HB 187 - AS INTRODUCED
2021 SESSION
21-0173
04/05
HOUSE BILL 187
AN ACT relative to the emergency powers of the commissioner of health and human
services.
SPONSORS: Rep. Marsh, Carr. 8; Rep. Lang, Belk. 4; Rep. Baldasaro, Rock. 5; Rep. Edwards,
Rock. 4; Rep. Craig, Coos 4; Rep. Prout, Hills. 37; Rep. J. Osborne, Rock. 4; Rep.
Salloway, Straf. 5; Rep. Blasek, Hills. 21
COMMITTEE: Health, Human Services and Elderly Affairs
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ANALYSIS
This bill makes various changes to the powers of the commissioner of the department of health
and human services during a public health emergency; authorizes the joint legislative oversight
committee on health and human services to review, and rescind by a 2/3 vote, emergency orders
issued by the commissioner; gives a person subject to a treatment order for a communicable disease
a right to a hearing on the order; and amends the membership and duties of the ethics oversight
advisory committee.
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Explanation: Matter added to current law appears in bold italics.
Matter removed from current law appears [in brackets and struckthrough.]
Matter which is either (a) all new or (b) repealed and reenacted appears in regular
type.
HB 187 - AS INTRODUCED
21-0173
04/05
STATE OF NEW HAMPSHIRE
In the Year of Our Lord Two Thousand Twenty One
AN ACT relative to the emergency powers of the commissioner of health and human
services.
Be it Enacted by the Senate and House of Representatives in General Court convened:
1 1 Department of Safety; Public Health Emergency Management Powers. Amend RSA 21-P:53 to
2 read as follows:
3 21-P:53 Public Health Powers and Duties. During the existence of a state of emergency under
4 this chapter, the commissioner of health and human services shall have the following powers and
5 duties, subject to the direction and control of the governor, which are in addition to those set forth in
6 RSA 141-C; provided that such powers and duties shall be limited to the specific nature of the
7 emergency, its geographic limits, and the conditions that brought it about, as specified in the
8 declaration of the state of emergency:
9 I. The commissioner shall have the responsibility and authority to carry out all public health
10 activities within the state in cooperation and collaboration with the division of homeland security
11 and emergency management.
12 II. The commissioner may, without the approval of the [governor's] executive council or the
13 legislative fiscal committee, and notwithstanding the provisions of RSA 4:45, 9:13-d, and 9:19, [and
14 any other law to the contrary,] purchase and distribute anti-toxins, serums, vaccines, immunizing
15 agents, antibiotics, and other pharmaceutical agents that the commissioner deems to be in the
16 interest of public health.
17 III. If there is a statewide or regional shortage or threatened shortage of any anti-toxins,
18 serums, vaccines, immunizing agents, antibiotics, and other pharmaceutical agents, the
19 commissioner may control, [restrict] prioritize, and ration the use, sale, dispensing, distribution, or
20 transportation of such products as necessary to best protect the health, safety, and welfare of the
21 people of this state. In making rationing or other supply and distribution decisions, the
22 commissioner shall determine high risk or critical need groups that shall receive priority for such
23 products.
24 III-a. The commissioner shall have no power to restrict the ability of a licensed
25 practitioner to prescribe pursuant to RSA 329 and RSA 326-B.
26 III-b. If during a public health emergency, a treatment or vaccination should
27 become available which is anticipated to be in limited supply, the commissioner shall
28 develop, in consultation with the ethics oversight advisory committee, established in RSA
29 141-C:27, a plan for its distribution.
HB 187 - AS INTRODUCED
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1 IV. The commissioner may investigate any incident or imminent threat of any disease or
2 health condition that may be caused by a natural disaster, radiation or chemical exposure, or the
3 release of any microorganism, infectious substance, or naturally occurring or manufactured
4 biological product, that poses a risk of a significant number of human fatalities or incidents of
5 permanent or long-term disability. Such investigations may include requiring information from any
6 health care provider or other person affected by, or having information related to, the incident or
7 threat, inspections of buildings and conveyances and their contents, laboratory analysis of samples
8 collected during the course of such inspections, and requiring a physical examination and the
9 provision of specimens of body secretions, excretions, fluids, and discharges for laboratory
10 examination of any person having a disease or health condition that necessitates an investigation
11 under this paragraph.
