23-1-1. General functions of department.

The department of health shall take cognizance of the interests of life and health among the peoples of the state; shall make investigations into the causes of disease, the prevalence of epidemics and endemics among the people, the sources of mortality, the effect of localities, employments and all other conditions and circumstances on the public health, and do all in its power to ascertain the causes and the best means for the prevention and control of diseases or conditions detrimental to the public health, and adopt proper and expedient measures to prevent and control diseases and conditions detrimental to the public health in the state. It shall publish and circulate, from time to time, information that the director may deem to be important and useful for diffusion among the people of the state, and shall investigate and give advice in relation to those subjects relating to public health that may be referred to it by the general assembly or by the governor when the general assembly is not in session, or when requested by any city or town. The department shall adopt and promulgate rules and regulations that it deems necessary, not inconsistent with law, to carry out the purposes of this section; provided, however, that the department shall not require all nonprofit volunteer ambulance, rescue service, and volunteer fire departments to have two (2) or more certified emergency medical technicians manning ambulances or rescue vehicles.

History of Section. P.L. 1929, ch. 1432, § 4; P.L. 1930, ch. 1549, § 1; G.L. 1938, ch. 255, § 3; impl. am. P.L. 1939, ch. 660, § 180; G.L. 1956, § 23-1-1 ; P.L. 1964, ch. 45, § 2; P.L. 1984, ch. 224, § 1.

23-1-1.1. Health planning — Findings.

It is found and determined that health planning is essential to promote appropriate access to high quality health services at a reasonable cost and is a precondition to effective public health practice by the department of health; and that health planning is a prerequisite to the effective discharge of the department of health’s certificate of need responsibilities.

History of Section. P.L. 1988, ch. 383, § 1.

23-1-1.2. Health planning process.

The department of health is authorized to conduct health planning studies and to develop health plan documents to assist the department of health, the director of health, and the health services council in the conduct of their public health responsibilities. The director of health, with the approval of the governor, may appoint various committees and task forces as appropriate to assist and advise the department of health in the conduct of its health planning responsibilities, provided that the director of health may appoint ad hoc short-term committees or task forces to advise and assist the director on technical issues.

History of Section. P.L. 1988, ch. 383, § 1.

23-1-1.3. Transfer of responsibilities.

Whenever, in any general or public law, the words “office of substance abuse”, “OSA”, “department of substance abuse” shall appear, they shall be deemed to refer to and to mean the “department of behavioral healthcare, developmental disabilities and hospitals”. Whenever, in any general or public law, the words “director of the department of substance abuse” shall appear, they shall be deemed to refer to and to mean the “director of the department of behavioral healthcare, developmental disabilities and hospitals”.

History of Section. P.L. 1995, ch. 370, art. 14, § 3; P.L. 1998, ch. 257, § 2; P.L. 1998, ch. 458, § 2.

23-1-2. Inquiries to local authorities and physicians.

The director of health shall make inquiry, from time to time, of the city and town clerks and practicing physicians, in relation to the prevalence of any disease, or knowledge of any known or generally believed source of disease or causes of general ill health, and also in relation to acts for the promotion and protection of the public health, and also in relation to diseases among domestic animals in their several cities and towns; and those city and town clerks and practicing physicians shall give information, in reply to the inquiries, of those facts and circumstances that have come to their knowledge.

History of Section. G.L. 1896, ch. 96, § 6; G.L. 1909, ch. 115, § 6; G.L. 1923, ch. 153, § 6; G.L. 1938, ch. 255, § 5; G.L. 1956, § 23-1-2 ; P.L. 1964, ch. 45, § 2.

23-1-3. Maintenance of laboratories.

1. The director of health shall maintain pathological, bacteriological, and chemical laboratories and shall select in accordance with law qualified persons to conduct and supervise the pathological, bacteriological, and chemical researches made in those laboratories.
2. The director of health is authorized to establish and modify fees by regulation for all laboratory services provided by the department of health laboratory. The fees as established by the director shall be related to the costs incurred in operating the laboratory and may include administrative, personnel, equipment, supplies, overhead, and other related costs necessary to develop and provide laboratory services. All fees collected under this section, except those fees in subsections (f) through (h) shall be deposited as general revenues.
3. The testing program for clinical tests designated by the director in regulation shall be a covered benefit and shall be reimbursable by all health insurers, as defined in § 27-38.2-2(1) , providing health insurance coverage in Rhode Island except for supplemental policies which only provide coverage for specific diseases, hospital indemnity Medicare supplements, or other supplemental policies. The charges for those testing programs shall be borne by the hospitals or other licensed health care providers and facilities in the absence of a third-party payor.
4. All funds received under chapter 16.2 of this title shall be deposited as general revenues.
5. The provisions of §§ 45-13-7 through 45-13-10 shall not apply to this section.
6. In addition to any other fine, assessment, penalty or forfeiture provided by law, the traffic tribunal shall collect an assessment of one hundred dollars ($100) from each defendant who is required to attend a special course on driver retraining, except from those who are ordered to attend a special course on driving while intoxicated, described in § 31-27-2 , by the traffic tribunal.
7. In addition to any other fine, assessment, penalty, or forfeiture provided by law, the court or tribunal shall collect the sum of one hundred and eighteen dollars ($118) for each drug-related charge from every defendant who is convicted after trial, or who enters a plea of guilty or of nolo contendere, with respect to violations of the following chapters and/or sections of the Rhode Island General Laws, which shall include but not be limited to: chapter 15 of title 7, 11-23-2 , 11-23-6 , 11-25-23 , chapter 28 of title 21, 21-28-4.01 , 21-28-4.01.1 , 21-28-4.01.2 , 21-28-4.02 , 21-28-4.03 , 21-28-4.04 , 21-28-4.05 , 21-28-4.06 , 21-28-4.07 , 21-28-4.07.1 , 21-28-4.09 , 21-28-4.10 , 21-28-4.11 , 21-28-4.14 , 21-28-4.15 , 21-28-4.16 , 21-28-4.17 , 21-28-4.17 .1, 21-28-4.19 , 31-27-1.1 , 31-27-2.2 , 31-27-2.4 , 31-27-2.6 , chapter 22.2 of title 46, 46-22.2-3 , 46-22.2-4 , and 46-22.2-5 .
8. In addition to any other fine, assessment, penalty, or forfeiture provided by law, the court or tribunal shall collect the sum of one hundred dollars ($100) for each charge from every defendant who is convicted after trial, or who enters a plea of guilty or of nolo contendere, with respect to violations of the following chapters and/or sections of the Rhode Island General Laws, which shall include but not be limited to: 11-5-1 , 11-5-2 , 11-5-2.1 , 11-5-4 , 11-5-5 , 11-5-6 , 11-5-7 , 11-5-8 , 11-5-10 , 11-5-10 .1, 11-5-1 0.2, 11-5-10.3 , 11-5-10.4 , 11-5-11 , 11-5-14 , 11-5-14 .1, 11-8-1 , 11-8-2.1 , 11-8-2.2 , 11-8-2.3 , 11-8-2.4 , 11-8-3 , 11-8-4 , 11-8-9 , 11-23-1 , 11-23-2.1 , 11-23-3 , 11-25-2 , 11-25-3 , 11-25-4 , 11-26-1 , 11-26-1 .4, 11-29-1 , 11-37-2 , 11-37-4 , 11-37-6 , 11-37-8.1 , 11-37-8.3 , and 11-39-1 .
9. All fees collected in subsections (f) through (h) shall be placed in the general fund.

History of Section. P.L. 1939, ch. 660, § 181; G.L. 1956, § 23-1-3 ; P.L. 1991, ch. 44, art. 17, § 1; P.L. 1992, ch. 133, art. 94, § 2; P.L. 1995, ch. 370, art. 24, § 1; P.L. 1995, ch. 370, art. 40, § 58; P.L. 2004, ch. 6, § 10.

23-1-4. Vital records.

The department of health and director of health shall carry on the registration of vital records as provided by chapter 3 of this title and the director of health shall be ex officio state registrar of vital records.

History of Section. P.L. 1939, ch. 660, § 182; G.L. 1956, § 23-1-4 .

23-1-5. Enforcement of sanitary laws.

The department of health and director of health shall enforce the provisions of all general laws and public laws relating to the sanitary inspection of swimming pools, bathing beaches, camp grounds, barber shops, hairdressing parlors, and any other premises and properties the inspection of which may be conferred upon the department of health. The sanitary inspection of barber shops shall be made by registered barbers and the director of health shall employ at least one registered barber for this purpose who shall enforce rules and regulations as prescribed under chapter 10 of title 5. The department and director shall enforce the provisions of chapter 27 of title 21 insofar as they relate to the inspection of bakeries and other establishments and shall perform the functions relating to child hygiene, food and drugs, the purification of waters, slaughterhouses, and narcotic drugs and pharmacies.

History of Section. P.L. 1939, ch. 660, § 183; G.L. 1956, § 23-1-5 ; P.L. 1996, ch. 100, art. 37, § 1.

23-1-5.1. Laboratory testing services.

1. The director of health is authorized to provide, upon request, testing for all private water supplies used as sources of drinking water. This testing shall be on a voluntary basis and does not confer upon the director or department of health jurisdiction over that private water supply, in addition to that provided for elsewhere.
2. The director is further authorized to provide, upon request, testing for public water supplies used as sources of drinking water. The testing shall be on a voluntary basis and does not confer upon the director or department of health jurisdiction over public water supplies in addition to that provided for elsewhere.
3. The director of health is further authorized to provide, upon request, testing for other substances of public health concern such as radon in air, lead in paint and soil, and other indoor air pollutants. The testing shall be on a voluntary basis and does not confer upon the director or department of health any additional jurisdiction.
4. The director is further authorized to establish fees by regulation. The fees as established by the director shall be related to the costs incurred in operating the program and may include administrative, personnel, equipment, and any other related costs necessary to carry out the provisions of this section of the law. All fees collected under this section shall be placed into the general fund.

History of Section. P.L. 1987, ch. 538, § 1; P.L. 1989, ch. 47, § 1; P.L. 1995, ch. 370, art. 40, § 58; P.L. 2002, ch. 161, § 1; P.L. 2002, ch. 162, § 1.

23-1-5.2. Office of private well water contamination.

There is created the office of private well water contamination within the department of health.

History of Section. P.L. 1988, ch. 634, § 1.

23-1-5.3. Duties of the office of private well water contamination.

The office of private well water contamination shall:

1. Coordinate the response of all state agencies to instances of private well water contamination;
2. Inform public officials of private well contamination events occurring within their jurisdictions and advise them of any actions proposed by the department of health or other state agencies;
3. Advise private well owners, public officials and others on applicable federal and state policies, regulations, and standards relative to private well water contamination;
4. Develop educational materials describing drinking water quality standards for private wells, private well testing requirements, groundwater contamination and existing programs and procedures for its abatement and prevention;
5. Develop regulations establishing procedures for providing emergency response to private well water contamination including the provision of bottled water and/or water filters where appropriate;
6. Develop and promulgate any rules and regulations that are necessary to establish drinking water quality standards for private wells, and shall be subject to the Administrative Procedures Act, chapter 35 of title 42. As a minimum, these rules and regulations shall:
   1. Specifically identify all contaminants to be tested, as well as the acceptable level for each contaminant;
   2. Require testing for coliform bacteria, fluoride, iron, lead, manganese, nitrate, nitrite and turbidity of all new private wells prior to being placed into service as a source of drinking water;
   3. Require testing for coliform bacteria, fluoride, iron, lead, manganese, nitrate, nitrite and turbidity of all private wells currently in service, or capable of being placed in service, as a source of drinking water, prior to sale of a property upon which they are located or serviced;
   4. Require the property owner to disclose the results of any previous well water testing prior to sale or lease of a property upon which the well(s) are located or serviced;
   5. Establish minimum qualifications for professionals engaged in sampling private water wells and preparing opinions relating to the quality of the water;
   6. Establish requirements and procedures for reporting the results of all private well testing to the director of health and municipal building officials;
   7. Establish specific guidance for municipal building officials as to what constitutes “potable” water for a private well, and contaminant levels which constitute a public health concern with regard to the issuance of a certificate of occupancy and recommendations for further testing beyond that required in paragraphs (ii) and (iii) of this subdivision; and
7. Establish and maintain a database showing known areas where there are contaminants of concern to public health and make these results available to the public through the website of the department of health.

History of Section. P.L. 1988, ch. 634, § 1; P.L. 2002, ch. 161, § 1; P.L. 2002, ch. 162, § 1.

23-1-5.4. Access to information.

1. The office of private well water contamination shall have access to the following information:
   1. The names of all persons who have registered complaints concerning private well water contamination and all information concerning their complaints; and
   2. All current records in the department of health and the department of environmental management pertaining to private well water contamination.
2. The office of private well water contamination shall have the authority to use this information in whatever ways are necessary to carry out the duties enumerated in § 23-1-5.3 .
3. The department of environmental management, the department of health, and all other state agencies shall assist the office of private well water contamination in the performance of these duties.

History of Section. P.L. 1988, ch. 634, § 1.

23-1-5.5. Annual report.

The department of health shall prepare and issue an annual report on the status of private well water contamination in the state. The report shall be submitted to the governor and the general assembly by January 15th of each year and shall be made available to the public.

History of Section. P.L. 1988, ch. 634, § 1.

23-1-5.6. Repealed.

23-1-5.7. Well water purification licensing.

1. The director of the department of health shall promulgate rules and regulations for the licensing of well water purification companies. The rules shall include minimum qualifications for testing and analysis of wells and shall set forth comprehensive criteria for the distribution of chemicals used in the treatment of drinking water and potable well water. Upon promulgation of the rules, no person, firm, partnership, or other business association shall engage in the business of well water purification without first obtaining a license from the director of health. The director may revoke the license for just cause. The director may charge an appropriate license or registration fee to cover administrative costs.
2. The licensing provisions of this section shall not apply to state employees carrying out official business of the state. The regulations issued under this section shall not apply to the design, installation, and operation of recovery wells utilized to treat contaminated groundwater provided that this activity is authorized by the department of environmental management and that the wells are not used for drinking water purposes.

History of Section. P.L. 1991, ch. 220, § 1.

23-1-6. Shellfish packing houses.

The department of health and director of health shall also perform the function of the sanitary regulation of shellfish packing houses as provided in chapter 14 of title 21.

History of Section. P.L. 1939, ch. 660, § 185; G.L. 1956, § 23-1-6 ; P.L. 1980, ch. 263, § 5.

23-1-7. Industrial hygiene.

The department of health and director of health shall perform the functions relating to industrial hygiene, which shall include the following:

1. The study of the problems of industrial hygiene and occupational diseases in industry;
2. Recommendation to the general assembly of those measures that study and experience may demonstrate to be advisable; and
3. The maintenance of proper records of its activities.

History of Section. P.L. 1939, ch. 660, § 186; G.L. 1956, § 23-1-7 .

23-1-8. Forensic scientist — Crime detection.

The director of health shall appoint in accordance with law a suitable and qualified forensic scientist to conduct examinations of evidence in connection with scientific crime detection, and for that purpose the director shall cooperate with the Rhode Island state police, the department of the attorney general, and other law enforcement agencies in the matter of scientific crime detection.

History of Section. P.L. 1939, ch. 660, § 187; G.L. 1956, § 23-1-8 ; P.L. 2009, ch. 68, art. 5, § 2.

23-1-9. Annual report to general assembly.

The director of health shall make an annual report to the general assembly of his or her proceedings during the year ending on the thirty-first (31st) day of December next preceding, with any suggestions in relation to the sanitary laws and interests of the state that he or she shall deem important.

History of Section. G.L. 1896, ch. 96, § 9; G.L. 1909, ch. 115, § 9; G.L. 1923, ch. 153, § 9; G.L. 1938, ch. 255, § 7; G.L. 1956, § 23-1-9 .

23-1-10 — 23-1-12. Repealed.

23-1-13. Appropriations and disbursements.

The general assembly shall annually appropriate those sums for the purposes of this chapter that it deems necessary; and the state controller is authorized and directed to draw his or her orders upon the general treasurer for the payment of those sums, or so much of those sums as may from time to time be required, upon the receipt by him or her of proper vouchers authenticated by the director of health.

History of Section. P.L. 1929, ch. 1432, § 11; P.L. 1930, ch. 1549, § 1; G.L. 1938, ch. 255, § 22; impl. am. P.L. 1939, ch. 660, §§ 65, 180; G.L. 1956, § 23-1-13 .

23-1-14. Vouchers for disbursements.

Notwithstanding the provisions of any general law, public law, or resolution which may provide for the personal approval of the director of health, the state controller is authorized to make payment for all expenditures of the department of health upon receipt of duly authenticated vouchers from that department.

History of Section. P.L. 1945, ch. 1589, 1; G.L. 1956, § 23-1-14 .

23-1-15. Providing a physician for New Shoreham.

Whenever it appears that the town of New Shoreham does not have a duly licensed physician in attendance, the director of health, with the approval of the governor, may request duly qualified state physicians from any department within the state government to accept assignment to be in residence there and to serve the people of the town of New Shoreham in the general practice of medicine. The town of New Shoreham shall provide the doctor with suitable living quarters and office facilities including light and heat free of charge, and the doctor shall charge regular fees for his or her services and shall account for the fees to the director of health. In addition to the regular remuneration being paid that doctor by the state at the time of the assignment, the doctor shall also receive a percentage of all fees collected by him or her that in the discretion of the director of health shall be deemed reasonable, and the proceeds of the remaining fees shall be paid to the general treasurer and become part of the general fund of the state.

History of Section. P.L. 1962, ch. 168, § 1.

23-1-16. Receipt and use of funds.

1. The state department of health shall have authority to receive and expend any funds which may become available from the federal government for public health purposes whenever it is so authorized by the governor. The department of health, with the approval of the governor, shall have authority:
   1. To meet those federal requirements with respect to the administration of those funds that may be set forth as conditions precedent to receiving those federal funds;
   2. To enter into and execute contracts to perform services for which the state may be compensated from the federal government for public health services, and
   3. To meet federal requirements with respect to the execution of public health services contracts between the federal government and the state.
2. To carry out the purposes of this chapter, the department of health, with the approval of the governor, shall also have the authority to receive and expend monies from any other sources, public or private, including but not limited to legislative enactments, bond issues, gifts, devises, grants, bequests, or donations. The department of health, with the approval of the governor, is authorized to enter into any contracts necessary to obtain and expend those funds.
3. All monies received by the state department of health from any federal agency, department, or any other source, as provided in this section, shall be paid into the state treasury and shall be for the use of the department of health. The monies so received shall be used solely for the purposes for which the grant or grants shall have been made and for no other purpose.

History of Section. P.L. 1964, ch. 16, § 1; P.L. 1974, ch. 65, § 1.

23-1-16.1. Letters of license verification — Fees.

1. There shall be a fee, to be paid by the individual or entity making the request as set forth in § 23-1-54 , for any letter issued by the department verifying a license which was issued by the department; and
2. The proceeds of any fees collected pursuant to the provisions of this chapter shall be paid into the state treasury and shall be for the use of the department of health to offset the costs of issuing the license verification letters.

History of Section. P.L. 2012, ch. 241, art. 9, § 48.

23-1-17. Additional general powers.

1. In addition to the other powers given to the director of health or the department of health by other provisions of the general laws, and in order to permit the director to properly perform the duties given to him or her by the general assembly, and to enforce the rules and regulations the director is authorized to promulgate and adopt, the director is further authorized to promulgate and adopt rules and regulations for the establishment of information collection, minimum sanitary requirements, and other duties given to the director by § 23-1-1 or by any other provision of law, and to enforce those rules and regulations. The director is further authorized to issue licenses or permits, and to revoke, suspend, or annul them, to aid in the enforcement of those rules and regulations.
2. In the event of a public health emergency, the director is authorized to grant a temporary Rhode Island healthcare provider license for a period not to exceed ninety (90) days and limited to those healthcare providers who hold an active valid license in another state. The director is authorized to promulgate and adopt rules and regulations to establish a process for this temporary emergency license.

History of Section. P.L. 1966, ch. 109, § 1; P.L. 1967, ch. 61, § 1; P.L. 2010, ch. 51, § 1; P.L. 2010, ch. 67, § 1.

23-1-18. Power to provide rules and regulations in specific areas.

Without limiting the generality of § 23-1-17 , the rules and regulations relating to sanitation and health provided for by § 23-1-17 may include:

1. Provisions fixing responsibilities of owners, operators, and occupants of land or buildings for the sanitary condition, maintenance, use, and occupancy of the land and buildings.
2. Minimum standards with respect to the reporting of any disease and the quarantine of persons affected by that disease.
3. Minimum standards and conditions for the location, construction, and sanitary quality of all drinking water supplies.
4. Minimum standards for facilities and sanitary conditions for schools and the health care for school children.
5. Minimum standards with respect to the maintenance and operation of food businesses.
6. Minimum standards of air quality consistent with human health.
7. Minimum standards consistent with human health for the quality of the waters of the state.
8. Minimum standards consistent with human health for the quality of public drinking water.
9. Minimum standards for immunization and testing for communicable diseases, including, but not limited to, tuberculosis, of employees, children, and students at any child daycare center, family daycare home, private nursery school, any other regular program providing educational services to preschool-aged children, public or private school, college, or university.
10. Provisions requiring the reporting of immunization status and any other relevant information that the director determines appropriate for all persons for the purpose of establishing and maintaining an immunization registry; provided, however, that the information collected by the department for the immunization registry will only include data elements nationally endorsed by the Centers for Disease Control and Prevention to meet standards for immunization information systems, and that all personally identifiable information obtained pursuant to this section shall be subject to the provisions of chapter 37.3 of title 5 and the Health Insurance Portability and Accountability Act of 1996, Pub. L. No. 104-191 (HIPAA), as amended. Any person may opt out of and choose to remove his or her information from the immunization registry by contacting the department directly by phone or by submitting a form online that shall be made available on the department’s website.
11. Provisions requiring the reporting of inventories and sales of drugs, devices, and other products potentially related to the outbreak of disease. All information acquired under this subsection by the department of health is confidential and not subject to public access pursuant to chapter 2 of title 38.

History of Section. P.L. 1966, ch. 109, § 1; P.L. 1967, ch. 61, § 1; P.L. 1968, ch. 192, § 1; P.L. 1971, ch. 42, § 1; P.L. 1977, ch. 182, § 8; P.L. 1977, ch. 279, § 1; P.L. 1978, ch. 131, § 2; P.L. 1978, ch. 229, § 3; P.L. 1993, ch. 253, § 2; P.L. 1993, ch. 406, § 2; P.L. 2003, ch. 185, § 1; P.L. 2003, ch. 189, § 1; P.L. 2019, ch. 196, § 1; P.L. 2019, ch. 284, § 1.

23-1-19. Inspection and examination — Penalty for obstruction.

1. The director is authorized to enter, examine, or survey at any reasonable time those places that he or she considers necessary to carry out his or her responsibilities under this chapter or under other provisions of law.
2. Any person who willfully impedes or obstructs an inspection, examination, or survey by the director shall, upon conviction, be punished by a fine of not more than one hundred dollars ($100) or by imprisonment for not more than thirty (30) days, or both.

History of Section. P.L. 1966, ch. 109, § 1.

23-1-20. Compliance order.

Whenever the director determines that there are reasonable grounds to believe that there is a violation of any law administered by him or her or of any rule or regulation adopted pursuant to authority granted to him or her, the director may give notice of the alleged violation to the person responsible for it. The notice shall be in writing, shall set forth the alleged violation, shall provide for a time within which the alleged violation shall be remedied, and shall inform the person to whom it is directed that a written request for a hearing on the alleged violation may be filed with the director within ten (10) days after service of the notice. The notice will be deemed properly served upon a person if a copy of the notice is served upon him or her personally, or sent by registered or certified mail to the last known address of that person, or if that person is served with notice by any other method of service now or later authorized in a civil action under the laws of this state. If no written request for a hearing is made to the director within ten (10) days of the service of notice, the notice shall automatically become a compliance order.

History of Section. P.L. 1966, ch. 109, § 1.

23-1-21. Immediate compliance order.

Whenever the director determines that there exists a violation of any law, rule, or regulation within the jurisdiction of the director which requires immediate action to protect the health, welfare, or safety of the public or any member of the public, the director may, without prior notice of violation or hearing, issue an immediate compliance order stating the existence of the violation and the action he or she deems necessary. The compliance order shall become effective immediately upon service or within the time specified by the director in the order. No request for a hearing on an immediate compliance order may be made.

History of Section. P.L. 1966, ch. 109, § 1.

23-1-22. Hearing.

If a person upon whom a notice of violation has been served under the provisions of § 23-1-20 or if a person aggrieved by any notice of violation requests a hearing before the director within ten (10) days of the service of notice of violation, the director shall set a time and place for the hearing, and shall give the person requesting a hearing at least five (5) days written notice of the hearing. After the hearing, the director may make findings of fact and shall sustain, modify, or withdraw the notice of violation. If the director sustains or modifies the notice, that decision shall be deemed a compliance order and shall be served upon the person responsible in any manner provided for the service of the notice in § 23-1-20 . The compliance order shall state a time within which the violation shall be remedied, and the original time specified in the notice of violation shall be extended to the time set in that order.

History of Section. P.L. 1966, ch. 109, § 1.

23-1-23. Enforcement of compliance orders.

Whenever a compliance order has become effective, whether automatically where no hearing has been requested, where an immediate compliance order has been issued, or upon decision following a hearing, the director may institute injunction proceedings in the superior court of the state for enforcement of the compliance order and for appropriate temporary relief, and in the proceeding the correctness of a compliance order shall be presumed and the person attacking the order shall bear the burden of proving error in the compliance order, except that the director shall bear the burden of proving in the proceeding the correctness of an immediate compliance order. The remedy provided for in this section shall be cumulative and not exclusive and shall be in addition to remedies relating to the removal or abatement of nuisances or any other remedies provided by law.

History of Section. P.L. 1966, ch. 109, § 1.

23-1-24. Review by supreme court.

Any party aggrieved by a final judgment of the superior court may, within thirty (30) days from the date of entry of the judgment, petition the supreme court for a writ of certiorari to review any questions of law. The petition shall set forth the errors claimed. Upon the filing of the petition with the clerk of the supreme court, the supreme court may, if it sees fit, issue its writ of certiorari.

History of Section. P.L. 1966, ch. 109, § 1.

23-1-25. Penalties.

Unless another penalty is provided by the laws of this state, any person who violates any law administered by the director or any rule or regulation adopted pursuant to authority granted to the director shall, upon conviction, be punished by a fine of not more than one hundred dollars ($100) or by imprisonment for not more than thirty (30) days, or both, and for violation of a compliance order of the director by a fine of not more than three hundred dollars ($300) or by imprisonment for not more than ninety (90) days, or both, for each offense or violation, and each day’s failure to comply with any such law, rule, regulation, or order shall constitute a separate offense.

History of Section. P.L. 1966, ch. 109, § 1.

23-1-26. Adoption of regulations — Status of present regulations.

Notwithstanding the provisions of chapter 35 of title 42, rules or regulations adopted by the director on or before December 31, 1966 and pursuant to authority granted to the director by law shall become effective twenty (20) days after filing those rules or regulations in the office of the secretary of state. The director shall hold a hearing on those rules and regulations, after reasonable notice, if within six (6) months of the adoption of the rules or regulations any interested person requests a hearing. At that hearing, all interested persons shall be given an opportunity to submit data, views, or arguments, orally or in writing, relative to the rules or regulations. Rules or regulations filed with the secretary of state under this section shall remain in effect notwithstanding that hearing, but following a hearing the director may file amendments to the rules or regulations as he or she deems advisable, those amendments to become effective twenty (20) days after filing. All rules and regulations of the director in effect on July 1, 1966 shall remain in full force and effect after that date unless expressly repealed by the director or by any provision of this chapter.

History of Section. P.L. 1966, ch. 109, § 1.

23-1-27. Exemption from hearing provisions of Administrative Procedures Act.

The provisions of §§ 42-35-9 through 42-35-18 shall not apply to this chapter.

History of Section. P.L. 1966, ch. 109, § 1.

23-1-28. Definitions.

The following definitions apply in the interpretation of the provisions of this chapter:

1. “Director” means the director of health of the state or his or her duly authorized agent.
2. “Food” means:
   1. Articles used for food or drink for people or other animals;
   2. Chewing gum; and
   3. Articles used for components of any such article.
3. “Food business” includes any establishment or place, whether fixed or mobile, where food or ice is held, processed, manufactured, packaged, prepared, displayed, served, transported, or sold.
4. “Person” includes any individual, group of individuals, firm, corporation, association, partnership or private or public entity, including a district, county, city, town, or other governmental unit or its agent, and in the case of a corporation, any individual having active and general supervision of the properties of that corporation.
5. “Service” upon a corporation under §§ 23-1-20 and 23-1-21 is deemed to include service upon both the corporation and upon the person having active and general supervision of the properties of the corporation.

History of Section. P.L. 1966, ch. 109, § 1; P.L. 1967, ch. 61, § 1; P.L. 1971, ch. 42, § 2.

23-1-29. Delegation.

1. The director may from time to time designate in writing any person in any department of the state government or any official of a district, county, city, town, or other governmental unit, with that official’s consent, to enforce any rule and regulation promulgated and adopted by the director under the provisions of this chapter.
2. For the purposes of this chapter, the building inspector of the city of Warwick is designated the duly authorized agent of the director and is vested with all the duties, powers, and authority granted to the director by § 23-1-19 and is authorized to exercise them only in the enforcement of minimum standards for the operation and maintenance of refuse disposal facilities or projects situated in the city of Warwick as standards are promulgated by the director of health in accordance with the provisions of this chapter.
3. Whenever the building inspector of the city of Warwick determines that there are reasonable grounds to believe that there is a violation of any law administered by him or her pursuant to this chapter or any rule or regulation adopted by the director, he or she may give notice of the alleged violation to the person responsible for it. The notice shall be in writing, shall set forth the alleged violation, shall provide for a time within which the alleged violation shall be remedied and shall inform the person to whom it is directed that a written request for a hearing on the violation may be filed with the director within ten (10) days after service of the notice. A copy of all notices of violations issued by the building inspector of the city of Warwick shall be forwarded immediately to the director. The notice will be deemed properly served upon a person if a copy of the notice is served upon him or her personally or sent by registered or certified mail to the last known address of that person, or if that person is served with notice by any other method of service now or later authorized in a civil action under the laws of this state. If no written request for a hearing is made to the director within ten (10) days of the service of notice, the notice shall automatically become a compliance order.
4. Nothing contained in this section shall be deemed to divest the director of the department of health of any duties, powers, or authority contained in this section.

History of Section. P.L. 1967, ch. 61, § 2; P.L. 1977, ch. 198, § 1.

23-1-30. Repealed.

23-1-31. Approval of construction by director.

1. No person shall construct any facility to be used for a food business, or add to, or otherwise alter an existing one, without having obtained the approval of the director of the plans and specifications for the proposed construction, addition, or alteration.
2. A plan review fee for new establishments, and for establishments where the cost of renovation exceeds fifty percent (50%) of the value of the establishment, shall be charged. The plan review fee for these establishments shall equal the annual cost of the license/registration fee.

History of Section. P.L. 1971, ch. 42, § 3; P.L. 1990, ch. 65, art. 50, § 1.

23-1-32. Limitation on civil liability.

The director of health and his or her duly authorized agents, individually and severally, and when acting in good faith and without malice, shall not be personally liable for damages because of any act undertaken in the lawful performance of official duties. Any suit or other legal action against the director and his or her duly authorized agents, because of any act performed by them, individually or severally, in the lawful performance of official duties, shall be defended at state expense until the final termination of proceedings.

History of Section. P.L. 1977, ch. 129, § 1.

23-1-33. Dr. Charles V. Chapin Health Laboratory.

The state health laboratory facility located at 50 Orms Street in Providence, Rhode Island, shall be known as the “Dr. Charles V. Chapin Health Laboratory”.

History of Section. P.L. 1984, ch. 98, § 1.

23-1-34. Health promotion income.

The director shall maintain an accurate and timely accounting of money received from the sale of health promotional products, services, or data created by the department of health. This money shall be deposited as general revenue.

History of Section. P.L. 1984, ch. 326, § 1; P.L. 1986, ch. 287, art. 14, § 1; P.L. 1995, ch. 370, art. 40, § 58.

23-1-35. Repealed.

23-1-36. Director’s duties regarding health education, alcohol, and substance abuse programs.

The director shall establish health education, alcohol, and substance abuse programs for students in grades kindergarten through twelve (12), in accordance with § 35-4-18 . The director shall make an annual report to the governor and the general assembly on the administration of the program.

History of Section. P.L. 1986, ch. 412, § 2; P.L. 2001, ch. 86, § 2.

23-1-36.1. [Repealed.]

23-1-37. Repealed.

23-1-38. HIV antibody testing — Sperm collection or donation.

The director shall promulgate guidelines for the prevention of transmission of HIV, and, particularly, in those instances of sperm collection or donation where the director shall require specific testing for HIV.

History of Section. P.L. 1987, ch. 507, § 1.

23-1-39. Tattooing and/or body piercing.

1. The director shall promulgate rules and regulations which provide minimum requirements to be met by any person performing tattooing and/or body piercing upon any individual and for any establishment where tattooing and/or body piercing is performed. These requirements shall include, but not be limited to, general sanitation of premises wherein tattooing and/or body piercing is to be performed and sterilization of instruments. These rules and regulations shall place emphasis on the prevention of disease, specifically including, but not limited to, transmission of hepatitis B and/or human immunodeficiency virus (HIV).
2. In addition, these rules and regulations shall establish procedures for registration with the department of health of all persons performing tattooing and/or body piercing, for registration of any establishment where tattooing and/or body piercing is performed, for regular inspections of premises where tattooing and/or body piercing is performed, for revocation of the registration of any person or establishment deemed in violation of the rules and regulations promulgated under this section. An annual registration fee in the amount as set forth in § 23-1-54 shall be paid by any person or establishment registered to perform tattooing and/or body piercing under this section. All fees shall be deposited by the department as general revenues.
3. Body piercing of a minor is prohibited; provided, however, that body piercing will be allowed if the minor is accompanied by his or her parent or guardian, and the parent or guardian gives consent to the body piercing.

History of Section. P.L. 1988, ch. 354, § 1; P.L. 1989, ch. 164, § 1; P.L. 1995, ch. 370, art. 40, § 58; P.L. 1999, ch. 364, § 1; P.L. 2001, ch. 77, art. 14, § 28; P.L. 2001, ch. 86, § 2; P.L. 2007, ch. 73, art. 39, § 25; P.L. 2012, ch. 241, art. 9, § 35.

23-1-39.1. Laser pointing device.

1. For purposes of this section, “laser pointing device” means any hand held device that emits light amplified by the stimulated emission of radiation which is visible to the human eye.
2. It shall be unlawful for any person to focus, point, or shine a laser beam on another person or an animal in a manner that is intended to alarm, annoy, harass, or harm the person or animal.
3. No person, firm, corporation, or association shall sell, offer to sell, lease, give, or otherwise provide a laser pointing device to any person under eighteen (18) years of age.
4. No person, firm, corporation, or association engaged in the sale of laser pointing devices shall display, hold, store, or offer for sale laser pointing devices unless these devices are securely contained within a sealed or locked case, or located behind a service counter, or stored in any other manner which restricts access to the laser pointing devices by customers and/or the general public.
5. Any person who violates the provisions of subsection (b) or any person, firm, corporation, or association who violates subsection (c) of this section shall, upon a first conviction, be deemed guilty of a violation and fined not more than five hundred dollars ($500), and upon a second or subsequent conviction, shall be deemed guilty of a petty misdemeanor and fined not more than five hundred dollars ($500) and/or imprisoned for not more than six (6) months. Any person, firm, corporation, or association who violates the provisions of subsection (d) shall be fined not more than one hundred dollars ($100).
6. This section shall not apply to members of the Rhode Island state police or to members of any city or town police department or any state or federal law enforcement officer in the performance of their official duties.

History of Section. P.L. 1999, ch. 440, § 1.

23-1-40. Misrepresentation on menu of food or food products.

1. It shall be unlawful for any person, firm, or corporation to misrepresent on a menu the identity of any food or food products to any of the patrons or customers of eating establishments including, but not limited to, restaurants, hotels, cafes, lunch counters, or other places where food is regularly prepared and sold for consumption on or off the premises.
2. The identity of any food or food products shall be deemed misrepresented if:
   1. Its description is false or misleading in any particular;
   2. Its description omits information which, by its omission, renders the description false or misleading in any particular;
   3. It is served, sold, or distributed under the name of another food or food product; or
   4. It purports to be or is represented as a food or food product for which a definition of identity and standard of quality has been established by custom and usage unless it conforms to that definition and standard.
3. Any person, firm, or corporation who violates any provisions of this section shall be guilty of a misdemeanor and for each violation and misrepresentation on a menu shall be punished by a fine of not more than five hundred dollars ($500).
4. This section shall not apply to any section or sections of a retail food or grocery store which do not provide facilities for consumption of food or food products on the premises.
5. The director of health is authorized to promulgate reasonable rules and regulations that are necessary to carry into effect the provisions of this section. The department of health shall have concurrent jurisdiction with the department of attorney general in the enforcement of this section.

History of Section. P.L. 1988, ch. 540, § 1.

23-1-41. Rhode Island public health foundation.

The Rhode Island department of health may establish a nonprofit corporation in the state for the purpose of obtaining and expediting competitive public health research, development, and innovation projects and programs funded by the federal government and private foundations. This new legal entity shall be known as the “Rhode Island public health foundation”.

History of Section. P.L. 1992, ch. 133, art. 25, § 1.

23-1-42. Renewal of licenses, certifications and registration — Date changes.

Notwithstanding the licensure, certification, or registration renewal dates specified in statutes governing assisted living residences, health care facilities, professions and occupations administered by the department of health, the director of health may, by regulation, set the dates for licensure, certification, or registration renewals for classes of these assisted living residences, health care facilities, professions and occupations for administrative purposes. Further, the director of health may prorate or otherwise alter those fees to allow for the appropriate implementation of the revisions; provided, however, that the fees charged shall be no greater than would otherwise be allowed for by statute for the relative period of licensure, certification, or registration.

History of Section. P.L. 1992, ch. 133, art. 61, § 1; P.L. 2007, ch. 30, § 1; P.L. 2007, ch. 41, § 1.

23-1-42.1. Wallet license cards for healthcare professionals.

The department shall, through its office of health professional regulations, offer wallet license cards during the process of online license renewal service for healthcare professionals. If a licensed healthcare professional opts to receive a wallet license card, the department shall mail said card within fourteen (14) days of license renewal at no additional charge.

History of Section. P.L. 2009, ch. 194, § 1; P.L. 2009, ch. 286, § 1.

23-1-43. Minority population health promotion.

The director of health shall establish a minority population health promotion program to provide health information, education, and risk reduction activities to reduce the risk of premature death from preventable disease in minority populations.

History of Section. P.L. 1992, ch. 133, art. 102, § 2.

23-1-44. Routine childhood and adult immunization vaccines.

1. The department of health shall include in the department’s immunization program those vaccines for routine childhood immunization as recommended by the Advisory Committee for Immunization Practices (ACIP) and the Academy of Pediatrics (AAP), and for routine adult immunization as recommended by the ACIP, to the extent permitted by available funds. The immunization program includes administrative and quality assurance services and the Rhode Island Child and Adult Immunization Registry (RICAIR), a confidential, computerized information system that is used to manage statewide immunizations, for all persons in Rhode Island.
2. The director of the department of health shall appoint an advisory committee that will be convened after the ACIP makes a recommendation regarding immunization. The committee will review the ACIP recommendations for the state; assess the vaccine cost and feasibility; and advise the director of health and the office of the health insurance commissioner regarding insurers and providers acting on the ACIP immunization recommendation. All recommendations will be posted on the department of health website. The advisory committee membership shall include, but not be limited to, a primary care provider, pharmacist, representatives of the nursing home industry, the home healthcare industry and major insurers.
3. For the purpose of protecting patients’ information, all personally-identifiable information obtained pursuant to this section shall be subject to the privacy protections of chapter 37.3 of title 5 and the Health Insurance Portability and Accountability Act of 1996, Pub. L. No. 104-191 (HIPAA), as amended.

History of Section. P.L. 1992, ch. 133, art. 8, § 1; P.L. 2001, ch. 86, § 2; P.L. 2006, ch. 269, § 1; P.L. 2006, ch. 294, § 1; P.L. 2007, ch. 320, § 1; P.L. 2008, ch. 100, art. 28, § 9; P.L. 2019, ch. 196, § 1; P.L. 2019, ch. 284, § 1.

23-1-45. Immunization account.

1. There is created within the general fund a restricted receipt account to be known as the “childhood immunization account”. All money in the account shall be utilized by the department of health to effectuate the provisions of § 23-1-44 that relate to the childhood immunization program. All money received pursuant to §§ 23-1-46 and 23-1-47 for the childhood immunization program shall be deposited in the childhood immunization account. Funding dedicated exclusively to effectuate the provisions of § 23-1-44 and this subsection received by the department of health from sources other than those identified in §§ 23-1-46 and 23-1-47 may also be deposited in the childhood immunization account. Up to 15% of the annual revenues from this account may be used to support costs associated with childhood immunization program administrative and quality assurance services and KIDSNET. The general treasurer is authorized and directed to draw his or her orders on the account upon receipt of properly authenticated vouchers from the department of health.
2. There is created within the general fund a restricted receipt account to be known as the “pandemic medications and equipment account” for the purposes of funding pandemic medications and equipment. There shall be an expenditure in FY 2007 not to exceed one million dollars ($1,000,000) for pandemic influenza medications and equipment. Funding dedicated exclusively to effectuate the provisions of this subsection and received by the department of health from sources other than those identified in §§ 23-1-45 , 23-1-46 and 23-1-47 may also be deposited in the pandemic medications and equipment account. The general treasurer is authorized and directed to draw his or her orders on the account upon receipt of properly authenticated vouchers from the department of health.
3. There is created within the general fund a restricted receipt account to be known as the “adult immunization account”. All funds in the account shall be utilized by the department of health to effectuate the provisions of § 23-1-44 that relate to the adult immunization program. All funds received for adult immunization programs pursuant to §§ 23-1-46 and 23-1-47 shall be deposited in the adult immunization account. Funding dedicated exclusively to effectuate the provisions of this subsection and received by the department of health from sources other than those identified in §§ 23-1-46 and 23-1-47 may also be deposited in the adult immunization account. The general treasurer is authorized and directed to draw his or her orders on the account upon receipt of properly authenticated vouchers from the department of health.

History of Section. P.L. 1992, ch. 133, art. 8, § 2; P.L. 2006, ch. 246, art. 31, § 1; P.L. 2006, ch. 269, § 1; P.L. 2006, ch. 294, § 1; P.L. 2007, ch. 73, art. 10, § 3; P.L. 2008, ch. 100, art. 28, § 9.

23-1-46. Insurers.

1. Beginning January 1, 2016, a portion of the amount collected pursuant to § 42-7.4-3 , up to the actual amount expended or projected to be expended by the state for vaccines for children that are recommended by the Advisory Committee on Immunization Practices (ACIP), the American Academy of Pediatrics (AAP), and/or mandated by state law, less the federal share determined by the Centers for Disease Control and Prevention, less any amount collected in excess of the prior year’s funding requirement as indicated in subsection (b) (the “child immunization funding requirement”) shall be deposited into the “childhood immunization account” described in § 23-1-45(a) . These funds shall be used solely for the purposes of the “childhood immunization programs” described in § 23-1-44 , and no other. Beginning January 1, 2016, a portion of the amount collected from the healthcare services funding method described in § 42-7.4-3 , up to the actual amount expended or projected to be expended by the state for adult immunizations recommended by ACIP and/or mandated by state law, less the federal share determined by the Centers for Disease Control and Prevention, less any amount collected in excess of the prior year’s funding requirement as indicated in subsection (b) (the “adult immunization funding requirement”) shall be deposited into the “adult immunization account” described in § 23-1-45(c) . These funds shall be used solely for the purposes of the “adult immunization programs” described in § 23-1-44 and no other.
2. The department of health shall submit to the general assembly an annual report on the immunization programs and costs related to the programs, on or before February 1 of each year.

   Any funds collected in excess of funds needed to carry-out ACIP recommendations, taking into account a reasonable annual carry forward surplus, shall be deducted from the subsequent year’s funding requirements.

History of Section. P.L. 1992, ch. 133, art. 8, § 3; P.L. 1995, ch. 210, § 1; P.L. 1999, ch. 375, § 1; P.L. 2000, ch. 293, § 1; P.L. 2001, ch. 154, § 1; P.L. 2006, ch. 269, § 1; P.L. 2006, ch. 294, § 1; P.L. 2007, ch. 73, art. 10, § 3; P.L. 2008, ch. 475, § 32; P.L. 2014, ch. 145, art. 16, § 2.

23-1-47. Health care providers — Immunities.

No health care provider, as defined in § 5-37.3-3(4) , acting in accordance with the provisions of this chapter, including, without limitation, any health care provider who administers any immunization vaccine pursuant to this chapter, shall be liable to any person who experiences or purports to experience adverse effects arising from the immunization or attendant procedures; provided, however, that informed consent is obtained. Nothing in this chapter shall exempt from liability for gross negligence any individual or public or private agency participating in an authorized mass immunization project, nor shall the provisions of this chapter exempt any drug manufacturer from any liability, regardless of the degree of negligence for any drug or vaccine used in the projects.

History of Section. P.L. 1992, ch. 133, art. 8, § 4; P.L. 2001, ch. 86, § 2.

23-1-48. Reimbursement for medical record copies.

1. The director shall promulgate rules and regulations that establish reasonable charges for expenses incurred in responding to requests for copies of medical records by physicians pursuant to § 5-37-22(c) and (d), and by any healthcare provider as defined in § 5-37.3-3 (“healthcare provider”). The director may utilize data provided by the Rhode Island health information management association or other similar local professional organization in his or her determination as to the amount of the charges permitted by this section.
2. A patient or a patient’s authorized representative, as defined in § 5-37.3-3 (“patient” or “authorized representative”), or a third-party requestor, also as defined in § 5-37.3-3 (“third-party requestor”), shall have the right to request a patient’s medical records.
3. If the healthcare provider utilizes patient’s medical records, an electronic health records system, or database:
   1. Any patient or any patient’s authorized representative or any third-party requestor shall have a right to obtain from any healthcare provider a copy of the patient’s records in an electronic format;
   2. Notwithstanding the provisions of subsection (a) of this section, the charges for responding to requests for copies of medical records in electronic format shall not exceed a fee for clerical services, research, and handling of twenty-five dollars ($25.00), inclusive of shipping costs and the costs of data retrieval and/or the data storage device used to transport the medical records. Provided, however, that fifty cents ($.50) per page for the first one hundred (100) pages and twenty-five cents ($.25) per page for all pages thereafter may be charged. In no event shall the charge for pages exceed one hundred dollars ($100).
4. If the healthcare provider does not utilize an electronic health records system or database, the charges for responding to requests for copies of medical records shall not exceed a fee for clerical services, research, and handling of twenty-five dollars ($25.00), inclusive of retrieval costs, plus actual shipping costs; provided, however, that fifty cents ($.50) per page for the first one hundred (100) pages and twenty-five cents ($.25) per page for all pages thereafter may be charged. In addition, the requestor shall pay for the actual shipping costs incurred.
5. Copies of X-rays or films not reproducible by photocopy shall be provided at the healthcare provider’s actual cost for materials and supplies. In addition, the requestor shall pay reasonable fees for clerical services, research, and handling, not to exceed twenty-five dollars ($25.00), plus actual shipping costs incurred.
6. A special handling fee of ten dollars ($10.00) may be charged if the records must be delivered to the patient or authorized representative or third-party requestor within forty-eight (48) hours of the request.

History of Section. P.L. 1996, ch. 93, § 2; P.L. 2017, ch. 120, § 1; P.L. 2017, ch. 140, § 1.

23-1-49. Registry of persons with head injuries and/or spinal cord injuries.

1. The state department of health is authorized, empowered, and directed to establish and maintain a central registry of persons suffering from acquired traumatic brain and/or spinal cord injuries.
2. The state director of health shall require the reporting of all newly diagnosed traumatic brain and/or spinal cord injuries and the submission of any specified additional information on reported injuries that she or he deems necessary and appropriate for the recognition, prevention, or control of those injuries.
3. The central traumatic brain and spinal cord injury registry shall maintain comprehensive records of all reports submitted pursuant to this section. These reports shall be confidential in accordance with chapter 37.3 of title 5 and subject to the restrictions on release incorporated in that chapter.
4. The state department of health shall make rules and regulations that are necessary to implement the provisions of this section pursuant to chapter 35 of title 42.

History of Section. P.L. 1996, ch. 160, § 1.

23-1-50. Public Records — Exemption — Requirements.

1. The department of health shall deem all application filings for certification, re-certification, and material modification, and correspondence directly related to those application filings, submitted under the provisions of chapters 17.12 and 17.13 of this title and chapter 41 of title 27, to be “public records” as defined in § 38-2-2(4) . Entities or agents certified under one or more of these statutes may request that certain portions of their application filings, or correspondence directly related to their application filings, be regarded as exempt from public disclosure, but may do so only by claiming one or more of the specific grounds delineated in § 38-2-2(4) .
2. For each document or for each portion of a document requested to be exempt from public disclosure, the certified entity or agent must specify the specific exemption claimed and the rationale for the exemption. Each specific exemption and the rationale for it shall themselves be public documents. The department shall determine which of the documents, or parts of the documents, for which an exemption is sought shall be public records and which shall be exempt from the disclosure required by chapter 2 of title 38.
3. Each application filing for certification, re-certification, or material modification submitted under the provisions of chapters 17.12 and 17.13 of this title and chapter 41 of title 27, and for which an exemption is sought, shall be made in three (3) parts:
   1. Part One shall be a complete application filing with no materials to be deleted. This part shall be for the official use of the department as appropriate.
   2. Part Two shall be a complete application filing, except that it shall not include those parts of the application filing which the filing party has claimed and the department determined to be exempt from the disclosure required by chapter 2 of title 38.
   3. Part Three of the application filing shall include those items and information requested to be excluded from the disclosure required by chapter 2 of title 38 with a delineation of the specific exemption and criteria claimed under § 38-2-2(4) and the application filing’s rationale for each specific exemption claimed.
4. All application filings for certification, re-certification, or material modification submitted under the provisions of chapters 17.12 and 17.13 of this title and chapter 41 of title 27 that are not made consistent with the three (3) part form described in subsection (c) shall, except as otherwise prohibited by state or federal law, be deemed “public records” under the provisions of chapter 2 of title 38.

History of Section. P.L. 1999, ch. 111, § 1.

23-1-51. Severability.

If any provision of this chapter or its application to any person or circumstances is held invalid, the invalidity shall not affect other provisions or applications of the chapter which can be given effect without the invalid provision or application, and to this end the provisions of this chapter are declared to be severable.

History of Section. P.L. 2001, ch. 86, § 65.

23-1-52. Adult daycare program licensure.

1. The director is authorized and directed to establish a program for the licensure of adult daycare programs. “Adult daycare program” shall mean a comprehensive, nonresidential program designed to address the biological, psychological, and social needs of adults through individual plans of care that incorporate, as needed, a variety of health, social, and related support services in a protective setting. The director is further authorized to promulgate regulations as he or she deems necessary to implement these provisions.
2. Any person seeking employment in any adult daycare facility licensed herein and having routine contact with an adult daycare client, or having access to such a client’s belongings or funds, shall undergo a national criminal records check that shall include fingerprints submitted to the Federal Bureau of Investigation (FBI) by the bureau of criminal identification of the department of attorney general. The national criminal records check shall be processed prior to, or within one week of, employment. All persons who, as of September 30, 2014, are already employed by an adult daycare facility and all persons who, as of such date, already provide services under this section shall be exempted from the requirements of this section for purposes of their current employment only.
   1. The director may, by rule, identify those positions requiring national criminal records checks. The employee, through the employer, shall apply to the bureau of criminal identification of the department of attorney general for a national criminal records check. Upon the discovery of any disqualifying information as defined in § 23-1-52(c) , and in accordance with rules promulgated by the director, the bureau of criminal identification of the department of attorney general shall inform the applicant, in writing, of the nature of the disqualifying information; and, without disclosing the nature of the disqualifying information, shall notify the employer, in writing, that disqualifying information has been discovered.
   2. An employee against whom disqualifying information has been found may provide a copy of the national criminal records check to the employer. The employer shall make a judgment regarding the continued employment of the employee.
   3. In those situations in which no disqualifying information has been found, the bureau of criminal identification of the department of attorney general shall inform the applicant and the employer, in writing, of this fact.
   4. The employer shall maintain on file, subject to inspection by the department of health, evidence that statewide criminal records checks have been initiated on all employees seeking employment between January 1, 2008, and September 30, 2014, and the results of the checks. The employer shall maintain on file, subject to inspection by the department, evidence that national criminal records checks have been initiated on all employees seeking employment on or after October 1, 2014, and the results of those checks. Failure to maintain that evidence may be grounds to revoke the license or registration of the employer.
   5. The employee shall be responsible for the cost of conducting the national criminal records check through the bureau of criminal identification of the department of attorney general.
3. Information produced by a national criminal records check pertaining to conviction for the following crimes will result in a letter to the employee and employer disqualifying the applicant from employment: murder, voluntary manslaughter, involuntary manslaughter, first-degree sexual assault, second-degree sexual assault, third-degree sexual assault, assault on persons sixty (60) years of age or older, assault with intent to commit specified felonies (murder, robbery, rape, burglary, or the abominable and detestable crimes against nature), felony assault, patient abuse, neglect or mistreatment of patients, burglary, first-degree arson, robbery, felony drug offenses, felony obtaining money under false pretenses, felony embezzlement, abuse, neglect and/or exploitation of adults with severe impairments, exploitation of elders, felony larceny, or felony banking law violations, or a crime under section 1128(a) of the Social Security Act (42 U.S.C. § 1320a-7(a)). An employee against whom disqualifying information has been found may provide a copy of the national criminal records check to the employer who shall make a judgment regarding the continued employment of the employee. For purposes of this subsection, “conviction” means, in addition to judgments of conviction entered by a court subsequent to a finding of guilty or a plea of guilty, those instances where the defendant has entered a plea of nolo contendere and has received a sentence of probation and those instances where a defendant has entered into a deferred sentence agreement with the attorney general.

History of Section. P.L. 2007, ch. 73, art. 24, § 2; P.L. 2014, ch. 347, § 2; P.L. 2014, ch. 399, § 2.

23-1-53. Cost of legal fees.

1. The director is hereby authorized and may in his or her discretion recover the reasonable cost of legal services provided to the department of health by attorneys of the office of legal counsel or attorneys under contract to perform attorney functions and activities for the department of health pursuant to chapters 15 and 17.14 of this title and §§ 23-17-14.3 and 23-17-14.4 . Nothing in this section shall limit the power of the director to retain legal counsel and to recover the costs of such legal counsel pursuant to other provisions of the general laws.
2. There is created within the general fund a restricted receipt account to be known as the “health systems reimbursement account.” All funds deposited in the account shall be utilized by the department of health to implement the provisions of this section incurred by the department pursuant to chapters 15 and 17.14 of this title and §§ 23-17-14.3 and 23-17-14.4 . All funds received for the department pursuant to this section shall be deposited in the “health system reimbursement account.” The general treasurer is authorized and directed to draw his or her orders on the account upon receipt of properly authenticated vouchers from the department of health.

History of Section. P.L. 2009, ch. 68, art. 14, § 1.

23-1-54. Fees payable to the department of health.

Fees payable to the department shall be as follows:

PROFESSION RIGL Section Description of Fee FEE Barbers/hairdressers 5-10-10(a) Renewal application $25.00 Barbers/hairdressers 5-10-10(a) Renewal application: Manicuring Instructors and mani- $25.00 curists Barbers/hairdressers 5-10-10(b) Minimum late renewal $25.00 fee Barbers/hairdressers 5-10-10(b) Maximum late renewal $100.00 fee Barbers/hairdressers 5-10-11 [c] Application fee $25.00 Barbers/hairdressers 5-10-11 [c] Application fee: mani- curing Instructors and mani- $25.00 curists Barbers/hairdressers 5-10-13 Demonstrator’s permit $90.00 Barbers/hairdressers 5-10-15 Shop license: initial $170.00 Barbers/hairdressers 5-10-15 Shop license: renewal $170.00 Veterinarians 5-25-10 Application fee $40.00 Veterinarians 5-25-11 Examination fee $540.00 Veterinarians 5-25-12 (a) Renewal fee $580.00 Veterinarians 5-25-12 [c] Late renewal fee $120.00 Podiatrists 5-29-7 Application fee $240.00 Podiatrists 5-29-11 Renewal fee: minimum $240.00 Podiatrists 5-29-11 Renewal fee: maximum $540.00 Podiatrists 5-29-13 Limited registration $65.00 Podiatrists 5-29-14 Limited registration: Academic faculty $240.00 Podiatrists 5-29-14 Application fee: Renewal minimum $240.00 Podiatrists 5-29-14 Application fee: Renewal maximum $440.00 Chiropractors 5-30-6 Examination fee: $210.00 Chiropractors 5-30-7 Examination exemp- $210.00 tion fee: Chiropractors 5-30-8(b) Exam Physiotherapy $210.00 Chiropractors 5-30-8(b) Exam chiro and physio- $210.00 therapy Chiropractors 5-30-12 Renewal fee $210.00 Dentists/dental hygien- 5-31.1-6(d) Dentist: application fee $965.00 ists Dentists/dental hygien- 5-31.1-6(d) Dental hygienist: appli- $65.00 ists cation fee Dentists/dental hygien- 5-31.1-6(d) Reexamination: dentist $965.00 ists Dentists/dental hygien- 5-31.1-6(d) Reexamination: hygien- $65.00 ists ist Dentists/dental hygien- 5-31.1-21(b) Reinstatement fee den- $90.00 ists tist Dentists/dental hygien- 5-31.1-21(b) Reinstatement fee hy- $90.00 ists gienist Dentists/dental hygien- 5-31.1-21(c) Inactive status: dentist $220.00 ists Dentists/dental hygien- 5-31.1-21(c) Inactive status: hygien- $40.00 ists ist Dentists/dental hygien- 5-31.1-22 Limited registration $65.00 ists Dentists/dental hygien- 5-31.1-23 [c] Limited reg: ists Academic faculty $965.00 Dentists/dental hygien- 5-31.1-23 [c] Limited reg: ists Academic faculty re- $500.00 newal Electrolysis 5-32-3 Application fee $25.00 Electrolysis 5-32-6(b) Renewal fee $25.00 Electrolysis 5-32-7 Reciprocal license fee $25.00 Electrolysis 5-32-17 Teaching license $25.00 Funeral directors/em- 5-33.2-12 Funeral establishment $120.00 balmers license Funeral services estab- lishments Funeral directors/em- 5-33.2-15 Renewal: funeral/direc- $90.00 balmers tor Funeral services estab- $30.00 lishments embalmer Funeral directors/em- 5-33.2-12 Funeral branch ofc li- $90.00 balmers cense Funeral directors/em- 5-33.2-13.1 Crematories: applica- $120.00 balmers tion fee Funeral services estab- lishments Funeral directors/em- 5-33.2-15 Renewal: funeral/direc- balmers tor Funeral Svcs establish- $120.00 ments establishment Funeral directors/em- 5-33.2-15 Additional branch of- balmers fice Funeral services Estab- $120.00 lishments licenses Funeral directors/em- 5-33.2-15 Crematory renewal fee balmers Funeral svcs establish- $120.00 ments Funeral directors/em- 5-33.2-15 Late renewal fee balmers Funeral svcs establish- $25.00 ments (All license types) Funeral directors/em- 5-33.2-16(a) Intern registration fee balmers Funeral Services estab- $25.00 lishments Nurses 5-34-12 RN Application fee $135.00 Nurses 5-34-16 LPN Application fee $45.00 Nurses 5-34-19 Renewal fee: RN $135.00 Nurses 5-34-19 Renewal fee: LPN $45.00 Nurses 5-34-37 RNP application fee $80.00 Nurses 5-34-37 RNP renewal fee $80.00 Nurses 5-34-37 RNP prescriptive privi- $65.00 leges Nurses 5-34-40.3 Clin nurse spec appli- $80.00 cation Nurses 5-34-40.3 Clin nurse spec re- $80.00 newal Nurses 5-34-40.3 Clin nurse spec Rx $65.00 privilege Nurse anesthetists 5-34.2-4(a) CRNA application fee $80.00 Nurse anesthetists 5-34.2-4(b) CRNA renewal fee $80.00 Optometrists 5-35.1-4 Application fee $280.00 Optometrists 5-35.1-7 Renewal fee $280.00 Optometrists 5-35.1-7 Late fee $90.00 Optometrists 5-35.1-7 Reactivation of license $65.00 fee Optometrists 5-35.1-19(b) Violations of section $650.00 Optometrists 5-35.1-20 Violations of chapter $260.00 Opticians 5-35.2-3 Application fee $30.00 Physicians 5-37-2 Application fee $1,090.00 Physicians 5-37-2 Re-examination fee $1,090.00 Physicians 5-37-10(b) Late renewal fee $170.00 Physicians 5-37-16 Limited registration $65.00 fee Physicians 5-37-16.1 Ltd reg: academic fac- $600.00 ulty Physicians 5-37-16.1 Ltd reg: academic Faculty renewal $170.00 Acupuncture 5-37.2-10 Application fee $310.00 Acupuncture 5-37.2-13(4) Acupuncture assistant $310.00 Licensure fee $170.00 Social workers 5-39.1-9 Application fee $70.00 Social workers 5-39.1-9 Renewal fee $70.00 Physical therapists 5-40-8 Application fee $155.00 Physical therapists 5-40-8 .1 Application: physical $50.00 therapy assistants Physical therapists 5-40-10 (a) Renewal fee: Physical therapists $155.00 Physical therapists 5-40-10 (a) Renewal fee: Physical therapy assistants $50.00 Physical therapists 5-40-10[c] Late renewals $50.00 Occupational thera- 5-40.1-12(2) Renewal fee $140.00 pists Occupational thera- 5-40.1-12(5) Late renewal fee $50.00 pists Occupational thera- 5-40.1-12(b) Reactivation fee $140.00 pists Occupational thera- 5-40.1-13 Application fee $140.00 pists Psychologists 5-44-12 Application fee $230.00 Psychologists 5-44-13 Temporary permit $120.00 Psychologists 5-44-15 [c] Renewal fee $230.00 Psychologists 5-44-15 (e) Late renewal fee $50.00 Nursing home adminis- 5-45-10 Renewal fee $160.00 trators Speech pathologist/au- 5-48-1(14) Speech lang support diologists personnel: late filing $90.00 Speech pathologist/au- 5-48-9(a) Application fee: Audiol- $65.00 diologists ogist Speech pathologist/au- 5-48-9(a) Application fee: diologists Speech Pathologist $145.00 Speech pathologist/au- 5-48-9(a) Renewal fee: Audiolo- $65.00 diologists gist Speech pathologist/au- 5-48-9(a) Renewal fee: Speech $145.00 diologists Pathologist Speech pathologist/au- 5-48-9(a) Provisional license: re- $65.00 diologists newal fee Speech pathologist/au- 5-48-9(b) Late renewal fee $50.00 diologists Speech pathologist/au- 5-48-9(d)(1) Reinstatement fee: au- $65.00 diologists diologist Speech pathologist/au- 5-48-9(d)(1) Reinstatement fee: au- $65.00 diologists diologist speech pathologists $145.00 personnel: late filing $65.00 Hearing aid dealers/ 5-49-6(a) License endorsement fitters Examination fee $25.00 Hearing aid dealers/ 5-49-8(b) Temporary permit fee $25.00 fitters Hearing aid dealers/ 5-49-8(d) Temporary permit re- $35.00 fitters newal fee Hearing aid dealers/ 5-49-11(a)(1) License fee $25.00 fitters Hearing aid dealers/ 5-49-11 (b) License renewal fee $25.00 fitters Hearing aid dealers/ 5-49-11 [c] License renewal late $25.00 fitters fee Physician assistants 5-54-9(4) Application fee $110.00 Physician assistants 5-54-11(b) Renewal fee $110.00 Orthotics/prosthetic 5-59.1-5 Application fee $120.00 practice Orthotics/prosthetic 5-59.1-12 Renewal fee $120.00 practice Athletic trainers 5-60-11 Application fee $60.00 Athletic trainers 5-60-11 Renewal fee $60.00 Athletic trainers 5-60-11 Late renewal fee $25.00 Mental health counsel- 5-63.2-16 Application fee: Mar- ors riage Marriage and family Family therapist $130.00 therapists Mental health counsel- 5-63.2-16 Application fee: Mental ors Marriage and family Health counselors $70.00 therapists Mental health counsel- 5-63.2-16 Reexamination fee: ors Marriage and family Marriage/family thera- $130.00 therapists pist Mental health counsel- 5-63.2-16 Reexamination fee: ors Marriage and family Mental health counsel- $70.00 therapists ors Mental health counsel- 5-63.2-17(a) Renewal fee: Marriage ors Marriage and Family Family therapist $130.00 therapists Mental health counsel- 5-63.2-17(a) Renewal fee: ors Marriage and Family Mental health coun- $50.00 therapist selor Mental health counsel- 5-63.2-17(b) Late renewal fee: ors Marriage and Family Marriage and family $90.00 therapist therapist Dieticians/nutritionists 5-64-6(b) Application fee $75.00 Dieticians/nutritionists 5-64-7 Graduate status: Application fee: $75.00 Dieticians/nutritionists 5-64-8 Renewal fee $75.00 Dieticians/nutritionists 5-64-8 Reinstatement fee $75.00 Radiologic technolo- 5-68.1-10 Application fee maxi- $190.00 gists mum Licensed chemical de- 5-69-9 Application fee $75.00 pendency professionals Licensed chemical de- 5-69-9 Renewal fee $75.00 pendency professionals Licensed chemical 5-69-9 Application fee $75.00 Licensed chemical 5-69-9 Application fee $75.00 dependency clinical su- pervisor Licensed chemical 5-69-9 Renewal fee $75.00 dependency clinical su- pervisor Deaf interpreters 5-71-8(a)(3) License fee maximum $25.00 Deaf interpreters 5-71-8(a)(3) License renewal fee $25.00 Milk producers 21-2-7(g)(1) In-state milk processor $160.00 Milk producers 21-2-7(g)(2) Out-of-state milk pro- $160.00 cessor Milk producers 21-2-7(g)(3) Milk distributors $160.00 Frozen desserts 21-9-3(1) In-state wholesale $550.00 Frozen desserts 21-9-3(2) Out-of-state wholesale $160.00 Frozen desserts 21-9-3(3) Retail frozen dess pro- $160.00 cessors Meats 21-11-4 Wholesale $160.00 Meats 21-11-4 Retail $40.00 Shellfish packing 21-14-2 License fee: houses Shipper/reshipper $320.00 Shellfish packing 21-14-2 License fee: houses Shucker packer/ $390.00 repacker Non-alcoholic bottled 21-23-2 Bottler permit beverages, drinks & $550.00 juices Non-alcoholic bottled 21-23-2 Bottle apple cider fee beverages, drinks and $60.00 juices Farm home food manu- 21-27-6.1(4) Registration fee $65.00 facturers Food businesses 21-27-10(e)(1) Food processors whole- $300.00 sale Food businesses 21-27-10(e)(2) Food processors retail $120.00 Food businesses 21-27-10(e)(3) Food service establish- ments 50 seats or less $160.00 Food businesses 21-27-10(e)(3) Food service establish- ments more than 50 seats $240.00 Food businesses 21-27-10(e)(3) Mobile food service $100.00 units Food businesses 21-27-10(e)(3) Industrial caterer or food vending Machine commissary $280.00 Food businesses 21-27-10(e)(3) Cultural heritage edu- cational Facility $80.00 Food businesses 21-27-10(e)(4) Vending Machine Loca- tion 3 units or less $50.00 Food businesses 21-27-10(e)(4) Vending Machine Location 4-10 units $100.00 Food businesses 21-27-10(e)(4) Vending Machine Location = 11 units $120.00 Food businesses 21-27-10(e)(5) Retail Mkt 1-2 cash registers $120.00 Food businesses 21-27-10(e)(5) Retail Market 3-5 cash registers $240.00 Food businesses 21-27-10(e)(5) Retail Market = 6 Cash registers $510.00 Food businesses 21-27-10(e)(6) Retail food peddler $100.00 Food businesses 21-27-10(e)(7) Food warehouses $190.00 Food businesses 21-27-11.2 Certified food safety $50.00 mgr License verification fee 23-1-16.1 All license types $50.00 Tattoo and body pierc- 23-1-39 Annual registration ing fee: Person $90.00 Tattoo and body pierc- 23-1-39 Annual registration ing fee: establishment $90.00 Vital records 23-3-25(a)(1) Certificate of birth, fe- tal death, death, marriage, birth, or Certification that such record Cannot be found $20.00 Vital records 23-3-25(a)(1) Each duplicate of cer- tificate of birth, fetal death, death, marriage, birth, or certification that such record cannot be found $15.00 Vital records 23-3-25(a)(2) Each additional calen- dar year Search, if within 3 months of original search and if receipt of original search presented $2.00 Vital records 23-3-25(a)(3) Expedited service $7.00 Vital records 23-3-25(a)(4) Adoptions, legitima- tions, or Paternity determina- $15.00 tions Vital records 23-3-25(a)(5) Authorized corrections, Alterations, and addi- $10.00 tions Vital records 23-3-25(a)(6) Filing of delayed record and Examination of docu- mentary Proof $20.00 Vital records 23-3-25(a)(6) Issuance of certified copy of a delayed record $20.00 Medical Examiner 23-4-13 Autopsy reports $40.00 Medical Examiner 23-4-13 Cremation certificates and statistics $30.00 Medical Examiner 23-4-13 Testimony in civil suits: Minimum/day $650.00 Medical Examiner 23-4-13 Testimony in civil suits: Maximum/day $3,250.00 Emergency medical 23-4.1-10 [c] Annual fee: ambulance technicians service maximum $540.00 Emergency medical 23-4.1-10 [c] Annual fee: vehicle li- technicians cense maximum $275.00 Emergency medical 23-4.1-10[c] Triennial fee: EMT li- technicians cense maximum $120.00 Emergency medical 23-4.1-10(c)(2) Exam fee maximum: $120.00 technicians EMT Emergency medical 23-4.1-10(c)(2) Vehicle inspection technicians Maximum $190.00 Clinical laboratories 23-16.2-4(a) Clinical laboratory li- cense per specialty $650.00 Clinical laboratories 23-16.2-4(a) Laboratory station li- $650.00 cense Clinical laboratories 23-16.2-4(b) Permit fee $70.00 Health care facilities 23-17-38 Hospital: base fee an- $16,900.00 nual Health care facilities 23-17-38 Hospital: annual per $120.00 bed fee Health care facilities 23-17-38 ESRD: annual fee $3,900.00 Health care facilities 23-17-38 Home nursing-care/ home- care providers $650.00 Health care facilities 23-17-38 OACF: annual fee $650.00 Assisted living resi- 23-17.4-15.2(d) License application fee: $220.00 dences/ administrators Assisted living resi- 23-17.4-15.2(d) License renewal fee: $220.00 dences/ administrators Assisted living resi- 23-17.4-31 Annual facility fee: base $330.00 dences Assisted living resi- 23-17.4-31 Annual facility per bed $70.00 dences Nursing assistant reg- 23-17.9-3 Application: compe- istration tency evaluation training program maximum $325.00 Nursing assistant reg- 23-17.9-5 Application fee $35.00 istration Nursing assistant reg- 23-17.9-5 Exam fee: skills profi- $170.00 istration ciency Nursing assistant reg- 23-17.9-6 Registration fee $35.00 istration Nursing assistant reg- 23-17.9-7 Renewal fee $35.00 istration Sanitarians 23-19.3-5(a) Registration fee $25.00 Sanitarians 23-19.3-5(b) Registration renewal $25.00 Massage therapy 23-20.8-3(e) Massage therapist appl $65.00 fee Massage therapy 23-20.8-3(e) Massage therapist re- $65.00 newal fee Recreational facilities 23-21-2 Application fee $160.00 Swimming pools 23-22-6 Application license: first pool $250.00 Swimming pools 23-22-6 Additional pool fee at same location $75.00 Swimming pools 23-22-6 Seasonal application license: first pool $150.00 Swimming pools 23-22-6 Seasonal additional pool fee at same location $75.00 Swimming pools 23-22-6 Year-round license for non-profit $25.00 Swimming pools 23-22-10 Duplicate license $2.00 Swimming pools 23-22-12 Penalty for violations $50.00 Respiratory care prac- 23-39-11 Application fee $60.00 titioners Respiratory care prac- 23-39-11 Renewal fee $60.00 titioners

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History of Section. P.L. 2012, ch. 241, art. 9, § 49; P.L. 2018, ch. 47, art. 7, § 7.

