Connecticut 2019 Regular Session

Connecticut Senate Bill SB00807 Compare Versions

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	7	+	General Assembly Substitute Bill No. 807
	8	+	January Session, 2019
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4		-	Substitute Senate Bill No. 807
5		-
6		-	Public Act No. 19-56
7	12
8	13
9	14		AN ACT CONCERNING TH E LEGISLATIVE COMMISSIONERS'
10	15		RECOMMENDATIONS FOR REVISIONS TO THE PUBLIC HEALTH
11		-	STATUTES~~, DENTAL ASS ISTANTS AND DENTAL THERAPY~~.
	16	+	STATUTES.
12	17		Be it enacted by the Senate and House of Representatives in General
13	18		Assembly convened:
14	19
15		-	Section 1. Subsection (b) of section 10a-109gg of the general statutes
16		-	is repealed and the following is substituted in lieu thereof (Effective
17		-	from passage):
18		-	(b) The proceeds of the sale of the bond issuance described in
19		-	subsection (a) of this section shall be used by the Office of Policy and
20		-	Management, in consultation with the chairperson of the Board of
21		-	Trustees of the university, for the purpose of the UConn health
22		-	network initiatives in the following manner: (1) Five million dollars of
23		-	such proceeds shall be used by Hartford Hospital to develop a
24		-	simulation and conference center on the Hartford Hospital campus to
25		-	be run exclusively by Hartford Hospital; [,] (2) five million dollars of
26		-	such proceeds shall be used to fulfill the initiative for a primary care
27		-	institute on the Saint Francis Hospital and Medical Center campus; [,]
28		-	(3) five million dollars of such proceeds shall be used to fulfill the
29		-	initiatives for a comprehensive cancer center and The University of
30		-	Connecticut-sponsored health disparities institute; (4) five million
31		-	dollars of such proceeds shall be used to fulfill the initiatives for the Substitute Senate Bill No. 807
32		-
33		-	Public Act No. 19-56 2 of 24
34		-
35		-	planning, design, land acquisition, development and construction of
36		-	(A) a cancer treatment center to be constructed by, or in partnership
37		-	with, The Hospital of Central Connecticut, provided such cancer
38		-	treatment center is located entirely within the legal boundaries of the
39		-	city of New Britain, (B) renovations and upgrades to the oncology unit
40		-	at The Hospital of Central Connecticut, and (C) if certificate of need
41		-	approval is received, a Permanent Regional Phase One Clinical Trials
42		-	Unit located at The Hospital of Central Connecticut in New Britain;
43		-	and (5) two million dollars of such proceeds shall be used to fulfill the
44		-	initiatives for patient room renovations at Bristol Hospital. In the event
45		-	that the cancer treatment center authorized pursuant to subdivision (4)
46		-	of this subsection is built in whole or in part outside the legal
47		-	boundaries of the city of New Britain, The Hospital of Central
48		-	Connecticut shall repay the entire amount of the proceeds used to
49		-	fulfill the initiatives for the planning, design, development and
50		-	construction of such center.
51		-	Sec. 2. Subsection (a) of section 17a-217a of the general statutes is
52		-	repealed and the following is substituted in lieu thereof (Effective from
53		-	passage):
54		-	(a) There shall be a Camp Harkness Advisory Committee to advise
55		-	the Commissioner of Developmental Services with respect to issues
56		-	concerning the health and safety of persons who attend and utilize the
57		-	facilities at Camp Harkness. The advisory committee shall be
58		-	composed of twelve members as follows: (1) Six members appointed
59		-	by the Governor, one of whom shall be the director of Camp Harkness,
60		-	who shall serve ex officio, one of whom shall represent the
61		-	Southeastern Connecticut Association for Developmental Disabilities,
62		-	one of whom shall represent the Southbury Training School, one of
63		-	whom shall represent the Arc of New London County, one of whom
64		-	[who is] shall be a person who uses the camp on a residential basis and
65		-	one of whom [is] shall be a relative or guardian of a person who uses Substitute Senate Bill No. 807
66		-
67		-	Public Act No. 19-56 3 of 24
68		-
69		-	the camp; and (2) six members appointed by the General Assembly,
70		-	one of whom shall be a relative or guardian of a person who uses the
71		-	camp, who shall be appointed by the president pro tempore of the
72		-	Senate; one of whom shall be a member of the Family Support Council
73		-	established pursuant to section 17a-219c and represent persons who
74		-	use the camp on a day basis, who shall be appointed by the speaker of
75		-	the House of Representatives; one of whom shall represent the board
76		-	of selectmen of the town of Waterford, who shall be appointed by the
77		-	majority leader of the House of Representatives; one of whom shall
78		-	represent a private nonprofit corporation that is: (A) Tax exempt under
79		-	Section 501(c)(3) of the Internal Revenue Code of 1986, or any
80		-	subsequent internal revenue code of the United States, as amended
81		-	from time to time, and (B) established to promote and support Camp
82		-	Harkness and its camping programs, who shall be appointed by the
83		-	majority leader of the Senate; one of whom shall represent the
84		-	Connecticut Institute for the Blind and the Oak Hill School, who shall
85		-	be appointed by the minority leader of the House of Representatives;
86		-	and one of whom shall represent the United Cerebral Palsy
87		-	Association, who shall be appointed by the minority leader of the
88		-	Senate.
89		-	Sec. 3. Subsection (c) of section 17b-337 of the general statutes is
90		-	repealed and the following is substituted in lieu thereof (Effective from
91		-	passage):
92		-	(c) The Long-Term Care Planning Committee shall consist of: (1)
93		-	The chairpersons and ranking members of the joint standing
94		-	committees of the General Assembly having cognizance of matters
95		-	relating to human services, public health, elderly services and long-
96		-	term care; (2) the Commissioner of Social Services, or the
97		-	commissioner's designee; (3) one member of the Office of Policy and
98		-	Management appointed by the Secretary of the Office of Policy and
99		-	Management; (4) one member from the Department of Public Health Substitute Senate Bill No. 807
100		-
101		-	Public Act No. 19-56 4 of 24
102		-
103		-	appointed by the Commissioner of Public Health; (5) one member
104		-	from the Department of Housing appointed by the Commissioner of
105		-	Housing; (6) one member from the Department of Developmental
106		-	Services appointed by the Commissioner of Developmental Services;
107		-	(7) one member from the Department of Mental Health and Addiction
108		-	Services appointed by the Commissioner of Mental Health and
109		-	Addiction Services; (8) one member from the Depart ment of
110		-	Transportation appointed by the Commissioner of Transportation; (9)
111		-	one member from the Department of Children and Families appointed
112		-	by the Commissioner of Children and Families; [and] (10) one member
113		-	from the Health Systems Planning Unit of the Office of Health Strategy
114		-	appointed by the executive director of the Office of Health Strategy;
115		-	and (11) one member from the Department of Rehabilitation Services
116		-	appointed by the Commissioner of Rehabilitation Services. The
117		-	committee shall convene no later than ninety days after June 4, 1998.
118		-	Any vacancy shall be filled by the appointing authority. The
119		-	chairperson shall be elected from among the members of the
120		-	committee. The committee shall seek the advice and participation of
121		-	any person, organization or state or federal agency it deems necessary
122		-	to carry out the provisions of this section.
123		-	Sec. 4. Subsection (d) of section 19a-36i of the general statutes is
124		-	repealed and the following is substituted in lieu thereof (Effective from
125		-	passage):
126		-	(d) Each class 2 food establishment, class 3 food establishment and
127		-	class 4 food establishment shall employ a certified food protection
128		-	manager. No person shall serve as a certified food protection manager
129		-	unless such person has satisfactorily passed a test as part of a food
130		-	protection manager certification program that is evaluated and
131		-	approved by an accrediting agency recognized by the Conference for
132		-	Food Protection as conforming to its standards for accreditation of
133		-	food protection manager certification programs. A certified food Substitute Senate Bill No. 807
134		-
135		-	Public Act No. 19-56 5 of 24
136		-
137		-	inspector shall verify that the food protection manager is certified
138		-	upon inspection of the food establishment. The owner or manager of
139		-	the food service establishment shall designate an alternate person or
140		-	persons to be in charge at all times when the certified food protection
141		-	manager cannot be present. The alternate person or persons in charge
142		-	shall be responsible for ensuring the following: [(A)] (1) All employees
143		-	are in compliance with the requirements of this section; [(B)] (2) foods
144		-	are safely prepared in accordance with the requirements of the food
145		-	code; [(C)] (3) emergencies are managed properly; [(D)] (4) a food
146		-	inspector is admitted into the food establishment upon request; and
147		-	[(E)] (5) he or she receives and signs inspection reports.
