4 | 11 | | |
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5 | 12 | | AN ACT CONCERNING THE DEPARTMENT OF PUBLIC HEALTH'S VARIOUS REVISIONS TO THE PUBLIC HEALTH STATUTES. |
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6 | 13 | | |
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7 | 14 | | Be it enacted by the Senate and House of Representatives in General Assembly convened: |
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8 | 15 | | |
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9 | 16 | | Section 1. Subsection (a) of section 19a-491 of the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2017): |
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10 | 17 | | |
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11 | 18 | | (a) No person acting individually or jointly with any other person shall establish, conduct, operate or maintain an institution in this state without a license as required by this chapter, except for persons issued a license by the Commissioner of Children and Families pursuant to section 17a-145 for the operation of (1) a substance abuse treatment facility, or (2) a facility for the purpose of caring for women during pregnancies and for women and their infants following such pregnancies. Application for such license shall (A) be made to the Department of Public Health upon forms provided by it, [and shall] (B) be accompanied by the fee required under subsection (c), (d) or (e) of this section, and (C) contain such information as the department requires, which may include affirmative evidence of ability to comply with reasonable standards and regulations prescribed under the provisions of this chapter. The commissioner may require as a condition of licensure that an applicant sign a consent order providing reasonable assurances of compliance with the Public Health Code. The commissioner may issue more than one chronic disease hospital license to a single institution until such time as the state offers a rehabilitation hospital license. |
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12 | 19 | | |
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13 | 20 | | Sec. 2. Section 19a-490 of the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2017): |
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14 | 21 | | |
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15 | 22 | | As used in this chapter and sections 17b-261e, 38a-498b and 38a-525b: |
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16 | 23 | | |
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17 | 24 | | (a) "Institution" means a hospital, short-term hospital special hospice, hospice inpatient facility, residential care home, health care facility for the handicapped, nursing home facility, home health care agency, homemaker-home health aide agency, behavioral health facility, assisted living services agency, substance abuse treatment facility, outpatient surgical facility, outpatient clinic, an infirmary operated by an educational institution for the care of students enrolled in, and faculty and employees of, such institution; a facility engaged in providing services for the prevention, diagnosis, treatment or care of human health conditions, including facilities operated and maintained by any state agency, except facilities for the care or treatment of mentally ill persons or persons with substance abuse problems; and a residential facility for persons with intellectual disability licensed pursuant to section 17a-227 and certified to participate in the Title XIX Medicaid program as an intermediate care facility for individuals with intellectual disability; |
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18 | 25 | | |
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19 | 26 | | (b) "Hospital" means an establishment for the lodging, care and treatment of persons suffering from disease or other abnormal physical or mental conditions and includes inpatient psychiatric services in general hospitals; |
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20 | 27 | | |
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21 | 28 | | (c) "Residential care home" or "rest home" means a community residence that furnishes, in single or multiple facilities, food and shelter to two or more persons unrelated to the proprietor and, in addition, provides services that meet a need beyond the basic provisions of food, shelter and laundry and may qualify as a setting that allows residents to receive home and community-based services funded by state and federal programs; |
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22 | 29 | | |
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23 | 30 | | (d) "Home health care agency" means a public or private organization, or a subdivision thereof, engaged in providing professional nursing services and the following services, available twenty-four hours per day, in the patient's home or a substantially equivalent environment: Homemaker-home health aide services as defined in this section, physical therapy, speech therapy, occupational therapy or medical social services. The agency shall provide professional nursing services and at least one additional service directly and all others directly or through contract. An agency shall be available to enroll new patients seven days a week, twenty-four hours per day; |
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24 | 31 | | |
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25 | 32 | | (e) "Homemaker-home health aide agency" means a public or private organization, except a home health care agency, which provides in the patient's home or a substantially equivalent environment supportive services which may include, but are not limited to, assistance with personal hygiene, dressing, feeding and incidental household tasks essential to achieving adequate household and family management. Such supportive services shall be provided under the supervision of a registered nurse and, if such nurse determines appropriate, shall be provided by a social worker, physical therapist, speech therapist or occupational therapist. Such supervision may be provided directly or through contract; |
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26 | 33 | | |
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27 | 34 | | (f) "Homemaker-home health aide services" as defined in this section shall not include services provided to assist individuals with activities of daily living when such individuals have a disease or condition that is chronic and stable as determined by a physician licensed in the state of Connecticut; |
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28 | 35 | | |
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29 | 36 | | (g) "Behavioral health facility" means any facility that provides mental health services to persons eighteen years of age or older or substance use disorder services to persons of any age in an outpatient treatment or residential setting to ameliorate mental, emotional, behavioral or substance use disorder issues; |
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30 | 37 | | |
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31 | 38 | | (h) "Alcohol or drug treatment facility" means any facility for the care or treatment of persons suffering from alcoholism or other drug addiction; |
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32 | 39 | | |
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33 | 40 | | (i) "Person" means any individual, firm, partnership, corporation, limited liability company or association; |
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34 | 41 | | |
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35 | 42 | | (j) "Commissioner" means the Commissioner of Public Health or the commissioner's designee; |
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36 | 43 | | |
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37 | 44 | | (k) "Home health agency" means an agency licensed as a home health care agency or a homemaker-home health aide agency; |
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38 | 45 | | |
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39 | 46 | | (l) "Assisted living services agency" means an agency that provides, among other things, nursing services and assistance with activities of daily living to a population that is chronic and stable; |
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40 | 47 | | |
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41 | 48 | | (m) "Outpatient clinic" means an organization operated by a municipality or a corporation, other than a hospital, that provides (1) ambulatory medical care, including preventive and health promotion services, (2) dental care, or (3) mental health services in conjunction with medical or dental care for the purpose of diagnosing or treating a health condition that does not require the patient's overnight care; |
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42 | 49 | | |
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43 | 50 | | (n) "Multicare institution" means a hospital, psychiatric outpatient clinic for adults, free-standing facility for the care or treatment of substance abusive or dependent persons, hospital for psychiatric disabilities, as defined in section 17a-495, or a general acute care hospital that provides outpatient behavioral health services that (1) is licensed in accordance with this chapter, (2) has more than one facility or one or more satellite units owned and operated by a single licensee, and (3) offers complex patient health care services at each facility or satellite unit; [and] |
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44 | 51 | | |