23-1-55. Electronic nicotine delivery system distributor, and dealer licenses required — Definitions.

Definitions. Whenever used in §§ 23-1-56 to 23-1-58 , unless the context requires otherwise:

1. “Dealer” means any person, whether located within or outside of this state, who sells or distributes electronic nicotine-delivery system products to a consumer in this state;
2. “Distributor” means any person:
   1. Whether located within or outside of this state, other than a dealer, who sells or distributes electronic nicotine-delivery system products within or into this state. Such term shall not include any electronic nicotine-delivery system products manufacturer, export warehouse proprietor, or importer with a valid permit, if such person sells or distributes electronic nicotine-delivery system products in this state only to licensed distributors or to an export warehouse proprietor or another manufacturer with a valid permit;
   2. Selling electronic nicotine-delivery system products directly to consumers in this state by means of at least twenty-five (25) electronic nicotine-delivery system product vending machines;
   3. Engaged in this state in the business of manufacturing electronic nicotine-delivery system products or any person engaged in the business of selling electronic nicotine-delivery system products to dealers, or to other persons, for the purpose of resale only; provided that seventy-five percent (75%) of all electronic nicotine-delivery system products sold by that person in this state are sold to dealers or other persons for resale and selling electronic nicotine-delivery system products directly to at least forty (40) dealers or other persons for resale; or
   4. Maintaining one or more regular places of business in this state for that purpose; provided, that seventy-five percent (75%) of the sold electronic nicotine-delivery system products are purchased directly from the manufacturer and selling electronic nicotine-delivery system products directly to at least forty (40) dealers or other persons for resale;
3. “Electronic nicotine-delivery system” means the products as defined in § 11-9-13.4(6) .

History of Section. P.L. 2014, ch. 182, § 2; P.L. 2014, ch. 223, § 2.

23-1-56. License.

1. Each person engaging in the business of selling electronic nicotine-delivery system products in the state, including any distributor or dealer, shall secure a license annually from the department before engaging in that business or continuing to engage in it. A separate application and license is required for each place of business operated by a distributor or dealer. If the applicant for a license does not have a place of business in this state, the license shall be issued for such applicant’s principal place of business, wherever located. A licensee shall notify the department within thirty (30) days in the event that it changes its principal place of business. A separate license is required for each class of business if the applicant is engaged in more than one of the activities required to be licensed by this section.  No person shall maintain or operate, or cause to be operated, a vending machine for electronic nicotine-delivery systems without procuring a dealer’s license for each machine.
2. The director shall have authority to set a reasonable fee not to exceed twenty-five dollars ($25.00) for the issuance of the license.
3. Each issued license shall be prominently displayed on the premises, if any, covered by the license.
4. The director shall create and maintain a website setting forth the identity of all licensed persons under this section, itemized by type of license possessed, and shall update the site no less frequently than six (6) times per year.
5. A manufacturer or importer may sell or distribute electronic nicotine-delivery systems to a person located or doing business within the state only if such person is a licensed distributor. An importer may obtain electronic nicotine-delivery systems only from a licensed manufacturer. A distributor may sell or distribute electronic nicotine-delivery systems to a person located or doing business within this state only if such person is a licensed distributor or dealer. A distributor may obtain electronic nicotine-delivery systems only from a licensed manufacturer, importer, or distributor. A dealer may obtain electronic nicotine-delivery systems only from a licensed distributor.
6. 1. No license under this chapter may be granted, maintained, or renewed if the applicant, or any combination of persons owning directly or indirectly any interests in the applicant:
      1. Is delinquent in any tax filings for one month or more; or
      2. Had a license under this chapter revoked within the past two (2) years.
   2. No person shall apply for a new license, or renewal of a license and no license shall be issued or renewed for any person, unless all outstanding fines, fees, or other charges relating to any license held by that person have been paid.
   3. No license shall be issued relating to a business at any specific location until all prior licenses relating to that location have been officially terminated and all fines, fees, or charges relating to the prior licenses have been paid or otherwise resolved or if the director has found that the person applying for the new license is not acting as an agent for the prior licensee who is subject to any such related fines, fees, or charges that are still due. Evidence of such agency status includes, but is not limited to, a direct familial relationship and/or employment, contractual, or other formal financial or business relationship with the prior licensee.
   4. No person shall apply for a new license pertaining to a specific location in order to evade payment of any fines, fees, or other charges relating to a prior license for that location.
   5. No new license shall be issued for a business at a specific location for which a license has already issued unless there is a bona fide, good-faith change in ownership of the business at that location.
   6. No license or permit shall be issued, renewed or maintained for any person, including the owners of the business being licensed, who has been convicted of violating any criminal law relating to tobacco products and/or electronic nicotine-delivery system products, the payment of taxes, or fraud, or has been ordered to pay civil fines of more than twenty-five thousand dollars ($25,000) for violations of any civil law relating to tobacco products and/or electronic nicotine-delivery system products, the payment of taxes, or fraud.

History of Section. P.L. 2014, ch. 182, § 2; P.L. 2014, ch. 223, § 2.

23-1-57. Penalties for unlicensed business.

Any distributor or dealer who sells, offers for sale, or possesses with intent to sell, electronic nicotine-delivery system products without a license as provided in § 23-1-56 , shall be fined in accordance with the provisions of, and the penalties contained in, § 23-1-58 .

History of Section. P.L. 2014, ch. 182, § 2; P.L. 2014, ch. 223, § 2.

23-1-58. Penalty for operating without a dealer license.

1. Any individual or business who violates this chapter by selling or conveying an electronic nicotine-delivery system product without a retail license shall be cited for that violation and shall be required to appear in district court for a hearing on the citation.
2. Any individual or business cited for a violation hereunder shall:
   1. Either post a five hundred dollar ($500) bond with the district court within ten (10) days of the citation; or
   2. Sign and accept the citation indicating a promise to appear in court.
3. An individual or business who or that has accepted the citation may:
   1. Pay the five hundred dollar ($500) fine, either by mail or in person, within ten (10) days after receiving the citation; or
   2. If that individual or business has posted a bond, forfeit the bond by not appearing at the scheduled hearing. If the individual or business cited pays the five hundred dollar ($500) fine or forfeits the bond, that individual or business is deemed to have admitted the cited violation and to have waived the right to a hearing on the issue of commission on the violation.
4. The court, after a hearing on a citation, shall make a determination as to whether a violation has been committed. If it is established that the violation did occur, the court shall impose a five hundred dollar ($500) fine in addition to any court costs or fees.

History of Section. P.L. 2014, ch. 182, § 2; P.L. 2014, ch. 223, § 2.

23-1.1-1. Definitions.

When used in this chapter:

1. “Code” means a standard body of rules for safety and health formulated, adopted, and issued by the commission under the provisions of this chapter.
2. “Director” means the director of health or his or her duly authorized representative.
3. “Employ” means the use of any services of an employee for compensation and includes to suffer or permit to work.
4. “Employee” means an individual who is employed by an employer.
5. “Employer” means a person, firm, corporation, partnership, association, receiver, or trustee in bankruptcy having one or more persons in his, her, or its employ, a state agency, or an agency of a political subdivision of the state, or any person acting directly or indirectly in the interest of an employer.

History of Section. P.L. 1973, ch. 261, § 1.

23-1.1-2. Creation.

There shall be a division of occupational health within the department of health which shall have all the powers and duties relating to the administration and enforcement of health codes as prescribed by the provisions of this chapter, and any other duties that may be conferred upon the division by law.

History of Section. P.L. 1973, ch. 261, § 1; P.L. 1976, ch. 54, § 1.

23-1.1-3. Annual report.

The director of health shall annually furnish information regarding the activities of the division of occupational health to the director of labor and training for inclusion in the director of labor and training’s annual report to the governor and to the general assembly. The director of health shall also provide information to the director of labor and training for reports to be submitted to the United States Secretary of Labor in the form and from time to time that the secretary of labor and training may require.

History of Section. P.L. 1973, ch. 261, § 1.

23-1.1-4. Chief of division — Compliance inspectors.

The director of health shall appoint the chief of the division of occupational health. The appointee shall be in the classified service of the state and shall be responsible to and report to the director. The director shall appoint health compliance inspectors who shall be in the classified service of the state. The director shall appoint other employees that are necessary to carry out the provisions of this chapter. Health compliance inspectors shall perform all duties necessary to determine compliance with the health provisions of this chapter and shall in this chapter be referred to as “compliance inspectors”. Nothing in this section shall be construed as terminating the services of any person now employed within the division of occupational health who is presently qualified and within the classified service of the state. All of those persons shall continue in the service of the division and their titles shall be changed, as necessary, to comply with the provisions of this chapter.

History of Section. P.L. 1973, ch. 261, § 1.

23-1.1-5. Compliance inspectors — Assignment — Duties.

Compliance inspectors shall devote their entire scheduled work time and attention to the duties of their respective offices. The director shall assign compliance inspectors to the duties to be performed. No employee of the division of occupational health shall accept other employment which the director determines is in conflict with his or her official duties.

History of Section. P.L. 1973, ch. 261, § 1.

23-1.1-6. Appropriations — Disbursement.

The general assembly shall annually appropriate sums that are necessary to carry out the provisions of this chapter. The state controller is authorized and directed to draw his or her orders on the general treasurer for the payment of the sums so appropriated or so much of the sums as may from time to time be required upon receipt by him or her of proper vouchers approved by the chief of the division of occupational health, and by the director.

History of Section. P.L. 1973, ch. 261, § 1; P.L. 1976, ch. 54, § 2.

23-1.1-7. Inspection powers.

1. The director, upon presenting appropriate credentials to the owner, operator, representative, or agent in charge is authorized:
   1. To enter without delay and at reasonable times any factory, plant establishment, construction site, or other area, workplace, or environment where work is performed by an employee of an employer; and
   2. To inspect and investigate during regular working hours and at other reasonable times, and within reasonable limits and in a reasonable manner, that place of employment and all pertinent conditions, structures, machines, apparatus, devices, equipment, and materials in that location, and to question privately any employer, owner, operator, agent, or employee.
2. If the director of health shall be denied entry to any place which he or she shall have reason to believe had been, is being, or is about to be used as a place of employment, he or she shall notify the director of labor and training, who shall then proceed in accordance with the provisions of § 28-20-12 .

History of Section. P.L. 1973, ch. 261, § 1.

23-1.1-8. Report of violations by employees — Inspection.

1. Any employee or representative of employees who believes that a violation of a health code exists that threatens physical harm, or that an imminent danger exists, may request an inspection by giving notice to the director of the violation or danger. Any notice shall be presented in writing, shall set forth with reasonable particularity the grounds for the notice, and shall be signed by the employee or representative of employees. Upon receipt of the notification, the director shall provide a copy to the employer or the employer’s agent not later than at the time of inspection, except that upon the request of the person giving the notice, his or her name and the name of the individual employee referred to in the notice shall not appear in the copy or in any record published, released, or made available. If, upon receipt of the notification, the director determines there are reasonable grounds to believe that a violation or danger exists, he or she shall make a special inspection in accordance with the provisions of this section as soon as practicable, to determine if a violation or danger exists. If the director determines that there are not reasonable grounds to believe that a violation or danger exists, he or she shall notify the employee or representative of the employees, in writing, of that determination.
2. Prior to or during any inspection of a workplace, any employee or representative of employees employed in the workplace may notify the director, in writing, of any violation of this chapter which the employee or representative has reason to believe exists in the workplace. The director of labor and training shall, by regulation, establish procedures for informal review of any refusal by representatives of the director of health to issue a compliance order with respect to any alleged violation and the director shall furnish the employee or representative of employees requesting the review a written statement of the reasons for the director’s final disposition of the case.
3. A representative of the employer and a representative authorized by the employees shall be given the opportunity to accompany the compliance inspector during a physical inspection of the workplace for the purpose of aiding the inspection. Where there is no authorized employee representative, the compliance inspector shall consult with a reasonable number of employees concerning matters of health in the workplace.

History of Section. P.L. 1973, ch. 261, § 1; P.L. 1976, ch. 54, § 3.

23-1.1-9. Procedures to counteract imminent dangers.

Where the director of health finds a condition of imminent danger, he or she shall immediately notify the director of labor and training who shall then take the necessary action pursuant to § 28-20-14 .

History of Section. P.L. 1973, ch. 261, § 1.

23-1.1-10. Prosecution of violations.

It shall be the duty of the director of health to notify the director of labor and training of all violations of this chapter and the director of labor and training shall then request the attorney general to prosecute all violations.

History of Section. P.L. 1973, ch. 261, § 1.

23-1.1-11. Compliance orders.

If upon inspection or investigation the director of health finds that an employer has violated any regulation prescribed pursuant to this chapter or has violated any requirements of § 28-20-8 , or of any code, rule, or order promulgated pursuant to § 28-20-24 , the director shall notify the director of labor and training who shall promptly issue a compliance order in accordance with subsections (a), (b), and (c) of § 28-20-16 .

History of Section. P.L. 1973, ch. 261, § 1; P.L. 1989, ch. 542, § 45.

23-1.1-12. Enforcement procedure.

The director of labor and training shall be responsible for enforcement of the provisions of this chapter in accordance with § 28-20-17 .

History of Section. P.L. 1973, ch. 261, § 1.

23-1.1-13. Penalties.

1. Any person who gives advance notice of any inspection to be conducted under this chapter, without authority from the director of labor and training, shall, upon conviction, be punished by a fine of not more than one thousand dollars ($1,000) or by imprisonment for not more than one year, or by both.
2. All other penalties shall be assessed in accordance with § 28-20-18 .

History of Section. P.L. 1973, ch. 261, § 1; P.L. 1976, ch. 54, § 4.

23-1.1-14. Discrimination on account of complaint.

1. No employer shall discharge or in any manner discriminate against any employee because that employee has filed any complaint or instituted or caused to be instituted any proceeding under or related to this chapter or has testified or is about to testify in any proceeding or because of the exercise by that employee on behalf of himself or herself or others of any right afforded by this chapter.
2. Any employee who believes that he or she has been discharged or otherwise discriminated against by any employer in violation of this section may, within thirty (30) days after a violation occurs, file a written complaint with the director of labor and training alleging discrimination. Upon receipt of a complaint, the director of labor and training shall cause an investigation to be made as he or she deems appropriate. If upon that investigation, the director of labor and training determines that the provisions of this section have been violated, and the employer fails or refuses to take remedial action as ordered by the director of labor and training, the director of labor and training shall then bring an action in any superior court against that person. In that action, the courts shall have jurisdiction, for cause shown, to restrain violations of subsection (a) of this section and order all appropriate relief including rehiring or reinstatement of the employee to his or her former position with back pay and any other benefits to which he or she was entitled.
3. Within ninety (90) days of the receipt of a complaint filed under this section, the director shall notify the complainant of his or her determination under subsection (b) of this section.

History of Section. P.L. 1973, ch. 261, § 1; P.L. 1976, ch. 54, § 5.

23-1.1-15. Confidentiality of trade secrets.

All information reported to or otherwise obtained by the director in connection with any inspection or proceeding under this chapter which contains or which might reveal a trade secret referred to in § 1905 of title 18 of the United States Code or any amendment of § 1905 of title 18 of the United States Code, 18 U.S.C. § 1905, shall be considered confidential for the purpose of that section, except that the information may be disclosed to other officers or employees concerned with carrying out this chapter or when relevant in any proceeding under this chapter. In any proceeding under this chapter the director of labor and training, the review board, or the court shall issue orders that may be appropriate to protect the confidentiality of trade secrets.

History of Section. P.L. 1973, ch. 261, § 1.

23-1.1-16. Other safety and health laws unimpaired.

Nothing in this chapter shall be construed to repeal or to limit or restrict in any way present state laws, codes, regulations, or orders governing the safety or health of employees in any place of employment which are not in conflict with this chapter.

History of Section. P.L. 1973, ch. 261, § 1.

23-1.1-17. Severability.

If any provision of this chapter, or the application of the provision to any person or circumstance, shall be held invalid, the remainder of this chapter, or the application of the provision to persons or circumstances other than those as to which it is held invalid, shall not be affected thereby.

History of Section. P.L. 1973, ch. 261, § 1.

23-1.2-1. Division of legal services.

There is established within the department of health a division which shall be known as the division of legal services.

History of Section. P.L. 1974, ch. 274, § 1.

23-1.2-2. Appointment of chief counsel.

The division of legal services shall be headed by a member of the bar of this state who shall be appointed by the director of health with the approval of the governor, and who shall be in the classified service.

History of Section. P.L. 1974, ch. 274, § 1.

23-1.2-3. Assistant counsel.

The chief counsel may appoint any assistants that may be deemed necessary whose powers and duties shall be similar to those imposed upon the chief counsel by law, and shall be performed under and by the advice and direction of the chief counsel.

History of Section. P.L. 1974, ch. 274, § 1.

23-1.2-4. Appropriation for expenses.

The general assembly shall annually appropriate the sum or sums that it may deem necessary for the payment of the salaries of clerical assistants that may be deemed necessary and for the payment of office expenses and other actual expenses incurred by the chief counsel in the performance of his or her duties, and the state controller is authorized and directed to draw his or her orders upon the general treasurer for the payment of the sum or sums, or so much of the sum or sums as may from time to time be required, upon receipt by him or her of proper vouchers approved by the chief counsel.

History of Section. P.L. 1974, ch. 274, § 1.

23-1.2-5. Office of chief counsel.

The chief counsel shall have an office in the department of health building which shall be assigned to him or her for his or her use by the director of the department of health.

History of Section. P.L. 1974, ch. 274, § 1.

23-1.2-6. Duties.

The chief counsel shall act as the legal adviser of the department of health and the officers of that department.

History of Section. P.L. 1974, ch. 274, § 1; P.L. 1982, ch. 267, § 2.

23-1.2-7. Repealed.

23-1.3-1. Definitions.

When used in this chapter:

1. “Artificially produced radioactive material” means any radioactive material other than by-product material, special nuclear material, and source material which is produced by any unnatural process such as through the bombardment of material with high energy atomic particles.
2. “By-product material” means any radioactive material except special nuclear material yielded in or made radioactive by exposure to the radiation incident to the process of producing or utilizing special nuclear material.
3. “Department” means the department of health.
4. “Electronic product” means any manufactured product or device or component part of a product or device that has an electronic circuit which during operation can generate or emit a physical field of radiation.
5. “General license” means a license effective pursuant to regulations promulgated by the state radiation control agency without the filing of an application to transfer, acquire, own, possess, or use quantities of, or devices of equipment utilizing, by-product, source, special nuclear materials, or other radioactive material occurring naturally or produced artificially. The agency may require notification of possession of generally licensed materials.
6. “Naturally occurring radioactive material” means any radioactive material that is not otherwise defined in this section and whose origin is wholly the result of natural processes.
7. “Person” means any individual, corporation, partnership, firm, association, trust, estate, public or private institution, group, agency, political subdivision of this state, any other state or political subdivision or agency of any other state, and any legal successor, representative, agent or agency of these, and other than federal government agencies licensed by the United States Nuclear Regulatory Commission, or any successor to the commission.
8. “Radiation” means:
   1. Ionizing radiation including gamma rays, x-rays, alpha particles, beta particles, and other atomic or nuclear particles or rays; and
   2. Any electromagnetic radiation that can be generated during the operation of a microwave oven.
9. “Radiation source” means any material or electronic product capable of emitting radiation.
10. “Radioactive material” means any material, solid, liquid, or gas, that emits ionizing radiation spontaneously.
11. “Registration” means the proper completion and filing with the state radiation control agency of a form provided by the agency, and containing information that the agency may require by its regulations.
12. “Source material” means:
    1. Uranium, thorium, or any other material which the director of health declared by order to be a source material after the United States Nuclear Regulatory Commission, or any successor to the commission, has determined the material to be source material; or
    2. Ores containing one or more of the materials listed in paragraph (i), in a concentration that the director of health declared by order to be source material after the United States Nuclear Regulatory Commission, or any successor to the commission, has determined the material in that concentration to be source material.
13. “Special nuclear material” means:
    1. Plutonium, uranium 233, uranium enriched in the isotope 233 or in the isotope 235, and any other material which the director of health declared by order to be special nuclear material after the United States Nuclear Regulatory Commission, or any successor to the commission, has determined the material to be special nuclear material, but does not include source material; or
    2. Any material artificially enriched by any of the material listed in paragraph (i), but does not include source material.
14. “Specific license” means a license, issued after application, to use, manufacture, produce, transfer, receive, acquire, own, or possess quantities of, or devices or equipment utilizing by-product, source, special nuclear materials, or other radioactive material occurring naturally or produced artificially.
15. “Unnecessary radiation” means radiation used in a manner that may present a hazard to the health of the people or the industrial or agricultural potentials or the ecology or wildlife of the state.

History of Section. P.L. 1976, ch. 195, § 1.

23-1.3-2. State radiation control agency.

1. The director of health shall designate a unit within the department of health as the state radiation control agency.
2. The director of health shall appoint a director of the agency, referred to as the administrator, who shall perform functions vested in the agency pursuant to the provisions of this chapter.
3. The agency shall for the protection of the public health and safety:
   1. Administer this chapter and codes, rules, or regulations promulgated under it.
   2. Develop and conduct policies and programs for evaluation of hazards associated with the use of radiation sources and for their amelioration.
   3. Develop and conduct programs with due regard for compatibility with federal programs for regulation of by-product, source, and special nuclear materials, naturally occurring and artificially produced radioactive materials, and electronic products as defined in this chapter.
   4. Have power to formulate and promulgate, amend, and repeal codes and rules and regulations, including licensing and registration of radiation sources, persons, and services as may be necessary to prohibit and prevent unnecessary radiation; provided, however, that no code, rule, regulation, amendment, or repeal shall be adopted except in accordance with the provisions of chapter 35 of title 42.
   5. Advise, consult, and cooperate with other agencies of the state, the federal government, other states and interstate agencies, political subdivisions, industries, and with groups concerned with control of radiation sources.
   6. Whenever the state emergency response plan for radiological emergencies is placed into operation, to act as the principal advisor to the governor or his or her authorized representative regarding the degree of potential hazard to the state’s population and the necessity for and types of protective actions to be taken to protect the public health and safety.
   7. Issue orders or modifications of those orders as may be necessary in connection with its proceedings.
   8. Have the authority to accept and administer loans, grants, or other funds or gifts, conditional or otherwise, in furtherance of its functions, from the federal government and from other sources, public or private.
   9. 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 the provisions of this chapter.
   10. Collect and disseminate information relating to control of radiation sources including:
       1. Maintenance of a file of all licenses for radioactive materials or services, applications, issuances, denials, amendments, transfers, renewals, modifications, suspensions, and revocations;
       2. Maintenance of a file of registrants requiring registration under the provisions of this chapter and any administrative or judicial action pertaining to that file; and
       3. Maintenance of a file of all rules and regulations relating to regulation of sources of radiation, pending or promulgated, and proceedings on them.
   11. Collect and disseminate health education information relating to radiation protection.
   12. Review plans and specifications for radiation sources submitted pursuant to codes, rules, or regulations promulgated under this chapter.
   13. Conduct a program of measurement of appropriate environmental media for radiation or radioactive material whenever the administrator shall determine that a program is warranted in connection with activities originating within the state or in neighboring states.
   14. Based upon information developed by the department of health and provided by other departments and state agencies, disseminate on a quarterly basis the schedule for cleaning up nuclear and radioactive materials at the United Nuclear plant in the town of Charlestown and at the sites of other nuclear and radioactive accidents and spillages.

History of Section. P.L. 1976, ch. 195, § 1; P.L. 1982, ch. 185, § 1.

23-1.3-3. Transportation or use of radiation sources.

All radiation sources shall be shielded, transported, handled, used, kept, and disposed of in a manner as to prevent all users of radiation sources and all persons within effective range of radiation sources from being exposed to unnecessary radiation.

History of Section. P.L. 1976, ch. 195, § 1.

23-1.3-4. Inspection and right of entry.

The administrator or his or her duly authorized representatives shall have the power to enter at all reasonable times upon any private or public property for the purpose of determining whether or not there is compliance with or violations of the provisions of this chapter and rules and regulations issued under the provisions of this chapter, except that entry into areas under the jurisdiction of the federal government shall be effected only after notification of appropriate federal government authorities. This entry may include, but shall not be limited to, inspections and investigations of radiation sources, their shieldings and immediate surroundings and records or memoranda pertaining to exposure to radiation sources as they may pertain to the public health and welfare.

History of Section. P.L. 1976, ch. 195, § 1.

23-1.3-5. Licensing and registration of radiation sources.

1. The agency shall provide by rule or regulation for general or specific licensing of by-product, source, special nuclear materials, artificially produced radioactive material, and naturally occurring radioactive material, or devices or equipment utilizing those materials. The rule or regulation shall provide for amendment, suspension, or revocation of licenses.
2. The agency is authorized to require registration or licensing of other radiation sources.
3. The agency is authorized to require registration or licensing of any person engaged in the business of installing or offering to install radiation sources or engaged in the business of furnishing or offering to furnish radiation source services or service in this state to any agency licensee or registrant.
4. The agency is authorized to exempt certain radiation sources or kinds of uses or users from the licensing or registration requirement set forth in this section when the agency makes a finding that the exemption will not constitute a significant risk to the health and safety of the public. Those sources, uses, or users that may be exempted from the licensing or registration requirement shall be specifically named in a schedule of regulations that may be promulgated under the authority of § 23-1.3-2 .
5. Rules and regulations promulgated pursuant to this chapter may provide for recognition of other state or federal licenses as the agency may deem desirable, subject to registration requirements that the agency may prescribe.
6. The agency may assess annual fees in connection with its licensing, registration, and inspection activities, provided that those fees are assessed only after procedures in accordance with chapter 35 of title 42 have been followed.
7. In lieu of a multiplicity of separate license and/or registration fees which may be assessed under this section, any person may elect to pay a combination license and registration fee, not to exceed a fixed dollar amount as periodically determined by the director of health after consultation with the radiation advisory committee.
8. The combined fee shall cover all specific licenses and/or registrations issued by the agency to the person for uses and services at one location or address.
9. All fees and fines collected under this chapter shall be paid to the general treasury of the state.
10. License and registration fees assessed under this chapter shall be due and payable on or before the expiration date shown on the license or registration.

History of Section. P.L. 1976, ch. 195, § 1.

23-1.3-6. Records.

1. The administrator may require each person who possesses or uses a radiation source or who is licensed by or registered with the radiation control agency to maintain records relating to the receipt, storage, transfer, or disposal of radiation sources and any other records as he or she may require subject to exemptions that may be provided by rules or regulations.
2. The administrator shall require each person who possesses or uses a radiation source or who is licensed by or registered with the agency to maintain appropriate records showing the radiation exposure of all individuals for whom personnel monitoring is required by his or her rules and regulations. Copies of these records and those required to be kept by subsection (a) of this section shall be submitted to the administrator on request. Any person possessing or using a radiation source or licensed by or registered with the agency shall furnish to each employee for whom personnel monitoring is required a copy of that employee’s personal exposure record, at any time that employee makes a request in writing, has received excessive exposure, and upon termination of employment.
3. The administrator may require the reporting of information that he or she deems necessary for the protection of the public concerning:
   1. The routine and non-routine operations of fixed facilities within the state in which sources of radiation are stored or in use; and
   2. The transport of radioactive materials within or through the state.
4. All records required by this section shall be maintained indefinitely unless otherwise specified by rule or regulation promulgated under the provisions of this chapter.

History of Section. P.L. 1976, ch. 195, § 1.

23-1.3-7. Federal-state agreements.

1. In accordance with the provisions of chapter 27 of title 42, the governor, on behalf of this state, is authorized to enter into agreements with the federal government providing for discontinuance of certain of the federal government’s responsibilities with respect to radiation sources and the assumption of those responsibilities by this state.
2. Any person who, on the effective date of an agreement under subsection (a), possesses a license issued by the federal government shall be deemed to possess the license pursuant to a license issued under this chapter, which shall expire either ninety (90) days after receipt from the administrator of a notice of expiration of the license, or on the date of expiration specified in the federal license, whichever is earlier.

History of Section. P.L. 1976, ch. 195, § 1.

23-1.3-8. Notification of violation and order of abatement.

Whenever the administrator or his or her authorized representative finds upon inspection and examination of a radiation source as constructed, operated, or maintained or through any other authorized means that there has been a violation of any of the provisions of this chapter or any codes, rules, regulations promulgated under the provisions of this chapter, he or she shall notify any person found to be causing, allowing, or permitting the violation of the nature of that violation and order that prior to a time fixed by the administrator, which shall not be later than ten (10) days from the date of service of the notice, that the person shall cease and abate causing, allowing, or permitting the violation and take any action that may be necessary to comply with this chapter and codes, rules, or regulations promulgated under the provisions of this chapter. In any proceeding under this chapter for granting, suspending, revoking, or amending any license, or for determining compliance with or granting exemptions from rules and regulations of the agency, the agency shall afford an opportunity for a hearing on the record upon the request of any person whose interest may be affected by the proceeding, and shall admit any interested person as a party to the proceeding. Any person aggrieved by the finding or order of the agency may request a hearing before the director of health or his or her authorized representative, at any time within fifteen (15) days after notification, and the director of health may affirm the finding or order of the agency or reverse or modify the finding or order of the agency. Any person aggrieved by the finding or order of the director of health may bring a civil action in superior court at any time within thirty (30) days after being notified of the finding or order, and the court may proceed in a summary manner or otherwise, and may affirm the finding or order of the agency or director of health or reverse or modify the finding or order of the agency or director of health in whole or in part as the court shall deem just and reasonable.

History of Section. P.L. 1976, ch. 195, § 1.

23-1.3-9. Authority of the administrator in cases of emergency.

Whenever the administrator finds that an emergency exists requiring immediate action to protect the public health or welfare, he or she may issue an order reciting the existence of the emergency and requiring that action be taken that he or she deems necessary to meet the emergency. The order shall be effective immediately. Any person to whom the order is directed shall immediately comply with the order, but on application to the director of health, shall be afforded a hearing within fifteen (15) days. On the basis of that hearing, the director of health shall continue the order in effect, revoke it, or modify it.

History of Section. P.L. 1976, ch. 195, § 1.

23-1.3-10. Injunctive relief.

A civil action may be instituted in superior court on behalf of the agency for injunctive relief to prevent the violation of the provisions of this chapter or codes, rules, or regulations promulgated under the provisions of this chapter, and the court may proceed in the action in a summary manner or otherwise and may restrain in all those cases any person from violating any of the provisions of this chapter or the rules or regulations.

History of Section. P.L. 1976, ch. 195, § 1.

23-1.3-11. Prohibited uses and services.

It shall be unlawful for any person to use, manufacture, produce, transport, transfer, receive, acquire, own, possess, or dispose of any radiation source unless licensed by or registered with the administrator when that licensing or registration is required in accordance with the provisions of this chapter and the rules and regulations promulgated under this chapter. It shall also be unlawful for any person to engage in the business of installing or offering to install radiation sources or to engage in the business of furnishing or offering to furnish radiation source services or service unless registered with or licensed by the administrator whenever that registration and licensing is required in accordance with the provisions of this chapter and the rules and regulations promulgated under this chapter.

History of Section. P.L. 1976, ch. 195, § 1.

23-1.3-12. Penalty.

Any person who violates any of the provisions of this chapter or rule or regulation of the agency or who violates any order of the agency promulgated pursuant to this chapter shall be guilty of a misdemeanor, and in addition may be enjoined from continuing the violation. Each day any person neglects or refuses to comply shall constitute a separate offense.

History of Section. P.L. 1976, ch. 195, § 1.

23-1.3-13. Radiation advisory commission.

There is created an advisory commission to be known as the state radiation advisory commission which shall consist of eleven (11) members. The commission membership shall at all times be limited to members having special expertise in radiation protection and radiological health. One member shall be a representative of the Rhode Island atomic energy commission. Membership shall also include persons representing a physical science or engineering, diagnostic radiology, nuclear medicine, dentistry, veterinary medicine, industrial radiation protection, and radiologic technology; provided that no more than two (2) individuals shall be specialists in any one field; and provided that at least one of the eleven (11) members shall be affiliated on a full-time basis with a voluntary, nonprofit hospital in the state. The members shall be residents of or work in the state and shall be appointed by the director of health. Each member shall be appointed for a term of four (4) years and until his or her successor shall be appointed; provided, that of the original appointments four (4) shall be appointed for a term of two (2) years, four (4) for a term of three (3) years, and three (3) for a term of four (4) years. In order to assure the proper balance of technical skills whenever a vacancy or vacancies occur, the state radiation advisory commission shall submit to the director of health for his or her consideration the names of three (3) nominees for each vacancy. The members shall receive no compensation for their services but shall receive necessary travel and other expenses while engaged in actual work of the commission. The administrator shall act as technical secretary to the commission.

History of Section. P.L. 1976, ch. 195, § 1.

23-1.3-14. Organization.

The director of health shall appoint a chairperson from among members of the advisory commission. The commission shall hold meetings on the call of the chairperson or director and all commission meetings and records of those meetings shall be open to the public.

History of Section. P.L. 1976, ch. 195, § 1.

23-1.3-15. Duties.

The commission shall:

1. Review and evaluate policies and programs of the state relating to radiation and advise the agency of its opinions and findings;
2. Make recommendations to the governor, the director of health and the agency administrator and furnish any technical advice that may be required on matters relating to development, utilization, and regulation of sources of radiation; and
3. Make a biennial report to the governor and the general assembly.

History of Section. P.L. 1976, ch. 195, § 1.

23-1.3-16. Existing remedies unimpaired.

No existing civil or criminal remedy for any wrongful action which is a violation of any code, rule, or regulation promulgated under the provisions of this chapter shall be excluded or impaired by this chapter.

History of Section. P.L. 1976, ch. 195, § 1.

23-1.3-17. Protection of department of health powers.

The powers and functions vested in the department of health under the provisions of this chapter shall not be construed to affect in any manner the powers, duties, and functions vested in the department of health under any other provisions of law.

History of Section. P.L. 1976, ch. 195, § 1.

23-1.3-18. Conflicting laws.

This chapter shall not be construed as repealing any laws of the state relating to radiation sources, exposures, radiation protection, and professional licensure, but shall be held and construed as auxiliary and supplementary to other laws, except to the extent that they are in direct conflict with this chapter. Nothing in this chapter or in any code, rules, or regulations promulgated pursuant to the provisions of this chapter shall preclude the right of any governing body of a municipality to adopt ordinances or regulations not inconsistent with this chapter or any code, rules, or regulations promulgated pursuant to those ordinances or regulations.

History of Section. P.L. 1976, ch. 195, § 1.

23-1.3-19. Severability.

If any provision of this chapter or its application to any person or circumstances is held invalid, the invalidity shall not affect other provisions or applications of this chapter which can be given effect without the invalid provisions or application, and to this end the provisions of this chapter are declared to be severable.

History of Section. P.L. 1976, ch. 195, § 1.

23-1.7-1. Duties — Director of the department of health.

The director of the department of health shall develop and carry out an assessment of all state programs that address Alzheimer’s disease and shall maintain and annually update the Rhode Island state plan for Alzheimer’s disease and related disorders, and promulgate rules and regulations to implement the purpose of this chapter.

History of Section. P.L. 2019, ch. 174, § 1; P.L. 2019, ch. 209, § 1.

23-1.7-2. Creation of advisory council.

1. There is hereby established a council to be called the “Advisory Council on Alzheimer’s Disease Research and Treatment.” The advisory council shall consist of thirteen (13) members to be composed as follows: the lieutenant governor, or designee; the director of the department of health, or designee; the director of the office of healthy aging, or designee; the chairperson of the long-term care coordinating council; one member appointed by the speaker of the house; one member appointed by the president of the senate; and seven (7) members appointed by the governor. The members appointed by the governor shall include one member who is an Alzheimer’s disease patient advocate; one member who is an Alzheimer’s disease caregiver; one member who is a healthcare provider; one member who is a researcher with Alzheimer’s-related expertise in basic, translational, clinical, or drug-development science; one member who is a representative from an Alzheimer’s disease organization that funds research and has demonstrated experience in care and patient services; one member from an Alzheimer’s advocacy organization that provides services to families and professionals, including information and referrals, support groups, care consultation, education, and safety services; and one member who is a representative of a healthcare insurer. Advisory council members shall select their own chairperson. Seven (7) members shall constitute a quorum.
2. The member appointed by the speaker of the house,, the member appointed by the president of the senate, and three (3) members appointed by the governor shall be initially appointed for a term to expire July 1, 2020, and four (4) members to be appointed by the governor shall be initially appointed for a term to expire July 1, 2021. After the initial term, the appointed members shall serve two-year (2) terms, until their successor is appointed.

History of Section. P.L. 2019, ch. 174, § 1; P.L. 2019, ch. 209, § 1.

23-1.7-3. Advisory council responsibility.

1. The advisory council shall meet at least quarterly and shall advise the governor, speaker of the house, and president of the senate on developments and advances on the diagnosis, treatment, and prevention of Alzheimer’s disease.
2. In coordination with the department of health, the advisory council shall determine the number of residents diagnosed with Alzheimer’s disease to ascertain the number of residents diagnosed with early-onset Alzheimer’s disease, regardless of age.
3. The advisory council shall identify available resources and services needed for the treatment and care of residents diagnosed with Alzheimer’s disease.
4. Annually, not later than March 1, the advisory council shall provide a report to the director of the department of health with a copy to the governor, the speaker of the house, and the president of the senate, which shall include:
   1. Information and recommendations on Alzheimer’s disease policy;
   2. An evaluation of all state-funded efforts in Alzheimer’s disease research, clinical care, institutional, home-based, and community-based programs; and
   3. Recommended amendments, updates, and changes to the state plan for Alzheimer’s disease and related disorders.

History of Section. P.L. 2019, ch. 174, § 1; P.L. 2019, ch. 209, § 1.

23-1.7-4. Assessment protocol.

1. The director of the department of health shall establish and publish an Alzheimer’s disease assessment protocol specifically focused on recognizing the signs and symptoms of cognitive impairments, including, but not limited to, Alzheimer’s disease and appropriate resource information for effective medical screening, investigation, and service planning.
2. The director of the department of health shall make available upon request a copy of the assessment protocol to protective-services caseworkers, healthcare professionals, and members of the public.
3. Protective-services caseworkers assigned to or employed by the office of healthy aging shall be familiar with the information contained in the assessment protocol.

History of Section. P.L. 2019, ch. 174, § 1; P.L. 2019, ch. 209, § 1.

23-1.7-5. Medical professional training.

1. All physicians licensed pursuant to chapter 37 of title 5, and nurses licensed pursuant to chapter 34 of title 5, shall, no later than October 1, 2021, complete a one-time course of training consisting of a minimum of one hour of instruction on the diagnosis, treatment, and care of patients with cognitive impairments including, but not limited to, Alzheimer’s disease and dementia.
2. The department of health shall promulgate rules to implement the training requirement of subsection (a).

History of Section. P.L. 2019, ch. 174, § 1; P.L. 2019, ch. 209, § 1.

23-1.7-6. Healthcare facility plan.

1. Every healthcare facility as defined in § 23-17-2 shall, not later than October 1, 2021, complete and implement an operational plan for the recognition and management of patients with Alzheimer’s disease or dementia.
2. The department of health shall promulgate rules and regulations to implement the operational plan requirements of subsection (a).

History of Section. P.L. 2019, ch. 174, § 1; P.L. 2019, ch. 209, § 1.

23-1.8-1. Purpose — Creation of commission.

1. In view of the barriers and disadvantages which deafness and hearing impairments impose on those individuals so affected, and in view of the testimony on deafness received by a legislative study commission, it is hereby proposed that a permanent Rhode Island commission on the deaf and hard-of-hearing be established. This commission shall be composed as follows: a thirteen (13) member commission, eleven (11) of whom are appointed by the governor, one representative appointed by the speaker of the house and one senator appointed by the president of the senate. Four (4) of the governor’s appointments shall be initially appointed for a term to expire July 1, 1995 and three (3) members shall be appointed for a term to expire July 1, 1994. Thereafter the commissioners shall serve staggered two (2) year terms, each member serving until his or her successor is appointed. These commissioners shall be responsible for the establishment of policies and the appointment of an executive director who shall be in the unclassified service and other staff as needed and for whom appropriations are available. They shall meet not less than four (4) times per year, and shall not be paid for their services, except for reimbursement of expenses incurred by their service. The commissioners may elect their own officers.
2. The members appointed by the governor shall include five (5) individuals who are deaf who use American Sign Language, one individual who is deaf who does not use American Sign Language, three (3) who are hard-of-hearing, and two (2) who are hearing. Commission members shall select their own chairperson. Five (5) members shall constitute a quorum.

History of Section. P.L. 1978, ch. 105, § 1; G.L. 1956, § 23-57-1 ; P.L. 1979, ch. 39, § 1; G.L. 1956, § 23-1.8-1 ; P.L. 1984, ch. 153, § 1; P.L. 1990, ch. 217, § 1; P.L. 1992, ch. 174, § 1; P.L. 1992, ch. 324, § 4; P.L. 1999, ch. 72, § 1; P.L. 1999, ch. 243, § 1; P.L. 2001, ch. 180, § 38; P.L. 2001, ch. 245, § 1; P.L. 2001, ch. 281, § 1.

23-1.8-2. Duties — Activities.

The commission shall be primarily a coordinating and advocating body, acting on behalf of the special concerns of deaf and hard-of-hearing persons in Rhode Island. Its activities shall be independent of any existing agency or department within the state. The commission shall be accountable directly to the executive office of the state, and shall submit an annual report to the governor. The commission will assume the following duties:

1. Bring about greater cooperation and coordination among agencies and organizations now servicing or having the potential to serve the deaf and hard-of-hearing;
2. Promote greater accessibility to services for the deaf and hard-of-hearing;
3. Conduct an ongoing needs assessment;
4. Promote increased awareness and provide information and referrals;
5. Advocate for the enactment of legislation that would assist the needs of individuals who are deaf and hard-of-hearing;
6. Administer a sign language interpreter referral service;
7. Take necessary action to improve the quality of life for deaf and hard-of-hearing individuals living in Rhode Island;
8. Develop a statewide coordinating council that will coordinate the implementation of the comprehensive statewide strategic plan for children in Rhode Island who are deaf or have hearing loss. The composition, functions and activities of the statewide coordinating council shall be consistent with the provisions of the strategic plan developed through the Rhode Island department of elementary and secondary education.
9. Track the yearly services provided by exempted interpreters, as defined in subsection 5-71-15(4) .

History of Section. P.L. 1978, ch. 105, § 1; G.L. 1956, § 23-57-2; P.L. 1979, ch. 39, § 1; G.L. 1956, § 23-1.8-1 ; P.L. 1984, ch. 153, § 1; P.L. 1992, ch. 174, § 1; P.L. 1999, ch. 72, § 1; P.L. 1999, ch. 243, § 1; P.L. 2006, ch. 261, § 4; P.L. 2006, ch. 277, § 4.

23-1.8-2.1. Sign language interpreter referral service.

The commission shall administer the sign language interpreter referral service for all certified licensee, licensee, grandparent licensee, and special licensee interpreters, as provided in chapter 71 of title 5, who hold a valid interpreter for the deaf license issued by the state board of examiners of interpreters for the deaf pursuant to § 5-71-9 or § 5-71-12 [repealed] or hold a valid license, certificate, or equivalent issued with another state with reciprocity pursuant to § 5-71-10 . The commission shall not impose any limits on the practice of certified licensees, licensees, grandparent licensees, or special licensees beyond those imposed by the state board of examiners for interpreters for the deaf. Prior to January 1, 1998 the commission’s sign language interpreter referral service shall be open to all interpreters for the deaf who meet or exceed qualifications for license in § 5-71-9 , 5-71-10 , 5-71-11 [repealed], or 5-71-12 [repealed]. The commission shall refer any complaints regarding the conduct or performance of any interpreter utilizing their referral service to the state board of examiners for interpreters for the deaf for appropriate action pursuant to § 5-71-13 . The commission shall upon receipt of notice of revocation or suspension of a license by the state board of examiners for interpreters for the deaf, immediately cease to refer customers to that licensee, unless and until the license is restored.

History of Section. P.L. 1996, ch. 151, § 2; P.L. 2008, ch. 475, § 33.

23-1.8-3. Committees.

1. To assist in the performance of its duties the commission shall establish various committees. Except as authorized by the commission, committees shall be composed of no more than seven (7) members who shall serve staggered terms.
2. At least one individual who is deaf, one individual who is hard-of-hearing, and one commission member, whenever possible, shall serve on each committee. In addition, governmental agencies shall assign one representative to the following committees:
   1. Telecommunications relay service committee: one representative of the public utilities commission;
   2. Education committee: one representative of the department of elementary and secondary education and one representative of the Rhode Island School for the Deaf;
   3. Employment committee: one representative of the department of human services, and one representative of the department of labor and training;
   4. Health care committee: one representative of the department of elderly affairs, one representative of the department of health, and one representative of the department of behavioral healthcare, developmental disabilities and hospitals;
3. The committees are responsible for appointing their chairpersons. Chairpersons shall report upon the activities of their committees at commission meetings.

History of Section. P.L. 1992, ch. 174, § 2.

23-1.8-4. Emergency and public communication access account.

1. There is established within the general fund the emergency and public communication access restricted receipt account, which shall be referred to as the EPCA account. The purpose of this account is to fund emergency communication and enhance public communication access for deaf and hard of hearing people, in accordance with § 39-1-42(d) . In addition, the account shall be used to enhance emergency communication systems to alert deaf and hard of hearing people to any type of emergencies within the state.
2. The account shall be used to purchase and install public communication access equipment and products at public sites for deaf and hard of hearing citizens.
3. The commission is authorized to establish, administer and promote its emergency and public communication access program.
4. The commission is authorized to make purchases specifically for the EPCA program and empowered to receive donations and grants from sources including, but not limited to, the federal government, governmental and private foundations, and corporate and individual donors; these donations and grants to be deposited in the EPCA account.
5. The commission is authorized to promulgate rules and regulations that will set forth how the commission shall utilize the EPCA account. In preparing rules and regulations regarding emergency communications, the commission shall confer with applicable departments and agencies.

History of Section. P.L. 2013, ch. 144, art. 17, § 2.

23-1.8-5. Communication access services.

A state employee who is approved by the commission for the deaf and hard of hearing as an interpreter or a communication access realtime translation (CART) provider may be employed by the commission or by other state agencies as long as the interpreter and CART services:

1. Are provided outside of the normal working hours of the employee in order to comply with federal, state, and local laws;
2. The services are not required as part of the regular duties of the employee;
3. The employee does not participate in or have official responsibility for the financial management of the contracting agency;
4. The employee is compensated for no more than four (4) hours in any day in which the employee is otherwise compensated by the state of Rhode Island; and
5. The head of the contracting agency files with the state ethics commission a written certification that there is a critical need for the services of the employee.

History of Section. P.L. 2019, ch. 181, § 1; P.L. 2019, ch. 210, § 1.

23-1.9-1, 23-1.9-2. Repealed.

23-1.10-1. Declaration of policy.

The problem of alcoholism, with its attendant effects upon the economic condition of alcoholics and those dependent upon them, and the substantial physical deterioration brought about by the misuse of alcohol, has, as shown by the studies, become more and more a major concern of government. Those who, through the misuse of alcohol, adversely affect their health and their economic independence have in recent years increased in number. This chapter is designed to provide proper treatment for those who have been habitually misusing alcohol as a beverage. It is the further policy of this state that alcoholics and intoxicated persons may not be subjected to criminal prosecution because of their consumption of alcoholic beverages but rather should be afforded a continuum of treatment in order that they may lead normal lives as productive members of society.

History of Section. P.L. 1951, ch. 2755, § 1; G.L. 1956, § 40-12-1 ; P.L. 1972, ch. 130, § 1; G.L. 1956, § 40.1-4-1 ; P.L. 1995, ch. 370, art. 14, § 4.

23-1.10-2. Definitions.

As used in this chapter:

1. “Alcoholic” means a person who habitually lacks self-control as to the use of alcoholic beverages, or uses alcoholic beverages to the extent that his or her health is substantially impaired or endangered or his or her social or economic function is substantially disrupted;
2. “Approved private treatment facility” means a private agency meeting the standards prescribed in § 23-1.10-7(a) and approved under § 23-1.10-7(c) ;
3. “Approved public treatment facility” means a treatment agency operating under the direction and control of the department or providing treatment under this chapter through a contract with the department under § 23-1.10-6(g) and meeting the standards prescribed in § 23-1.10-7(a) ;
4. “Department” means department of behavioral healthcare, developmental disabilities and hospitals;
5. “Director” means the director of the department of behavioral healthcare, developmental disabilities and hospitals;
6. “Incapacitated by alcohol” means a person, who as a result of the use of alcohol is intoxicated to such an extent that he or she is unconscious or has his or her judgment otherwise so impaired that he or she is incapable of realizing and making a rational decision with respect to his or her need for treatment;
7. “Incompetent person” means a person who has been adjudged incompetent by the probate court of the city and town in which the person resides, or any other court of competent jurisdiction;
8. “Intoxicated person” means a person whose mental or physical functioning is substantially impaired as a result of the use of alcohol;
9. “Treatment” means the broad range of emergency, outpatient, intermediate, and inpatient services and care, including diagnostic evaluation, medical, psychiatric, psychological, and social service care, vocational rehabilitation and career counseling, which may be extended to alcoholics and intoxicated persons.

History of Section. P.L. 1972, ch. 130, § 1; P.L. 1984, ch. 122, § 1; G.L. 1956, § 40.1-4-2; P.L. 1995, ch. 370, art. 14, § 4.

23-1.10-3. Powers assumed by department.

The department may:

1. Plan, establish, and maintain treatment programs as necessary or desirable;
2. Make contracts necessary or incidental to the performance of its duties and the execution of its powers, including contracts with public and private agencies, organizations, and individuals to pay them for services rendered or furnished to alcoholics or intoxicated persons;
3. Solicit and accept for use any gift of money or property made by will or otherwise, and any grant of money, services, or property from the federal government, the state, or any political subdivision of the state or any private source, and do all things necessary to cooperate with the federal government or any of its agencies in making an application for any grant;
4. Administer or supervise the administration of the provisions relating to alcoholics and intoxicated persons of any state plan submitted for federal funding pursuant to federal health, welfare, or treatment legislation;
5. Coordinate its activities and cooperate with alcoholism programs in this and other states, and make contracts and other joint or cooperative arrangements with state, local, or private agencies in this and other states for the treatment of alcoholics and intoxicated persons and for the common advancement of alcoholism programs;
6. Keep records and engage in research and the gathering of relevant statistics;
7. Do other acts and things necessary or convenient to execute the authority expressly granted to it; and
8. Acquire, hold, or dispose of real property or any interest in real property, and construct, lease, or otherwise provide treatment facilities for alcoholics and intoxicated persons.

History of Section. P.L. 1972, ch. 130, § 1; G.L. 1956, § 40.1-4-3; P.L. 1995, ch. 370, art. 14, § 4.

23-1.10-4. Duties of department.

The department shall:

1. Develop, encourage, and foster statewide, regional, and local plans and programs for the prevention of alcoholism and treatment of alcoholics and intoxicated persons in cooperation with public and private agencies, organizations, and individuals and provide technical assistance and consultation services for these purposes;
2. Coordinate the efforts and enlist the assistance of all public and private agencies, organizations, and individuals interested in prevention of alcoholism and treatment of alcoholics and intoxicated persons;
3. Cooperate with the department of corrections and board of parole in establishing and conducting programs to provide treatment for alcoholics and intoxicated persons in or on parole from penal institutions;
4. Cooperate with the board of regents for elementary and secondary education, board of governors for higher education, schools, police departments, courts, and other public and private agencies, organizations, and individuals in establishing programs for the prevention of alcoholism and treatment of alcoholics and intoxicated persons, and preparing curriculum materials for use at all levels of school education;
5. Prepare, publish, evaluate, and disseminate educational material dealing with the nature and effects of alcohol;
6. Develop and implement, as an integral part of treatment programs, an educational program for use in the treatment of alcoholics and intoxicated persons, which program shall include the dissemination of information concerning the nature and effects of alcohol;
7. Organize and foster training programs for all persons engaged in treatment of alcoholics and intoxicated persons;
8. Sponsor and encourage research into the causes and nature of alcoholism and treatment of alcoholics and intoxicated persons, and serve as a clearing house for information relating to alcoholism;
9. Specify uniform methods for keeping statistical information by public and private agencies, organizations, and individuals, and collect and make available relevant statistical information, including number of persons treated, frequency of admission and readmission, and frequency and duration of treatment;
10. Advise the governor in the preparation of a comprehensive plan for treatment of alcoholics and intoxicated persons;
11. Review all state health, welfare, and treatment plans to be submitted for federal funding under federal legislation, and advise the governor on provisions to be included relating to alcoholism and intoxicated persons;
12. Assist in the development of, and cooperate with, alcohol education and treatment programs for employees of state and local governments and businesses and industries in the state;
13. Utilize the support and assistance of interested persons in the community, particularly recovered alcoholics, to encourage alcoholics to voluntarily undergo treatment;
14. Cooperate with the department of transportation and related agencies both state and local in establishing and conducting programs designed to deal with the problem of persons operating motor vehicles while intoxicated;
15. Encourage general hospitals and other appropriate health facilities to admit without discrimination alcoholics and intoxicated persons and to provide them with adequate and appropriate treatment;
16. Encourage all health and disability insurance programs to include alcoholism as a covered illness;
17. Submit to the governor an annual report covering the activities of the department; and
18. Establish alcohol and substance abuse prevention programs for students in kindergarten through grade twelve (12), in accordance with § 35-4-18 . The director shall make an annual report to the governor and the general assembly on the administration of the program and shall submit to the governor and the general assembly the results of an independent evaluation of the alcohol and substance abuse prevention program established in accordance with this section. This evaluation shall address the following areas:
    1. Program development;
    2. Implementation;
    3. Impact; and
    4. Recommendations for future needs.

History of Section. P.L. 1972, ch. 130, § 1; P.L. 1984, ch. 81, § 18; P.L. 1986, ch. 412, § 4; G.L. 1956, § 40.1-4-4; P.L. 1995, ch. 370, art. 14, § 4; P.L. 2001, ch. 86, § 4.

23-1.10-5. [Reserved.]

23-1.10-6. Comprehensive program for treatment.

1. The department shall establish a comprehensive and coordinated program for the treatment of alcoholics and intoxicated persons. The director shall divide the state into appropriate regions for the conduct of the program and establish standards for the development of the program on the regional level. In establishing the regions, consideration shall be given to city, town, and county lines and population concentrations.
2. The program of the division shall include:
   1. Emergency treatment provided by a facility affiliated with or part of the medical service of a general hospital;
   2. Inpatient treatment;
   3. Intermediate treatment; and
   4. Outpatient and follow-up treatment.
3. The department shall provide for adequate and appropriate treatment for alcoholics and intoxicated persons admitted pursuant to §§ 23-1.10-11 and 23-1.10-12 . Treatment may not be provided at a correctional institution except for inmates.
4. The department shall maintain, supervise, and control all facilities operated by it subject to its policies. The administrator of each facility shall make an annual report of its activities to the director in the form and manner the director specifies.
5. All appropriate public and private resources shall be coordinated with and utilized in the program whenever possible.
6. The director shall prepare, publish, and distribute annually a list of all approved public and private treatment facilities.
7. The department may contract for the use of any facility as an approved public treatment facility if the director, subject to the policies of the department, considers this to be an effective and economical course to follow.

History of Section. P.L. 1972, ch. 130, § 1; G.L. 1956, § 40.1-4-6 ; P.L. 1995, ch. 370, art. 14, § 4.

23-1.10-7. Standards for treatment facilities — Inspections — Furnishing information to department — Noncompliance with standards.

1. The department shall establish standards for approved treatment facilities that must be met for a treatment facility to be approved as a public or private treatment facility, and fix the fees to be charged by the department for the required inspections. The standards may concern only the health standards to be met and standards of treatment to be afforded patients.
2. The department shall periodically inspect approved public and private treatment facilities at reasonable times and in a reasonable manner.
3. The department shall maintain a list of approved public and private treatment facilities.
4. Each approved public and private treatment facility shall file with the department on request: data, statistics, schedules, and any other information that the department reasonably requires. An approved public or private treatment facility that without good cause fails to furnish any data, statistics, schedules, and any other information as requested, or files fraudulent returns, shall be removed from the list of approved treatment facilities.
5. The department, after holding a hearing, may suspend, revoke, limit, or restrict an approval, or refuse to grant an approval, for failure to meet its standards.

History of Section. P.L. 1972, ch. 130, § 1; G.L. 1956, § 40.1-4-7; P.L. 1995, ch. 370, art. 14, § 4.

23-1.10-8. Rules as to acceptance for treatment.

The director shall adopt and may amend and repeal rules for acceptance of persons into the treatment program, considering available treatment resources and facilities for the purpose of early and effective treatment of alcoholics and intoxicated persons. In establishing the rules the director shall be guided by the following standards:

1. If possible a patient shall be treated on a voluntary rather than an involuntary basis.
2. A patient shall be initially assigned or transferred to outpatient or intermediate treatment, unless he or she is found to require inpatient treatment.
3. A person shall not be denied treatment solely because he or she has withdrawn from treatment against medical advice on a prior occasion or because he or she has relapsed after earlier treatment.
4. An individualized treatment plan shall be prepared and maintained on a current basis for each patient.
5. Provision shall be made for a continuum of coordinated treatment services, so that a person who leaves a facility or a form of treatment will have available and utilize other appropriate treatment.

History of Section. P.L. 1972, ch. 130, § 1; G.L. 1956, § 40.1-4-8; P.L. 1995, ch. 370, art. 14, § 4.

