does not exceed the amount set forth in, or the amount calculated by the Governor pursuant to, section 2 of P.L.1954, c.48 (C.52:34-7), unless other State law sets forth a lower bid threshold in a particular case, in which case the lower threshold shall apply. The authority may not divide a contract into multiple proposed contracts in order to take advantage of this exception and shall, if invoking this exception, certify that it has not done so and maintain a record of that certification;
(2) In cases of unforeseen life, safety, or health emergencies where the public exigency requires that services or products be purchased immediately;
(3) To acquire subject matter which is described in section 4 of P.L.1954, c.48 (C.52:34-9);
(4) To make a purchase or award or make a contract or agreement under the circumstances described in section 5 of P.L.1954, c.48 (C.52:34-10);
(5) When the contract to be entered into is for the furnishing or performance of services of a professional or technical nature, including legal services, provided that the contract shall be made or awarded directly by the authority;
(6) Where a firm has brought an innovative idea to the authority, a request for proposals cannot be constructed without communicating the new idea, and the procurement would not benefit from a competitive selection process;
(7) When the authority has advertised for bids and has received no bids in response to its advertisement, or received no responsive bids. Any purchase, contract, or agreement may then be negotiated and may be awarded to any contractor or supplier determined to be responsible, as "responsible" is defined in section 2 of P.L.1971, c.198 (C.40A:11-2), provided that the terms, conditions, restrictions, and specifications set forth in the negotiated contract or agreement are not substantially different from those which were the subject of competitive bidding; and
(8) When a purchase is to be made through or by the Director of the Division of Purchase and Property in the Department of the Treasury pursuant to section 1 of P.L.1959, c.40 (C.52:27B-56.1).
b. The members of the community advisory committee shall be appointed by the Governor, who shall consider any recommended candidates presented by the board. The board may solicit applications for candidates to the advisory committee in order to inform its recommendations to the Governor. Committee members shall serve for a term of three years, except that, of the committee members first appointed to the committee, five shall serve for a term of one year and six shall serve for a term of two years. The successors to the initially appointed members shall each be appointed for a term of three years, except that any person appointed to fill a vacancy shall serve only for the unexpired term. The members of the community advisory committee shall be eligible for reappointment to the committee.
c. The chairperson and vice-chairperson of the community advisory committee shall be annually selected by the Governor from among the public members of the board pursuant to subparagraph (d) of paragraph (2) of subsection a. of section 5 of P.L.2023, c.109 (C.26:18-21). The chairperson shall coordinate the activities of the community advisory committee. In the event that the chairperson position is vacant or the chairperson is absent from a meeting of the community advisory committee, the vice-chairperson shall act as chairperson of the committee.
d. Four members of the community advisory committee, including either the chairperson or vice-chairperson of the community advisory committee, shall be residents of the City of Trenton with background as either a mother with personal experience in receiving perinatal services in Trenton or as a community stakeholder. The remaining members of the community advisory committee shall be residents of municipalities in different geographic regions of the State with the highest rates of Black and Hispanic infant mortality, and shall have backgrounds as mothers with personal experience in receiving perinatal services or as community stakeholders.
e. The committee members shall receive an annual stipend of $20,000, to be paid in increments as determined by the board.
A nonprofit entity established pursuant to this section may be established pursuant to the provisions of the "New Jersey Nonprofit Corporation Act," N.J.S.15A:1-1 et seq.
b. A nonprofit entity established or over which control is assumed pursuant to this section shall have the power to:
(1) conduct fundraising activities to solicit funding from public and private organizations to be used in support of maternal and infant health services, social services, perinatal workforce development, education, research, and innovation in the State; and
(2) establish, sponsor, and operate membership, including the ability to generate revenue from members of the nonprofit entity.
c. The board and any nonprofit entities created or over which control is assumed by the board pursuant to this section may enter into any agreements necessary to provide for the establishment, operation, and financial support of the authority and each nonprofit entity.
d. A nonprofit entity established or over which control is assumed pursuant to this section may be organized and operated in such a manner as to be eligible under applicable federal law for tax-exempt status and for the receipt of tax-deductible contributions.
e. A nonprofit entity established or over which control is assumed pursuant to this section shall be authorized to sue and to be sued as a legal entity separate from the State of New Jersey.
f. No member or employee of a nonprofit established or over which control is assumed pursuant to this section shall engage in any for-profit business transaction or professional activity with the authority.
g. All funds received by a nonprofit entity formed or over which control is assumed pursuant to this section, other than those necessary to pay for the expenses of the nonprofit entity, shall be used exclusively for the support of the authority.
b. Notwithstanding the provisions of any State law, rule, or regulation to the contrary, the authority may direct State departments, boards, bureaus, commissions, and agencies to report any data collected or maintained by such entity related to maternal and infant health care, social determinants of health, clinical services, and any other information that may advance the purposes of the authority, as deemed necessary by the authority, and such data shall be provided by the reporting entity on an annual basis, or at such times as otherwise requested by the authority. Nothing in this section shall require the disclosure of information when such disclosure would violate any provision of federal law, rule, or regulation.