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58 | 65 | | |
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59 | 66 | | (4) "Contact hour" means a minimum of fifty minutes of continuing education activity. |
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60 | 67 | | |
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61 | 68 | | Sec. 4. Subsection (g) of section 20-126l of the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2017): |
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62 | 69 | | |
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63 | 70 | | (g) Each licensed dental hygienist applying for license renewal shall earn a minimum of sixteen contact hours of continuing education within the preceding twenty-four-month period, including, for registration periods beginning on and after October 1, 2016, at least one contact hour of training or education in infection control in a dental setting and, for registration periods beginning on and after October 1, 2017, at least one contact hour of training or education in cultural competency. The subject matter for continuing education shall reflect the professional needs of the licensee in order to meet the health care needs of the public. Continuing education activities shall provide significant theoretical or practical content directly related to clinical or scientific aspects of dental hygiene. Qualifying continuing education activities include, but are not limited to, courses, including on-line courses, that are offered or approved by dental schools and other institutions of higher education that are accredited or recognized by the Council on Dental Accreditation, a regional accrediting organization, the American Dental Association, a state, district or local dental association or society affiliated with the American Dental Association, the National Dental Association, the American Dental Hygienists Association or a state, district or local dental hygiene association or society affiliated with the American Dental Hygienists Association, the Academy of General Dentistry, the Academy of Dental Hygiene, the American Red Cross or the American Heart Association when sponsoring programs in cardiopulmonary resuscitation or cardiac life support, the United States Department of Veterans Affairs and armed forces of the United States when conducting programs at United States governmental facilities, a hospital or other health care institution, agencies or businesses whose programs are accredited or recognized by the Council on Dental Accreditation, local, state or national medical associations, or a state or local health department. Eight hours of volunteer dental practice at a public health facility, as defined in subsection (a) of this section, may be substituted for one contact hour of continuing education, up to a maximum of five contact hours in one two-year period. Activities that do not qualify toward meeting these requirements include professional organizational business meetings, speeches delivered at luncheons or banquets, and the reading of books, articles, or professional journals. Not more than four contact hours of continuing education may be earned through an on-line or other distance learning program. |
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64 | 71 | | |
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65 | 72 | | Sec. 5. Subsection (f) of section 10-206 of the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2017): |
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66 | 73 | | |
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67 | 74 | | (f) On and after [February 1, 2004] October 1, 2017, each local or regional board of education shall report to the local health department and the Department of Public Health, on an [annual] triennial basis, the total number of pupils per school and per school district having a diagnosis of asthma (1) at the time of public school enrollment, (2) in grade six or seven, and (3) in grade ten or eleven. The report shall contain the asthma information collected as required under subsections (b) and (c) of this section and shall include pupil age, gender, race, ethnicity and school. Beginning on October 1, 2004, and every three years thereafter, the Department of Public Health shall review the asthma screening information reported pursuant to this section and shall submit a report to the joint standing committees of the General Assembly having cognizance of matters relating to public health and education concerning asthma trends and distributions among pupils enrolled in the public schools. The report shall be submitted in accordance with the provisions of section 11-4a and shall include, but not be limited to, trends and findings based on pupil age, gender, race, ethnicity, school and the education reference group, as determined by the Department of Education for the town or regional school district in which such school is located. |
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68 | 75 | | |
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69 | 76 | | Sec. 6. Section 19a-580d of the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2017): |
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70 | 77 | | |
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71 | 78 | | (a) For purposes of this section, "do not resuscitate order" or "DNR order" means an order written by a physician licensed under chapter 370 or advanced practice registered nurse licensed under chapter 378 for a particular patient to withhold cardiopulmonary resuscitation of such patient, including chest compressions, defibrillation or breathing, or ventilation of such patient by any assistive or mechanical means, including, but not limited to, mouth-to-mouth, bag-valve mask, endotracheal tube or ventilator. |
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72 | 79 | | |
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73 | 80 | | (b) The Department of Public Health shall adopt regulations, in accordance with chapter 54, to provide for a system governing the recognition and transfer of ["] do not resuscitate ["] or DNR orders between health care institutions licensed pursuant to chapter 368v and upon intervention by emergency medical services providers certified or licensed pursuant to chapter 368d. The regulations shall include, but not be limited to, procedures concerning the use of ["] do not resuscitate ["] bracelets. The regulations shall specify that, upon request of the patient or his or her authorized representative, the physician or advanced practice registered nurse who issued the ["] do not resuscitate ["] order shall assist the patient or his or her authorized representative in utilizing the system. The regulations shall not limit the authority of the Commissioner of Developmental Services under subsection (g) of section 17a-238 concerning orders applied to persons receiving services under the direction of the Commissioner of Developmental Services. |
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74 | 81 | | |
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76 | 85 | | |
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77 | 86 | | (a) Each board or commission established under chapters 369 to 376, inclusive, 378 to 381, inclusive, and 383 to 388, inclusive, and the Department of Public Health with respect to professions under its jurisdiction that have no board or commission may take any of the following actions, singly or in combination, based on conduct that occurred prior or subsequent to the issuance of a permit or a license upon finding the existence of good cause: |
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78 | 87 | | |
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79 | 88 | | (1) Revoke a practitioner's license or permit; |
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80 | 89 | | |
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81 | 90 | | (2) Suspend a practitioner's license or permit; |
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82 | 91 | | |
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83 | 92 | | (3) Censure a practitioner or permittee; |
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84 | 93 | | |
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85 | 94 | | (4) Issue a letter of reprimand to a practitioner or permittee; |
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86 | 95 | | |
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87 | 96 | | (5) Place a practitioner or permittee on probationary status and require the practitioner or permittee to: |
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88 | 97 | | |
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89 | 98 | | (A) Report regularly to such board, commission or department upon the matters which are the basis of probation; |
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90 | 99 | | |
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91 | 100 | | (B) Limit practice to those areas prescribed by such board, commission or department; |
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92 | 101 | | |
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93 | 102 | | (C) Continue or renew professional education until a satisfactory degree of skill has been attained in those areas which are the basis for the probation; |
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94 | 103 | | |
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95 | 104 | | (6) Assess a civil penalty of up to twenty-five thousand dollars; |
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96 | 105 | | |
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98 | 107 | | |