148		-	Sec. 5. Subsection (c) of section 19a-59i of the general statutes is
149		-	repealed and the following is substituted in lieu thereof (Effective from
150		-	passage):
151		-	(c) The maternal mortality review committee may include, but need
152		-	not be limited to, any of the following members, as needed, depending
153		-	on the maternal death case being reviewed:
154		-	(1) A physician licensed pursuant to chapter 370 who specializes in
155		-	obstetrics and gynecology, appointed by the Connecticut State Medical
156		-	Society;
157		-	(2) A physician licensed pursuant to chapter 370 who is a
158		-	pediatrician, appointed by the Connecticut State Medical Society;
159		-	(3) A community health worker, appointed by the Commission on
160		-	Equity and Opportunity;
161		-	(4) A nurse-midwife licensed pursuant to chapter 377, appointed by
162		-	the Connecticut Nurses Association;
163		-	(5) A clinical social worker licensed pursuant to chapter 383b,
164		-	appointed by the Connecticut Chapter of the National Association of Substitute Senate Bill No. 807
165		-
166		-	Public Act No. 19-56 6 of 24
167		-
168		-	Social Workers;
169		-	(6) A psychiatrist licensed pursuant to chapter 370, appointed by the
170		-	Connecticut Psychiatric Society;
171		-	(7) A psychologist licensed pursuant to chapter 20-136, appointed
172		-	by the Connecticut Psychological Association;
173		-	(8) The Chief Medical Examiner, or the Chief Medical Examiner's
174		-	designee;
175		-	(9) A member of the Connecticut Hospital Association;
176		-	(10) A representative of a community or regional program or facility
177		-	providing services for persons with psychiatric disabilities or persons
178		-	with substance use disorders, appointed by the Commissioner of
179		-	Public Health;
180		-	(11) A representative of The University of Connecticut-sponsored
181		-	health disparities institute; or
182		-	(12) Any additional member the cochairpersons determine would be
183		-	beneficial to serve as a member of the committee.
184		-	Sec. 6. Subparagraphs (D) and (E) of subdivision (8) of section 19a-
185		-	177 of the general statutes are repealed and the following is substituted
186		-	in lieu thereof (Effective from passage):
187		-	(D) The commissioner shall collect the data required by
188		-	subparagraph (A) of this subdivision, in the manner provided in said
189		-	subparagraph, from each emergency medical service organization
190		-	licensed or certified pursuant to this chapter. Any such emergency
191		-	medical service organization that fails to comply with the provisions of
192		-	this section shall be liable for a civil penalty not to exceed one hundred
193		-	dollars per day for each failure to report the required data regarding
194		-	emergency medical services provided to a patient, as determined by Substitute Senate Bill No. 807
195		-
196		-	Public Act No. 19-56 7 of 24
197		-
198		-	the commissioner. The civil penalties set forth in this subparagraph
199		-	shall be assessed only after the department provides a written notice of
200		-	deficiency and the organization is afforded the opportunity to respond
201		-	to such notice. An organization shall have not more than fifteen
202		-	business days after the date of receiving such notice to provide a
203		-	written response to the department. The commissioner may adopt
204		-	regulations, in accordance with chapter 54, concerning the
205		-	development, implementation, monitoring and collection of
206		-	emergency medical service system data. All state agencies licensed or
207		-	certified as emergency medical service organizations shall be exempt
208		-	from the civil penalties set forth in this subparagraph. [;]
209		-	(E) The commissioner shall, with the recommendation of the
210		-	Connecticut Emergency Medical Services Advisory Board established
211		-	pursuant to section 19a-178a, adopt for use in trauma data collection
212		-	the most recent version of the National Trauma Data Bank's National
213		-	Trauma Data Standards and Data Dictionary and nationally
214		-	recognized guidelines for field triage of injured patients; [.]
215		-	Sec. 7. Section 19a-575 of the general statutes is repealed and the
216		-	following is substituted in lieu thereof (Effective from passage):
217		-	Any person eighteen years of age or older may execute a document
218		-	that contains directions as to any aspect of health care, including the
219		-	withholding or withdrawal of life support systems. Such document
220		-	shall be signed and dated by the maker with at least two witnesses and
221		-	may be in substantially the following form:
222		-	DOCUMENT CONCERNING HEALTH CARE AND
223		-	WITHHOLDING OR WITHDRAWAL OF LIFE SUPPORT SYSTEMS.
224		-	If the time comes when I am incapacitated to the point when I can
225		-	no longer actively take part in decisions for my own life, and am
226		-	unable to direct my physician or advanced practice registered nurse as Substitute Senate Bill No. 807
227		-
228		-	Public Act No. 19-56 8 of 24
229		-
230		-	to my own medical care, I wish this statement to stand as a testament
231		-	of my wishes.
232		-	"I, .... (Name), request that, if my condition is deemed terminal or if
233		-	it is determined that I will be permanently unconscious, I be allowed to
234		-	die and not be kept alive through life support systems. By terminal
235		-	condition, I mean that I have an incurable or irreversible medical
236		-	condition which, without the administration of life support systems,
237		-	will, in the opinion of my attending physician or advanced practice
238		-	registered nurse, result in death within a relatively short time. By
239		-	permanently unconscious I mean that I am in a permanent coma or
240		-	persistent vegetative state which is an irreversible condition in which I
241		-	am at no time aware of myself or the environment and show no
242		-	behavioral response to the environment. The life support systems
243		-	which I do not want include, but are not limited to:
244		-	Artificial respiration
245		-	Cardiopulmonary resuscitation
246		-	Artificial means of providing nutrition and hydration
247		-
248		-	(Cross out and initial life support systems you want administered)
249		-	I do not intend any direct taking of my life, but only that my dying
250		-	not be unreasonably prolonged.
251		-	If I am pregnant:
252		-	(Place a check to indicate option (1) or (2) or specify alternative
253		-	instructions after (3))
254		-	.... (1) I intend to accept life support systems if my doctor
255		-	believes that doing so would allow my fetus to reach a live birth.
256		-	.... (2) I intend this document to apply without modifications.
257		-	(3) I intend this document to apply as follows: …." Substitute Senate Bill No. 807
258		-
259		-	Public Act No. 19-56 9 of 24
	20	+	Section 1. Subsection (b) of section 10a-109gg of the general statutes 1
	21	+	is repealed and the following is substituted in lieu thereof (Effective 2
	22	+	from passage): 3
	23	+	(b) The proceeds of the sale of the bond issuance described in 4
	24	+	subsection (a) of this section shall be used by the Office of Policy and 5
	25	+	Management, in consultation with the chairperson of the Board of 6
	26	+	Trustees of the university, for the purpose of the UConn health 7
	27	+	network initiatives in the following manner: (1) Five million dollars of 8
	28	+	such proceeds shall be used by Hartford Hospital to develop a 9
	29	+	simulation and conference center on the Hartford Hospital campus to 10
	30	+	be run exclusively by Hartford Hospital; [,] (2) five million dollars of 11
	31	+	such proceeds shall be used to fulfill the initiative for a primary care 12
	32	+	institute on the Saint Francis Hospital and Medical Center campus; [,] 13
	33	+	(3) five million dollars of such proceeds shall be used to fulfill the 14
	34	+	initiatives for a comprehensive cancer center and The University of 15
	35	+	Connecticut-sponsored health disparities institute; (4) five million 16
	36	+	dollars of such proceeds shall be used to fulfill the initiatives for the 17
	37	+	planning, design, land acquisition, development and construction of 18 Substitute Bill No. 807
260	38
261	39
262		-	Other specific requests:
263		-	"This request is made, after careful reflection, while I am of sound
264		-	mind."
265		-	.... (Signature)
266		-	.... (Date)
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268		-	This document was signed in our presence, by the above-named ....
269		-	(Name) who appeared to be eighteen years of age or older, of sound
270		-	mind and able to understand the nature and consequences of health
271		-	care decisions at the time the document was signed.
