LCO \\PRDFS1\HCOUSERS\BARRYJN\WS\2019HB-06146-R02- HB.docx 1 of 11 General Assembly Substitute Bill No. 6146 January Session, 2019 AN ACT CONCERNING TH E EXPANSION OF CERTIFICATION COURSES IN CARDIOPUL MONARY RESUSCITATION AND EDUCATION AND TRAINI NG COURSES IN THE USE OF AUTOMATIC EXTERNAL DEFIBRILLAT ORS AND THE ADMINIST RATION OF FIRST AID. Be it enacted by the Senate and House of Representatives in General Assembly convened: Section 1. Section 19a-113a of the general statutes is repealed and 1 the following is substituted in lieu thereof (Effective October 1, 2019): 2 The Commissioner of Public Health shall adopt regulations, in 3 accordance with chapter 54, requiring that persons who are employed 4 as lifeguards shall be certified in cardiopulmonary resuscitation by the 5 American Heart Association, the American Red Cross, [or] the 6 American Safety and Health Institute or an organization with 7 substantially similar cardiopulmonary resuscitation certification 8 requirements, as determined by the Department of Public Health. 9 Sec. 2. Section 19a-197b of the general statutes is repealed and the 10 following is substituted in lieu thereof (Effective October 1, 2019): 11 A paid or volunteer firefighter or police officer, a member of a ski 12 patrol, a lifeguard, a conservation officer, patrol officer or special 13 police officer of the Department of Energy and Environmental 14 Protection or emergency medical service personnel who has been 15 Substitute Bill No. 6146 LCO {\\PRDFS1\HCOUSERS\BARRYJN\WS\2019HB-06146- R02-HB.docx } 2 of 11 trained in the use of an automatic external defibrillator in accordance 16 with the standards set forth by the American Red Cross, [or] American 17 Heart Association or by an organization with substantially similar 18 standards, as determined by the Department of Public Health, shall not 19 be subject to additional requirements, except recertification 20 requirements, in order to use an automatic external defibrillator. 21 Sec. 3. Section 52-557b of the general statutes is repealed and the 22 following is substituted in lieu thereof (Effective October 1, 2019): 23 (a) A person licensed to practice medicine and surgery under the 24 provisions of chapter 370 or dentistry under the provisions of section 25 20-106 or members of the same professions licensed to practice in any 26 other state of the United States, a person licensed as a registered nurse 27 under section 20-93 or 20-94 or certified as a licensed practical nurse 28 under section 20-96 or 20-97, a medical technician or any person 29 operating a cardiopulmonary resuscitator or a person trained in 30 cardiopulmonary resuscitation in accordance with the guidelines set 31 forth by the American Red Cross, [or] American Heart Association or 32 by an organization with substantially similar guidelines, as determined 33 by the Department of Public Health, or a person operating an 34 automatic external defibrillator, who, voluntarily and gratuitously and 35 other than in the ordinary course of such person's employment or 36 practice, renders emergency medical or professional assistance to a 37 person in need thereof, shall not be liable to such person assisted for 38 civil damages for any personal injuries which result from acts or 39 omissions by such person in rendering the emergency care, which may 40 constitute ordinary negligence. A person or entity that provides or 41 maintains an automatic external defibrillator shall not be liable for the 42 acts or omissions of the person or entity in providing or maintaining 43 the automatic external defibrillator, which may constitute ordinary 44 negligence. The immunity provided in this subsection does not apply 45 to acts or omissions constituting gross, wilful or wanton negligence. 46 With respect to the use of an automatic external defibrillator, the 47 immunity provided in this subsection shall only apply to acts or 48 Substitute Bill No. 6146 LCO {\\PRDFS1\HCOUSERS\BARRYJN\WS\2019HB-06146- R02-HB.docx } 3 of 11 omissions involving the use of an automatic external defibrillator in 49 the rendering of emergency care. Nothing in this subsection shall be 50 construed to exempt paid or volunteer firefighters, police officers or 51 emergency medical services personnel from completing training in 52 cardiopulmonary resuscitation or in the use of an automatic external 53 defibrillator in accordance with the guidelines set forth by the 54 American Red Cross, [or] American Heart Association or by an 55 organization with substantially similar guidelines, as determined by 56 the Department of Public Health. For the purposes of this subsection, 57 "automatic external defibrillator" means a device that: (1) Is used to 58 administer an electric shock through the chest wall to the heart; (2) 59 contains internal decision-making electronics, microcomputers or 60 special software that allows it to interpret physiologic