Connecticut 2016 Regular Session

Connecticut House Bill HB05285 Compare Versions

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1-General Assembly Substitute Bill No. 5285
2-February Session, 2016 *_____HB05285AGE___030916____*
1+General Assembly Raised Bill No. 5285
2+February Session, 2016 LCO No. 1470
3+ *01470_______AGE*
4+Referred to Committee on AGING
5+Introduced by:
6+(AGE)
37
48 General Assembly
59
6-Substitute Bill No. 5285
10+Raised Bill No. 5285
711
812 February Session, 2016
913
10-*_____HB05285AGE___030916____*
14+LCO No. 1470
15+
16+*01470_______AGE*
17+
18+Referred to Committee on AGING
19+
20+Introduced by:
21+
22+(AGE)
1123
1224 AN ACT REQUIRING THE STATE OMBUDSMAN TO INVESTIGATE COMPLAINTS CONCERNING RECIPIENTS OF HOME AND COMMUNITY-BASED CARE.
1325
1426 Be it enacted by the Senate and House of Representatives in General Assembly convened:
1527
1628 Section 1. Section 17a-405 of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2016):
1729
1830 (a) As used in this chapter:
1931
2032 (1) "State agency" means the Department on Aging.
2133
2234 (2) "Office" means the Office of the Long-Term Care Ombudsman established in this section.
2335
2436 (3) "State Ombudsman" means the State Ombudsman established in this section.
2537
2638 (4) "Assistant State Ombudsman" means the person appointed by the State Ombudsman to assist the State Ombudsman in carrying out the duties of the State Ombudsman pursuant to section 17a-408, as amended by this act.
2739
2840 [(4)] (5) "Program" means the long-term care ombudsman program administered by the Office of the Long-Term Care Ombudsman established in this section.
2941
3042 [(5)] (6) "Representative" includes the Assistant State Ombudsman, a regional ombudsman, a residents' advocate or an employee of the Office of the Long-Term Care Ombudsman who is individually designated by the State Ombudsman.
3143
3244 [(6)] (7) "Resident" means an [older] individual who resides in or is a patient in a long-term care facility who is sixty years of age or older.
3345
3446 [(7)] (8) "Long-term care facility" means any skilled nursing facility, as defined in Section 1819(a) of the Social Security Act, (42 USC 1395i-3(a)) any nursing facility, as defined in Section 1919(a) of the Social Security Act, (42 USC 1396r(a)) a board and care facility as defined in Section 102(19) of the federal Older Americans Act, (42 USC 3002(19)) and for purposes of ombudsman program coverage, an institution regulated by the state pursuant to Section 1616(e) of the Social Security Act, (42 USC 1382e(e)) and any other adult care home similar to a facility or nursing facility or board and care home.
3547
3648 [(8)] (9) "Commissioner" means the Commissioner on Aging.
3749
3850 [(9)] (10) "Applicant" means an [older] individual who has applied for admission to a long-term care facility or for home and community-based services.
3951
4052 (11) "Home and community-based services" means long-term care provided in a home or community setting, or both, to a recipient who is sixty years of age or older.
4153
4254 (b) There is established an independent Office of the Long-Term Care Ombudsman within the Department on Aging. The Commissioner on Aging shall appoint a State Ombudsman who shall be selected from among individuals with expertise and experience in the fields of long-term care and advocacy to head the office and the State Ombudsman shall appoint an Assistant State Ombudsman and assistant regional ombudsmen. In the event the State Ombudsman [or an assistant regional ombudsman] is unable to fulfill the duties of the office, the commissioner shall appoint an acting State Ombudsman. [and] In the event the Assistant State Ombudsman or a regional ombudsman is unable to fulfill the duties of the office, the State Ombudsman shall appoint an acting Assistant State Ombudsman or an acting assistant regional ombudsman, as the case may be.
4355
4456 (c) Notwithstanding the provisions of subsection (b) of this section, on and after July 1, 1990, the positions of State Ombudsman and regional ombudsmen shall be classified service positions. The State Ombudsman and regional ombudsmen holding said positions on said date shall continue to serve in their positions as if selected through classified service procedures. As vacancies occur in such positions thereafter, such vacancies shall be filled in accordance with classified service procedures.