23-1.10-9. Voluntary treatment of alcoholics.

1. An alcoholic may apply for voluntary treatment directly to an approved public treatment facility. If the proposed patient is a minor or an incompetent person, he or she, a parent, a legal guardian, or other legal representative may make the application.
2. Subject to rules adopted by the director, the administrator in charge of an approved public treatment facility may determine who shall be admitted for treatment; provided, however, that a person so admitted may be held by the department for at least thirty (30) days. That person shall be released at the end of thirty (30) days upon written request to the administrator in charge of the treatment facility. If a person is refused admission to an approved public treatment facility, the administrator, subject to rules adopted by the director, shall refer the person to another approved public treatment facility for treatment if possible and appropriate.
3. If a patient receiving inpatient care leaves an approved public treatment facility, he or she shall be encouraged to consent to appropriate outpatient or intermediate treatment. If it appears to the administrator in charge of the treatment facility that the patient is an alcoholic who requires help, the department shall arrange for assistance in obtaining supportive services and residential facilities.
4. If a patient leaves an approved public treatment facility, with or against the advice of the administrator in charge of the facility, the department will attempt to make reasonable provisions for his or her transportation to another facility or to his or her home. If he or she has no home, he or she shall be referred or advised to make contact with the appropriate state or federal agency for assistance in obtaining shelter. If he or she is a minor or an incompetent person, the request for discharge from an inpatient facility shall be made by a parent, legal guardian, or other legal representative or by the minor or incompetent if he or she was the original applicant.

History of Section. P.L. 1972, ch. 130, § 1; P.L. 1984, ch. 122, § 1; G.L. 1956, § 40.1-4-9; P.L. 1995, ch. 370, art. 14, § 4.

23-1.10-10. Treatment and services for intoxicated persons and persons incapacitated by alcohol.

1. An intoxicated person may come voluntarily to an approved public treatment facility for emergency treatment. A person who appears to be intoxicated in a public place and to be in need of help, if he or she consents to the proffered help, may be assisted to his or her home, an approved public treatment facility, an approved private treatment facility, or other health facility by the police.
2. A person who appears to be incapacitated by alcohol shall be taken into protective custody by the police and immediately brought to an approved public treatment facility for emergency treatment. If no approved public treatment facility is readily available, he or she shall be taken to an emergency medical service customarily used for incapacitated persons. The police, in detaining the person and in taking him or her to an approved public treatment facility, are taking him or her into protective custody and shall make every reasonable effort to protect his or her health and safety. In taking the person into protective custody, the detaining officer may take reasonable steps to protect himself or herself. If it is impracticable to take a person to an approved facility, the police may take him or her into protective custody in the police station in suitable quarters, for a reasonable time. A taking into protective custody under this section is not an arrest. No entry or other record shall be made to indicate that the person has been arrested or charged with a crime.
3. A person who comes voluntarily or is brought to an approved public treatment facility shall be examined by a licensed physician as soon as possible. He or she may then be admitted as a patient or referred to another health facility, or be released to his or her own custody. The referring approved public treatment facility shall arrange for his or her transportation as provided for in § 23-1.10-9(d) .
4. A person who by medical examination is found to be incapacitated by alcohol at the time of his or her admission or to have become incapacitated at any time after his or her admission, may not be detained at the facility: (1) once he or she is no longer incapacitated by alcohol, or (2) if he or she remains incapacitated by alcohol for more than five (5) days after admission as a patient, unless he or she is committed under § 23-1.10-11 . A person may consent to remain in the facility for as long as the physician in charge believes appropriate.
5. A person who is not admitted to an approved public treatment facility, who is not referred to another health facility, and who has no funds may be taken to his or her home, if any. If he or she has no home, the approved public treatment facility shall refer or advise him or her to make contact with the appropriate state or federal agency for assistance in obtaining shelter.
6. If a patient is admitted to an approved public treatment facility, his or her family or next-of-kin shall be notified as promptly as possible if requested by the patient. If an adult patient who is not incapacitated requests that there be no notification, his or her request shall be respected.
7. The police, who act in compliance with this section, are acting in the course of their official duty and are not criminally or civilly liable for acting in the course of their official duty.
8. If the physician in charge of the approved public treatment facility determines it is for the patient’s benefit, the patient shall be encouraged to agree to further diagnosis and appropriate voluntary treatment.

History of Section. P.L. 1972, ch. 130, § 1; P.L. 1973, ch. 186, § 1; P.L. 1973, ch. 196, § 1; P.L. 1984, ch. 122, § 1; G.L. 1956, § 40.1-4-10; P.L. 1995, ch. 370, art. 14, § 4.

23-1.10-11. Emergency commitment.

1. An intoxicated person who (1) has threatened, attempted, or inflicted physical harm on himself or herself or another and is likely to inflict physical harm on himself or herself or another unless committed, or (2) is incapacitated by alcohol, may be committed to an approved public treatment facility for emergency treatment. A refusal to undergo treatment does not constitute evidence of lack of judgment as to the need for treatment.
2. The certifying physician, spouse, guardian, or relative of the person to be committed, or any other responsible person, may make a written application for commitment under this section, directed to the administrator of the approved public treatment facility. The application shall state facts to support the need for emergency treatment and be accompanied by a physician’s certificate stating that he or she has examined the person sought to be committed within two (2) days before the certificate’s date and facts supporting the need for emergency treatment.
3. Upon approval of the application by the administrator in charge of the approved public treatment facility, the person shall be brought to the facility by a peace officer, health officer, the applicant for commitment, the patient’s spouse, the patient’s guardian, or any other interested person. The person shall be retained at the facility to which he or she was admitted, or transferred to another appropriate public or private treatment facility, until discharged under subsection (e).
4. The administrator in charge of an approved public treatment facility shall refuse an application if in his or her opinion the application and certificate failed to sustain the grounds for commitment.
5. When, on the advice of the medical staff, the administrator determines that the grounds for commitment no longer exist, he or she shall discharge a person committed under this section. No person committed under this section may be detained in any treatment facility for more than ten (10) days. If a petition for involuntary commitment under § 23-1.10-12 has been filed within the ten (10) days and the administrator in charge of an approved public treatment facility finds that grounds for emergency commitment still exist, he or she may detain the person until the petition has been heard and determined, but no longer than ten (10) days after filing the petition.
6. A copy of the written application for commitment and of the physician’s certificate, and a written explanation of the person’s right to counsel, shall be given to the person within twenty-four (24) hours after commitment by the administrator, who shall provide a reasonable opportunity for the person to consult counsel.

History of Section. P.L. 1972, ch. 130, § 1; P.L. 1973, ch. 196, § 1; P.L. 1984, ch. 122, § 1; G.L. 1956, § 40.1-4-11; P.L. 1995, ch. 370, art. 14, § 4.

23-1.10-12. Involuntary commitment of alcoholics.

1. A person may be committed to the custody of the department by the district court upon the petition of his or her spouse or guardian, a relative, the certifying physician, or the administrator in charge of any approved public treatment facility. The petition shall allege that the person is an alcoholic who habitually lacks self-control as to the use of alcoholic beverages and that he or she: (1) has threatened, attempted, or inflicted physical harm on himself or herself or another and that unless committed is likely to inflict physical harm on himself or herself or another; or (2) will continue to suffer abnormal mental, emotional, or physical distress, will continue to deteriorate in ability to function independently if not treated, and is unable to make a rational and informed choice as to whether or not to submit to treatment, and as a result, poses a danger to himself or herself. Evidence that the person has had numerous short-term, involuntary admissions to a treatment facility shall be considered by the court in making a decision pursuant to this chapter. The petition shall be accompanied by a certificate of a licensed physician who has examined the person within three (3) days before submission of the petition, unless the person whose commitment is sought has refused to submit to a medical examination, in which case the fact of refusal shall be alleged in the petition. The certificate shall set forth the physician’s findings in support of the allegations of the petition.
2. Upon filing the petition, the court shall fix a date for a hearing no later than ten (10) days after the date the petition was filed. A copy of the petition and of the notice of the hearing, including the date fixed by the court, shall be served on the petitioner, the person whose commitment is sought, his or her next-of-kin other than the petitioner, a parent or his or her legal guardian if he or she is a minor, the administrator in charge of the approved public treatment facility to which he or she has been committed for emergency care, and any other person the court believes advisable. A copy of the petition and certificate shall be delivered to each person notified.
3. At the hearing the court shall hear all relevant testimony, including, if possible, the testimony of at least one licensed physician who has examined the person whose commitment is sought. The person shall be present unless the court believes that his or her presence is likely to be injurious to him or her; in this event the court shall appoint a guardian ad litem to represent him or her throughout the proceeding. The court shall examine the person in open court, or if advisable shall examine the person out of court. If the person has refused to be examined by a licensed physician, he or she shall be given an opportunity to be examined by a court-appointed licensed physician. If he or she refuses and there is sufficient evidence to believe that the allegations of the petition are true, or if the court believes that more medical evidence is necessary, the court may make a temporary order committing him or her to the division for a period of not more than five (5) days for purposes of a diagnostic examination.
4. If after hearing all relevant evidence, including the results of any diagnostic examination by the department, the court finds that grounds for involuntary commitment have been established by clear and convincing proof, it shall make an order of commitment to the department. It may not order commitment of a person unless it determines that the department is able to provide adequate and appropriate treatment for him or her and the treatment is likely to be beneficial.
5. A person committed under this section shall remain in the custody of the department for treatment for a period of thirty (30) days unless sooner discharged. At the end of the thirty (30) day period, he or she shall be discharged automatically unless the department before the expiration of the period obtains a court order for his or her recommitment upon the grounds set forth in subsection (a) for a further period of ninety (90) days unless sooner discharged. If a person has been committed because he or she is an alcoholic likely to inflict physical harm on himself or herself or another, the department shall apply for recommitment if after examination it is determined that the likelihood still exists.
6. A person recommitted under subsection (a) who has not been discharged by the department before the end of the ninety (90) day period shall be discharged at the expiration of that period unless the department, before the expiration of the period, obtains a court order on the grounds set forth in subsection (a) for recommitment for a further period not to exceed ninety (90) days. If a person has been committed because he or she is an alcoholic likely to inflict physical harm on himself or herself or another, the department shall apply for recommitment if after examination it is determined that the likelihood still exists. Only two (2) recommitment orders under subsection (e) and (f) shall be permitted.
7. Upon the filing of a petition for recommitment under subsection (e) or (f), the court shall fix a date for a hearing no later than ten (10) days after the date the petition was filed. A copy of the petition and of the notice of the hearing, including the date fixed by the court, shall be served on the petitioner, the person whose commitment is sought, his or her next-of-kin other than the petitioner, the original petitioner under subsection (a) if different from the petitioner for recommitment, one of his or her parents or his or her legal guardian if he or she is a minor, and any other person the court believes advisable. At the hearing the court shall proceed as provided in subsection (c).
8. The department shall provide for adequate and appropriate treatment of a person committed to its custody. The department may transfer any person committed to its custody from one approved public treatment facility to another if transfer is medically advisable.
9. A person committed to the custody of the department for treatment shall be discharged at any time before the end of the period for which he or she has been committed if either of the following conditions is met:
   1. In case of an alcoholic committed on the grounds of likelihood of infliction of physical harm upon himself or herself or another, that he or she is no longer an alcoholic or the likelihood no longer exists; or
   2. In case of an alcoholic committed on the grounds of the need of treatment, deterioration, inability to function, or the fact that he or she is a danger to himself or herself, that the deterioration no longer exists, that he or she is no longer a danger to himself or herself, that he or she is able to function, that further treatment will not be likely to bring about significant improvement in the person’s condition, or treatment is no longer adequate or appropriate.
10. The court shall inform the person whose commitment or recommitment is sought of his or her right to contest the application, be represented by counsel at every stage of any proceedings relating to his or her commitment and recommitment, and have counsel appointed by the court or provided by the court if he or she wants the assistance of counsel and is unable to obtain counsel. If the court believes that the person needs the assistance of counsel, the court shall require, by appointment if necessary, counsel for him or her regardless of his or her wishes. The person whose commitment or recommitment is sought shall be informed of his or her right to be examined by a licensed physician of his or her choice. If the person is unable to obtain a licensed physician and requests examination by a physician, the court shall employ a licensed physician.
11. If a private treatment facility agrees with the request of a competent patient or his or her parent, sibling, adult child, or guardian to accept the patient for treatment, the administrator of the public treatment facility shall transfer him or her to the private treatment facility.
12. A person committed under this chapter may at any time seek to be discharged from commitment by writ of habeas corpus.
13. 1. Any aggrieved party may appeal to the superior court from a judgment of the district court by claiming the appeal in writing filed with the clerk within forty-eight (48) hours, exclusive of Sundays and legal holidays, after the judgment is entered.
    2. All court actions shall be heard within fourteen (14) days after the appeal and shall have precedence on the calendar and shall continue to have precedence on the calendar on a day-to-day basis until the matter is heard.

History of Section. P.L. 1972, ch. 130, § 1; P.L. 1984, ch. 122, § 1; P.L. 1987, ch. 232, § 1; G.L. 1956, § 40.1-4-12; P.L. 1995, ch. 370, art. 14, § 4.

23-1.10-13. Confidentiality of records — Availability for research.

1. The registration and other records of treatment facilities shall remain confidential and are privileged to the patient.
2. Notwithstanding subsection (a), the director may make available information from patients’ records for purposes of research into the causes and treatment of alcoholism. Information under this subsection shall not be published in a way that discloses patients’ names or other identifying information.

History of Section. P.L. 1951, ch. 2755, § 19; G.L. 1956, § 40-12-22; P.L. 1972, ch. 130, § 1; G.L. 1956, § 40.1-4-13; P.L. 1995, ch. 370, art. 14, § 4.

23-1.10-14. Visitation rights — Mail and other communications.

1. Subject to reasonable rules regarding hours of visitation which the director may adopt, patients in any approved treatment facility shall be granted opportunities for adequate consultation with counsel, and for continuing contact with family and friends consistent with an effective treatment program.
2. Neither mail nor other communication to or from a patient in any approved treatment facility may be intercepted, read, or censored. The director may adopt reasonable rules regarding the use of telephone by patients in approved treatment facilities.

History of Section. P.L. 1972, ch. 130, § 1; G.L. 1956, § 40.1-4-14; P.L. 1995, ch. 370, art. 14, § 4.

23-1.10-15. Payment for treatment.

1. If treatment is provided by an approved public treatment facility and the patient has not paid the charge for that treatment, the department is entitled to any payment:
   1. Received by the patient or to which he or she may be entitled because of the services rendered; and
   2. From any public or private source available to the department because of the treatment provided to the patient.
2. A patient in an approved treatment facility, or the estate of the patient, or a person obligated to provide for the cost of treatment and having sufficient financial ability, is liable to the division for cost of maintenance and treatment of the patient in an approved treatment facility in accordance with established rates.
3. The director shall adopt rules governing financial ability that take into consideration the income, savings, and other personal and real property of the person required to pay, and any support being furnished by him or her to any person he or she is required by law to support.

History of Section. P.L. 1951, ch. 2755, § 17; G.L. 1956, § 40-12-20; P.L. 1972, ch. 130, § 1; G.L. 1956, § 40.1-4-15; P.L. 1995, ch. 370, art. 14, § 4.

23-1.10-16. Limits on application of laws punishing intoxication.

1. Neither the state, municipality, nor other political subdivision of the state or municipality may adopt or enforce a law, ordinance, resolution, or rule having the force of law that includes drinking, being a common drunkard, or being found in an intoxicated condition as one of the elements of the offense giving rise to a criminal or civil penalty or sanction.
2. Neither the state, municipality, nor other political subdivision of the state or municipality shall interpret or apply any law of general application to circumvent the provision of subsection (a).
3. Nothing in this chapter affects any law, ordinance, resolution, or rule against drunken driving, driving under the influence of alcohol, or other similar offense involving the operation of a vehicle, aircraft, boat, machinery, or other equipment, or regarding the sale, purchase, dispensing, possessing, or use of alcoholic beverages at stated time and places or by a particular class of persons.

History of Section. P.L. 1972, ch. 130, § 1; G.L. 1956, § 40.1-4-16; P.L. 1995, ch. 370, art. 14, § 4.

23-1.10-17. Severability.

If any provision of this chapter or the application of that provision to any person or circumstance is held invalid, the invalidity does not affect other provisions or applications of the chapter which can be given effect without the invalid provision or application, and to this end the provisions of this chapter are severable.

History of Section. P.L. 1972, ch. 130, § 1; G.L. 1956, § 40.1-4-17; P.L. 1995, ch. 370, art. 14, § 4.

23-1.10-18. Application of Administrative Procedures Act.

Except as otherwise provided in this chapter, the state Administrative Procedures Act, chapter 35 of title 42, applies to and governs all administrative action taken by the director.

History of Section. P.L. 1972, ch. 130, § 1; G.L. 1956, § 40.1-4-18; P.L. 1995, ch. 370, art. 14, § 4.

23-1.10-19. Rules and regulations.

All rules and regulations promulgated in accordance with the provisions of this chapter shall be adopted in accordance with the procedures specified in chapter 35 of title 42, the Administrative Procedures Act.

History of Section. P.L. 1972, ch. 130, § 1; G.L. 1956, § 40.1-4-19; P.L. 1995, ch. 370, art. 14, § 4.

23-1.10-20. Pilot alternative program established.

1. There is hereby created a program for individuals impaired by substance abuse related issues, as an alternative treatment/referral service to the emergency room department, to foster their entry into a continuum of care for treatment and recovery. This pilot program shall be an addition and shall not alter the comprehensive and coordinated program for the treatment of alcoholics and intoxicated persons as set forth in § 23-1.10-6 .
2. As used in this section, the following words and terms shall have the following meanings:
   1. “Department” means the Rhode Island department of behavioral healthcare, developmental disabilities and hospitals.
   2. “Pilot program” means the program described in this section. The pilot program shall not be subject to subsections 23-1.10-10(a) , (b), (c) and (d).
   3. “Substance abuse related issues” means any of the symptoms that are caused by either active substance use, substance abuse/dependence or a combination of both.
3. No later than December 31, 2012, and subject to approval of the Rhode Island executive office of health and human services, the department shall present a proposal to the governor and general assembly to expand existing service(s), that shall result in services described in subsection (a) available twenty-four (24) hours a day, seven (7) days a week to implement the pilot program.
4. Subject to approval from the governor and general assembly and the receipt of required funds, the director shall commence the implementation of the pilot program.
5. The director may adopt such rules and regulations governing the management of the pilot program as he/she deems necessary to carry out the provisions of this section.
6. The pilot program shall have a duration of three (3) years, commencing on the date that the first licensed facility becomes operational.
7. The department shall provide an annual report of its findings and recommendations to the general assembly and governor no later than January 31 of each year beginning in 2014.
8. After three (3) years of operations, the department shall provide an analysis demonstrating outcomes related to the pilot program to the general assembly and governor.

History of Section. P.L. 2012, ch. 257, § 1; P.L. 2012, ch. 265, § 1.

23-1.11-1. Definitions.

As used in this chapter, the term:

1. “Employer” means those individuals or corporations with employees who have the potential to be exposed to blood-borne pathogens through a needlestick or other contaminated sharps;
2. “Engineering controls” means controls including sharps disposal containers, self-sheathing needles, safer medical devices such as sharps with engineered sharps injury protections and needleless systems that isolate or remove the blood-borne pathogen hazard from the workplace;
3. “Exposure control plan” is a document, which shall be produced and reviewed and updated at least annually and whenever necessary to reflect new or modified tasks, and procedures, which affect occupational exposure and reflect employee positions concerning occupational exposure;
4. “Needleless system” means a device that does not use needles for: (i) the collection of bodily fluids or withdrawal of body fluids after initial venous or arterial access is established; (ii) the administration of medication or fluids; or (iii) any other procedure involving the potential for occupational exposure to blood-borne pathogens due to percutaneous injuries from contaminated sharps;
5. “Sharps with engineered sharps injury protections” means a non-needle sharps or a needle device used for withdrawing body fluids, accessing a vein or artery, or administering medications or other fluids with a built-in safety feature or mechanism that effectively reduces the risk of an exposure incident.

History of Section. P.L. 2001, ch. 372, § 1; P.L. 2001, ch. 382, § 1.

23-1.11-2. Purpose.

The Needlestick Safety and Injury Prevention Act includes all aspects related to engineering controls, revision and updating of an exposure control plan and record keeping.

History of Section. P.L. 2001, ch. 372, § 1; P.L. 2001, ch. 382, § 1.

23-1.11-3. Devices.

Sharps with engineered sharps injury protections shall include an array of devices that make injury involving a contaminated sharps less likely, and include, but are not limited to, syringes with a sliding sheath that shields the attached needle after use; needles that retract into a syringe after use; shielded or retracting catheters used to access the bloodstream for intravenous administration of medications or fluids; and intravenous medication delivery systems that administer medications or fluids through a catheter port or connector site using a needle that is housed in a protective covering.

History of Section. P.L. 2001, ch. 372, § 1; P.L. 2001, ch. 382, § 1.

23-1.11-4. Needleless systems.

Needleless systems provide an alternative to needles for the specified procedures, reducing the risk of percutaneous injury involving contaminated sharps and shall include, but are not limited to, intravenous medication delivery systems that administer medications or fluids through a catheter port or connector site using a blunt cannula or other non-needle connection, and jet injection systems that deliver subcutaneous or intramuscular injections of liquid medication through the skin without the use of a needle.

History of Section. P.L. 2001, ch. 372, § 1; P.L. 2001, ch. 382, § 1.

23-1.11-5. Engineering controls.

Engineering controls shall include sharps with engineered sharps injury protections and needleless systems designed to reduce the risk of percutaneous exposure to blood-borne pathogens.

History of Section. P.L. 2001, ch. 372, § 1; P.L. 2001, ch. 382, § 1.

23-1.11-6. Exposure control plan.

An exposure control plan will include requirements that employers document consideration and implementation of the safer medical devices that are appropriate, commercially available, and effective. No one medical device is appropriate in all circumstances of use. For purposes of this standard, an appropriate safer medical device includes only devices whose use, based on reasonable judgment in individual cases, will not jeopardize patient or employee safety or be medically contraindicated; commercially available means available in the marketplace; and an effective safer medical device is a device that, based on reasonable judgment, will make an exposure incident involving a contaminated sharps less likely to occur in the application in which it is used. Prefilled units are exempt from this section until January 2003.

History of Section. P.L. 2001, ch. 372, § 1; P.L. 2001, ch. 382, § 1.

23-1.11-7. Employer requirement.

Every employer is required to: (1) document annually in the exposure control plan consideration and implementation of appropriate commercially available and safer medical devices designed to eliminate or minimize occupational exposure to blood-borne pathogens; (2) solicit input from nonmanagerial employees responsible for direct patient care who are potentially exposed to injuries from contaminated sharps in the identification, evaluation, and selection of effective work practice controls and shall document the solicitation in the exposure control plan.

History of Section. P.L. 2001, ch. 372, § 1; P.L. 2001, ch. 382, § 1.

23-1.11-8. Sharps injury log.

To serve as a tool in identifying high risk areas and evaluating devices, a sharps injury log will be established and maintained by the employer. The log will be for percutaneous injuries from contaminated sharps. The information in the sharps injury log shall be recorded and maintained in such manner as to protect the confidentiality of the injured employee. The sharps injury log shall contain, at a minimum: (1) the type and brand of device involved in the incident, (2) the department work area where the exposure incident occurred, and (3) an explanation of how the incident occurred. The sharps injury log will be maintained for a period of five (5) years.

History of Section. P.L. 2001, ch. 372, § 1; P.L. 2001, ch. 382, § 1.

23-2-1. Repealed.

23-2-2. , 23-2-3. [Transferred.]

23-2-4 — 23-2-15. Repealed.

23-2-16. Use of words referring to local health officers or local health boards — Meaning in general laws.

Whenever in the general laws the words “local health officers,” “health officer” or “board of health” or any other word or phrase connoting a local health board or local health officer is used, appropriate wording shall be substituted so as to vest the power and authority in the state department of health or the director of health; provided, however, that nothing contained in this section shall be construed or interpreted to mean that a city or town shall not appoint a health officer or some other official to carry out the provisions of chapter 9 of this title.

History of Section. P.L. 1964, ch. 45, § 5.

23-3-1. Definitions.

As used in this chapter:

1. “Adoptee” means a person who was born in this state and who has had an original birth certificate sealed due to an adoption.
2. “Adoptee vital records file” means a file operated by the division of vital records that maintains adoptees’ birth certificates, makes available the contact preference forms, and provides adoptees with non-certified copies of their birth certificates.
3. “Adult adoptee” means an adoptee eighteen years of age or older.
4. “Birth parent” is the person, the father or mother of genetic origin of a child, who is legally presumed under the laws of this state to be the father or mother of genetic origin of a child.
5. “Community of residence” means the city or town within the state of a person’s home address at the time of his or her marriage or death, or of his or her mother’s home address at the time of his or her birth.
6. “Contact preference form” means the form prepared and maintained by the division that birth parent(s) of adoptees may file to express his or her preference regarding contact with the adoptee. The contact preference form shall include language informing the birth parent(s) of their ability to provide genetic, social, and health history to the Passive Voluntary Adoption Mutual Consent Registry as defined in chapter 7.2 of title 15.
7. “Dead body” means a lifeless human body or parts of a lifeless human body or its bones from the state of which it reasonably may be concluded that death recently occurred.
8. “Division” means the division of vital records as defined in this chapter.
9. “Fetal death” means death prior to the complete expulsion or extraction from its mother of a product of human conception, irrespective of the duration of pregnancy; the death is indicated by the fact that after the expulsion or extraction the fetus does not breathe or show any other evidence of life such as beating of the heart, pulsation of the umbilical cord, or definite movement of the voluntary muscles.
10. “Filing” means the presentation of a certificate, report, or other record provided for in this chapter, of a birth, death, fetal death, adoption, marriage, or divorce for registration by the division of vital records.
11. “Final disposition” means the burial, interment, cremation, or other disposition of a dead body or fetus.
12. “Institution” means any establishment, public or private, that provides in-patient medical, surgical, or diagnostic care or treatment, or nursing, custodial or domiciliary care to two (2) or more unrelated individuals, or to which persons are committed by law.
13. “Live birth” means the complete expulsion or extraction from its mother of a product of human conception, irrespective of the duration of pregnancy, that, after that expulsion or extraction, breathes or shows any other evidences of life such as beating of the heart, pulsation of the umbilical cord, or definite movement of the voluntary muscles, whether or not the umbilical cord has been cut or the placenta is attached.
14. “Physician” means a person authorized or licensed to practice medicine pursuant to chapter 37 of title 5.
15. “Registration” means the acceptance by the division of vital records and the incorporation in its official records of certificates, reports, or other records provided for in this chapter, or births, deaths, fetal deaths, adoptions, marriages, or divorces.
16. “Signing” or “Signature” means the application of either a hand signature to a paper record or an electronic process approved by the state registrar of vital records.
17. “System of vital records” means the registration, collection, preservation, amendment, and certification of vital statistics records, and activities related to them including the tabulation, analysis, and publication of statistical data derived from those records.
18. “Vital records” means records of birth, death, fetal death, marriage, divorce, and data related to those records.

History of Section. P.L. 1961, ch. 87, § 1; P.L. 1964, ch. 127, § 1; P.L. 1982, ch. 385, § 1; P.L. 2000, ch. 164, § 1; P.L. 2008, ch. 475, § 34; P.L. 2011, ch. 228, § 2; P.L. 2011, ch. 239, § 2; P.L. 2021, ch. 233, § 2, effective July 8, 2021; P.L. 2021, ch. 234, § 2, effective July 8, 2021.

23-3-2. Division of vital records and statewide system.

There is established in the state department of health a division of vital records that shall install, maintain, and operate the system of vital records throughout this state.

History of Section. P.L. 1961, ch. 87, § 1.

23-3-3. Rules and regulations.

The state director of health is authorized after notice and public hearing to adopt, amend, and repeal rules and regulations for the purpose of carrying out the provisions of this chapter. Those rules and regulations shall take effect thirty (30) days after publication.

History of Section. P.L. 1961, ch. 87, § 1.

23-3-4. Appointment of state registrar of vital records.

The director of health shall appoint the chief of the division of vital records in accordance with civil service laws and regulations, who shall be known as the state registrar of vital records and shall carry out the provisions of this chapter.

History of Section. P.L. 1961, ch. 87, § 1.

23-3-5. Duties of state registrar of vital records.

1. The state registrar of vital records shall:
   1. Administer and enforce this chapter and the rules and regulations issued under this chapter, and issue instructions for the efficient administration of the statewide system of vital records.
   2. Direct and supervise the statewide system of vital records and the division of vital records and be custodian of its records.
   3. Direct, supervise, and control the activities of local registrars and the activities of town and city clerks related to the operation of the vital records system.
   4. Prescribe, with approval of the state director of health, and distribute any forms that are required by this chapter and the rules and regulations issued under this chapter.
   5. Prepare and publish annual reports of vital records of this state and any other reports that may be required by the state director of health.
   6. Electronically transmit to the office of the secretary of state, on a monthly basis, a list of any reported deaths of a person or persons eighteen (18) years of age or older, and maintain a list of those deceased persons.
   7. Provide a copy on alkaline paper or an electronic record of each certificate of birth, death, and marriage to the city or town clerk before the tenth (10th) day of the month after the certificate is received by the division of vital records as authorized by regulations.
   8. 1. Flag birth certificates of missing children and perform all other acts and duties required to be performed by him or her pursuant to chapter 28.8 of title 42.
      2. Upon receipt of information pursuant to § 42-28.8-3 , provide the local registrars of the several cities and towns with that information.
   9. Direct, supervise, and control the transition from a paper-based system to an electronic system.
2. The state registrar of vital records, with the approval of the director of health, may appoint a deputy state registrar and may delegate any functions and duties vested in him or her to employees of the division of vital records and to local registrars that he or she deems necessary or expedient.

History of Section. G.L. 1896, ch. 100, § 2; G.L. 1909, ch. 121, § 2; P.L. 1915, ch. 1239, § 1; G.L. 1923, ch. 166, § 2; P.L. 1923, ch. 436, § 1; P.L. 1929, ch. 1432, § 13; P.L. 1935, ch. 2250, § 110; G.L. 1938, ch. 268, §§ 2, 25; impl. am. P.L. 1939, ch. 660, §§ 65, 180; P.L. 1942, ch. 1191, § 1; G.L. 1956, §§ 23-3-38, 23-3-41; G.L. 1956, § 23-3-5 ; P.L. 1961, ch. 87, § 1; P.L. 1978, ch. 191, § 2; P.L. 1982, ch. 385, § 1; P.L. 1986, ch. 252, § 3; P.L. 1991, ch. 209, § 1; P.L. 1993, ch. 132, § 1; P.L. 1996, ch. 404, § 26; P.L. 2000, ch. 164, § 1; P.L. 2008, ch. 164, § 2; P.L. 2008, ch. 177, § 2.

23-3-5.1. Transfer of public historical documents.

At the end of each calendar year, records of births and marriages which have occurred one hundred (100) years or more from the date of transfer and deaths which have occurred fifty (50) years or more from the date of transfer, shall be permanently transferred by the state registrar of vital records to the custody of the state archives under control of the secretary of state who may promulgate rules and regulations pertaining to these public historical documents.

History of Section. P.L. 1993, ch. 118, § 1; P.L. 1993, ch. 282, § 1.

23-3-6. Local registrars.

The town clerks of the several towns or any person whom the city council of any city or the town council of any town may appoint for that purpose shall be known as the local registrar, and he or she shall perform the duties provided for in § 23-3-7 .

History of Section. G.L. 1896, ch. 100, § 1; G.L. 1909, ch. 121, § 1; P.L. 1921, ch. 2096, § 1; G.L. 1923, ch. 166, § 1; P.L. 1933, ch. 2050, § 1; G.L. 1938, ch. 268, § 1; impl. am. P.L. 1939, ch. 660, § 180; G.L. 1956, § 23-3-1 ; G.L., § 23-3-6 ; P.L. 1961, ch. 87, § 1.

23-3-7. Duties of local registrars.

The local registrar, with respect to his or her respective city or town, shall:

1. Administer and enforce the provisions of this chapter and instructions, rules, and regulations issued under this chapter.
2. Require that certificates be completed and filed in accordance with provisions of this chapter and the rules and regulations issued under this chapter.
3. Transmit on or before the tenth (10th) day of each month the certificates, reports, or other returns filed with him or her for the preceding month to the state registrar of vital records or more frequently when directed to do so by the state registrar of vital records.
4. Maintain records, make reports, and perform all other duties that may be required by the state registrar of vital records.
5. Flag birth certificates of missing children and perform all other acts and duties required to be performed pursuant to chapter 28.8 of title 42.

History of Section. G.L. 1896, ch. 100, § 1; G.L. 1909, ch. 121, § 1; P.L. 1921, ch. 2096, § 1; G.L. 1923, ch. 166, § 1; P.L. 1933, ch. 2050, § 1; G.L. 1938, ch. 268, § 1; impl. am. P.L. 1939, ch. 660, § 180; G.L. 1956, § 23-3-1 ; G.L. 1956, § 23-3-7 ; P.L. 1961, ch. 87, § 1; P.L. 1965, ch. 176, § 1; P.L. 1986, ch. 252, § 3; P.L. 2008, ch. 164, § 2; P.L. 2008, ch. 177, § 2.

23-3-8. Compensation of local registrars.

1. Each local registrar not otherwise compensated out of the respective town or city treasuries for this purpose shall be paid by the town or city the sum of twenty cents ($0.20) for each certificate of birth, death, fetal death, or marriage registered by him or her and transmitted to the state registrar of vital records in accordance with the rules and regulations issued under this chapter.
2. If no birth, death, fetal death, or marriage is registered by him or her during any calendar month, the local registrar shall report that fact to the state registrar of vital records.

History of Section. G.L. 1896, ch. 100, §§ 12, 19; G.L. 1909, ch. 121, §§ 12, 19; P.L. 1910, ch. 575, § 6; G.L. 1923, ch. 166, §§ 11, 16; P.L. 1930, ch. 1603, § 1; P.L. 1932, ch. 1938, § 1; G.L. 1938, ch. 268, §§ 10, 17; P.L. 1942, ch. 1121, § 1; G.L. 1956, §§ 23-3-26 , 23-3-27 ; G.L. 1956, § 23-3-8 ; P.L. 1961, ch. 87, § 1.

23-3-9. Form of certificates.

1. In order to promote and maintain uniformity in the system of vital records, the forms of certificates, reports, and other returns required by this chapter, or by regulations adopted under this chapter, shall include as a minimum the items recommended by the federal agency responsible for national vital records subject to approval of and modification by the state director of health.
2. Each certificate, report, and form required to be filed under this chapter shall have entered upon its face the duly attested date of registration.
3. Every person required by this chapter to sign any certificate, report, or form shall type or print his or her name and address where there is a place designated for the person’s name and address. On death certificates, the cause of death shall be typed or printed in the space provided by the physician filling out the certificate.
4. The state registrar of vital records shall maintain a record of the social security numbers of the bride and groom as it appears on the application for the marriage license unless the registrar finds good cause for not requiring the number. That social security number shall be kept confidential and shall be disclosed only to the state agency responsible for administering the state’s child support enforcement program. Social security numbers obtained pursuant to this section shall not be used for any purpose other than for the establishment and enforcement of child support orders, to the extent authorized by federal laws.
5. The state registrar shall obtain the social security number of the deceased and that social security number shall appear on the death certificate unless the registrar finds good cause for not requiring the number.

History of Section. G.L. 1896, ch. 100, § 3; G.L. 1909, ch. 121, § 3; P.L. 1910, ch. 575, § 1; G.L. 1923, ch. 166, § 3; P.L. 1930, ch. 1603, § 1; G.L. 1938, ch. 268, § 3; impl. am. P.L. 1939, ch. 660, § 180; G.L. 1956, § 23-3-15 ; G.L. 1956, § 23-3-9 ; P.L. 1961, ch. 87, § 1; P.L. 1979, ch. 230, § 1; P.L. 1997, ch. 170, § 4.

23-3-10. Birth registration.

1. A certificate of birth for each live birth which occurs in this state shall be filed with the state registrar of vital records, or as otherwise directed by the state registrar, within four (4) days after that birth.
2. When a birth occurs in an institution, the person in charge of the institution, or his or her designated representative, shall obtain the personal data; prepare the certificate; secure the signatures required by the certificate; and file it with the state registrar of vital records, or as otherwise directed by the state registrar. The physician and/or midwife in attendance, or his or her authorized designee as defined in department regulations, shall certify to the facts of birth and provide the medical information required by the certificate within three (3) days after the birth.
3. When a birth occurs outside an institution, the certificate shall be prepared and filed by one of the following in the indicated order of priority:
   1. The physician in attendance at, or immediately after, the birth, or in the absence of a physician;
   2. Any other person in attendance at, or immediately after, the birth, or in the absence of any person in attendance at or immediately after the birth;
   3. The father, the mother, or, in the absence of the father and the inability of the mother, the person in charge of the premises where the birth occurred.
   4. When a birth occurs in a moving conveyance, the place of birth shall be that address in the city or town where the child is first removed from the conveyance.
4. 1. If the mother was married either at the time of conception or birth, the name of the husband shall be entered on the certificate as the father of the child unless paternity has been determined otherwise by a court of competent jurisdiction, in which case the name of the father as determined by the court shall be entered.
   2. [Deleted by P.L. 2020, ch. 59, § 3 and P.L. 2020, ch. 60, § 3].
5. The state registrar shall not decline to register and/or issue any birth certificate or certified copy of any birth certificate on the grounds that medical or health information collected for statistical purposes has not been supplied.

History of Section. G.L. 1896, ch. 100, § 6; G.L. 1909, ch. 121, § 6; G.L. 1909, ch. 121, § 6; P.L. 1921, ch. 2096, § 3; P.L. 1921, ch. 2096, § 3; G.L. 1923, ch. 166, § 5; G.L. 1938, ch. 268, § 5; G.L. 1956, §§ 23-3-3 , 23-3-5 ; G.L. 1956, § 23-3-10 ; P.L. 1961, ch. 87, § 1; P.L. 1984, ch. 261, § 1; P.L. 1985, ch. 459, § 1; P.L. 1986, ch. 198, § 11; P.L. 1987, ch. 327, § 1; P.L. 1991, ch. 273, § 1; P.L. 2000, ch. 164, § 1; P.L. 2014, ch. 193, § 1; P.L. 2020, ch. 59, § 3; P.L. 2020, ch. 60, § 3.

23-3-10.1. Certificates of birth — Social security numbers.

The state registrar of vital records shall maintain a record of the social security number of each parent whose name is recorded on any certificate of birth established or amended under this chapter on or after September 1, 1996, unless the registrar finds good cause for not requiring the number. That social security number shall be kept confidential and shall be disclosed only to the state agency responsible for administering the state’s child support enforcement program. Social security numbers obtained pursuant to this section shall not be used for any purpose other than for the establishment and enforcement of child support orders, to the extent authorized by federal law.

History of Section. P.L. 1996, ch. 129, § 8; P.L. 1996, ch. 131, § 8; P.L. 1996, ch. 132, § 8; P.L. 1996, ch. 133, § 8; P.L. 1996, ch. 265, § 1.

23-3-10.2. Certificates of birth resulting in stillbirth — Filing.

1. The state registrar of vital records shall establish a certificate of birth resulting in stillbirth for fetal deaths, defined as the naturally occurring intrauterine death of a fetus that occurs after the twentieth (20th) week of pregnancy. The certificate shall be issued only at the request of either individual listed as mother or father on the report of fetal death. The certificate of birth resulting in stillbirth shall meet all of the format requirements for a certificate of live birth as provided for in this chapter. If the parents of the stillborn child decide not to name the stillborn child, the person preparing a certificate of birth resulting in stillbirth shall leave blank any references to the stillborn child’s name.
2. The certificate of birth resulting in stillbirth shall be filed with the state registrar of vital records within ten (10) days after the delivery. When a birth resulting in stillbirth occurring in the state has not been registered within one year after the date of delivery, a certificate marked “delayed” may be filed and registered in accordance with regulations of the department of health promulgated pursuant to the provisions of § 23-3-3 relating to evidentiary and other requirements sufficient to substantiate the alleged facts of birth resulting in stillbirth.

History of Section. P.L. 2007, ch. 24, § 1; P.L. 2007, ch. 26, § 1.

23-3-11. Infants of unknown parentage — Foundling registration.

1. Whoever assumes the custody of a living infant of unknown parentage shall report on a form and in the manner prescribed by the state registrar of vital records within four (4) days to the local registrar of the city or town in which the child was found, the following information:
   1. The date and place of finding;
   2. Sex, color or race, and approximate age of child;
   3. Name and address of the persons or institution with whom the child has been placed for care;
   4. Name given to the child by the custodian; and
   5. Other data required by the state registrar of vital records.
2. The place where the child was found shall be entered as the place of birth and the date of birth shall be determined by approximation.
3. A report registered under this section shall constitute the certificate of birth for the infant.
4. If the child is identified and a certificate of birth is found or obtained, any report registered under this section shall be sealed and filed and may be opened only by order of a court of competent jurisdiction or as provided by regulation.

History of Section. G.L. 1938, ch. 268, § 26; P.L. 1948, ch. 2042, § 1; G.L. 1956, § 23-3-7 ; G.L. 1956, § 23-3-11 ; P.L. 1961, ch. 87, § 1.

23-3-12. Delayed registration of births.

1. When the birth of a person born in this state or adopted by residents of this state has not been registered, a certificate may be filed in accordance with regulations of the state department of health. This certificate shall be registered subject to evidentiary requirements that the state department of health shall by regulation prescribe to substantiate the alleged facts of birth.
2. Certificates of birth registered one year or more after the date of occurrence shall be marked “delayed” and show on their face the date of the delayed registration.
3. A summary statement of the evidence submitted in support of the delayed registration shall be endorsed on the certificate.
4. 1. When an applicant does not submit the minimum documentation required in the regulations for delayed registration or when the state registrar of vital records finds reason to question the validity or adequacy of the certificate or the documentary evidence, the state registrar of vital records shall not register the delayed certificate and shall advise the applicant of the reasons for this action.
   2. The state director of health may by regulation provide for the dismissal of an application that is not actively prosecuted.

History of Section. P.L. 1961, ch. 87, § 1; P.L. 1986, ch. 193, § 1.

23-3-12A. Delayed registration of death and marriage.

1. When a death or marriage occurring in this state has not been registered, a certificate may be filed in accordance with regulations of the state director of health. This certificate shall be registered subject to evidentiary requirements that the state director of health shall by regulation prescribe to substantiate the alleged facts of death or marriage.
2. Certificate of death and marriage registered one year or more after the date of occurrence shall be marked “delayed” and shall show on their face the date of delayed registration.

History of Section. P.L. 1961, ch. 87, § 1.

23-3-13. Judicial procedure to establish facts of birth.

1. If any certificate of birth is rejected by the state registrar of vital records, including a delayed certificate of birth under the provisions of § 23-3-12 , the applicant may, in the absence of an order from the family court, acknowledging or establishing paternity, or change in parentage through adoption, petition the superior court for an order establishing a record of the date and place of the birth and the parentage of the person whose birth is to be registered. The superior court shall have sole jurisdiction over proceedings relating to certificates of birth rejected by the state registrar of vital records.
2. The petition shall allege:
   1. That the person for whom a certificate of birth is sought was born in this state;
   2. That no record of birth of the person can be found in the office of the state or local custodian of birth records;
   3. That the state registrar of vital records has refused to register a delayed certificate of birth; and
   4. Other allegations as may be required.
3. The petition shall be accompanied by all documentary evidence which was submitted to the registration official in support of the registration. The petition shall be sworn to by the petitioner.
4. The superior court shall fix a time and place for hearing the petition and shall give the registrar of vital records ten (10) days notice of the hearing. The registrar of vital records, or his or her authorized representative, may appear and testify in the proceeding.
5. If the superior court from the evidence presented finds that the person for whom a delayed certificate of birth is sought was born in this state, it shall make findings as to the place and date of birth, parentage, and any other findings that the case may require and shall issue an order to establish a record of birth. The superior court may use a form prescribed and furnished by the state registrar of vital records. This order shall include the birth data to be registered; a description of the evidence presented in the manner prescribed by § 23-3-12 ; and the date of the superior court’s action.
6. The clerk of the superior court shall forward each order to establish a record of birth to the state registrar of vital records not later than the tenth (10th) day of the calendar month following the month in which it was entered. The order shall be registered by the state registrar of vital records and shall constitute the record of birth, from which copies may be issued in accordance with §§ 23-3-24 and 23-3-25 .

History of Section. P.L. 1961, ch. 87, § 1; P.L. 1986, ch. 193, § 1; P.L. 2014, ch. 193, § 1.

23-3-14. Court reports of adoption.

1. For each adoption decreed by any court in this state, the court shall require the preparation of a record of adoption on a form prescribed and furnished by the state registrar of vital records. The record shall include those facts that are necessary to locate and identify the certificate of birth of the person adopted or, in the case of a person who was born in a foreign country, evidence from sources determined to be reliable by the court as to the date and place of birth of the person; provide information necessary to establish a new certificate of birth of the person adopted; and shall identify the order of adoption and be certified by the clerk of court.
2. Information in the possession of the petitioner necessary to prepare the adoption report shall be furnished with the petition for adoption by each petitioner for adoption or his or her attorney. The welfare agency or other person concerned shall supply the court with any additional information in their possession that may be necessary to complete the record. The provision of that information shall be a prerequisite to the issuance of a final decree in the matter by the court.
3. Whenever an adoption decree is amended or annulled, the clerk of the court shall prepare a certificate which shall include the facts that are necessary to identify the original adoption report and the facts amended in the adoption decree that shall be necessary to properly amend the birth record.
4. Not later than the tenth (10th) day of each calendar month, the clerk of the court shall forward to the state registrar of vital records records of decrees of adoption, annulment of adoption, or amendments of those entered in the preceding month, together with any related reports that the state registrar of vital records shall require.
5. When the state registrar of vital records shall receive a record of adoption, annulment of adoption, or amendment of those from a court for a person born outside this state, that record shall be forwarded to the appropriate registration authority in the state of birth. If the birth occurred in a foreign country, and the child was not a citizen of the United States at the time of birth, the state registrar shall prepare a “certificate of foreign birth” as provided by § 23-3-15(e)(1) .

History of Section. P.L. 1961, ch. 87, § 1; P.L. 1986, ch. 193, § 1.

23-3-15. New certificates of birth following adoption — Legitimation and paternity determination.

1. The state registrar of vital records shall establish a new certificate of birth for a person born in this state when he or she receives the following:
   1. An adoption report as provided in § 23-3-14 or a certified copy of the decree of adoption together with the information necessary to identify the original certificate of birth and to establish a new certificate of birth; except that a new certificate of birth shall not be established if the court decreeing the adoption, the adoptive parents, or the adopted person requests that a new certificate shall not be established.
   2. A request that a new certificate be established and evidence required by regulation proving that the person has been legitimated, or that a court of competent jurisdiction has determined the paternity of the person; provided, however, that where a court of competent jurisdiction has determined the paternity of the person, the name of the person who has been adjudicated as being the father shall be inserted on the birth certificate.
2. When a new certificate of birth is established, the actual place and date of birth shall be shown. It shall be substituted for the original certificate of birth.
   1. Thereafter, the original certificate and the evidence of adoption, paternity, or legitimation shall not be subject to inspection except as allowed by this chapter in the case of adoption by the adult adoptee, or upon order of a court of competent jurisdiction, or as provided by regulation.
   2. Upon receipt of a notice of annulment of adoption, the original certificate of birth shall be restored to its place in the files and the new certificate and evidence shall not be subject to inspection except upon order of a court of competent jurisdiction.
   3. Upon receipt from a passive voluntary adoption mutual consent registry of a certificate provided for in § 15-7.2-12(b) , the adult adoptee named in the certificate shall be entitled to receive non-certified copies of his or her original birth certificate.
3. If no certificate of birth is on file for the person for whom a new certificate is to be established under this section, a delayed certificate of birth shall be filed with the state registrar of vital records as provided in § 23-3-12 or § 23-3-13 , before a new certificate of birth is established, except that when the date and place of birth and parentage have been established in accordance with this chapter in the adoption proceedings, a delayed certificate shall not be required.
4. When a new certificate of birth is established by the state registrar of vital records, all copies of the original certificate of birth in the custody of any custodian of permanent local records in this state shall be sealed from inspection or forwarded to the state registrar of vital records, as he or she shall direct.
5. 1. The state registrar shall, upon request, prepare and register a certificate in this state for a person born in a foreign country who is not a citizen of the United States and who was adopted through a court of competent jurisdiction in this state. The certificate shall be established upon receipt of a report of adoption from the court decreeing the adoption, proof of the date and place of the child’s birth, and a request from the court, the adopting parents, or the adopted person if eighteen (18) years of age or over that a certificate be prepared. The certificate shall be labeled “certificate of foreign birth” and shall show the actual country of birth. After registration of the birth certificate in the new name of the adopted person, the state registrar shall seal and file the report of adoption which shall not be subject to inspection except upon order of a court of competent jurisdiction or as provided by regulation.
   2. If the child was born in a foreign country but was a citizen of the United States at the time of birth, the state registrar shall not prepare a “certificate of foreign birth” and shall notify the adoptive parents of the procedures for obtaining a revised birth certificate for their child through the U.S. Department of State.
6. When a new certificate of birth is established following an adoption or legitimation in this state, and when no record of the original birth is on file at the city or town of occurrence, the state registrar of vital records shall cause a copy to be filed with the registrar of births in the city or town where the child was born and the city or town of residence of the parents indicated on the new certificate, if that residence is within the state.
7. 1. The division shall establish, maintain, and operate the adoptee vital records file. Beginning July 1, 2012, upon written application by an adult adoptee who was born in the State of Rhode Island the division shall issue to the applicant a non-certified copy of the unaltered, original certificate of birth of the adoptee, with procedures, filing fees, and waiting periods identical to those imposed upon non-adopted citizens of the state.
   2. The division shall prescribe and, upon request, shall make available to each birth parent of an adoptee named on the original birth certificate, a contact preference form on which the birth parent may state a preference regarding contact by an adoptee who is the birth child of the birth parent. The contact preference form shall be returned to the division. Upon such a request, the division shall also provide the birth parent with an updated medical history form, which may be completed and returned to the Passive Voluntary Adoption Mutual Consent Registry. The contact preference form shall provide the birth parent with the following options from which the birth parent shall select one:

      “(a) I would like to be contacted.

      (b) I would prefer to be contacted only through an intermediary.

      (c) I would prefer not to be contacted at this time.”

   3. When the division receives a completed contact preference form from a birth parent, the division shall place the form on file and create an index of all contact preference forms filed. When the vital records office receives a request for an original birth certificate they will then open the adoptee’s sealed file and check the file for the names of the birth parent(s). These names will then be cross referenced with the birth parent(s) names listed on the contact preference form index. If there is a match, the vital records office will provide the adoptee a copy of the contact preference form. The division shall inform the adoptee of his or her right to contact the Passive Voluntary Adoption Mutual Consent Registry to see if an updated medical history form has been filed by his or her birth parent.
   4. Beginning September 1, 2011, the division shall make reasonable efforts to inform the public of the existence of the adoptee vital records file; the ability of adult adoptees born in the State of Rhode Island to access non-certified copies of their birth certificates subject to the provisions of this chapter; and the ability of the birth parent(s) of adoptees to file a contact preference form with the division of vital records.
8. The division shall maintain the following statistics that shall be made available to the general public on a quarterly basis or more frequently if possible:
   1. Number of original birth certificates released since the effective date of this bill;
   2. Number of contact preference forms filed; and
   3. Number of birth parent(s) who indicated on the contact preference form that they would like to be contacted, would like to be contacted but only through an intermediary, or do not want to be contacted.

History of Section. G.L. 1938, ch. 268, § 26; P.L. 1944, ch. 1484, § 1; P.L. 1952, ch. 2927, § 1; G.L. 1956, § 23-3-34; G.L. 1956, § 23-3-15 ; P.L. 1961, ch. 87, § 1; P.L. 1980, ch. 232, § 1; P.L. 1986, ch. 193, § 1; P.L. 1986, ch. 234, § 1; P.L. 1995, ch. 54, § 2; P.L. 2011, ch. 228, § 2; P.L. 2011, ch. 239, § 2; P.L. 2021, ch. 233, § 2, effective July 8, 2021; P.L. 2021, ch. 234, § 2, effective July 8, 2021.

23-3-15.1. New certificates of birth following foreign adoption — Exempt from judicial proceedings.

1. A child who has automatically acquired United States citizenship following a foreign adoption and possesses a certificate of citizenship in accordance with the “Child Citizenship Act” (CAA, P.L. 106-395) shall be exempt from the provisions of this chapter which require judicial procedures and reports to acquire a new birth certificate.
2. The state registrar of vital records shall, upon written request, prepare a “Certificate of Foreign Birth” for a child who was born in a foreign country, adopted by a United States citizen and has automatically acquired citizenship in accordance with the “Child Citizenship Act” upon the production of the following documentations:
   1. Certificate of citizenship;
   2. Foreign birth certificate;
   3. Original documents certified by the United States Embassy abroad;
   4. Permanent United States identification card; and
   5. Social Security card.

History of Section. P.L. 2006, ch. 607, § 1.

23-3-16. Death registration.

1. A death certificate for each death that occurs in this state shall be filed with the state registrar of vital records or as otherwise directed by the state registrar within seven (7) calendar days after death and prior to removal of the body from the state, and shall be registered if it has been completed and filed in accordance with this section, provided:
   1. That if the place of death is unknown, a death certificate shall be filed with the state registrar of vital records or as otherwise directed by the state registrar within seven (7) calendar days after the occurrence; and
   2. That if death occurs in a moving conveyance, a death certificate shall be filed with the state registrar of vital records or as otherwise directed by the state registrar.
2. The funeral director, his or her duly authorized agent, or person acting as agent, who first assumes custody of a dead body, shall file the death certificate. He or she shall obtain the personal data from the next of kin or the best qualified person or source available. He or she shall obtain the medical certification of cause of death from the person responsible for certification. The death certificate shall indicate the following:
   1. The sex of the decedent shall be recorded to reflect the decedent’s gender identity, as reported by the next of kin or the best qualified person available, unless the person completing the death certificate is presented with a document that memorializes the decedent’s gender transition. In case of conflicting information on the sex of the decedent from the sources, the death certificate shall be based on documentation that memorializes the decedent’s gender transition. Documents that may memorialize a gender transition include: written instructions from the decedent; a court order approving a name or gender change; an advance healthcare directive; documentation of an appropriate course of treatment for the purpose of gender transition; documentation of a change to the gender marker on a birth certificate; or a state or federally issued identification card, or any additional document as authorized by the Rhode Island department of health. If more than one document is presented and the documents are in conflict regarding the decedent’s gender identity, the most recent document that memorializes the decedent’s gender transition shall prevail. If documentation is not available, it shall be based on information from individuals most familiar with the decedent’s gender identity at the time of death.
3. A physician, after the death of a person whom he or she has attended during his or her last illness, or the physician declaring that person dead, or if the death occurred in a hospital, a registered hospital medical officer duly appointed by the hospital director or administrator, shall immediately furnish for registration a standard certificate of death to a funeral director or other authorized person or any member of the family of the deceased, stating to the best of his or her knowledge and belief the name of the deceased; the disease of which he or she died; where it was contracted; the duration of the illness from which he or she died; when last seen alive by the physician, or, if death occurs in a hospital, when last seen alive by a physician; and the date of death.
4. When death occurred without medical attendance as set forth in subsection (c) or when inquiry is required by chapter 4 of this title, the medical examiner shall investigate the cause of death and shall complete and sign the medical certification within forty-eight (48) hours after taking charge of the case.

History of Section. G.L. 1896, ch. 100, §§ 7, 9; P.L. 1897, ch. 452, § 1; G.L. 1909, ch. 121, §§ 7, 9; P.L. 1910, ch. 575, § 2; G.L. 1923, ch. 166, § 6; G.L. 1938, ch. 268, § 6; impl. am. P.L. 1939, ch. 660, §§ 180, 182; P.L. 1960, ch. 24, § 1; G.L. 1956, §§ 23-3-9 to 23-3-11 ; G.L. 1956, § 23-3-16 ; P.L. 1961, ch. 87, § 1; P.L. 1975, ch. 293, § 1; P.L. 1977, ch. 110, § 1; P.L. 2000, ch. 164, § 1; P.L. 2018, ch. 85, § 1; P.L. 2018, ch. 93, § 1.

23-3-17. Fetal death registration.

1. A fetal death certificate for each fetal death which occurs in this state after a gestation period of twenty (20) completed weeks or more shall be filed with the state registrar of vital records or as otherwise directed by the state registrar within seven (7) calendar days after the delivery and prior to removal of the fetus from the state, and shall be registered if it has been completed and filed in accordance with this section; provided:
   1. That if the place of fetal death is unknown, a fetal death certificate shall be filed with the state registrar of vital records or as otherwise directed by the state registrar within seven (7) calendar days after the occurrence; and
   2. That if a fetal death occurs on a moving conveyance, a fetal death certificate shall be filed with the state registrar of vital records or as otherwise directed by the state registrar.
2. All other fetal deaths, irrespective of the number of weeks uterogestation, shall be reported directly to the state department of health within seven (7) calendar days after delivery.
3. The funeral director, his or her duly authorized agent, or another person acting as agent, who first assumes custody of a fetus, shall file the fetal death certificate. In the absence of a funeral director or agent, the physician or another person in attendance at or after delivery shall file the certificate of fetal death. He or she shall obtain the personal data from the next of kin or the best qualified person or source available. He or she shall obtain the medical certification of cause of death from the person responsible for the certification.
4. The medical certification shall be completed and signed within forty-eight (48) hours after delivery by the physician in attendance at or after delivery except when inquiry is required by chapter 4 of this title.
5. When a fetal death occurs without medical attendance upon the mother at or after the delivery or when inquiry is required by chapter 4 of this title, the medical examiner shall investigate the cause of fetal death and shall complete and sign the medical certification within forty-eight (48) hours after taking charge of the case.
6. Each funeral director shall, on or before the tenth (10th) day of the following month, file a report with the state registrar of vital records listing funerals and/or decedents serviced following deaths or fetal deaths within the month. Failure to file these reports or any of the certificates required under § 23-3-16 and this section within the prescribed time limits shall be grounds for disciplinary action, including revocation of license by the state board of examiners in embalming.

History of Section. P.L. 1961, ch. 87, § 1; P.L. 1976, ch. 293, § 1; P.L. 1977, ch. 110, § 1; P.L. 2000, ch. 164, § 1.

23-3-18. Permits.

1. The funeral director, his or her duly authorized agent, or another person acting as a duly authorized agent, who first assumes custody of a dead body or fetus shall prepare a burial-transit permit prior to final disposition or removal from the state of the body or fetus and within seven (7) calendar days after death.
2. The burial-transit permit shall be signed by the funeral director and by the certifying physician as designated in § 23-3-16(c) .
3. A burial-transit permit issued under the law of another state which accompanies a dead body or fetus brought into this state shall be authority for final disposition of the body or fetus in this state.
4. A permit for disinterment and re-interment shall be required prior to disinterment of a dead body or fetus except as authorized by regulation or otherwise provided by law. The permit shall be issued by the local registrar of vital records at the place of disinterment to a licensed funeral director, embalmer, his or her duly authorized agent, or another person acting as a duly authorized agent, upon proper application.
5. 1. The body of a deceased person shall not be cremated within twenty-four (24) hours after his or her death unless he or she dies of a contagious or infectious disease. The body shall not be received or cremated by any corporation authorized to cremate the bodies of the dead until its officers have received the burial permit required by law before burial, and a cremation certificate issued by the Rhode Island office of state medical examiners. A cremation certificate shall be issued only if the office of state medical examiners determines that the cause and manner of death is such that no further examination or judicial inquiry concerning the cause and manner of death is necessary.
   2. The cremation certificate issued to the funeral director by the medical examiner, in duplicate, shall accompany the body to the crematory. The crematory shall retain the duplicate copy and mail the original copy to the state division of vital records.

History of Section. G.L. 1896, ch. 100, § 9; P.L. 1897, ch. 452, § 1; G.L. 1909, ch. 121, § 9; P.L. 1910, ch. 575, § 4; P.L. 1911, ch. 713, § 1; P.L. 1914, ch. 1092, § 1; P.L. 1921, ch. 2096, § 4; G.L. 1923, ch. 166, § 8; P.L. 1931, ch. 1698, § 1; P.L. 1932, ch. 1947, § 1; G.L. 1938, ch. 268, § 7; impl. am. P.L. 1939, ch. 660, §§ 180, 182; P.L. 1941, ch. 980, § 1; P.L. 1955, ch. 3442, § 1; impl. am. P.L. 1955, ch. 3453, § 1; G.L. 1956, §§ 23-3-18 to 23-3-22 ; G.L. 1956, § 23-3-18 ; P.L. 1961, ch. 87, § 1; P.L. 1962, ch. 13, § 1; P.L. 1977, ch. 110, § 1; P.L. 1977, ch. 242, § 1; P.L. 1978, ch. 361, § 1; P.L. 1993, ch. 272, § 1.

23-3-19. Extension of time.

1. The director of health may, by regulation and upon conditions that he or she may prescribe to assure compliance with the purposes of this chapter, provide for the extension of the periods prescribed in §§ 23-3-16 , 23-3-17 , and 23-3-18 for the filing of death certificates, fetal death certificates, medical certifications of cause of death, and for the obtaining of burial-transit permits in cases in which compliance with the applicable prescribed period would result in undue hardship.
2. Regulations of the director of health may provide for the issuance of a burial-transit permit under § 23-3-18 prior to the filing of a certificate of death or fetal death upon conditions designed to assure compliance with the purposes of this chapter in cases in which compliance with the requirement that the certificate be filed prior to the issuance of the permit would result in undue hardship.

History of Section. P.L. 1961, ch. 87, § 1.

23-3-20. Court reports of divorce.

1. For each divorce granted by any court in this state, a report shall be prepared and filed by the clerk of the court with the state registrar of vital records. The report shall be furnished, with the final decree, to the clerk of the court by the prevailing party or his or her legal representative on forms prescribed and furnished by the state registrar of vital records.
2. On or before the tenth (10th) day of each third (3rd) month commencing on April 10, 1962, the clerk of the court shall forward to the state registrar of vital records the report of each divorce granted during the preceding three (3) calendar months and related reports that may be required by regulations issued under this chapter.
3. The clerk of the court shall be paid by the general treasurer the sum of fifty cents ($0.50) for each certificate of divorce so registered and transmitted to the state registrar of vital records in accordance with rules and regulations issued under this chapter.

History of Section. G.L. 1896, ch. 100, § 24; C.P.A. 1905, § 1220; G.L. 1909, ch. 121, § 24; G.L. 1923, ch. 166, § 22; G.L. 1938, ch. 268, § 21; impl. am. P.L. 1939, ch. 660, §§ 180, 182; G.L. 1956, § 23-3-39; G.L. 1956, § 23-3-20 ; P.L. 1961, ch. 87, § 1.

23-3-21. Correction and amendment of vital records.

1. A certificate or record registered under this chapter may be amended only in accordance with this chapter and regulations adopted under this chapter by the director of health to protect the integrity and accuracy of vital statistics records.
2. A certificate that is amended under this section shall be marked “amended” except as provided in subsection (d) of this section. The date of amendment and a summary description of the evidence submitted in support of the amendment shall be endorsed on or made a part of the record. The director of health shall prescribe by regulation the conditions under which additions or minor corrections shall be made to birth certificates within one year after the date of birth without the certificate being considered as amended.
3. Upon receipt of a certified copy of a court order changing the name of a person born in this state and upon request of that person or his or her parent, guardian, or legal representative, the state registrar of vital records shall amend the certificate of birth to reflect the new name.
4. Upon request and receipt of a sworn acknowledgement of paternity of a child born out of wedlock signed by both parents, the state registrar of vital records shall amend a certificate of birth to show paternity if paternity is not shown on the birth certificate. The department of human services and the division of taxation within the department of administration are authorized to accept a sworn acknowledgment of paternity of a child born out of wedlock signed by both parents on forms prescribed in accordance with § 23-3-9 , to forward the acknowledgment to the state registrar of vital records, and the state registrar of vital records shall amend the certificate of birth to show paternity if paternity is not shown on the birth certificate. Upon request of the parents, after approval by a court of competent jurisdiction, the surname of the child shall be changed on the certificate to that of the father. The certificate shall not be marked “amended.”
5. When a certificate is amended under this section, the state registrar of vital records shall report the amendment to the custodian of any permanent local records and that record shall be amended accordingly.

History of Section. G.L. 1896, ch. 100, § 25; P.L. 1899, ch. 616, § 1; G.L. 1909, ch. 121, § 25; P.L. 1921, ch. 2096, § 8; G.L. 1923, ch. 166, § 23; G.L. 1938, ch. 268, § 22; impl. am. P.L. 1939, ch. 660, §§ 180, 182; P.L. 1944, ch. 1483, §§ 1, 2; G.L. 1956, §§ 23-3-32, 23-3-33; G.L. 1956, § 23-3-21 ; P.L. 1961, ch. 87, § 1; P.L. 1996, ch. 129, § 9; P.L. 1996, ch. 131, § 9; P.L. 1996, ch. 132, § 9; P.L. 1996, ch. 133, § 9.