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99 | 108 | | (8) Summarily take any action specified in this subsection against a practitioner's license or permit upon receipt of proof that such practitioner has been: |
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100 | 109 | | |
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101 | 110 | | (A) Found guilty or convicted as a result of an act which constitutes a felony under (i) the laws of this state, (ii) federal law, or (iii) the laws of another jurisdiction and which, if committed within this state, would have constituted a felony under the laws of this state; or |
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102 | 111 | | |
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103 | 112 | | (B) Subject to disciplinary action similar to that specified in this subsection by a duly authorized professional agency of any state, the federal government, the District of Columbia, a United States possession or territory or a foreign jurisdiction. The applicable board or commission, or the department shall promptly notify the practitioner or permittee that his license or permit has been summarily acted upon pursuant to this subsection and shall institute formal proceedings for revocation within ninety days after such notification. |
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104 | 113 | | |
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105 | 114 | | (b) Such board or commission or the department may withdraw the probation if it finds that the circumstances that required action have been remedied. |
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106 | 115 | | |
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107 | 116 | | (c) Such board or commission or the department where appropriate may summarily suspend a practitioner's license or permit in advance of a final adjudication or during the appeals process if such board or commission or the department finds that a practitioner or permittee represents a clear and immediate danger to the public health and safety if he is allowed to continue to practice. |
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108 | 117 | | |
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109 | 118 | | (d) In addition to the authority provided to the Department of Public Health in subsection (a) of this section, the department may resolve any disciplinary action with respect to a practitioner's license or permit in any profession by voluntary surrender or agreement not to renew or reinstate. |
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110 | 119 | | |
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111 | 120 | | (e) Such board or commission or the department may reinstate a license that has been suspended or revoked if, after a hearing, such board or commission or the department is satisfied that the practitioner or permittee is able to practice with reasonable skill and safety to patients, customers or the public in general. As a condition of reinstatement, the board or commission or the department may impose disciplinary or corrective measures authorized under this section. |
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112 | 121 | | |
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113 | 122 | | (f) Such board or commission or the department may take disciplinary action against a practitioner's license or permit as a result of the practitioner having been subject to disciplinary action similar to an action specified in subsection (a) of this section by a duly authorized professional disciplinary agency of any state, [a federal governmental agency] the federal government, the District of Columbia, a United States possession or territory or a foreign jurisdiction. Such board or commission or the department may rely upon the findings and conclusions made by a duly authorized professional disciplinary agency of any state, [a federal governmental agency] the federal government, the District of Columbia, a United States possession or territory or foreign jurisdiction in taking such disciplinary action. |
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114 | 123 | | |
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115 | 124 | | (g) As used in this section, the term "license" shall be deemed to include the following authorizations relative to the practice of any profession listed in subsection (a) of this section: (1) Licensure by the Department of Public Health; (2) certification by the Department of Public Health; and (3) certification by a national certification body. |
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116 | 125 | | |
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117 | 126 | | (h) As used in this chapter, the term "permit" includes any authorization issued by the department to allow the practice, limited or otherwise, of a profession which would otherwise require a license; and the term "permittee" means any person who practices pursuant to a permit. |
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118 | 127 | | |
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120 | 133 | | |
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121 | 134 | | As used in this chapter: |
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122 | 135 | | |
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123 | 136 | | (1) "Occupational therapy" means the evaluation, planning and implementation of a program of purposeful activities to develop or maintain adaptive skills necessary to achieve the maximal physical and mental functioning of the individual in his daily pursuits. The practice of "occupational therapy" includes, but is not limited to, evaluation and treatment of individuals whose abilities to cope with the tasks of living are threatened or impaired by developmental [deficits] disabilities, the aging process, learning disabilities, poverty and cultural differences, physical injury or disease, psychological and social disabilities, or anticipated [disfunction] dysfunction, using (A) such treatment techniques as task-oriented activities to prevent or correct physical or emotional [deficits] disabilities or to minimize the disabling effect of these [deficits] disabilities in the life of the individual, (B) such evaluation techniques as assessment of sensory motor abilities, assessment of the development of self-care activities and capacity for independence, assessment of the physical capacity for prevocational and work tasks, assessment of play and leisure performance, and appraisal of living areas for [the handicapped] persons with disabilities, (C) specific occupational therapy techniques such as activities of daily living skills, the fabrication and application of splinting devices, sensory motor activities, the use of specifically designed manual and creative activities, guidance in the selection and use of adaptive equipment, specific exercises to enhance functional performance and treatment techniques for physical capabilities for work activities. Such techniques are applied in the treatment of individual patients or clients, in groups or through social systems. Occupational therapy also includes the establishment and modification of peer review. |
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124 | 137 | | |
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125 | 138 | | (2) "Occupational therapist" means a person licensed to practice occupational therapy as defined in this chapter and whose license is in good standing. |
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126 | 139 | | |
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127 | 140 | | (3) "Occupational therapy assistant" means a person licensed to assist in the practice of occupational therapy, under the supervision of or with the consultation of a licensed occupational therapist, and whose license is in good standing. |
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128 | 141 | | |
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129 | 142 | | (4) "Commissioner" means the Commissioner of Public Health, or the commissioner's designee. |
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130 | 143 | | |
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131 | 144 | | (5) "Department" means the Department of Public Health. |
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132 | 145 | | |
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133 | 146 | | (6) "Supervision" means the overseeing of or participation in the work of an occupational therapist assistant by a licensed occupational therapist, including, but not limited to: (A) Continuous availability of direct communication between the occupational therapist assistant and the licensed occupational therapist; (B) availability of the licensed occupational therapist on a regularly scheduled basis to (i) review the practice of the occupational therapist assistant, and (ii) support the occupational therapist assistant in the performance of the occupational therapist assistant's services; and (C) a predetermined plan for emergency situations, including the designation of an alternate licensed occupational therapist to oversee or participate in the work of the occupational therapist assistant in the absence of the regular licensed occupational therapist. |
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134 | 147 | | |