4557
4658 Sec. 2. Subsection (a) of section 17a-406 of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2016):
4759
4860 (a) Residents' advocates shall be appointed by the State Ombudsman, in consultation with the regional ombudsmen, for each region in sufficient number to serve the long-term care facilities and recipients of home and community-based services, within such region. Such residents' advocates shall, if possible, be residents of the region in which they will serve, and shall have demonstrated an interest in the care of the elderly. Residents' advocates shall serve without compensation but may be reimbursed for reasonable expenses incurred in the performance of their duties, within available appropriations.
4961
5062 Sec. 3. Section 17a-408 of the 2016 supplement to the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2016):
5163
5264 (a) The State Ombudsman shall establish and operate ombudsman programs in this state pursuant to Sections 711 to 713, inclusive, of the federal Older Americans Act of 1965, as amended from time to time.
5365
5466 (b) The State Ombudsman shall serve on a full-time basis, and shall personally or through representatives of the office:
5567
5668 (1) Identify, investigate and resolve complaints that:
5769
5870 (A) Are made by, or on behalf of, residents of long-term care facilities and recipients of home and community-based services or, as to complaints involving the application for admission to a long-term care facility or for home and community-based services, by or on behalf of applicants; and
5971
6072 (B) Relate to action, inaction or decisions that may adversely affect the health, safety, welfare or rights of the residents of long-term care facilities and recipients of home and community-based services, including the welfare and rights of the residents and recipients with respect to the appointment and activities of guardians and representative payees, of (i) providers or representatives of providers of long-term care services and home and community-based services, (ii) public agencies, or (iii) health and social service agencies;
6173
6274 (2) Provide services to protect the health, safety, welfare and rights of the residents of long-term care facilities and recipients of home and community-based services;
6375
6476 (3) Inform the residents of long-term care facilities and recipients of home and community-based services about means of obtaining services provided by providers or agencies described in subparagraph (B) of subdivision (1) of this subsection or services described in subdivision (2) of this subsection;
6577
6678 (4) Ensure that the residents of long-term care facilities, recipients of home and community-based services and [, as to issues involving applications for admission to long-term care facilities,] applicants have regular and timely access to the services provided through the office and that the residents of long-term care facilities, recipients of home and community-based services, applicants and other complainants receive timely responses from representatives of the office to complaints;
6779
6880 (5) Represent the interests of the residents [,] of long-term care facilities, recipients of home and community-based services and [of] applicants in relation to issues concerning applications [to long-term care facilities,] before governmental agencies and seek administrative, legal and other remedies to protect the health, safety, welfare and rights of the residents, recipients and applicants;
6981
7082 (6) Provide administrative and technical assistance to representatives and training in areas including, but not limited to, Alzheimer's disease and dementia symptoms and care;
7183
7284 (7) (A) Analyze, comment on and monitor the development and implementation of federal, state and local laws, regulations, and other governmental policies and actions that pertain to the health, safety, welfare and rights of the residents of long-term care facilities and recipients of home and community-based services with respect to the adequacy of long-term care facilities and home and community-based services in this state and to the rights of applicants in relation to applications to long-term care facilities and for home and community-based services;
7385
7486 (B) Recommend any changes in such laws, regulations, policies and actions as the office determines to be appropriate; and
7587
7688 (C) Facilitate public comment on such laws, regulations, policies and actions;
7789
7890 (8) Advocate for:
7991
8092 (A) Any changes in federal, state and local laws, regulations and other governmental policies and actions that pertain to the health, safety, welfare and rights of residents of long-term care facilities and recipients of home and community-based services with respect to the adequacy of long-term care facilities and home and community-based services in this state and to the health, safety, welfare and rights of applicants [which] to long-term care facilities and recipients of home and community-based services that the State Ombudsman determines to be appropriate;
8193
8294 (B) Appropriate action by groups or agencies with jurisdictional authority to deal with problems affecting individual residents of long-term care facilities and recipients of home and community-based services and the general resident population and applicants in relation to issues concerning applications to long-term care facilities and for home and community-based services; and
8395
8496 (C) The enactment of legislative recommendations by the General Assembly and of regulatory recommendations by commissioners of Connecticut state agencies;