23-3-22. Reproduction of records.

To preserve original documents, the state registrar of vital records is authorized to prepare typewritten, photographic, or other reproductions of original records and files in his or her office. These reproductions, when certified by him or her, shall be accepted as the original record.

History of Section. P.L. 1961, ch. 87, § 1.

23-3-23. Disclosure of records.

1. To protect the integrity of vital records, to ensure their proper use, and to ensure the efficient and proper administration of the vital records system, it shall be unlawful for any person to permit inspection of, or to disclose information contained in, vital records, or to copy, or issue a copy, of all, or part of, any vital record, except as authorized by regulation or as provided for herein.
2. The director of health may authorize, under appropriate safeguards, the disclosure of data contained in vital records for research purposes.
3. Information in vital records indicating that a birth occurred out of wedlock shall not be disclosed, except as provided by regulation, upon order of a court of competent jurisdiction, or until the record becomes a public record as defined by regulations.
4. Appeals from decisions of the custodians of permanent local records refusing to disclose information, or to permit inspection of or copying of records, of persons born one hundred (100) years before the date of inspection, under the authority of this section and regulation issued under this section, shall be made to the state registrar of vital records. Notwithstanding the provisions of this section, those records shall be open for research to any member of a legally incorporated genealogy society and those societies shall be permitted to incorporate statistics derived from those records in their publications, upon receipt of permission of the director of health; and provided, further, that no person, except the person whose birth is recorded, his or her issue, parent or guardian, spouse, civil union and/or registered domestic partner, grandparent, or sibling; or attorneys at law, title examiners, or members of legally incorporated genealogical societies in the conduct of their official duties as defined in regulations shall have any access to, or be permitted to, examine the original or any copy of the birth certificate or birth record, of any person in the custody of any registrar of vital records or of the state department of health.
5. Title examiners, attorneys, or members of legally incorporated genealogical societies, in the conduct of their official duties as defined in regulations, shall be allowed to examine death certificates that have been filed with the department of health and/or municipalities. No fees shall be charged to such persons for the searching or viewing of death certificates, but fees for copies pursuant to § 23-1-54 or § 23-3-25 shall apply.

History of Section. P.L. 1961, ch. 87, § 1; P.L. 1972, ch. 278, § 1; P.L. 1983, ch. 198, § 2; P.L. 2014, ch. 193, § 1; P.L. 2016, ch. 522, § 1; P.L. 2016, ch. 526, § 1.

23-3-24. Copies of data from vital records.

In accordance with § 23-3-23 and the regulations adopted pursuant to that section:

1. The state registrar of vital records shall upon request issue a certified copy of any certificate or record in his or her custody or a part thereof. Each copy issued shall show the date of registration; and copies issued from records marked “delayed,” “amended,” or “court order” shall be similarly marked and show the effective date. Any copies issued of a “certificate of foreign birth” shall indicate this fact and show the actual place of birth.
2. The custodian of permanent local records shall upon request issue a certified copy of any certificate or record in his or her custody only in a form that shall be prescribed by the state director of health.
3. A certified copy of a certificate or any part thereof, issued in accordance with subdivision (1) or (2) of this section, shall be considered for all purposes the same as the original, and shall be prima facie evidence of the facts stated in the certificate, provided that the evidentiary value of a certificate or record filed more than one year after the event, or a record which has been amended, or a “certificate of foreign birth,” shall be determined by the judicial or administrative body or official before whom the certificate is offered as evidence.
4. The National Office of Vital Statistics may be furnished copies or data that it may require for national statistics; provided, that the state shall be reimbursed for the cost of furnishing the data; and provided further, that the data shall not be used for other than statistical purposes by the National Office of Vital Records unless so authorized by the state registrar of vital records.
5. Federal, state, local, and other public or private agencies may, upon request, be furnished copies or data for statistical purposes upon terms or conditions that may be prescribed by the state director of health.
6. No person shall prepare or issue any certificate which purports to be an original certified copy, or copy of a certificate of birth, death, or fetal death, except as authorized in this chapter or regulations adopted under this chapter.

History of Section. G.L. 1896, ch. 100, § 16; G.L. 1909, ch. 121, § 16; G.L. 1923, ch. 166, § 15; G.L. 1909, ch. 166, § 24; P.L. 1923, ch. 436, § 2; G.L. 1938, ch. 268, §§ 14, 23; G.L. 1956, §§ 23-3-31, 23-3-37; G.L. 1956, § 23-3-24 ; P.L. 1961, ch. 87, § 1; P.L. 1986, ch. 193, § 1.

23-3-24.1. Native Americans — Certified copies of birth records.

Any American Indian or Native American whose certified copy of a birth record contains a racial designation that is incorrect may, without paying a fee, obtain one certified copy of his or her birth record from which the incorrect racial designation has been amended. The person requesting the birth record shall provide satisfactory proof from a tribal authority.

History of Section. P.L. 1998, ch. 309, § 1.

23-3-25. Fees for copies and searches.

1. The state registrar shall charge fees for searches and copies as follows:
   1. For a search of two (2) consecutive calendar years under one name and for issuance of a certified copy of a certificate of birth, fetal death, death, or marriage, or a certification of birth, or a certification that the record cannot be found, and each duplicate copy of a certificate or certification issued at the same time, the fee is as set forth in § 23-1-54 .
   2. For each additional calendar year search, if applied for at the same time or within three (3) months of the original request and if proof of payment for the basic search is submitted, the fee is as set forth in § 23-1-54 .
   3. For providing expedited service, the additional handling fee is as set forth in § 23-1-54.
   4. For processing of adoptions, legitimations, or paternity determinations as specified in §§ 23-3-14 and 23-3-15 , there shall be a fee as set forth in § 23-1-54.
   5. For making authorized corrections, alterations, and additions, the fee is as set forth in § 23-1-54; provided, no fee shall be collected for making authorized corrections or alterations and additions on records filed before one year of the date on which the event recorded has occurred.
   6. For examination of documentary proof and the filing of a delayed record, there is a fee as set forth in § 23-1-54; and there is an additional fee as set forth in § 23-1-54 for the issuance of a certified copy of a delayed record.
2. Fees collected under this section by the state registrar shall be deposited in the general fund of this state, according to the procedures established by the state treasurer.
3. The local registrar shall charge fees for searches and copies of records as follows:
   1. For a search of two (2) consecutive calendar years under one name and for issuance of a certified copy of a certificate of birth, fetal death, death, delayed birth, or marriage, or a certification of birth or a certification that the record cannot be found, the fee is twenty dollars ($20.00). For each duplicate copy of a certificate or certification issued at the same time, the fee is fifteen dollars ($15.00).
   2. For each additional calendar year search, if applied for at the same time or within three (3) months of the original request and if proof of payment for the basic search is submitted, the fee is two dollars ($2.00).
4. Fees collected under this section by the local registrar shall be deposited in the city or town treasury according to the procedures established by the city or town treasurer except that six dollars ($6.00) of the certified copy fees shall be submitted to the state registrar for deposit in the general fund of this state.
5. To acquire, maintain, and operate an electronic statewide registration system (ESRS), the state registrar shall assess a surcharge of no more than five dollars ($5.00) for a mail-in certified records request, no more than three dollars ($3.00) for each duplicate certified record, and no more than two dollars ($2.00) for a walk-in certified records request or a certified copy of a vital record requested for a local registrar. Notwithstanding the provisions of subsection (d), any such surcharges collected by the local registrar shall be submitted to the state registrar. Any funds collected from the surcharges listed above shall be deposited into the information technology investment fund (ITIF).

History of Section. G.L. 1909, ch. 121, § 12; by P.L. 1910, ch. 575, § 6; P.L. 1911, ch. 713, § 1; G.L. 1909, ch. 166, § 24; P.L. 1923, ch. 436, § 2; G.L. 1923, ch. 166, § 11; P.L. 1930, ch. 1603, § 1; P.L. 1932, ch. 1938, § 1; G.L. 1938, ch. 268, §§ 10, 23; P.L. 1942, ch. 1121, § 1; G.L. 1956, §§ 23-3-35, 23-3-37; G.L. 1956, § 23-3-25 ; P.L. 1961, ch. 87, § 1; P.L. 1974, ch. 75, § 1; P.L. 1981, ch. 127, § 1; P.L. 1983, ch. 198, § 2; P.L. 1984, ch. 261, § 1; P.L. 1990, ch. 65, art. 58, § 1; P.L. 1991, ch. 354, § 5; P.L. 1993, ch. 138, art. 31, § 1; P.L. 1995, ch. 370, art. 35, § 1; P.L. 1996, ch. 404, § 26; P.L. 2007, ch. 73, art. 39, § 26; P.L. 2008, ch. 475, § 34; P.L. 2012, ch. 241, art. 9, § 36; P.L. 2018, ch. 47, art. 7, § 4.

23-3-25.1. Veterans’ exemption for fees for copies and searches.

Any veteran who served honorably in the military or naval service of the United States shall be processed without a charge or fee when making a request for vital statistics regarding a request for his or her own personal records.

History of Section. P.L. 1997, ch. 267, § 1.

23-3-26. Persons required to keep records.

1. Every person in charge of an institution, as defined in this chapter, shall keep a record of personal particulars and data concerning each person admitted or confined to that institution. This record shall include the information required by the standard certificates of birth, death, and fetal death forms issued under the provisions of this chapter. The record shall be made at the time of admission from information provided by those persons, but when it cannot be so obtained, it shall be obtained from relatives or other persons acquainted with the facts. The name and address of the person providing the information shall be a part of the record.
2. When a dead human body is released or disposed of by an institution, the person in charge of the institution shall keep a record showing the name of the deceased, date of death, name and address of the person to whom the body is released, date of removal from the institution, or if finally disposed of by the institution, the date, place, and manner of disposition shall be recorded.
3. A funeral director, embalmer, or other person who removes from the place of death or transports or finally disposes of a dead body or fetus, in addition to filing any certificate or other form required by this chapter, shall keep a record which shall identify the body, and information pertaining to his receipt, removal, and delivery of the body that may be prescribed in regulations adopted by the director of health.
4. Records maintained under this section shall be retained for a period of not less than five (5) years and shall be made available for inspection by the state registrar of vital records or his or her representative upon demand.

History of Section. P.L. 1961, ch. 87, § 1.

23-3-27. Duties to furnish information relative to vital events.

Any person having knowledge of the facts shall furnish information that he or she may possess regarding any birth, death, fetal death, marriage, or divorce, upon demand of the state registrar of vital records.

History of Section. P.L. 1961, ch. 87, § 1.

23-3-28. Penalties.

1. 1. Any person who willfully and knowingly makes any false statement in a report, record, or certificate required to be filed under this chapter, or in an application for an amendment of those, or who willfully and knowingly supplies false information intending that this false information be used in the preparation of any report, record, or certificate, or amendment; or
   2. Any person who without lawful authority and with the intent to deceive, makes, alters, amends, or mutilates any report, record, or certificate required to be filed under this chapter or a certified copy of any report, record, or certificate; or
   3. Any person who willfully and knowingly uses or attempts to use, or furnish to another for use, for any purpose of deception, any certificate, record, report, or certified copy thereof so made, altered, amended, or mutilated; or
   4. Any person who with the intention to deceive willfully uses or attempts to use any certificate of birth or certified copy of a record of birth knowing that the certificate or certified copy was issued upon a record which is false in whole or in part or which relates to the birth of another person; or
   5. Any person who willfully and knowingly furnishes a certificate of birth or a certified copy of a record of birth with the intention that it be used by a person other than the person to whom the record of birth relates;

      Shall be punished by a fine of not more than one thousand dollars ($1,000) or imprisoned not more than one year, or both.

2. 1. Any person who knowingly transports and accepts for transportation, interment, or other disposition a dead body without an accompanying permit as provided in this chapter; or
   2. Any person who refuses to provide information required by this chapter; or
   3. Any person who willfully neglects or violates any of the provisions of this chapter or refuses to perform any of the duties imposed upon him by this chapter;

      Shall be punished by a fine of not less than twenty-five dollars ($25.00) nor more than one hundred dollars ($100) or be imprisoned for not more than thirty (30) days, or by both fine and imprisonment.

History of Section. G.L. 1896, ch. 100, § 13; G.L. 1909, ch. 121, § 13; P.L. 1921, ch. 2096, § 5; G.L. 1923, ch. 166, § 12; G.L. 1938, ch. 268, § 11; G.L. 1956, § 23-3-14 ; G.L., § 23-3-28 ; P.L. 1961, ch. 87, § 1.

23-3-29. Division of vital records and state registrar of vital records.

Wherever in the general or public laws there appear the words “division of vital statistics” and the words “state registrar of vital statistics” in relation to the Rhode Island department of health, the word “records” shall be substituted for the word “statistics”.

History of Section. P.L. 1988, ch. 95, § 1; P.L. 1988, ch. 276, § 1.

23-4-1. Definitions.

1. “Assistant medical examiner” means a duly licensed doctor of medicine or osteopathy appointed to assist the office of state medical examiners on a part-time basis.
2. “Autopsy” means the dissection of a dead body and the removal and examination of bone, tissue, organs, and foreign objects for the purpose of determining the condition of the body and the cause and the manner of the death.
3. “Cause of death” means the agent that has directly or indirectly resulted in a death.
4. “Inquest” means an official judicial inquiry before a medical examiner and/or medical examiners jury for the purpose of determining the manner of death.
5. “Manner of death” means the means or fatal agency that caused a death.
6. “Postmortem examination” means examination after death and includes an examination of the dead body and surroundings by an agent of the office of state medical examiners but does not include dissection of the body for any purpose.
7. “Work product” means preliminary drafts, notes, impressions, memoranda, working papers, and similar documents of a governmental entity, whether in electronic or other format.

History of Section. P.L. 1973, ch. 169, § 1; P.L. 2018, ch. 82, § 1; P.L. 2018, ch. 92, § 1.

23-4-2. Establishment of office.

1. There is established in the department of health the office of state medical examiners. The director of health, with the advice of the state medical examiners commission, is authorized to adopt, amend, promulgate, and enforce rules and regulations and standards that may be designed to further the accomplishment of the purposes of this chapter.
2. The office of state medical examiners shall obtain and maintain accreditation by the National Association of Medical Examiners or other national accrediting organization in the field of forensic medicine and pathology.

History of Section. P.L. 1973, ch. 169, § 1; P.L. 1992, ch. 400, § 1; P.L. 2005, ch. 122, § 1; P.L. 2005, ch. 169, § 1.

23-4-3. Functions.

The office of state medical examiners shall be responsible for:

1. The investigation of deaths within the state that, in its judgment, might reasonably be expected to involve causes of death enumerated in this chapter;
2. For the conduct of inquests when requested by the attorney general;
3. For the performance of autopsies, including the retention, examination, and appropriate disposal of tissue, when appropriate, for deaths that, in its judgment, might reasonably be expected to involve causes of deaths enumerated in this chapter;
4. For the written determination of the causes of death investigated pursuant to this chapter;
5. For the presentation to the courts of Rhode Island of expert testimony relating to the cause of death;
6. For the keeping of complete records, including names, places, circumstances, and causes of deaths, of deaths investigated and reported, copies of which shall be delivered to the attorney general and of which written determinations of causes of death shall be made available for public inspection;
7. For the burial of bodies for which there is no other existing legal responsibility to do so;
8. For the development and enforcement of procedures for the pronouncement of death and for the transplantation of organs from bodies of persons who have died within the state;
9. 1. For a multidisciplinary team review of child fatalities with the goal to decrease the prevalence of preventable child deaths and report recommendations for community- and systems-intervention strategies. A child death-review team shall include, but is not limited to, representation from state agencies, health care, child welfare, and law enforcement; and
   2. The work product of the child death-review team shall be confidential and protected under all applicable laws, including the federal Health Insurance Portability and Accountability Act of 1996 and the Rhode Island confidentiality of health care information act (chapter 37.3 of title 5) and shall be exempt from the provisions of chapter 2 of title 38 and shall be deemed privileged pursuant to § 23-17.21-8 ;
10. The department of health shall work with the department of children, youth and families and the office of the child advocate to develop a process to ensure the timely availability of autopsy reports on child deaths;
11. 1. For a multidisciplinary team review of drug-related overdose deaths with the goal of reducing the prevalence of these deaths by examining emerging trends in overdose, identifying potential demographic, geographic, and structural points for prevention, and other factors. The multidisciplinary team for review of drug-related overdose deaths may include, as determined by the director of the department of health, representatives from the department of health; the department of the attorney general; the Rhode Island state police; the department of corrections; the department of behavioral healthcare, developmental disabilities and hospitals; the Rhode Island Police Chiefs Association; the Hospital Association of Rhode Island; an emergency department physician; a primary care physician; an addiction medicine/treatment provider; a mental health clinician; a toxicologist; a recovery coach or other representative of the recovery community; and others as may be determined by the director of the department of health;
    2. The work product of the multidisciplinary team for review of drug-related overdose deaths shall be confidential and protected under all applicable laws, including the federal Health Insurance Portability and Accountability Act of 1996 and the Rhode Island confidentiality of health care information act (chapter 37.3 of title 5), and shall be exempt from the provisions of chapter 2 of title 38, not subject to subpoena, discovery, or introduction into evidence in any civil or criminal proceeding, and not subject to disclosure beyond the team members (except to authorized employees of the department of health as necessary to perform its official duties pursuant to this subsection (11));
    3. The multidisciplinary team shall report on or before December 1 of each year to the governor, the speaker of the house, and president of the senate, which report shall summarize the activities of the team, as well as the team’s findings, progress towards reaching its goals, and recommendations for any needed changes in legislation or otherwise; and
    4. [Deleted by P.L. 2021, ch. 21, § 1 and P.L. 2021, ch. 22, § 1.]
12. 1. For a multidisciplinary maternal mortality review committee for review of maternal deaths of women that occur during pregnancy, delivery, or within one year of the end of pregnancy with the goal of reducing the prevalence of such deaths by examining emerging trends in such deaths, identifying potential demographic, geographic, and structural points for prevention, and other factors. This committee has the authority to request and receive data from vital records, healthcare providers, healthcare facilities, pharmacy records, and any other agencies or officials having information that is necessary for the committee to carry out its duties under this section. The multidisciplinary maternal mortality review committee shall include, but not be limited to, as determined by the director of the department of health, representation from state agencies; an obstetric provider from each hospital that delivers obstetrical care; a neonatal specialist; individuals or organizations that represent the populations that are most affected by pregnancy-related deaths or pregnancy-associated deaths and lack of access to maternal healthcare services; a perinatal pathologist; and a maternal fetal medicine specialist. This committee shall develop recommendations for the prevention of maternal deaths and disseminate findings and recommendations to policy makers, healthcare providers, healthcare facilities, and the general public.
    2. The work product of the maternal mortality review committee shall be confidential and protected under all applicable laws, including the federal Health Insurance Portability and Accountability Act of 1996 and the Rhode Island confidentiality of health care information act (chapter 37.3 of title 5) and shall be exempt from the provisions of chapter 2 of title 38 and shall be deemed privileged pursuant to § 23-17.21-8 .

History of Section. P.L. 1973, ch. 169, § 1; P.L. 1992, ch. 400, § 1; P.L. 2008, ch. 26, § 1; P.L. 2008, ch. 27, § 1; P.L. 2010, ch. 141, § 1; P.L. 2010, ch. 143, § 1; P.L. 2016, ch. 342, § 1; P.L. 2016, ch. 368, § 1; P.L. 2018, ch. 82, § 1; P.L. 2018, ch. 92, § 1; P.L. 2019, ch. 106, § 1; P.L. 2019, ch. 139, § 1; P.L. 2021, ch. 21, § 1, effective May 26, 2021; P.L. 2021, ch. 22, § 1, effective May 26, 2021.

23-4-3.1. Immunity.

No member of the multidisciplinary teams shall be subject to arrest, prosecution, or penalty in any manner, or denied any right or privilege, including, but not limited to, civil penalty or disciplinary action by a business, occupational, or professional licensing board or entity (and, for members who are state employees, termination or loss of employee or pension benefits), for acting in accordance with § 23-4-3 .

History of Section. P.L. 2018, ch. 82, § 2; P.L. 2018, ch. 92, § 2; P.L. 2019, ch. 106, § 1; P.L. 2019, ch. 139, § 1; P.L. 2019, ch. 308, art. 2, § 6.

23-4-4. Jurisdiction.

The office of state medical examiners shall have the authority to make postmortem examinations, to undertake inquests, and to perform autopsies where there may be in its judgment a reasonable belief that the manner of death could be pronounced as:

1. Death by a homicide, suicide, or casualty;
2. Death due to a criminal abortion;
3. Death due to an accident involving lack of due care on the part of a person other than the deceased;
4. Death which is the immediate or remote consequences of any physical or toxic injury incurred while the deceased person was employed;
5. Death due to the use of addictive or unidentifiable chemical agents; or
6. Death due to an infectious agent capable of spreading an epidemic within the state.

History of Section. P.L. 1973, ch. 169, § 1.

23-4-4.1. Procedure for performance of autopsies against a family’s religious beliefs.

1. Notwithstanding any other provision of law, in the absence of a compelling public necessity, no dissection or autopsy shall be performed over the objection of a surviving relative or friend of the deceased that the procedure is contrary to the religious belief of the decedent.
2. For the purposes of this section:
   1. “Compelling public necessity” means:
      1. That the dissection or autopsy is essential to the conduct of a criminal investigation of a suspected homicide, of which the decedent is the victim,
      2. That 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 and/or manner of death, or
      3. That the dissection or autopsy is necessary to obtain proper toxicologic or other specimens which may represent evidence of a crime and will deteriorate over time, or the need for a dissection or autopsy is otherwise established in accordance with subsection (e) of this section.
   2. “Relative” means the person most closely related to the decedent by consanguinity or affinity. In the event that person is unavailable, the objection may be raised on his or her behalf by the next most closely related person. The official who has authority to order a dissection or autopsy of the decedent’s body may require a relative to present an affidavit stating his or her relationship to the decedent, the religious affiliation of the decedent, if any, that the decedent had religious objection to an autopsy, the basis for that belief, and that he or she will assume responsibility for the lawful disposition of the body of the deceased.
   3. “Friend” means any person who, prior to the decedent’s death, maintained such regular contact with the decedent as to be familiar with his or her activities, health, and religious beliefs and who presents an affidavit stating the facts and circumstances upon which the claim that he or she is a friend is based, the religious affiliation of the decedent, if any, that the decedent had religious objections to an autopsy, the basis for that belief, and that he or she will assume responsibility for the lawful disposition of the body of the deceased.
3. All dissections or autopsies performed pursuant to this section shall be the least intrusive procedure consistent with the compelling state interest as defined in this section.
4. Whenever, in the opinion of a medical examiner, there is a compelling public necessity under subsection (b)(1)(i) or (b)(1)(ii) to perform an autopsy or dissection, and a member of the deceased’s immediate family or, in the absence of a member of the deceased’s immediate family, a friend objects that the autopsy or dissection is contrary to the religious beliefs of the deceased or there is an obvious reason to believe, based on written information or records provided the medical examiner, that the autopsy or dissection is contrary to the religious beliefs of the deceased, then no dissection or autopsy shall be performed until forty-eight (48) hours after notice of the dissection or autopsy is given by the medical examiner to the objecting party, or, if there is no objecting party, to any party that the court may name. During that forty-eight (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, but the court may dispense with the waiting period upon ex parte motion if it determines that the delay may prejudice the accuracy of the autopsy or dissection.
5. Whenever, in the opinion of a medical examiner, there is a compelling public necessity in circumstances not provided for in subsection (b)(1)(i) or (b)(1)(ii), but authorized by § 23-4-4 , to perform an autopsy or dissection, and a member of the deceased’s immediate family or, in the absence of a member of the deceased’s immediate family, a friend objects that the autopsy or dissection is contrary to religious beliefs of the deceased or there is an obvious reason to believe, based on written information or records provided the medical examiner, that the autopsy or dissection is contrary to the religious beliefs of the deceased, then the medical examiner may institute an action in the superior court for an order authorizing the autopsy or dissection. The action shall be instituted by an order to show cause on notice to the next of kin or friend, or if none is known to the petitioner, then to any party that the court may direct, returnable at the earliest possible time. The proceeding shall have preference over all other cases in the court and shall be determined summarily upon the petition and the oral or written proof that may be offered by the parties. The court shall grant the relief sought in the petition if it finds that the petitioner has established a demonstrable need for the autopsy or dissection that, under all circumstances of the case, outweighs the state’s interest in observing the decedent’s religious beliefs. If the petition is denied, and no stay is granted by the court, the body shall immediately be released for burial to the surviving relative or friend.

History of Section. P.L. 1990, ch. 497, § 1.

23-4-5. Chief medical examiner — Assistants and other staff.

1. The office shall be under the immediate supervision of a chief, who shall be known as the “chief medical examiner” and who shall be a physician licensed under the provisions of chapter 37 of title 5, and a qualified pathologist certified by the American Board of Pathology and who has had forensic training or experience. He or she shall be appointed by the director of health as shall the deputy chief medical examiner with the advice of the medical examiner’s commission. The chief medical examiner shall be in the unclassified service and the deputy chief medical examiner shall be in the classified service.
2. The chief medical examiner shall appoint, with the approval of the director of health, assistant medical examiners and shall hire other staff as necessary to carry out the provisions of this chapter.
3. Persons employed full time at the time of enactment of this chapter within the division of medical examiners in the department of the attorney general shall be transferred to the office of state medical examiners with their former rights and privileges of employment. For members eligible to retire on or before June 30, 2012, such members shall be eligible for retirement benefits after the age of fifty (50) years and service of twenty (20) years, including service within the division of medical examiners. For members eligible to retire on or after July 1, 2012, such members shall be eligible for retirement benefits in accordance with chapters 8 through 10 of title 36.

History of Section. P.L. 1973, ch. 169, § 1; P.L. 1992, ch. 400, § 1; P.L. 2011, ch. 408, § 21; P.L. 2011, ch. 409, § 21.

23-4-6. State medical examiners commission.

1. There is established the state medical examiners commission. The commission shall hear and determine appeals to decisions by chief medical examiners regarding the undertaking of investigations, inquests, and autopsies, and shall advise the chief medical examiner on matters of public concern.
2. The commission shall consist of twelve (12) members, three (3) of whom shall be ex officio members, viz., the director of health, the attorney general, the superintendent of state police, and nine (9) citizens of the state to be appointed by the governor with the advice and consent of the senate for the term of three (3) years. The governor shall give due consideration to any recommendations for nominations submitted to him or her by the president of the Rhode Island Medical Society, the president of the Rhode Island Society of Pathologists, the president of the Rhode Island Bar Association, the vice president of Brown University Division of Biological and Medical Sciences and the president of the Rhode Island Funeral Directors Association. Each citizen member shall hold office for the term of his or her appointment and until his or her successor is appointed. Vacancies for citizen members shall be filled by appointment for the unexpired term only.
3. The director of health and the attorney general shall be the chairperson and vice chairperson, respectively, of the commission. The chief medical examiner of the office of state medical examiners shall serve as the executive secretary of the commission, and the expenses of the commission shall be a responsibility of the department of health. The board may elect from among its members such other officers as it deems necessary. Seven (7) members of the board shall constitute a quorum and the vote of a majority of those present and voting shall be required for action. The commission shall meet at the call of its chairperson and at least four (4) times each year, the time and the place for each meeting to be fixed by the chairperson.
4. Members of the commission shall be removable by the governor pursuant to the provisions of § 36-1-7 of the general laws and for cause only, and removal solely for partisan or personal reasons unrelated to capacity or fitness for the office shall be unlawful.
5. Within ninety (90) days after the end of each fiscal year, the commission shall approve and submit an annual report to the governor, the speaker of the house of representatives, the president of the senate, and the secretary of state, of its activities during that fiscal year. The report shall provide an operating statement summarizing meetings or hearings held, including meeting minutes, subjects addressed, decisions rendered, appeals considered and their disposition, rules or regulations promulgated, studies conducted, policies and plans developed, approved, or modified, and programs administered or initiated; a consolidated financial statement of all funds received and expended including the source of the funds, a listing of any staff supported by these funds, and a summary of any clerical, administrative or technical support received; a summary of performance during the previous fiscal year including accomplishments, shortcomings and remedies; a synopsis of hearing, complaints, suspensions, or other legal matters related to the authority of the commission; a summary of any training courses held pursuant to this chapter; a briefing on anticipated activities in the upcoming fiscal year; and findings and recommendations for improvements. The report shall be posted electronically on the websites of the general assembly and the secretary of state pursuant to the provisions of § 42-20-8.2 . The director of the department of administration shall be responsible for the enforcement of the provisions of this subsection.
6. The commission shall conduct a training course for newly appointed and qualified members within six (6) months of their qualification or designation. The course shall be developed by the chair of the commission, be approved by the commission, and be conducted by the chair of the commission. The commission may approve the use of any commission and/or staff members and/or individuals to assist with training. The training course shall include instruction in the following areas: the provisions of chapters 42-46, 36-14 and 38-2; and the commission’s rules and regulations. The director of the department of administration shall, within ninety (90) days of June 16, 2006, prepare and disseminate training materials relating to the provisions of chapters 42-46, 36-14, and 38-2.

History of Section. P.L. 1973, ch. 169, § 1; P.L. 1979, ch. 318, § 1; P.L. 1992, ch. 400, § 1; P.L. 2006, ch. 103, § 1; P.L. 2006, ch. 144, § 1; P.L. 2008, ch. 475, § 35.

23-4-7. Reporting of certain deaths required — Violations — Penalties.

1. 1. Where any person shall die in any manner to suggest the possibility of a criminal act or as the result of violence or apparent suicide, or from a criminal abortion or in any suspicious or unusual manner, it shall be the duty of any person having knowledge of those deaths to immediately notify the police of the city or town where the body of the deceased person lies or to notify the office of state medical examiners. The same procedure shall be followed upon discovery of anatomical material suspected of being or determined to be a part of a human body.
   2. Any person who willfully neglects or refuses to report that death or who without an order from an agent of the office of medical examiners willfully touches, removes, or disturbs the body of that dead person, or willfully touches, removes, or disturbs the clothing or any article upon or near that body, shall be guilty of a misdemeanor.
2. If any person buries or causes to be buried the dead body of a person supposed to have come to a violent death before giving notice as stated in subsection (a) and before inquiry is made into the manner and circumstances of the death, that person shall be guilty of a misdemeanor.
3. When any person may appear to have met death when unattended by a physician, or in any unnatural manner, or as the apparent result of the negligence of another person, or as the consequence of any physical or toxic injury incurred while employed, or from the use of any addictive or unidentifiable chemical agent, or from accidental hypothermia, or from an infectious agent capable of spreading an epidemic within the state, it shall be the duty of any physician, law enforcement officer, funeral director, hospital official having knowledge of the death, or of any other person having responsibility for burial or cremation of the deceased person to notify the office of the state medical examiners. In the case of any prisoner committed by law to the custody of the department of corrections or in the department of behavioral healthcare, developmental disabilities and hospitals who dies or in the case of a person who dies while in the custody of the state police or local police departments, the person charged with the responsibility for that custody shall have the duty to immediately notify the office of the state medical examiners. Any person charged with the responsibility of notifying the office of state medical examiners of any of the deaths stated in the first sentence of this subsection who neglects to give that notice shall upon conviction be guilty of a misdemeanor.
4. If an agent of the office of state medical examiners is of the opinion that a death was caused by the act of neglect of some person other than the deceased, he or she shall at once notify the attorney general, and the police of the city or town where the body was found or in which it lies. If any person shall be arrested and charged with causing any death by the act of neglect, the person so arrested shall be entitled to receive a copy of the record of the autopsy, upon written request delivered to the attorney general.
5. Where any person age sixty-five (65) years or older may appear to have died from accidental hypothermia, the death shall be reported to the department of elderly affairs by the state medical examiner or when any person, under the age of eighteen (18) shall die, the physician signing the death certificate shall report the death to the state medical examiner’s office within twenty-four (24) hours of the death.
6. Any person who violates any of the provisions of subsection (a) or (b) of this section and does so with the intention of concealing a crime shall be guilty of a felony and, upon conviction, shall be imprisoned for a term of not more than five (5) years or fined ten thousand dollars ($10,000), or both.

History of Section. P.L. 1973, ch. 169, § 1; P.L. 1982, ch. 333, § 1; P.L. 1991, ch. 184, § 1; P.L. 1996, ch. 163, § 1.

23-4-8. Procedure for investigation of deaths.

1. When the office of state medical examiners has notice that there has been found or is lying within this state the body of a person who is supposed to have come to his or her death by violence, or in any manner as stated in § 23-4-7 , an agent of the office of state medical examiners shall immediately proceed to the place where the body lies and take charge of it, view it, and make personal inquiry into the cause and manner of death. If the body is found at the residence of the deceased, the agent of the office of state medical examiners shall not remove the body from the residence unless necessary for further postmortem examination or autopsy.
2. A health care facility shall disclose any and all information in its possession requested by the state medical examiner or his or her agent in connection with the investigation of the death of a current or former patient to the extent necessary to assist the medical examiner in determining the cause of death.

History of Section. P.L. 1973, ch. 169, § 1; P.L. 1988, ch. 351, § 1.

23-4-9. Deaths in public places.

In the event that a person dies suddenly on a public highway or elsewhere in the public view and the death appears to be from natural causes or the result of injuries received from a highway accident, the state police or any superior officer of the local police or an agent of the office of state medical examiners may order the removal of the body from the place of death, upon completion of their investigation as to the cause and manner of death, to the funeral home designated by a family representative of the deceased or to the state morgue or any hospital.

History of Section. P.L. 1973, ch. 169, § 1.

23-4-10. Disposition of deceased bodies.

1. The office of state medical examiners shall, after any postmortem examination or any autopsy, promptly release the deceased body to the relatives, representatives or domestic partners of the deceased. The cost of transporting the deceased body to a mortuary within the state of the relatives’ or domestic partner’s choice shall be borne by the state if the autopsy was required to be performed as provided in this chapter. If there are no known relatives, representatives or domestic partners, the office of state medical examiners, after reasonable public notices, shall cause the body of the deceased person to be buried. The general treasurer of the state shall have first priority in recovering the expenses of burial from the estate of the deceased person.
2. For the purpose of this chapter, “domestic partner” shall be defined as a person who, prior to the decedent’s death, was in an exclusive, intimate and committed relationship with the decedent, and who certifies by affidavit that their relationship met the following qualifications:
   1. Both partners were at least eighteen (18) years of age and were mentally competent to contract;
   2. Neither partner is married to anyone else;
   3. Partners were not related by blood to a degree which would prohibit marriage in the state of Rhode Island;
   4. Partners resided together and had resided together for at least one year at the time of death; and
   5. Partners were financially interdependent as evidenced by at least two (2) of the following:
      1. Domestic partnership agreement or relationship contract;
      2. Joint mortgage or joint ownership of primary residence;
      3. Two (2) of the following:
         1. Joint ownership of motor vehicle;
         2. Joint checking account;
         3. Joint credit account;
         4. Joint lease; and/or
      4. The domestic partner had been designated as a beneficiary for the decedent’s will, retirement contract or life insurance.

History of Section. P.L. 1973, ch. 169, § 1; P.L. 1980, ch. 306, § 1; P.L. 2009, ch. 369, § 2; P.L. 2009, ch. 385, § 2.

23-4-11. Effects and property of deceased.

An agent of the office of state medical examiners, as the case may be, may take into his or her possession all articles and property of the deceased on or about the body and shall deliver them to the office of the chief medical examiner if an autopsy or postmortem examination is ordered, but shall otherwise deliver them to a member of the family taking a receipt for them. Provided, however, any letter, note, or any other written instrument, the contents of which relate to the manner or cause of the death of the deceased, shall be permanently retained in the files of the office. If an autopsy is ordered, the chief medical examiner shall upon completion of the investigation deliver all other articles or property to a member of the family of the deceased taking a receipt from that family member and, if any dispute exists among members of the family, he or she shall hold the other articles or property for the executor or administrator of the estate of the deceased when appointed. In the event that death shall have occurred in a hotel or other public place where possessions of the deceased may be lying, an agent of the office of state medical examiners shall make suitable arrangements for the protection of the property.

History of Section. P.L. 1973, ch. 169, § 1.

23-4-12. Compensation for recovery of body from water.

When services are rendered in bringing to land the dead body of a person found in any of the harbors, rivers, or waters of the state, compensation for services as he or she deemed reasonable may be allowed; but this privilege shall not entitle any person to compensation for services rendered in search for a dead body.

History of Section. P.L. 1973, ch. 169, § 1; P.L. 1992, ch. 400, § 1.

23-4-13. Establishment of fees.

The director of the department of health shall establish fees for autopsy reports, cremation certificates, and statistics. The director shall also impose fees, at an hourly or daily rate, to give testimony in civil suits under this chapter. All fees are as set forth in § 23-1-54 . The director is authorized to establish in regulation reasonable fees for additional documents not otherwise specified in this section. All of these fees shall be collected and deposited as general revenues; provided, however, that no city or town, or any agency or department of a city and town within the state, or the department of human services, shall be required to pay any fees established by the director pursuant to this section.

History of Section. P.L. 1973, ch. 169, § 1; P.L. 1992, ch. 133, art. 27, § 1; P.L. 1992, ch. 400, § 2; P.L. 1995, ch. 370, art. 40, § 59; P.L. 2003, ch. 172, § 1; P.L. 2003, ch. 179, § 1; P.L. 2007, ch. 73, art. 39, § 27; P.L. 2012, ch. 241, art. 9, § 37.

23-4-14. Preservation of reports — Tabular reports.

The director of the department of health shall cause the returns received by the office of state medical examiners and reports made by that office on causes of death for each year, in accordance with this chapter, to be bound together with an index to the volume. The director of health in his or her capacity as ex officio state registrar shall prepare or cause to be prepared from the returns tabular results that will render them of practical utility, and shall annually report thereof in connection with the report of births, marriages, and deaths required by chapter 3 of this title.

History of Section. P.L. 1973, ch. 169, § 1.

23-4-14.1. Repealed.

23-4-15. Morgue.

A centrally located morgue shall be provided with laboratories, furniture, equipment, records, and supplies that may be required in the conduct of the office of state medical examiners.

History of Section. P.L. 1973, ch. 169, § 1; P.L. 1992, ch. 400, § 1.

23-4-16. Uniform determination of death.

A person who has sustained either: (1) irreversible cessation of circulatory and respiratory functions, or (2) irreversible cessation of all functions of the entire brain, including the brain stem, is dead. A determination of death must be made in accordance with accepted medical standards.

History of Section. P.L. 1982, ch. 411, § 1.

23-4.1-1. Declaration of policy and purpose.

1. The general assembly declares that it is the policy of the state to save lives and speed the healing of persons injured in accidents or otherwise in need of medical service by providing an emergency care system that will bring the injured or sick person under the care of persons properly trained to care for the injured or sick in the shortest practical time and that will provide safe transportation for the injured or sick person to a treatment center prepared to receive the injured person.
2. It is the purpose of this chapter to promote this policy by providing the means by which the best possible first aid treatment can be brought to the injured or sick person in the shortest practical time and by which the injured or sick person can be safely transported to a medical treatment center in proper equipment that is designed to provide supportive care for the injured or sick person and which is able to communicate with the medical treatment center regarding the treatment of the injured or sick person.
3. It is the plan of this chapter to provide help for any scheme of emergency medical service that provides trained personnel, furnishes adequate equipment, and which furnishes emergency medical service to the public.
4. It is not the intent of this chapter to prevent the operation of any nonprofit ambulance service which meets the minimum standards as provided by this chapter for the training of ambulance personnel and for medical service equipment.

History of Section. P.L. 1974, ch. 264, § 1; G.L. 1956, § 23-52-1 ; P.L. 1979, ch. 39, § 1; G.L. 1956, § 23-4.1-1 .

23-4.1-2. Ambulance service coordinating advisory board.

1. The ambulance service coordinating advisory board is hereby created and shall consist of twenty-five (25) members appointed as set out in this section. The governor shall appoint the members of the board as follows: (1) One mayor, town administrator, town manager, or other municipal official recommended by the senate president; (2) Eight (8) practicing, licensed emergency medical technicians as follows: three (3) from a full-time, paid department, who shall be recommended from the Rhode Island State Association of Fire Fighters, IAFF, AFL-CIO; two (2) who are active E.M.S. administrators, one recommended by the Rhode Island Association of Fire Chiefs and one recommended by the Rhode Island State Firemen’s League from a volunteer fire department; and two (2) recommended by the speaker of the house and one recommended by the senate president; (3) One from the R.I. Hospital Association; (4) One from the R.I. Medical Society; (5) One from the R.I. chapter of the American College of Surgeons, committee on trauma; (6) One from the R.I. chapter of the American College of Emergency Physicians; (7) One from the Rhode Island chapter of the American Academy of Pediatrics; (8) Two (2) from a professional ambulance service; (9) Two (2) from the general public; (10) Two (2) from Providence county who are active members of a public ambulance service or fire department rescue squad unit, one from a full-time paid department and one from a volunteer department; (11) Four (4), one each from the counties of Kent, Newport, Bristol, and Washington, who shall be members of a public ambulance service or a fire department rescue squad; and (12) One certified, emergency nurse in current practice who is a member of the Emergency Room Nurses Association. The members of the board shall be chosen and shall hold office for five (5) years and until their respective successors are appointed and qualified. In the month of February in each year, the governor shall appoint successors to the members of the board whose terms shall expire in that year, to hold office until the first day of March in the fifth (5th) year after their appointment and until their respective successors are appointed and qualified. Any vacancy that may occur in the board shall be filled by appointment for the remainder of the unexpired term in the same manner as the original appointment. Each member may designate a representative to attend in his or her absence by notifying the chair prior to that meeting of the board. The board shall meet at least quarterly and to elect its officers annually.
2. The division of emergency medical services of the department of health shall provide staff support to the board.

History of Section. P.L. 1974, ch. 264, § 1; G.L. 1956, § 23-52-2; P.L. 1979, ch. 39, § 1; G.L. 1956, § 23-4.1-2 ; P.L. 1979, ch. 378, § 1; P.L. 1982, ch. 95, § 1; P.L. 1983, ch. 281, § 1; P.L. 1986, ch. 423, § 1; P.L. 1987, ch. 189, § 1; P.L. 2007, ch. 162, § 1; P.L. 2007, ch. 278, § 1; P.L. 2014, ch. 480, § 1; P.L. 2014, ch. 516, § 1; P.L. 2016, ch. 512, art. 1, § 9; P.L. 2019, ch. 221, § 1; P.L. 2019, ch. 258, § 1.

23-4.1-3. Duties of the director.

1. The director of health, referred to as the “director,” shall have full authority to implement the provisions of this chapter and shall be guided by the purposes and intent of this chapter.
2. The director shall cooperate with hospitals, furnishers of ambulance services, local governments, police departments, fire departments, emergency units, first aid groups, or any other groups that furnish or work with groups that furnish emergency medical services.
3. The director shall cooperate with concerned agencies and individuals to coordinate programs for training emergency medical technicians, and other persons who provide emergency medical care services, including dispatchers. If funds are available, the director may establish training grants to aid groups and communities to train people in emergency medical care.
4. The standards used by the director under this chapter shall be reasonable and based upon local and statewide conditions. However, the minimum standards imposed by the director may be the standards issued by any responsible organization having its main concern the disposition of injured persons.
5. The director shall annually submit a report to the governor and the general assembly.
6. The director shall cooperate in the coordination of ambulance services throughout the state with local or state police and fire authorities and other concerned agencies and individuals, including the state civil defense agency. This coordination may be tested by local exercises from time to time.
7. The director shall cooperate with concerned agencies and individuals in the development of a state communications network involving the transportation of injured persons by vehicles licensed under this chapter and hospitals. The director may allocate available funds for the establishing and maintenance of a communications network involving vehicles, hospitals, and other emergency treating organizations within the state.
8. The director shall cooperate with concerned agencies and individuals in the development of a plan for the coordination of ambulance dispatching services with the state.
9. When proposing standards under this chapter, the director shall prepare and publish for the board a financial impact statement.

History of Section. P.L. 1974, ch. 264, § 1; G.L. 1956, § 23-52-3; P.L. 1979, ch. 39, § 1; G.L. 1956, § 23-4.1-3 ; P.L. 1979, ch. 378, § 1; P.L. 1983, ch. 281, § 1; P.L. 1987, ch. 189, § 1; P.L. 1988, ch. 84, § 20; P.L. 1990, ch. 363, § 1; P.L. 2021, ch. 371, § 1, effective July 13, 2021; P.L. 2021, ch. 372, § 1, effective July 13, 2021.

23-4.1-4. Minimum standards.

The director shall establish minimum standards to be met in the following areas:

1. Licensing;
2. Vehicles;
3. Equipment for vehicles;
4. Personnel;
5. Training;
6. Communications;
7. Cooperation with other units;
8. Treatment of acutely ill or injured persons by ambulance and rescue personnel; and
9. Financial capacity of private ambulance service providers.

History of Section. P.L. 1974, ch. 264, § 1; G.L. 1956, § 23-52-4; P.L. 1979, ch. 39, § 1; G.L. 1956, § 23-4.1-4 ; P.L. 1979, ch. 378, § 1; P.L. 1982, ch. 95, § 1; P.L. 1983, ch. 281, § 1; P.L. 1987, ch. 189, § 1; P.L. 2010, ch. 170, § 1.

23-4.1-5. Supervision of ambulance services.

The director is responsible for the statewide supervision of ambulance and rescue services and all equipment and persons coming under the provisions of this chapter.

History of Section. P.L. 1974, ch. 264, § 1; G.L. 1956, § 23-52-5; P.L. 1979, ch. 39, § 1; G.L. 1956, § 23-4.1-5 ; P.L. 1983, ch. 281, § 1; P.L. 1987, ch. 189, § 1.

23-4.1-6. Licensing of ambulances and ambulance service.

1. A person shall not engage in the business or service of the transportation of patients upon any public way of the state unless that person holds a license by the director of health for engaging in that business or service.
2. A person shall not operate an ambulance on public ways in this state if the ambulance is not licensed by the director of health under this chapter.
3. The director of health shall not issue or renew a license for an ambulance under this chapter unless the ambulance meets the minimum equipment standards established under this chapter.
4. If a major emergency occurs and the licensed ambulances in the state are not sufficient to meet the needs to transport the injured or sick persons, the licensing provisions of this section do not apply during the period of the emergency.
5. 1. If an ambulance is owned by a nonresident and is licensed as a motor vehicle in another state, it may be operated on the public ways of this state to transport patients who are picked up out of state and brought to treatment centers in the state, without the ambulance, its owners, the driver, the attendant, or the attendant drivers being licensed under this section.
   2. Also exempted are:
      1. Any motor vehicles or aircraft owned by or operated under the direct control of the United States;
      2. Those hospital-based and owned vehicles and their attendants which are used solely for the transportation of non-emergency patients to and from other institutions for the purpose of therapy and/or other medical treatment and services of a non-emergency nature; and
      3. Those private ambulance and service companies and their attendants which are used solely for the transportation of non-emergency patients; provided, however, that those private ambulance and service companies annually attest to the ambulance service coordinating board the fact that the ambulance or service companies are not engaged in the transportation of emergency patients.
6. Any change of ownership of a licensed ambulance or of a business or service engaged in the transportation of patients ends the license concerned. Upon a change of ownership, the director of health shall issue a ninety (90) day temporary license upon the application of the new owner for a current license.
7. All persons engaged in the business or service of the transportation of patients on any public ways in the state, all person operating an ambulance for ambulance purposes on any public way in the state, and all ambulances operated on public ways in this state shall conform to the minimum standards set by regulations issued under the authority of this chapter.
8. If there is a hardship imposed on any applicant for a license because of an unusual circumstance, the applicant may apply to the director for a temporary waiver of the licensing provisions of this section for good cause shown. The director has the power to waive licensing provisions for a period not to exceed ninety (90) days.

History of Section. P.L. 1974, ch. 264, § 1; P.L. 1975, ch. 125, § 1; G.L. 1956, § 23-52-6; P.L. 1979, ch. 39, § 1; G.L. 1956, § 23-4.1-6 ; P.L. 1983, ch. 281, § 1.

23-4.1-7. Standards for ambulance license.

The director of health shall issue regulations to govern the standards of suitability of ambulances for the transportation of patients from the standpoint of health, sanitation, safety, communications, maintenance, on-board medical equipment, safety equipment, extraction equipment, ambulance markings, garaging conditions, and care and condition of the ambulance and its equipment, and to govern minimum financial capacity of private ambulance service providers.

History of Section. P.L. 1974, ch. 264, § 1; G.L. 1956, § 23-52-7; P.L. 1979, ch. 39, § 1; G.L. 1956, § 23-4.1-7 ; P.L. 1983, ch. 281, § 1; P.L. 1987, ch. 189, § 1; P.L. 2010, ch. 170, § 1.

23-4.1-7.1. Restocking of municipal ambulance supplies.

1. The director of health, with the cooperation of hospitals and freestanding emergency-care facilities licensed in accordance with chapter 17 of this title, will develop a listing of supplies that are subject to mandatory restocking in accordance with subsection (b).
2. Every hospital and freestanding emergency-care facility licensed in accordance with chapter 17 of this title is required to restock supplies listed in accordance with subsection (a) that are used by a licensed, emergency-medical-services provider in transporting emergency patients to hospitals or freestanding emergency-care facilities licensed in accordance with chapter 17 of this title. Restocking will not be required:
   1. In the absence of documentation of supply usage on the emergency patient’s RI EMS ambulance run report; or
   2. If the licensed, emergency-medical-services provider bills any third-party payer for the supplies that were used.

History of Section. P.L. 1998, ch. 336, § 1; P.L. 2001, ch. 292, § 1; P.L. 2016, ch. 417, § 2; P.L. 2016, ch. 418, § 2.

23-4.1-8. Applications for license.

1. Any person, firm, partnership, corporation, municipality, volunteer units, or any other business or organization providing ambulance service shall, at the time of license application, furnish the director of health with a list of all persons authorized to act as an attendant of any ambulance owned or operated by the applicant. Further, all applicants shall submit to the director the person who shall serve as the emergency medical service physician medical director (the “physician medical director”). The physician medical director shall be a physician board-certified or board-eligible in emergency medicine and/or E.M.S. The physician medical director must have an active Rhode Island license to practice medicine. The ambulance service coordinating advisory board shall establish standards for the duties and responsibilities of the physician medical director.
2. The director shall provide application forms for licenses under this section.
3. Subject to the approval of the board, the director shall make reasonable minimum standards of health, performance, fitness, education, and moral fitness. The director may use the guides established by the American College of Surgeons’ Board of Regents as a standard, except that a felony conviction shall not necessarily disqualify an attendant.
4. Each applicant shall hold a current certificate of completion of either:
   1. An emergency medical responder course;
   2. An emergency medical technician course;
   3. An advanced emergency medical technician course;
   4. An advanced emergency medical technician-cardiac course; or
   5. A paramedic course.

      These courses shall be approved by the board. The certificate needed shall be decided by the person, firm, partnership, corporation, municipality, or any other business or organization providing ambulance service employing the individual licensee or in the case of a volunteer unit the unit for whom the individual licensee is volunteering for.

5. If there is a hardship imposed upon any applicant for a license because of an unusual circumstance, the applicant may apply to the director for a temporary waiver of the licensing provisions for good cause shown. The director has the power to waive licensing provisions for a period not to exceed ninety (90) days.

History of Section. P.L. 1974, ch. 264, § 1; G.L. 1956, § 23-52-8; P.L. 1979, ch. 39, § 1; G.L. 1956, § 23-4.1-8 ; P.L. 1983, ch. 281, § 1; P.L. 2021, ch. 371, § 1, effective July 13, 2021; P.L. 2021, ch. 372, § 1, effective July 13, 2021.

23-4.1-9. Revocation of license.

1. Any license granted under this chapter may be suspended or revoked by the director for cause, after a hearing. Appeal from a decision of the director may be taken pursuant to the Administrative Procedures Act, chapter 35 of title 42.
2. Cause for suspension or revocation of a license is failure to comply with any of the provisions or standards of this chapter or of any regulations of the director issued under authority of this chapter. All inspection reports are rebuttable evidence of the facts or conclusions stated in them as to the compliance or noncompliance with the pertinent laws or regulations involved in the licensing.
3. Before suspending or revoking a license, the director shall give the licensee notice of the particular charge of violation against him or her.
4. If the licensee fails to correct the deficiencies charged against him or her, or fails to comply with the law or regulations to the satisfaction of the director, the director shall notify the licensee of the charges against him or her, and the time and place of the hearing on the charges. The director shall set a reasonable time to allow a proper defense against the charges. The licensee may be represented by counsel, and may present witnesses in his or her behalf. The director shall issue a written decision, which shall include findings of fact. The decision shall be sent to the licensee by registered mail within ten (10) days of the decision.
5. If any license is suspended or revoked, the holder shall immediately stop all operations authorized by the license.

History of Section. P.L. 1974, ch. 264, § 1; G.L. 1956, § 23-52-9; P.L. 1979, ch. 39, § 1; G.L. 1956, § 23-4.1-9 ; P.L. 1983, ch. 281, § 1; P.L. 1987, ch. 189, § 1.

23-4.1-10. Regulations and fees.

1. The director shall be guided by the purposes and intent of this chapter in the making of regulations as authorized by this chapter.
2. The director may issue regulations necessary to bring into effect any of the provisions of this chapter.
3. 1. The director shall charge license fees for an annual license for an ambulance service, for an annual vehicle license, and for an emergency medical technician license. All such fees are as set forth in § 23-1-54 .
   2. The director may charge an examination fee for examinations for an emergency medical technician license and an inspection fee for inspections for a vehicle license as set forth in § 23-1-54 .
   3. The director is also authorized to establish reasonable fees for other administrative actions that the director shall deem necessary to implement this chapter. The fees provided for in this section shall be deposited as general revenues and shall not apply to any city or town employee providing services referenced in this chapter on behalf of the city or town, and shall not apply to any individual providing services referenced in this chapter on behalf of any bona fide volunteer or not for profit organization. Further, the services licensure fees and vehicle inspection fees shall not apply to services and vehicles operated by any city, town, or fire district or to services and vehicles operated by bona fide volunteer or not for profit organizations.

History of Section. P.L. 1974, ch. 264, § 1; G.L. 1956, § 23-52-10; P.L. 1979, ch. 39, § 1; G.L. 1956, § 23-4.1-10 ; P.L. 1983, ch. 281, § 1; P.L. 1987, ch. 189, § 1; P.L. 1993, ch. 138, art. 33, § 1; P.L., 1995, ch. 370, art. 40, § 60; P.L. 2001, ch. 77, art. 14, § 29; P.L. 2007, ch. 73, art. 39, § 28; P.L. 2012, ch. 241, art. 9, § 38.

23-4.1-11. Repealed.

23-4.1-12. Immunity from liability.

1. No person, licensed and authorized pursuant to this chapter or rules and regulations promulgated pursuant to this chapter, shall be liable for any civil damages for any act or omission in connection with emergency medical services (EMS) training or in connection with services rendered outside a hospital, unless the act or omission is inconsistent with the level and scope of the person’s training and experience and unless the act or omission was the result of gross negligence or willful misconduct.
2. No agency, organization, institution, corporation, or entity of state or local government that sponsors, authorizes, supports, finances, or supervises the functions of emergency medical services personnel licensed and authorized pursuant to this chapter, including advanced life support personnel, shall be liable for any civil damages for any act or omission in connection with sponsorship, authorization, support, finance, or supervision of those emergency medical services personnel, where the act or omission occurs in connection with EMS training or with services rendered outside a hospital, unless the act or omission is inconsistent with the level and scope of the training of the emergency medical services personnel and unless the act or omission was the result of gross negligence or willful misconduct.
3. No principal, agent, contractor, employee, or representative of an agency, organization, institution, corporation, or entity of state or local government that sponsors, authorizes, supports, finances, or supervises any functions of emergency medical services personnel licensed and authorized pursuant to this chapter, or rules and regulations promulgated pursuant to this chapter, including advanced life support personnel, shall be liable for any civil damages for any act or omission in connection with that sponsorship, authorization, support, finance, or supervision of those emergency medical services personnel, where the act or omission occurs in connection with EMS training, or occurs outside a hospital, unless the act or omission is inconsistent with the level and scope of the training of the emergency medical services personnel and unless the act or omission was the result of gross negligence or willful misconduct.
4. No physician, who in good faith arranges for, requests, recommends, or initiates the transfer of a patient from a hospital to a critical medical care facility in another hospital, shall be liable for any civil damages as a result of the transfer, where sound medical judgment indicates that the patient’s medical condition is beyond the care capability currently available in the transferring hospital or the medical community in which that hospital is located and where a prior agreement exists from the transferee facility to accept and render necessary treatment to those patients.
5. Any municipal, fire district, or state firefighter, paramedic, or emergency medical technician who, in good faith, without the expectation of monetary or other compensation from the person aided or treated, renders first aid, emergency treatment, rescue assistance, or transport services to a person at the scene of an accident, fire, or in any other emergency situation, or en route from the scene to any hospital, medical clinic, or doctor’s office, shall not be liable for any civil damages for acts or omissions resulting from the rendering of that care, treatment, or assistance.
6. The individual immunity granted in this section applies to members or employees of governmental ambulance, rescue, or emergency units, whether or not a user or service fee may be charged by the governmental entity and whether or not the members or employees receive salaries or other compensation from the governmental entity.
7. The immunity granted in this section also extends to any city, town, or fire district engaged in rendering emergency aid.
8. This section shall not be construed to provide immunity to a person or entity causing any damage by his willful, wanton, or reckless acts or omissions.

History of Section. P.L. 1982, ch. 95, § 2; P.L. 2000, ch. 432, § 1.

23-4.1-13. Exclusion of non-emergency providers.

Private ambulance services that are used solely for the transportation of non-emergency patients shall be exempted from the provisions of this chapter and chapter 17.6 of this title. These services, however, must continue to conform to rules and regulations promulgated under this chapter which were in effect on May 1, 1982.

History of Section. P.L. 1982, ch. 95, § 3.

23-4.1-14. Notification of next of kin or other member of household.

Whenever any person requires emergency medical transportation from their home or business establishment by any private or public ambulance or rescue vehicle, and no member of the patient’s family, household or a business associate is present at the time of evaluation, the rescue team shall affix a sticker or other means of notification in the place of evaluation. The sticker shall note the patient’s name if available and a telephone number where information can be obtained to ascertain the patient’s whereabouts. Failure to comply with the provisions of this section shall not result in any civil or criminal liability on the part of the private or public ambulance or rescue vehicle company or their personnel.

History of Section. P.L. 1990, ch. 67, § 1.

23-4.1-15. Trauma system advisory committee.

There is established within the department of health a trauma system advisory committee. The committee, appointed by the director, shall include representatives of the following groups: consumers, third-party payers, emergency medical technicians, hospitals, physicians, nurses, the Hospital Association of Rhode Island, the department of health, the ambulance service advisory board, emergency medical service providers, and the Rhode Island Medical Society. Each nonprofit hospital with an emergency medical service shall have a representative appointed by its president. In addition, there shall be two (2) members of the house of representatives appointed by the speaker, one of whom shall be a member of the minority party, and two (2) members of the senate appointed by the president of the senate, one of whom shall be a member of the minority party. Subject to the limitations of existing data and other resources, the committee shall undertake a thorough examination of all aspects of the state’s trauma system, including:

1. A review of the current utilization of trauma services for each acute care hospital;
2. A review of each hospital’s trauma patient mix and mortality and morbidity rates for classes of patients;
3. Hospital staffing patterns and likely future needs;
4. The current financing of trauma care including the issue of uncompensated care and an examination of additional costs for system enhancement; and
5. Pre-hospital care protocols and emergency medical services’ capabilities and integration needs.

History of Section. P.L. 1993, ch. 375, § 1; P.L. 2001, ch. 180, § 39.

23-4.1-16. Emergency medical services for children.

1. There is established within the department of health, division of emergency medical services (EMS), an emergency medical services for children (EMSC) program. The EMSC program, operated within the department of emergency medicine of Hasbro Children’s Hospital, shall be recognized by the department of health as a resource to the state’s overall emergency medical services system, in order to effect the provisions of this chapter. The objective and directive of the EMSC program shall be to continue, to the extent that funds through the federal government, state government or private sources are available for this purpose, the growth and development of those programs already in effect pursuant to the federal grant received under the maternal and child health bureau. The goal and objective of the program shall include, but shall not be limited to the following:
   1. To develop and implement new statewide EMS treatment protocols that emphasize pediatric emergency care, along with supporting EMT education and training programs;
   2. To develop programs for parents and communities, which shall:
      1. Identify and reduce barriers to emergency care for children;
      2. Provide information relating to health promotion and injury prevention; and
      3. Focus on recognition of emergencies, and improving access to and appropriate use of the local EMS systems; and
   3. The program shall also provide periodic case reviews and follow-up to EMS personnel in pediatric cases.
2. The EMSC program may solicit, receive, and spend funds it receives from the federal government, state government or private sources to carry out the purposes of this chapter.
3. The EMSC program may employ or contract with professional, technical, research, and clerical staff, and with health care facilities that have expertise in pediatric care, as necessary within the limits of available funding.

History of Section. P.L. 1997, ch. 120, § 1; P.L. 2005, ch. 109, § 1; P.L. 2005, ch. 163, § 1.

23-4.1-17. Advertising services.

Any licensee licensed pursuant to this chapter shall include in any advertising of its services that is directed to the general public, the following language: “In case of medical emergency dial 911.”

History of Section. P.L. 1997, ch. 294, § 1.

23-4.1-18. Peer review boards — Definition, activities and immunities.

1. For the purposes of this chapter, “peer review board” means any committee of a state or local professional association or society, or any committee authorized by the director of the department of health, or a committee of any licensed emergency medical service employing practicing licensed emergency medical personnel, organized for the purpose of furnishing emergency medical services, the function of which, or one of the functions of which, is to evaluate and improve the quality of health care rendered by providers of health care service or to determine that health care services rendered were professionally indicated or were performed in compliance with the applicable standard of care or that the cost of health care rendered was considered reasonable by the providers of professional health care services in the area.
2. The proceedings and associated records of peer review boards shall not be subject to discovery or be admissible in evidence in any case except litigation arising out of the imposition of sanctions upon an emergency medical technician. However, any imposition or notice of a restriction of privileges, or a requirement of supervision imposed on an emergency medical technician for failure to comply with the provisions or standards of this chapter, and any regulations promulgated pursuant to § 23-4.1-10 , shall be subject to discovery and be admissible in any proceeding against the emergency medical technician for performing, or against any licensed emergency medical service which allows the emergency medical technician to perform, the procedures which are the subject of the restriction or supervision during the period of the restriction or supervision, or subsequent to that period. Nothing contained in this section shall apply to records made in the regular course of business by an emergency medical service or other provider of health care information. Documents or records otherwise available from original sources are not to be construed as immune from discovery or use in any civil proceedings merely because they were presented during the proceedings of the committee.
3. There shall be no monetary liability on the part of, and no cause of action for damages shall arise, against any member of a duly appointed peer review board operated pursuant to written bylaws, for any act or proceeding undertaken or performed within the scope of the functions of any peer review board.
4. There shall be no monetary liability on the part of, and no cause of action for damages shall arise against, any person on account of the communication of information to any peer review board or the department of health or the ambulance service advisory board, when the communication is intended to aid in the evaluation of the qualifications, fitness, or character of an emergency medical technician, and does not represent as true any matter not reasonably believed to be true.
5. Any peer review processes authorized by statute and carried out in good faith shall have the benefit of the state action exemption to the state antitrust law.

History of Section. P.L. 2005, ch. 242, § 1; P.L. 2005, ch. 245, § 1.

23-4.1-19. Documentation of pre-healthcare facility exposure of emergency medical services workers.

1. Any emergency service worker responding on behalf of a licensed ambulance/rescue service, or a fire department or a law enforcement agency who has sufficient reason to believe that, in the course of their professional duties, they have been exposed to bodily fluids or other substances that may result in the worker contracting a serious infection and/or illness shall complete a pre-healthcare facility exposure form. The worker shall file a copy of the form with the hospital or freestanding emergency-care facility receiving the transported patient believed to be the source of the infectious materials to which the worker believes he or she has been exposed. The worker shall file the form with the hospital or freestanding emergency-care facility immediately post exposure. The worker shall retain a copy of the completed form, except for that information protected by applicable confidentiality laws. The source patient’s diagnostic information shall not appear on the pre-healthcare facility exposure form.
2. The director of the department of health, with the advice of the ambulance services advisory board, shall develop the pre-healthcare facility exposure form, and shall make copies available to all agencies employing emergency medical service workers, hospitals and freestanding emergency-care facilities.

History of Section. P.L. 2006, ch. 224, § 1; P.L. 2016, ch. 417, § 2; P.L. 2016, ch. 418, § 2.

23-4.5-1. Blood donations by minors.

Any person of the age of seventeen (17) or over shall be eligible to donate blood in any voluntary and non-compensatory blood program without the necessity of obtaining permission or authorization of his/her parent or guardian. Any person sixteen (16) years of age may donate his or her blood upon obtaining prior permission of his or her parent or guardian.