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137 | | - | (a) Nothing in this chapter shall be construed to limit the activities and services of a graduate student, intern or resident in psychology, pursuing a course of study in an educational institution under the provisions of section 20-189, if such activities constitute a part of a supervised course of study. No license as a psychologist shall be required of a person holding a doctoral degree based on a program of studies whose content was primarily psychological from an educational institution approved under the provisions of section 20-189, provided (1) such activities and services are necessary to satisfy the work experience as required by section 20-188, and (2) the exemption from the licensure requirement shall cease upon notification that the person did not successfully complete the licensing examination, as required under section 20-188, or one year after completion of such work experience, whichever occurs first. The provisions of this chapter shall not apply to any person in the salaried employ of any person, firm, corporation, educational institution or governmental agency when acting within the person's own organization. Nothing in this chapter shall be construed to prevent the giving of accurate information concerning education and experience by any person in any application for employment. Nothing in this chapter shall be construed to prevent physicians, optometrists, chiropractors, members of the clergy, attorneys-at-law or social workers from doing work of a psychological nature consistent with accepted standards in their respective professions. |
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| 150 | + | (a) Nothing in this chapter shall be construed to limit the activities and services of a graduate student, intern or resident in psychology, pursuing a course of study in an educational institution under the provisions of section 20-189, if such activities constitute a part of a supervised course of study. No license as a psychologist shall be required of a person holding a doctoral degree based on a program of studies whose content was primarily psychological from an educational institution approved under the provisions of section 20-189, provided (1) such activities and services are necessary to satisfy the work experience as required by section 20-188, and (2) the exemption from the licensure requirement shall cease upon notification that the person did not successfully complete the licensing examination, as required under section 20-188, or six months after completion of such work experience, whichever occurs first. The provisions of this chapter shall not apply to any person in the salaried employ of any person, firm, corporation, educational institution or governmental agency when acting within the person's own organization. Nothing in this chapter shall be construed to prevent the giving of accurate information concerning education and experience by any person in any application for employment. Nothing in this chapter shall be construed to prevent physicians, optometrists, chiropractors, members of the clergy, attorneys-at-law or social workers from doing work of a psychological nature consistent with accepted standards in their respective professions. |
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141 | | - | (c) No license as a professional counselor shall be required of the following: (1) A person who furnishes uncompensated assistance in an emergency; (2) a clergyman, priest, minister, rabbi or practitioner of any religious denomination accredited by the religious body to which the person belongs and settled in the work of the ministry, provided the activities that would otherwise require a license as a professional counselor are within the scope of ministerial duties; (3) a sexual assault counselor, as defined in section 52-146k; (4) a person participating in uncompensated group or individual counseling; (5) a person with a master's degree in a health-related or human services-related field employed by a hospital, as defined in subsection (b) of section 19a-490, as amended by this act, performing services in accordance with section 20-195aa under the supervision of a person licensed by the state in one of the professions identified in subparagraphs (A) to (F), inclusive, of subdivision (2) of subsection (a) of section 20-195dd; (6) a person licensed or certified by any agency of this state and performing services within the scope of practice for which licensed or certified; (7) a student, intern or trainee pursuing a course of study in counseling in a regionally accredited institution of higher education, provided the activities that would otherwise require a license as a professional counselor are performed under supervision and constitute a part of a supervised course of study; (8) a person employed by an institution of higher education to provide academic counseling in conjunction with the institution's programs and services; [or] (9) a vocational rehabilitation counselor, job counselor, credit counselor, consumer counselor or any other counselor or psychoanalyst who does not purport to be a counselor whose primary service is the application of established principles of psycho-social development and behavioral science to the evaluation, assessment, analysis and treatment of emotional, behavioral or interpersonal dysfunction or difficulties that interfere with mental health and human development; or (10) a person who earned a degree in accordance with the requirements of subdivision (2) of subsection (a) of section 20-195dd, provided (A) the activities performed and services provided by such person constitute part of the supervised experience required for licensure under subdivision (3) of subsection (a) of said section, and (B) the exemption to the licensure requirement shall cease upon notification that the person did not successfully complete the licensing examination, as required under subdivision (4) of subsection (a) of said section, or one year after completion of such supervised experience, whichever occurs first. |
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| 154 | + | (c) No license as a professional counselor shall be required of the following: (1) A person who furnishes uncompensated assistance in an emergency; (2) a clergyman, priest, minister, rabbi or practitioner of any religious denomination accredited by the religious body to which the person belongs and settled in the work of the ministry, provided the activities that would otherwise require a license as a professional counselor are within the scope of ministerial duties; (3) a sexual assault counselor, as defined in section 52-146k; (4) a person participating in uncompensated group or individual counseling; (5) a person with a master's degree in a health-related or human services-related field employed by a hospital, as defined in subsection (b) of section 19a-490, as amended by this act, performing services in accordance with section 20-195aa under the supervision of a person licensed by the state in one of the professions identified in subparagraphs (A) to (F), inclusive, of subdivision (2) of subsection (a) of section 20-195dd; (6) a person licensed or certified by any agency of this state and performing services within the scope of practice for which licensed or certified; (7) a student, intern or trainee pursuing a course of study in counseling in a regionally accredited institution of higher education, provided the activities that would otherwise require a license as a professional counselor are performed under supervision and constitute a part of a supervised course of study; (8) a person employed by an institution of higher education to provide academic counseling in conjunction with the institution's programs and services; [or] (9) a vocational rehabilitation counselor, job counselor, credit counselor, consumer counselor or any other counselor or psychoanalyst who does not purport to be a counselor whose primary service is the application of established principles of psycho-social development and behavioral science to the evaluation, assessment, analysis and treatment of emotional, behavioral or interpersonal dysfunction or difficulties that interfere with mental health and human development; or (10) a person who earned a degree in accordance with the requirements of subdivision (2) of subsection (a) of section 20-195dd, provided (A) the activities performed and services provided by such person constitute part of the supervised experience required for licensure under subdivision (3) of subsection (a) of said section, and (B) the exemption to the licensure requirement shall cease upon notification that the person did not successfully complete the licensing examination, as required under subdivision (4) of subsection (a) of said section, or six months after completion of such supervised experience, whichever occurs first. |
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153 | | - | (a) [Each person licensed to practice medicine, surgery, midwifery, chiropractic, naturopathy, podiatry or nursing or to use any other means or agencies to treat, prescribe for, heal or otherwise alleviate deformity, ailment, disease or any other form of human ills, who has professional knowledge that any child under five years of age has any physical defect shall, within forty-eight hours from the time of acquiring such knowledge, mail to the Department of Public Health a report, stating the name and address of the child, the name and address of the child's parents or guardians,] As used in this section: |
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| 166 | + | [Each person licensed to practice medicine, surgery, midwifery, chiropractic, naturopathy, podiatry or nursing or to use any other means or agencies to treat, prescribe for, heal or otherwise alleviate deformity, ailment, disease or any other form of human ills, who has professional knowledge that any child under five years of age has any physical defect shall, within forty-eight hours from the time of acquiring such knowledge, mail to the Department of Public Health a report, stating the name and address of the child, the name and address of the child's parents or guardians,] |