8597
8698 (9) (A) Provide for training representatives of the office;
8799
88100 (B) Promote the development of citizen organizations to participate in the program; and
89101
90102 (C) Provide technical support for the development of resident and family councils to protect the well-being and rights of residents;
91103
92104 (10) Coordinate ombudsman services with the protection and advocacy systems for individuals with developmental disabilities and mental illnesses established under (A) Part A of the Development Disabilities Assistance and Bill of Rights Act (42 USC 6001, et seq.), and (B) The Protection and Advocacy for Mentally Ill Individuals Act of 1986 (42 USC 10801 et seq.);
93105
94106 (11) Coordinate, to the greatest extent possible, ombudsman services with legal assistance provided under Section 306(a)(2)(C) of the federal Older Americans Act of 1965, (42 USC 3026(a)(2)(C)) as amended from time to time, through the adoption of memoranda of understanding and other means;
95107
96108 (12) Create, and periodically update as needed, a training manual for nursing home facilities identified in section 19a-522c that provides guidance on structuring and implementing the training required by said section;
97109
98110 (13) Provide services described in this subsection, to residents under age sixty living in a long-term care facility, if (A) a majority of the residents of the facility where the younger person resides are over age sixty and (B) such services do not weaken or decrease service to older individuals covered under this chapter;
99111
100112 (14) [Implement and administer, within available appropriations, a pilot program that serves home and community-based care recipients in Hartford County] Provide services described in this subsection to residents of long-term care facilities and recipients of home and community-based services; and
101113
102114 (15) Carry out such other activities and duties as may be required under federal law.
103115
104116 Sec. 4. Section 17a-409 of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2016):
105117
106118 The State Ombudsman is authorized to investigate and make reports and recommendations concerning any act or the failure to act by any agency, official or public employee, with respect to their responsibilities and duties in connection with long-term care facilities or home and community-based services, except the courts and their personnel, legislative bodies and their personnel and the chief executive of the state and the chief executive's personal staff and all elected officials.
107119
108120 Sec. 5. Section 17a-410 of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2016):
109121
110122 The regional ombudsmen shall, in accordance with the policies and procedures established by the Office of the Long-Term Care Ombudsman:
111123
112124 (1) Provide services to protect the health, safety, welfare and rights of residents of long-term care facilities or recipients of home and community-based services;
113125
114126 (2) Ensure that residents of long-term care facilities or recipients of home and community-based services in service areas have regular timely access to representatives of the program and timely responses to complaints and requests for assistance;
115127
116128 (3) Identify, investigate and resolve complaints made by or on behalf of residents of long-term care facilities or recipients of home and community-based services that relate to action, inaction or decisions that may adversely affect the health, safety, welfare or rights of [the] residents or recipients or by, or on behalf of, applicants in relation to issues concerning applications; [to long-term care facilities;]
117129
118130 (4) Represent the interests of residents of long-term care facilities or recipients of home and community-based services and applicants, in relation to their applications, [to long-term care facilities,] before government agencies and seek administrative, legal and other remedies to protect the health, safety, welfare and rights of [the] residents and recipients;
119131
120132 (5) (A) Review and, if necessary, comment on any existing and proposed laws, regulations and other government policies and actions that pertain to the rights and well-being of residents of long-term care facilities or recipients of home and community-based services and applicants in relation to their applications; [to long-term care facilities,] and (B) facilitate the ability of the public to comment on the laws, regulations, policies and actions;
121133
122134 (6) Support the development of resident and family councils; and
123135
124136 (7) Carry out other activities that the State Ombudsman determines to be appropriate.
125137
126138 Sec. 6. Section 17a-414 of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2016):
127139
128140 (a) The state agency shall ensure that:
129141
130142 (1) Adequate legal counsel is available and is able, without conflict of interest, to: (A) Provide advice and consultation needed to protect the health, safety, welfare and rights of residents of long-term care facilities, recipients of home and community-based services and applicants in relation to their applications; [to long-term care facilities;] and (B) assist the ombudsman and representatives of the office in the performance of the official duties of the ombudsman and representatives; and
131143
132144 (2) Administrative, legal and other appropriate remedies are pursued on behalf of residents of long-term care facilities, recipients of home and community-based services and applicants in relation to their applications. [to long-term care facilities.]