12 V. The commissioner may order a person to undergo such medical care as may be necessary
13 to treat or prevent an incident or threat of disease or other health condition prompting an
14 investigation pursuant to paragraph IV. Such care may include immunization of individuals as
15 necessary to prevent the spread of contagious disease, except that an individual may refuse
16 treatment or immunization pursuant to the provisions of [RSA 141-C:15, VI] RSA 141-C:16 and
17 RSA 141-C:20-c.
18 VI. Any order compelling an investigation, physical examination, the provision of specimens,
19 medical treatment or care, or immunization, and any other order of the commissioner under this
20 chapter, shall be subject to the due process requirements of RSA 141-C:14-a.
21 VII. The department of health and human services shall acquire and retain only the
22 minimum amount of information, specimens, and samples relating to individuals necessary to carry
23 out its obligations under this section. Any genetic testing of specimens and samples shall be limited
24 to the viruses, bacteria, fungi, or other microorganisms therein. Personally identifiable information
25 shall not be acquired or retained unless necessary for the department to carry out its responsibilities
26 under this section, RSA 141-C, or any other provision of law. Such information shall not be retained
27 beyond the duration of the state of emergency without the approval of the governor and executive
28 council, which information shall be subject to the confidentiality provisions of RSA 141-C:10.
29 VIII. Any emergency order issued under this section shall be subject to review by the
30 joint legislative oversight committee on health and human services, established in RSA
31 126-A:13, and may be rescinded by a 2/3 vote of that committee. The commissioner shall
32 notify the ethics oversight advisory committee established in RSA 141-C:27 of any
33 emergency order issued under this section, and the joint legislative oversight committee
34 shall consider the input of the ethics committee, if provided, in any decision. If the
35 emergency precludes either committee from meeting in person, they shall be authorized,
36 notwithstanding any other provision of law, to meet remotely for this purpose.
HB 187 - AS INTRODUCED
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1 2 Communicable Disease; Treatment and Care of Sick. Amend RSA 141-C:15, VI to read as
2 follows:
3 VI. When an individual subject to an order for treatment by the commissioner refuses to
4 undergo such ordered treatment, the commissioner may issue a complaint, which shall be sworn to
5 before a justice of the peace. Such complaint shall set forth the reasons for the order imposing
6 treatment, the nature of the treatment to be provided, and the place or facility where the treatment
7 shall be provided. Upon being presented with such an order, the individual may petition the
8 superior court in the county in which the person resides for a hearing on the order. If a
9 hearing is granted, the superior court shall hear the matter within 48 hours of the date of
10 the order, excluding weekends and holidays. The superior court shall issue a decision as
11 soon as practicable after completion of the hearing. An aggrieved individual may petition
12 the supreme court for an expedited appeal. If no appeal is granted or the commissioner's
13 order is affirmed on appeal, any law enforcement officer shall take such individual into custody
14 and transport the individual to the place or facility where the treatment is to be provided.
15 3 Communicable Disease; Ethics Committee. Amend RSA 141-C:27 to read as follows:
16 141-C:27 Ethics Oversight Advisory Committee.
17 I. There is hereby established an ethics oversight advisory committee to offer advice to the
18 commissioner relative to the ethical issues that may be identified in the course of planning for, and
19 responding to, outbreaks of communicable disease that threaten to become epidemic or pandemic
20 and to review and provide recommendations for investigations, orders, and treatment
21 ordered by the commissioner.