272		-	.... (Witness)
273		-	.... (Address)
274		-	.... (Witness)
275		-	.... (Address)
276		-
277		-	Sec. 8. Subsection (a) of section 19a-575a of the general statutes is
278		-	repealed and the following is substituted in lieu thereof (Effective from
279		-	passage):
280		-	(a) Any person eighteen years of age or older may execute a
281		-	document that contains health care instructions, the appointment of a
282		-	health care representative, the designation of a conservator of the
283		-	person for future incapacity and a document of anatomical gift. Any
284		-	such document shall be signed and dated by the maker with at least
285		-	two witnesses and may be in the substantially following form:
286		-	THESE ARE MY HEALTH CARE INSTRUCTIONS.
287		-	MY APPOINTMENT OF A HEALTH CARE REPRESENTATIVE,
288		-	THE DESIGNATION OF MY CONSERVATOR OF THE PERSON Substitute Senate Bill No. 807
289		-
290		-	Public Act No. 19-56 10 of 24
291		-
292		-	FOR MY FUTURE INCAPACITY
293		-	AND
294		-	MY DOCUMENT OF ANATOMICAL GIFT
295		-	To any physician or advanced practice registered nurse who is
296		-	treating me: These are my health care instructions including those
297		-	concerning the withholding or withdrawal of life support systems,
298		-	together with the appointment of my health care representative, the
299		-	designation of my conservator of the person for future incapacity and
300		-	my document of anatomical gift. As my physician or advanced
301		-	practice registered nurse, you may rely on these health care
302		-	instructions and any decision made by my health care representative
303		-	or conservator of my person, if I am incapacitated to the point when I
304		-	can no longer actively take part in decisions for my own life, and am
305		-	unable to direct my physician or advanced practice registered nurse as
306		-	to my own medical care.
307		-	I, ...., the author of this document, request that, if my condition is
308		-	deemed terminal or if I am determined to be permanently
309		-	unconscious, I be allowed to die and not be kept alive through life
310		-	support systems. By terminal condition, I mean that I have an
311		-	incurable or irreversible medical condition which, without the
312		-	administration of life support systems, will, in the opinion of my
313		-	attending physician or advanced practice registered nurse, result in
314		-	death within a relatively short time. By permanently unconscious I
315		-	mean that I am in a permanent coma or persistent vegetative state
316		-	which is an irreversible condition in which I am at no time aware of
317		-	myself or the environment and show no behavioral response to the
318		-	environment. The life support systems which I do not want include,
319		-	but are not limited to: Artificial respiration, cardiopulmonary
320		-	resuscitation and artificial means of providing nutrition and hydration.
321		-	I do want sufficient pain medication to maintain my physical comfort. Substitute Senate Bill No. 807
322		-
323		-	Public Act No. 19-56 11 of 24
324		-
325		-	I do not intend any direct taking of my life, but only that my dying not
326		-	be unreasonably prolonged.
327		-	If I am pregnant:
328		-	(Place a check to indicate option (1) or (2) or specify alternative
329		-	instructions after (3))
330		-	.... (1) I intend to accept life support systems if my doctor
331		-	believes that doing so would allow my fetus to reach a live
332		-	birth.
333		-	.... (2) I intend this document to apply without modifications.
334		-	(3) I intend this document to apply as follows: ....
335		-
336		-	I appoint .... to be my health care representative. If my attending
337		-	physician or advanced practice registered nurse determines that I am
338		-	unable to understand and appreciate the nature and consequences of
339		-	health care decisions and unable to reach and communicate an
340		-	informed decision regarding treatment, my health care representative
341		-	is authorized to make any and all health care decisions for me,
342		-	including (1) the decision to accept or refuse any treatment, service or
343		-	procedure used to diagnose or treat my physical or mental condition,
344		-	except as otherwise provided by law such as for psychosurgery or
345		-	shock therapy, as defined in section 17a-540, and (2) the decision to
346		-	provide, withhold or withdraw life support systems. I direct my health
347		-	care representative to make decisions on my behalf in accordance with
348		-	my wishes, as stated in this document or as otherwise known to my
349		-	health care representative. In the event my wishes are not clear or a
350		-	situation arises that I did not anticipate, my health care representative
351		-	may make a decision in my best interests, based upon what is known
352		-	of my wishes.
353		-	If .... is unwilling or unable to serve as my health care
354		-	representative, I appoint .... to be my alternative health care Substitute Senate Bill No. 807
355		-
356		-	Public Act No. 19-56 12 of 24
357		-
358		-	representative.
359		-	If a conservator of my person should need to be appointed, I
360		-	designate .... be appointed my conservator. If .... is unwilling or unable
361		-	to serve as my conservator, [I designate ....] I designate .... to be
362		-	successor conservator. No bond shall be required of either of them in
363		-	any jurisdiction.
364		-	I hereby make this anatomical gift, if medically acceptable, to take
365		-	effect upon my death.
366		-	I give: (check one)
367		-	.... (1) any needed organs or parts
368		-	.... (2) only the following organs or parts ….
369		-
370		-	to be donated for: (check one)
371		-	(1) .... any of the purposes stated in subsection (a) of section 19a-289j
372		-	(2) .... these limited purposes ....
373		-
374		-	These requests, appointments, and designations are made after
375		-	careful reflection, while I am of sound mind. Any party receiving a
376		-	duly executed copy or facsimile of this document may rely upon it
377		-	unless such party has received actual notice of my revocation of it.
378		-	Date ...., 20..
379		-	.... L.S.
380		-
381		-	This document was signed in our presence by .... the author of this
382		-	document, who appeared to be eighteen years of age or older, of sound
383		-	mind and able to understand the nature and consequences of health
384		-	care decisions at the time this document was signed. The author
385		-	appeared to be under no improper influence. We have subscribed this
386		-	document in the author's presence and at the author's request and in Substitute Senate Bill No. 807
387		-
388		-	Public Act No. 19-56 13 of 24
389		-
390		-	the presence of each other.
391		-	.... ....
392		-	(Witness) (Witness)
393		-	.... ....
394		-	(Number and Street) (Number and Street)
395		-	.... ....