133145
134146 (b) The Assistant State Ombudsman, regional ombudsmen and residents' advocates shall be considered state employees under section 4-141 for the purposes of any civil action for damages on account of any act or omission that is not wanton, wilful or malicious and that is within the scope of employment or duties under sections 17a-405 to 17a-417, inclusive, as amended by this act, 19a-531 and 19a-532.
135147
136148 Sec. 7. Section 17a-415 of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2016):
137149
138150 (a) The [ombudsman] State Ombudsman, Assistant State Ombudsman, regional ombudsmen and representatives of the office shall have:
139151
140152 (1) Access to long-term care facilities and residents;
141153
142154 (2) Appropriate access to review the medical and social records of a resident of a long-term care facility or recipient of home and community-based services, if (A) the representative has the permission of the resident, recipient or the legal representative of the resident or recipient, (B) the resident or recipient is unable to consent to the review and has no legal representative, or (C) access to the records is necessary to investigate a complaint and a legal guardian of the resident or recipient refuses to give permission, a representative of the office has reasonable cause to believe that the guardian is not acting in the best interests of the resident or recipient, and the representative obtains the approval of the [ombudsman] State Ombudsman;
143155
144156 (3) Access to the administrative records, policies and documents, to which the residents have, or the general public has access, of long-term care facilities; and
145157
146158 (4) Access to and, on request, copies of all licensing and certification records maintained by the state with respect to long-term care facilities and providers of home and community-based services.
147159
148-(b) Any person or entity who wilfully interferes with representatives of the office in the performance of the official duties of the representatives, or any long-term care facility or other entity which retaliates or exacts reprisals with respect to any resident of a long-term care facility, recipient of home and community-based services, employee or other person for filing a complaint with, providing information to, or otherwise cooperating with any representative of the office, or long-term care facility which refuses to permit the State Ombudsman, [or] Assistant State Ombudsman, any regional ombudsman or any residents' advocate entry into such facility or refuses to cooperate with the State Ombudsman, [or] Assistant State Ombudsman, any regional ombudsman or any residents' advocate in the carrying out of [their] his or her mandated duties and responsibilities enumerated under sections 17a-405 to 17a-417, inclusive, as amended by this act, 19a-531 and 19a-532 or refuses to permit [residents] any resident of a long-term care facility or recipient of home and community-based services or staff to communicate freely with the State Ombudsman, [or] Assistant State Ombudsman, any regional ombudsman or any residents' advocate shall be subject to the penalty prescribed for a class B violation under section 19a-527.
160+(b) Any person or entity who wilfully interferes with representatives of the office in the performance of the official duties of the representatives, or any long-term care facility or other entity which retaliates or exacts reprisals with respect to any resident of a long-term care facility, recipient of home and community-based services, employee or other person for filing a complaint with, providing information to, or otherwise cooperating with any representative of the office, or long-term care facility which refuses to permit the State Ombudsman, [or] Assistant State Ombudsman, any regional ombudsman or any residents' advocate entry into such facility or refuses to cooperate with the State Ombudsman, [or] Assistant State Ombudsman, any regional ombudsman or any residents' advocate in the carrying out of [their] his or her mandated duties and responsibilities enumerated under sections 17a-405 to 17a-417, inclusive, as amended by this act, 19a-531 and 19a-532 or refuses to permit [residents] any resident or recipient of home and community-based services or staff to communicate freely with the State Ombudsman, [or] Assistant State Ombudsman, any regional ombudsman or any residents' advocate shall be subject to the penalty prescribed for a class B violation under section 19a-527.
149161
150162 (c) In carrying out the duties enumerated in sections 17a-405 to 17a-417, inclusive, as amended by this act, 19a-531 and 19a-532, the State Ombudsman, the Assistant State Ombudsman, the regional ombudsmen and the residents' advocates shall have access to all relevant public records, except [that] records [which] that are confidential to a resident of a long-term care facility or recipient of home and community-based services shall only be divulged with the written consent of the resident or recipient.