History of Section. P.L. 1970, ch. 318, § 1; G.L. 1956, § 23-50-1 ; P.L. 1979, ch. 39, § 1; G.L. 1956, § 23-4.5-1 ; P.L. 1985, ch. 249, § 1; P.L. 2009, ch. 237, § 1; P.L. 2009, ch. 238, § 1.

23-4.5-2. Blood banks regulated.

1. No person or entity may collect blood, blood products, plasma or blood derivatives in the state of Rhode Island for transfusion unless it:
   1. Is licensed as a hospital in the state of Rhode Island; or
   2. 1. Is licensed as a clinical laboratory as defined in §§ 23-16.2 and 23-16.2-4 ; and
      2. Maintains a facility in the state of Rhode Island for the collection, processing and testing of blood, blood products, plasma or blood derivatives, such testing to include all tests required by the food and drug administration regarding testing of donated blood.
2. The director of the Rhode Island department of health shall have the power to issue regulations implementing this section, including the enforcement hereof. Whether or not regulations have been issued, no license may be issued or renewed under subsection (a) hereof except in accordance with the requirements of this chapter.
3. No person or entity licensed as described in subsection (a) hereof may authorize any third party not so licensed to collect blood or blood products on its behalf in the state of Rhode Island, except that those entities as described in subsection (a) may temporarily authorize a qualified third party to collect blood on their behalf should the licensed entity be unable to collect blood to meet emergency needs.

History of Section. P.L. 2013, ch. 266, § 1; P.L. 2013, ch. 360, § 1.

23-4.6-1. Consent to medical and surgical care.

1. Any person of the age of sixteen (16) or over or married may consent to routine, emergency, medical or surgical care. A minor parent may consent to treatment of his or her child.
2. In addition to the provisions of subsection (a), any person, including, but not limited to, a minor who is pregnant, may give effective consent for medical, dental, health, and hospital services relating to prenatal, delivery, and post-delivery care. The attending physician shall comply with § 40-11-3 . Consent shall not be given pursuant to this subsection for abortion or sterilization.

History of Section. P.L. 1971, ch. 145, § 1; G.L. 1956, § 23-51-1 ; P.L. 1979, ch. 39, § 1; G.L. 1956, § 23-4.6-1 ; P.L. 2018, ch. 132, § 1; P.L. 2018, ch. 251, § 1.

23-4.7-1. “Abortion” defined.

“Abortion” for the purpose of this chapter means administering to a woman, known to be pregnant, any medicine, drug, substance, or thing whatever, or the employment upon her of any instrument or means whatever, with intent to terminate a pregnancy. The term shall not include the administering of any medicine, drug, substance, or thing or the employment of any instrument or means for the purpose of completing an incomplete, spontaneous miscarriage.

History of Section. P.L. 1982, ch. 323, § 2.

23-4.7-2. Informed written consent required.

In order to insure that a woman’s consent to abortion is truly informed consent, an abortion shall be performed only after the woman has given her consent, in writing, in a form satisfying the provisions of § 23-4.7-5 .

History of Section. P.L. 1982, ch. 323, § 2.

23-4.7-3. Required disclosures.

1. Either the physician who is to perform the abortion or his or her authorized agent or another physician or his or her authorized agent shall:
   1. Inform the woman that she is pregnant and inform her of the estimated gestational age of the fetus at the time of the disclosure.
   2. Explain to the woman the medical nature of an abortion, including the probable gestational age of the fetus at the time the abortion is to be performed.
   3. Explain to the woman the medical or surgical procedure to be employed to perform the abortion.
   4. Explain to the woman all known material medical risks associated with the particular abortion procedure to be employed. In the event a physician or his or her authorized agent determines that the disclosure of a known material risk should not be made, that risk need not be disclosed, provided the medical basis for the nondisclosure is certified in writing in the patient’s medical record.
2. In addition, a physician or his or her authorized agent may inform the woman of any other material facts or opinions or otherwise state anything with respect to the disclosures required in this section which, in the exercise of his or her best medical judgment, is reasonably necessary to enable the woman to give her informed consent to the proposed abortion, with full knowledge of its nature and consequences.

History of Section. P.L. 1982, ch. 323, § 2.

23-4.7-4. Emergency requiring immediate action.

Where there is an emergency requiring immediate action, the requirements of this chapter may be waived. The woman’s attending physician shall certify in writing in the patient’s medical record that an emergency exists and the medical basis for his or her opinion.

History of Section. P.L. 1982, ch. 323, § 2.

23-4.7-5. Consent form.

1. The woman’s written consent required by § 23-4.7-2 shall be on a form provided by the physician or facility and containing:
   1. The disclosures required by § 23-4.7-3 ; and
   2. The woman’s acknowledgment that either the physician who is to perform the abortion or his or her authorized agent or another physician or his or her authorized agent has provided her with the information required by § 23-4.7-3 .
2. 1. The form shall in addition include the following statement: “If you decide to carry your pregnancy to term but not to keep the child, you may be able to place the child with either a relative, or with another family through foster care or adoption.”
   2. The person making the disclosures required under § 23-4.7-3 shall not be required to state anything with respect to the contents of subdivision (1) of this subsection.
3. In cases where the woman does not understand English, either the consent form shall be written in a language understood by her, or the person informing her shall certify on the consent form that in his or her opinion, the information required to be given by § 23-4.7-3 has been given in a manner as to be understandable by her; if an interpreter is used, the interpreter shall be named and reference to that use shall be made on the consent form.
4. A copy of the form shall be made available to the woman upon her request.

History of Section. P.L. 1982, ch. 323, § 2.

23-4.7-6. Minors — Parental consent — Judicial proceedings.

Except in the case of a minor who has been found by a court of competent jurisdiction to be emancipated, if a pregnant woman is less than eighteen (18) years of age and has not married, an abortion shall not be performed upon her unless both the consent of the pregnant woman and that of at least one of her parents is obtained, except as provided in this section. In deciding whether to grant consent, a pregnant woman’s parents shall consider only their child’s best interests. If both parents have died or are otherwise unavailable to the physician within a reasonable time and in a reasonable manner, consent of the pregnant woman’s legal guardian or one of her guardians shall be sufficient. If a pregnant woman less than eighteen (18) years of age has not married and if neither of her parents or guardians agree to consent to the performance of an abortion, or if she elects not to seek the consent of either of her parents or guardians, a judge of the family court shall, upon petition, or motion, and after an appropriate hearing, authorize a physician to perform the abortion, if the judge determines that the pregnant woman is mature and capable of giving informed consent to the proposed abortion or if the judge determines that she is not mature, but that the performance of an abortion upon her would be in her best interests. A pregnant woman less than eighteen (18) years of age may participate in proceedings in the family court on her own behalf, and she shall be represented in her proceeding by a guardian ad litem. Proceedings in the family court under this section shall be confidential and shall be given such precedence over other pending matters that the court may reach a decision promptly and without delay so as to serve the best interests of the pregnant woman. A judge of the family court who conducts proceedings under this section shall make in writing specific factual findings and legal conclusions supporting his or her decision and shall order a record of the evidence to be maintained including his or her own findings and conclusions.

History of Section. P.L. 1982, ch. 323, § 2.

23-4.7-7. Liability of physician.

Any physician who knowingly violates the requirements of this chapter shall be deemed to have engaged in “unprofessional conduct” for the purposes of § 5-37-5.1 . The willful failure to provide the woman with the substance of the information pursuant to the requirements of § 23-4.7-3 shall be prima facie evidence of failure to obtain informed consent in an action at law or in equity.

History of Section. P.L. 1982, ch. 323, § 2.

23-4.7-8. Severability.

If any section or provision of this chapter or the application of any section or provision is held invalid, that invalidity shall not affect other sections, provisions, or applications, and to this end the sections and provisions of this chapter are declared severable.

History of Section. P.L. 1982, ch. 323, § 2.

23-4.8-1. [Repealed.]

History of Section. P.L. 1982, ch. 325, § 1; Repealed by P.L. 2019, ch. 27, § 5, effective June 19, 2019.

23-4.8-2. [Repealed.]

History of Section. P.L. 1982, ch. 325, § 1; Repealed by P.L. 2019, ch. 27, § 5, effective June 19, 2019.

23-4.8-3. [Repealed.]

History of Section. P.L. 1982, ch. 325, § 1; P.L. 2008, ch. 475, § 37; Repealed by P.L. 2019, ch. 27, § 5, effective June 19, 2019.

23-4.8-4. [Repealed.]

History of Section. P.L. 1982, ch. 325, § 1; Repealed by P.L. 2019, ch. 27, § 5, effective June 19, 2019.

23-4.8-5. [Repealed.]

History of Section. P.L. 1982, ch. 325, § 1; Repealed by P.L. 2019, ch. 27, § 5, effective June 19, 2019.

23-4.9-1. Retention of x-rays by health care providers.

Every physician, surgeon, hospital, health maintenance organization, or any other health care facility or provider that takes a mammography x-ray of any individual within this state shall keep and maintain that mammography x-ray for the life of the individual. Provided, further, however, that any mammography x-ray may be destroyed if the individual has had no contact with the physician, surgeon, hospital, health maintenance organization, or other health care facility or provider for a period exceeding fifteen (15) years.

History of Section. P.L. 1986, ch. 57, § 1.

23-4.10-1. Purpose.

1. The legislature finds that adult persons have the fundamental right to control the decisions relating to the rendering of their own medical care.
2. In order that the rights of patients may be respected even after they are no longer able to participate actively in decisions about themselves, the legislature declares that the laws of the state shall recognize the right of an adult person to make a written durable power of attorney which might include instructing his or her physician to withhold or withdraw life-sustaining procedures in the event of a terminal condition.

History of Section. P.L. 1992, ch. 443, § 2; P.L. 1993, ch. 72, § 1.

23-4.10-1.1. Definitions.

The following definitions govern the construction of this chapter:

1. “Advance directive protocol” means a standardized, state-wide method developed for emergency service personnel by the department of health and approved by the ambulance service advisory board, of providing palliative care to, and withholding life-sustaining procedures from, a qualified patient.
2. “Artificial feeding” means the provision of nutrition or hydration by parenteral, nasogastric, gastric, or any means other than through per oral voluntary sustenance.
3. “Attending physician” means the physician who has primary responsibility for the treatment and care of the patient.
4. “Director” means the director of health.
5. “Durable power of attorney” means a witnessed document executed in accordance with the requirements of § 23-4.10-2 .
6. “Emergency medical services personnel” means paid or volunteer firefighters, law enforcement officers, first responders, emergency medical technicians, or other emergency services personnel acting within the ordinary course of their professions.
7. “Health-care provider” means a person who is licensed, certified, or otherwise authorized by the law of this state to administer health care in the ordinary course of business or practice of a profession.
8. “Life-sustaining procedure” means any medical procedure or intervention that, when administered to a patient, will serve only to prolong the dying process. “Life-sustaining procedure” shall not include any medical procedure or intervention considered necessary by the attending physician or emergency service personnel to provide comfort, care, or alleviate pain.
9. “Person” means an individual, corporation, business trust, estate, trust, partnership, association, government, governmental subdivision or agency, or any other legal entity.
10. “Physician and/or doctor” means an individual licensed to practice medicine in this state.
11. “Terminal condition” means an incurable or irreversible condition that, without the administration of life-sustaining procedures, will, in the opinion of the attending physician, result in death.

History of Section. P.L. 1992, ch. 443, § 2; P.L. 1993, ch. 72, § 1; P.L. 2001, ch. 140, § 1; P.L. 2001, ch. 320, § 1.

23-4.10-2. Statutory form of durable power of attorney.

The statutory form of durable power of attorney is as follows:

STATUTORY FORM DURABLE POWER OF ATTORNEY FOR HEALTH CARE WARNING TO PERSON EXECUTING THIS DOCUMENT This is an important legal document which is authorized by the general laws of this state. Before executing this document, you should know these important facts: You must be at least eighteen (18) years of age and a resident of the state for this document to be legally valid and binding. This document gives the person you designate as your agent (the attorney in fact) the power to make health care decisions for you. Your agent must act consistently with your desires as stated in this document or otherwise made known. Except as you otherwise specify in this document, this document gives your agent the power to consent to your doctor not giving treatment or stopping treatment necessary to keep you alive. Notwithstanding this document, you have the right to make medical and other health care decisions for yourself so long as you can give informed consent with respect to the particular decision. In addition, no treatment may be given to you over your objection at the time, and health care necessary to keep you alive may not be stopped or withheld if you object at the time. This document gives your agent authority to consent, to refuse to consent, or to withdraw consent to any care, treatment, service, or procedure to maintain, diagnose, or treat a physical or mental condition. This power is subject to any statement of your desires and any limitation that you include in this document. You may state in this document any types of treatment that you do not desire. In addition, a court can take away the power of your agent to make health care decisions for you if your agent: (1) Authorizes anything that is illegal, (2) Acts contrary to your known desires, or (3) Where your desires are not known, does anything that is clearly contrary to your best interests. Unless you specify a specific period, this power will exist until you revoke it. Your agent’s power and authority ceases upon your death except to inform your family or next of kin of your desire, if any, to be an organ and tissue owner. You have the right to revoke the authority of your agent by notifying your agent or your treating doctor, hospital, or other health care provider orally or in writing of the revocation. Your agent has the right to examine your medical records and to consent to their disclosure unless you limit this right in this document. This document revokes any prior durable power of attorney for health care. You should carefully read and follow the witnessing procedure described at the end of this form. This document will not be valid unless you comply with the witnessing procedure. If there is anything in this document that you do not understand, you should ask a lawyer to explain it to you. Your agent may need this document immediately in case of an emergency that requires a decision concerning your health care. Either keep this document where it is immediately available to your agent and alternate agents or give each of them an executed copy of this document. You may also want to give your doctor an executed copy of this document. (1) DESIGNATION OF HEALTH CARE AGENT.I, (insert your name and address) do hereby designate and appoint: (insert name, address, and telephone number of one individual only as your agent to make health care decisions for you. None of the following may be designated as your agent: (1) your treating health care provider, (2) a nonrelative employee of your treating health care provider, (3) an operator of a community care facility, or (4) a nonrelative employee of an operator of a community care facility.) as my attorney in fact (agent) to make health care decisions for me as authorized in this document. For the purposes of this document, “health care decision” means consent, refusal of consent, or withdrawal of consent to any care, treatment, service, or procedure to maintain, diagnose, or treat an individual’s physical or mental condition. (2) CREATION OF DURABLE POWER OF ATTORNEY FOR HEALTH CARE. By this document I intend to create a durable power of attorney for health care. (3) GENERAL STATEMENT OF AUTHORITY GRANTED. Subject to any limitations in this document, I hereby grant to my agent full power and authority to make health care decisions for me to the same extent that I could make such decisions for myself if I had the capacity to do so. In exercising this authority, my agent shall make health care decisions that are consistent with my desires as stated in this document or otherwise made known to my agent, including, but not limited to, my desires concerning obtaining or refusing or withdrawing life-prolonging care, treatment, services, and procedures and informing my family or next of kin of my desire, if any, to be an organ or tissue donor. (If you want to limit the authority of your agent to make health care decisions for you, you can state the limitations in paragraph (4) (“Statement of Desires, Special Provisions, and Limitations”) below. You can indicate your desires by including a statement of your desires in the same paragraph.) (4) STATEMENT OF DESIRES, SPECIAL PROVISIONS, AND LIMITATIONS. (Your agent must make health care decisions that are consistent with your known desires. You can, but are not required to, state your desires in the space provided below. You should consider whether you want to include a statement of your desires concerning life-prolonging care, treatment, services, and procedures. You can also include a statement of your desires concerning other matters relating to your health care. You can also make your desires known to your agent by discussing your desires with your agent or by some other means. If there are any types of treatment that you do not want to be used, you should state them in the space below. If you want to limit in any other way the authority given your agent by this document, you should state the limits in the space below. If you do not state any limits, your agent will have broad powers to make health care decisions for you, except to the extent that there are limits provided by law.) In exercising the authority under this durable power of attorney for health care, my agent shall act consistently with my desires as stated below and is subject to the special provisions and limitations stated below: (a) Statement of desires concerning life-prolonging care, treatment, services, and procedures: (b) Additional statement of desires, special provisions, and limitations regarding health care decisions: (c) Statement of desire regarding organ and tissue donation: Initial if applicable: [ ] In the event of my death, I request that my agent inform my family/next of kin of my desire to be an organ and tissue donor, if possible. (You may attach additional pages if you need more space to complete your statement. If you attach additional pages, you must date and sign EACH of the additional pages at the same time you date and sign this document.) (5) INSPECTION AND DISCLOSURE OF INFORMATION RELATING TO MY PHYSICAL OR MENTAL HEALTH. Subject to any limitations in this document, my agent has the power and authority to do all of the following: (a) Request, review, and receive any information, verbal or written, regarding my physical or mental health, including, but not limited to, medical and hospital records. (b) Execute on my behalf any releases or other documents that may be required in order to obtain this information. (c) Consent to the disclosure of this information. (If you want to limit the authority of your agent to receive and disclose information relating to your health, you must state the limitations in paragraph (4) (“Statement of desires, special provisions, and limitations”) above.) (6) SIGNING DOCUMENTS, WAIVERS, AND RELEASES. Where necessary to implement the health care decisions that my agent is authorized by this document to make, my agent has the power and authority to execute on my behalf all of the following: (a) Documents titled or purporting to be a “Refusal to Permit Treatment” and “Leaving Hospital Against Medical Advice.” (b) Any necessary waiver or release from liability required by a hospital or physician. (7) DURATION. (Unless you specify a shorter period in the space below, this power of attorney will exist until it is revoked.) This durable power of attorney for health care expires on (Fill in this space ONLY if you want the authority of your agent to end on a specific date.) (8) DESIGNATION OF ALTERNATE AGENTS. (You are not required to designate any alternate agents but you may do so. Any alternate agent you designate will be able to make the same health care decisions as the agent you designated in paragraph (1), above, in the event that agent is unable or ineligible to act as your agent. If the agent you designated is your spouse, he or she becomes ineligible to act as your agent if your marriage is dissolved.) If the person designated as my agent in paragraph (1) is not available or becomes ineligible to act as my agent to make a health care decision for me or loses the mental capacity to make health care decisions for me, or if I revoke that person’s appointment or authority to act as my agent to make health care decisions for me, then I designate and appoint the following persons to serve as my agent to make health care decisions for me as authorized in this document, such persons to serve in the order listed below: (A) First Alternate Agent: (Insert name, address, and telephone number of first alternate agent.) (B) Second Alternate Agent: (Insert name, address, and telephone number of second alternate agent.) (9) PRIOR DESIGNATIONS REVOKED. I revoke any prior durable power of attorney for health care. DATE AND SIGNATURE OF PRINCIPAL (YOU MUST DATE AND SIGN THIS POWER OF ATTORNEY) I sign my name to this Statutory Form Durable Power of Attorney for Health Care on at (Date) (City) (State) (You sign here) (THIS POWER OF ATTORNEY WILL NOT BE VALID UNLESS IT IS SIGNED BY ONE NOTARY PUBLIC OR TWO (2) QUALIFIED WITNESSES WHO ARE PRESENT WHEN YOU SIGN OR ACKNOWLEDGE YOUR SIGNATURE. IF YOU HAVE ATTACHED ANY ADDITIONAL PAGES TO THIS FORM, YOU MUST DATE AND SIGN EACH OF THE ADDITIONAL PAGES AT THE SAME TIME YOU DATE AND SIGN THIS POWER OF ATTORNEY.) STATEMENT OF WITNESSES (This document must be witnessed by two (2) qualified adult witnesses or one (1) notary public. None of the following may be used as a witness: (1) A person you designate as your agent or alternate agent, (2) A health care provider, (3) An employee of a health care provider, (4) The operator of a community care facility, (5) An employee of an operator of a community care facility. I declare under penalty of perjury that the person who signed or acknowledged this document is personally known to me to be the principal, that the principal signed or acknowledged this durable power of attorney in my presence, that the principal appears to be of sound mind and under no duress, fraud, or undue influence, that I am not the person appointed as attorney in fact by this document, and that I am not a health care provider, an employee of a health care provider, the operator of a community care facility, nor an employee of an operator of a community care facility. Option 1 — Two (2) Qualified Witnesses: Signature: Residence Address: Print Name: Date: Signature: Residence Address: Print Name: Date: Option 2 — One Notary Public Signature: , Notary Public Print Name: Date: My commission expires on: (AT LEAST ONE OF THE ABOVE WITNESSES OR THE NOTARY PUBLIC MUST ALSO SIGN THE FOLLOWING DECLARATION.) I further declare under penalty of perjury that I am not related to the principal by blood, marriage, or adoption, and, to the best of my knowledge, I am not entitled to any part of the estate of the principal upon the death of the principal under a will now existing or by operation of law. Signature: Print Name:

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History of Section. P.L. 1986, ch. 190, § 1; P.L. 1989, ch. 291, § 1; P.L. 2000, ch. 261, § 1; P.L. 2002, ch. 334, § 1; P.L. 2006, ch. 604, § 1.

23-4.10-3. Revocation.

1. A durable power of attorney may be revoked at any time and in any manner by which the declarant is able to communicate an intent to revoke, without regard to mental or physical condition. A revocation is only effective as to the attending physician or any health care provider or emergency medical services personnel upon communication to that physician or health care provider or emergency medical services personnel by the declarant or by another who witnessed the revocation.
2. The attending physician or health care provider shall make the revocation a part of the declarant’s medical record.
3. For emergency medical services personnel, the absence of reliable documentation shall constitute a revocation of a durable power of attorney.

History of Section. P.L. 1992, ch. 443, § 2.

23-4.10-4. Recording contents of durable power of attorney.

The attending physician who had knowledge of the existence of a durable power of attorney shall note in the medical record the existence of the durable power of attorney. In the instance where the durable power of attorney includes a DNR (do not resuscitate) order, that should also be entered into the medical record.

History of Section. P.L. 1992, ch. 443, § 2; P.L. 1993, ch. 72, § 1.

23-4.10-5. Treatment of patients.

1. A patient has the right to make decisions regarding use of life sustaining procedures as long as the patient is able to do so. If a patient is not able to make those decisions, the durable power of attorney governs decisions regarding use of life sustaining procedures.
2. This chapter does not prohibit any action considered necessary by the attending physician, health care provider, or emergency medical services personnel for comfort, care, or alleviation of pain.
3. The durable power of attorney of a patient known to the attending physician to be pregnant shall be given no force or effect as long as it is probable that the fetus could develop to the point of live birth with continued application of life sustaining procedures.

History of Section. P.L. 1992, ch. 443, § 2; P.L. 1993, ch. 72, § 1.

23-4.10-6. Transfer of patients.

An attending physician or health-care provider who refuses to comply with the durable power of attorney of a patient pursuant to this chapter shall make the necessary arrangements to effect the transfer of the patient to another physician who will effectuate the durable power of attorney of the patient.

History of Section. P.L. 1992, ch. 443, § 2; P.L. 1993, ch. 72, § 1.

23-4.10-7. Immunities.

1. In the absence of actual notice of the revocation of a durable power of attorney, the following, while acting in accordance with the requirements of this chapter, are not subject to civil or criminal liability or charges of unprofessional conduct:
   1. A physician who acts pursuant to the terms of a durable power of attorney or at the direction of the agent so designated by a durable power of attorney.
   2. A person who acts under the direction or with the authorization of a physician.
   3. The health-care provider owning or operating the facility in which the terms of durable power of attorney are implemented.
   4. Emergency medical services personnel who act pursuant to an advanced directive protocol.
   5. Emergency medical services personnel who proceed to provide life-sustaining treatment to a patient pursuant to a revocation communicated to them.
   6. An agent acting in accordance with a valid durable power of attorney.
2. A physician is not subject to civil or criminal liability for actions under this chapter which are in accordance with reasonable medical standards.

History of Section. P.L. 1992, ch. 443, § 2; P.L. 1993, ch. 72, § 1; P.L. 1993, ch. 422, § 5; P.L. 1994, ch. 14, § 5.

23-4.10-8. Penalties.

1. Failure of a physician to transfer a patient pursuant to § 23-4.10-6 shall constitute “unprofessional conduct” as that term is used in § 5-37-5.1 .
2. Any person who willfully conceals, cancels, defaces, or obliterates the durable power of attorney of another absent the declarant’s consent or direction or who falsifies or forges a revocation of the durable power of attorney of another shall be imprisoned for no less than six (6) months but no more than one year, or shall be fined not less than two thousand dollars ($2,000) but no more than five thousand dollars ($5,000).
3. Any person who falsifies or forges the durable power of attorney of another, or willfully conceals or withholds personal knowledge of a revocation as provided in § 23-4.10-3 with the intent to cause a withholding or withdrawal of life sustaining procedures, shall be imprisoned for no less than one year but no more than five (5) years, or shall be fined not less than five thousand dollars ($5,000) but no more than ten thousand dollars ($10,000).
4. In addition to the sanctions and/or penalties previously mentioned in this section, any physician or person referred to in this section or in violation of this section, shall be civilly liable.

History of Section. P.L. 1992, ch. 443, § 2; P.L. 1993, ch. 72, § 1.

23-4.10-9. General provisions.

1. Death resulting from the withholding or withdrawal of life-sustaining procedures pursuant to a durable power of attorney and in accordance with this chapter does not constitute, for any purpose, a suicide or homicide.
2. The making of a durable power of attorney pursuant to § 23-4.10-3 does not affect in any manner the sale, procurement, or issuance of any policy of life insurance, nor does it modify the terms of an existing policy of life insurance. A policy of life insurance is not legally impaired or invalidated in any manner by the withholding or withdrawal of life-sustaining procedures from an insured qualified patient, notwithstanding any term of the policy to the contrary.
3. A person may not prohibit or require the execution of a durable power of attorney as a condition for being insured for, or receiving, health care services.
4. This chapter creates no presumption concerning the intention of an individual who has revoked or has not executed a durable power of attorney with respect to the use, withholding, or withdrawal of life-sustaining procedures in the event of a terminal condition.
5. This chapter does not increase or decrease the right of a patient to make decisions regarding use of life-sustaining procedures so long as the patient is able to do so, or impair or supersede any right or responsibility that any person has to effect the withholding or withdrawal of medical care.
6. This chapter does not condone, authorize, or approve mercy-killing or euthanasia.

History of Section. P.L. 1992, ch. 443, § 2.

23-4.10-10. Presumption of validity of durable power of attorney.

A physician or health care provider or emergency medical services personnel may presume, in the absence of actual notice to the contrary, that a durable power of attorney complies with the requirements of this chapter and is valid.

History of Section. P.L. 1992, ch. 443, § 2.

23-4.10-11. Recognition of durable power of attorney executed in another state.

A durable power of attorney executed in another state in compliance with the law of that state is validly executed for purposes of this chapter.

History of Section. P.L. 1992, ch. 443, § 2.

23-4.10-12. Severability.

If any provision of this chapter or its application to any person or circumstance is held invalid, the invalidity does not affect other provisions or applications of this chapter which can be given effect without the invalid provision or application, and to this end the provisions of this chapter are severable.

History of Section. P.L. 1992, ch. 443, § 2.

23-4.11-1. Purpose.

1. The legislature finds that adult persons have the fundamental right to control the decisions relating to the rendering of their own medical care, including the decision to have life sustaining procedures withheld or withdrawn in instances of a terminal condition.
2. In order that the rights of patients may be respected even after they are no longer able to participate actively in decisions about themselves, the legislature declares that the laws of the state shall recognize the right of an adult person to make a written declaration instructing his or her physician to withhold or withdraw life sustaining procedures in the event of a terminal condition.

History of Section. P.L. 1991, ch. 166, § 1; P.L. 1991, ch. 308, § 1.

23-4.11-2. Definitions.

The following definitions govern the construction of this chapter:

1. “Advance directive protocol” means a standardized, state-wide method developed for emergency medical services personnel by the department of health and approved by the ambulance service advisory board, of providing palliative care to, and withholding life-sustaining procedures from, a qualified patient.
2. “Artificial feeding” means the provision of nutrition or hydration by parenteral, nasogastric, gastric or any means other than through per oral voluntary sustenance.
3. “Attending physician” means the physician who has primary responsibility for the treatment and care of the patient.
4. “Declaration” means a witnessed document executed in accordance with the requirements of § 23-4.11-3 or § 23-4.11-3 .1.
5. “Director” means the director of health.
6. “Emergency medical services personnel” means paid or volunteer firefighters, law enforcement officers, first responders, emergency medical technicians, or other emergency services personnel acting within the ordinary course of their professions.
7. “Healthcare decision maker” means a person authorized by law or by the qualified patient to make healthcare decisions for the qualified patient. The qualified patient may revoke at any time and in any manner the appointment of a healthcare decision maker.
8. “Healthcare provider” means a person who is licensed, certified, or otherwise authorized by the law of this state to administer health care in the ordinary course of business or practice of a profession.
9. “Life sustaining procedure” means any medical procedure or intervention that, when administered to a qualified patient, will serve only to prolong the dying process. “Life sustaining procedure” shall not include any medical procedure or intervention considered necessary by the attending physician to provide comfort and care or alleviate pain.
10. “Medical orders for life sustaining treatment” or “MOLST” means a voluntary request that directs a healthcare provider regarding resuscitative and life-sustaining measures.
11. “Medical orders for life sustaining treatment form” or “MOLST Form” means a document which directs healthcare providers regarding resuscitative and life-sustaining measures.
12. “MOLST qualified healthcare provider” means the physician, registered nurse practitioner, or physician assistant who is authorized by the patient to sign a MOLST form.
13. “Physician assistant” shall mean a person licensed as a physician assistant under chapter 54 of title 5.
14. “Person” means an individual, corporation, business trust, estate, trust, partnership, association, government, governmental subdivision or agency, or any other legal entity.
15. “Physician” means an individual licensed to practice medicine under § 5-37-1(13) .
16. “Qualified patient” means a patient who has executed a declaration in accordance with this chapter and who has been determined by the attending physician to be in a terminal condition.
17. “Registered nurse practitioner” shall mean a person licensed as such under chapter 34 of title 5.
18. “Reliable documentation” means a standardized, state-wide form of identification such as a nontransferable necklace or bracelet of uniform design, adopted by the director of health, with consultation from the local community emergency medical services agencies and licensed hospice and home health agencies, that signifies and certifies that a valid and current declaration is on file and that the individual is a qualified patient.
19. “Request regarding resuscitative and life sustaining measures” means a written document, signed by:
    1. A qualified patient with capacity, or a recognized healthcare decision maker; and
    2. The MOLST qualified healthcare provider, which directs a healthcare provider regarding resuscitative and life sustaining measures. Such a request regarding resuscitative and life sustaining measures is a medical order.
20. “Terminal condition” means an incurable or irreversible condition that, without the administration of life sustaining procedures, will, in the opinion of the attending physician, result in death.

History of Section. P.L. 1991, ch. 166, § 1; P.L. 1991, ch. 308, § 1; P.L. 1992, ch. 324, § 5; P.L. 1992, ch. 443, § 3; P.L. 1998, ch. 337, § 1; P.L. 2012, ch. 187, § 1; P.L. 2012, ch. 199, § 1.

23-4.11-3. Declaration relating to use of life sustaining procedures.

1. A competent individual eighteen (18) years of age or older may at any time execute a declaration governing the withholding or withdrawal of life sustaining procedures. The declaration must be signed by the declarant, or another at the declarant’s direction in the presence of two (2) subscribing witnesses who are not related to the declarant by blood or marriage.
2. A physician or other health care provider who is provided a copy of the declaration shall make it a part of the declarant’s medical record.
3. A declaration has operative effect only when:
   1. The declaration is communicated to the attending physician;
   2. The declarant is determined by the attending physician to be in a terminal condition; and
   3. The declarant is unable to make treatment decisions.
4. A declaration may, but need not, be in the following form:

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DECLARATION I, , being of sound mind willfully and voluntarily make known my desire that my dying shall not be artificially prolonged under the circumstances set forth below, do hereby declare: If I should have an incurable or irreversible condition that will cause my death and if I am unable to make decisions regarding my medical treatment, I direct my attending physician to withhold or withdraw procedures that merely prolong the dying process and are not necessary to my comfort, or to alleviate pain. This authorization includes ( ) does not include ( ) the withholding or withdrawal of artificial feeding (check only one box above). Signed this day of , . Signature Address The declarant is personally known to me and voluntarily signed this document in my presence. WitnessWitness AddressAddress

History of Section. P.L. 1991, ch. 166, § 1; P.L. 1991, ch. 308, § 1; P.L. 2001, ch. 140, § 2; P.L. 2001, ch. 320, § 2.

23-4.11-3.1. Medical orders for life sustaining treatment.

1. The department of health shall establish rules and regulations, consistent with the provisions of this section, for the establishment of Medical Orders for Life Sustaining Treatment and the structure and content of Medical Orders for Life Sustaining Treatment forms.
2. 1. A declaration by a qualified patient may be recorded as a medical order for life-sustaining treatment provided that:
      1. The medical orders for life-sustaining treatment and medical intervention and procedures are explained by a MOLST qualified healthcare provider to the qualified patient or healthcare decision maker. The MOLST qualified healthcare provider shall further inform the patient of the difference between an advance healthcare directive and MOLST medical order;
      2. A MOLST qualified healthcare provider has conducted an evaluation of the qualified patient; and
      3. A MOLST form documenting the declaration has been completed by a MOLST qualified healthcare provider based on qualified patient preferences and medical appropriateness, and has been signed by a MOLST qualified healthcare provider and the qualified patient or his or her recognized healthcare decision maker.
   2. A healthcare decision maker may execute the MOLST form if the qualified patient lacks capacity, or if the qualified patient has designated that the healthcare decision maker’s authority is valid.
   3. A request regarding resuscitative measures may also be evidenced by the words “do not resuscitate” or the letters “DNR,” in a qualified patient’s medical record and/or through a mechanism established by the department of health consistent with the provisions of chapter 23-4.11.
3. 1. A healthcare provider shall treat a qualified patient in accordance with the qualified patient’s MOLST, subject to the provisions of this chapter.
   2. A MOLST qualified healthcare provider may conduct an evaluation of the qualified patient and if necessary, in consultation with the qualified patient or recognized healthcare decision maker, issue a new MOLST consistent with the most current information available about the qualified patient’s health status and care preferences.
   3. The recognized healthcare decision maker of a qualified patient who is without capacity shall consult with the MOLST qualified healthcare provider prior to making a request to modify the qualified patient’s MOLST.
4. 1. MOLST Form.  A MOLST shall be documented on an easily identifiable form approved by the director. The director shall promulgate rules and regulations for the implementation of this section.
   2. The MOLST form shall be signed by the qualified patient, or the qualified patient’s recognized healthcare decision maker, and a MOLST qualified healthcare provider.
   3. The MOLST form shall contain all other information as required by this section.
5. 1. A MOLST shall apply regardless of whether the qualified patient executes the MOLST form within or outside a hospital or other healthcare setting.
   2. The MOLST form is valid within or outside a hospital or other healthcare setting.
6. 1. Revocation.  A qualified patient or his/her recognized healthcare decision maker may, at any time, revoke in any manner that communicates an intent to revoke his/her declaration by informing the MOLST qualified healthcare providers, other healthcare providers, or any member of the medical or nursing staff of the revocation of the declaration concerning life-sustaining or resuscitative measures.
   2. Any member of the medical or nursing staff informed of a revocation shall immediately notify a MOLST qualified healthcare provider of the revocation.
   3. The MOLST qualified healthcare provider informed of a revocation of MOLST made pursuant to this section shall immediately:
      1. Record the revocation in the qualified patient’s medical record;
      2. Cancel any orders implementing the decision to withhold or withdraw treatment; and
      3. Notify the healthcare providers and staff directly responsible for the qualified patient’s care of the revocation and any cancellations.
   4. If a decision to withhold or withdraw life-sustaining treatment has been made by a recognized healthcare decision maker pursuant to this section, and the MOLST qualified healthcare provider determines at any time that the decision is no longer appropriate or authorized because the qualified patient has regained decision-making capacity or because the qualified patient’s condition has otherwise improved, the MOLST qualified healthcare provider shall immediately:
      1. Include such determination in the qualified patient’s medical record;
      2. Cancel any orders or plans of care implementing the decision to withhold or withdraw life-sustaining treatment;
      3. Notify the healthcare decision maker who made the decision to withhold or withdraw treatment; and
      4. Notify the other healthcare providers, including the medical and nursing staff directly responsible for the qualified patient’s care, of any cancelled MOLST orders or plans of care.
7. If a qualified patient with a MOLST order is transferred from a hospital, a licensed health facility, or the community, the MOLST order or plan shall remain effective until a MOLST qualified healthcare provider first examines the transferred qualified patient, whereupon a MOLST qualified healthcare provider shall issue appropriate orders to continue the prior order or plan. Such orders may be issued without obtaining another consent to withhold or withdraw life-sustaining treatment pursuant to this chapter.
8. The MOLST is a voluntary option for qualified patients.  No patient is required to elect a MOLST.

History of Section. P.L. 2012, ch. 187, § 2; P.L. 2012, ch. 199, § 2; P.L. 2013, ch. 501, § 4.

23-4.11-4. Revocation of declaration.

1. 1. A declaration may be revoked at any time and in any manner by which the declarant is able to communicate an intent to revoke, without regard to mental or physical condition. A revocation is only effective as to the attending physician or any health care provider upon communication to that physician or health care provider by the declarant or by another who witnessed the revocation.
   2. The attending physician or health care provider shall make the revocation a part of the declarant’s medical record.
   3. If there is an inconsistency between a declaration executed pursuant to this chapter and a durable health care power of attorney executed pursuant to chapter 4.10 of this title, both of which have been executed by the same person, the latter executed document shall control as to any inconsistent provision.
   4. For emergency medical services personnel, absence of reliable documentation as defined in § 23-4.11-2(6) shall constitute a revocation of the declaration.
2. A revocation is only effective as to the attending physician or any health care provider or emergency medical services personnel upon communication to that physician health care provider or emergency medical services personnel by the declarant or by another who witnessed the revocation.

History of Section. P.L. 1991, ch. 166, § 1; P.L. 1991, ch. 308, § 1; P.L. 1992, ch. 443, § 3.

23-4.11-5. Recording determination of terminal condition and contents of declaration.

Upon determining that the declarant is in a terminal condition, the attending physician who has notice of a declaration shall record the determination and the substance of the declaration in the declarant’s medical record.

History of Section. P.L. 1991, ch. 166, § 1; P.L. 1991, ch. 308, § 1.

23-4.11-6. Treatment of qualified patients.

1. A qualified patient has the right to make decisions regarding use of life sustaining procedures as long as the patient is able to do so. If a qualified patient is not able to make those decisions, the declaration governs decisions regarding use of life sustaining procedures.
2. This chapter does not prohibit any action considered necessary by the attending physician for comfort and care or alleviation of pain.
3. The declaration of a qualified patient known to the attending physician to be pregnant shall be given no force or effect as long as it is probable that the fetus could develop to the point of live birth with continued application of life sustaining procedures.

History of Section. P.L. 1991, ch. 166, § 1; P.L. 1991, ch. 308, § 1; P.L. 1992, ch. 324, § 5.

23-4.11-7. Transfer of patients.

An attending physician or health care provider who refuses to comply with the declaration of a qualified patient pursuant to this chapter shall make the necessary arrangements to effect the transfer of the qualified patient to another physician who will effectuate the declaration of the qualified patient.

History of Section. P.L. 1991, ch. 166, § 1; P.L. 1991, ch. 308, § 1.

23-4.11-8. Immunities.

1. In the absence of actual notice of the revocation of a declaration, the following, while acting in accordance with the requirements of this chapter, are not subject to civil or criminal liability or charges of unprofessional conduct:
   1. A physician who causes the withholding or withdrawal of life sustaining procedures from a qualified patient.
   2. A person who participates in the withholding or withdrawal of life sustaining procedures under the direction or with the authorization of a physician.
   3. The health care provider owning or operating the facility in which the withholding or withdrawal occurs.
   4. Emergency medical services personnel who cause or participate in the withholding or withdrawal of life-sustaining procedures under the direction of or with the authorization of a physician or who on receipt of reliable documentation follow an advance directive protocol.
   5. Emergency medical services personnel who proceed to provide life-sustaining treatment to a qualified patient pursuant to a revocation communicated to them.
2. A physician is not subject to civil or criminal liability for actions under this chapter which are in accordance with reasonable medical standards.

History of Section. P.L. 1991, ch. 166, § 1; P.L. 1991, ch. 308, § 1; P.L. 1992, ch. 443, § 3.

23-4.11-9. Penalties.

1. Failure of a physician to transfer a patient pursuant to § 23-4.11-7 shall constitute “unprofessional conduct” as that term is used in § 5-37-5.1 .
2. Failure of a physician to record the determination of terminal condition pursuant to § 23-4.11-5 shall constitute “unprofessional conduct” as that term is used in § 5-37-5.1 .
3. Any person who willfully conceals, cancels, defaces, or obliterates the declaration of another absent the declarant’s consent or direction or who falsifies or forges a revocation of the declaration of another shall be imprisoned for no less than six (6) months but no more than one year, or shall be fined not less than two thousand dollars ($2,000) but no more than five thousand dollars ($5,000).
4. Any person who falsifies or forges the declaration of another, or willfully conceals or withholds personal knowledge of a revocation as provided in § 23-4.11-4 with the intent to cause a withholding or withdrawal of life sustaining procedures, shall be imprisoned for no less than one year but no more than five (5) years, or shall be fined not less than five thousand dollars ($5,000) but no more than ten thousand dollars ($10,000).
5. In addition to the sanctions and/or penalties mentioned in this section, any physician or person referred to in this section or in violation of this section, shall be civilly liable.

History of Section. P.L. 1991, ch. 166, § 1; P.L. 1991, ch. 308, § 1.

23-4.11-10. General provisions.

1. Death resulting from the withholding or withdrawal of life sustaining procedures pursuant to a declaration and in accordance with this chapter does not constitute, for any purpose, a suicide or homicide.
2. The making of a declaration pursuant to § 23-4.11-3 does not affect in any manner the sale, procurement, or issuance of any policy of life insurance, nor does it modify the terms of an existing policy of life insurance. A policy of life insurance is not legally impaired or invalidated in any manner by the withholding or withdrawal of life sustaining procedures from an insured qualified patient, notwithstanding any term of the policy to the contrary.
3. A person may not prohibit or require the execution of a declaration as a condition for being insured for, or receiving, health care services.
4. This chapter creates no presumption concerning the intention of an individual who has revoked or has not executed a declaration with respect to the use, withholding or withdrawal of life sustaining procedures in the event of a terminal condition.
5. This chapter does not increase or decrease the right of a patient to make decisions regarding use of life sustaining procedures so long as the patient is able to do so, or impair or supersede any right or responsibility that any person has to effect the withholding or withdrawal of medical care.
6. This chapter does not condone, authorize, or approve mercy killing or euthanasia.

History of Section. P.L. 1991, ch. 166, § 1; P.L. 1991, ch. 308, § 1; P.L. 1992, ch. 443, § 3.

23-4.11-11. Presumption of validity of declaration.

A physician or health care provider or emergency medical services personnel may presume, in the absence of actual notice to the contrary, that a declaration complies with the requirements of this chapter and is valid.

History of Section. P.L. 1991, ch. 166, § 1; P.L. 1991, ch. 308, § 1; P.L. 1992, ch. 443, § 3.

23-4.11-12. Recognition of declaration executed in another state.

A declaration executed in another state in compliance with the law of that state is validly executed for purposes of this chapter.

History of Section. P.L. 1991, ch. 166, § 1; P.L. 1991, ch. 308, § 1.

23-4.11-13. Repealed.

23-4.11-14. Instructional bracelets.

1. Upon the request of a physician, acting on behalf of a qualified patient who does not wish to be resuscitated, the department of health shall issue a nontransferable, nonremovable bracelet to a specific qualified patient, which will be marked “DNR”, meaning “do not resuscitate”. The bracelet shall also bear the name and address of the patient and the name, address, license number and signature of the physician who has ordered the bracelet to be affixed to the patient’s wrist.
2. If it appears that the bracelet has been tampered with, or has been removed, any physician or emergency medical personnel shall not follow the instructions of the bracelet or former bracelet and may resuscitate the patient.
3. All bracelets issued by the department of health pursuant to this section shall be registered with the fire department for the city or town in which the patient resides.
4. The director of the department of health is empowered and directed to promulgate reasonable rules and regulations consistent with this chapter to carry out the purposes of this section.

History of Section. P.L. 1992, ch. 443, § 4; P.L. 2001, ch. 291, § 1.

23-4.11-15. Severability.

If any provision of this chapter or its application to any person or circumstances is held invalid, the invalidity does not affect other provisions or applications of this chapter which can be given effect without the invalid provision or application, and to this end the provisions of this chapter are severable.

History of Section. P.L. 2001, ch. 86, § 67.

23-4.12-1. [Repealed.]

History of Section. P.L. 1997, ch. 76, § 2; P.L. 1998, ch. 305, § 1; Repealed by P.L. 2019, ch. 27, § 6, effective June 19, 2019.

23-4.12-2. [Repealed.]

History of Section. P.L. 1997, ch. 76, § 2; Repealed by P.L. 2019, ch. 27, § 6, effective June 19, 2019.

23-4.12-3. [Repealed.]

History of Section. P.L. 1997, ch. 76, § 2; Repealed by P.L. 2019, ch. 27, § 6, effective June 19, 2019.

23-4.12-4. [Repealed.]

History of Section. P.L. 1997, ch. 76, § 2; Repealed by P.L. 2019, ch. 27, § 6, effective June 19, 2019.

23-4.12-5. [Repealed.]

History of Section. P.L. 1997, ch. 76, § 2; P.L. 1998, ch. 305, § 1; Repealed by P.L. 2019, ch. 27, § 6, effective June 19, 2019.

23-4.12-6. [Repealed.]

History of Section. P.L. 1997, ch. 76, § 2; Repealed by P.L. 2019, ch. 27, § 6, effective June 19, 2019.

23-4.13-1. Short title.

This chapter shall be known and may be cited as the “Reproductive Privacy Act.”

History of Section. P.L. 2019, ch. 27, § 1.

23-4.13-2. Noninterference in reproductive health care.

1. Neither the state, nor any of its agencies, or political subdivisions shall:
   1. Restrict an individual person from preventing, commencing, continuing, or terminating that individual’s pregnancy prior to fetal viability;
   2. Interfere with an individual person’s decision to continue that individual’s pregnancy after fetal viability;
   3. Restrict an individual person from terminating that individual’s pregnancy after fetal viability when necessary to preserve the health or life of that individual;
   4. Restrict the use of evidence-based, medically recognized methods of contraception or abortion except in accordance with evidence-based medically appropriate standards that are in compliance with state and federal statutes enumerated in subsections (c)(1) and (c)(2), department of health regulations and standards referenced in subsection (c)(3), and subsection (d); or
   5. Restrict access to evidence-based, medically recognized methods of contraception or abortion or the provision of such contraception or abortion except in accordance with evidence-based medically appropriate standards that are in compliance with state and federal statutes enumerated in subsections (c)(1) and (c)(2), department of health regulations and standards referenced in subsection (c)(3), and subsection (d).
2. For purposes of this section, “fetal viability” means that stage of gestation where the attending physician, taking into account the particular facts of the case, has determined that there is a reasonable likelihood of the fetus’ sustained survival outside of the womb with or without artificial support.
3. Notwithstanding the foregoing, this section shall not be construed to:
   1. Abrogate the provisions of §§ 11-9-18 titled “Care of babies born alive during attempted abortions,” 11-54-1 titled “Experimentation on human fetuses,” 23-4.6-1 titled “Consent to medical and surgical care,” 23-4.7-1 through 23-4.7-8 titled “Informed consent for abortion,” 23-13-21 titled “Comprehensive reproductive health services,” 23-17-11 titled “Abortion and sterilization — Protection for nonparticipation — Procedure,” or 42-157-3(d) of the section titled “Rhode Island Health Benefit Exchange — General requirements”;
   2. Abrogate the provisions of 18 U.S.C. § 1531, titled “Partial-birth abortions prohibited” and cited as the “Partial-Birth Abortion Ban Act of 2003”;
   3. Prevent the department of health from applying to licensed healthcare facilities that provide abortion any generally applicable regulations or standards that are in accordance with evidence-based, medically recognized standards for the provision of abortion in compliance with state and federal statutes enumerated in subsections (c)(1) and (c)(2) and with subsection (d), provided that such application, adoption or enforcement is not a pretext for violating subsection (a) of this section.
4. The termination of an individual’s pregnancy after fetal viability is expressly prohibited except when necessary, in the medical judgment of the physician, to preserve the life or health of that individual.
   1. Any physician who knowingly violates the provisions of this subsection shall be deemed to have engaged in “unprofessional conduct” for the purpose of § 5-37-5.1 .
   2. A physician who performs a termination after fetal viability shall be required to record in the patient’s medical records the basis for the physician’s medical judgment that termination was necessary to preserve the life or health of the patient and must comply with all other relevant requirements applicable to physicians in § 23-3-17 .
   3. The director of the department of health is authorized to deny or revoke any license to practice allopathic or osteopathic medicine or otherwise discipline a licensee upon finding by the board that the person is guilty of unprofessional conduct under § 5-37-5.1(31) .

History of Section. P.L. 2019, ch. 27, § 1.

23-5-1 — 23-5-4. Repealed.

23-5-5. Reporting of occupational diseases.

Every physician licensed by the department of health attending on or called in to evaluate a patient whom he or she believes to be suffering from an occupational disease or condition identified by the department of health in regulation as a reportable occupational disease shall within thirty (30) days of that attendance or evaluation send to the department of health a report, on a form acceptable to the director of health, stating:

1. Name, address, and occupation of patient.
2. Name, address, and business of employer.
3. Nature of disease.
4. Any other information that may be reasonably required by the department of health.

History of Section. P.L. 1915, ch. 1226, § 1; G.L. 1923, ch. 153, § 23; G.L. 1938, ch. 255, § 18; impl. am. P.L. 1939, ch. 660, § 180; G.L. 1956, § 23-5-5 ; P.L. 1992, ch. 187, § 1.

23-5-6, 23-5-7. Repealed.

23-5-8. Reports not evidence.

Reports made under § 23-5-5 shall not be evidence of the facts stated in the reports in any action arising out of the disease reported in the reports.

History of Section. P.L. 1915, ch. 1226, § 3; G.L. 1923, ch. 153, § 25; G.L. 1938, ch. 255, § 20; G.L. 1956, § 23-5-8 .

23-5-9. Upon death — Report of infectious disease.

1. As used in this section, “infectious or communicable disease” includes the following:
   1. Infectious hepatitis;
   2. Tuberculosis;
   3. Rabies;
   4. Tularemia;
   5. Herpes simplex;
   6. Acquired immune deficiency syndrome;
   7. Viral hemorrhagic fever;
   8. Gonorrhea;
   9. Syphilis;
   10. Burkett’s lymphoma; and
   11. Kaposi’s sarcoma.
2. Notwithstanding the provisions of §§ 40.1-5-26 and 5-37.3-4 , when a person who has been diagnosed as having an infectious or communicable disease dies in a hospital or other health care facility, the attending physician or other responsible officer shall prepare a written notification describing the disease to accompany the body when the body is picked up for disposition.
3. Notwithstanding the provisions of §§ 40.1-5-26 and 5-37.3-4 , when a person dies outside of a hospital or health care facility and without an attending physician, any family member or person making arrangements for the disposition of the dead body who knows that the dead person has been diagnosed as having an infectious or communicable disease at the time of death shall make known that disposition.
4. Notwithstanding the provisions of §§ 40.1-5-26 and 5-37.3-4 , any person who picks up or transports a dead body for disposition and who has been notified pursuant to subdivision (2) or (3) of this section shall present a notification accompanying the dead body to any embalmer, funeral director, or other person taking possession of the dead body.
5. Information regarding a deceased’s infectious or communicable disease contained in a notification required under this section shall be privileged and confidential and may be disclosed only if the disclosure is required under state or federal laws.
6. Any person having duties imposed upon him or her under subsection (b), (c), or (d) of this section who knowingly refuses or omits to perform those duties shall be subject to a fine of three hundred dollars ($300) for a first offense, five hundred dollars ($500) for a second offense, and one thousand dollars ($1000) for a third and subsequent offense within any calendar year.

History of Section. P.L. 1987, ch. 453, § 1; P.L. 1988, ch. 503, § 1.

23-5.1-1. Identification bracelet.

Any person who has epilepsy, diabetes, a cardiac condition, or any other type of illness that causes temporary blackouts, semi-conscious periods, or complete unconsciousness, is authorized to wear an identification bracelet with the person’s name, type of illness, physician’s name, and medication required, engraved, stamped, or imprinted on that bracelet.

History of Section. P.L. 1974, ch. 251, § 1; P.L. 1999, ch. 83, § 45; P.L. 1999, ch. 130, § 45.

23-5.1-2. Duty of law enforcement officers.

It shall be the duty of all law enforcement officers in this state to make a diligent effort to determine if any person they may find in a semi-conscious or unconscious condition is an epileptic or diabetic or a person who is suffering from any other type of illness which would cause semi-consciousness or unconsciousness by looking for an identification bracelet. If any law enforcement officer shall determine that an epileptic or diabetic person is actually suffering from an affliction that would cause semi-consciousness or unconsciousness, it shall be his or her duty to have the person immediately transported to a physician or to some facility where the services of a physician are available.

History of Section. P.L. 1974, ch. 251, § 1.

23-5.1-3. Penalty for misrepresentation.

Any person who willfully and knowingly falsifies an identification or deliberately misrepresents an illness that causes blackouts, unconsciousness, or semi-conscious periods as described in § 23-5.1-1 shall be guilty of a misdemeanor and upon conviction shall be sentenced to pay a fine of not more than five hundred dollars ($500) or be imprisoned for not more than one year, or both.

History of Section. P.L. 1974, ch. 251, § 1.

23-6-1. Common drinking cups and towels.

1. In order to prevent the spread of communicable diseases, the state department of health is authorized to prohibit, in any public places, vehicles, or buildings that it may designate, the use of a common drinking cup and a common towel, and the director may establish rules and regulations for this purpose.
2. Whoever violates the provisions of this section, or any rule or regulation of the state department of health made under authority of the provisions of this section, shall be deemed guilty of a misdemeanor and may be fined not more than twenty-five dollars ($25.00) for each offense.

History of Section. G.L. 1909, ch. 115, § 15; P.L. 1915, ch. 1238, § 1; G.L. 1923, ch. 153, § 15; G.L. 1938, ch. 255, § 12; impl. am. P.L. 1939, ch. 660, § 180; G.L. 1956, § 23-6-1 .

23-6-2. Spitting in public places.

No person shall spit upon the floor, or upon the sides, or upon any of the furnishings or equipment of any public conveyance, not devoted exclusively to smoking, or of any shop, store, hall, church, schoolhouse, railroad station, or other public building, or in the hallways of any private office building or upon the steps or platforms of the conveyance or buildings, or upon the sidewalk of any public highway in this state, except into suitable receptacles provided for that purpose. Any person violating any of the provisions of this section shall be fined not exceeding twenty dollars ($20.00) for each offense.

History of Section. P.L. 1908, ch. 1595, §§ 1, 2; G.L. 1909, ch. 110, §§ 33, 34; G.L. 1923, ch. 154, §§ 33, 34; G.L. 1938, ch. 256, §§ 33, 34; G.L. 1956, § 23-6-2 .

23-6-3. Vaccinations provided by cities or towns.

The city or town councils in the several cities or towns shall provide annually for the gratuitous vaccination of the inhabitants of the several cities or towns.

History of Section. G.L. 1896, ch. 94, § 28; G.L. 1909, ch. 110, § 28; G.L. 1923, ch. 154, § 28; G.L. 1938, ch. 256, § 28; G.L. 1956, § 23-6-3 .

23-6-4. Employment of physicians for vaccinations.

The city or town councils shall contract with and provide a suitable number of physicians to vaccinate as provided in § 23-6-3 and order the city or town treasurers of the several cities or towns respectively to pay them the compensation that may be previously agreed upon; and the physicians shall give due and reasonable notice of the time and place of meeting for the purpose of vaccination.

History of Section. G.L. 1896, ch. 94, § 29; G.L. 1909, ch. 110, § 29; G.L. 1923, ch. 154, § 29; G.L. 1938, ch. 256, § 29; G.L. 1956, § 23-6-4 .

23-6-5. Record of vaccinations.

The physicians contracted with in § 23-6-4 , as soon after fulfilling their contract as may be convenient, shall deposit in the city or town clerk’s office a book in which they have respectively recorded, in a fair and legible hand, the name and age of every person they have vaccinated as provided in § 23-6-4 and also any other remarks and observations they may deem useful.

History of Section. G.L. 1896, ch. 94, § 30; G.L. 1909, ch. 110, § 30; G.L. 1923, ch. 154, § 30; G.L. 1938, ch. 256, § 30; G.L. 1956, § 23-6-5 .

23-6-6. Preservation of records.

City and town clerks shall safely keep the books described in § 23-6-5 for the accommodation of those physicians and others, without any compensation, and deliver them over to their successors; but they may charge lawful fees for searching them or for any copies.

History of Section. G.L. 1896, ch. 94, § 31; G.L. 1909, ch. 110, § 31; G.L. 1923, ch. 154, § 31; G.L. 1938, ch. 256, § 31; G.L. 1956, § 23-6-6 .

23-6-7. Investigation and suppression of poliomyelitis.

The department of health is authorized and directed to investigate any conditions associated with any case or suspected case of, or the spread of, the disease known as anterior poliomyelitis or infantile paralysis in this state and, as far as possible, to aid in the suppression of that disease.

History of Section. P.L. 1911, ch. 728, § 2; G.L. 1923, ch. 153, § 19; G.L. 1938, ch. 255, § 16; impl. am. P.L. 1939, ch. 660, § 180; G.L. 1956, § 23-6-7 .

23-6-8. Local authorization of hospital or camp for communicable disease.

No person, association, corporation, city, or town shall establish any hospital, camp, or other establishment for the treatment of patients suffering from contagious diseases or from the disease known as pulmonary tuberculosis, unless the department of health shall by resolution authorize its establishment in that city or town within definite limits to be specified in the resolution. Before authorizing the establishment of the hospital, camp, or other establishment, the department shall give public notice of the proposed site and give all persons concerned an opportunity to be heard by the department with reference to the establishment and location of the hospital, camp, or other establishment.

History of Section. P.L. 1909, ch. 400, § 1; G.L. 1923, ch. 154, § 36; G.L. 1938, ch. 256, § 36; G.L. 1956, § 23-6-8 .

23-6-9. Abatement of unauthorized hospital or camp.

Any hospital, camp, or other establishment, as described in § 23-6-8 established without the authority may be abated as a nuisance by any court of competent jurisdiction.

History of Section. P.L. 1909, ch. 400, § 2; G.L. 1923, ch. 154, § 37; G.L. 1938, ch. 256, § 37; G.L. 1956, § 23-6-9 .

23-6-10 — 23-6-27. Repealed.

23-6.1-1. Declaration of policy.

The legislature finds that there is a need to train public high school students in the life-saving technique known as cardiopulmonary resuscitation (CPR). In order to initiate this program, it is the purpose of this chapter to provide for the establishment of a pilot program of training to be administered by the department of elementary and secondary education.

History of Section. P.L. 1981, ch. 148, § 1.

23-6.1-2. Cardiopulmonary resuscitation training program established.

1. The department of elementary and secondary education shall establish a cardiopulmonary resuscitation (CPR) training program for public high schools in the state. This program shall be conducted for a one-year pilot period and shall be coordinated by the department of elementary and secondary education.
2. The training program shall be conducted in ten (10) public high schools during the year that the state pilot program is in existence.

History of Section. P.L. 1981, ch. 148, § 1.

23-6.1-3. Criteria and requirements of program.

The American Heart Association, Rhode Island Affiliate, Inc., shall submit the requirements and criteria for the cardiopulmonary resuscitation (CPR) training program to the department of elementary and secondary education for approval.

History of Section. P.L. 1981, ch. 148, § 1.

23-6.1-4. Promulgation of guidelines.

The department of elementary and secondary education shall promulgate program guidelines and take any other actions that will promote the full implementation of all provisions of this chapter. A copy of the program guidelines issued by the department shall be sent to all participating high schools in the state.

History of Section. P.L. 1981, ch. 148, § 1.

23-6.1-5. Appropriations.

The general assembly shall appropriate the sum of fifteen thousand dollars ($15,000), to be administered by the department of elementary and secondary education, to carry out the purpose of this chapter, and the state controller is authorized and directed to draw his or her orders upon the general treasurer for the payment of that sum or so much of that sum as may be required from time to time, upon receipt by him or her of proper vouchers duly authenticated.

History of Section. P.L. 1981, ch. 148, § 1.

23-6.2-1. Declaration of policy.

1. The legislature recognizes the work of the American Heart Association in establishing that heart disease is a leading cause of death in this country as over three hundred and fifty thousand (350,000) Americans, including three thousand (3,000) Rhode Islanders, die from sudden cardiac arrest every year. Rhode Islanders currently have a survival rate of over five percent (5%) to ten percent (10%) in instances of sudden cardiac arrests occurring outside of hospitals.
2. Greater public access to defibrillation devices may increase the rate of survival in those instances by up to forty-four percent (44%).
3. It is the intent and purpose of this chapter to provide greater public access to defibrillators by distributing those devices to law enforcement and safety personnel throughout the state.

History of Section. P.L. 1998, ch. 82, § 1.

23-6.2-2. State to provide and distribute defibrillators.

On or after September 30, 1998, the Rhode Island municipal police academy, after consultation with the coalition for public safety defibrillators, shall provide two (2) defibrillators for distribution to each and every city or town in the state, one defibrillator to the State House, one defibrillator to each campus of the University of Rhode Island, one defibrillator to Rhode Island College, and one defibrillator to each campus of the Community College of Rhode Island. On or after July 1, 1999, thirty-five (35) defibrillators shall be provided to the Rhode Island state police; two (2) defibrillators to the Licht Judicial Complex, two (2) defibrillators to the Garrahy Judicial Complex, two (2) defibrillators to the Kent County Leighton Judicial Complex, one defibrillator to the Washington County McGrath Judicial Complex, one defibrillator to the Newport County Murray Judicial Complex, and fifty (50) automated external defibrillators to cities or towns within the state based upon current deployment levels of automated external defibrillators, population, and geographic need. These devices shall be placed in the possession of the chief and/or the highest ranking member of the municipality’s police department, the Rhode Island state police, the capitol police in the State House, the sheriff’s department in each county judicial complex, the director of public safety or the chief of the campus police at the University of Rhode Island, the director of public safety or the chief of the department of security and safety at Rhode Island College, the director of public safety or the chief of campus police at the Community College of Rhode Island, or the Rhode Island state police in those municipalities where the state police provide law enforcement service, to be deployed by that officer in the manner in which he or she determines will best promote the availability of and access to the defibrillator by the general public. Provided that one or both defibrillators may be deployed to the municipality’s fire department if the police chief determines that that deployment would best promote the intent and purpose of this chapter. These defibrillators will at all times be deployed and used in accordance with all applicable federal and state statutes. The Rhode Island municipal police academy will, in consultation with the coalition for public safety defibrillation, also provide training in cardiopulmonary resuscitation and automated external defibrillator use for all law enforcement personnel serving the municipalities and agencies referenced in this section to which automated external defibrillators have been provided.

History of Section. P.L. 1998, ch. 82, § 1; P.L. 1999, ch. 185, § 1; P.L. 2000, ch. 209, § 1; P.L. 2000, ch. 258, § 1.

23-6.3-1. Purpose.

The purpose of this chapter is to reduce vulnerability to HIV/AIDS transmission, protect persons who are infected with HIV from discrimination, ensure informed consent for testing, and to provide consistent terms and standards within this title and as applicable to chapters 34.1 and 37 of title 11, chapter 28 of title 21, and chapter 24 of title 40.1.

History of Section. P.L. 2009, ch. 196, § 1; P.L. 2009, ch. 289, § 1; P.L. 2010, ch. 239, § 18.

23-6.3-2. Definitions.