signals, make 61 medical diagnosis and, if necessary, apply therapy; (3) guides the user 62 through the process of using the device by audible or visual prompts; 63 and (4) does not require the user to employ any discretion or judgment 64 in its use. 65 (b) A paid or volunteer firefighter or police officer, a teacher or 66 other school personnel on the school grounds or in the school building 67 or at a school function, a member of a ski patrol, a lifeguard, a 68 conservation officer, patrol officer or special police officer of the 69 Department of Energy and Environmental Protection, or emergency 70 medical service personnel, who (1) has completed a course in first aid 71 offered by the American Red Cross, the American Heart Association, 72 the National Ski Patrol, the Department of Public Health, [or] any 73 director of health [, as] or an organization with a substantially similar 74 course in first aid, as determined by the Department of Public Health, 75 that is certified by the [agency] organization or director of health 76 offering the course, and, [who] (2) renders emergency first aid to a 77 person in need thereof, shall not be liable to such person assisted for 78 civil damages for any personal injuries which result from acts or 79 omissions by such person in rendering the emergency first aid, which 80 may constitute ordinary negligence. No paid or volunteer firefighter, 81 police officer or emergency medical service personnel who forcibly 82 Substitute Bill No. 6146 LCO {\\PRDFS1\HCOUSERS\BARRYJN\WS\2019HB-06146- R02-HB.docx } 4 of 11 enters the residence of any person in order to render emergency first 83 aid to a person whom such firefighter, police officer or emergency 84 medical service personnel reasonably believes to be in need thereof 85 shall be liable to such person for civil damages incurred as a result of 86 such entry. The immunity provided in this subsection does not apply 87 to acts or omissions constituting gross, wilful or wanton negligence. 88 (c) An employee of a railroad company, including any company 89 operating a commuter rail line, who has successfully completed a 90 course in first aid, offered by the American Red Cross, the American 91 Heart Association, the National Ski Patrol, the Department of Public 92 Health, [or] any director of health [, as] or an organization with a 93 substantially similar course in first aid, as determined by the 94 department, that is certified by the [agency] organization or director of 95 health offering the course, and who renders emergency first aid or 96 cardiopulmonary resuscitation to a person in need thereof, shall not be 97 liable to such person assisted for civil damages for any personal injury 98 or death which results from acts or omissions by such employee in 99 rendering the emergency first aid or cardiopulmonary resuscitation 100 which may constitute ordinary negligence. The immunity provided in 101 this subsection does not apply to acts or omissions constituting gross, 102 wilful or wanton negligence. 103 (d) A railroad company, including any commuter rail line, which 104 provides emergency medical training or equipment to any employee 105 granted immunity pursuant to subsection (c) of this section shall not be 106 liable for civil damages for any injury sustained by a person or for the 107 death of a person which results from the company's acts or omissions 108 in providing such training or equipment or which results from acts or 109 omissions by such employee in rendering emergency first aid or 110 cardiopulmonary resuscitation, which may constitute ordinary 111 negligence. The immunity provided in this subsection does not apply 112 to acts or omissions constituting gross, wilful or wanton negligence. 113 (e) (1) For purposes of this subsection, "cartridge injector" means an 114 automatic prefilled cartridge injector or similar automatic injectable 115 Substitute Bill No. 6146 LCO {\\PRDFS1\HCOUSERS\BARRYJN\WS\2019HB-06146- R02-HB.docx } 5 of 11 equipment used to deliver epinephrine in a standard dose for 116 emergency first aid response to allergic reactions. 117 (2) Any volunteer worker associated with, or any person employed 118 to work for, a program offered to children sixteen years of age or 119 younger by a corporation, other than a licensed health care provider, 120 that is exempt from federal income taxation under Section 501 of the 121 Internal Revenue Code of 1986, or any subsequent corresponding 122 internal revenue code of the United States, as from time to time 123 amended, who (A) has been trained in the use of a cartridge injector by 124 a licensed physician, physician assistant, advanced practice registered 125 nurse or registered nurse, (B) has obtained the consent of a parent or 126 legal guardian to use a cartridge injector on his or her child, and (C) 127 uses a cartridge injector on such child in apparent need thereof 128 participating in such program, shall not be liable to such child assisted 129 or to such child's parent or guardian for civil damages for any personal 130 injury or death which results from acts or omissions by such worker in 131 using a cartridge injector which may constitute ordinary negligence. 