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| 167 | + | |
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| 168 | + | (a) As used in this section: |
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154 | 169 | | |
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155 | 170 | | (1) "Commissioner" means the Commissioner of Public Health, or the commissioner's designee; |
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156 | 171 | | |
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157 | 172 | | (2) "Department" means the Department of Public Health; |
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158 | 173 | | |
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159 | 174 | | (3) "Licensed health care professional" means a physician licensed pursuant to chapter 370, a physician assistant licensed pursuant to chapter 370, an advanced practice registered nurse or a registered nurse licensed pursuant to chapter 378 or a nurse midwife licensed pursuant to chapter 377; and |
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160 | 175 | | |
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161 | 176 | | (4) "Newborn screening system" means the department's tracking system for the screening of newborns pursuant to section 19a-55, as amended by this act. |
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162 | 177 | | |
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163 | 178 | | (b) The department may, within available appropriations, establish a birth defects surveillance program. Such program shall monitor the frequency, distribution and types of birth defects occurring in the state. |
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164 | 179 | | |
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165 | 180 | | (c) Each child that is born in the state shall have a birth defects screening completed by a licensed health care professional prior to discharge from the hospital. The administrative officer or other person in charge of each hospital shall enter the results of each birth defects screening into the birth defects registry located in the department's newborn screening system in a form and manner prescribed by the commissioner. |
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166 | 181 | | |
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167 | 182 | | (d) Any licensed health care professional who provides care or treatment to a child that is under the age of one and was born in the state and who observes or acquires knowledge that the child has a birth defect shall, not later than forty-eight hours after observing or acquiring knowledge of such defect, notify the department of such defect in a form and manner prescribed by the commissioner. Such notification shall contain information, including, but not limited to, the nature of the [physical] birth defect and such other information as may reasonably be required by the department. The department shall [prepare and furnish suitable blanks in duplicate for such reports, shall] post the notification form on the department's Internet web site and keep each [report] notification made under this section on file for at least six years from the date of its receipt. [thereof and shall furnish a copy thereof to the State Board of Education within ten days.] |
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168 | 183 | | |
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169 | 184 | | (e) The commissioner shall have access to identifying information in the hospital discharge records of newborn infants born in the state upon request. Such identifying information shall be used solely for purposes of the birth defects surveillance program. A hospital, as defined in section 19a-490, as amended by this act, shall make available to the department upon request the medical records of a patient diagnosed with a birth defect or other adverse reproductive outcomes for purposes of research and verification of data. |
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170 | 185 | | |
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171 | 186 | | (f) The commissioner shall use the information collected under this section and information available from other sources to conduct routine analyses to determine whether there were any preventable causes of the birth defects about which the department was notified under this section. |
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172 | 187 | | |
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173 | 188 | | (g) All information, including, but not limited to, personally identifiable information collected from a health care professional or hospital under this section shall be confidential. Such personally identifiable information shall be used solely for purposes of the birth defects surveillance program. Access to such information shall be limited to the department and persons with a valid scientific interest and qualification as determined by the commissioner, provided the department and such persons are engaged in demographic, epidemiologic or other similar studies related to health and agree, in writing, to maintain the confidentiality of such information as prescribed in this section and section 19a-25. |
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174 | 189 | | |
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175 | 190 | | (h) The commissioner shall maintain an accurate record of all persons who are given access to the information in the newborn screening system. The record shall include (1) the name, title and organizational affiliation of persons given access to the system, (2) dates of access, and (3) the specific purpose for which the information is used. The record shall be open to public inspection during the department's normal operating hours. |
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176 | 191 | | |
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177 | 192 | | (i) All research proposed to be conducted using personally identifiable information in the newborn screening system or requiring contact with affected individuals shall be reviewed and approved in advance by the commissioner. |
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178 | 193 | | |
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179 | 194 | | (j) The commissioner may publish statistical compilations relating to birth defects or other adverse reproductive outcomes that do not in any way identify individual cases or individual sources of information. |
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180 | 195 | | |
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186 | 201 | | |
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187 | 202 | | (a) As used in this section: |
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188 | 203 | | |
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189 | 204 | | (1) "Laboratory or firm" means an environmental laboratory registered by the Department of Public Health pursuant to section 19a-29a; |
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190 | 205 | | |
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191 | 206 | | (2) "Private well" means a water supply well that meets all of the following criteria: (A) Is not a public well; (B) supplies a population of less than twenty-five persons per day; and (C) is owned or controlled through an easement or by the same entity that owns or controls the building or parcel that is served by the water supply; |
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192 | 207 | | |
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193 | 208 | | (3) "Public well" means a water supply well that supplies a public water system; |
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194 | 209 | | |
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195 | 210 | | (4) "Well for semipublic use" means a water supply well that (A) does not meet the definition of a private well or public well, and (B) provides water for drinking and other domestic purposes; and |
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196 | 211 | | |
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197 | 212 | | (5) "Water supply well" means an artificial excavation constructed by any method for the purpose of getting water for drinking or other domestic use. |
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198 | 213 | | |
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199 | 214 | | [(a)] (b) The Commissioner of Public Health may adopt regulations in the Public Health Code for the preservation of the public health pertaining to (1) protection and location of new water supply wells or springs for residential construction or for public or semipublic use, and (2) inspection for compliance with the provisions of municipal regulations adopted pursuant to section 22a-354p. |
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200 | 215 | | |