396		-	(City, State and Zip Code) (City, State and Zip Code)
	44	+	(A) a cancer treatment center to be constructed by, or in partnership 19
	45	+	with, The Hospital of Central Connecticut, provided such cancer 20
	46	+	treatment center is located entirely within the legal boundaries of the 21
	47	+	city of New Britain, (B) renovations and upgrades to the oncology unit 22
	48	+	at The Hospital of Central Connecticut, and (C) if certificate of need 23
	49	+	approval is received, a Permanent Regional Phase One Clinical Trials 24
	50	+	Unit located at The Hospital of Central Connecticut in New Britain; 25
	51	+	and (5) two million dollars of such proceeds shall be used to fulfill the 26
	52	+	initiatives for patient room renovations at Bristol Hospital. In the event 27
	53	+	that the cancer treatment center authorized pursuant to subdivision (4) 28
	54	+	of this subsection is built in whole or in part outside the legal 29
	55	+	boundaries of the city of New Britain, The Hospital of Central 30
	56	+	Connecticut shall repay the entire amount of the proceeds used to 31
	57	+	fulfill the initiatives for the planning, design, development and 32
	58	+	construction of such center. 33
	59	+	Sec. 2. Subsection (a) of section 17a-217a of the general statutes is 34
	60	+	repealed and the following is substituted in lieu thereof (Effective from 35
	61	+	passage): 36
	62	+	(a) There shall be a Camp Harkness Advisory Committee to advise 37
	63	+	the Commissioner of Developmental Services with respect to issues 38
	64	+	concerning the health and safety of persons who attend and utilize the 39
	65	+	facilities at Camp Harkness. The advisory committee shall be 40
	66	+	composed of twelve members as follows: (1) Six members appointed 41
	67	+	by the Governor, one of whom shall be the director of Camp Harkness, 42
	68	+	who shall serve ex officio, one of whom shall represent the 43
	69	+	Southeastern Connecticut Association for Developmental Disabilities, 44
	70	+	one of whom shall represent the Southbury Training School, one of 45
	71	+	whom shall represent the Arc of New London County, one of whom 46
	72	+	[who is] shall be a person who uses the camp on a residential basis and 47
	73	+	one of whom [is] shall be a relative or guardian of a person who uses 48
	74	+	the camp; and (2) six members appointed by the General Assembly, 49
	75	+	one of whom shall be a relative or guardian of a person who uses the 50
	76	+	camp, who shall be appointed by the president pro tempore of the 51 Substitute Bill No. 807
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	83	+	Senate; one of whom shall be a member of the Family Support Council 52
	84	+	established pursuant to section 17a-219c and represent persons who 53
	85	+	use the camp on a day basis, who shall be appointed by the speaker of 54
	86	+	the House of Representatives; one of whom shall represent the board 55
	87	+	of selectmen of the town of Waterford, who shall be appointed by the 56
	88	+	majority leader of the House of Representatives; one of whom shall 57
	89	+	represent a private nonprofit corporation that is: (A) Tax exempt under 58
	90	+	Section 501(c)(3) of the Internal Revenue Code of 1986, or any 59
	91	+	subsequent internal revenue code of the United States, as amended 60
	92	+	from time to time, and (B) established to promote and support Camp 61
	93	+	Harkness and its camping programs, who shall be appointed by the 62
	94	+	majority leader of the Senate; one of whom shall represent the 63
	95	+	Connecticut Institute for the Blind and the Oak Hill School, who shall 64
	96	+	be appointed by the minority leader of the House of Representatives; 65
	97	+	and one of whom shall represent the United Cerebral Palsy 66
	98	+	Association, who shall be appointed by the minority leader of the 67
	99	+	Senate. 68
	100	+	Sec. 3. Subsection (c) of section 17b-337 of the general statutes is 69
	101	+	repealed and the following is substituted in lieu thereof (Effective from 70
	102	+	passage): 71
	103	+	(c) The Long-Term Care Planning Committee shall consist of: (1) 72
	104	+	The chairpersons and ranking members of the joint standing 73
	105	+	committees of the General Assembly having cognizance of matters 74
	106	+	relating to human services, public health, elderly services and long-75
	107	+	term care; (2) the Commissioner of Social Services, or the 76
	108	+	commissioner's designee; (3) one member of the Office of Policy and 77
	109	+	Management appointed by the Secretary of the Office of Policy and 78
	110	+	Management; (4) one member from the Department of Public Health 79
	111	+	appointed by the Commissioner of Public Health; (5) one member 80
	112	+	from the Department of Housing appointed by the Commissioner of 81
	113	+	Housing; (6) one member from the Department of Developmental 82
	114	+	Services appointed by the Commissioner of Developmental Services; 83
	115	+	(7) one member from the Department of Mental Health and Addiction 84 Substitute Bill No. 807
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	121	+
	122	+	Services appointed by the Commissioner of Mental Health and 85
	123	+	Addiction Services; (8) one member from the Department of 86
	124	+	Transportation appointed by the Commissioner of Transportation; (9) 87
	125	+	one member from the Department of Children and Families appointed 88
	126	+	by the Commissioner of Children and Families; [and] (10) one member 89
	127	+	from the Health Systems Planning Unit of the Office of Health Strategy 90
	128	+	appointed by the executive director of the Office of Health Strategy; 91
	129	+	and (11) one member from the Department of Rehabilitation Services 92
	130	+	appointed by the Commissioner of Rehabilitation Services. The 93
	131	+	committee shall convene no later than ninety days after June 4, 1998. 94
	132	+	Any vacancy shall be filled by the appointing authority. The 95
	133	+	chairperson shall be elected from among the members of the 96
	134	+	committee. The committee shall seek the advice and participation of 97
	135	+	any person, organization or state or federal agency it deems necessary 98
	136	+	to carry out the provisions of this section. 99
	137	+	Sec. 4. Subsection (d) of section 19a-36i of the general statutes is 100
	138	+	repealed and the following is substituted in lieu thereof (Effective from 101
	139	+	passage): 102
	140	+	(d) Each class 2 food establishment, class 3 food establishment and 103
	141	+	class 4 food establishment shall employ a certified food protection 104
	142	+	manager. No person shall serve as a certified food protection manager 105
	143	+	unless such person has satisfactorily passed a test as part of a food 106
	144	+	protection manager certification program that is evaluated and 107
	145	+	approved by an accrediting agency recognized by the Conference for 108
	146	+	Food Protection as conforming to its standards for accreditation of 109
	147	+	food protection manager certification programs. A certified food 110
	148	+	inspector shall verify that the food protection manager is certified 111
	149	+	upon inspection of the food establishment. The owner or manager of 112
	150	+	the food service establishment shall designate an alternate person or 113
	151	+	persons to be in charge at all times when the certified food protection 114
	152	+	manager cannot be present. The alternate person or persons in charge 115
	153	+	shall be responsible for ensuring the following: [(A)] (1) All employees 116
	154	+	are in compliance with the requirements of this section; [(B)] (2) foods 117 Substitute Bill No. 807
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	161	+	are safely prepared in accordance with the requirements of the food 118
	162	+	code; [(C)] (3) emergencies are managed properly; [(D)] (4) a food 119
	163	+	inspector is admitted into the food establishment upon request; and 120
	164	+	[(E)] (5) he or she receives and signs inspection reports. 121
	165	+	Sec. 5. Subsection (c) of section 19a-59i of the general statutes is 122
	166	+	repealed and the following is substituted in lieu thereof (Effective from 123
	167	+	passage): 124
	168	+	(c) The maternal mortality review committee may include, but need 125
	169	+	not be limited to, any of the following members, as needed, depending 126
	170	+	on the maternal death case being reviewed: 127
	171	+	(1) A physician licensed pursuant to chapter 370 who specializes in 128
	172	+	obstetrics and gynecology, appointed by the Connecticut State Medical 129
	173	+	Society; 130
	174	+	(2) A physician licensed pursuant to chapter 370 who is a 131
	175	+	pediatrician, appointed by the Connecticut State Medical Society; 132
	176	+	(3) A community health worker, appointed by the Commission on 133
	177	+	Equity and Opportunity; 134
	178	+	(4) A nurse-midwife licensed pursuant to chapter 377, appointed by 135
	179	+	the Connecticut Nurses Association; 136
	180	+	(5) A clinical social worker licensed pursuant to chapter 383b, 137
	181	+	appointed by the Connecticut Chapter of the National Association of 138
	182	+	Social Workers; 139
	183	+	(6) A psychiatrist licensed pursuant to chapter 370, appointed by the 140
	184	+	Connecticut Psychiatric Society; 141
	185	+	(7) A psychologist licensed pursuant to chapter 20-136, appointed 142
	186	+	by the Connecticut Psychological Association; 143
	187	+	(8) The Chief Medical Examiner, or the Chief Medical Examiner's 144
	188	+	designee; 145 Substitute Bill No. 807
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	195	+	(9) A member of the Connecticut Hospital Association; 146
	196	+	(10) A representative of a community or regional program or facility 147
	197	+	providing services for persons with psychiatric disabilities or persons 148
	198	+	with substance use disorders, appointed by the Commissioner of 149
	199	+	Public Health; 150
	200	+	(11) A representative of The University of Connecticut-sponsored 151
	201	+	health disparities institute; or 152
	202	+	(12) Any additional member the cochairpersons determine would be 153
	203	+	beneficial to serve as a member of the committee. 154
	204	+	Sec. 6. Subparagraphs (D) and (E) of subdivision (8) of section 19a-155
	205	+	177 of the general statutes are repealed and the following is substituted 156
	206	+	in lieu thereof (Effective from passage): 157
	207	+	(D) The commissioner shall collect the data required by 158
	208	+	subparagraph (A) of this subdivision, in the manner provided in said 159
	209	+	subparagraph, from each emergency medical service organization 160
	210	+	licensed or certified pursuant to this chapter. Any such emergency 161
	211	+	medical service organization that fails to comply with the provisions of 162
	212	+	this section shall be liable for a civil penalty not to exceed one hundred 163