132 The immunity provided in this subsection does not apply to acts or 133 omissions constituting gross, wilful or wanton negligence. 134 (3) A corporation, other than a licensed health care provider, that is 135 exempt from federal income taxation under Section 501 of the Internal 136 Revenue Code of 1986, or any subsequent corresponding internal 137 revenue code of the United States, as from time to time amended, 138 which provides training in the use of cartridge injectors to any 139 volunteer worker granted immunity pursuant to subdivision (2) of this 140 subsection shall not be liable for civil damages for any injury sustained 141 by, or for the death of, a child sixteen years of age or younger who is 142 participating in a program offered by such corporation, which injury 143 or death results from acts or omissions by such worker in using a 144 cartridge injector, which may constitute ordinary negligence. The 145 immunity provided in this subsection does not apply to acts or 146 omissions constituting gross, wilful or wanton negligence. 147 (f) A teacher or other school personnel, on the school grounds or in 148 Substitute Bill No. 6146 LCO {\\PRDFS1\HCOUSERS\BARRYJN\WS\2019HB-06146- R02-HB.docx } 6 of 11 the school building or at a school function, who has completed both a 149 course in first aid in accordance with subsection (b) of this section and 150 a course given by the medical advisor of the school or by a licensed 151 physician in the administration of medication by injection, who 152 renders emergency care by administration of medication by injection 153 to a person in need thereof, shall not be liable to the person assisted for 154 civil damages for any injuries which result from acts or omissions by 155 the person in rendering the emergency care of administration of 156 medication by injection, which may constitute ordinary negligence. 157 The immunity provided in this subsection does not apply to acts or 158 omissions constituting gross, wilful or wanton negligence. 159 (g) The provisions of this section shall not be construed to require 160 any teacher or other school personnel to render emergency first aid or 161 administer medication by injection. 162 (h) Any person who has completed a course in first aid offered by 163 the American Red Cross, the American Heart Association, the National 164 Ski Patrol, the Department of Public Health, [or] any director of health 165 [, as] or by an organization with a substantially similar course in first 166 aid, as determined by the department, that is certified by the [agency] 167 organization or director of health offering the course, or has been 168 trained in the use of a cartridge injector by a licensed physician, 169 physician assistant, advanced practice registered nurse or registered 170 nurse, and who, voluntarily and gratuitously and other than in the 171 ordinary course of such person's employment or practice, renders 172 emergency assistance by using a cartridge injector on another person 173 in need thereof, or any person who is an identified staff member of a 174 before or after school program, day camp or child care facility, as 175 defined in section 19a-900, and who renders emergency assistance by 176 using a cartridge injector on another person in need thereof, shall not 177 be liable to such person assisted for civil damages for any personal 178 injuries which result from acts or omissions by such person in using a 179 cartridge injector, which may constitute ordinary negligence. The 180 immunity provided in this subsection does not apply to acts or 181 Substitute Bill No. 6146 LCO {\\PRDFS1\HCOUSERS\BARRYJN\WS\2019HB-06146- R02-HB.docx } 7 of 11 omissions constituting gross, wilful or wanton negligence. For the 182 purposes of this subsection, "cartridge injector" has the same meaning 183 as provided in subdivision (1) of subsection (e) of this section. 184 (i) A school bus driver, on or in the immediate vicinity of a school 185 bus during the provision of school transportation services, who 186 renders emergency care by administration of medication with a 187 cartridge injector to a student in need thereof who has a medically 188 diagnosed allergic condition that may require prompt treatment in 189 order to protect the student against serious harm or death, shall not be 190 liable to the student assisted for civil damages for any injuries which 191 result from acts or omissions by the school bus driver in rendering the 192 emergency care of administration of medication with a cartridge 193 injector, which may constitute ordinary negligence. The immunity 194 provided in this subsection does not apply to acts or omissions 195 constituting gross, wilful or wanton negligence. For the purposes of 196 this subsection, "cartridge injector" has the same meaning as provided 197 in subdivision (1) of subsection (e) of this section. 