As used in this chapter the following words shall have the following meanings:

1. “Agent” means a person empowered by the patient to assert or waive the confidentiality, or to disclose or consent to the disclosure of confidential information, as established by chapter 37.3 of title 5, as amended, entitled “Confidentiality of Health Care Communications and Information Act.”
2. “AIDS” means the medical condition known as acquired immune deficiency syndrome, caused by infection of an individual by the human immunodeficiency virus (HIV).
3. “Anonymous HIV testing” means an HIV test that utilizes a laboratory generated code based system, which does not require an individual’s name or other identifying information that may reveal one’s identity, including information related to the individual’s health insurance policy, to be associated with the test.
4. “Antibody” means a protein produced by the body in response to specific foreign substances such as bacteria or viruses.
5. “Community-based organization” means an entity that has written authorization from the department for HIV counseling, testing and referral services (HIV CTRS).
6. “Confidential HIV testing” means an HIV test that requires the individual’s name and other identifying information including information related to the individual’s health insurance policy, as appropriate.
7. “Consent” means an explicit exchange of information between a person and a healthcare provider or qualified professional HIV test counselor through which an informed individual can choose whether to undergo HIV testing or decline to do so. Elements of consent shall include providing each individual with verbal or written information regarding an explanation of HIV infection, a description of interventions that can reduce HIV transmission, the meanings of positive and negative test results, the voluntary nature of the HIV testing, an opportunity to ask questions and to decline testing.
8. “Controlled substance” means a drug, substance, or immediate precursor in schedules I-V listed in the provisions of chapter 28 of title 21 entitled, “Uniform Controlled Substances Act.”
9. “Department” means the Rhode Island department of health.
10. “Diagnosis of AIDS” means the most current surveillance case definition for AIDS published in the Centers for Disease Control & Prevention (CDC).
11. “Diagnosis of HIV” means the most current surveillance case definition for HIV infection published in the CDC’s (MMWR).
12. “Director” means the director of the Rhode Island department of health.
13. “ELISA result” means enzyme-linked immunosorbent assay or EIA (enzyme immunoassay) which is a serologic technique used in immunology to detect the presence of either antibody or antigen.
14. “Health benefits” include accident and sickness, including disability or health insurance, health benefit plans and/or policies, hospital, health, or medical service plans, or any health maintenance organization plan pursuant to title 27 or otherwise.
15. “Healthcare facility” means those facilities licensed by the department in accordance with the provisions of chapter 17 of this title.
16. “Healthcare provider,” as used herein, means a licensed physician, physician assistant, certified nurse practitioner or midwife.
17. “Healthcare settings” means venues offering clinical STD services including, but not limited to, hospitals, urgent care clinics, STD clinics and other substance abuse treatment facilities, mental health treatment facilities, community health centers, primary care and OB/GYN physician offices, and family planning providers.
18. “HIV” means the human immunodeficiency virus, the pathogenic organism responsible for HIV infection and/or the acquired immunodeficiency syndrome (AIDS) in humans.
19. “HIV CD4 T-lymphocyte test result” means the results of any currently medically accepted and/or FDA approved test used to count CD4 T-lymphatic cells in the blood of an HIV-infected person.
20. “HIV counseling” means an interactive process of communication between a person and a healthcare provider or qualified professional HIV test counselor during which there is an assessment of the person’s risks for HIV infection and the provision of counseling to assist the person with behavior changes that can reduce risks for acquiring HIV infection.
21. “HIV screening” means the conduct of HIV testing among those who do not show signs or symptoms of an HIV infection.
22. “HIV test” means any currently medically accepted and/or FDA approved test for determining HIV infection in humans.
23. “Occupational health representative” means a person, within a healthcare facility, trained to respond to occupational, particularly blood borne, exposures.
24. “Opts out” means that a person who has been notified that a voluntary HIV test will be performed, has elected to decline or defer testing. Consent to HIV testing is inferred unless the individual declines testing.
25. “Perinatal case report for HIV” means the information that is provided to the department related to a child aged less than eighteen (18) months born to an HIV-infected mother and the child does not meet the criteria for HIV infection or the criteria for “not infected” with HIV as defined in the most current surveillance case definition for HIV infection published by the CDC.
26. “Person” means any individual, trust or estate, partnership, corporation (including associations, joint stock companies), limited liability companies, state, or political subdivision or instrumentality of a state.
27. “Persons at high risk for HIV infection” means persons defined as being high risk in the CDC’s most current recommendations for HIV testing of adults, adolescents and pregnant women in healthcare settings or through authority and responsibilities conferred on the director by law in protecting the public’s health.
28. “Polymerase chain reaction (PCR) test” means a common laboratory method of creating copies of specific fragments of DNA or RNA.
29. “Qualified professional HIV test counselor” means: (i) A physician, physician assistant, certified nurse practitioner, midwife, or nurse licensed to practice in accordance with applicable state law; (ii) A medical student who is actively matriculating in a medical degree program and who performs duties assigned to them by a physician; or (iii) A person who has completed an HIV counseling training program, in accordance with regulations hereunder promulgated.
30. “Sexually transmitted diseases (STD’s)” means those diseases included in § 23-11-1 , as amended, entitled “Sexually Transmitted Diseases,” and any other sexually transmitted disease that may be required to be reported by the department.

History of Section. P.L. 2009, ch. 196, § 1; P.L. 2009, ch. 289, § 1.

23-6.3-3. HIV screening and testing of adults, adolescents, and pregnant women.

1. This section shall pertain to patients in all healthcare settings and HIV CTRS sites.
2. HIV screening and testing shall be based on the most current recommendations for HIV counseling, testing and referral of adults, adolescents and pregnant women issued by the CDC. Provided, however, those guidelines shall be interpreted by the department so as to best serve the individuals and patients receiving HIV testing, and shall in no event be interpreted or implemented in a manner inconsistent with the minimum informed consent standards and other provisions and protections of state law and regulations.
3. All individuals who desire anonymous HIV testing shall be referred to an HIV CTRS site funded by the department that provides anonymous HIV testing.
4. All healthcare settings and HIV CTRS sites shall develop protocols that include no less than the following: assessment for individuals at high risk for HIV infection; frequency of HIV testing; communication of HIV test results; and post-test linkages to needed care and support services.
5. Those adults, adolescents and pregnant women who test positive for HIV infection shall be given priority for outpatient substance abuse treatment programs that are sponsored or supported by the appropriate state agency responsible for these services, and those who test negative for HIV infection shall be referred to the appropriate state agency responsible for these services for earliest possible evaluation and treatment.
6. A positive test result must be given in person. Persons testing positive for HIV must also be provided with linkages and referrals to HIV-related counseling, health care and support.
7. All persons tested under this section shall be informed of the results of the HIV test.
8. Consent and providing information for HIV testing:
   1. Except as provided in § 23-6.3-4 , HIV screening shall be voluntary, free from coercion, incorporated into routine medical testing, and undertaken only with the individual’s knowledge and understanding that HIV testing will be performed.
   2. No person shall order the performance of an HIV test without first: (i) Providing the information and opportunity for discussion or counseling set forth in this section; (ii) Informing the patient that he or she has a right to decline testing; and (iii) Obtaining the oral consent of the patient to be tested or of a person authorized to consent to health care for such individual. Said consent and exchange of HIV information shall be documented in the patient’s medical record.
   3. A physician or healthcare provider may tailor HIV counseling to best meet the needs of the individual to be tested. Decisions concerning patient-specific tailoring and the extent of pre-test counseling shall be made on a case-by-case basis.
   4. In no event shall a patient be tested for HIV pursuant to this section without first being provided with verbal or written information that includes the following:
      1. An explanation of HIV infection;
      2. A description of interventions that can reduce HIV transmission;
      3. The meanings of positive and negative test results;
      4. The possibility that a recent infection may not be detected; and
      5. An opportunity to ask questions and to decline testing.
9. For pregnant women:
   1. HIV screening shall be incorporated as part of routine prenatal testing for all pregnant women as early and often as appropriate during each pregnancy after the patient has been notified that voluntary testing, in accordance with the consent and information requirements of subsection (h), will be performed unless the patient opts out.
   2. Any woman with an undocumented HIV test status in her record at the time of labor and/or delivery shall be screened with an HIV test in accordance with the consent and information requirements of subsection (h), unless she opts out.
   3. A newborn shall be tested as soon as possible at delivery without the mother’s consent if the mother’s HIV status is not documented, provided that:
      1. Reasonable efforts have been made to secure voluntary consent from the mother to test the newborn; and
      2. A mother is informed that HIV antibodies in the newborn indicate that the mother is infected with HIV.
10. The department shall provide guidance and access to written information to be used for the purposes of this section. This information shall notify the patients about risk-reduction strategies; the merits of repeat HIV and STD testing; and the availability of counseling and HIV prevention services. Informational materials shall be easily understandable and made available in Spanish and in other languages as appropriate to assure that the information presented is in a format that the individual can understand. Interpreters and bilingual staff shall demonstrate competency in providing language assistance to patients with limited English proficiency. Family or friends shall not be used as language interpreters.
11. A distinction shall be made between anonymous and confidential HIV testing. To protect the anonymity of patients tested anonymously, written consent shall not be offered as an option to verbal informed consent in anonymous testing.
12. In accordance with chapter 8 of this title, individuals under eighteen (18) years of age may give legal consent for testing, examination, and/or treatment for any reportable communicable disease, including HIV.
13. The department shall initiate medical provider training sessions, develop standardized materials to support more universal testing, utilize community input to create implementation plans, and evaluate the impact of this section.
14. No physician or healthcare provider shall discriminate against a patient because he or she is HIV positive or has declined to take an HIV test.

History of Section. P.L. 2009, ch. 196, § 1; P.L. 2009, ch. 289, § 1.

23-6.3-4. Exceptions to consent requirements.

1. A healthcare provider may test for the presence of HIV without obtaining consent from the individual to be tested under the following conditions:
   1. When the individual to be tested is under one year of age;
   2. When a child between one and thirteen (13) years of age appears to be symptomatic for HIV;
   3. When the individual to be tested is a minor under the care and authority of the department of children, youth and families, and the director of that department certifies that an HIV test is necessary to secure health or human services for that individual;
   4. In a licensed healthcare facility or healthcare setting, in the event that an occupational health representative or physician, registered nurse practitioner, physician assistant, or nurse-midwife, not directly involved in the exposure, determines that an employee or emergency service worker, other than one in a supervisory position to the person making the determination, had a significant exposure to the blood and/or body fluids of a patient and the patient or the patient’s guardian refuses to grant consent for an HIV test to determine whether the patient has HIV, then, if a sample of the patient’s blood is available, that blood shall be tested for HIV.
      1. If a sample of the patient’s blood is not otherwise available and the patient refuses to grant consent to draw blood, the employee or emergency service worker may petition the superior court for a court order mandating that the test be performed.
      2. Before a patient or a sample of the patient’s blood is required to undergo an HIV test, the employee or emergency service worker must submit to a baseline HIV test within seventy-two (72) hours of the exposure.
      3. No person who determines that an employee or emergency service worker has sustained a significant exposure and authorizes the HIV testing of a patient, nor any person or healthcare facility who acts in good faith and recommends the test be performed, shall have any liability as a result of their actions carried out under this chapter, unless those persons are proven to have acted in bad faith.
      4. For the purposes of this section, “emergency service worker” means a worker responding on behalf of a licensed ambulance/rescue service, or a fire department or a law enforcement agency, who, in the course of his/her professional duties, has been exposed to bodily fluids in circumstances that present a significant risk of transmission of HIV, and has completed a pre-hospital exposure form in accordance with § 23-4.1-19 .
   5. In an emergency, where due to a grave medical or psychiatric condition, and it is impossible to obtain consent from the patient or, if applicable under state law, the patient’s parent, guardian, or agent.
   6. As permitted under § 23-1-38 entitled “HIV Antibody Testing-Sperm Collection or Donation.”
   7. Any individual convicted of a violation of any provisions of chapter 34.1 of title 11 entitled “Commercial Sexual Activity,” shall be required to be tested for HIV unless already documented HIV positive. All individuals tested under this section shall be informed of their test results. All individuals tested under this section who are determined to be injecting and/or intra-nasal drug users shall be referred to appropriate substance abuse treatment as outlined in § 23-6.3-3(e) .
   8. Any individual convicted of possession of any controlled substance as defined in chapter 28 of title 21 entitled “Uniform Controlled Substances Act,” that has been administered with a hypodermic instrument, retractable hypodermic syringe, needle, intra-nasally, or any similar instrument adapted for the administration of drugs shall be required to be tested for HIV unless already documented HIV positive.
   9. All individuals tested under this section shall be informed of their test results.
   10. In accordance with the provisions of chapter 37 of title 11, entitled, “Sexual Assault,” any individual who has admitted to or been convicted of or adjudicated wayward or delinquent by reason of having committed any sexual offense involving penetration whether or not a sentence or fine is imposed or probation granted, shall be ordered by the court upon petition of the victim, immediate family members of the victim or legal guardian of the victim, to submit to a blood test for the presence of a sexually transmitted disease including, but not limited to, HIV. All individuals tested under this section shall be informed of their test results.
   11. In accordance with the provisions or § 42-56-37 , entitled “HIV Testing,” every individual who is committed to the adult correctional institutions to any criminal offense, after conviction, is required to be tested for HIV.
2. It is unlawful for any person to disclose to a third party the results of an individual’s HIV test without the prior written consent of that individual, except in accordance with § 23-6.3-7 .

History of Section. P.L. 2009, ch. 196, § 1; P.L. 2009, ch. 289, § 1; P.L. 2010, ch. 239, § 18.

23-6.3-5. Reasonable efforts to secure consent.

No involuntary testing for HIV shall take place under any of the exceptions set forth in § 23-6.3-4 , unless reasonable efforts have been made to: (1) Secure voluntary consent from the individual to be tested, or in the case of a minor patient, from the legal parent or guardian of the minor patient; and (2) Provide verbal or written information as specified in § 23-6.3-3(h) .

History of Section. P.L. 2009, ch. 196, § 1; P.L. 2009, ch. 289, § 1.

23-6.3-6. Due process — Right to bring suit.

Nothing in §§ 23-6.3-1 to 23-6.3-1 6 shall be construed to limit or deprive any person of his or her right to due process of law, or to bar an action of relief and/or damages before a court of competent jurisdiction.

History of Section. P.L. 2009, ch. 196, § 1; P.L. 2009, ch. 289, § 1.

23-6.3-7. Confidentiality.

1. It is unlawful for any person to disclose to a third-party the results of an individual’s HIV test without the prior written consent of that individual, except for:
   1. A licensed laboratory or other healthcare facility that performs HIV tests shall report test results to the healthcare provider who requested the test and to the director.
   2. A healthcare provider shall enter HIV test results in the patient’s medical record.
   3. Notification to the director of the department of children, youth and families, pursuant to subdivision 23-6.3-4(3).
   4. As provided in chapter 37.3 of title 5, § 40.1-5-26 , §§ 23-6.3-10 and 23-6.3-14 or as otherwise permitted by law.
   5. By a healthcare provider to appropriate persons entitled to receive notification of individuals with infectious or communicable diseases pursuant to §§ 23-5-9 and 23-28.36-3 .
2. This chapter shall not be construed to interfere with any other federal or state laws or regulations that provide more extensive protection than provided in this chapter for the confidentiality of healthcare information.

History of Section. P.L. 2009, ch. 196, § 1; P.L. 2009, ch. 289, § 1.

23-6.3-8. Protection of records.

1. Providers of health care, public health officials, and any other person who maintains records containing information on HIV test results of individuals are responsible for maintaining full confidentiality of this data and shall take appropriate steps for their protection, including:
   1. Keeping records secure at all times and establishing adequate confidentiality safeguards for any records electronically stored;
   2. Establishing and enforcing reasonable rules limiting access to these records; and
   3. Training persons who handle records in security objectives and technique.
2. The department shall evaluate reports of HIV/AIDS for completeness and potential referrals for service. All case reports shall be kept in a confidential and secure setting. An HIV/AIDS policy and protocol for security shall be developed and implemented by the department for this purpose.
3. The department shall evaluate its procedures for HIV/AIDS reporting on a continuous basis for timeliness, completeness of reporting, and security of confidential information.
4. The department shall develop a protocol that shall be in accordance with the most recent recommendations of the CDC’s Guidelines for National Human Immunodeficiency Virus Case Surveillance, including monitoring for Human Immunodeficiency Virus infection and Acquired Immunodeficiency Syndrome, pertaining to patient records and confidentiality; provided, however, that in no event shall the protocol be less protective than that required by state law.
5. All reports and notifications made pursuant to this section shall be confidential and protected from release except under the provisions of law. Any person aggrieved by a violation of this section shall have a right of action in the superior court and may recover for each violation.

History of Section. P.L. 2009, ch. 196, § 1; P.L. 2009, ch. 289, § 1.

23-6.3-9. Penalties and remedies.

The penalties and remedies contained in chapter 37.3 of title 5 entitled “Confidentiality of Health Care Communications and Information” shall apply to violations of §§ 23-6.3-7 confidentiality and 23-6.3-8 protection of records.

History of Section. P.L. 2009, ch. 196, § 1; P.L. 2009, ch. 289, § 1.

23-6.3-10. Notification of disclosure.

1. In all cases when an individual’s HIV test results are disclosed to a third-party, other than a person involved in the care and treatment of the individual, and except as permitted by § 23-6.3-7 (permitted disclosures re: confidentiality), and permitted by and disclosed in accordance with the Federal Health Insurance Portability and Accountability Act of 1996 (Public law 104-191) enacted on August 21, 1996 and as thereafter amended, the person so disclosing shall make reasonable efforts to inform that individual in advance of:
   1. The nature and purpose of the disclosure;
   2. The date of disclosure;
   3. The recipient of the disclosed information.
2. Healthcare providers may inform third-parties with whom an HIV infected patient is in close and continuous exposure related contact, including, but not limited to a spouse and/or partner, if the nature of the contact, in the healthcare provider’s opinion, poses a clear and present danger of HIV transmission to the third-party, and if the physician has reason to believe that the patient, despite the healthcare provider’s strong encouragement, has not and will not inform the third-party that they may have been exposed to HIV.

History of Section. P.L. 2009, ch. 196, § 1; P.L. 2009, ch. 289, § 1; P.L. 2010, ch. 239, § 18.

23-6.3-11. Discrimination prohibited.

No person, agency, organization, or legal entity may discriminate against an individual on the basis of a positive HIV test result, or perception of a positive test, in housing, education, employment, the granting of credit, public accommodation, or delivery of services, nor shall an HIV test be required as a condition of employment.

History of Section. P.L. 2009, ch. 196, § 1; P.L. 2009, ch. 289, § 1.

23-6.3-12. Administrative relief.

Any individual who believes that he or she has been unlawfully discriminated against in housing, education, employment, the granting of credit, public accommodations, or delivery of services on the basis of a positive HIV test, or perception of a positive test, may bring action for administrative relief before the Rhode Island human rights commission; and that commission may hear the matter and grant relief in those cases.

History of Section. P.L. 2009, ch. 196, § 1; P.L. 2009, ch. 289, § 1.

23-6.3-13. HIV Counseling, Testing, Referral and Services Sites (HIV CTRS).

The department shall designate and fund HIV CTRS sites, for providing both anonymous and confidential HIV testing and HIV counseling and referral services.

Anonymous and confidential HIV testing provided by HIV CTRS sites funded by the department shall screen individuals for their ability to pay for such HIV testing, using a fee schedule and screening process available to the department on request. HIV CTRS sites shall not deny HIV testing to any individual based on his or her inability to pay.

History of Section. P.L. 2009, ch. 196, § 1; P.L. 2009, ch. 289, § 1.

23-6.3-14. Reporting and notification of HIV/AIDS.

1. Except in the case of anonymous HIV testing, a diagnosis of HIV or AIDS shall be notifiable and reportable to the department by name.

   The following shall be reported to the department:

   1. A diagnosis of HIV, according to the most current CDC case definition of HIV.
   2. A diagnosis of AIDS, according to the most recent CDC case definition of AIDS.
   3. A positive ELISA result of any HIV test and/or other FDA approved test indicative of the presence of HIV.
   4. Notification of a perinatal exposure to HIV shall be made to the department regardless of confirmatory testing. A perinatal case report for HIV shall be indicated by two (2) positive polymerase chain reaction (PCR) tests; < 18 months; and/or other U.S. Food and Drug Administration approved tests that indicate the presence of HIV in pediatric cases.
2. The following persons shall report information required by this section to the department:
   1. A healthcare provider who diagnoses or treats HIV/AIDS;
   2. The administrator of a healthcare facility as defined in chapter 17 of this title who diagnoses or treats HIV/AIDS; or
   3. The administrator of a prison in which there is an HIV/AIDS infected individual or perinatal exposure to HIV/AIDS.
3. A person responsible for the administration of a clinical or hospital laboratory, blood bank, mobile unit, or other facility in which a laboratory examination of any specimen derived from a human body yields serological, or other evidence of HIV/AIDS, including perinatal exposure to HIV/AIDS shall notify the department in a timely manner.
4. All positive HIV test results shall be confirmed with a Western Blot or other FDA approved confirmatory test.

History of Section. P.L. 2009, ch. 196, § 1; P.L. 2009, ch. 289, § 1.

23-6.3-15. Laboratory analyses and reporting.

1. All biological samples or specimens taken for the purpose of performing laboratory analysis for the detection of antibody to HIV, by or under the direction or order of any healthcare provider working within the scope of his or her practice, shall be sent to the department of health laboratory for analysis. This provision shall not apply to those HIV tests performed in a hospital laboratory, clinical laboratories as defined in § 23-16.2-2 with testing facilities located in Rhode Island, or to those sites performing rapid HIV testing.
2. Hospitals shall forward all positive confirmatory HIV test results to the department. All sites performing HIV testing must submit an annual HIV testing report to the department in accordance with regulations promulgated by the department.
3. The department laboratory shall conduct all confirmatory testing for HIV/AIDS with the exception of written waivers issued by the department as indicated in subsection (d) below.
4. Sites performing non-venapuncture HIV testing (e.g., rapid testing) must seek a waiver from the department to provide confirmatory HIV testing from a laboratory other than the state laboratory, and shall forward all positive and negative confirmatory HIV tests results to the department.
5. Except in the case of anonymous HIV testing, a healthcare provider working within the scope of his or her practice providing samples of specimens for HIV testing, or results of HIV tests to the department, shall include the name of the patient and other identifying information including information related to the individual’s health insurance policy as applicable.
6. Any HIV cases reported in the previous code-based system shall remain in a code-based data set. This does not prohibit a physician from submitting or requesting that an updated name case report on a patient replace a previously coded case report.

History of Section. P.L. 2009, ch. 196, § 1; P.L. 2009, ch. 289, § 1; P.L. 2021, ch. 80, § 1, effective June 24, 2021; P.L. 2021, ch. 81, § 1, effective June 24, 2021.

23-6.3-16. Insurance exemption.

1. Sections 23-6.3-1 — 23-6.3-1 4 do not apply to the offering or sale of life insurance in Rhode Island; provided, however, that any insurance company offering or selling life insurance within Rhode Island that requires an individual to be tested for infection with human immunodeficiency virus (HIV) or any other identified causative agent of HIV for purposes of determining insurability shall: (1) Give that individual prior written notice of those requirements; (2) Proceed with that testing only upon the written authorization of the individual or in the event the individual is a minor, the individual’s parent or guardian; and (3) Notify the tested person of his or her positive or negative test results. If the person has a positive test result he or she must receive appropriate information and referral from the insurance company. Notwithstanding anything in this chapter to the contrary, life insurance companies offering or selling life insurance in Rhode Island may otherwise obtain or disclose HIV test results in accordance with this chapter. Nothing in this chapter prohibits that company from collecting data for statistical purposes, so long as the insured is not identified. However, nothing in this section shall be construed to permit that insurance company to cancel or refuse to renew a life insurance policy that by its terms has not lapsed on the basis of a positive HIV test result.
2. The provisions of this chapter apply to the offer or sale of health benefits in this state by any company regulated under the laws of this state, including, but not limited to, title 27 and chapter 62 of title 42, provided, however, this chapter does not apply to the following:
   1. Individual health benefit policies;
   2. Small group health benefits plans, i.e., groups having fewer than twenty-five (25) employees eligible to participate in an employer sponsored plan, or, in the case of non-employer groups, a group having fewer than twenty-five (25) employees;
   3. Late entrants into any group health benefits plan, regardless of the size of the group. A late entrant shall be defined as any individual who does not enroll into a health plan when first eligible under the plan, but who later seeks coverage under the group plan;
   4. Where an individual seeks to become eligible for an amount of group disability income benefit, which benefit would be in excess of the insurer’s non-medical maximum as defined under the group plan.
3. Any company offering or selling health benefits in this state and regulated under the laws of this state that requires an individual to be tested for infection with HIV or any other identified causative agent of HIV as permitted in paragraphs (2)(i) to (iv) for purposes of determining insurability shall: (1) Give that individual prior written notice of those requirements; and (2) Proceed with that testing only upon the written authorization of the individual, or in the event the individual is a minor, the individual’s parent or guardian. Notwithstanding anything in this chapter to the contrary, companies offering or selling health benefits in this state may otherwise obtain or disclose HIV test results in accordance with this chapter. Nothing in this chapter shall prohibit that company from collecting data for statistical purposes so long as the identity of the insured may not be determined from the information released.
4. Nothing in this chapter shall be construed to permit any company that offers or sells health benefits in this state to cancel or refuse to renew a health benefit, which has not by its terms lapsed, on the basis of a positive HIV test result.

History of Section. P.L. 2009, ch. 196, § 1; P.L. 2009, ch. 289, § 1.

23-6.3-17. Rules and regulations.

The director is authorized to promulgate regulations as he or she deems necessary or desirable to implement the provisions of this chapter, in accordance with the provisions set forth in § 23-1-17 and chapter 35 of title 42.

History of Section. P.L. 2009, ch. 196, § 1; P.L. 2009, ch. 289, § 1.

23-6.3-18. Severability.

If any provision of this chapter is held by a court to be invalid, that invalidity shall not affect the remaining provisions of the chapter, and to this end the provisions of the chapter are declared severable.

History of Section. P.L. 2009, ch. 196, § 1; P.L. 2009, ch. 289, § 1.

23-6.3-19. Construction of the chapter.

This chapter shall be liberally construed to accomplish the purposes sought in it.

History of Section. P.L. 2009, ch. 196, § 1; P.L. 2009, ch. 289, § 1.

23-6.4-1. Definitions.

As used in this chapter:

1. “Administer” means the direct application of an epinephrine auto-injector to the body of an individual.
2. “Authorized entity” means any entity or organization at, or in connection with, where allergens capable of causing anaphylaxis may be present, as identified by the department of health. The department shall, through rule or other guidance, identify the types of entities and organizations that are considered authorized entities no later than January 1, 2015, and shall review and update such rule or guidance at least annually thereafter.
3. “Authorized healthcare provider” means a physician, nurse, or other person duly authorized by law, in the state in which they practice, to prescribe drugs.
4. “Epinephrine auto-injector” means a single-use device used for the automatic injection of a premeasured dose of epinephrine into the human body.
5. “Provide” means the supplying of one or more epinephrine auto-injectors to an individual.
6. “Self-administration” means a person’s discretionary use of an epinephrine auto-injector.

History of Section. P.L. 2014, ch. 514, § 1.

23-6.4-2. Prescribing to an authorized entity permitted.

An authorized healthcare provider may prescribe epinephrine auto-injectors in the name of an authorized entity for use in accordance with this section, and pharmacists may dispense epinephrine auto-injectors pursuant to a prescription issued in the name of an authorized entity.

History of Section. P.L. 2014, ch. 514, § 1.

23-6.4-3. Designated entities permitted to maintain supply.

An authorized entity may acquire and stock a supply of epinephrine auto-injectors pursuant to a prescription issued in accordance with this chapter. Such epinephrine auto-injectors shall be stored in a location readily accessible in an emergency and in accordance with the epinephrine auto-injector’s instructions for use and any additional requirements that may be established by the department of health. An authorized entity shall designate employees or agents who have completed the training required by § 23-6.4-6 to be responsible for the storage, maintenance, and general oversight of epinephrine auto-injectors acquired by the authorized entity.

History of Section. P.L. 2014, ch. 514, § 1; P.L. 2016, ch. 512, art. 1, § 11.

23-6.4-4. Use of epinephrine auto-injectors.

An employee or agent of an authorized entity, or other individual, who has completed the training required by § 23-6.4-6 , may, on the premises of or in connection with the authorized entity, use epinephrine auto-injectors prescribed pursuant to § 23-6.4-2 to:

1. Provide an epinephrine auto-injector to any individual who, the employee, agent, or other individual, believes in good faith is experiencing anaphylaxis, for immediate self-administration, regardless of whether the individual has a prescription for an epinephrine auto-injector or has previously been diagnosed with an allergy.
2. Administer an epinephrine auto-injector to any individual who, the employee, agent, or other individual, believes in good faith is experiencing anaphylaxis, regardless of whether the individual has a prescription for an epinephrine auto-injector or has previously been diagnosed with an allergy.

History of Section. P.L. 2014, ch. 514, § 1; P.L. 2016, ch. 512, art. 1, § 11.

23-6.4-5. Expanded availability.

An authorized entity that acquires a stock supply of epinephrine auto-injectors pursuant to a prescription issued in accordance with this chapter, may make such epinephrine auto-injectors available to individuals other than those trained individuals described in § 23-6.4-6 , and such individuals may administer such epinephrine auto-injector to any individual believed in good faith to be experiencing anaphylaxis, if the epinephrine auto-injectors are stored in a locked, secure container and are made available only upon remote authorization by an authorized healthcare provider after consultation with the authorized healthcare provider by audio, televideo, or other similar means of electronic communication. Consultation with an authorized healthcare provider for this purpose shall not be considered the practice of telemedicine or otherwise be construed as violating any law or rule regulating the authorized healthcare provider’s professional practice.

History of Section. P.L. 2014, ch. 514, § 1; P.L. 2016, ch. 512, art. 1, § 11.

23-6.4-6. Training.

An employee, agent, or other individual described in § 23-6.4-4 must complete an anaphylaxis training program prior to providing or administering an epinephrine auto-injector made available by an authorized entity. Such training shall be conducted by a nationally recognized organization experienced in training laypersons in emergency health treatment, or an entity or individual approved by the department of health. Training may be conducted online or in person and, at a minimum, shall cover:

1. Techniques on how to recognize symptoms of severe allergic reactions, including anaphylaxis;
2. Standards and procedures for the storage and administration of an epinephrine auto-injector; and
3. Emergency follow-up procedures.

   The entity that conducts the training shall issue a certificate, on a form developed or approved by the department of health, to each person who successfully completes the anaphylaxis training program.

History of Section. P.L. 2014, ch. 514, § 1; P.L. 2016, ch. 512, art. 1, § 11.

23-6.4-7. Good Samaritan protections.

An authorized entity that possesses and makes available epinephrine auto-injectors and its employees, agents, and other trained individuals; a person who uses an epinephrine auto-injector made available pursuant to § 23-6.4-5 ; an authorized healthcare provider who prescribes epinephrine auto-injectors to an authorized entity; and an individual or entity that conducts the training described in § 23-6.4-6 , shall not be liable for any civil damages that result from the administration or self-administration of an epinephrine auto-injector; the failure to administer an epinephrine auto-injector; or any other act or omission taken pursuant to this chapter; provided, however, this immunity does not apply to acts or omissions constituting gross negligence or willful or wanton conduct. The administration of an epinephrine auto-injector in accordance with this chapter is not the practice of medicine. This section does not eliminate, limit, or reduce any other immunity or defense that may be available under state law. An entity located in this state shall not be liable for any injuries or related damages that result from the provision or administration of an epinephrine auto-injector by its employees or agents outside of this state if the entity or its employee or agent:

1. Would not have been liable for such injuries or related damages had the provision or administration occurred within this state; or
2. Are not liable for such injuries or related damages under the law of the state in which such provision or administration occurred.

History of Section. P.L. 2014, ch. 514, § 1; P.L. 2016, ch. 512, art. 1, § 11.

23-6.4-8. Reporting.

An authorized entity that possesses and makes available epinephrine auto-injectors shall submit to the department of health, on a form developed by the department of health, a report of each incident on the authorized entity’s premises that involves the administration of an epinephrine auto-injector. The department of health shall annually publish a report that summarizes and analyzes all reports submitted to it under this section.

History of Section. P.L. 2014, ch. 514, § 1.

23-6.5-1. Legislative findings.

1. Approximately three hundred twenty-five thousand (325,000) Americans suffer sudden cardiac arrest (“SCA”) each year and more than ninety-five percent (95%) of them die before reaching the hospital;
2. In the population of Rhode Island, an estimated one thousand (1,000) residents will die of cardiac arrest every year;
3. Facilities that host large numbers of visitors are more likely to experience an event that requires an automated external defibrillator (“AED”);
4. If defibrillation is performed within five (5) to seven (7) minutes, chances of survival are increased by forty-nine percent (49%). Every minute that goes by without defibrillation reduces the chance of survival by seven percent (7%) to ten percent (10%);
5. Automated external defibrillators (AEDs) are extremely accurate computerized devices that can be operated by the average person; and
6. Automated external defibrillators (AEDs) can be acquired through grants from various organizations or through government agencies.

History of Section. P.L. 2017, ch. 388, § 1; P.L. 2017, ch. 433, § 1.

23-6.5-2. Automated external defibrillators requirements.

1. As used in this chapter, “public place” means an enclosed area capable of holding three hundred (300) people or more and to which the public is invited or in which the public is permitted, including, but not limited to: banks; bars; educational facilities; healthcare facilities; laundromats; public transportation facilities; reception areas; restaurants; retail food production and marketing establishments; retail service establishments; retail stores; shopping malls; sports arenas; government offices; theaters; and waiting rooms. A private residence is not a “public place” unless it is used as a childcare, adult daycare, or healthcare facility.
2. Notwithstanding the provisions contained in § 5-50-12 or § 16-21-33.1 relating to automated external defibrillators in health clubs and schools, any person who owns or operates a public place as defined in subsection (a) of this section shall provide and maintain:
   1. On-site, functional automated external defibrillators (AEDs) in quantities and types, deemed by the director of health, to be adequate to ensure ready and appropriate access for use during emergencies; and
   2. At least one person who is properly trained in the operation and use of an AED. Training required by this chapter may be conducted by qualified personnel, including, but not limited to, municipal fire and police department employees.

History of Section. P.L. 2017, ch. 388, § 1; P.L. 2017, ch. 433, § 1.

23-6.5-3. Rules and regulations.

The director of health is hereby authorized to adopt, modify, repeal, or promulgate rules and regulations necessary to implement the provisions of this chapter.

History of Section. P.L. 2017, ch. 388, § 1; P.L. 2017, ch. 433, § 1.

23-7-1. Short title.

This chapter shall be known and cited as “The Mosquito Abatement Act”.

History of Section. P.L. 1978, ch. 108, § 2.

23-7-2. Declaration of policy.

Mosquitoes in Rhode Island do not pose a routine threat to the public health. There has rarely, if ever, been a case of mosquito-transmitted viral encephalitis recorded in this state. Mosquitoes are recognized to be a nuisance problem to the residents of this state. Specifically, it is declared to be the policy of the state that:

1. Since large amounts of money have been spent by some individual cities and towns on mosquito control programs that have been ineffective, a combined effort by contiguous municipalities would be more economical and beneficial.
2. The environment surrounding the areas within which mosquitoes live and breed shall remain in such condition that it will continue to sustain the full range of natural plant and animal life characteristic of that area while providing relief from that nuisance.
3. Unwarranted and sometimes excessive spraying can irreversibly damage the environment. For this reason, pesticide use must be minimized.
4. Water-level management is presently the best type of program suited for most areas of this state.
5. Mosquito abatement programs should be accompanied by a public education campaign emphasizing individual citizen’s action for home and yard relief.

History of Section. P.L. 1978, ch. 108, § 2.

23-7-3. Board established.

There shall be established a state mosquito abatement board consisting of eleven (11) members. The board shall have the authority to approve, authorize, regulate, terminate and/or deny any and all mosquito abatement programs of any type within the state. The board shall have the authority to promulgate and enforce rules and regulations in accordance with chapter 35 of title 42 as may be deemed necessary by the board. Specifically, the board may prescribe or prohibit by regulation the use of materials, rates of application, methods, and timing to be used in the application of pesticides for mosquito control when necessary to protect health or property, or to prevent injury to plants and animals (including pollinating insects, birds, and aquatic life). In issuing its regulations, the board shall give due consideration to pertinent research findings, recommendations, and laws or regulations of other agencies of the state and of the federal government and to the best interests of the environment. Specifically, the director of environmental management, on behalf of the board, is authorized to enter or examine at any reasonable time those premises that the board considers necessary to carry out its responsibilities under §§ 23-7-1 — 23-7-1 5. The board may also provide technical assistance and educational information to any city, town, subdivision of any city or town, or any district in the development and implementation of a mosquito abatement program. The board shall draw staff support from the department of environmental management with the consent of the director.

History of Section. P.L. 1978, ch. 108, § 2.

23-7-4. Membership of board.

1. The directors of the departments of health and environmental management, or their designees, shall be ex officio members. The governor shall, with the advice and consent of the senate, appoint one professional agricultural chemist, one professional wildlife biologist, one professional entomologist, one medical doctor, one person representing an established conservation or environmental group within the state, and three (3) citizens representing any four (4) cities, towns, subdivisions of cities or towns, or districts, having regard, among other factors, to their qualifications, experience, and interest in effective mosquito control. Members of the board shall annually elect their own officers.
2. Those members of the commission as of January 1, 2005 who are members of the general assembly shall cease to be members of the commission on January 1, 2005 and the director shall appoint two (2) new members, representing two (2) cities, towns, subdivisions of cities or towns, or districts, having regard, among other factors, to their qualifications, experience and interest in effective mosquito control, each of whom shall serve for a three (3) year term.
3. All appointed public members as of January 1, 2005 shall continue to serve the balance of their current terms.
4. Except as provided in subsection (b) of this section, members shall serve until their successors are appointed and qualified.
5. No person shall be eligible for appointment pursuant to this section unless he or she is a resident of this state.

History of Section. P.L. 1978, ch. 108, § 2; P.L. 2001, ch. 180, § 41; P.L. 2006, ch. 22, § 3; P.L. 2006, ch. 27, § 3.

23-7-5. Vacancies, quorum and removal for cause.

1. Any vacancy which may occur in the board shall be filled by the governor with the advice and consent of the senate for the remainder of the unexpired term. A member shall be eligible to succeed himself or herself.
2. Six (6) members of the board shall constitute a quorum.
3. Members of the board shall be removable by the governor pursuant to § 36-1-7 of the general laws and for cause only, and removal solely for partisan or personal reasons unrelated to capacity or fitness for the office shall be unlawful.

History of Section. P.L. 1978, ch. 108, § 2; P.L. 2001, ch. 180, § 41; P.L. 2006, ch. 22, § 3; P.L. 2006, ch. 27, § 3.

23-7-6. Meetings.

The members of the board shall meet initially at the call of the director of environmental management and, at their first meeting, shall elect a chairperson, a secretary, and any other officers that they may find necessary. Thereafter, the board shall meet as necessary, but not less than three (3) times per year. All regular board meetings shall be open to the public and all records of its proceedings, resolutions, and actions shall be open to public view.

History of Section. P.L. 1978, ch. 108, § 2.

23-7-6.1. Officers of the board.

Upon the appointment of the two (2) new members prescribed in subsection 23-7-5(b) , the board shall elect from among its members a chair. Thereafter, the board shall annually elect in October a chair from among the members. The board may elect from among its members such other officers as it deems necessary.

History of Section. P.L. 2006, ch. 22, § 4; P.L. 2006, ch. 27, § 4.

23-7-6.2. Board training.

Newly appointed and qualified members of the board and new designees of ex officio members are required to complete a training course within six (6) months of their qualification or designation. The course shall be developed by the chair of the board, approved by the board and conducted by the chair of the board. The board may approve the use of any board or staff members or other individuals to assist with training. The course shall include instruction in the following areas: the provisions of chapters 23-7, 42-46, 36-14 and 38-2; and the board’s rules and regulations. The director of the department of administration shall, within ninety (90) days of April 20, 2006, prepare and disseminate training materials relating to the provisions of chapters 42-46, 36-14 and 38-2.

History of Section. P.L. 2006, ch. 22, § 4; P.L. 2006, ch. 27, § 4; P.L. 2008, ch. 475, § 39.

23-7-6.3. Reporting requirements.

Within ninety (90) days after the end of each fiscal year, the board shall approve and submit an annual report to the governor, the speaker of the house of representatives, the president of the senate, and the secretary of state of its activities during that fiscal year. The report shall provide: an operating statement summarizing meetings or hearings held, including meeting minutes, subjects addressed, decisions rendered, rules or regulations promulgated, studies conducted, policies and plans developed, approved, or modified, and programs administered or initiated; a consolidated financial statement of all funds received and expended including the source of the funds, a listing of any staff supported by these funds, and a summary of any clerical, administrative or technical support received; a summary of performance during the previous fiscal year including accomplishments, shortcomings and remedies; a synopsis of any legal matters related to the authority of the board; a summary of any training courses held pursuant to § 23-7-6.1 ; a briefing on anticipated activities in the upcoming fiscal year; and findings and recommendations for improvements. The report shall be posted electronically as prescribed in § 42-20-8.2 . The director of the department of administration shall be responsible for the enforcement of this provision.

History of Section. P.L. 2006, ch. 22, § 4; P.L. 2006, ch. 27, § 4.

23-7-7. Establishment of mosquito abatement districts and local councils.

Any city or town or subdivision of a city or town or any two (2) or more cities and towns in Rhode Island and bordering communities may become a mosquito abatement district in accordance with chapter 43 of title 45. That district must be titled “The mosquito abatement district”. Notice of the formation of a mosquito abatement district must be filed with the secretary of state with a description of the proposed boundaries of the district. Any mosquito abatement district formed must also notify the state mosquito abatement board through the agricultural division of the department of environmental management. Under normal conditions, no city or town or subdivision of a city or town, or number of cities and towns, shall undertake any mosquito control program without first being established as a mosquito abatement district and without approval of its mosquito control program by the board. The board shall be allowed ninety (90) days to act upon the proposed mosquito control program. A district council shall be established in accordance with § 45-24-36 and shall be called “The mosquito abatement council”. That council is declared to be the corporate authority of that district and shall exercise all of the powers and control all of the affairs and property of that district. The council shall keep regular records of all proceedings and financial affairs that shall be open to the inspection of the public at reasonable hours.

History of Section. P.L. 1978, ch. 108, § 2; P.L. 1988, ch. 66, § 1.

23-7-8. Powers and duties of councils.

With the prior approval and written consent of the state mosquito abatement board, the council of the district shall have the power to take all necessary or proper steps for the extermination of mosquitoes within the district and to abate as nuisances all stagnant pools of water and other breeding places for mosquitoes within the district, to purchase supplies and materials and to employ labor and assistants that may be necessary or proper in furtherance of the objects of the council, to build, construct, and repair and maintain necessary levees, cuts, canals, or channels upon land within the district, and generally to do any and all things necessary or incident to powers granted and to carry out the objects specified in this section. Prior to adoption of a district mosquito abatement program, a public hearing must be held. A hearing required by a federal, state, or municipal agency on the program will suffice for purposes of this section.

History of Section. P.L. 1978, ch. 108, § 2.

23-7-9. Right to appeal board decisions.

Any decision of the state mosquito abatement board on a proposed mosquito abatement program may be appealed to the director of environmental management. Appeal proceedings shall be in accordance with chapter 35 of title 42.

History of Section. P.L. 1978, ch. 108, § 2.

23-7-10. Notice to cease operation.

Whenever any city, town, or district commences any activity set forth in this chapter without first having obtained the written consent of the state mosquito abatement board, or violates any rule or regulation of the board, the director of the department of environmental management shall have the power by written notice to order the violator to cease and desist immediately. If the violator does not conform to the board’s order, the director may bring prosecution by complaint and warrant and the prosecution shall be made in the district court of the state. The director, without being required to enter into any recognizance or to give surety for cost, may institute those proceedings in the name of the state. It shall be the duty of the attorney general to conduct the prosecution of all of those proceedings brought by the director. The director may obtain relief in equity or by prerogative writ whenever that relief shall be necessary for the proper performance of his or her duties under §§ 23-7-1 — 23-7-1 5.

History of Section. P.L. 1978, ch. 108, § 2.

23-7-11. Annexation by district.

Any city or town or subdivisions of any city or town may, if willing, be annexed by appropriate action to a mosquito abatement district.

History of Section. P.L. 1978, ch. 108, § 2; P.L. 1988, ch. 66, § 1.

23-7-12. Dissolution of district.

Any mosquito abatement district organized under the provisions of this chapter may be dissolved and discontinued by appropriate action of either the state mosquito abatement board or the district council. Notice of dissolution must be filed with the secretary of state and the state mosquito abatement board.

History of Section. P.L. 1978, ch. 108, § 2.

23-7-13. Disconnection of territory from district.

Any town or city or subdivision of any city or town which lies within a mosquito abatement district may be disconnected, if willing, from a district upon the proper action by the council.

History of Section. P.L. 1978, ch. 108, § 2.

23-7-14. Severability.

The invalidity of any part or portion of this chapter shall not affect the validity of the remaining part of this chapter.

History of Section. P.L. 1978, ch. 108, § 2.

23-7-15. Emergency powers.

Nothing in this chapter shall prevent the director of health in an extreme emergency to the public health from exercising powers provided in §§ 23-1-20 — 23-1-23 .

History of Section. P.L. 1978, ch. 108, § 2.

23-7-16. Grants for mosquito abatement.

1. Consistent with the provisions of this chapter and the rules and regulations promulgated pursuant to the provisions of this chapter, the mosquito abatement board shall establish a competitive grant program. Only a mosquito abatement district formed or authorized pursuant to § 23-7-7 is eligible to receive a grant pursuant to this section. A mosquito abatement district shall be eligible to apply for one grant per year. The purpose of the grant program shall be to provide financial support to mosquito abatement districts for programs of long term preventive mosquito control that lead to minimization of pesticide use and minimal disruption of natural environments. The mosquito abatement board shall promulgate rules and regulations regarding the awarding of grants pursuant to this section. Appropriate uses of grant money may include, but are not limited to, the following: assisting cities and towns in mapping and data collection or in any start-up projects relating to the establishment of a mosquito abatement district, inventory of larval mosquito breeding sources, application of innovative and environmentally sound mosquito control methods, execution of approved water management projects which deal with mosquito control, and the purchase of educational materials and educational services, larvicide application equipment, and larval management operations. All grants shall be used in a manner consistent with established state policy for mosquito abatement. In the event that a district does not utilize all or any portion of its grant money, then the district shall return to the mosquito abatement board the nonutilized grant money.
2. The mosquito abatement board pursuant to chapter 35 of title 42 shall promulgate in regulation form the criteria upon which the grants will be awarded. The regulations setting forth grant criteria, in their final form, shall be given to all grant applicants. The mosquito abatement board shall clearly state, in writing, the reasons for its approval or denial of a grant.
3. The director of the department of environmental management will allocate funds to the Rhode Island mosquito abatement board to establish and carry out the mosquito abatement grant program. This program shall consist of up to eighty percent (80%) state matching grants for all eligible uses as outlined in subsection (a) of this section. Grants issued to Rhode Island cities and towns registered with the mosquito abatement board as mosquito abatement districts shall be conducted in accordance with this chapter and all rules and regulations promulgated pursuant to this chapter.

History of Section. P.L. 1989, ch. 96, § 1; P.L. 2001, ch. 139, § 1.

23-7.1-1. Short title.

This chapter shall be known and may be cited as the “Rodent Control Act”.

History of Section. P.L. 1968, ch. 277, § 1; G.L. 1956, § 23-45-1 ; P.L. 1979, ch. 39, § 1; G.L. 1956, § 23-7.1-1 .

23-7.1-2. Declaration of purpose.

The purpose of this chapter is to regulate the systematic control and eradication of rodents in the state so as to promote the public health, welfare, and safety, and to prevent injury, disease, or detriment to human life. It shall be the responsibility of the local communities to institute rodent control programs; however, since an effective rodent control program requires close cooperation between the local communities and the state department of health in planning and carrying out any rodent control program, this chapter requires the department of health to cooperate with local communities in developing and carrying out rodent control programs and to promulgate regulations establishing minimum standards which must be followed by all local communities in the state. This chapter also establishes incentives that encourage local communities to undertake more comprehensive rodent control programs.

History of Section. P.L. 1968, ch. 277, § 1: G.L. 1956, § 23-45-2; P.L. 1979, ch. 39, § 1: G.L. 1956, § 23-7.1-2 .

23-7.1-3. Definitions.

As used in this chapter, the following terms shall, unless the context otherwise requires, be construed as follows:

1. “Director” means the director of the department of health, or any subordinate or subordinates to whom he or she has delegated the powers and duties vested in him or her by this chapter.
2. “Federal government” means the government of the United States of America.
3. “Local communities” means any cities and towns of Rhode Island.
4. “Person” means any individual, firm, private corporation, association, partnership, municipal corporation, or any other entity recognized by the law as a subject of rights and duties.
5. “Rodent” means rats, mice, and/or bats.
6. “State” means the government of the state of Rhode Island.

History of Section. P.L. 1968, ch. 277, § 1: G.L. 1956, § 23-45-3; P.L. 1979, ch. 39, § 1: G.L. 1956, § 23-7.1-3 .

23-7.1-4. Powers and duties of the director.

It shall be the responsibility of the director to administer this chapter. In addition to the other powers and duties granted in this chapter, the director shall have and may exercise the following powers and duties:

1. Exercise general supervision of the administration and enforcement of this chapter.
2. Promulgate statewide minimum standards for rodent control and any other rules and regulations that may be necessary to further the purposes of this chapter.
3. Advise, consult, and cooperate with the local communities in furthering the purposes of this chapter.
4. Assist the local communities in the preparation of rodent control programs and in the preparation of applications to the federal government for the financing of rodent control programs.
5. Make agreements with local communities with respect to state financing pursuant to this chapter and certify disbursements pursuant to those agreements.
6. Make available, so far as is feasible and practicable, technical and advisory assistance to aid the local communities in furthering the purposes of this chapter.
7. Foster and establish continuing biological studies as part of the department of health’s program for the systematic control and eradication of rodents.
8. Exercise all incidental powers necessary to carry out the purposes of this chapter.

History of Section. P.L. 1968, ch. 277, § 1: G.L. 1956, § 23-45-4; P.L. 1979, ch. 39, § 1: G.L. 1956, § 23-7.1-4 .

23-7.1-5. Contributions to local communities.

The state may contribute to local communities for comprehensive rodent control programs approved by the director an amount not to exceed one-half (1/2) of the cost of those programs as determined by the director. If any rodent control programs receive financing from the federal government, the state contribution may not exceed one-half (1/2) of the excess of the cost of those programs over the federal grant-in-aid for those programs as follows:

1. If the federal government is financing a given percentage of the total costs of a program, the state contribution will be fixed as a percentage of the total costs and state disbursements will be made on a pro-rata basis at the time disbursements are made by the federal government.
2. If certain costs are not eligible for federal financing, the director shall nevertheless have the discretion to include those costs in the local contribution for the purpose of determining the maximum state contribution. In those cases, the disbursements of the state contribution will be related to the federal disbursements to the greatest extent possible.
3. Costs of the department of health attributable to carrying out its duties pursuant to this chapter as well as its regular activities with respect to environmental health will not be counted in determining the maximum amount of the state contribution.

History of Section. P.L. 1968, ch. 277, § 1: G.L. 1956, § 23-7.1-5 ; P.L. 1979, ch. 39, § 1: G.L. 1956, § 23-7.1-5 .

23-7.1-6. Penalty for violation.

Any person who shall knowingly violate any rule or regulation promulgated by the director pursuant to this chapter shall be fined not more than five hundred dollars ($500).

History of Section. P.L. 1968, ch. 277, § 1: G.L. 1956, § 23-45-6; P.L. 1979, ch. 39, § 1: G.L. 1956, § 23-7.1-6 .

23-7.1-7. Bite report not violation of physician-patient relationship.

Any report of rodent bites made pursuant to regulations promulgated by the director shall not be deemed a violation of the physician-patient relationship or otherwise contrary to the ethics of the medical profession.

History of Section. P.L. 1968, ch. 277, § 1: G.L. 1956, § 23-45-7; P.L. 1979, ch. 39, § 1: G.L. 1956, § 23-7.1-7 .

23-7.1-8. Severability.

If any provision of this chapter or the application of any provision to any person or circumstance shall be held invalid, that invalidity shall not affect the provisions or applications of this chapter which can be given effect without the invalid provision or application, and to this end the provisions of the chapter are declared to be severable.

History of Section. P.L. 1968, ch. 277, § 1: G.L. 1956, § 23-45-8; P.L. 1979, ch. 39, § 1: G.L. 1956, § 23-7.1-8 .

23-8-1. Reports of communicable diseases.

In addition to the provisions of chapters 10 and 11 of this title, the director of health may by regulation declare any disease to be a reportable disease. Every physician or other person having knowledge of a case or suspected case of a reportable disease shall give notice to the department of health in a manner prescribed by the director. The director may add or remove, at any time, the name of any disease to or from the list of diseases which he or she shall declare to be reportable and may, at any time, revise the manner of reporting. The regulations in respect to the reportable diseases shall state the time within which the notification to the department of health must be made, the individual by whom it is to be made, the method, whether by writing, telegraph, or telephone, in which it shall be made, and whether the case or suspected case is to be identified by name, address, and date of onset of illness.

History of Section. G.L. 1896, ch. 94, § 13; G.L. 1909, ch. 110, § 13; P.L. 1916, ch. 1382, § 1; G.L. 1923, ch. 154, § 13; P.L. 1931, ch. 1766, § 2; G.L. 1938, ch. 256, § 13; P.L. 1942, ch. 1159, § 1; G.L. 1956, § 23-8-1 ; P.L. 1963, ch. 88, § 1.

23-8-1.1. Consent to testing and treatment — Reportable — Communicable diseases.

Persons under eighteen (18) years of age may give legal consent for testing, examination, and/or treatment for any reportable communicable disease.

History of Section. P.L. 1990, ch. 169, § 6.

23-8-2. Authority of the governor to authorize immunization programs.

Whenever it shall be determined by the governor that a voluntary mass immunization program is necessary to protect the health and welfare of the people, he or she may issue a proclamation authorizing the program, and a copy of the proclamation shall be filed in the office of the secretary of state. All individuals or public or private agencies that participate in the authorized mass immunization projects shall not be liable to any person who experiences or purports to experience adverse effects arising from the immunization or attendant procedures; provided, however, that informed consent is obtained. Nothing in this chapter shall exempt from liability for gross negligence any individual or public or private agency participating in an authorized mass immunization project, nor shall the provisions of this chapter exempt any drug manufacturer from any liability, regardless of the degree of negligence for any drug or vaccine used in the projects.

History of Section. P.L. 1976, ch. 316, § 1.

23-8-3. Repealed.

23-8-4. Quarantine.

If the state director of health, or his or her duly authorized agent, determines, upon investigation, that a threat to the public health exists because any person is suffering, or appears to be suffering, from a communicable disease, the director or his or her authorized agent may require or provide that person to be confined, in some proper place, for the purpose of isolation or quarantine, or another less restrictive intervention treatment, including, but not limited to, immunization, treatment, exclusion or other protective actions until the threat to the public health has abated. Nothing in this section shall be construed to prevent a person who is unable or unwilling for reasons of health, religion, or conscience to undergo immunization or treatment from choosing to submit to quarantine or isolation as an alternative to immunization or treatment. Orders under this chapter shall be in accordance with the procedures for compliance order and immediate compliance orders set forth in §§ 23-1-20 — 23-1-24 . A person subject to quarantine under this section shall be entitled to file a petition for relief from such order at any time, included, but not limited to, a petition based upon compliance with a treatment under less restrictive alternatives.

History of Section. G.L. 1896, ch. 94, § 15; G.L. 1909, ch. 110, § 15; G.L. 1923, ch. 154, § 15; G.L. 1938, ch. 256, § 15; G.L. 1956, § 23-8-4 ; P.L. 1967, ch. 60, § 1; P.L. 2003, ch. 185, § 2; P.L. 2003, ch. 189, § 2.

23-8-4.1. Power to examine suspected cases — Right of individual to own physician.

For the purpose of carrying out the provisions of this chapter, the state department of health is empowered to make examinations of persons reasonably suspected of having a communicable disease; provided, however, that any person so examined shall have the right to have present at that examination, a physician of his or her own choice, at his or her own expense. The state department of health shall inform him or her of this right and afford him or her a reasonable opportunity to exercise that right; and at the trial of any person being prosecuted under the provisions of § 23-1-25 , the prosecution must demonstrate that he or she was so informed and was afforded that opportunity.

History of Section. P.L. 2003, ch. 185, § 3; P.L. 2003, ch. 189, § 3.

23-8-5, 23-8-6. Repealed.

23-8-7. Violation of quarantine.

Any person who is confined by the director or his or her authorized agent under the provision of § 23-8-4 and who violates that confinement shall be punished by a fine of not more than fifty dollars ($50.00) or by imprisonment for not more than ninety (90) days, or both.

History of Section. G.L. 1896, ch. 94, § 24; G.L. 1909, ch. 110, § 24; G.L. 1923, ch. 154, § 24; G.L. 1938, ch. 256, § 24; G.L. 1956, § 23-8-7 ; P.L. 1967, ch. 60, § 1.

23-8-8 — 23-8-17. Repealed.

23-8-18. Proclamation of general quarantine.

The power to establish quarantine in this state shall also be vested in the governor; and whenever the governor shall deem it advisable for the preservation of public health and the prevention of the spread of infectious diseases, he or she may, by proclamation, place under quarantine the whole state or that portion of the state that he or she may deem necessary, and he or she shall authorize and empower the state director of health to take any action and make and enforce any rules and regulations that may be deemed necessary to prevent the introduction and to restrict the spread of infectious diseases in the state.

History of Section. G.L. 1896, ch. 95, § 13; G.L. 1909, ch. 114, § 13; G.L. 1923, ch. 157, § 13; G.L. 1938, ch. 258, § 13; impl. am. P.L. 1939, ch. 660, § 180; G.L. 1956, § 23-8-18 .

23-8-19. Compliance with quarantine by transportation agencies.

Whenever quarantine is declared, all railroad and steamboat corporations, stage lines, the owners, assignees, officials, and employees of those companies, and all vehicles and modes of conveyance of passengers, baggage, and freight, shall observe and comply with the rules and regulations made by the director of health; and any person knowingly violating any of the rules and regulations of the director shall, upon conviction, be fined not more than fifty dollars ($50.00), or be imprisoned not more than two (2) years.

History of Section. G.L. 1896, ch. 95, § 14; G.L. 1909, ch. 114, § 14; G.L. 1923, ch. 157, § 14; G.L. 1938, ch. 258, § 14; impl. am. P.L. 1939, ch. 660, § 180; G.L. 1956, § 23-8-19 .

23-8-20. Expense of quarantine and suppression of disease.

The state department of health, with the approval of the governor, may incur all necessary expenses for preventing and restricting the prevalence of epidemic diseases and of carrying out the provisions of §§ 23-8-18 and 23-8-19 , and the state controller shall draw his or her orders upon the general treasurer for the payment of those expenses out of any money in the treasury not otherwise appropriated, upon receipt of itemized bills for those expenses approved by the governor.

History of Section. G.L. 1896, ch. 95, § 15; G.L. 1909, ch. 114, § 15; G.L. 1923, ch. 157, § 15; G.L. 1938, ch. 258, § 15; impl. am. P.L. 1939, ch. 660, §§ 65, 180; G.L. 1956, § 23-8-20 .

23-8-21. Ship quarantine powers preserved — Local enforcement of quarantine — Rules and regulations — Penalty.

Nothing in §§ 23-8-18 — 23-8-20 shall be construed to impair the validity of any rules and regulations made and in force under the provisions of §§ 23-9-1 — 23-9-11 , nor to abridge the powers of any officer mentioned in §§ 23-9-1 — 23-9-11 ; and every officer shall also have power, within the city or town for which he or she was appointed, to enforce, during the period that any proclamation made by the governor for the purpose of establishing quarantine shall be in force, all rules and regulations made by the state director of health; and it shall be the duty of the several city and town councils to require those officers to enforce the rules and regulations mentioned and referred to in this section within their respective cities and towns; provided, that the director of health, during the period when any proclamation of quarantine shall be in force, shall have power at any time, and from time to time, to suspend any of the rules and regulations mentioned and referred to in this section, and to make and establish rules and regulations in substitution for them and in addition to them, respecting quarantine in any city or town, and that any person knowingly violating any of those rules and regulations so made and established shall, upon conviction, be fined not more than fifty dollars ($50.00) or be imprisoned not more than two (2) years; and provided, further, that any and all powers and duties in this chapter conferred and imposed upon any officer or city or town council shall, during any quarantine period, be exercised and performed by that officer or city or town council subject to the orders and directions of the director of health.

History of Section. G.L. 1896, ch. 95, § 16; G.L. 1909, ch. 114, § 16; G.L. 1923, ch. 157, § 16; G.L. 1938, ch. 258, § 16; impl. am. P.L. 1939, ch. 660, § 180; G.L. 1956, § 23-8-21 .

23-9-1. Appointment of seaport health officers — Duties and compensation.

Each seaport city or town, or the city or town council of each seaport city or town, may appoint a health officer for the city or town who shall visit all vessels which shall be subject to examination of quarantine, and carry into execution all regulations established by the city or town council, and shall be at all times accountable to the city or town council, and shall receive for his or her services compensation that the council may allow, to be paid by the owners, agents or commanders of any vessels that may be subjected to quarantine or examination.

History of Section. G.L. 1896, ch. 95, § 1; G.L. 1909, ch. 114, § 1; G.L. 1923, ch. 157, § 1; G.L. 1938, ch. 258, § 1; G.L. 1956, § 23-9-1 .

23-9-2. Publication of city or town quarantine regulations.

The city or town council shall publish in one or more newspapers published in the state, within or nearest the city or town where the rules and regulations shall be adopted, at the expense of the city or town, all rules and regulations made by it respecting quarantine.

History of Section. G.L. 1896, ch. 95, § 2; G.L. 1909, ch. 114, § 2; G.L. 1923, ch. 157, § 2; G.L. 1938, ch. 258, § 2; G.L. 1956, § 23-9-2 .

23-9-3. Places from which vessels arriving are subject to quarantine.

The city or town council shall prescribe from time to time the several ports, places, or countries from which vessels arriving shall be subject to examination or quarantine.

History of Section. G.L. 1896, ch. 95, § 3; G.L. 1909, ch. 114, § 3; G.L. 1923, ch. 157, § 3; G.L. 1938, ch. 258, § 3; G.L. 1956, § 23-9-3 .

23-9-4. Designation of time and place of quarantine.

The city or town council shall designate the particular place in the harbor, bay, or river adjacent to the city or town where all arriving ships or vessels subject to examination or quarantine shall come to anchor; and shall define the limits of the quarantine ground, and assign the time for which those ships or vessels shall be detained, and where and how unladen.

History of Section. G.L. 1896, ch. 95, § 4; G.L. 1909, ch. 114, § 4; G.L. 1923, ch. 157, § 4; G.L. 1938, ch. 258, § 4; G.L. 1956, § 23-9-4 .

23-9-5. Sentinel to order ships into quarantine.

The city or town council may appoint a sentinel, who shall be paid by the city or town and stationed in some convenient place on shore, or in some properly situated boat or vessel, to hail all ships or vessels which may arrive in that river, bay, or harbor; and if the sentinel shall find that any ship or vessel is subject to quarantine, he or she shall direct the commander of that ship or vessel to come to anchor within the limits of that quarantine ground, and remain there until visited by the health officer, and to place a signal in the shrouds of the vessel in a manner as to be seen at a proper distance.

History of Section. G.L. 1896, ch. 95, § 5; G.L. 1909, ch. 114, § 5; G.L. 1923, ch. 157, § 5; G.L. 1938, ch. 258, § 5; G.L. 1956, § 23-9-5 .

23-9-6. Penalty for refusal to anchor in quarantine.

Every commander of a ship or vessel who shall, upon being hailed and directed by the sentinel, refuse or neglect to bring his or her ship or vessel to anchor within the limits as described in § 23-9-4 , shall be fined not exceeding five hundred dollars ($500) nor less than twenty dollars ($20.00), to the use of the city or town.

History of Section. G.L. 1896, ch. 95, § 6; G.L. 1909, ch. 114, § 6; G.L. 1923, ch. 157, § 6; G.L. 1938, ch. 258, § 6; G.L. 1956, § 23-9-6 ; P.L. 2001, ch. 86, § 68.

23-9-7. Council order to anchor in quarantine.

The city or town council may order a ship or vessel to be anchored on the quarantine ground, at the expense of the owners, master, or commanding officer of the ship or vessel, to remain there until legally discharged from the quarantine ground.

History of Section. G.L. 1896, ch. 95, § 7; G.L. 1909, ch. 114, § 7; G.L. 1923, ch. 157, § 7; G.L. 1938, ch. 258, § 7; G.L. 1956, § 23-9-7 .

23-9-8. Unauthorized departure from vessel under quarantine.

Every person who shall leave any ship or vessel under order of quarantine without permission from the health officer or the city or town council of that city or town, shall be fined not exceeding twenty dollars ($20.00); and the city or town council may order that person to be returned on board of that vessel, and to remain there until the council orders him or her to be dismissed.

History of Section. G.L. 1896, ch. 95, § 8; G.L. 1909, ch. 114, § 8; G.L. 1923, ch. 157, § 8; G.L. 1938, ch. 258, § 8; G.L. 1956, § 23-9-8 .

23-9-9. Quarantine of vessels bound for Providence.

If any vessel shall arrive in the waters of the state bound to the port of Providence at any time while the quarantine regulations of the city of Providence are in force, no person on board that vessel shall leave it until it has been visited and examined by the health officer of Providence, and permission to land has been given by that health officer or by the city council of Providence to that person to enter the city. Every person leaving that vessel without first obtaining permission, shall be fined not exceeding twenty dollars ($20.00); and the city council may cause that person to be returned to the vessel in case it is under quarantine, and to remain there until permitted to depart.

History of Section. G.L. 1896, ch. 95, §§ 9, 10; G.L. 1909, ch. 114, §§ 9, 10; G.L. 1923, ch. 157, §§ 9, 10; G.L. 1938, ch. 258, §§ 9, 10; G.L. 1956, § 23-9-9 .