	213	+	dollars per day for each failure to report the required data regarding 164
	214	+	emergency medical services provided to a patient, as determined by 165
	215	+	the commissioner. The civil penalties set forth in this subparagraph 166
	216	+	shall be assessed only after the department provides a written notice of 167
	217	+	deficiency and the organization is afforded the opportunity to respond 168
	218	+	to such notice. An organization shall have not more than fifteen 169
	219	+	business days after the date of receiving such notice to provide a 170
	220	+	written response to the department. The commissioner may adopt 171
	221	+	regulations, in accordance with chapter 54, concerning the 172
	222	+	development, implementation, monitoring and collection of 173
	223	+	emergency medical service system data. All state agencies licensed or 174
	224	+	certified as emergency medical service organizations shall be exempt 175
	225	+	from the civil penalties set forth in this subparagraph. [;] 176 Substitute Bill No. 807
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	232	+	(E) The commissioner shall, with the recommendation of the 177
	233	+	Connecticut Emergency Medical Services Advisory Board established 178
	234	+	pursuant to section 19a-178a, adopt for use in trauma data collection 179
	235	+	the most recent version of the National Trauma Data Bank's National 180
	236	+	Trauma Data Standards and Data Dictionary and natio nally 181
	237	+	recognized guidelines for field triage of injured patients; [.] 182
	238	+	Sec. 7. Section 19a-575 of the general statutes is repealed and the 183
	239	+	following is substituted in lieu thereof (Effective from passage): 184
	240	+	Any person eighteen years of age or older may execute a document 185
	241	+	that contains directions as to any aspect of health care, including the 186
	242	+	withholding or withdrawal of life support systems. Such document 187
	243	+	shall be signed and dated by the maker with at least two witnesses and 188
	244	+	may be in substantially the following form: 189
	245	+	DOCUMENT CONCERNING HEALTH CARE AND 190
	246	+	WITHHOLDING OR WITHDRAWAL OF LIFE SUPPORT SYSTEMS. 191
	247	+	If the time comes when I am incapacitated to the point when I can 192
	248	+	no longer actively take part in decisions for my own life, and am 193
	249	+	unable to direct my physician or advanced practice registered nurse as 194
	250	+	to my own medical care, I wish this statement to stand as a testament 195
	251	+	of my wishes. 196
	252	+	"I, .... (Name), request that, if my condition is deemed terminal or if 197
	253	+	it is determined that I will be permanently unconscious, I be allowed to 198
	254	+	die and not be kept alive through life support systems. By terminal 199
	255	+	condition, I mean that I have an incurable or irreversible medical 200
	256	+	condition which, without the administration of life support systems, 201
	257	+	will, in the opinion of my attending physician or advanced practice 202
	258	+	registered nurse, result in death within a relatively short time. By 203
	259	+	permanently unconscious I mean that I am in a permanent coma or 204
	260	+	persistent vegetative state which is an irreversible condition in which I 205
	261	+	am at no time aware of myself or the environment and show no 206
	262	+	behavioral response to the environment. The life support systems 207 Substitute Bill No. 807
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	268	+
	269	+	which I do not want include, but are not limited to: 208
	270	+	T1 Artificial respiration
	271	+	T2 Cardiopulmonary resuscitation
	272	+	T3 Artificial means of providing nutrition and hydration
	273	+
	274	+	(Cross out and initial life support systems you want administered) 209
	275	+	I do not intend any direct taking of my life, but only that my dying 210
	276	+	not be unreasonably prolonged. 211
	277	+	If I am pregnant: 212
	278	+	(Place a check to indicate option (1) or (2) or specify alternative 213
	279	+	instructions after (3)) 214
	280	+	T4 .... (1) I intend to accept life support systems if my doctor
	281	+	T5 believes that doing so would allow my fetus to reach a live birth.
	282	+	T6 .... (2) I intend this document to apply without modifications.
	283	+	T7 (3) I intend this document to apply as follows: …."
	284	+
	285	+	Other specific requests: 215
	286	+	"This request is made, after careful reflection, while I am of sound 216
	287	+	mind." 217
	288	+
	289	+	T8 .... (Signature)
	290	+	T9 .... (Date)
	291	+
	292	+	This document was signed in our presence, by the above-named .... 218
	293	+	(Name) who appeared to be eighteen years of age or older, of sound 219
	294	+	mind and able to understand the nature and consequences of health 220
	295	+	care decisions at the time the document was signed. 221
	296	+	T10 .... (Witness)
	297	+	T11 .... (Address) Substitute Bill No. 807
	298	+
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	303	+
	304	+	T12 .... (Witness)
	305	+	T13 .... (Address)
	306	+
	307	+	Sec. 8. Subsection (a) of section 19a-575a of the general statutes is 222
	308	+	repealed and the following is substituted in lieu thereof (Effective from 223
	309	+	passage): 224
	310	+	(a) Any person eighteen years of age or older may execute a 225
	311	+	document that contains health care instructions, the appointment of a 226
	312	+	health care representative, the designation of a conservator of the 227
	313	+	person for future incapacity and a document of anatomical gift. Any 228
	314	+	such document shall be signed and dated by the maker with at least 229
	315	+	two witnesses and may be in the substantially following form: 230
	316	+	THESE ARE MY HEALTH CARE INSTRUCTIONS. 231
	317	+	MY APPOINTMENT OF A HEALTH CARE REPRESENTATIVE, 232
	318	+	THE DESIGNATION OF MY CONSERVATOR OF THE PERSON 233
	319	+	FOR MY FUTURE INCAPACITY 234
	320	+	AND 235
	321	+	MY DOCUMENT OF ANATOMICAL GIFT 236
	322	+	To any physician or advanced practice registered nurse who is 237
	323	+	treating me: These are my health care instructions including those 238
	324	+	concerning the withholding or withdrawal of life support systems, 239
	325	+	together with the appointment of my health care representative, the 240
	326	+	designation of my conservator of the person for future incapacity and 241
	327	+	my document of anatomical gift. As my physician or advanced 242
	328	+	practice registered nurse, you may rely on these health care 243
	329	+	instructions and any decision made by my health care representative 244
	330	+	or conservator of my person, if I am incapacitated to the point when I 245
	331	+	can no longer actively take part in decisions for my own life, and am 246
	332	+	unable to direct my physician or advanced practice registered nurse as 247 Substitute Bill No. 807
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	338	+
	339	+	to my own medical care. 248
	340	+	I, ...., the author of this document, request that, if my condition is 249
	341	+	deemed terminal or if I am determined to be permanently 250
	342	+	unconscious, I be allowed to die and not be kept alive through life 251
	343	+	support systems. By terminal condition, I mean that I have an 252
	344	+	incurable or irreversible medical condition which, without the 253
	345	+	administration of life support systems, will, in the opinion of my 254
	346	+	attending physician or advanced practice registered nurse, result in 255
	347	+	death within a relatively short time. By permanently unconscious I 256
	348	+	mean that I am in a permanent coma or persistent vegetative state 257
	349	+	which is an irreversible condition in which I am at no time aware of 258
	350	+	myself or the environment and show no behavioral response to the 259
	351	+	environment. The life support systems which I do not want include, 260
	352	+	but are not limited to: Artificial respiration, cardiopulmonary 261
	353	+	resuscitation and artificial means of providing nutrition and hydration. 262
	354	+	I do want sufficient pain medication to maintain my physical comfort. 263
	355	+	I do not intend any direct taking of my life, but only that my dying not 264
	356	+	be unreasonably prolonged. 265
	357	+	If I am pregnant: 266
	358	+	(Place a check to indicate option (1) or (2) or specify alternative 267
	359	+	instructions after (3)) 268
	360	+	T14 .... (1) I intend to accept life support systems if my doctor
	361	+	T15 believes that doing so would allow my fetus to reach a live
	362	+	T16 birth.
	363	+	T17 .... (2) I intend this document to apply without modifications.
	364	+	T18 (3) I intend this document to apply as follows: ....
	365	+
	366	+	I appoint .... to be my health care representative. If my attending 269
	367	+	physician or advanced practice registered nurse determines that I am 270
	368	+	unable to understand and appreciate the nature and consequences of 271
	369	+	health care decisions and unable to reach and communicate an 272
	370	+	informed decision regarding treatment, my health care representative 273 Substitute Bill No. 807
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	376	+
	377	+	is authorized to make any and all health care decisions for me, 274
	378	+	including (1) the decision to accept or refuse any treatment, service or 275
	379	+	procedure used to diagnose or treat my physical or mental condition, 276
	380	+	except as otherwise provided by law such as for psychosurgery or 277
	381	+	shock therapy, as defined in section 17a-540, and (2) the decision to 278
	382	+	provide, withhold or withdraw life support systems. I direct my health 279
	383	+	care representative to make decisions on my behalf in accordance with 280
	384	+	my wishes, as stated in this document or as otherwise known to my 281
	385	+	health care representative. In the event my wishes are not clear or a 282
	386	+	situation arises that I did not anticipate, my health care representative 283
	387	+	may make a decision in my best interests, based upon what is known 284
	388	+	of my wishes. 285
	389	+	If .... is unwilling or unable to serve as my health care 286
	390	+	representative, I appoint .... to be my alternative health care 287
	391	+	representative. 288
	392	+	If a conservator of my person should need to be appointed, I 289
	393	+	designate .... be appointed my conservator. If .... is unwilling or unable 290
	394	+	to serve as my conservator, [I designate ....] I designate .... to be 291
	395	+	successor conservator. No bond shall be required of either of them in 292
	396	+	any jurisdiction. 293
	397	+	I hereby make this anatomical gift, if medically acceptable, to take 294
	398	+	effect upon my death. 295
	399	+	I give: (check one) 296
	400	+	T19 .... (1) any needed organs or parts
	401	+	T20 .... (2) only the following organs or parts ….