198 Sec. 4. Subsection (b) of section 10a-55l of the general statutes is 199 repealed and the following is substituted in lieu thereof (Effective 200 October 1, 2019): 201 (b) Each athletic department of an institution of higher education 202 shall (1) (A) provide and maintain in a central location that is not more 203 than one-quarter mile from the premises used by the athletic 204 department at least one automatic external defibrillator, as defined in 205 section 19a-175, and (B) make such central location known and 206 accessible to employees and student-athletes of such institution of 207 higher education during all hours of intercollegiate sport practice, 208 training and competition, (2) ensure that at least one licensed athletic 209 trainer or other person who is trained in cardiopulmonary 210 resuscitation and the use of an automatic external defibrillator in 211 accordance with the standards set forth by the American Red Cross, 212 [or] American Heart Association or an organization with substantially 213 similar standards, as determined by the Department of Public Health, 214 Substitute Bill No. 6146 LCO {\\PRDFS1\HCOUSERS\BARRYJN\WS\2019HB-06146- R02-HB.docx } 8 of 11 is on the premises used by the athletic department during all hours of 215 intercollegiate sport practice, training and competition, (3) maintain 216 and test the automatic external defibrillator in accordance with the 217 manufacturer's guidelines, and (4) promptly notify a local emergency 218 medical services provider after each use of such automatic external 219 defibrillator. As used in this section, "the premises used by the athletic 220 department" means those premises that are used for intercollegiate 221 sport practice, training or competition and may include, but need not 222 be limited to, an athletic building or room, gymnasium, athletic field or 223 stadium; and "intercollegiate sport" means a sport played at the 224 collegiate level for which eligibility requirements for participation by a 225 student-athlete are established by a national association for the 226 promotion or regulation of collegiate athletics. 227 Sec. 5. Subsection (a) of section 19a-79 of the general statutes is 228 repealed and the following is substituted in lieu thereof (Effective 229 October 1, 2019): 230 (a) The Commissioner of Early Childhood shall adopt regulations, 231 in accordance with the provisions of chapter 54, to carry out the 232 purposes of sections 19a-77 to 19a-80, inclusive, and 19a-82 to 19a-87, 233 inclusive, and to assure that child care centers and group child care 234 homes meet the health, educational and social needs of children 235 utilizing such child care centers and group child care homes. Such 236 regulations shall (1) specify that before being permitted to attend any 237 child care center or group child care home, each child shall be 238 protected as age-appropriate by adequate immunization against 239 diphtheria, pertussis, tetanus, poliomyelitis, measles, mumps, rubella, 240 hemophilus influenzae type B and any other vaccine required by the 241 schedule of active immunization adopted pursuant to section 19a-7f, 242 including appropriate exemptions for children for whom such 243 immunization is medically contraindicated and for children whose 244 parents or guardian objects to such immunization on religious 245 grounds, and that any objection by parents or a guardian to 246 immunization of a child on religious grounds shall be accompanied by 247 Substitute Bill No. 6146 LCO {\\PRDFS1\HCOUSERS\BARRYJN\WS\2019HB-06146- R02-HB.docx } 9 of 11 a statement from such parents or guardian that such immunization 248 would be contrary to the religious beliefs of such child or the parents 249 or guardian of such child, which statement shall be acknowledged, in 250 accordance with the provisions of sections 1-32, 1-34 and 1-35, by (A) a 251 judge of a court of record or a family support magistrate, (B) a clerk or 252 deputy clerk of a court having a seal, (C) a town clerk, (D) a notary 253 public, (E) a justice of the peace, or (F) an attorney admitted to the bar 254 of this state, (2) specify conditions under which child care center 255 directors and teachers and group child care home providers may 256 administer tests to monitor glucose levels in a child with diagnosed 257 diabetes mellitus, and administer medicinal preparations, including 258 controlled drugs specified in the regulations by the commissioner, to a 259 child receiving child care services at such child care center or group 260 child care home pursuant to the written order of a physician licensed 261 to practice medicine