151163
152164 (d) In the performance of the duties and responsibilities enumerated under sections 17a-405 to 17a-417, inclusive, as amended by this act, 19a-531 and 19a-532, the State Ombudsman, the Assistant State Ombudsman, the regional ombudsmen and the residents' advocates may utilize any other state department, agency or commission, or any other public or private agencies, groups or individuals who are appropriate and who may be available.
153165
154166 Sec. 8. Section 17a-417 of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2016):
155167
156168 The Commissioner on Aging shall require the State Ombudsman to:
157169
158170 (1) Prepare an annual report:
159171
160172 (A) Describing the activities carried out by the office in the year for which the report is prepared;
161173
162174 (B) Containing and analyzing the data collected under section 17a-418, as amended by this act;
163175
164-(C) Evaluating the problems experienced by, and the complaints made by or on behalf of, residents of long-term care facilities and recipients of home and community-based services;
176+(C) Evaluating the problems experienced by, and the complaints made by or on behalf of, residents and recipients of home and community-based services;
165177
166-(D) Containing recommendations for (i) improving the quality of the care and life of [the] residents of long-term care facilities and recipients of home and community-based services, and (ii) protecting the health, safety, welfare and rights of the residents of long-term care facilities and recipients of home and community-based services;
178+(D) Containing recommendations for (i) improving the quality of the care and life of [the] residents of long-term care facilities and recipients of home and community-based services, and (ii) protecting the health, safety, welfare and rights of the residents and recipients of home and community-based services;
167179
168180 (E) (i) Analyzing the success of the program including success in providing services to residents of long-term care facilities and recipients of home and community-based services; and (ii) identifying barriers that prevent the optimal operation of the program; and
169181
170-(F) Providing policy, regulatory and legislative recommendations to solve identified problems, to resolve the complaints, to improve the quality of the care and life of residents of long-term care facilities and recipients of home and community-based services, to protect the health, safety, welfare and rights of residents of long-term care facilities and recipients of home and community-based services and to remove the barriers that prevent the optimal operation of the program.
182+(F) Providing policy, regulatory and legislative recommendations to solve identified problems, to resolve the complaints, to improve the quality of the care and life of residents of long-term care facilities and recipients of home and community-based services, to protect the health, safety, welfare and rights of residents and recipients of home and community-based services and to remove the barriers that prevent the optimal operation of the program.
171183
172184 (2) Analyze, comment on and monitor the development and implementation of federal, state and local laws, regulations and other government policies and actions that pertain to long-term care facilities and home and community-based services, and to the health, safety, welfare and rights of residents of long-term care facilities and recipients of home and community-based services, in the state, and recommend any changes in such laws, regulations and policies as the office determines to be appropriate.
173185
174186 (3) (A) Provide such information as the office determines to be necessary to public and private agencies, legislators and other persons, regarding (i) the problems and concerns of [older] individuals residing in long-term care facilities and recipients of home and community-based services; and (ii) recommendations related to the problems and concerns; and (B) make available to the public and submit to the federal assistant secretary for aging, the Governor, the General Assembly, the Department of Public Health and other appropriate governmental entities, each report prepared under subdivision (1) of this section.
175187
176188 Sec. 9. Section 17a-418 of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2016):
177189
178190 The state agency shall establish a state-wide uniform system to: (1) Collect and analyze data relating to complaints and conditions in long-term care facilities and [to residents] complaints relating to services provided to recipients of home and community-based services for the purpose of identifying and resolving significant problems; and (2) submit the data, on a regular basis to: (A) The Department of Public Health; (B) other state and federal entities that the State Ombudsman determines to be appropriate; and (C) the National Ombudsman Resource Center, established in Section 202(a)(21) of the federal Older Americans Act of 1965, as amended from time to time.
179191
180192 Sec. 10. Section 17a-419 of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2016):
181193
182194 The state agency shall:
183195
184196 (1) Provide that the files and records maintained by the program may be disclosed only at the discretion of the State Ombudsman or the person designated by the ombudsman to disclose the files and records; and
185197
186-(2) Prohibit the disclosure of the identity of any complainant or resident of a long-term care facility or recipient of home and community-based services with respect to whom the office maintains such files or records unless (A) the complainant, [or] resident of a long-term care facility or recipient of home and community-based services, or the legal representative of the complainant, [or] resident [,] or recipient consents to the disclosure and the consent is given in writing; (B) (i) the complainant, [or] resident or recipient gives consent orally; and (ii) the consent is documented contemporaneously in a writing made by a representative of the office in accordance with such requirements as the state agency shall establish; or (iii) the disclosure is required by court order.