	402	+
	403	+	to be donated for: (check one) 297
	404	+
	405	+	T21 (1) .... any of the purposes stated in subsection (a) of section 19a-289j
	406	+	T22 (2) .... these limited purposes ....
	407	+	Substitute Bill No. 807
	408	+
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	414	+	These requests, appointments, and designations are made after 298
	415	+	careful reflection, while I am of sound mind. Any party receiving a 299
	416	+	duly executed copy or facsimile of this document may rely upon it 300
	417	+	unless such party has received actual notice of my revocation of it. 301
	418	+
	419	+	T23 Date ...., 20..
	420	+	T24 .... L.S.
	421	+
	422	+	This document was signed in our presence by .... the author of this 302
	423	+	document, who appeared to be eighteen years of age or older, of sound 303
	424	+	mind and able to understand the nature and consequences of health 304
	425	+	care decisions at the time this document was signed. The author 305
	426	+	appeared to be under no improper influence. We have subscribed this 306
	427	+	document in the author's presence and at the author's request and in 307
	428	+	the presence of each other. 308
	429	+
	430	+	T25 .... ....
	431	+	T26 (Witness) (Witness)
	432	+	T27 .... ....
	433	+	T28 (Number and Street) (Number and Street)
	434	+	T29 .... ....
	435	+	T30 (City, State and Zip Code) (City, State and Zip Code)
	436	+
	437	+	T31
	438	+	T32
400	439		STATE OF CONNECTICUT
401	440		}
402	441
403		-	ss. ....
404		-	COUNTY OF ....
	442	+	T33 ss. ....
	443	+	T34 COUNTY OF ....
405	444
406		-	We, the subscribing witnesses, being duly sworn, say that we
407		-	witnessed the execution of these health care instructions, the
408		-	appointments of a health care representative, the designation of a
409		-	conservator for future incapacity and a document of anatomical gift by
410		-	the author of this document; that the author subscribed, published and
411		-	declared the same to be the author's instructions, appointments and
412		-	designation in our presence; that we thereafter subscribed the
413		-	document as witnesses in the author's presence, at the author's request,
414		-	and in the presence of each other; that at the time of the execution of
415		-	said document the author appeared to us to be eighteen years of age or
416		-	older, of sound mind, able to understand the nature and consequences
417		-	of said document, and under no improper influence, and we make this
418		-	affidavit at the author's request this .... day of .... 20....
419		-	.... ....
420		-	(Witness) (Witness)
	445	+	We, the subscribing witnesses, being duly sworn, say that we 309
	446	+	witnessed the execution of these health care instructions, the 310
	447	+	appointments of a health care representative, the designation of a 311
	448	+	conservator for future incapacity and a document of anatomical gift by 312
	449	+	the author of this document; that the author subscribed, published and 313 Substitute Bill No. 807
421	450
422		-	Subscribed and sworn to before me this .... day of .... 20..
423		-	.... Substitute Senate Bill No. 807
424	451
425		-	Public Act No. 19-56 14 of 24
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426	455
427		-	Commissioner of the Superior Court
428		-	Notary Public
429		-	My commission expires: ....
	456	+	declared the same to be the author's instructions, appointments and 314
	457	+	designation in our presence; that we thereafter subscribed the 315
	458	+	document as witnesses in the author's presence, at the author's request, 316
	459	+	and in the presence of each other; that at the time of the execution of 317
	460	+	said document the author appeared to us to be eighteen years of age or 318
	461	+	older, of sound mind, able to understand the nature and consequences 319
	462	+	of said document, and under no improper influence, and we make this 320
	463	+	affidavit at the author's request this .... day of .... 20.... 321
	464	+	T35 .... ....
	465	+	T36 (Witness) (Witness)
430	466
431		-	(Print or type name of all persons signing under all signatures)
432		-	Sec. 9. Subdivision (2) of subsection (f) of section 19a-639a of the
433		-	general statutes is repealed and the following is substituted in lieu
434		-	thereof (Effective from passage):
435		-	(2) The unit may hold a public hearing with respect to any certificate
436		-	of need application submitted under this chapter. The unit shall
437		-	provide not less than two weeks' advance notice to the applicant, in
438		-	writing, and to the public by publication in a newspaper having a
439		-	substantial circulation in the area served by the health care facility or
440		-	provider. In conducting its activities under this chapter, the unit may
441		-	hold [hearing on] hearings with respect to applications of a similar
442		-	nature at the same time.
443		-	Sec. 10. Subdivision (4) of subsection (b) of section 19a-754a of the
444		-	general statutes is repealed and the following is substituted in lieu
445		-	thereof (Effective from passage):
446		-	(4) (A) Coordinating the state's health information technology
447		-	initiatives, (B) seeking funding for and overseeing the planning,
448		-	implementation and development of policies and procedures for the
449		-	administration of the all-payer claims database program established
450		-	under section 19a-775a, (C) establishing and maintaining a consumer
451		-	health information Internet web site under section 19a-755b, and (D)
452		-	designating an unclassified individual from the office to perform the
453		-	duties of a health information technology officer as set forth in sections
454		-	17b-59f and 17b-59g;
455		-	Sec. 11. Subdivisions (1) and (2) of subsection (j) of section 21a-252 Substitute Senate Bill No. 807
	467	+	Subscribed and sworn to before me this .... day of .... 20.. 322
456	468
457		-	Public Act No. 19-56 15 of 24
	469	+	T37 ....
	470	+	T38 Commissioner of the Superior Court
	471	+	T39 Notary Public
	472	+	T40 My commission expires: ....
458	473
459		-	of the general statutes are repealed and the following is substituted in
460		-	lieu thereof (Effective from passage):
461		-	(j) (1) A prescribing practitioner, as defined in section 20-14c, shall
462		-	not, except in an emergency, prescribe, dispense or administer
463		-	controlled substances in schedules II to IV, inclusive, to [a member of]
464		-	his or her immediate family member. For purposes of this section,
465		-	"immediate family member" means a spouse, parent, child, sibling,
466		-	parent-in-law, son or daughter-in-law, brother or sister-in-law, step-
467		-	parent, step-child, step-sibling or other relative residing in the same
468		-	residence as the prescribing practitioner and shall not include an
469		-	animal in the residence. In an emergency, a prescribing practitioner
470		-	may prescribe, dispense or administer not more than a seventy-two-
471		-	hour supply of such controlled substances to an immediate family
472		-	member only when there is no other qualified prescribing practitioner
473		-	available.
474		-	(2) A prescribing practitioner who prescribes, dispenses or
475		-	administers any controlled substance to [a member of] his or her
476		-	immediate family member pursuant to subdivision (1) of this
477		-	subsection shall perform an assessment for the care and treatment of
478		-	the patient, medically evaluate the patient's need for such controlled
479		-	substance and document such assessment and need in the normal
480		-	course of his or her business. The prescribing practitioner shall
481		-	document the emergency that gave rise to the prescription, dispensing
482		-	or administering of such controlled substance to the immediate family
483		-	member.
484		-	Sec. 12. Section 1 of special act 18-2 is amended to read as follows
485		-	(Effective from passage):
486		-	(a) There is established a task force to study (1) the short-term and
487		-	long-term needs of adults with intellectual disability, including, but
488		-	not limited to, such adults with significant behavioral health issues or Substitute Senate Bill No. 807
	474	+	(Print or type name of all persons signing under all signatures) 323
	475	+	Sec. 9. Subdivision (2) of subsection (f) of section 19a-639a of the 324
	476	+	general statutes is repealed and the following is substituted in lieu 325
	477	+	thereof (Effective from passage): 326
	478	+	(2) The unit may hold a public hearing with respect to any certificate 327
	479	+	of need application submitted under this chapter. The unit shall 328
	480	+	provide not less than two weeks' advance notice to the applicant, in 329
	481	+	writing, and to the public by publication in a newspaper having a 330
	482	+	substantial circulation in the area served by the health care facility or 331
	483	+	provider. In conducting its activities under this chapter, the unit may 332
	484	+	hold [hearing on] hearings with respect to applications of a similar 333
	485	+	nature at the same time. 334
	486	+	Sec. 10. Subdivision (4) of subsection (b) of section 19a-754a of the 335 Substitute Bill No. 807
489	487
490		-	Public Act No. 19-56 16 of 24
491	488
492		-	significant issues related to aging, including Alzheimer's disease,
493		-	dementia and related disorders, and (2) ways in which the services and
494		-	support such adults need may be provided.