or a dentist licensed to practice dental medicine in 262 this or another state, or an advanced practice registered nurse licensed 263 to prescribe in accordance with section 20-94a, or a physician assistant 264 licensed to prescribe in accordance with section 20-12d, and the written 265 authorization of a parent or guardian of such child, (3) specify that an 266 operator of a child care center or group child care home, licensed 267 before January 1, 1986, or an operator who receives a license after 268 January 1, 1986, for a facility licensed prior to January 1, 1986, shall 269 provide a minimum of thirty square feet per child of total indoor 270 usable space, free of furniture except that needed for the children's 271 purposes, exclusive of toilet rooms, bathrooms, coatrooms, kitchens, 272 halls, isolation room or other rooms used for purposes other than the 273 activities of the children, (4) specify that a child care center or group 274 child care home licensed after January 1, 1986, shall provide thirty-five 275 square feet per child of total indoor usable space, (5) establish 276 appropriate child care center staffing requirements for employees 277 certified in cardiopulmonary resuscitation by the American Red Cross, 278 the American Heart Association, the National Safety Council, 279 American Safety and H ealth Institute, [or] Medic First Aid 280 International, Inc. or an organization with substantially similar 281 cardiopulmonary resuscitation certification requirements, as 282 Substitute Bill No. 6146 LCO {\\PRDFS1\HCOUSERS\BARRYJN\WS\2019HB-06146- R02-HB.docx } 10 of 11 determined by the Department of Public Health, (6) specify that on 283 and after January 1, 2003, a child care center or group child care home 284 (A) shall not deny services to a child on the basis of a child's known or 285 suspected allergy or because a child has a prescription for an 286 automatic prefilled cartridge injector or similar automatic injectable 287 equipment used to treat an allergic reaction, or for injectable 288 equipment used to administer glucagon, (B) shall, not later than three 289 weeks after such child's enrollment in such a center or home, have staff 290 trained in the use of such equipment on-site during all hours when 291 such a child is on-site, (C) shall require such child's parent or guardian 292 to provide the injector or injectable equipment and a copy of the 293 prescription for such medication and injector or injectable equipment 294 upon enrollment of such child, and (D) shall require a parent or 295 guardian enrolling such a child to replace such medication and 296 equipment prior to its expiration date, (7) specify that on and after 297 January 1, 2005, a child care center or group child care home (A) shall 298 not deny services to a child on the basis of a child's diagnosis of 299 asthma or because a child has a prescription for an inhalant medication 300 to treat asthma, and (B) shall, not later than three weeks after such 301 child's enrollment in such a center or home, have staff trained in the 302 administration of such medication on-site during all hours when such 303 a child is on-site, and (8) establish physical plant requirements for 304 licensed child care centers and licensed group child care homes that 305 exclusively serve school-age children. When establishing such 306 requirements, the Office of Early Childhood shall give consideration to 307 child care centers and group child care homes that are located in 308 private or public school buildings. With respect to this subdivision 309 only, the commissioner shall implement policies and procedures 310 necessary to implement the physical plant requirements established 311 pursuant to this subdivision while in the process of adopting such 312 policies and procedures in regulation form. Until replaced by policies 313 and procedures implemented pursuant to this subdivision, any 314 physical plant requirement specified in the office's regulations that is 315 generally applicable to child care centers and group child care homes 316 shall continue to be applicable to such centers and homes that 317 Substitute Bill No. 6146 LCO {\\PRDFS1\HCOUSERS\BARRYJN\WS\2019HB-06146- R02-HB.docx } 11 of 11 exclusively serve school-age children. The commissioner shall print 318 notice of the intent to adopt regulations pursuant to this subdivision in 319 the Connecticut Law Journal not later than twenty days after the date 320 of implementation of such policies and procedures. Policies and 321 procedures implemented pursuant to this subdivision shall be valid 322 until the time final regulations are adopted. 323 This act shall take effect as follows and shall amend the following sections: Section 1 October 1, 2019 19a-113a Sec. 2 October 1, 2019 19a-197b Sec. 3 October 1, 2019 52-557b Sec. 4 October 1, 2019 10a-55l(b) Sec. 5 October 1, 2019 19a-79(a) PH Joint Favorable Subst.