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201 | 216 | | [(b)] (c) The Commissioner of Public Health shall adopt regulations, in accordance with chapter 54, for the testing of water quality in private residential wells and wells for semipublic use. Any laboratory or firm which conducts a water quality test on a private well serving a residential property or well for semipublic use shall, not later than thirty days after the completion of such test, report the results of such test to (1) the public health authority of the municipality where the property is located, and (2) the Department of Public Health in a format specified by the department, provided such report shall [not] only be required if the party for whom the laboratory or firm conducted such test informs the laboratory or firm identified on the chain of custody documentation submitted with the test samples that the test was [not conducted within six months of] conducted in connection with the sale of such property. No regulation may require such a test to be conducted as a consequence or a condition of the sale, exchange, transfer, purchase or rental of the real property on which the private residential well or well for semipublic use is located. [For purposes of this section, "laboratory or firm" means an environmental laboratory registered by the Department of Public Health pursuant to section 19a-29a.] |
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202 | 217 | | |
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203 | 218 | | [(c)] (d) Prior to the sale, exchange, purchase, transfer or rental of real property on which a residential well is located, the owner shall provide the buyer or tenant notice that educational material concerning private well testing is available on the Department of Public Health web site. Failure to provide such notice shall not invalidate any sale, exchange, purchase, transfer or rental of real property. If the seller or landlord provides such notice in writing, the seller or landlord and any real estate licensee shall be deemed to have fully satisfied any duty to notify the buyer or tenant that the subject real property is located in an area for which there are reasonable grounds for testing under subsection [(f)] (g) or [(i)] (j) of this section. |
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204 | 219 | | |
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205 | 220 | | [(d)] (e) The Commissioner of Public Health shall adopt regulations, in accordance with chapter 54, to clarify the criteria under which the commissioner may issue a well permit exception and to describe the terms and conditions that shall be imposed when a well is allowed at a premises (1) that is connected to a public water supply system, or (2) whose boundary is located within two hundred feet of an approved community water supply system, measured along a street, alley or easement. Such regulations shall (A) provide for notification of the permit to the public water supplier, (B) address the quality of the water supplied from the well, the means and extent to which the well shall not be interconnected with the public water supply, the need for a physical separation, and the installation of a reduced pressure device for backflow prevention, the inspection and testing requirements of any such reduced pressure device, and (C) identify the extent and frequency of water quality testing required for the well supply. |
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206 | 221 | | |
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207 | 222 | | [(e)] (f) No regulation may require that a certificate of occupancy for a dwelling unit on such residential property be withheld or revoked on the basis of a water quality test performed on a private residential well pursuant to this section, unless such test results indicate that any maximum contaminant level applicable to public water supply systems for any contaminant listed in the public health code has been exceeded. No administrative agency, health district or municipal health officer may withhold or cause to be withheld such a certificate of occupancy except as provided in this section. |
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208 | 223 | | |
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209 | 224 | | [(f)] (g) The local director of health may require a private residential well or well for semipublic use to be tested for arsenic, radium, uranium, radon or gross alpha emitters, when there are reasonable grounds to suspect that such contaminants are present in the groundwater. For purposes of this subsection, "reasonable grounds" means (1) the existence of a geological area known to have naturally occurring arsenic, radium, uranium, radon or gross alpha emitter deposits in the bedrock; or (2) the well is located in an area in which it is known that arsenic, radium, uranium, radon or gross alpha emitters are present in the groundwater. |
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210 | 225 | | |
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211 | 226 | | [(g)] (h) Except as provided in subsection [(h)] (i) of this section, the collection of samples for determining the water quality of private residential wells and wells for semipublic use may be made only by (1) employees of a laboratory or firm certified or approved by the Department of Public Health to test drinking water, if such employees have been trained in sample collection techniques, (2) certified water operators, (3) local health departments and state employees trained in sample collection techniques, or (4) individuals with training and experience that the Department of Public Health deems sufficient. |
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212 | 227 | | |
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213 | 228 | | [(h)] (i) Any owner of a residential construction, including, but not limited to, a homeowner, on which a private residential well is located or any general contractor of a new residential construction on which a private residential well is located may collect samples of well water for submission to a laboratory or firm for the purposes of testing water quality pursuant to this section, provided (1) such laboratory or firm has provided instructions to said owner or general contractor on how to collect such samples, and (2) such owner or general contractor is identified to the subsequent owner on a form to be prescribed by the Department of Public Health. No regulation may prohibit or impede such collection or analysis. |
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214 | 229 | | |
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215 | 230 | | [(i)] (j) The local director of health may require private residential wells and wells for semipublic use to be tested for pesticides, herbicides or organic chemicals when there are reasonable grounds to suspect that any such contaminants might be present in the groundwater. For purposes of this subsection, "reasonable grounds" means (1) the presence of nitrate-nitrogen in the groundwater at a concentration greater than ten milligrams per liter, or (2) that the private residential well or well for semipublic use is located on land, or in proximity to land, associated with the past or present production, storage, use or disposal of organic chemicals as identified in any public record. |
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216 | 231 | | |
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217 | 232 | | (k) Any water transported in bulk by any means to a premises currently supplied by a private well or well for semipublic use where the water is to be used for purposes of drinking or domestic use shall be provided by a bulk water hauler licensed pursuant to section 20-278h. No bulk water hauler shall deliver water without first notifying the owner of the premises of such delivery. Bulk water hauling to a premises currently supplied by a private well or well for semipublic use shall be permitted only as a temporary measure to alleviate a water supply shortage. |
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218 | 233 | | |
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238 | 253 | | |
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239 | 254 | | (a) For purposes of this section: [, (1) a "biolevel-three laboratory" or "laboratory"] |
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240 | 255 | | |
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241 | 256 | | (1) "Microbiological and biomedical biosafety laboratory" means a laboratory that (A) utilizes any living agent capable of causing a human infection or reportable human disease, or (B) is used to secure evidence of the presence or absence of a living agent capable of causing a human infection or reportable human disease, for the purposes of teaching, research or quality control of the infection or disease; |
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242 | 257 | | |
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243 | 258 | | (2) "Biolevel-two microbiological and biomedical biosafety laboratory" means a microbiological and biomedical biosafety laboratory that presents a moderate hazard to personnel of exposure to an infection or disease and utilizes agents that are associated with human infection or disease; |
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244 | 259 | | |
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245 | 260 | | (3) "Biolevel-three microbiological and biomedical biosafety laboratory" means a microbiological and biomedical biosafety laboratory [which is] operated by an institution of higher education, or any other research entity, that (A) handles agents that (i) have a known potential for aerosol transmission, (ii) may cause serious and potentially lethal human infections or diseases, and (iii) are either indigenous or exotic in origin, and (B) is designed and equipped under guidelines issued by the National Institutes of Health and the National Centers for Disease Control as a biolevel-three laboratory; [, and (2) "biolevel-three agent"] and |
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246 | 261 | | |