495		-	(b) The task force shall consist of the following members:
496		-	(1) Two appointed by the speaker of the House of Representatives,
497		-	one of whom has expertise in the diagnosis, care and treatment of
498		-	persons with intellectual disability and one of whom has expertise in
499		-	the provision of residential services to persons with intellectual
500		-	disability;
501		-	(2) Two appointed by the president pro tempore of the Senate, one
502		-	of whom has expertise in the provision of day services for persons
503		-	with intellectual disability and one of whom has expertise in the
504		-	provision of program support services to persons with intellectual
505		-	disability;
506		-	(3) One appointed by the majority leader of the House of
507		-	Representatives, who is the parent, guardian or relative of a person
508		-	with intellectual disability who has high-level needs;
509		-	(4) One appointed by the majority leader of the Senate, who is the
510		-	parent, guardian or relative of a person with intellectual disability;
511		-	(5) One appointed by the minority leader of the House of
512		-	Representatives, who is the parent, guardian or relative of a person
513		-	with intellectual disability;
514		-	(6) One appointed by the minority leader of the Senate, who is the
515		-	parent, guardian or relative of a person with intellectual disability who
516		-	has high-level needs;
517		-	(7) The chairpersons and ranking members of the joint standing
518		-	committee of the General Assembly having cognizance of matters Substitute Senate Bill No. 807
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519	492
520		-	Public Act No. 19-56 17 of 24
	493	+	general statutes is repealed and the following is substituted in lieu 336
	494	+	thereof (Effective from passage): 337
	495	+	(4) (A) Coordinating the state's health information technology 338
	496	+	initiatives, (B) seeking funding for and overseeing the planning, 339
	497	+	implementation and development of policies and procedures for the 340
	498	+	administration of the all-payer claims database program established 341
	499	+	under section 19a-775a, (C) establishing and maintaining a consumer 342
	500	+	health information Internet web site under section 19a-755b, and (D) 343
	501	+	designating an unclassified individual from the office to perform the 344
	502	+	duties of a health information technology officer as set forth in sections 345
	503	+	17b-59f and 17b-59g; 346
	504	+	Sec. 11. Subdivisions (1) and (2) of subsection (j) of section 21a-252 347
	505	+	of the general statutes are repealed and the following is substituted in 348
	506	+	lieu thereof (Effective from passage): 349
	507	+	(j) (1) A prescribing practitioner, as defined in section 20-14c, shall 350
	508	+	not, except in an emergency, prescribe, dispense or administer 351
	509	+	controlled substances in schedules II to IV, inclusive, to [a member of] 352
	510	+	his or her immediate family member. For purposes of this section, 353
	511	+	"immediate family member" means a spouse, parent, child, sibling, 354
	512	+	parent-in-law, son or daughter-in-law, brother or sister-in-law, step-355
	513	+	parent, step-child, step-sibling or other relative residing in the same 356
	514	+	residence as the prescribing practitioner and shall not include an 357
	515	+	animal in the residence. In an emergency, a prescribing practitioner 358
	516	+	may prescribe, dispense or administer not more than a seventy-two-359
	517	+	hour supply of such controlled substances to an immediate family 360
	518	+	member only when there is no other qualified prescribing practitioner 361
	519	+	available. 362
	520	+	(2) A prescribing practitioner who prescribes, dispenses or 363
	521	+	administers any controlled substance to [a member of] his or her 364
	522	+	immediate family member pursuant to subdivision (1) of this 365
	523	+	subsection shall perform an assessment for the care and treatment of 366
	524	+	the patient, medically evaluate the patient's need for such controlled 367 Substitute Bill No. 807
521	525
522		-	relating to public health, or their designees;
523		-	(8) The Commissioner of Developmental Services, or the
524		-	commissioner's designee; and
525		-	(9) The Secretary of the Office of Policy and Management, or the
526		-	secretary's designee.
527		-	(c) Any member of the task force appointed under subdivision (1),
528		-	(2), (3), (4), (5), (6) or (7) of subsection (b) of this section may be a
529		-	member of the General Assembly.
530		-	(d) All appointments to the task force shall be made not later than
531		-	thirty days after the effective date of this section. Any vacancy shall be
532		-	filled by the appointing authority.
533		-	(e) The speaker of the House of Representatives and the president
534		-	pro tempore of the Senate shall select the chairpersons of the task force
535		-	from among the members of the task force. Such chairpersons shall
536		-	schedule the first meeting of the task force, which shall be held not
537		-	later than sixty days after the effective date of this section.
538		-	(f) The administrative staff of the joint standing committee of the
539		-	General Assembly having cognizance of matters relating to public
540		-	health shall serve as administrative staff of the task force.
541		-	(g) Not later than January 1, [2019] 2020, the task force shall submit
542		-	a report on its findings and recommendations to the joint standing
543		-	committee of the General Assembly having cognizance of matters
544		-	relating to public health, in accordance with the provisions of section
545		-	11-4a of the general statutes. The task force shall terminate on the date
546		-	that it submits such report or January 1, [2019] 2020, whichever is later.
547		-	Sec. 13. Subsections (c) and (d) of section 20-112a of the general
548		-	statutes are repealed and the following is substituted in lieu thereof Substitute Senate Bill No. 807
549	526
550		-	Public Act No. 19-56 18 of 24
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551	530
552		-	(Effective July 1, 2019):
553		-	(c) (1) A licensed dentist may delegate to dental assistants such
554		-	dental procedures as the dentist may deem advisable, including: (A)
555		-	The taking of dental x-rays if the dental assistant can demonstrate
556		-	successful completion of the dental radiation health and safety
557		-	examination administered by the Dental Assisting National Board; (B)
558		-	the taking of impressions of teeth for study models; and (C) the
559		-	provision of fluoride varnish treatments. Such procedures shall be
560		-	performed under the direct supervision of a licensed dentist and the
561		-	dentist providing direct supervision shall assume responsibility for
562		-	such procedures.
563		-	(2) A licensed dentist may delegate to an expanded function dental
564		-	assistant such dental procedures as the dentist may deem advisable,
565		-	including: (A) The placing, finishing and adjustment of temporary
566		-	restorations and long-term individual fillings, capping materials and
567		-	cement bases; (B) oral health education for patients; (C) dental sealants;
568		-	[and] (D) coronal polishing, provided the procedure is not represented
569		-	or billed as prophylaxis; (E) administration of topical anesthetic under
570		-	the direct supervision of the dentist prior to the administration of local
571		-	anesthetic by a dentist or dental hygienist; and (F) taking alginate
572		-	impressions of teeth, under the direct supervision of the dentist, for
573		-	use in study models, orthodontic appliances, whitening trays, mouth
574		-	guards or fabrication of temporary crowns. Such procedures shall be
575		-	performed under [the] either direct or indirect supervision, except as
576		-	specifically provided in this subdivision, and the dentist providing
577		-	such supervision shall assume responsibility for such procedures.