23-9-10. Enforcement by sheriffs, sergeants, and constables.

Every sheriff, deputy sheriff, town sergeant, and town constable shall carry the rules and regulations of the city or town council within his or her precinct into effect.

History of Section. G.L. 1896, ch. 95, § 11; G.L. 1909, ch. 114, § 11; G.L. 1923, ch. 157, § 11; G.L. 1938, ch. 258, § 11; G.L. 1956, § 23-9-10 ; P.L. 2015, ch. 260, § 29; P.L. 2015, ch. 275, § 29.

23-9-11. Disposition of fines.

The fines for the violation of any of the provisions of this chapter shall be recovered to the use of the city or town where the offense was committed.

History of Section. G.L. 1896, ch. 95, § 12; G.L. 1909, ch. 114, § 12; G.L. 1923, ch. 157, § 12; G.L. 1938, ch. 258, § 12; G.L. 1956, § 23-9-11 .

23-9-12. Federal quarantine system superseding Providence regulations.

Whenever the United States of America shall put in force a system of national quarantine inspection for the port of Providence, the duties of the quarantine health officer and sentinel of that city shall be suspended for so long a period as the quarantine inspection shall be maintained, and whenever the United States shall establish a quarantine station, ground, or anchorage on or in the Providence River or Narragansett Bay, north of Conimicut Point, and put in force a complete system of national quarantine for the port of Providence, the provisions of §§ 23-9-1 — 23-9-11 shall not apply to the city of Providence or the port of Providence.

History of Section. G.L. 1909, ch. 114, § 17; P.L. 1912, ch. 801, § 1; G.L. 1923, ch. 157, § 17; G.L. 1938, ch. 258, § 17; G.L. 1956, § 23-9-12 .

23-9-13. Repealed.

23-9-14. Hoisting of quarantine colors.

The commander of a vessel as described in this chapter, on his or her arrival in any of the waters of the state, shall immediately hoist and keep his or her colors in the shrouds of that vessel as a signal that he or she has come from some infected place or has infection or contagion on board.

History of Section. G.L. 1896, ch. 94, § 2; G.L. 1909, ch. 110, § 2; G.L. 1923, ch. 154, § 2; G.L. 1938, ch. 256, § 2; G.L. 1956, § 23-9-14 ; P.L. 2008, ch. 475, § 40.

23-9-15. Unauthorized departure from infected vessel.

If any person shall come on shore from on board a vessel as described in this chapter without first obtaining a license, the city or town council may immediately send that offender back on board that vessel, or confine him or her on shore in a convenient place that appears to the city or town council most effectual to prevent the spreading of any infection; and the offending person shall satisfy and pay all charges that shall arise on the confinement, and shall be fined forty dollars ($40.00).

History of Section. G.L. 1896, ch. 94, § 3; G.L. 1909, ch. 110, § 3; G.L. 1923, ch. 154, § 3; G.L. 1938, ch. 256, § 3; G.L. 1956, § 23-9-15 ; P.L. 2008, ch. 475, § 40.

23-9-16. Examination of vessel — Guards to prevent unauthorized communication.

The city or town council of the city or town where a vessel as described in this chapter arrives shall send a physician or other suitable person to examine and report to them of the true state of that vessel and the people on board, at the charge of the master or owner of that vessel; and they shall immediately put on board that vessel some suitable person or persons to secure that vessel and effectually prevent any communication with that vessel, at the like charge of the master or owner of that vessel.

History of Section. G.L. 1896, ch. 94, § 4; G.L. 1909, ch. 110, § 4; G.L. 1923, ch. 154, § 4; G.L. 1938, ch. 256, § 4; G.L. 1956, § 23-9-16 ; P.L. 2008, ch. 475, § 40.

23-9-17. Confinement or removal of persons on board.

The city or town council of the city or town where a vessel as described in this chapter arrives shall confine on board that vessel, or send to some hospital or other suitable place, all persons who came in that vessel, for a convenient time, until those of them that have, or are likely to have, the smallpox or other infectious or contagious distemper are perfectly recovered and cleansed from that distemper, or have passed a suitable quarantine, and also all persons who have gone on board that vessel without license, at the charge and expense of those persons respectively.

History of Section. G.L. 1896, ch. 94, § 5; G.L. 1909, ch. 110, § 5; G.L. 1923, ch. 154, § 5; G.L. 1938, ch. 256, § 5; G.L. 1956, § 23-9-17 ; P.L. 2008, ch. 475, § 40.

23-9-18. Disinfection of imported goods.

The city or town council of a city or town where a vessel as described in this chapter arrives shall appoint suitable persons to take effectual care that all goods, wares, and merchandise imported in that vessel which they think may hold and communicate the infection or contagion are landed in some suitable place to be appointed by the council and cleansed in the manner directed by the council before they are permitted to be brought into any house, shop, or warehouse, other than that in which they are cleansed.

History of Section. G.L. 1896, ch. 94, § 6; G.L. 1909, ch. 110, § 6; G.L. 1923, ch. 154, § 6; G.L. 1938, ch. 256, § 6; G.L. 1956, § 23-9-18 ; P.L. 2008, ch. 475, § 40.

23-9-19. Certification and delivery of disinfected goods — Expense of disinfection.

Whenever infected or contagious goods are sufficiently aired and cleansed, those persons described in § 23-9-18 shall give the owners or persons entitled to possession of those goods a certificate to that effect; and the city or town council shall allow and order those goods, wares, and merchandise to be delivered to their owners; and the charge and expense of airing, landing, and cleansing those goods, wares, and merchandise shall be borne by the respective owners; and that charge shall be a lien on those goods, wares, and merchandise.

History of Section. G.L. 1896, ch. 94, § 7; G.L. 1909, ch. 110, § 7; G.L. 1923, ch. 154, § 7; G.L. 1938, ch. 256, § 7; G.L. 1956, § 23-9-19 .

23-9-20. Delivery of goods not infected — Cleansing or destruction of infected goods.

All goods that are judged by the city or town council not to be infected shall be delivered to the owners without delay and expense of airing and as soon as may be consistent with the safety of the city or town; and all goods, wares, and merchandise imported into any city or town by land from any place infected with the smallpox or other contagious or infectious distemper, shall be aired and cleansed at the discretion of the city or town council of that city or town and at the expense of their owners, or destroyed if necessary.

History of Section. G.L. 1896, ch. 94, § 8; G.L. 1909, ch. 110, § 8; G.L. 1923, ch. 154, § 8; G.L. 1938, ch. 256, § 8; G.L. 1956, § 23-9-20 .

23-9-21. Forfeiture of unlawfully imported goods.

All goods imported in a vessel as described in this chapter that shall be clandestinely landed or brought into any house, shop, or warehouse without a certificate and allowance as provided in § 23-9-19 , or that shall be imported by land as provided in § 23-9-20 and not cleansed or aired by order of the city or town council, shall be forfeited; one-third (1/3) of those goods to the use of the state and two-thirds (2/3) to the use of the person who shall sue for the goods.

History of Section. G.L. 1896, ch. 94, § 9; G.L. 1909, ch. 110, § 9; G.L. 1923, ch. 154, § 9; G.L. 1938, ch. 256, § 9; G.L. 1956, § 23-9-21 ; P.L. 2008, ch. 475, § 40.

23-9-22. Settlement of wages and charges.

The city and town councils of the respective cities and towns shall fix, settle, and adjust all wages and charges demanded by persons employed by them to secure a vessel, or to air and cleanse those goods, or to attend upon and nurse those persons as provided in this chapter.

History of Section. G.L. 1896, ch. 94, § 10; G.L. 1909, ch. 110, § 10; G.L. 1923, ch. 154, § 10; G.L. 1938, ch. 256, § 10; G.L. 1956, § 23-9-22 .

23-9-23. Action for recovery of expenses.

If any owner, freighter, mariner, or passenger shall refuse to pay those wages and charges settled, adjusted, and fixed pursuant to § 23-9-22 , then the city or town shall sue for and recover those wages and charges, and the court where the action is brought and maintained shall tax double costs for the plaintiff.

History of Section. G.L. 1896, ch. 94, § 11; G.L. 1909, ch. 110, § 11; G.L. 1923, ch. 154, § 11; G.L. 1938, ch. 256, § 11; G.L. 1956, § 23-9-23 .

23-9-24. Waters under concurrent jurisdiction of Newport.

The health officer of the city of Newport shall, under the direction of the council of that city, have authority concurrent with the city or town councils of the several cities or towns in the county of Newport bordering on the public waters of the state in all matters arising under this chapter in relation to any vessel coming within Dutch Island Harbor or within the waters of the East River below the bridges between Portsmouth and Tiverton.

History of Section. G.L. 1896, ch. 94, § 32; G.L. 1909, ch. 110, § 32; G.L. 1923, ch. 154, § 32; G.L. 1938, ch. 256, § 32; G.L. 1956, § 23-9-24 .

23-10-1. Report of tubercular cases by state institutions.

The superintendent or other person in charge or control of any hospital, school, reformatory, or other institution, deriving the whole or any part of its support from the public funds of the state, having in charge or under its care or custody any person or persons suffering with tuberculosis, shall, within forty-eight (48) hours after recognition of that disease, make or cause to be made in the manner and form prescribed by the state department of health a record of the name, age, sex, color, race, occupation, social condition, and residence of the person or persons, so affected, together with any other appropriate information that may be demanded by the state department of health. That information shall be furnished on blanks supplied by the state department of health, and that information shall be forwarded each week to the office of the director of health, on those blanks. Any superintendent, or any other person, charged with any duty under this section who shall fail or refuse to comply with the requirements of this section shall be guilty of a misdemeanor and upon conviction shall be fined not more than twenty-five dollars ($25.00).

History of Section. G.L. 1896, ch. 96, § 11; P.L. 1909, ch. 386, § 1; G.L. 1923, ch. 153, § 11; G.L. 1938, ch. 255, § 9; P.L. 1939, ch. 713, § 1; G.L. 1956, § 23-10-1 .

23-10-2. Reports by physicians.

Whenever any physician knows that any person under his or her professional care is affected with tuberculosis, he or she shall transmit to the director of the state department of health within seven (7) days, upon blanks provided by the state department of health for that purpose, the name, sex, age, color, race, occupation, social condition, and residence of that person. Any physician failing or refusing to comply with the requirements of this section shall be guilty of a misdemeanor and on conviction shall be subject to a fine of ten dollars ($10.00).

History of Section. G.L. 1896, ch. 96, § 12; P.L. 1909, ch. 386, § 1; G.L. 1923, ch. 153, § 12; G.L. 1938, ch. 255, § 10; P.L. 1939, ch. 713, § 1; G.L. 1956, § 23-10-2 .

23-10-3. Prosecution of violations.

It shall be the duty of the director of health to report to the prosecuting officers of the different cities and towns in this state any violation of the requirements of §§ 23-10-1 and 23-10-2 , and it shall be the duty of the prosecuting officers of the several cities and towns to immediately obtain warrants for the apprehension of persons violating the requirements of §§ 23-10-1 and 23-10-2 .

History of Section. G.L. 1896, ch. 96, § 13; P.L. 1909, ch. 386, § 1; G.L. 1923, ch. 153, § 13; G.L. 1938, ch. 255, § 11; impl. am. P.L. 1939, ch. 660, § 180; G.L. 1956, § 23-10-3 .

23-10-4. Register of tubercular cases.

It shall be the duty of the state department of health to keep a register of all persons in this state known to be affected with tuberculosis. The state department of health shall have sole, exclusive control of that register and shall not permit its inspection nor disclose any of its personal particulars except to officials authorized under the laws of this state to receive that information.

History of Section. G.L. 1896, ch. 96, § 10; P.L. 1909, ch. 386, § 1; G.L. 1923, ch. 153, § 10; G.L. 1938, ch. 255, § 8; P.L. 1939, ch. 713, § 1; G.L. 1956, § 23-10-4 .

23-10-5. Transmission of reports to local agencies.

The state department of health shall be authorized to submit reports of cases of tuberculosis which it receives and has on file in its register to city and town health departments and to other community agencies, voluntary and official, properly organized to receive those reports, capable of maintaining an adequate system of tuberculosis control within their respective communities.

History of Section. G.L. 1938, ch. 255, § 15; P.L. 1939, ch. 713, § 2; G.L. 1938, ch. 255, § 151/2; P.L. 1941, ch. 1014, § 2; G.L. 1956, § 23-10-5 .

23-10-6. Quarantine for treatment of actively or chronically diseased persons.

1. For the purposes of this section, a person has active tuberculosis when: (1) a sputum smear or culture taken from a pulmonary, laryngeal, or other source has tested positive for tuberculosis and the person has not completed an appropriate prescribed course of medication for tuberculosis, or (2) a smear or culture from an extra-pulmonary source has tested positive for tuberculosis and there is clinical evidence or clinical suspicion of pulmonary tuberculosis disease and the person has not completed an appropriate prescribed course of medication for tuberculosis. A person also has active tuberculosis when, in those cases where sputum smears or cultures are unobtainable, the radiographic evidence, in addition to current clinical evidence and/or laboratory tests, is sufficient to establish a medical diagnosis of tuberculosis for which treatment is indicated.
2. Where the director determines that the public health or the health of any other person is endangered by a case of tuberculosis, or a suspected case of tuberculosis, the director may issue any appropriate orders necessary to protect the public health or the health of any other person in accordance with this chapter, and may make application to a court for enforcement of any appropriate orders. In any court proceeding for enforcement, the director shall demonstrate the particularized circumstances constituting the necessity for an order. Detention shall not be authorized until all less-restrictive alternatives have been tried and no less-restrictive alternative is available. Those orders may include, but shall not be limited to:
   1. An order authorizing the removal to and/or detention in a hospital or other treatment facility for appropriate examination for tuberculosis of a person who has active tuberculosis or who is suspected of having active tuberculosis and who is unable or unwilling to voluntarily submit to an appropriate examination by a physician or by the department;
   2. An order requiring a person who has active tuberculosis to complete an appropriate prescribed course of medication for tuberculosis and, if necessary, to follow required contagion precautions for tuberculosis;
   3. An order requiring a person who has active tuberculosis and who is unable or unwilling otherwise to complete an appropriate prescribed course of medication for tuberculosis to follow a course of directly observed therapy. For the purposes of this provision, “directly observed therapy” means a course of treatment for tuberculosis in which the prescribed anti-tuberculosis medication is administered to the person or taken by the person under direct observation as specified by the department;
   4. An order for the removal to and/or detention in a hospital or other treatment facility of a person: (i) who has active tuberculosis that is infectious or who presents a substantial likelihood of having active tuberculosis that is infectious, based upon epidemiologic evidence, clinical evidence, x-ray readings, or laboratory test results; and (ii) where the department finds, based on recognized infection control principles, that there is a substantial likelihood the person may transmit to others tuberculosis because of his or her inadequate separation from others; or
   5. An order for the removal to and/or detention in a hospital or other treatment facility of a person: (i) who has active tuberculosis, or who has been reported to the department as having active tuberculosis with no subsequent report to the department of the completion of an appropriate prescribed course of medication for tuberculosis; and (ii) where there is a substantial likelihood that the person poses a significant risk of harm to others and who refuses to report for treatment or who refuses to continue or complete treatment for tuberculosis, until the director determines that the person is no longer a danger to the public.
3. After two (2) licensed physicians, including at least one board certified pulmonary or infectious disease specialist, have certified the diagnosis of tuberculosis, the director may remove to or detain in a hospital or other place for examination or treatment a person who is the subject of an order of removal or detention issued pursuant to subsection (a) without prior court order; provided, however, that when a person detained pursuant to subsection (a) has requested release, the director shall make an application for a court order authorizing detention within seventy-two (72) hours after a release request, or, if the seventy-two (72) hour period ends on a Saturday, Sunday or legal holiday, by the end of the first business day following the Saturday, Sunday or legal holiday, which application shall include a request for an expedited hearing. In the event that the detained person requests release thereby triggering this seventy-two (72) hour expedited hearing, the hearing shall be a preliminary hearing, shall be treated with priority on the court calendar, and may be continued only for good cause shown. If at this preliminary hearing the court determines that there is no probable cause to support detention, the director’s petition shall be dismissed, the director’s order vacated, and the person shall be discharged unless the person applies for voluntary admission to care and treatment. However, if the court is satisfied that there is probable cause to support the director’s order, the director’s order shall remain in full force and effect and the full hearing procedures as set forth at subsection (h) shall be effectuated. In any event, detention shall not continue for more than five (5) business days in the absence of a court-order authorizing detention. The court order shall be sought by the director pursuant to the hearing procedures as set forth at subsection (h). The director shall seek further court review of detention within forty-five (45) days following the initial court order authorizing detention and subsequently within forty-five (45) days of each subsequent court review. In any court proceeding to enforce a director’s order for the removal or detention of a person issued pursuant to this chapter or for review of the continued detention of a person, the director shall prove the particularized circumstances constituting the necessity for detention by clear and convincing evidence. Any person who is subject to a detention order shall have the right to be represented by counsel and upon the request of the person, counsel shall be provided by the court. The person subject to detention shall be entitled to file a petition for release at any time, included but not limited to, a petition based upon compliance with therapy and a plan to complete therapy in another less restrictive setting.
4. 1. An order of the director pursuant to subsection (b) shall set forth;
      1. The legal authority under which the order is issued, including the particular sections of this chapter;
      2. An individualized assessment of the person’s circumstances and/or behavior constituting the basis for the issuance of the order;
      3. The less restrictive treatment alternatives that were attempted and were unsuccessful and/or the less restrictive treatment alternatives that were considered and rejected, and the reasons those alternatives were rejected.
   2. In addition, an order for the removal and detention of a person shall:
      1. Include the purpose of the detention;
      2. Advise the person being detained that he or she has the right to request release from detention by contacting a person designated on the director’s order at a telephone number stated on the director’s order, and that the detention shall not continue for more than five (5) business days after a release request in the absence of a court order authorizing the detention;
      3. Advise the person being detained that, whether or not he or she requests release from detention, the director must obtain a court order authorizing detention within five (5) days following the commencement of detention and thereafter must further seek court review of the detention within forty-five (45) days of the court order, and within forty-five (45) days of each subsequent court review;
      4. Advise the person being detained that he or she has the right to arrange to be represented by counsel or to have counsel appointed, and that if he or she chooses to have counsel appointed, the counsel will be notified that the person has requested legal representation.
5. A person who is detained solely pursuant to subsection (b)(1) shall not continue to be detained beyond the minimum period of time required, with the exercise of all due diligence, to make a medical determination of whether a person who is suspected of having tuberculosis has active tuberculosis or whether a person who has active tuberculosis is infectious. Further detention of the person shall be authorized only upon the issuance of a director’s order pursuant to subsection (b)(4) or (b)(5);
6. A person who is detained pursuant to this section solely for the reasons described in subsection (b)(4) shall not continue to be detained after the department ascertains that changed circumstances exist that permit him or her to be adequately separated from others so as to prevent transmission of tuberculosis after his or her release from detention or that a less-restrictive alternative to the detention is established.
7. A person who is detained pursuant to this section for the reasons described in subsection (b)(5) shall not continue to be detained after he or she has completed an appropriate prescribed course of medication.
8. 1. A verified petition may be filed in the district court, or family court in the case of a person who has not reached his or her eighteenth (18th) birthday, for the detention to a facility of any person who is subject to an order of the director pursuant to subsection (b). The petition may be filed by the director and shall be filed only after the petitioner has investigated what alternatives to detention are available and determined why the alternatives are not deemed suitable.
   2. A hearing scheduled under this section shall be conducted pursuant to the following requirements:
      1. All evidence shall be presented according to the usual rules of evidence that apply in civil, non-jury cases. The subject of the proceedings shall be given the right to present evidence in his or her own behalf, and to cross-examine all witnesses against him or her, including any physician who has certified the diagnosis of tuberculosis pursuant to subsection (c) of this section. The subject of the proceedings shall have the further right to subpoena witnesses and documents, the cost of subpoenaing witnesses and documents to be borne by the court where the court finds upon an application of the subject that the person cannot afford to pay for the cost of subpoenaing witnesses and documents.
      2. A verbatim transcript or electronic recording shall be made of the hearing which shall be impounded and obtained or examined only with the consent of the subject of the hearing (or in the case of a person who has not yet attained his or her eighteenth (18th) birthday, his or her parent, guardian, or next of kin) or by order of the court.
      3. The hearing may be held at a location other than a court, including any facility where the subject may then be a patient, where it appears to the court that holding the hearing at another location would be in the best interests of the subject of the hearing or any participants in the hearing.
      4. The burden of proceeding and the burden of proof in a hearing held pursuant to this section shall be upon the petitioner. The petitioner has the burden of demonstrating that the subject of the hearing is in need of care and treatment in a facility, is one whose continued unsupervised presence in the community would create a likelihood of serious harm, and what alternatives to detention are available, what alternatives to detention were investigated, and why these alternatives were not deemed suitable.
      5. The court shall render a decision within forty-eight (48) hours after the hearing is concluded.
   3. If the court after a hearing finds by clear and convincing evidence that the subject of the hearing is in need of care and treatment in a facility, and is one whose continued unsupervised presence in the community would create a likelihood of serious harm, and that all alternatives to detention have been investigated and deemed unsuitable, it shall issue an order committing the person to the custody of the director for care and treatment in an appropriate facility. The person shall be cared for in a facility that imposes the least restraint upon the liberty of the person consistent with affording him or her the care and treatment necessary and appropriate to his or her condition. All detention orders shall be reviewed by the court within forty-five (45) days of the court order, and within forty-five (45) days of each subsequent court review.
   4. 1. A person detained under this section shall have a right to appeal from a court order of detention to the supreme court of the state within thirty (30) days of the entry of an order of detention. The person shall have the right to be represented on appeal by counsel of his or her choice or by court appointed counsel if the supreme court finds that he or she cannot afford to retain counsel. Upon a showing of indigency the supreme court shall permit an appeal to proceed without payment of costs, and a copy of the transcript of the proceedings below shall be furnished to the subject of the proceedings or to his or her attorney at the expense of the state. The court which issued the detention order shall advise the person of all his or her rights pursuant to this section immediately upon the entry of the detention order.
      2. Appeals under this section shall be given precedence, insofar as practicable, on the supreme court dockets. The district and family courts shall promulgate rules with the approval of the supreme court to insure the expeditious transmission of the record and transcript in all appeals pursuant to this chapter.
9. Where necessary, language interpreters and persons skilled in communicating with vision and hearing impaired individuals shall be provided.
10. The provisions of this section shall not be construed to permit or require the forcible administration of any medication without a prior court order.
11. No person, for religious or other reasons, may be compelled by the department of health to undergo treatment for tuberculosis as long as the individual is willing to place himself or herself in an environment that excludes others from risk of acquiring tuberculosis.
12. The director of health shall ensure that appropriate treatment, monitoring, and care for tuberculosis are made available for every individual who is isolated and confined, and these services shall be provided with no restrictions as to the quarantined individual’s ability to pay for those services.
13. The department of health is authorized to promulgate rules and regulations in order to implement and enforce the provisions of this chapter.

History of Section. P.L. 1993, ch. 253, § 5; P.L. 1993, ch. 406, § 3.

23-10-7. Laboratory culture for tuberculosis.

All biological samples or specimens taken from Rhode Island residents for the purpose of performing laboratory culture for tuberculosis (Mycobacterium tuberculosis) or for determining antibiotic sensitivities of cases of tuberculosis, by or under the direction or order of any physician licensed to practice medicine in this state, shall be sent to the Rhode Island department of health laboratory for analysis. Those biological samples or specimens may be split at the time of procurement to permit one portion of the sample or specimen to be sent to the department of health laboratory for analysis and the other portion to be analyzed at another appropriately credentialed laboratory. In the case of split samples or specimens, third party payers shall pay both the department of health laboratory and the appropriately credentialed laboratory for analyzing those samples or specimens. The department of health shall waive the requirement for samples or specimens to be sent to the department of health laboratory and shall establish a written memorandum of agreement with any appropriately credentialed laboratory which can meet or exceed the most current laboratory standard of practice for tuberculosis testing, including maximum turnaround time.

History of Section. P.L. 1994, ch. 374, § 1.

23-10.1-1. Short title.

This chapter shall be known as the “Emergency Commitment for Drug Intoxication Law”.

History of Section. P.L. 1995, ch. 370, art. 14, § 20.

23-10.1-2. Definitions.

Whenever used in this chapter, or in any order, rule, or regulation made or promulgated pursuant to this chapter, or in any printed forms prepared by the department or the director, unless otherwise expressly stated, or unless the context or subject matter otherwise requires:

1. “Approved public treatment facility” means a treatment agency operating under the direction and control of the department or providing treatment under this chapter through a contract with the department.
2. “Department” means the state department of behavioral healthcare, developmental disabilities and hospitals.
3. “Director” means the director of the state department of behavioral healthcare, developmental disabilities and hospitals.
4. “Drug intoxication” means an altered physiological substance or psychoactive substances, in which normal functioning is seriously impeded.
5. “Likely to injure him or herself or others” means:
   1. A substantial risk of physical harm to himself or herself as manifested by behavior evidencing serious threats of, or attempts at, suicide or by behavior which will result in serious bodily harm; or
   2. A substantial risk of physical harm to other persons as manifested by behavior or threats evidencing homicidal or other violent behavior.
6. “Physician” means a person duly licensed to practice medicine or osteopathy in this state.
7. “Psychoactive substance” means a drug that affects the central nervous system and alters mood, perception, and/or consciousness.

History of Section. P.L. 1995, ch. 370, art. 14, § 20.

23-10.1-3. General powers and duties.

1. The department is charged with the execution of the laws relating to the emergency admission and custody of drug intoxicated individuals.
2. The department may adopt rules and regulations that it may deem necessary to carry out the provisions of this chapter to insure the safety and promote the welfare of individuals committed to its custody pursuant to this chapter.

History of Section. P.L. 1995, ch. 370, art. 14, § 20.

23-10.1-4. Emergency commitment.

1. Any police officer may take an individual into protective custody and transport him or her to the emergency room of any hospital if the officer has reason to believe that:
   1. The individual is intoxicated by drugs other than alcohol and as a result is likely to injure him or herself or others if allowed to be at liberty pending examination by a licensed physician; or
   2. The individual is in need of immediate assistance due to the use of drugs and requests the assistance.
2. A physician in charge of an emergency room of a hospital shall determine if any individual brought into the emergency room by a police officer, family member, or other interested person, requires emergency medical treatment for his or her condition or if the individual is appropriate for emergency commitment to an approved public treatment facility by reason of the grounds stated in this section.
3. If a physician determines, upon examination, that an individual is medically stable and appropriate for emergency commitment to an approved public treatment facility, he or she shall make application for the individual’s admission to the approved public treatment facility.
4. The application for admission shall state the circumstances under which an individual was taken into custody, brought to the emergency room, or brought to an approved public treatment facility and the reason for the physician’s determination that the individual needs emergency commitment for drug intoxication.
5. Upon the request of any physician making application in writing under this section, it shall be the duty of any police department of this state or any governmental subdivision of this state to whom the request is made, to take into custody and transport the individual to the designated approved public treatment facility.

History of Section. P.L. 1995, ch. 370, art. 14, § 20.

23-10.1-5. Period of treatment.

An individual admitted to an approved public treatment facility pursuant to this chapter shall be held for a minimum of twenty-four (24) hours for evaluation, and shall be discharged no later than five (5) days measured from the date of his or her admission.

History of Section. P.L. 1995, ch. 370, art. 14, § 20.

23-10.1-6. Criminal law limitations.

Nothing in this chapter affects any law, ordinance, or resolution against driving under the influence of drugs, or other similar offense involving the operation of a vehicle, aircraft, boat, machinery, or other equipment, or regarding the sale, purchase, dispensing, possessing, or use of drugs.

History of Section. P.L. 1995, ch. 370, art. 14, § 20.

23-11-1. Diseases declared contagious — Exposure of another to infection.

Sexually transmitted diseases shall include, but not be limited to, syphilis, gonorrhea, chancroid, granuloma inguinale, and lymphogranuloma venereum and other diseases that the director of health may by regulation determine to constitute a sexually transmitted disease. Sexually transmitted diseases are declared to be contagious, infectious, communicable, and dangerous to the public health. It shall be unlawful for anyone knowingly, while in the infectious condition with these diseases, or any of them, to expose another person to infection. Any person found guilty of violating the provisions of this section shall be fined not more than one hundred dollars ($100) or imprisoned for not more than three (3) months.

History of Section. P.L. 1921, ch. 2081, §§ 1, 2; G.L. 1923, ch. 163, §§ 1, 2; G.L. 1938, ch. 257, §§ 1, 2; G.L. 1956, § 23-11-1 ; P.L. 1967, ch. 58, § 1; P.L. 1986, ch. 246, § 2; P.L. 1986, ch. 436, § 2.

23-11-2. Repealed.

23-11-3. Compulsory treatment of infected persons.

The department of health is empowered to require persons who are in an infectious condition with a sexually transmitted disease to report for treatment to a licensed physician and to continue treatment until cured of his or her infectious condition. Any person suffering from any sexually transmitted disease while in the infectious and contagious stage of that disease who refuses to report for treatment, or who refuses to continue treatment, shall be isolated and treated until that person has been pronounced by a licensed physician to be noninfectious and no longer a danger to the public health.

History of Section. P.L. 1921, ch. 2081, § 4; G.L. 1923, ch. 163, § 4; G.L. 1938, ch. 257, § 4; impl. am. P.L. 1939, ch. 660, § 180; G.L. 1956, § 23-11-3 ; P.L. 1986, ch. 246, § 2; P.L. 1986, ch. 436, § 2.

23-11-4. State laboratory facilities and treatment.

The state department of health shall provide and/or make arrangements for laboratory tests for the diagnosis of sexually transmitted disease and shall provide and/or make arrangements for the clinical treatment of sexually transmitted diseases as determined by the director of health. In addition, the department of health is authorized to establish by rule and regulation a reasonable fee structure for these laboratory tests and clinical treatments.

History of Section. P.L. 1921, ch. 2081, § 5; G.L. 1923, ch. 163, § 5; G.L. 1938, ch. 257, § 5; impl. am. P.L. 1939, ch. 660, § 180; G.L. 1956, § 23-11-4 ; P.L. 1986, ch. 246, § 2; P.L. 1986, ch. 436, § 2; P.L. 1992, ch. 133, art. 26, § 1.

23-11-5. Reports of cases by public and private institutions.

The superintendent or other officer or other person in charge of public or private institutions, such as hospitals or other licensed health care facilities, dispensaries, clinics, homes, asylums, and charitable and correctional institutions, shall promptly report the identity of every patient suffering from a sexually transmitted disease in any form in a manner that may be prescribed by the director of the department of health.

History of Section. P.L. 1921, ch. 2081, § 6; G.L. 1923, ch. 163, § 6; G.L. 1938, ch. 257, § 6; impl. am. P.L. 1939, ch. 660, § 180; G.L. 1956, § 23-11-5 ; P.L. 1967, ch. 58, § 1; P.L. 1986, ch. 246, § 2; P.L. 1986, ch. 436, § 2.

23-11-6. Reports by physicians.

Any physician who diagnoses and/or treats a case of sexually transmitted disease shall immediately make a report of that case to the state department of health in the manner and form that the department shall direct.

History of Section. P.L. 1921, ch. 2081, § 7; G.L. 1923, ch. 163, § 7; G.L. 1938, ch. 257, § 7; impl. am. P.L. 1939, ch. 660, § 180; G.L. 1956, § 23-11-6 ; P.L. 1967, ch. 58, § 1; P.L. 1986, ch. 246, § 2; P.L. 1986, ch. 436, § 2.

23-11-7. Penalty for failure to report.

Any person who shall neglect for a period of ten (10) days to make a report as provided in §§ 23-11-5 , 23-11-6 , and 23-11-14 shall be fined not more than one hundred dollars ($100).

History of Section. P.L. 1921, ch. 2081, § 8; G.L. 1923, ch. 163, § 8; G.L. 1938, ch. 257, § 8; G.L. 1956, § 23-11-7 ; P.L. 1967, ch. 58, § 1.

23-11-8. Blood test of pregnant women.

It shall be the duty of every physician engaged in prenatal attendance upon a pregnant woman to obtain a blood specimen of that pregnant woman within thirty (30) days after the first professional visit. That blood specimen shall be submitted to the laboratory of the state department of health, or to a laboratory approved by the department, for the performance of a Wassermann or other standard laboratory blood test for syphilis. Any violation of the provisions of this section shall constitute a misdemeanor and that physician shall be fined not less than ten dollars ($10.00) nor more than one hundred dollars ($100) for each offense.

History of Section. G.L. 1923, ch. 395, § 251/2; P.L. 1938, ch. 2606, § 1; G.L. 1938, ch. 606, § 27; impl. am. P.L. 1939, ch. 660, § 180; G.L. 1956, § 23-11-8 .

23-11-9. Repealed.

History of Section. P.L. 1921, ch. 2081, § 9; G.L. 1923, ch. 163, § 9; G.L. 1938, ch. 257, § 9; G.L. 1956, § 23-11-9 ; P.L. 1986, ch. 246, § 2; P.L. 1986, ch. 436, § 2; Repealed by P.L. 2017, ch. 13, § 1, effective June 19, 2017; P.L. 2017, ch. 25, § 1, effective June 19, 2017.

23-11-10. Investigation of suspected cases and sources.

In all suspected cases of sexually transmitted disease, the state department of health is empowered to take appropriate measures to determine whether the person or persons suspected of being infected are suffering from any sexually transmitted disease; and whenever any sexually transmitted disease is found to exist, the state department of health shall, whenever possible, ascertain the sources of the infections. In these investigations, the state department of health is vested with full powers of inspection and examination and treatment as determined by the director of health.

History of Section. G.L. 1923, ch. 163, § 11; P.L. 1936, ch. 2366, § 1; G.L. 1938, ch. 257, § 10; impl. am. P.L. 1939, ch. 660, § 180; G.L. 1956, § 23-11-10 ; P.L. 1986, ch. 246, § 2; P.L. 1986, ch. 436, § 2.

23-11-11. Power to examine suspected cases — Right of suspect to own physician.

For the purpose of carrying out the provisions of this chapter, the state department of health is empowered to make examinations of persons reasonably suspected of having sexually transmitted disease; provided, however, that any person so examined shall have the right to have present at that examination, at his or her own expense, a physician selected by him or her. The state department of health shall inform him or her of this right and afford him or her a reasonable opportunity to exercise that right; and at the trial of any person being prosecuted under the provisions of § 23-11-12 , the prosecution must prove that he or she was so informed and was afforded that opportunity. Persons under eighteen (18) years of age may give legal consent for examination and treatment for any sexually transmitted disease. For the purposes of this section, physical examination and treatment by a licensed physician or his or her designated representative upon the person of a minor who has given consent shall not constitute an assault or an assault and battery upon the person.

History of Section. G.L. 1923, ch. 163, § 12; P.L. 1936, ch. 2366, § 1; G.L. 1938, ch. 257, § 11; impl. am. P.L. 1939, ch. 660, § 180; G.L. 1956, § 23-11-11 ; P.L. 1967, ch. 58, § 1; P.L. 1986, ch. 246, § 2; P.L. 1986, ch. 436, § 2.

23-11-12. Refusal to submit to examination.

Any person refusing to permit the department of health to examine him or her, as provided in § 23-11-11 , shall be guilty of a misdemeanor, and upon conviction shall be punished by a fine of fifty dollars ($50.00), or by imprisonment for thirty (30) days, or by both fine and imprisonment.

History of Section. G.L. 1923, ch. 163, § 13; P.L. 1936, ch. 2366, § 1; G.L. 1938, ch. 257, § 12; impl. am. P.L. 1939, ch. 660, § 180; G.L. 1956, § 23-11-12 .

23-11-13. Appropriations and disbursements.

The general assembly shall annually appropriate that sum that it may deem necessary for carrying out the provisions and purposes of this chapter, and the state controller shall draw his or her orders upon the general treasurer for the payment of the sum appropriated, or so much of it as may be from time to time required, upon receipt by him or her of proper vouchers authenticated by the director of health.

History of Section. P.L. 1921, ch. 2081, § 10; G.L. 1923, ch. 163, § 10; G.L. 1938, ch. 257, § 13; impl. am. P.L. 1939, ch. 660, §§ 65, 180; G.L. 1956, § 23-11-13 .

23-11-14. Reports by public and private laboratories.

Whenever any public or private laboratory performs a laboratory test for any sexually transmitted disease, the result, if reactive or positive, shall be reported within ten (10) days after the test by the person in charge of the laboratory to the state department of health in the manner and form that may be prescribed by the director of health.

History of Section. G.L. 1956, § 23-11-14 ; P.L. 1967, ch. 58, § 2; P.L. 1986, ch. 246, § 2; P.L. 1986, ch. 436, § 2.

23-11-15. Report not violation of physician-patient relationship.

Any report made pursuant to the provisions of this chapter shall not be deemed a violation of the physician-patient relationship or otherwise contrary to the ethics of the medical profession.

History of Section. G.L. 1956, § 23-11-15 ; P.L. 1967, ch. 58, § 2.

23-11-16. Violations — Penalties.

Unless another penalty is provided by the laws of this state, any person who shall violate any provision of this chapter, or any rule or regulation adopted under this chapter, shall, upon conviction, be punished by a fine of not more than one hundred dollars ($100), or by imprisonment for not more than thirty (30) days, or both.

History of Section. P.L. 1986, ch. 246, § 3; P.L. 1986, ch. 436, § 3.

23-11-17. Human immunodeficiency virus (HIV) testing.

The physician or healthcare provider attending any person for a suspected sexually transmitted disease shall offer testing for human immunodeficiency virus (HIV). All testing pursuant to this section shall be as provided for in chapter 6.3 of this title.

History of Section. P.L. 1988, ch. 405, § 3; P.L. 2000, ch. 171, § 2; P.L. 2006, ch. 599, § 5; P.L. 2008, ch. 475, § 41; P.L. 2009, ch. 196, § 5; P.L. 2009, ch. 289, § 5.

23-11-18. Legislative findings.

The general assembly recognizes and declares that:

1. The special legislative commission to study the feasibility of implementing a needle exchange program has met in accordance with 1992 joint resolution 192, and strongly recommends passage of a law enabling the department of health to implement a pilot needle exchange program for the prevention of HIV transmission among intravenous drug users;
2. Seventy-one percent (71%) of all AIDS cases among women are linked to injection drug use; fifty-eight percent (58%) of children with AIDS were infected through their mother who injected drugs or had sex with an IDU. In Rhode Island, the number of injection drug users has been estimated as high as eight thousand (8,000); and intravenous drug use accounts for forty-five percent (45%) of reported cases of HIV infection since 1989;
3. The yearly cost of a syringe exchange program is often less than the costs to treat a single person with AIDS. The lifetime medical costs for treating someone with AIDS is approximately eighty-five thousand dollars ($85,000);
4. Needle exchange programs have been shown to reduce HIV transmission by as much as thirty-three percent (33%), and have been successfully implemented in over twenty (20) locations in the United States, including Boulder, Colorado; New Haven, Connecticut; Honolulu, Hawaii; Portland, Oregon; Seattle and Tacoma, Washington; San Francisco, California; Boston, Massachusetts; Chicago, Illinois; Philadelphia, Pennsylvania; and Indianapolis, Indiana;
5. That legislation is necessary to enable the department of health to pursue additional funding from the federal government and private foundations for a needle exchange program; and the general assembly of the state does recognize and declare that a well designed and well monitored pilot needle exchange program should play a vital and necessary role in our larger public health effort to reduce the transmission of HIV; and
6. This act should not be misconstrued to mean that the state endorses or encourages the illegal use and/or abuse of illicit or harmful substances in any form or method of transmission whatsoever. Rather, the express purpose of this act is to assist in the reduction of the transmission of life-threatening diseases, such as AIDS and HIV, through the use of contaminated needles and syringes. Moreover, it shall be the ongoing policy of the state to use its considerable resources to educate its citizens about the dangers of all forms of substance abuse in any manner of transmission and to foster programs of prevention so as to reduce the incidence of substance abuse, drug addiction, AIDS/HIV, and like problems.

History of Section. P.L. 1994, ch. 30, § 1.

23-11-19. Exchange of hypodermic needles and syringes.

1. The director of the department of health shall maintain a program offering the free exchange of new hypodermic needles and syringes for used hypodermic needles and syringes as a means to prevent the transmission of human immunodeficiency virus (HIV) or viral hepatitis among injecting drug users eighteen (18) years of age or older. Any site used in the program shall be approved by the director of health and shall make available educational materials, HIV counseling and testing, and referral services targeted to the education of HIV/AIDS and viral hepatitis transmission as well as information and referrals pertaining to substance abuse prevention and treatment.
2. Any program of needle and syringe exchange must be implemented pursuant to the provisions of this section and shall incorporate an on-going evaluation plan to determine the impact of the needle exchange program on the participants and the community in the efforts to lower the HIV rate among injecting users including successful referrals to substance abuse treatment.

History of Section. P.L. 1994, ch. 30, § 1; P.L. 1997, ch. 213, § 1; P.L. 1997, ch. 309, § 1; P.L. 2006, ch. 599, § 5.

23-11-20. Expedited partner therapy.

1. Notwithstanding any other provision of law to the contrary, a physician licensed under chapter 37 of title 5, a physician assistant licensed under chapter 54 of title 5 or a certified registered nurse practitioner licensed under chapter 34 of title 5 who is authorized to prescribe and dispense prescription drugs, and who diagnoses a sexually transmitted chlamydia or gonorrhea infection in an individual patient, may prescribe prescription drugs to the patient’s sexual partner or partners for the treatment of the sexually transmitted chlamydia or gonorrhea infection without an examination of the sexual partner or partners.
2. Neither a licensed physician, licensed physician assistant or certified registered nurse practitioner who, in good faith, prescribes prescription drugs to a patient’s sexual partner or partners for the treatment of a sexually transmitted chlamydia or gonorrhea infection in accordance with this section, nor the group or healthcare facility for which they work, shall be subject to civil or criminal liability and shall not be deemed to have engaged in unprofessional conduct.

History of Section. P.L. 2010, ch. 166, § 1; P.L. 2010, ch. 175, § 1.

23-12-1. Formulation of plans and minimum standards for care and treatment.

It shall be the duty of the state director of health to formulate a plan for the care and treatment of indigent persons suffering from cancer and to establish and designate standard requirements for the organization, equipment, and conduct of cancer units or departments in general hospitals of this state. The state director of health shall consult with physicians designated by the president of the Rhode Island Medical Society, with other interested organizations, and with any other experts or nonexperts wherever located that he or she may deem proper with a view to carrying out the purposes of this chapter and with a view to establishing a minimum standard for the conduct and equipment of cancer units or departments in general hospitals in those parts or districts of the state as may, in the opinion of the state director of health, be deemed most advantageous to the public health.

History of Section. P.L. 1942, ch. 1254, § 1; G.L. 1956, § 23-12-1 .

23-12-2. Educational plan.

The state director of health shall formulate and put into effect an educational plan for the purpose of preventing cancer, for the purpose of aiding in the early diagnosis of cancer, and for the purpose of informing hospitals and cancer patients of the proper treatment.

History of Section. P.L. 1942, ch. 1254, § 2; G.L. 1956, § 23-12-2 .

23-12-3. Aid to indigent patients.

The state director of health is authorized and directed to make rules and regulations specifying to what extent and on what terms and conditions indigent cancer patients of this state may receive financial aid for the diagnosis and treatment of cancer in any approved hospital in this state. The director of health is authorized to furnish aid to indigent cancer patients of this state who are citizens of this state and who through no fault of their own are financially unable to provide proper treatment for themselves, to the extent of and within the available funds as the state director of health shall deem proper. The state director of health shall have the power in his or her discretion to administer aid in any manner that in his or her judgment will afford the greater benefit to cancer patients throughout the state, and shall have the power, to the extent of and within the available funds which may be provided by the general assembly.

History of Section. P.L. 1942, ch. 1254, § 3; G.L. 1956, § 23-12-3 .

23-12-4. Central cancer registry — Reports.

1. The state director of health may enter into a contract with a non-profit organization to establish a registry to record certain cases of malignant disease that occur in residents of the state, and any appropriate information concerning these cases that it shall deem necessary and appropriate in order to conduct epidemiologic surveys of cancer and to apply appropriate preventive and control measures.
2. The state director of health shall require the reporting of certain cases of malignant disease and the submission of any specified additional information on reported cases or control populations that he or she deems necessary and appropriate for the recognition, prevention, or control of certain cases of malignant diseases.
3. The central cancer registry shall maintain comprehensive records of all reports submitted pursuant to this section. These reports shall be confidential in accordance with chapter 37.3 of title 5 and subject to the restrictions on release incorporated in that chapter.
4. The state director of health shall conduct those activities to prevent and control cancer among the residents of the state that he or she shall deem necessary and appropriate and as are indicated from the findings of the central cancer registry.
5. Nothing in this section shall be construed to compel any individual to submit to medical or department examination or supervision.
6. The department shall make rules and regulations that are necessary to implement the provisions of this section pursuant to chapter 35 of title 42.
7. The general assembly shall annually appropriate the sum of four hundred thousand dollars ($400,000) for the support of the central cancer registry.

History of Section. P.L. 1985, ch. 402, § 1; P.L. 1986, ch. 287, art. 28, § 4.

23-12.1-1. “Hemophilia” defined.

For purposes of this chapter, “Hemophilia” means a bleeding tendency resulting from a genetically determined deficiency of a clotting factor in the blood.

History of Section. P.L. 1977, ch. 209, § 1.

23-12.1-2. Establishment of program.

The state department of health, referred to in this chapter as “the department”, shall establish a program for the care and treatment of persons suffering from hemophilia. This program shall assist persons who require continuing treatment with blood and blood derivatives to avoid crippling, extensive hospitalization, and other effects associated with this critical chronic bleeding condition, but who are unable to pay for the entire cost of care and treatment services on a continuing basis despite the existence of various types of hospital and medical insurance coverages, Medicare, Medicaid, and other government assistance programs, and private charitable assistance programs.

History of Section. P.L. 1977, ch. 209, § 1.

23-12.1-3. Duties of department of health.

The department shall:

1. Develop standards for determining eligibility for care and treatment under this program;
2. Extend financial assistance to persons suffering from hemophilia 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 this support will facilitate the supplying of blood, blood derivates and concentrates, and other efficacious agents to hemophiliac patients at an economical cost, thus increasing the effectiveness of the moneys appropriated to carry out the provisions of this chapter;
3. Assist in the development and expansion of programs for the care and treatment of persons suffering from hemophilia, 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 this condition;
4. Institute and carry on educational programs among physicians, dentists, hospitals, public health departments, and the public concerning hemophilia, including dissemination of information and the conducting of educational programs concerning the methods of care and treatment of persons suffering from this condition; and
5. Promulgate all rules and regulations necessary to effectuate the purposes of this chapter.

History of Section. P.L. 1977, ch. 209, § 1.

23-12.5-1. Compact enacted.

The New England compact on radiological health protection, hereinafter called “the compact”, is hereby enacted into law and entered into with all other jurisdictions legally joining the compact, in the form substantially as follows:

NEW ENGLAND COMPACT ON RADIOLOGICAL HEALTH PROTECTION

23-12.5-2. Radiation incident plan.

The director of health shall formulate and keep current a radiation incident plan for this state, in accordance with the duty assumed pursuant to article III (a) of the compact contained in § 23-12.5-1 .

History of Section. P.L. 1967, ch. 90, § 1; G.L. 1956, § 23-44-2; P.L. 1979, ch. 39, § 1; G.L. 1956, § 23-12.5-2 .

23-12.5-3. State administrator.

The compact administrator for this state, as required by article VI of the compact contained in § 23-12.5-1 , shall be the director of health.

History of Section. P.L. 1967, ch. 90, § 1; G.L. 1956, § 23-44-3; P.L. 1979, ch. 39, § 1; G.L. 1956, § 23-12.5-3 .

23-12.6-1. Short title.

This chapter shall be known as the “Rhode Island Ovarian Cancer Education, Detection, and Prevention Act”.

History of Section. P.L. 1999, ch. 246, § 1.

23-12.6-2. Preamble.

Ovarian cancer is a dangerous threat to the female population in the state as one in every fifty-five (55) women is stricken with the disease; three quarters (3/4) of ovarian cancer cases are diagnosed after the disease has reached advanced stages (3rd or 4th stage) and fifty percent (50%) of women die within five (5) years of diagnosis. When ovarian cancer is detected in its early stages, the survival rate is ninety-two percent (92%). The overwhelming majority of women who get ovarian cancer have no known risk factors. Ovarian cancer symptoms are subtle and easily confused with symptoms of other disorders. The result is most often women do not recognize the symptoms, the result of which is often fatal. The Rhode Island general assembly declares it a matter of public health and urgency to declare war on ovarian cancer in Rhode Island and creates the “Rhode Island Ovarian Cancer Evaluation, Detection, and Prevention Act ”.

History of Section. P.L. 1999, ch. 246, § 1.

23-12.6-3. Public policy goals — Department of health.

The department of health, through the Rhode Island Cancer Council, is authorized and mandated to achieve and implement the following public health policy goals as they relate to ovarian cancer in Rhode Island:

1. The department of health, through the Rhode Island Cancer Council, is mandated to sponsor a yearly public education campaign to expand women’s and health care providers awareness about the disease. This campaign shall consist of awareness about the common symptoms of the disease, screening tests, and examinations by gynecologists that can detect the early symptoms of the disease.
2. The department of health, through the Rhode Island Cancer Council, shall establish as public policy in the state increased funding for research and advocacy for creating genetic testing policies.
3. The department of health, through the Rhode Island Cancer Council, shall work with major health providers in Rhode Island to research and extend and promote the awareness and understanding of ovarian cancer in order to improve screening and detection tools and to work with the national organizations to assist in finding a cure.
4. The department of health, through the Rhode Island Cancer Council, shall coordinate the work of ovarian cancer groups, activists, researchers, support groups, and health advocates and shall annually report to the general assembly the progress it is making to advance education, detection and research and improved therapies concerning ovarian cancer affecting women in the state.

History of Section. P.L. 1999, ch. 246, § 1.

23-12.7-1. Short title.

This chapter shall be known and may be cited as the “The Breast Cancer Act.”

History of Section. P.L. 2000, ch. 277, § 1.

23-12.7-2. Legislative findings.

It is found and declared as follows:

1. Breast cancer is a significant threat to the health of women. Breast cancer is the most common form of cancer in women, and causes the death of a woman in the United States every twelve (12) minutes.
2. The incidence of breast cancer continues to increase at a dramatic rate. In 1964, one woman in twenty (20) developed breast cancer over the course of her lifetime. By 1987, the probability had increased to one in eleven (11) and by 1992, it was one in eight (8). At the current rate of increase, early in 2000, one woman in six (6) will develop breast cancer in her lifetime. Presently breast cancer claims over two hundred (200) lives in Rhode Island annually.
3. Breast cancer exacts an enormous economic toll on our society, including over two billion dollars ($2,000,000,000) in direct medical costs, and over eight billion dollars ($8,000,000,000) in both direct medical and indirect costs.
4. Medical experts still do not know the cause of breast cancer, or how to prevent breast cancer.
5. The state of Rhode Island must take the lead in combating the increasingly rapid spread of breast cancer and the current lack of knowledge with respect to breast cancer’s cause and cure, and effective methods of screening and treatment.
6. It is the intent of the legislature in enacting this chapter to fund screening mammography for women, who are uninsured and/or underinsured, satisfying eligibility criteria as established by the Rhode Island department of health with assistance from a community advisory board consisting of consumer advocates and physicians.
7. It is the further intent of the legislature to direct the Rhode Island department of health to provide appropriate diagnostic testing to determine a diagnosis of breast cancer and staging of the disease and case management of the woman’s care by facilitating contact with a breast surgeon, medical oncologist, and/or radiation oncologist.
8. In addition, this legislation will include a mandate for programs of outreach, education, increased awareness, and cultural competence to the statewide community.
9. There are over twenty-two thousand (22,000) women in Rhode Island today with breast cancer. Nationally, one million six hundred thousand (1,600,000) women have breast cancer. Mammography screening is the most useful tool, to date, to identify a breast cancer.
10. There are four thousand eight hundred forty-four (4,844) Rhode Island women, who are uninsured or underinsured and cannot afford a mammogram.
11. In 1995, the Rhode Island general assembly passed a resolution declaring breast cancer an epidemic in the state.
12. In keeping with its progressive and concerned outlook for the health and welfare of women in Rhode Island, the guarantee of breast cancer screening must be extended to uninsured and underinsured women.
13. There should be no barrier to quality breast screening in Rhode Island.

History of Section. P.L. 2000, ch. 277, § 1.

23-12.7-3. Program established.

1. Through funding from the Rhode Island Cancer Council, the Rhode Island department of health is required to establish a program of free mammography screening according to American Cancer Society standards, and, where required, follow-up, diagnostic testing, and case management for women in the state who are uninsured or underinsured.
2. The screening program shall:
   1. Secure radiology facilities to participate in the screening program;
   2. Pay for screening mammograms;
   3. Ensure that screening results are sent by mail, electronically, or otherwise, to the patient in a timely manner;
   4. Provide diagnostic tests as required to diagnose breast cancer;
   5. Provide case management facilitating appropriate contact to breast surgeons, medical oncologists, and radiation oncologists; and
   6. Provide follow-up support to women who are found to have breast cancer as a result of this screening program.
3. The director of the Rhode Island department of health is required to provide a quarterly report to the general assembly on the program of free mammography screening, follow-up diagnostic testing and case management, and public education. An advisory committee concerned with advocacy, outreach, and public education shall meet on a quarterly basis and report to the director.

History of Section. P.L. 2000, ch. 277, § 1; P.L. 2021, ch. 45, § 1, effective June 11, 2021; P.L. 2021, ch. 46, § 1, effective June 11, 2021.

23-12.8-1. Short title.

This chapter shall be known and may be cited as “The Firefighter Cancer Wellness Act.”

History of Section. P.L. 2008, ch. 130, § 1; P.L. 2008, ch. 184, § 1.

23-12.8-2. Legislative findings.

It is found and declared as follows:

1. Studies indicate that firefighters have a significantly higher risk of developing certain cancers due to exposure to toxins and chemicals.
2. The state of Rhode Island must take action to promote firefighter wellness and reduce the incidence and effects of cancer among firefighters.

History of Section. P.L. 2008, ch. 130, § 1; P.L. 2008, ch. 184, § 1.

23-12.8-3. Education program established.

1. The director of the department of health shall annually provide to the office of the state fire marshal information regarding cancer incidence among professional and volunteer firefighters, the increase in survival rates attributable to early detection and the availability of cancer screening as well as any other applicable testing methods designed to decrease the incidence and severity of malignant conditions resulting from occupational exposure to hazardous materials.
2. The office of the state fire marshal shall annually inform the fire chiefs of all professional and volunteer departments and districts in the state of Rhode Island of the cancer risks associated with firefighting and the importance of frequent medical examination including cancer screening.
3. The department of health, the state fire marshal and Rhode Island municipalities may enter into contracts with healthcare and/or cancer screening providers for the purpose of establishing preventative programs for firefighters and related professions.

History of Section. P.L. 2008, ch. 130, § 1; P.L. 2008, ch. 184, § 1.

23-12.9-1. Short title.

This chapter shall be known and may be cited as “The Dense Breast Notification and Education Act.”

History of Section. P.L. 2014, ch. 47, § 1; P.L. 2014, ch. 54, § 1.

23-12.9-2. Public policy goals — Department of health.

The department of health, through the Rhode Island Cancer Council, is authorized and mandated to implement the following public health policy goals as they relate to dense breast notification in Rhode Island. Commencing on October 1, 2014, all healthcare facilities that perform mammography examinations shall include in the summary of the mammography report to be provided to a patient by mail, electronically, or otherwise, information that identifies the patient’s individual Breast Tissue Classification based on the Breast Imaging Reporting and Data System established by the American College of Radiology. If the facility determines that a patient has heterogeneously or extremely dense breasts, the summary of the mammography report shall also include the following notice:

“Your mammogram indicates that you have dense breast tissue. Dense breast tissue is relatively common and is found in about forty percent (40%) of women. The presence of dense tissue can make it more difficult to detect cancers in the breast by mammography because it can hide small abnormalities and may be associated with an increased risk. Hence, you may benefit from supplementary screening tests, which may include a breast ultrasound screening, or a breast MRI examination, or both, depending on your individual risk factors.

We are providing this information to raise your awareness of this important factor and to encourage you to discuss your dense breast tissue, as well as other breast cancer risk factors, with your healthcare provider. Together, you can decide which screening options are right for you.

A report of your results was sent to your physician. You should contact your physician if you have any questions or concerns about this report.”

History of Section. P.L. 2014, ch. 47, § 1; P.L. 2014, ch. 54, § 1; P.L. 2021, ch. 45, § 2, effective June 11, 2021; P.L. 2021, ch. 46, § 2, effective June 11, 2021.

23-12.10-1. Purpose and creation — Municipal authorization required. [Effective March 1, 2022, and Expires March 1, 2024.]

1. The purpose of this chapter is to authorize a two-year (2) pilot program to prevent drug overdoses through the establishment of “harm reduction centers,” which, as used in this chapter, shall be defined as a community-based resource for health screening, disease prevention, and recovery assistance where persons may safely consume pre-obtained substances.
2. Each harm reduction center shall provide the necessary healthcare professionals to prevent overdose, and shall provide referrals for counseling or other medical treatment that may be appropriate for persons utilizing the harm reduction center.
3. The director of the department of health shall promulgate regulations to authorize the program established by this chapter, and in accordance with § 23-12.10-5 . Nothing contained in this section authorizes a harm reduction center without approval of the municipality in which the center is proposed.
4. 1. Any harm reduction center proposed to be operated pursuant to the provisions of this chapter shall require municipal authorization and approval prior to opening or operating in any community within this state.
   2. As used in this chapter, the term “municipal authorization and approval” means an express affirmative vote by the city or town council, or the equivalent governing body, of any municipality where a harm reduction center is proposed to be located, which affirmative vote approves:
      1. The opening and operation of the proposed harm reduction center;
      2. The exact location of the proposed harm reduction center, which shall include street address and plat and lot number or other applicable number as used by the municipality’s tax assessor; and
      3. An express authorization as to the hours of operation of the proposed harm reduction center.
5. Each harm reduction center approved for operation pursuant to the provisions of this chapter shall cease operations on or before March 1, 2024, unless an act of the general assembly expressly authorizes the continuation of the operation of the harm reduction center.

History of Section. P.L. 2021, ch. 185, § 1, effective March 1, 2022; P.L. 2021, ch. 324, § 1, effective March 1, 2022.

23-12.10-2. Establishment of advisory committee. [Effective March 1, 2022, and Expires March 1, 2024.]

There is hereby established an advisory committee to advise the director of the department of health with respect to the regulations necessary to effectuate the purpose of this chapter. The advisory committee shall be chaired by the director of the department of health, or the director’s designee, and consist of nine (9) additional members: one of whom shall be the attorney general, or designee; one member from the Rhode Island Medical Society; one member from the Hospital Association of Rhode Island; one member from the Rhode Island chapter of the American Society of Addiction Medicine; and five (5) members appointed by the governor, one of whom shall be a person with a substance use disorder; one of whom shall be a person working in overdose prevention; one of whom shall be a current or former law enforcement official; one of whom shall be a representative of the Rhode Island League of Cities and Towns; and one of whom shall be a person who has suffered a drug overdose or a family member of a person who suffered a fatal drug overdose.

History of Section. P.L. 2021, ch. 185, § 1, effective March 1, 2022; P.L. 2021, ch. 324, § 1, effective March 1, 2022.

23-12.10-3. Role of advisory committee. [Effective March 1, 2022, and Expires March 1, 2024.]

The advisory committee shall make recommendations to the director of the department of health with respect to the following:

1. Maximizing the potential public health and safety benefits of harm reduction centers;
2. The proper disposal of hypodermic needles and syringes;
3. The recovery of persons utilizing such harm reduction centers;
4. Federal, state, and local laws impacting the creation and operation of the harm reduction centers;
5. Appropriate guidance to relevant professional licensing boards;
6. Potential collaboration with other public health efforts;
7. Consideration of any other factors beneficial to promoting the public health and safety; and
8. Liability protection for property owners, harm reduction center staff, and volunteers and participants, from criminal or civil liability resulting from the operation of a harm reduction center.

History of Section. P.L. 2021, ch. 185, § 1, effective March 1, 2022; P.L. 2021, ch. 324, § 1, effective March 1, 2022.

23-12.10-4. Liability protections. [Effective March 1, 2022, and Expires March 1, 2024.]

Notwithstanding any other law to the contrary, a person or entity, including, but not limited to, property owners, managers, employees, volunteers, clients or participants, and state, city, or town government employees acting in the course and scope of employment, shall not be arrested, charged, or prosecuted pursuant to § 21-28-4.01(c)(1) , § 21-28-4.06 , § 21-28-4.08 , § 21-28-5.06 , or § 21-28.5-2 , including for attempting, aiding and abetting, or conspiracy to commit a violation of any of those sections; nor have their property subject to forfeiture; nor be subject to any civil or administrative penalty, including, but not limited to, disciplinary action by a professional licensing board, credentialing restrictions, contractual or civil liability, or medical staff or other employment action; nor be denied any right or privilege for actions, conduct, or omissions relating to the approval or operation of a harm reduction center in compliance with this chapter and any rules and regulations promulgated pursuant to this chapter.

History of Section. P.L. 2021, ch. 185, § 1, effective March 1, 2022; P.L. 2021, ch. 324, § 1, effective March 1, 2022.

23-12.10-5. Promulgation of regulations. [Effective March 1, 2022, and Expires March 1, 2024.]

The director of the department of health shall promulgate regulations authorized by this chapter no later than March 1, 2022.

History of Section. P.L. 2021, ch. 185, § 1, effective March 1, 2022; P.L. 2021, ch. 324, § 1, effective March 1, 2022.

23-13-1. Acceptance of federal act — Administration and purpose of program.

1. The state accepts the provisions of Title V, relative to maternal and child health services, of an act passed by the congress of the United States, entitled the “Social Security Act”, approved August 14, 1935, and as subsequently amended, 42 U.S.C. § 701 et seq., and designates the state department of health as the state agency for administering in Rhode Island the provisions of Title V of the “Social Security Act” relative to maternal and child health services.
2. The state department of health shall administer a program of ambulatory health services for mothers and children and shall supervise the administration of those services included in the program which are not directly administered by the department. The purposes of those programs shall be: to reduce maternal and infant mortality, to reduce the incidence and prevalence of preventable diseases and disabling conditions among children, to reduce the need for inpatient and long-term care services, to increase the number of children (especially low income children) receiving immunization, health assessment, diagnostic, and treatment services, to develop, extend, and improve ambulatory health services to locate, diagnose, care for, and rehabilitate children with disabling conditions, and otherwise preserve, protect, and promote the health of mothers and children. The director of health is authorized to promulgate rules and regulations that may be necessary to carry into effect the provisions of this section.

History of Section. P.L. 1937, ch. 2481, § 1; G.L. 1938, ch. 271, § 2; impl. am. P.L. 1939, ch. 660, §§ 65, 180; G.L. 1956, § 23-13-1 ; P.L. 1982, ch. 390, § 3; P.L. 1999, ch. 83, § 46; P.L. 1999, ch. 130, § 46.

23-13-2. Acceptance of gifts.

1. In addition to sums of money received from the federal government and in addition to appropriations made by the general assembly, the state department of health may accept in the name of and in behalf of the state gifts of money, other than federal and state government allotments or appropriations, which shall be construed as gifts and shall be deposited by the general treasurer in an account or accounts of the department that the director of health may designate.
2. The provisions of § 35-4-1 shall not apply to the subsection (a) of this section, insofar as they relate to the disposal of money received as gifts.

History of Section. P.L. 1937, ch. 2481, § 2; G.L. 1938, ch. 271, § 3; impl. am. P.L. 1939, ch. 660, § 180; G.L. 1956, § 23-13-2 .

23-13-3. Appropriations by cities and towns.

Any city or town may annually appropriate a sum to be expended for the promotion of the welfare and hygiene of maternity and infancy in that city or town, under the supervision of and in cooperation with the state department of health, and that city or town may provide that any appropriation may be expended by the state department of health or under the joint supervision of the department and an officer or agent appointed by that city or town to co-operate with the department in carrying out the purposes of the appropriation.

History of Section. G.L. 1923, ch. 47, § 26; P.L. 1927, ch. 1055, § 1; G.L. 1938, ch. 329, § 32; impl. am. P.L. 1939, ch. 660, § 180; G.L. 1956, § 23-13-3 .

23-13-4. Ophthalmia neonatorum — Definition — Treatment.

1. Any diseased condition of the eye or eyes of an infant in which there is inflammation, redness, swelling, or any unnatural discharge at any time within two (2) weeks after birth shall, for the purpose of §§ 23-13-4 — 23-13-8 be deemed to be ophthalmia neonatorum.
2. It shall be the duty of the physician, nurse, or midwife attending the birth of an infant immediately after the birth to treat the eyes of that infant with any approved prophylactic remedy as may be recommended by the department of health.
3. For the purpose of §§ 23-13-4 — 23-13-8 , midwives, who previously have not been permitted to use medical agents under any conditions, may employ the approved prophylactic of the department of health with the consent of the parent or guardian.