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247 | 262 | | (4) "Biolevel-three agent" means an agent classified as a biolevel-three agent by the National Institutes of Health and the National Centers for Disease Control. |
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248 | 263 | | |
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249 | 264 | | (b) No biolevel-two microbiological and biomedical biosafety laboratory or biolevel-three microbiological and biomedical biosafety laboratory shall operate unless such laboratory has registered with the Department of Public Health and paid the registration fee required under subsection (c) of this section. |
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250 | 265 | | |
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251 | 266 | | (c) The biennial registration fee for a biolevel-two microbiological and biomedical biosafety laboratory and a biolevel-three microbiological and biomedical biosafety laboratory shall be four hundred dollars. |
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252 | 267 | | |
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253 | 268 | | (d) Microbiological and biomedical biosafety laboratories that are state or federally operated entities shall be exempt from the registration fee requirements set forth in subsection (c) of this section. |
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254 | 269 | | |
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255 | 270 | | [(b)] (e) If an institution [which] that operates a biolevel-three microbiological and biomedical biosafety laboratory establishes a biosafety committee pursuant to the National Institutes of Health or the National Centers for Disease Control guidelines, such committee shall (1) forward the minutes of its meetings to the Department of Public Health and (2) meet at least annually with a representative of the Department of Public Health to review safety procedures and discuss health issues relating to the operation of the laboratory. |
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256 | 271 | | |
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257 | 272 | | [(c)] (f) Each such institution shall report to the Department of Public Health any infection or injury relating to work at the laboratory with biolevel-three agents and any incidents relating to such work which result in a recommendation by the institution that employees or members of the public be tested or monitored for potential health problems because of the possibility of infection or injury or incidents which pose a threat to public health. |
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258 | 273 | | |
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259 | 274 | | [(d)] (g) Each such institution shall report to the Department of Public Health any sanctions imposed on the laboratory or on the institution for incidents occurring at the laboratory by the National Institutes of Health, the National Centers for Disease Control, the United States Department of Defense or any other government agency. |
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260 | 275 | | |
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275 | | - | (b) The task force shall consist of the following members: |
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| 287 | + | This act shall take effect as follows and shall amend the following sections: |
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| 288 | + | Section 1 October 1, 2017 19a-491(a) |
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| 289 | + | Sec. 2 October 1, 2017 19a-490 |
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| 290 | + | Sec. 3 October 1, 2017 20-126l(a) |
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| 291 | + | Sec. 4 October 1, 2017 20-126l(g) |
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| 292 | + | Sec. 5 October 1, 2017 10-206(f) |
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| 293 | + | Sec. 6 October 1, 2017 19a-580d |
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| 294 | + | Sec. 7 October 1, 2017 New section |
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| 295 | + | Sec. 8 October 1, 2017 19a-17 |
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| 296 | + | Sec. 9 October 1, 2017 20-110 |
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| 297 | + | Sec. 10 October 1, 2017 20-74a |
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| 298 | + | Sec. 11 October 1, 2017 20-195(a) |
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| 299 | + | Sec. 12 October 1, 2017 20-195bb(c) |
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| 300 | + | Sec. 13 October 1, 2017 20-195f(a) |
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| 301 | + | Sec. 14 October 1, 2017 19a-52 |
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| 302 | + | Sec. 15 October 1, 2017 19a-53 |
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| 303 | + | Sec. 16 October 1, 2017 19a-55(b) |
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| 304 | + | Sec. 17 October 1, 2017 19a-37 |
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| 305 | + | Sec. 18 July 1, 2017 19a-320(a) |
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| 306 | + | Sec. 19 October 1, 2017 19a-127l(c)(1) |
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| 307 | + | Sec. 20 October 1, 2017 19a-131g |
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| 308 | + | Sec. 21 October 1, 2017 19a-491c(f) |
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| 309 | + | Sec. 22 October 1, 2017 19a-31a |
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| 310 | + | Sec. 23 October 1, 2017 19a-59c |
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| 311 | + | Sec. 24 October 1, 2017 Repealer section |
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359 | | - | (b) (1) Notwithstanding the provisions of section 31-40q, as amended by this act, no person shall smoke: (A) In any building or portion of a building owned and operated or leased and operated by the state or any political subdivision thereof; (B) in any area of a health care institution; (C) in any area of a retail food store; (D) in any restaurant; (E) in any area of an establishment with a permit issued for the sale of alcoholic liquor pursuant to section 30-20a, 30-21, 30-21b, 30-22, 30-22c, 30-28, 30-28a, 30-33a, 30-33b, 30-35a, 30-37a, 30-37e or 30-37f, in any area of an establishment with a permit for the sale of alcoholic liquor pursuant to section 30-23 issued after May 1, 2003, and, on and after April 1, 2004, in any area of an establishment with a permit issued for the sale of alcoholic liquor pursuant to section 30-22a or 30-26 or the bar area of a bowling establishment holding a permit pursuant to subsection (a) of section 30-37c, as amended by this act; (F) within a school building while school is in session or student activities are being conducted; (G) in any passenger elevator, provided no person shall be arrested for violating this subsection unless there is posted in such elevator a sign which indicates that smoking is prohibited by state law; (H) in any dormitory in any public or private institution of higher education; or (I) on and after April 1, 2004, in any area of a dog race track or a facility equipped with screens for the simulcasting of off-track betting race programs or jai alai games. For purposes of this subsection, "restaurant" means space, in a suitable and permanent building, kept, used, maintained, advertised and held out to the public to be a place where meals are regularly served to the public. |
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| 395 | + | October 1, 2017 |
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435 | | - | Sec. 45. (Effective from passage) (a) The Department of Public Health shall, within available appropriations and in consultation with the Department of Social Services and the Insurance Department, convene a working group to implement a mobile integrated health care program. The program shall permit a paramedic, as defined in section 20-206jj of the general statutes, to provide community-based health care within his or her scope of practice and to make recommendations regarding transportation by emergency medical services providers of a patient to a destination other than an emergency department. For purposes of this section, "community-based health care" means health care provided using patient-centered, mobile resources outside of the hospital environment. |
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436 | | - | |