198+(2) Prohibit the disclosure of the identity of any complainant or resident of a long-term care facility or recipient of home and community-based services with respect to whom the office maintains such files or records unless (A) the complainant, [or] resident or recipient of home and community-based services, or the legal representative of the complainant, [or] resident [,] or recipient consents to the disclosure and the consent is given in writing; (B) (i) the complainant, [or] resident or recipient gives consent orally; and (ii) the consent is documented contemporaneously in a writing made by a representative of the office in accordance with such requirements as the state agency shall establish; or (iii) the disclosure is required by court order.
187199
188200 Sec. 11. Subdivision (3) of section 17a-421 of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2016):
189201
190202 (3) Ensure that the State Ombudsman: (A) Does not have a direct involvement in the licensing or certification of a long-term care facility or of a provider of a long-term care or a home and community-based service; (B) does not have an ownership or investment interest, represented by equity, debt or other financial relationship, in a long-term care facility or a long-term care or a home and community-based service; (C) is not employed by, or participating in the management of, a long-term care facility or a home and community-based service; and (D) does not receive, or have the right to receive, directly or indirectly, remuneration, in cash or in kind, under a compensation arrangement with an owner or operator of a long-term care facility or a home and community-based service; and
191203
192204
193205
194206
195207 This act shall take effect as follows and shall amend the following sections:
196208 Section 1 July 1, 2016 17a-405
197209 Sec. 2 July 1, 2016 17a-406(a)
198210 Sec. 3 July 1, 2016 17a-408
199211 Sec. 4 July 1, 2016 17a-409
200212 Sec. 5 July 1, 2016 17a-410
201213 Sec. 6 July 1, 2016 17a-414
202214 Sec. 7 July 1, 2016 17a-415
203215 Sec. 8 July 1, 2016 17a-417
204216 Sec. 9 July 1, 2016 17a-418
205217 Sec. 10 July 1, 2016 17a-419
206218 Sec. 11 July 1, 2016 17a-421(3)
207219
208220 This act shall take effect as follows and shall amend the following sections:
209221
210222 Section 1
211223
212224 July 1, 2016
213225
214226 17a-405
215227
216228 Sec. 2
217229
218230 July 1, 2016
219231
220232 17a-406(a)
221233
222234 Sec. 3
223235
224236 July 1, 2016
225237
226238 17a-408
227239
228240 Sec. 4
229241
230242 July 1, 2016
231243
232244 17a-409
233245
234246 Sec. 5
235247
236248 July 1, 2016
237249
238250 17a-410
239251
240252 Sec. 6
241253
242254 July 1, 2016
243255
244256 17a-414
245257
246258 Sec. 7
247259
248260 July 1, 2016
249261
250262 17a-415
251263
252264 Sec. 8
253265
254266 July 1, 2016
255267
256268 17a-417
257269
258270 Sec. 9
259271
260272 July 1, 2016
261273
262274 17a-418
263275
264276 Sec. 10
265277
266278 July 1, 2016
267279
268280 17a-419
269281
270282 Sec. 11
271283
272284 July 1, 2016
273285
274286 17a-421(3)
275287
276-Statement of Legislative Commissioners:
288+Statement of Purpose:
277289
278-In Section 7(b), "any resident or recipient" was changed to "any resident of a long-term care facility or recipient"; in Section 8(1)(C), (D) and (F), "residents and recipients" was changed to "residents of long-term care facilities and recipients"; and in Section 10(2), "resident or recipient of home" was changed to "resident of a long-term care facility or recipient of home" for clarity and internal consistency.
290+To expand the oversight of the State Ombudsman to home and community-based services.
279291
280-
281-
282-AGE Joint Favorable Subst. -LCO
283-
284-AGE
285-
286-Joint Favorable Subst. -LCO
292+[Proposed deletions are enclosed in brackets. Proposed additions are indicated by underline, except that when the entire text of a bill or resolution or a section of a bill or resolution is new, it is not underlined.]