History of Section. G.L. 1909, ch. 343, § 25; P.L. 1914, ch. 1081, § 1; P.L. 1918, ch. 1641, § 1; P.L. 1919, ch. 1757, § 1; G.L. 1923, ch. 395, § 25; G.L. 1938, ch. 606, § 24; impl. am. P.L. 1939, ch. 660, § 180; G.L. 1956, § 23-13-4 ; P.L. 1979, ch. 199, § 1.

23-13-5. Advice to parents concerning ophthalmia neonatorum.

It shall be the duty of physicians, midwives, and any other persons that may be lawfully engaged in the practice of obstetrics or assisting at childbirths to inform parents or guardians of the serious nature and consequences of this disease and to advise the use of prophylactic measures designated by the department of health.

History of Section. G.L. 1909, ch. 343, § 25; P.L. 1918, ch. 1641, § 1; P.L. 1919, ch. 1757, § 1; G.L. 1923, ch. 395, § 25; G.L. 1938, ch. 606, § 24; impl. am. P.L. 1939, ch. 660, § 180; G.L. 1956, § 23-13-5 .

23-13-6. Reports of ophthalmia neonatorum.

It shall be the duty of any physician, midwife, nurse, parent, or other person or persons assisting any woman in childbirth or assisting in the care of any infant to report within twelve (12) hours after noting any case of ophthalmia neonatorum coming to his or her attention to the department of health.

History of Section. G.L. 1896, ch. 277, § 24; G.L. 1909, ch. 343, § 25; P.L. 1914, ch. 1081, § 1; P.L. 1918, ch. 1641, § 1; P.L. 1919, ch. 1757, § 1; G.L. 1923, ch. 395, § 25; G.L. 1938, ch. 606, § 24; G.L. 1956, § 23-13-6 .

23-13-7. Investigation of cases — Enforcement of provisions — Publication of information — Reports to attorney general.

It shall be the duty of the department of health to:

1. Investigate each case of ophthalmia neonatorum;
2. Enforce the provisions of §§ 23-13-4 — 23-13-8 ;
3. Publish and distribute information concerning the dangers and prevention of ophthalmia neonatorum; and
4. Bring all violations of the law to the attorney general, whether occasioned by the failure of the physician, nurse, midwife, parent, or other person or persons assisting in childbirth or in the care of infants, to report the violations.

History of Section. G.L. 1909, ch. 343, § 26; P.L. 1914, ch. 1081, § 2; P.L. 1918, ch. 1641, § 2; G.L. 1923, ch. 395, § 26; P.L. 1930, ch. 1590, § 2; G.L. 1938, ch. 606, § 25; impl. am. P.L. 1939, ch. 660, § 180; impl. am. P.L. 1951, ch. 2724, § 2; G.L. 1956, § 23-13-7 ; P.L. 1979, ch. 199, § 1.

23-13-8. Violations pertaining to ophthalmia neonatorum.

The failure of any person mentioned in §§ 23-13-4 — 23-13-7 to report any and all cases of ophthalmia neonatorum, as directed in this chapter, or the failure or refusal of any person or institution mentioned in §§ 23-13-4 — 23-13-7 , to obey any rule or regulation adopted by the department of health under this chapter, shall constitute a misdemeanor, and upon conviction, shall be fined not less than ten dollars ($10.00) nor more than one hundred dollars ($100), or imprisoned for not less than ten (10) days nor more than six (6) months, or both.

History of Section. G.L. 1896, ch. 277, § 26; G.L. 1909, ch. 343, § 27; P.L. 1918, ch. 1641, § 2; G.L. 1923, ch. 395, § 27; P.L. 1930, ch. 1590, § 2; G.L. 1938, ch. 606, § 26; impl. am. P.L. 1939, ch. 660, § 180; G.L. 1956, § 23-13-8 .

23-13-9. Licensing and regulation of midwives — Penalty for violations.

The state director of health is authorized and directed to make rules for the regulation of the practice of midwifery and for the licensing of midwives, including regulations that require the payment of an initial application fee equal to that fee that is imposed upon applicants for licensure as nurse practitioners and a renewal fee also equivalent to that for nurse practitioners. The rules regarding the regulation of the practice of midwifery shall authorize a licensed, certified nurse-midwife (CNM) or a licensed, certified midwife (CM) to prescribe medications that might be reasonably required by his or her patients; provided however, that a licensed, certified nurse-midwife (CNM) or a licensed, certified midwife (CM) shall prescribe any of those medications as authorized by the director of health. The provisions of this section relating to prescription authority by certified nurse-midwives and certified midwives shall be overseen by the department of health as defined in the department’s rules and regulations for licensing of midwives (R23-13MID). No person not a licensed midwife or a physician, registered under the provisions of chapter 37 of title 5, shall practice midwifery, or shall make a practice of attending women in childbirth for hire, or use the name or title of midwife. Any person who violates the provisions of this section, or who violates any of the rules of the department of health made in pursuance of this section, shall be fined not more than one hundred dollars ($100), or imprisoned not more than six (6) months, or both, and the director of health may revoke the license issued to any person when, in the opinion of the director of health, that person is guilty of unprofessional conduct.

History of Section. G.L. 1909, ch. 115, § 16; P.L. 1918, ch. 1634, § 1; G.L. 1923, ch. 153, § 16; G.L. 1938, ch. 255, § 13; impl. am. P.L. 1939, ch. 660, § 180; G.L. 1956, § 23-13-9 ; P.L. 1988, ch. 554, § 1; P.L. 1997, ch. 30, art. 28, § 7; P.L. 1999, ch. 89, § 1; P.L. 2015, ch. 159, § 1; P.L. 2015, ch. 181, § 1.

23-13-10. Complaints for violations.

Complaints for violation of the provisions of § 23-13-9 shall be made by the director of the state department of health or by any one authorized by the director, and persons making a complaint under the authority of § 23-13-9 shall be exempted from giving surety for costs on the complaint.

History of Section. G.L. 1909, ch. 115, § 17; P.L. 1918, ch. 1634, § 1; G.L. 1923, ch. 153, § 17; G.L. 1938, ch. 255, § 14; impl. am. P.L. 1939, ch. 660, § 180; G.L. 1956, § 23-13-10 .

23-13-11. Repealed.

23-13-12. Repealed.

23-13-13. Testing for hearing impairments.

1. It is declared to be the public policy of this state that every newborn infant be evaluated by procedures approved by the state department of health for the detection of hearing impairments, in order to prevent many of the consequences of these disorders. No hearing impairment test shall be made as to any newborn infant if the parents of that child object to the test on the grounds that a hearing impairment test would conflict with their religious tenets or practices.
2. The physician attending a newborn child shall cause the child to be subject to hearing impairment tests as described in department of health regulations.
3. In addition, the department of health is authorized to establish by rules and regulations a reasonable fee structure for hearing impairment testing to cover program costs not otherwise covered by federal grant funds specifically secured for this purpose. This testing shall be a covered benefit reimbursable by all health insurers, as defined in § 27-38.2-2(1) except for supplemental policies that only provide coverage for specific diseases, hospital indemnity, Medicare supplement, or other supplemental policies. The department of human services shall pay for hearing impairment testing when the patient is eligible for medical assistance under the provisions of chapter 8 of title 40. In the absence of a third party payor the charges for hearing impairment testing shall be paid by the hospital or other health care facility where the birth occurred. Nothing in this section shall preclude the hospital or health care facility from billing the patient directly. Those fees shall be deposited into a restricted receipt account entitled the “newborn screening account”.
4. There is created a hearing impairments testing advisory committee which shall advise the director of the department of health regarding the validity and cost of testing procedures. That advisory committee shall:
   1. Meet at least four (4) times per year;
   2. Be chaired by the director or his or her designee;
   3. Be composed of seven (7) members appointed by the director from the following professions or organizations:
      1. A representative of the health insurance industry;
      2. A pediatrician, designated by the R.I. chapter of the American Academy of Pediatrics;
      3. An audiologist, designated by the R.I. chapter of the American Speech and Hearing Association;
      4. Two (2) representatives of hospital neonatal nurseries;
      5. A representative of special education designated by the department of elementary and secondary education; and
      6. The director of health or his or her designee.

History of Section. P.L. 1979, ch. 174, art. 15, § 1; P.L. 1992, ch. 185, § 1; P.L. 1995, ch. 370, art. 40, § 61; P.L. 1996, ch. 404, § 28; P.L. 2008, ch. 100, art. 28, § 4; P.L. 2008, ch. 475, § 42.

23-13-14. Newborn screening program.

1. The physician attending a newborn child shall cause that child to be subject to newborn screening tests for metabolic, endocrine, and hemoglobinopathy disorders, and other conditions for which there is a medical benefit to the early detection and treatment of the disorder, and an assessment for developmental risk. The department of health shall make rules and regulations pertaining to screenings, diagnostic, and treatment services as accepted medical practice shall indicate. The rules and regulations shall include, at a minimum, newborn screening tests for all disorders and conditions for which there is a medical benefit to the early detection and treatment of the disorder or condition listed in the current version of the federal Recommended Uniform Screening Panel (RUSP) issued by the Secretary of the U.S. Department of Health and Human Services, and shall include newborn screening tests for all new disorders or conditions for which there is a medical benefit to the early detection and treatment of the disorder or condition added to the federal RUSP within two (2) years after the disorder or condition is added; provided, if the director of health determines in writing that it is not practicable to include a new disorder or condition within two (2) years, the time period may be extended for the shortest amount of time necessary, as determined by the director. The provisions of this section shall not apply if the parents of the child object to the tests on the grounds that those tests conflict with their religious tenets and practices.
2. In addition, the department of health is authorized to establish by rule and regulation a reasonable fee structure for the newborn screening and disease control program, which includes but is not limited to, screening, diagnostic, and treatment services. The program shall be a covered benefit and be reimbursable by all health insurers, as defined in § 27-38.2-2 , providing health insurance coverage in Rhode Island except for supplemental policies that only provide coverage for specific diseases, hospital indemnity Medicare supplements, or other supplemental policies. The department of human services shall pay for the program where the patient is eligible for medical assistance under the provisions of chapter 8 of title 40. The charges for the program shall be borne by the hospitals or other healthcare facilities where births occur in the absence of a third-party payor. Nothing in this section shall preclude the hospital or healthcare facility from billing the patient directly.
3. There is created within the general fund a restricted receipt account to be known as the “newborn screening account” to implement the provisions of §§ 23-13-13 and 23-13-14 . All funds received pursuant to §§ 23-13-13 and 23-13-14 shall be deposited in the account. Funding dedicated exclusively to implement the provisions of §§ 23-13-13 and 23-13-14 and received by the department of health from sources other than those identified in §§ 23-13-13 and 23-13-14 may also be deposited in the newborn screening account. The general treasurer is authorized and directed to draw his or her orders on the account upon receipt of properly authenticated vouchers from the department of health.

History of Section. P.L. 1987, ch. 276, § 2; P.L. 1988, ch. 285, § 1; P.L. 1995, ch. 110, § 1; P.L. 1995, ch. 370, art. 40, § 61; P.L. 2001, ch. 63, § 1; P.L. 2001, ch. 213, § 1; P.L. 2004, ch. 6, § 11; P.L. 2008, ch. 100, art. 28, § 4; P.L. 2011, ch. 211, § 1; P.L. 2011, ch. 247, § 1; P.L. 2021, ch. 359, § 1, effective January 1, 2022; P.L. 2021, ch. 360, § 1, effective January 1, 2022.

23-13-15. Repealed.

23-13-16. Annual maternal and child health report.

The department of health shall prepare and issue an annual report on the status of maternal and child health in this state. The report shall include, but need not be limited to, the following: (1) a statistical review and analysis of indicators of maternal and child health, such as low birthweights and infant mortality, including a discussion of any trends revealed by those statistics; (2) a summary of peer reviews of pregnancy-related and early childhood deaths occurring during the previous year; (3) identification of groups of mothers and children at high risk for morbidity and mortality; (4) identification of barriers to adequate maternal and child health care; (5) information regarding both government-funded and third party reimburse maternal and child health care services; and (6) recommendations to strengthen state efforts to improve pregnancy outcomes and to promote effective and coordinated maternal and child health care services. The report shall be submitted to the governor and the general assembly by January 15th of each year and shall be made available to the public.

History of Section. P.L. 1987, ch. 303, § 1.

23-13-16.1. Maternity patient’s informational pamphlet.

1. The director of health shall require that each hospital submit to the department statistics relating to the annual rate of caesarean sections, primary and repeat;
2. A pamphlet shall be prepared annually by each hospital listing the statistics stated in subsection (a), and that pamphlet shall be presented in a three (3) year aggregate with each of the years included in the aggregate listed separately;
3. The director of health shall require each hospital to distribute to each prospective maternity patient prior to treatment (in other than a medical emergency), and upon request, to the general public, that maternity informational pamphlet.
4. Notwithstanding the provisions of subsection (b), the informational pamphlet for the first (1st) and second (2nd) year after January 1, 1989 need only contain statistical information in a one or two (2) year aggregate, respectively.

History of Section. P.L. 1988, ch. 205, § 1.

23-13-17. Special supplemental food program for women, infants, and children (WIC).

1. The director of health shall administer a program to be called the WIC program, to provide supplemental foods and nutrition education to pregnant, postpartum, and breastfeeding women, infants, and young children from families who meet financial eligibility standards established by the department and who are at special risk with respect to their physical and mental health by reason of inadequate nutrition, or health care, or both. The WIC program shall be administered in a manner consistent with applicable federal law, 42 U.S.C. § 1786, and the provision of this chapter.
2. All applicants and participants who are eligible shall be entitled to participate in the WIC program.
3. The cost of the program shall not exceed two hundred thousand dollars ($200,000).
4. Every person, party, entity, partnership, corporation, or other business, governmental, or nonprofit entity which embezzles, willfully misapplies, steals, or obtains by fraud or deception any funds, assets or property provided under § 7 of the Child Nutrition Act of 1966, 42 U.S.C. § 1776, or under this chapter, whether received directly or indirectly from the United States Department of Agriculture or the Rhode Island department of health, or receives, conceals, or retains those funds, assets, or property for his or her own interest, knowing those funds, assets, or property have been embezzled, willfully misapplied, stolen, or obtained by fraud or deception shall, if the amount of funds, assets, or property are of the value of five hundred dollars ($500) or more, be fined not more than ten thousand dollars ($10,000), or if the amount of funds, assets, or property are of a value of less than five hundred dollars ($500), shall be fined not more than one thousand dollars ($1,000). The amount of funds, assets, or property provided under the special supplemental food program for women, infants, and children misdirected in violation of this chapter shall be calculated as the aggregate from any and all incidents or acts prohibited by this chapter occurring in any consecutive twelve (12) month period.
5. Every person, party, entity, partnership, corporation, or other business, governmental, or nonprofit entity which duplicates, causes to be duplicated, creates, manufactures, or causes to be created or manufactured any copy or facsimile of any article or method employed by the Rhode Island department of health to identify food vendors which redeem food instruments of the special supplemental food program for women, infants, and children (WIC program) without the express written authorization of the Rhode Island department of health or whoever obtains, steals, conceals or retains a WIC program vendor identifier knowing the identifier has been copied or created without department of health authorization or obtains or retains an identifier or copy or facsimile of it, without the express written authorization of the Rhode Island department of health, shall, if the WIC program vendor identifier is used in the acceptance, redemption, or deposit of WIC program food instruments, be fined not more than ten thousand dollars ($10,000), or if the unauthorized vendor identifier is not shown to have been used in the acceptance, redemption, or deposit of WIC program food instruments, shall be fined not more than one thousand dollars ($1,000).
6. Every person, party, entity, firm, or corporation which misrepresents itself as, or in any other manner improperly, fraudulently or deceptively holds itself out to be, authorized by any unit of the federal, state, or local government or other entity to accept, redeem, or deposit WIC program food instruments, such as WIC checks, or which otherwise attempts or solicits to accept, redeem, or deposit WIC food instruments without the express authorization of the department in any manner shall, if the action is accompanied by the unauthorized acceptance, redemption, or deposit of WIC program food instruments, be fined not more than ten thousand dollars ($10,000), or if those actions are not shown to have been accompanied by the acceptance, redemption, or deposit of WIC program food instruments, shall be fined not more than one thousand dollars ($1,000).
7. The possession of any funds, assets, property, vendor identifier, or WIC food instruments shall be evidence of guilty knowledge by the person having possession that the property was embezzled, willfully misapplied, stolen, or obtained by fraud or deception or created or received without authorization except the person shows that it was acquired in the due course of trade and for adequate consideration.
8. Any penalty imposed under this chapter shall be in addition to immediate repayment of any claim made under the provisions of the Rhode Island state plan of operation and administration of the special supplemental food program for women, infants, and children for funds improperly obtained or received.
9. Any fine imposed under this chapter does not preclude any other sanctions or penalties set forth in state or federal regulations, rules or the provisions of the Rhode Island state plan of operation and administration for the special supplemental food program or the provisions of the vendor participation agreement in force between the Rhode Island department of health and any WIC program vendor.

History of Section. P.L. 1987, ch. 382, § 1; P.L. 1991, ch. 156, § 1; P.L. 2001, ch. 86, § 69; P.L. 2008, ch. 475, § 42.

23-13-18. Repealed.

23-13-19. Human immunodeficiency virus (HIV) testing.

1. Every physician or healthcare provider attending any person for prenatal care or family planning services shall include HIV screening consistent with the provisions of chapter 23-6.3.
2. through (i)[Deleted by P.L. 2009, ch. 196, § 6 and P.L. 2009, ch. 289, § 6].

History of Section. P.L. 1988, ch. 405, § 4; P.L. 2000, ch. 171, § 3; P.L. 2006, ch. 599, § 6; P.L. 2007, ch. 170, § 2; P.L. 2007, ch. 279, § 2; P.L. 2009, ch. 196, § 6; P.L. 2009, ch. 289, § 6.

23-13-20. Coordination of community-based family life and sex education.

1. The director of health, with the consultation from the commissioner of elementary and secondary education, the director of human services, the Family Life Center at the Community College of Rhode Island, and the director of the department of children, youth, and families, is authorized to establish a family life and sex education coordination program to assist in the establishment of community networks of educators, counselors, and health and human service providers in the maternal and child health planning areas of the state with high rates of teenage pregnancy. The epidemic of teenage pregnancy is, in part, a result of a deteriorating quality of family life reflected in high divorce rates, confusion between love and sex, and increasing reports of isolation and hopelessness. This community-based approach can address the problem of teenage pregnancy created by the demographic, economic, and cultural phenomena that have dramatically changed both the definition and the role of the family. This program shall include counseling in substance abuse prevention.
2. It is the intent of the general assembly that the complex social problem of teenage pregnancy be addressed by the thoughtful orchestration of community institutions and interest groups to support a sound school program designed both to enhance the personal competence and self-esteem of youth, and improve parent skills in providing explicit sexuality education in the home.

History of Section. P.L. 1988, ch. 414, § 1; P.L. 1990, ch. 79, § 1.

23-13-21. Comprehensive reproductive health services.

1. The director of health is authorized and directed to establish a payor of last resort program to cover the cost of outpatient family planning counseling and comprehensive reproductive health services for men and women who are ineligible for Medicaid, lack health insurance coverage for these services, and whose family’s income is between one hundred percent (100%) and one hundred eighty-five percent (185%) of the federal poverty level. The director shall promulgate regulations to implement this program. These regulations shall include: specific eligibility criteria, scope and standards for services to be covered, mechanisms for administration, and service delivery.
2. It is the intent of the general assembly that the following services be provided through this program:
   1. Patient education and counseling on options for timing and spacing pregnancy;
   2. Comprehensive medical services to prevent and control the spread of sexually transmitted diseases;
   3. Access to safe and effective methods of contraception.
3. Excluded services will include but not be limited to elective abortion, elective hysterectomy, infertility related services, and other non-family planning procedures. No funds shall be expended to support school-based clinics dispensing contraceptive methods.

History of Section. P.L. 1988, ch. 414, § 1.

23-13-22. Early intervention program for developmentally disabled infants.

1. The director of the department of human services shall ensure that all developmentally disabled infants from birth to three (3) years of age shall be enrolled in the early intervention program. Regulations governing the delivery of services under this program, including eligibility criteria, shall be promulgated by the department of human services, with the advice of the interagency coordinating council; provided, however, that all regulations promulgated by the department of health shall remain in full force and effect until the time they are replaced by regulations promulgated by the department of human services. The regulations shall stipulate, at a minimum, the following provisions that are consistent with the intent of this chapter:
   1. The director shall develop and maintain a procedure for the earliest possible identification and efficient referral of all developmentally disabled infants;
   2. The director shall ensure that every infant identified and referred to this program is enrolled as soon as possible after birth; and further, that for infants placed on a waiting list for facility based group programming, an early intervention program shall be made available within a thirty (30) day period from the time a need is identified in the individual program plan;
   3. Unless parents refuse the service, the home visiting component of the program shall commence as soon as the infant has been identified as having a possible developmental disability;
   4. Any parent(s) who is/are dissatisfied with decisions or termination of service or with practices and procedures of a particular agency or the department of human services shall notify the director of the department of human services in writing within thirty (30) calendar days and the complaint shall be reviewed in accordance with department of health policy and procedures, as amended, and the Administrative Procedures Act, chapter 35 of title 42.
   5. An early intervention program for purposes of this section shall mean a comprehensive array of educational, developmental, health, and social services provided on a calendar year basis to eligible infants, children, and their families as specified in program regulations.
2. Within ninety (90) days after October 1, 2004, an evaluation plan describing outcome measures that document the program’s successes and shortcomings from the previous fiscal year shall be submitted to the speaker of the house of representatives, the president of the senate and the house oversight committee and the governor and the interagency coordinating council. Development of the plan shall be made in consultation with the entities with expertise in this area and the interagency coordinating council. The plan shall include a memorandum of understanding between the department of health, department of human services and the department of elementary and secondary education that demonstrates coordination and continuity of early intervention services among these departments.
3. Within six (6) months after January 1, 2005 where prescribed outcomes documented in the evaluation plan have not been accomplished the responsible agencies shall submit written explanations for the shortfalls, together with their proposed remedies. The report shall also include evaluation of the progress of the coordination efforts between the department of health and the department of human services and the department of elementary and secondary education and the interagency coordinating council and shall include any recommendations regarding modifications of the reimbursement mechanisms of this chapter.
4. Within twelve (12) months after August 1, 2005 a final report shall include the progress of the coordination efforts between the department of health and the department of human services and department of elementary and secondary education, interagency coordinating council and shall include any recommendations regarding modifications to the comprehensive array of educational, developmental, health and social services provided on a calendar year basis to eligible infants, children and their families as specified in an early intervention system.
5. All reports or documents required to be produced pursuant to 20 U.S.C. § 1471 et seq., shall be submitted to the speaker of the house, president of the senate and the chairpersons of the appropriate house of representatives and senate oversight committees and the governor and the interagency coordinating council. Adherence to such plans and reporting requirements, and budgets and the timely achievement of goals contained therein shall be considered by the oversight committees of the house of representatives and senate, among other relevant factors, in determining appropriations or other systemic changes.

History of Section. P.L. 1991, ch. 243, § 3; P.L. 2004, ch. 595, art. 42, § 1; P.L. 2004, ch. 598, § 1; P.L. 2008, ch. 475, § 42.

23-13-23. Interagency coordinating council.

The interagency coordinating council, which is composed in accordance with 20 U.S.C. § 1441, as added by Public Law 108-446, shall monitor the multiagency operation of the early intervention program and to provide a forum where problems may be addressed relating to the delivery of services in the early intervention program.

History of Section. P.L. 1991, ch. 243, § 3; P.L. 2001, ch. 86, § 69; P.L. 2008, ch. 475, § 42.

23-13-24. Recommendations of the council.

The interagency coordinating council shall offer recommendations for the betterment of the delivery of early intervention services to the appropriate state agencies and the general assembly whenever necessary.

History of Section. P.L. 1991, ch. 243, § 3.

23-13-25. Powers of council cumulative.

The powers and authority of the interagency coordinating council, as stated in this chapter, are in addition to and not in lieu of the powers and authority of any other state agency, department, or division.

History of Section. P.L. 1991, ch. 243, § 3.

23-13-26. Technology-dependent children — Definitions — Caretakers’ skills.

1. For the purposes of this section, the following definitions apply:
   1. “Advanced skills” means familiarity and current experience with the following:
      1. Pediatric intensive care assessments skills;
      2. Ventilator and respirator equipment;
      3. Maintenance in oxygen therapy and pulse oximeter equipment;
      4. Tracheostomy care — daily and emergency care;
      5. Respiratory suctioning and maintenance of suctioning equipment;
      6. Administration of respiratory treatment and chest therapy;
      7. Gastrostomy and naso-gastric care and gavage/pump feedings;
      8. Administration and familiarity of multiple cardio—pulmonary medications; and
      9. Basic life support certification and periodic recertification.
   2. “Medical devices or equipment” include, but are not limited to, the following:
      1. Respirator;
      2. Tracheostomy;
      3. Oxygen;
      4. Naso-gastric or gastrostomy tube;
      5. Indwelling catheter;
      6. Intravenous device;
      7. Total parenteral nutritional support; and
      8. Peritoneal or hemodialysis.
   3. “Technology-dependent children” means:
      1. Children who have severe, chronic disabilities attributable to a mental or physical impairment or combination of mental and physical impairments, which disability is manifested before the person attains the age of twenty-two (22), is likely to continue indefinitely, results in substantial functional limitations in three (3) or more of the following areas of major life activity:
         1. Self-care;
         2. Receptive and expressive language;
         3. Learning;
         4. Mobility;
         5. Self-direction;
         6. Capacity for independent living; or
         7. Economic self-sufficiency; and
      2. Who requires medical devices or equipment to compensate for the chronic, persistent reduction or absence of a vital body function.
2. Certified school nurse teachers, as defined in § 16-21-8 , who provide direct care for technology-dependent children shall have advanced skills which include, but are not limited to, those skills in subsection (a)(1) of this section.
3. The specific guidelines for the care of technology-dependent children in schools shall be included in the rules and regulations issued jointly by the director of the department of health and the board of regents for elementary and secondary education under the provisions of U.S. Public Law 108-446, 20 U.S.C. § 1400 et seq., and chapter 24 of title 16 as part of the school health program.
4. Nothing in § 16-11-2 shall be construed to prevent the board of regents from promulgating regulations requiring certified nurse teachers who provide direct care for technology-dependent children to obtain the advanced skills required under this section.
5. The obligation of a school district to provide the services set forth in this section shall be determined in accordance with other applicable state and federal laws and regulations.

History of Section. P.L. 1992, ch. 340, § 1; P.L. 2008, ch. 475, § 42.

23-13.1-1. Short title.

This chapter may be cited as the “Safe Haven for Infants Act.”

History of Section. P.L. 2001, ch. 53, § 1; P.L. 2001, ch. 130, § 1.

23-13.1-2. Definitions.

As used in this chapter:

“Infant” means a newborn human child which is thirty (30) days old or younger.

History of Section. P.L. 2001, ch. 53, § 1; P.L. 2001, ch. 130, § 1.

23-13.1-3. Voluntary surrender of infant child.

1. Every hospital, open medical emergency facility, fire station, or police station operating in the state of Rhode Island shall, without court order, take temporary physical custody of an infant, who appears to be age thirty (30) days or younger, who is voluntarily left with a staff member of the hospital, open medical emergency facility, fire station, or police station by any person who does not express an intent to return for the infant and the circumstances give rise to a reasonable belief that the person does not intend to return for the infant.
2. The person leaving the infant may, but shall not be required to leave any information disclosing the identity of himself/herself, the infant, the parents of the infant or other family member of the infant and/or the medical history of himself/herself, the infant, the parents of the infant, or other family member of the infant. The hospital or other facility designated in this section shall offer the person leaving the infant written information concerning the legal effect of leaving the infant with the hospital or other facility designated in this section. The department of children, youth and families shall create this information and provide it at no charge to hospitals and other facilities designated in this section. Any information obtained by the hospital or other facility designated in this section from the person leaving the infant relating to the identity of the person, the infant, the parents of the infant or other family member of the infant shall be kept confidential by the hospital or other facility and shared with no one other than the director of the department of children, youth and families or his or her designee. However, if a court of competent jurisdiction determines that the immunity provisions of § 23-13.1-4 do not apply, the hospital or other facility where the infant was left must disclose the information relating to the identity of the person, the infant, the parents of the infant, or other family member of the infant to the department of attorney general upon order of the court. Nothing in this section shall be construed to prevent disclosing to medical care providers any information about the infant necessary to provide medical care or treatment to the infant.
3. Nothing contained in this section shall preclude the department of children, youth and families from notifying law enforcement authorities of any criminal wrongdoing in accordance with §§ 11-9-5 and/or 40-11-5 .
4. The hospital or other facility with responsibility for performing duties under this chapter, and/or any employee, independent contractor, agent, doctor, other medical professional, law enforcement or fire official associated with the hospital or facility shall be immune from any criminal or civil liability arising from action(s) taken in accordance with this chapter including, but not limited to, determining the age of, receiving, examining or otherwise treating the infant. This immunity does not apply to acts or omissions constituting negligence or reckless, wanton or intentional misconduct.
5. The hospital or other facility in this section performing duties under this chapter and/or any staff member, employee, independent contractor, agent, doctor, other medical professional, law enforcement or fire official associated with the hospital or facility shall be immune from any criminal or civil liability that otherwise might result from the failure to make a report under the provisions of chapter 11 of title 40 if the entity or person acted in good faith in complying with this section.
6. Any hospital, medical facility or licensed physician, and its employees, independent contractors and agents, are authorized to provide to an infant left at a hospital or other facility in accordance with this chapter any medical care and treatment, including testing for the human immunodeficiency virus and hepatitis, that the attending physician believes necessary for the infant’s well-being.

History of Section. P.L. 2001, ch. 53, § 1; P.L. 2001, ch. 130, § 1.

23-13.1-4. Immunity.

A person who leaves an infant, age thirty (30) days or younger, at a hospital or other facility designated under this chapter, or directs another person to do so, shall be immune from prosecution only for the act of abandonment of the infant pursuant to §§ 11-2-1 and 11-9-5(a) provided that:

1. The person is the parent of the infant or is acting at the direction of a parent;
2. The infant is left in the physical custody of a staff member of the hospital or other facility designated under this chapter;
3. A comprehensive medical examination of the infant determines the infant has not been harmed or been the victim or any physical neglect or abuse. Injuries and/or conditions resulting from childbirth shall not be considered harm, abuse or neglect for the purposes of this section.

History of Section. P.L. 2001, ch. 53, § 1; P.L. 2001, ch. 130, § 1.

23-13.1-5. DCYF — Procedure.

1. Immediately upon any time that a hospital or other facility designated in this chapter takes physical possession of an infant pursuant to this chapter, the hospital or other facility designated in this chapter shall notify the director of the department of children, youth and families, or his or her designee, that it has physical possession of the infant. The director of the department of children, youth and families shall establish a procedure by which a hospital or other facility designated in this chapter can notify the department for children, youth and families. The department of children, youth and families shall immediately respond to the hospital or other facility designated in this chapter and place the infant in the temporary protective custody of the department and make arrangements for the infant to undergo a comprehensive medical examination by a licensed physician or a duly certified registered nurse practitioner in accordance with the provisions of § 40-11-5 . Thereafter, the department of children, youth and families shall file an emergency petition for the removal of the infant from the care and custody of the parents in accordance with the provisions of § 40-11-7 .
2. The department of children, youth and families shall, upon obtaining temporary custody of the infant and provided that no person has asserted a claim to be the parent of the infant within ninety (90) days of the department obtaining custody, commence proceedings to terminate the parental rights of the parents of the infant in accordance with the provisions of § 15-7-7 . The leaving of the infant at a hospital or other facility designated herein and the failure of a person to assert a claim to be the parent of the infant within ninety (90) days of the infant being placed in the temporary custody of the department of children, youth and families shall constitute prima facie evidence of permanent abandonment of the infant.

History of Section. P.L. 2001, ch. 53, § 1; P.L. 2001, ch. 130, § 1.

23-13.1-6. Awareness program.

There shall be established a “Safe Haven for Infants Awareness Program” which shall distribute literature relative to the rights and immunity established under this chapter. The awareness program shall be administered by the director of the department of children, youth and families or his or her designee. As part of the program, the director shall establish a toll free telephone information line, issue pamphlets and other literature, and secure print and other advertisements in order to disseminate information relative to this chapter.

History of Section. P.L. 2001, ch. 53, § 1; P.L. 2001, ch. 130, § 1.

23-13.1-7. Annual report to the legislature.

The director of the department of children, youth and families shall report annually to the general assembly at its January session as to the status of any infant abandoned under this chapter and all costs incurred by the department relative to this chapter.

History of Section. P.L. 2001, ch. 53, § 1; P.L. 2001, ch. 130, § 1.

23-13.1-8. Severability.

If any provision of this chapter or the application of any provision to any person or circumstance shall be held invalid, that invalidity shall not affect the provisions or application of this chapter, which can be given effect without the invalid provision or application, and to this end the provisions of this chapter are declared to be severable.

History of Section. P.L. 2001, ch. 53, § 1; P.L. 2001, ch. 130, § 1.

23-13.2-1. Workplace policies protecting a woman’s choice to breastfeed.

1. An employer may provide reasonable unpaid break time each day to an employee who needs to breastfeed or express breast milk for her infant child to maintain milk supply and comfort. The break time must, if possible, run concurrently with any break time already provided to the employee. An employer is not required to provide break time under this section if to do so would create an undue hardship on the operations of the employer.
2. An employer shall make a reasonable effort to provide a private, secure and sanitary room or other location in close proximity to the work area, other than a toilet stall, where an employee can express her milk or breastfeed her child.
3. The department of health shall issue periodic reports on breastfeeding rates, complaints received and benefits reported by both working breastfeeding mothers and employers.
4. As used in this section:
   1. “Employer” means a person engaged in business who has one or more employees, including the state and any political subdivision of the state;
   2. “Employee” means any person engaged in service to an employer in the business of the employer;
   3. “Reasonable efforts” means any effort that would not impose an undue hardship on the operation of the employer’s business; and
   4. “Undue hardship” means any action that requires significant difficulty or expense when considered in relation to factors such as the size of the business, its financial resources and the nature and structure of its operation.

History of Section. P.L. 2003, ch. 53, § 1; P.L. 2003, ch. 67, § 1; P.L. 2008, ch. 475, § 43.

23-13.3-1. Preamble to birth defects surveillance and information system.

Whereas birth defects are a major cause of infants deaths and childhood disabilities; and whereas early recognition and response to birth defects often prevents more serious effects; and whereas the epidemiological patterns of specific birth defects may provide keys to improved birth outcomes. An active birth defects surveillance and information system is essential to developing programs and disseminating information that can reduce birth defects and infant mortality. An active birth defects surveillance and information system serves to:

1. Describe occurrence of birth defects in the newborn and children up to five (5);
2. Detect trends of morbidity and mortality, stimulate epidemiological research diminish the impact of birth defects and infant mortality;
3. Identify newborns and children with birth defects to intervene on a timely basis for treatment.

History of Section. P.L. 2003, ch. 116, § 1; P.L. 2003, ch. 183, § 1; P.L. 2008, ch. 475, § 44.

23-13.3-2. Definitions.

1. “Birth defects” means a physical or mental functional deficit or impairment resulting from one or more genetic or environmental causes detected in a newborn or before a child’s fifth (5th) birthday.
2. “Council” means the birth defects surveillance and information advisory council.
3. “Department” means the Rhode Island department of health.
4. “Director” means the director of the department of health.

History of Section. P.L. 2003, ch. 116, § 1; P.L. 2003, ch. 183, § 1.

23-13.3-3. Statewide birth defects surveillance and information system.

1. The director shall establish and implement not later than one year after passage of this act a statewide birth defects reporting, surveillance and information system for the collection of information concerning birth defects of newborns and spontaneous fetal deaths. The director shall establish the types of birth defects to be reported, reporting requirements and confidentiality standards.
2. The director shall require the reporting of birth defects and the submission of any specified additional information on cases necessary and appropriate for the recognition of birth defects and to conduct epidemiological surveys of birth defects.
3. The birth defects surveillance and information system shall maintain comprehensive records of all reports submitted pursuant to this section. These reports shall be confidential in accordance with chapter 37.3 of title 5 and subject to the restrictions on release incorporated in that chapter. Provided, however: (1) any such information shall be available only for the purposes of this chapter; and (2) any data requested for demographic or epidemiological studies shall be provided in a format without individually identifiable information.
4. The department shall maintain a public listing of any nondepartmental employees who are given access to identifiable information in the surveillance and information system. The listing shall include: the name of the person authorizing access; the name, title and organizational affiliation of each person given access; the date of access; and the specific purpose for which the information was used.
5. Nothing in this section shall be construed to compel any individual to submit to medical or department examination or supervision.
6. The director shall make rules and regulations that are necessary to implement the provision of this section pursuant to chapter 35 of title 42.
7. The department shall not require the reporting of information or entering of information into the birth defects surveillance and information system regarding birth defects of a child whose parents or legal guardian objects.
8. Parents and/or guardians shall have the right to prohibit the release of individually identifiable information on their children from the birth defects surveillance and information system, and shall have the right to prohibit being contacted by the Birth Defects Surveillance Program.
9. The department shall provide timely notification to parents and/or guardians of their rights under subsections (g) and (h).

History of Section. P.L. 2003, ch. 116, § 1; P.L. 2003, ch. 183, § 1.

23-13.3-4. Advisory council.

1. Not later than thirty (30) days after July 7, 2003, the director shall appoint a council to advise the department on the establishment and implementation of the birth defects reporting, surveillance and information system.
2. The council shall recommend to the director a list of birth defects to be reported to the surveillance system.
3. The council shall include not more than fifteen (15) persons who collectively bring the following expertise: (1) representative of the Children’s Cabinet; (2) health care services; (3) the Rhode Island March of Dimes and other community organizations concerned with birth defects; (4) parents of children with birth defects; and (5) the public.
4. Members may serve for two (2) three (3) year terms. Terms for each appointee begin at the initial appointment date.
5. Not later than thirty (30) days after the initial appointments are made the director shall convene the first meeting of the council. In consultation with and with the approval of the council, the director shall appoint, at the first meeting of the council, the chairperson and vice chairperson of the council from among the members of the council. The chairperson may call additional meetings, as the chairperson considers appropriate.
6. The council may establish rules of procedure as necessary to facilitate the council’s orderly conduct of business.
7. Council members shall serve without compensation.

History of Section. P.L. 2003, ch. 116, § 1; P.L. 2003, ch. 183, § 1; P.L. 2008, ch. 475, § 44.

23-13.3-5. Reports.

Three (3) years after the date a birth defects surveillance and information system is implemented the department shall submit the first annual report to the governor, the general assembly, the Children’s Cabinet and the Interagency Coordinating Council. The report shall describe the findings of the first year’s reporting and set forth the council’s recommendations for the betterment of the birth defects surveillance and information system. In addition, the council shall make recommendations to the appropriate state agencies whenever it considers the recommendations to be necessary.

History of Section. P.L. 2003, ch. 116, § 1; P.L. 2003, ch. 183, § 1.

23-13.4-1. Legislative findings.

The legislature finds and declares all of the following:

1. Chemicals known as brominated flame retardants (BFRs) are widely used in Rhode Island. To meet stringent fire standards, manufacturers add BFRs to a multitude of products, including plastic housing of electronics and computers, circuit boards, and the foam and textiles used in furniture.
2. Polybrominated diphenyl ether (PBDE), which is a subcategory of BFRs, has increased fortyfold in human breast milk since the 1970s.
3. PBDE has the potential to disrupt thyroid hormone balance and contribute to a variety of developmental deficits, including low intelligence and learning disabilities. PBDE may also have the potential to cause cancer.
4. Substantial efforts to eliminate BFRs from products have been made throughout the world, including private and public sectors. These efforts have made available numerous alternatives safe to human health while meeting stringent fire standards. To meet market demand, it is in the interest of Rhode Island manufacturers to eliminate the use of BFRs.
5. In order to protect the public health and the environment, the legislature believes it is necessary for the state to develop a precautionary approach regarding the production, use, storage, and disposal of products containing brominated fire retardants.

History of Section. P.L. 2006, ch. 591, § 1; P.L. 2008, ch. 475, § 45.

23-13.4-2. Definitions.

For purposes of this chapter, the following words shall have the following meanings:

1. “DecaBDE” means decabromodiphenyl ether.
2. “OctaBDE” means octabrominated diphenyl ether or any technical mixture in which octabrominated diphenyl ether is a predominate congener.
3. “PBDE” means polybrominated diphenyl ether.
4. “PentaBDE” means pentabrominated diphenyl ether or any technical mixture in which pentabrominated diphenyl ether is a predominate congener including, but not limited to, metal furniture, machinery, major appliances, electronic products, and wood-burning stoves.

History of Section. P.L. 2006, ch. 591, § 1; P.L. 2008, ch. 475, § 45.

23-13.4-3. Manufacturing, processing or distribution.

1. Effective January 1, 2007, a person may not manufacture, process, or distribute in commerce a product or a flame-retardant part of a product containing more than one-tenth (1/10%) of one percent (1%) of pentaBDE or octaBDE.
2. Subsection (a) of this section does not apply to the following:
   1. The sale by a business, charity, or private party of any used product containing PBDE.
   2. The distribution in commerce of original equipment manufacturer replacement service parts manufactured prior to July 14, 2006.
   3. The processing of recycled material containing pentaBDE or octaBDE in compliance with applicable state and federal laws.
   4. Use of products containing small quantities of PBDEs that are produced or used or used for scientific research on the health or environmental effects of PBDEs.

History of Section. P.L. 2006, ch. 591, § 1; P.L. 2008, ch. 475, § 45.

23-13.4-4. “DecaBDE” study.

By January 2, 2007, the department of environmental management shall submit to the general assembly a report that reviews the latest available scientific research to address the following issues:

1. Whether decaBDE is bio-accumulating in humans and the environment, and if so, whether the levels of decaBDE are increasing, decreasing, or staying the same;
2. How are humans exposed to decaBDE;
3. What health effects could result from exposure to decaBDE, and are current levels of exposure at levels that could produce these effects;
4. Whether decaBDE breaks down into more harmful chemicals that could damage public health; and
5. Whether effective flame retardants are available for decaBDE uses, and whether the use of available alternatives reduce health risks while still maintaining an adequate level of flame retardant performance.

History of Section. P.L. 2006, ch. 591, § 1; P.L. 2008, ch. 475, § 45.

23-13.4-5. Review of “decaBDE” Study.

By February 28, 2007, the department of health shall submit to the general assembly a report that reviews the department of environmental management’s decaBDE study. In addition to a review of any public health implications the department of health believes would result from exposure to decaBDE, it shall also comment on the following:

1. The known exposure pathways for humans to decaBDE;
2. What scientific evidence exists to demonstrate that decaBDE breaks down into other chemicals that could pose public health concerns; and
3. What research and analysis exists on the potential human health effects of flame retardants that could be used as alternative to decaBDE.

History of Section. P.L. 2006, ch. 591, § 1; P.L. 2008, ch. 475, § 45.

23-13.4-6. Transportation of products containing PBDEs.

Nothing in this chapter restricts a manufacturer, importer, or distributor from transporting products containing PBDEs through this state or storing PBDEs in this state for further distribution.

History of Section. P.L. 2006, ch. 591, § 1.

23-13.5-1. Breastfeeding in public places.

A woman may feed her child by bottle or breast in any place open to the public.

History of Section. P.L. 2008, ch. 223, § 1; P.L. 2008, ch. 308, § 1.

23-13.5-2. Remedies.

In any civil action alleging a violation of this chapter, the court may:

1. Afford injunctive relief against any person, entity or public accommodation that commits or proposes to commit a violation of this chapter; and
2. Award compensatory damages and reasonable attorney’s fees and costs to a prevailing plaintiff.

History of Section. P.L. 2008, ch. 223, § 1; P.L. 2008, ch. 308, § 1.

23-13.6-1. Short title.

This chapter shall be known and may be cited as the “Lactation Consultant Practice Act of 2014.”

History of Section. P.L. 2014, ch. 420, § 1; P.L. 2014, ch. 444, § 1.

23-13.6-2. Definitions.

As used in this chapter, the following words and terms shall have the following meanings:

1. “Lactation consultant” means a healthcare professional who specializes in the clinical management of breastfeeding.

History of Section. P.L. 2014, ch. 420, § 1; P.L. 2014, ch. 444, § 1.

23-13.6-3. Licensing and regulation of lactation consultants.

The director of health is authorized and directed to formulate, promulgate, amend, and repeal procedures, rules, and regulations for the following:

1. The licensing of lactation consultants;
2. Standards and specifications for education, knowledge, and experience required for licensure as a lactation consultant. In establishing these requirements, the director shall give due consideration to criteria established by the International Board of Lactation Consultant Examiners (IBLCE), or other national standards established by professional societies with expertise in the training and certification of lactation consultants;
3. Establishment of a minimum standard of care for providing lactation care and services;
4. Establishment of a nonrefundable application fee and license renewal fee. All fees collected pursuant to this chapter shall be deposited as general revenues;
5. Any other rule or regulation deemed necessary by the director of health to carry out the provisions of this chapter, provided that no rule or regulation shall take effect until it has been promulgated in accordance with the provisions of chapter 35 of title 42 (the “Administrative Procedures Act”).

History of Section. P.L. 2014, ch. 420, § 1; P.L. 2014, ch. 444, § 1.

23-13.6-4. Persons and practices exempt.

1. Nothing in this chapter shall be construed to prevent qualified members of other professions or other occupations or volunteers from performing functions consistent with the accepted standards of their respective professions; provided, however, that they do not hold themselves out to the public by any title or description stating or implying that they are lactation consultants licensed to practice clinical lactation care and services.
2. Nothing in this chapter shall be construed to prevent the practice of lactation care and services by students, interns, or persons preparing for practice under the qualified supervision of a licensee.
3. Lactation care and services provided through the Federal Special Supplemental Nutrition Program for Women, Infants and Children (WIC) program shall be considered exempt.

History of Section. P.L. 2014, ch. 420, § 1; P.L. 2014, ch. 444, § 1.

23-13.6-5. Enforcement.

1. This chapter shall be enforced by the director of health and he or she shall be exempt from the requirements of providing surety for costs.
2. Any person who violates the provisions of this chapter, or who violates any of the rules and regulations of the department of health made in pursuance of this chapter, shall be fined not more than one thousand dollars ($1,000), and the director of health may suspend or revoke the license issued to any person when, in the opinion of the director of health, that person is found to have engaged in unprofessional conduct.
3. Except as otherwise provided in this chapter, the inspection, enforcement, and penalties for violations of the provisions of this chapter, or the rules and regulations of the department of health made pursuant to this chapter, shall be in accordance with the provisions and procedures set forth in §§ 23-1-19 through 23-1-25 .
4. The powers and functions vested in the department of health under the provisions of this chapter shall not be construed to affect, in any manner, the powers, duties, and functions vested in the department of health under any other provisions of the general laws.

History of Section. P.L. 2014, ch. 420, § 1; P.L. 2014, ch. 444, § 1.

23-13.6-6. Severability.

If any provision of this chapter or its application to any person or circumstance is held invalid, the invalidity shall not affect other provisions or applications of this chapter which can be given effect without the invalid provision or application, and to this end the provisions of this chapter are severable.

History of Section. P.L. 2014, ch. 420, § 1; P.L. 2014, ch. 444, § 1.

23-13.7-1. Short title.

This chapter may be known and may be cited as “The Rhode Island Family Home-Visiting Act.”

History of Section. P.L. 2016, ch. 23, § 1; P.L. 2016, ch. 28, § 1.

23-13.7-2. Home-visiting system components.

1. The Rhode Island department of health shall coordinate the system of early childhood home-visiting services in Rhode Island and shall work with the department of human services and department of children, youth and families to identify effective, evidence-based, home-visiting models that meet the needs of vulnerable families with young children.
2. The Rhode Island department of health shall implement a statewide home-visiting system that uses evidence-based models proven to improve child and family outcomes. Evidence-based, home-visiting programs must follow with fidelity a program model with comprehensive standards that ensure high-quality service delivery, use research-based curricula, and have demonstrated significant positive outcomes in at least two (2) of the following areas:
   1. Improved prenatal, maternal, infant, or child health outcomes;
   2. Improved safety and reduced child maltreatment and injury;
   3. Improved family economic security and self-sufficiency;
   4. Enhanced early childhood development (social-emotional, language, cognitive, physical) to improve children’s readiness to succeed in school.
3. The Rhode Island department of health shall implement a system to identify and refer families prenatally, or as early after the birth of a child as possible, to voluntary, evidence-based, home-visiting programs. The referral system shall prioritize families for services based on risk factors known to impair child development, including:
   1. Adolescent parent(s);
   2. History of prenatal drug or alcohol abuse;
   3. History of child maltreatment, domestic abuse, or other types of violence;
   4. Incarcerated parent(s);
   5. Reduced parental cognitive functioning or significant disability;
   6. Insufficient financial resources to meet family needs;
   7. History of homelessness; or
   8. Other risk factors as determined by the department.
4. Beginning on or before October 1, 2016, and annually thereafter, the Rhode Island department of health shall issue a state home-visiting report that outlines the components of the state’s family home-visiting system that shall be made publicly available on the department’s website. The report shall include:
   1. The number of families served by each evidence-based model; and
   2. Demographic data on families served; and
   3. Duration of participation of families; and
   4. Cross-departmental coordination; and
   5. Outcomes related to prenatal, maternal, infant and child health, child maltreatment, family economic security, and child development and school readiness; and
   6. An annual estimate of the number of children born to Rhode Island families who face significant risk factors known to impair child development, and a plan including the fiscal costs and benefits to gradually expand access to the existing evidence-based, family home-visiting programs in Rhode Island to all vulnerable families.
5. State appropriations for this purpose shall be combined with federal dollars to fund the expansion of evidence-based, home-visiting programs, with the goal of offering the program to all the state’s pregnant and parenting teens; families with a history of involvement with the child welfare system; and other vulnerable families.

History of Section. P.L. 2016, ch. 23, § 1; P.L. 2016, ch. 28, § 1; P.L. 2017, ch. 208, § 1; P.L. 2017, ch. 252, § 1.

23-14-1. Declaration of intent.

1. Whereas, the state recognizes that many of the children with special health care needs, as well as their families, are forced to bear substantial physical, emotional, social, and financial hardships associated with the child’s illness;
2. Whereas, the financial costs for treatment and continued health care for children with special health care needs are often prohibitive, while many families may be without health care coverage, or be ineligible for publicly funded assistance, or coverage may be inadequate to cover many of the costs related to treatment or continued medical care;
3. Whereas, many families of children with special health care needs cannot be with their children during vital pre-and post operative periods or for periods of post operative treatment due to their inability to meet travel expenses;
4. Whereas, many nonprofit organizations in Rhode Island attempt to ameliorate this distressing situation for the children with special health care needs and their families by providing medicines, medical equipment, and funding to help to defray the costs associated with the care and treatment of these youngsters not otherwise provided for; and
5. Whereas, as admirable as the efforts of these nonprofit organizations are, it is widely acknowledged that they lack the funding to meet all of the remaining needs of children with special health care needs;
6. It is declared to be the intent of the state to provide a means by which children with special health care needs, whose needs for medical treatment, care, and equipment are not otherwise provided for, may be financed through a voluntary check-off of a portion of an income tax refund owed to a taxpayer by the state. It is also intended that funds generated by the check-off be supplemental to any funds which would otherwise be available for the purposes mentioned in this section, and that the funds be used only for direct provision of medicines, medical equipment, medical treatment, or care to children with special health care needs and travel expenses for child disease victims and their families when it is necessary for the child to receive treatment at an out-of-state medical treatment facility.

History of Section. P.L. 1989, ch. 384, § 1; P.L. 1999, ch. 83, § 48; P.L. 1999, ch. 130, § 48.

23-14-2. Definitions.

As used in this chapter, the following words shall be construed as follows unless the context clearly indicates otherwise:

1. “Child with special healthcare needs” means any minor under the age of eighteen (18) who is a domiciled resident of the state who suffers from a chronic medical illness.
2. “Eligible organization(s)” means the following Rhode Island based organizations and Rhode Island affiliates of the following national organizations:
   1. American Diabetes Association, R.I. Affiliate, Inc.;
   2. R.I. Lung Association, Inc.;
   3. Arthritis Foundation, R.I. Chapter;
   4. American Cancer Society, R.I. Division, Inc.;
   5. Hospice Care of R.I., Inc.;
   6. Leukemia Society of R.I., Inc., R.I. Chapter;
   7. Easter Seal Society of R.I., Inc.;
   8. R.I. Society to Prevent Blindness;
   9. United Cerebral Palsy of R.I.;
   10. R.I. Hemophilia Foundation;
   11. American Heart Association, R.I. Affiliate, Inc.;
   12. Cystic Fibrosis Foundation, R.I. Chapter;
   13. National Foundation of Ileitis & Colitis;
   14. Mental Health Association of R.I.;
   15. Muscular Dystrophy Association, Inc.;
   16. National Multiple Sclerosis Society;
   17. RI Arc; and
   18. Substance Use and Mental Health Leadership Council of RI.
3. “Eligible services” means the direct provision of medicines, medical equipment and supplies, medical treatment or care to children with special healthcare needs, and travel expenses including transportation, meals, and lodging of children with special healthcare needs and their families when it is necessary for the child to receive medical treatment at an out-of-state medical treatment facility. The term “eligible services” shall not include any financial costs related to administration, promotion, education, or personnel related to the provision of eligible services or any other services that may be provided by a qualified organization. “Eligible services” shall also not include any tangible or intangible items that are not provided directly to children with special healthcare needs.
4. “Emergency services” means eligible services that would normally be provided for by a health insurance program or a publicly funded assistance program, but for any reason are not immediately available to the child with special healthcare needs. The term “emergency services” also means the provision of eligible services on an emergency only basis to a child with special healthcare needs who is not a domiciled resident of the state.
5. “Qualified organization(s)” means eligible organizations that have submitted applications to the general treasurer and have been certified for the application year by the general treasurer as provided by the provisions of this chapter.

History of Section. P.L. 1989, ch. 384, § 1; P.L. 1999, ch. 83, § 48; P.L. 1999, ch. 130, § 48; P.L. 2018, ch. 223, § 2.

23-14-3. Childhood disease fund established — Uses of the fund.

1. There is established a separate fund within the general fund to be called the childhood disease fund which shall be administered by the general treasurer in accordance with the same laws and fiscal procedures as the general funds of the state. The fund shall consist of sums collected as a result of the taxpayer check-off as provided for in section 44-30-2.3 . The general treasurer is authorized to accept any grant, devise, bequest, donation, gift, or assignment of money, bonds, or other valuable securities for deposit in and credit of the childhood disease fund.
2. The monies received under this chapter and § 44-30-2.3 shall be made available by the treasurer annually by September 30 to qualified organizations and shall be distributed equally among all qualified organizations certified by the department of health for the funding year.
3. Upon distribution to qualified organizations, the monies shall be used exclusively for child disease victims and their families for eligible services and emergency services. Provided, however, that qualified organizations shall seek and are entitled to reimbursement from a health insurance program or publicly funded assistance program, for emergency services when the cost of emergency services would normally be provided for by the respective program.
4. Any eligible organization which seeks qualified organization status for a funding year shall submit an application to the department of health not later than July 15 of the year for which they seek status. The application must include:
   1. The specific nature of the eligible and/or emergency services the eligible organization is proposing to provide and which group or classification(s) of child disease victims the services are proposed to be provided to;
   2. Eligible services that the eligible organization has provided in the past year or is currently providing and the annual cost of the services;
   3. Whether the monies sought under this chapter will be used to fund new or existing programs for eligible services; and
   4. Any other information the department of health deems necessary to facilitate the purposes of this chapter.
5. Upon receipt of the annual application from eligible organizations as provided in this section, the director of the department of health shall review each application to determine if it complies with the intent and requirements of this chapter. Upon a finding by the director of the department of health that the application complies with the intent and requirements of this chapter, the director of the department of health shall certify that the eligible organization has been designated as a qualified organization for the funding year. The director of the department of health shall provide notice of approval or denial of certification not later than September 15 to each eligible organization that has submitted an annual application.
6. The director of the department of health is authorized to promulgate any rules or regulations and prescribe forms necessary to facilitate the provisions of this chapter.

History of Section. P.L. 1989, ch. 384, § 1; P.L. 1990, ch. 374, § 2; P.L. 1999, ch. 83, § 48; P.L. 1999, ch. 130, § 48.

23-14-4. Severability.

If the provisions of this chapter or the application of the provisions of this chapter to any person or circumstances is held invalid, that invalidity shall not affect other provisions or applications of the chapter which can be given effect without the invalid provision or application, and to this end the provisions of the chapter are declared to be severable.

History of Section. P.L. 1989, ch. 384, § 1.

23-14.1-1. Legislative findings.

The general assembly finds that:

1. It is the right of every citizen of the state to have ready access to quality health care; and
2. Health care facilities serving the poor, including community health centers throughout the state, are experiencing increasing difficulty in attracting and retaining physicians and other health professionals to administer to the needy populations they serve. Therefore, it is the general assembly’s intent to provide incentives, in the form of loan repayment, to physicians, dentists, dental hygienists, nurse practitioners, certified nurse midwives, physician assistants and any other eligible health care professional under § 338A of the Public Health Service Act, 42 U.S.C. § 254l, who desire to serve the health care needs of medically underserved individuals in Rhode Island.

History of Section. P.L. 1993, ch. 191, § 1.

23-14.1-2. Definitions.

For the purpose of this chapter, the following words and terms have the following meanings unless the context clearly requires otherwise:

1. “Board” means the health professional loan repayment board.
2. “Commissioner” means the commissioner of postsecondary education.
3. “Community health center” means a healthcare facility as defined and licensed under chapter 17 of this title.
4. “Division” means the Rhode Island division of higher education assistance.
5. “Eligible health professional” means a physician, dentist, dental hygienist, nurse practitioner, certified nurse midwife, physician assistant, or any other eligible healthcare professional under § 338A of the Public Health Service Act, 42 U.S.C. § 254l, licensed in the state who has entered into a contract with the board to serve medically underserved populations.
6. “Loan repayment” means an amount of money to be repaid to satisfy loan obligations incurred to obtain a degree or certification in an eligible health profession as defined in subdivision (5).

History of Section. P.L. 1993, ch. 191, § 1; P.L. 2015, ch. 141, art. 7, § 11.

23-14.1-3. Health professional loan repayment program established.

There is established within the division, to be administered by the commissioner, the health professional loan repayment program whose purpose shall be to provide loan repayment to eligible health professionals to defray the cost of their professional education.

History of Section. P.L. 1993, ch. 191, § 1; P.L. 2015, ch. 141, art. 7, § 11.

23-14.1-4. Health professional loan repayment board.

1. There is created the health professional loan repayment board, which shall consist of the director of the department of health and eight (8) members appointed by the governor with the advice and consent of the senate. The governor shall give due consideration to any recommendations for nominations submitted to him or her by the Rhode Island Medical Society; the Rhode Island Dental Association; the Rhode Island Health Center Association; the dean of the Brown University Medical School; the dean of the College of Nursing at the University of Rhode Island; the Rhode Island State Nurses’ Association; the Hospital Association of Rhode Island; the Rhode Island division of higher education assistance. All appointed members shall serve for terms of three (3) years and shall receive no compensation for their services. Board members shall be eligible to succeed themselves.
2. The director of the department of health shall serve as chairperson. The board shall elect such other officers as it deems necessary from among its members. All meetings shall be called by the chairperson.
3. Members of the board shall be removable by the governor pursuant to the provisions of § 36-1-7 and for cause only, and removal solely for partisan or personal reasons unrelated to capacity or fitness for the office shall be unlawful.

History of Section. P.L. 1993, ch. 191, § 1; P.L. 1995, ch. 58, § 1; P.L. 2001, ch. 180, § 42; P.L. 2006, ch. 103, § 2; P.L. 2006, ch. 144, § 2; P.L. 2007, ch. 310, § 1; P.L. 2007, ch. 412, § 1; P.L. 2015, ch. 141, art. 7, § 11.

23-14.1-5. Duties of the board.

The board shall:

1. Determine which areas of the state shall be eligible to participate in the loan repayment program each year, based on health professional shortage area designations.
2. Receive and consider all applications for loan repayment made by eligible health professionals.
3. Conduct a careful and full investigation of the ability, character, financial needs, and qualifications of each applicant.
4. Consider the intent of the applicant to practice in a health professional shortage area and to adhere to all the requirements for participation in the loan repayment program.
5. Submit to the commissioner a list of those individuals eligible for loan repayment and amount of loan repayment to be granted.
6. Promulgate rules and regulations to ensure an effective implementation and administration of the program.
7. Within ninety (90) days after the end of each fiscal year, the board shall approve and submit an annual report to the governor, the speaker of the house of representatives, the president of the senate, and the secretary of state, of its activities during that fiscal year. The report shall provide: an operating statement summarizing meetings or hearings held, including meeting minutes, subjects addressed, decisions rendered, applications considered and their disposition, rules or regulations promulgated, studies conducted, polices and plans developed, approved, or modified, and programs administered or initiated; a consolidated financial statement of all funds received and expended including the source of the funds, a listing of any staff supported by these funds, and a summary of any clerical, administrative or technical support received; a summary of performance during the previous fiscal year including accomplishments, shortcomings and remedies; a synopsis of hearings, complaints, suspensions, or other legal matters related to the committee; a summary of any training courses held pursuant to this chapter; a briefing on anticipated activities in the upcoming fiscal year, and findings and recommendations for improvements. The report shall be posted electronically on the websites of the general assembly and the secretary of state pursuant to the provisions of § 42-20-8.2 . The director of the department of administration shall be responsible for the enforcement of the provisions of this subsection.
8. Conduct a training course for newly appointed and qualified members within six (6) months of their qualification or designation. The course shall be developed by the chair of the board, be approved by the board, and be conducted by the chair of the board. The board may approve the use of any board and/or staff members and/or individuals to assist with training. The training course shall include instruction in the following areas: the provisions of chapter 46 of title 42, chapter 14 of title 36, chapter 2 of title 38; and the board’s rules and regulations. The director of the department of administration shall, within ninety (90) days of June 16, 2006, prepare and disseminate training materials relating to the provisions of chapter 46 of title 42, chapter 14 of title 36, chapter 2 of title 38.

History of Section. P.L. 1993, ch. 191, § 1; P.L. 2006, ch. 103, § 2; P.L. 2006, ch. 144, § 2; P.L. 2008, ch. 475, § 46; P.L. 2015, ch. 141, art. 7, § 11.

23-14.1-6. Duties of the commissioner.

The commissioner shall:

1. Grant loan repayments to successful applicants as determined by the board.
2. Enter into contracts, on behalf of the division with each successful applicant, reflecting the purpose and intent of this chapter.

History of Section. P.L. 1993, ch. 191, § 1; P.L. 2015, ch. 141, art. 7, § 11.

23-14.1-7. Conditions of loan repayment.

1. Loan repayments under the provisions of this chapter shall be based upon the condition that the recipient apply for a license to practice medicine, dentistry, dental hygiene, nurse midwifery, as a registered nurse practitioner, or as a health care professional under § 338A of the Public Health Service Act, 42 U.S.C. § 254l, or be registered as a physician assistant in Rhode Island at the earliest practicable opportunity.
2. A recipient must agree to accept all patients regardless of their ability to pay for services received. A recipient must agree to accept all forms of insurance as payment in full, including Titles XVIII and XIX of the Social Security Act, 42 U.S.C. § 1395 et seq.
3. A recipient shall be required to practice full-time in a health professional shortage area for a minimum of two (2) years in order to be eligible to participate in the program.

History of Section. P.L. 1993, ch. 191, § 1.

23-14.1-8. Contracts required.

Prior to being granted loan repayment, each eligible health professional shall enter into a contract with the division agreeing to the terms and conditions upon which the loan repayment is granted. The contract shall include any provisions that are required to fulfill the purposes of this chapter and those deemed advisable by the commissioner.

History of Section. P.L. 1993, ch. 191, § 1; P.L. 2015, ch. 141, art. 7, § 11.

23-14.1-9. Penalty for failure to complete contract.

1. If the recipient of a loan repayment fails, without justifiable cause, to practice pursuant to the terms and conditions of his or her contract with the division, a penalty for the failure to complete the contract will be imposed. If the recipient fails to complete the period of obligated service, he or she shall be liable to the state of Rhode Island for:
   1. An amount equal to the total paid on behalf of the recipient; and
   2. An unserved obligation penalty equal to the number of months of obligated service not completed by the recipient multiplied by one thousand dollars ($1,000).
2. If the recipient fails to complete one year of service, he or she shall be liable to the state of Rhode Island for:
   1. An amount equal to the total paid on behalf of the recipient; and
   2. An unserved obligation penalty equal to the number of months in the full period multiplied by one thousand dollars ($1,000).
3. Any amount owed shall be paid to the state of Rhode Island within one year of the date that the recipient is in breach of contract.
4. Where the commissioner, subject to the approval of the board, determines that there exists justifiable cause for the failure of a recipient to practice pursuant to the terms and conditions of the contract, he or she may relieve the recipient of the obligation to fulfill any or all of the terms of the contract.