22 II. The committee shall:
23 (a) Consider the ethical implications of any of the powers that may be exercised by the
24 commissioner under the provisions of this chapter including, but not limited to, the confiscation,
25 distribution, and rationing of anti-toxins, serums, vaccines, immunizing agents, antibiotics, and
26 other pharmaceutical agents, and mechanical equipment; the issuance and enforcement of orders of
27 isolation, quarantine, medical examination, and medical treatment; issues relative to information
28 sharing and confidentiality; and the provisions for due process for orders issued pursuant to this
29 chapter.
30 (b) Review investigations initiated pursuant to RSA 141-C:9, orders issued
31 pursuant to RSA 141-C:12, and treatment ordered pursuant to RSA 141-C:15.
32 (c) Review orders issued by the commissioner pursuant to RSA 141-C:16-a and
33 RSA 141-C:16-b not appealed to the superior court. If the committee should determine any
34 such orders to be inappropriate, they may by majority vote direct the commissioner to
35 rescind the order. When meeting for this purpose, and when discussing protected health
36 information obtained for public health purposes pursuant to 45 C.F.R. 164.512(b)(1)(i), as
37 provided by RSA 91-A:5 IV, the committee's proceedings shall be exempt from RSA 91-A.
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1 (d) Consider the competing rights of disabled persons who might be unable to
2 comply with certain orders, health care workers who are entitled to a safe workplace, and
3 the need to protect the public from communicable disease, and may recommend
4 modification of orders to address specific concerns.
5 (e) Consider both the need to protect the most vulnerable members of society as
6 well as the need for the most efficacious means to control a public health emergency when
7 consulting with the commissioner pursuant to RSA 21-P:53, III-b in developing a plan for
8 the distribution of a new treatment or vaccination.
9 III. The members of the committee shall be as follows:
10 (a) Two members of the house or representatives, one of whom shall be from the
11 minority party, appointed by the speaker of the house of representatives.
12 (b) One member of the senate, appointed by the senate president.
13 (c) The director of the department of health and human services, division of public
14 health services.
15 [(b)] (d) The state epidemiologist.
16 [(c)] (e) The attorney general, or designee.
17 [(d)] (f) A representative of a public health network, appointed by the commissioner.
18 [(e)] (g) A representative from a college or university public health program, appointed
19 by the commissioner.
20 [(f) A chief of police or a police officer of a local police department, appointed by the New
21 Hampshire Association of Chiefs of Police.
22 (g) A chief of a local fire department, appointed by the New Hampshire Association
23 of Fire Chiefs.]
24 (h) A physician, licensed under RSA 329, appointed by the New Hampshire Medical
25 Society.
26 (i) The commissioner of the department of safety, or designee.
27 (j) [A member of a fire department with a minimum of EMT-B certification, appointed by
28 the Professional Firefighters of New Hampshire.
29 (k)] A representative of a hospital, appointed by the New Hampshire Hospital
30 Association.
31 [(l) A county representative, appointed by the New Hampshire Association of Counties.]
32 (k) A representative of the Disability Rights Center of New Hampshire,
33 appointed by the center.
34 (l) The commissioner of the department of labor, or designee.
35 IV. [The commissioner shall appoint a member of the committee to act as chairperson.] The
36 committee shall elect one of the legislative members as chairperson. Legislative member of
37 the committee shall receive mileage at the legislative rate when attending to the duties of
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1 the committee. The committee shall meet initially within 30 days of the effective date of this
2 section and then as regularly as the chairperson shall direct.
3 V. The commissioner may at any time direct questions to the committee or request guidance
4 on ethical issues.
5 VI. The committee [shall be solely advisory in nature and any guidance, guidelines, or
6 protocols issued by the committee shall not be binding on the commissioner] may issue advisory
7 opinions, guidance, guidelines, or protocols at any time, which shall not be binding on the
8 commissioner.
9 4 Effective Date. This act shall take effect upon its passage.

Statutes affected:
Introduced: 21-P:53, 141-C:15, 141-C:27
latest version: 21-P:53, 141-C:27, 126-A:13