c. Except as provided in subsection d. of this section, the information required pursuant to subsection b. of this section shall be provided by the reporting entity in such manner as may be necessary to protect against the disclosure of any confidential or personal identifying information of any individual.
d. In the event the authority requests that a reporting entity provide data that includes any confidential or personal identifying information of any individual, such data shall be kept confidential by the authority consistent with any applicable State and federal law, rule, or regulation.
b. The initial rules and regulations adopted pursuant to subsection a. of this section shall be in effect for a period not to exceed one year after the date of filing with the Office of Administrative Law. Thereafter, the rules and regulations shall be adopted, amended, or readopted, and any subsequent rules and regulations shall be adopted, amended, or readopted, by the board in accordance with the requirements of the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.), in consultation with the State Treasurer, the Commissioner of Health, and the Chief Executive Officer of the Economic Development Authority, and such other departments, agencies, and authorities as the board deems appropriate.
b. All funds received by the authority, other than those necessary to pay the expenses of the authority, shall be used to advance the purposes of the authority.
a. Pregnancy is a significant health event in the lives of many women that presents unique physical, mental, and medical issues, many of which a woman will not encounter at any other point in her life.
b. Women experiencing pregnancy, particularly a first pregnancy, frequently lack information and guidance concerning many of the physical symptoms encountered during and after pregnancy. Because so many aspects of a woman's body change during pregnancy, it can be difficult to determine when a particular symptom is normal or may be a sign of an adverse complication that requires medical attention, particularly with regard to symptoms occurring during the postpartum period and after a pregnancy loss or stillbirth.
c. Maternal mortality and morbidity rates have increased over the last 20 years both in New Jersey and nationwide, which increased rates have disproportionately affected minority communities. In many cases, the common causes of maternal mortality, including excessive bleeding and infection, are preventable if diagnosed and treated in a timely manner. Moreover, postpartum, pregnancy loss, and stillbirth issues that are not typically fatal can seriously affect a woman's quality of life if left untreated.
d. Frequently, postpartum issues cannot be detected before the woman is discharged from the hospital. Many symptoms do not manifest until after the woman has returned home, and issues may occur up to one year after birth. It is estimated that between one-third and one-half of pregnancy-associated deaths occur during the postpartum period. All women are susceptible to postpartum complications, not just those identified as "high risk" for complications during pregnancy.
e. As many as 40 percent of women never seek out or receive postpartum care, which represents a missed opportunity to screen for postpartum issues and provide necessary medical care.
f. Although New Jersey has taken significant steps to improve the provision of maternity care in this State, more needs to be done to ensure that women have the information and resources necessary to enable them to identify and seek treatment for potentially fatal postpartum, pregnancy loss, and stillbirth issues.
g. Therefore, it is essential that women have the opportunity to develop an individualized postpartum treatment plan in the course of prenatal care and that they be provided with postpartum care, pregnancy loss, and stillbirth information prior to discharge, including information about normal and abnormal postpartum symptoms, to enable them to make informed observations about their postpartum, pregnancy loss, and stillbirth experiences and seek out medical care when needed.
(1) the name, phone number, and office address of the patient's care team;
(2) if applicable, the time, date, and location for the patient's postpartum visits and a phone number to call to schedule or reschedule appointments;
(3) guidance regarding breastfeeding to allow the patient to make an informed feeding decision;
(4) a reproductive life plan and appropriate contraception;
(5) notes about any of the patient's pregnancy complications and recommended follow-ups or test results;
(6) guidance regarding signs and symptoms of postpartum depression or anxiety;
(7) management, including recommendations on how to manage anxiety, depression, or other psychiatric issues identified during pregnancy or in the postpartum period;
(8) recommendations for the management of postpartum issues, such as, without limitation, pelvic floor exercise for stress, urinary incontinence, or water-based lubricant for dyspareunia; and
(9) a treatment plan for ongoing physical and mental health conditions which identifies the care team member responsible for follow-up.
The health care professional shall take reasonable steps to ensure that the patient is offered the opportunity to participate in a postpartum planning session during the first trimester of pregnancy or, if holding the session during the first trimester is not feasible, at the earliest time thereafter. At a minimum, each plan shall include the designation of a medical home where the patient may access care and support during the period between the end of the pregnancy and the comprehensive postpartum visit. If the patient does not have a plan in place or affirmatively waives their right to develop a plan, the health care professional shall educate the patient about the risks of foregoing adequate postpartum care and offer to consult with the patient to develop a plan.
b. Each general hospital, ambulatory care facility, and birthing center licensed pursuant to P.L.1971, c.136 (C.26:2H-1 et seq.) that provides maternity care services shall ensure that, prior to discharge following the end of a pregnancy, pregnancy loss, or stillbirth, each patient receiving maternity care services is provided with postpartum care information based on best practices and guidance, as determined by the American College of Obstetricians and Gynecologists or other nationally recognized bodies.
c. As used in this section:
"Care team" means an interdisciplinary team comprised of health care professionals, the patient, and the patient's relatives and friends. Members of the care team may vary depending on a patient's needs.
"Medical home" means as a primary care provider or facility from which a patient can access primary and preventive care that maintains all of the patient's medical information.
Collega Omnilex per cercare nel corpus legale dal tuo assistente IA.