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437 | | - | (b) The working group shall consist of the following members, who shall be appointed by the Commissioner of Public Health not later than sixty days after the effective date of this section: (1) A representative of the Connecticut Hospital Association, or such representative's designee; (2) a chairperson of the Connecticut Emergency Medical Services Medical Advisory Committee, established pursuant to section 19a-178a of the general statutes, or such chairperson's designee; (3) an advanced practice registered nurse licensed under section 20-94a of the general statutes; (4) a licensed behavioral health professional; (5) a representative of the Community Health Center Association of Connecticut; (6) a representative from a primary care provider that self-identifies as an urgent care facility; (7) a representative of the Connecticut commercial health insurance industry; (8) a representative of a fire department-based emergency medical services provider; (9) three representatives of emergency medical services providers, at least one of whom shall be a designee of the Association of Connecticut Ambulance Providers and have a background in providing ambulance services in a rural area of the state, one of whom shall have a background in providing ambulance services in an urban area of the state, and one of whom shall be a designee of the Connecticut Emergency Medical Services Chiefs' Association; (10) a representative of the Connecticut Association for Healthcare at Home; (11) a representative of an agency providing hospice care that is licensed to provide such care by the Department of Public Health or certified to provide such care pursuant to 42 USC 1395x, as amended from time to time; (12) a representative of the Connecticut Nurses Association; and (13) a representative of the Connecticut College of Emergency Physicians. The working group shall also consist of the following members, or their designees: (A) The director of the Office of Emergency Medical Services, as defined in section 19a-175 of the general statutes; (B) the chairperson of the Emergency Medical Services Advisory Board, established pursuant to section 19a-178a of the general statutes; (C) the Commissioners of Public Health and Social Services and the Insurance Commissioner; (D) the Secretary of the Office of Policy and Management; and (E) the chairpersons, vice chairpersons and ranking members of the joint standing committee of the General Assembly having cognizance of matters relating to public health. |
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438 | | - | |
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439 | | - | (c) (1) The tasks of the working group shall include, but not be limited to, identifying (A) areas in the state that would benefit from a mobile integrated health care program due to gaps in the availability of health care services in such areas, (B) any patient care interventions that a paramedic may provide within a paramedic's scope of practice, (C) any additional education or training that paramedics may need in order to provide community-based health care, (D) any potential savings or additional costs associated with the provision of health care coverage for community-based health care that an insured, as defined in section 38a-1 of the general statutes, or the Medicaid program administered by the Department of Social Services, may incur, (E) any potential reimbursement issues related to health care coverage for the provision of community-based health care by a paramedic, (F) minimum criteria for the implementation of the mobile integrated health care program, (G) any statute or regulation that may be impacted by the implementation of the mobile integrated health care program, and (H) any successful models for a mobile integrated health care program implemented in other areas of the country. |
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440 | | - | |
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441 | | - | (2) The working group shall, in collaboration with the Emergency Medical Services Advisory Board and its Medical Advisory Committee, make recommendations regarding (A) the ability of an emergency medical services provider to transport a patient to an alternative destination other than a hospital emergency department for health care services when established protocols dictate that the emergency department is not the most appropriate destination for such patient, and (B) whether an emergency medical services provider requires additional training for purposes of making a determination regarding whether to transport a patient to an alternative destination. |
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442 | | - | |
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443 | | - | (d) Not later than January 1, 2019, the Commissioner of Public Health shall report, in accordance with the provisions of section 11-4a of the general statutes, regarding the outcome and the recommendations of the working group to implement the mobile integrated health care program to the joint standing committees of the General Assembly having cognizance of matters relating to public health, human services and insurance. |
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444 | | - | |
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445 | | - | Sec. 46. (Effective from passage) (a) There is established a task force to study the projected shortage in the psychiatry workforce in the state. Such study shall include, but need not be limited to, an examination of the causes of and potential solutions for avoiding or reducing the projected shortage in the psychiatry workforce. |
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446 | | - | |
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447 | | - | (b) The task force shall consist of the following members: |
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448 | | - | |
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449 | | - | (1) Two appointed by the speaker of the House of Representatives, one of whom is a child and adolescent psychiatrist and one of whom is a psychologist; |
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450 | | - | |
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451 | | - | (2) Two appointed by the president pro tempore of the Senate, one of whom is a psychiatrist and one of whom has expertise in workforce shortages and development; |
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452 | | - | |
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453 | | - | (3) Two appointed by the majority leader of the House of Representatives, one of whom has expertise in social work and counseling and one of whom is a primary care provider who consults with psychiatrists; |
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454 | | - | |
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455 | | - | (4) Two appointed by the majority leader of the Senate, one of whom has expertise in recovery support and one of whom is a representative of an institution that employs psychiatrists, including an inpatient psychiatric hospital, outpatient clinic or emergency department in the state; |
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456 | | - | |
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457 | | - | (5) Two appointed by the minority leader of the House of Representatives, one of whom is a physician assistant for a psychiatrist and one of whom is an emergency medicine physician; and |
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458 | | - | |
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459 | | - | (6) Two appointed by the minority leader of the Senate, one of whom is a psychiatric nurse practitioner and one of whom is a faculty member from a department of psychiatry of a school of medicine in the state. |
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460 | | - | |
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461 | | - | (c) Any member of the task force appointed under subdivision (1), (2), (3), (4), (5) or (6) of subsection (b) of this section may be a member of the General Assembly. |
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462 | | - | |
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463 | | - | (d) All appointments to the task force shall be made not later than thirty days after the effective date of this section. Any vacancy shall be filled by the appointing authority. |
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464 | | - | |
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465 | | - | (e) The speaker of the House of Representatives and the president pro tempore of the Senate shall select the chairpersons of the task force from among the members of the task force. Such chairpersons shall schedule the first meeting of the task force, which shall be held not later than thirty days after the effective date of this section. |
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466 | | - | |
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467 | | - | (f) The administrative staff of the joint standing committee of the General Assembly having cognizance of matters relating to public health shall serve as administrative staff of the task force. |
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468 | | - | |
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469 | | - | (g) Not later than July 1, 2018, the task force shall submit a report on its findings and recommendations to the joint standing committee of the General Assembly having cognizance of matters relating to public health, in accordance with the provisions of section 11-4a of the general statutes. The task force shall terminate on the date that it submits such report or July 1, 2018, whichever is later. |
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470 | | - | |
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471 | | - | Sec. 47. Section 10-500 of the general statutes is amended by adding subsection (e) as follows (Effective from passage): |
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472 | | - | |
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473 | | - | (NEW) (e) The Connecticut Head Start State Collaboration Office shall be based in the Office of Early Childhood. |
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474 | | - | |
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475 | | - | Sec. 48. Sections 19a-6j to 19a-6l, inclusive, and 19a-6n of the general statutes are repealed. (Effective October 1, 2017) |
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| 469 | + | Joint Favorable Subst. -LCO |
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