578		-	(3) [On or after July 1, 2018, (A) no] (A) No licensed dentist may
579		-	delegate dental procedures to a dental assistant or expanded function
580		-	dental assistant unless the dental assistant or expanded function dental
581		-	assistant provides records demonstrating successful completion of the
582		-	Dental Assisting National Board's infection control examination or an Substitute Senate Bill No. 807
	531	+	substance and document such assessment and need in the normal 368
	532	+	course of his or her business. The prescribing practitioner shall 369
	533	+	document the emergency that gave rise to the prescription, dispensing 370
	534	+	or administering of such controlled substance to the immediate family 371
	535	+	member. 372
	536	+	Sec. 12. Section 1 of special act 18-2 is amended to read as follows 373
	537	+	(Effective from passage): 374
	538	+	(a) There is established a task force to study (1) the short-term and 375
	539	+	long-term needs of adults with intellectual disability, including, but 376
	540	+	not limited to, such adults with significant behavioral health issues or 377
	541	+	significant issues related to aging, including Alzheimer's disease, 378
	542	+	dementia and related disorders, and (2) ways in which the services and 379
	543	+	support such adults need may be provided. 380
	544	+	(b) The task force shall consist of the following members: 381
	545	+	(1) Two appointed by the speaker of the House of Representatives, 382
	546	+	one of whom has expertise in the diagnosis, care and treatment of 383
	547	+	persons with intellectual disability and one of whom has expertise in 384
	548	+	the provision of residential services to persons with intellectual 385
	549	+	disability; 386
	550	+	(2) Two appointed by the president pro tempore of the Senate, one 387
	551	+	of whom has expertise in the provision of day services for persons 388
	552	+	with intellectual disability and one of whom has expertise in the 389
	553	+	provision of program support services to persons with intellectual 390
	554	+	disability; 391
	555	+	(3) One appointed by the majority leader of the House of 392
	556	+	Representatives, who is the parent, guardian or relative of a person 393
	557	+	with intellectual disability who has high-level needs; 394
	558	+	(4) One appointed by the majority leader of the Senate, who is the 395
	559	+	parent, guardian or relative of a person with intellectual disability; 396 Substitute Bill No. 807
583	560
584		-	Public Act No. 19-56 19 of 24
585	561
586		-	infection control competency assessment administered by a dental
587		-	education program in the state that is accredited by the American
588		-	Dental Association's Commission on Dental Accreditation, except as
589		-	provided in subdivision (2) of this subsection, (B) a dental assistant
590		-	may receive not more than [nine] fifteen months of on-the-job training
591		-	by a licensed dentist for purposes of preparing the dental assistant for
592		-	the [Dental Assisting National Board's] infection control examination
593		-	or infection control competency assessment, and (C) any licensed
594		-	dentist who delegates dental procedures to a dental assistant shall
595		-	retain and make such records available for inspection upon request of
596		-	the Department of Public Health.
597		-	(4) On and after January 1, 2018, upon successful completion of the
598		-	Dental Assisting National Board's infection control examination or an
599		-	infection control competency assessment administered by a dental
600		-	education program in the state that is accredited by the American
601		-	Dental Association's Commission on Dental Accreditation, each dental
602		-	assistant or expanded function dental assistant shall complete not less
603		-	than one hour of training or education in infection control in a dental
604		-	setting every two years, including, but not limited to, courses,
605		-	including online courses, offered or approved by a dental school or
606		-	another institution of higher education that is accredited or recognized
607		-	by the Commission on Dental Accreditation, a regional accrediting
608		-	organization, the American Dental Association or a state, district or
609		-	local dental association or society affiliated with the American Dental
610		-	Association or the American Dental Assistants Association.
611		-	(d) [Under] Except as provided in subsection (c) of this section,
612		-	under no circumstances may a dental assistant or expanded function
613		-	dental assistant engage in: (1) Diagnosis for dental procedures or
614		-	dental treatment; (2) the cutting or removal of any hard or soft tissue
615		-	or suturing; (3) the prescribing of drugs or medications that require the
616		-	written or oral order of a licensed dentist or physician; (4) the Substitute Senate Bill No. 807
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617	565
618		-	Public Act No. 19-56 20 of 24
	566	+	(5) One appointed by the minority leader of the House of 397
	567	+	Representatives, who is the parent, guardian or relative of a person 398
	568	+	with intellectual disability; 399
	569	+	(6) One appointed by the minority leader of the Senate, who is the 400
	570	+	parent, guardian or relative of a person with intellectual disability who 401
	571	+	has high-level needs; 402
	572	+	(7) The chairpersons and ranking members of the joint standing 403
	573	+	committee of the General Assembly having cognizance of matters 404
	574	+	relating to public health, or their designees; 405
	575	+	(8) The Commissioner of Developmental Services, or the 406
	576	+	commissioner's designee; and 407
	577	+	(9) The Secretary of the Office of Policy and Management, or the 408
	578	+	secretary's designee. 409
	579	+	(c) Any member of the task force appointed under subdivision (1), 410
	580	+	(2), (3), (4), (5), (6) or (7) of subsection (b) of this section may be a 411
	581	+	member of the General Assembly. 412
	582	+	(d) All appointments to the task force shall be made not later than 413
	583	+	thirty days after the effective date of this section. Any vacancy shall be 414
	584	+	filled by the appointing authority. 415
	585	+	(e) The speaker of the House of Representatives and the president 416
	586	+	pro tempore of the Senate shall select the chairpersons of the task force 417
	587	+	from among the members of the task force. Such chairpersons shall 418
	588	+	schedule the first meeting of the task force, which shall be held not 419
	589	+	later than sixty days after the effective date of this section. 420
	590	+	(f) The administrative staff of the joint standing committee of the 421
	591	+	General Assembly having cognizance of matters relating to public 422
	592	+	health shall serve as administrative staff of the task force. 423
	593	+	(g) Not later than January 1, [2019] 2020, the task force shall submit 424 Substitute Bill No. 807
619	594
620		-	administration of local, parenteral, inhalation or general anesthetic
621		-	agents in connection with any dental operative procedure; (5) the
622		-	taking of any final impression of the teeth or jaws or the relationship of
623		-	the teeth or jaws for the purpose of fabricating any appliance or
624		-	prosthesis; or (6) the practice of dental hygiene as defined in section
625		-	20-126l.
626		-	Sec. 14. (NEW) (Effective January 1, 2020) (a) As used in this section:
627		-	(1) "Practice of dental therapy" means the performance of
628		-	educational, preventive and therapeutic services through any one or
629		-	more of the following practices and procedures: (A) Identification of
630		-	oral and systemic conditions requiring evaluation or treatment by
631		-	dentists, physicians or other health care providers, and management of
632		-	referrals to dentists, physicians and other health care providers; (B)
633		-	diagnosis and treatment of oral diseases and conditions that are within
634		-	the dental therapist scope of practice; (C) comprehensive charting of
635		-	the oral cavity; (D) oral health instruction and disease prevention
636		-	education, including nutritional counseling and dietary analysis; (E)
637		-	dispensing and administering of nonnarcotic analgesics and anti-
638		-	inflammatory and antibiotic medications as prescribed by a licensed
639		-	health care provider, except schedule II, III or IV controlled substances;
640		-	(F) applying topical preventive or prophylactic agents, including
641		-	fluoride varnish, antimicrobial agents and pit and fissure sealants; (G)
642		-	pulp vitality testing; (H) applying desensitizing medication or resin in
643		-	the oral cavity; (I) interim therapeutic restorations; (J) fabricating
644		-	athletic mouth guards; (K) changing periodontal dressings; (L)
645		-	administering local anesthetics in the oral cavity under the general
646		-	supervision of a dentist; (M) simple extraction of erupted primary
647		-	teeth; (N) nonsurgical extraction of periodontally diseased permanent
648		-	teeth with tooth mobility of three or greater, except a tooth that is
649		-	unerupted, impacted, fractured or needs to be sectioned for removal;
650		-	(O) emergency palliative treatment of dental pain; (P) preparation and Substitute Senate Bill No. 807
651	595
652		-	Public Act No. 19-56 21 of 24
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653	599
654		-	placement of direct restoration in primary and permanent teeth that
655		-	does not require the fabrication of crowns, bridges, veneers or
656		-	dentures; (Q) fabrication and placement of single-tooth temporary
657		-	crowns; (R) preparation and placement of preformed crowns on
658		-	primary teeth; (S) indirect and direct pulp capping on permanent teeth;
659		-	(T) indirect pulp capping on primary teeth; (U) dental suture removal;
660		-	(V) minor adjustments and repairs on removable prostheses; (W)
661		-	placement and removal of space maintainers; and (X) recementing
662		-	permanent crowns;
663		-	(2) "Collaborative agreement" means a written agreement between a
664		-	dental therapist and a dentist licensed pursuant to chapter 379 of the
665		-	general statutes, that defines the working relationship between the
666		-	dental therapist and the dentist and the parameters of the practice of
667		-	dental therapy;
668		-	(3) "Dental therapist" means a licensed dental hygienist authorized
669		-	to engage in the practice of dental therapy under a collaborative
670		-	agreement; and
671		-	(4) "Public health facility" has the same meaning as provided in
672		-	section 20-126l of the general statutes.
673		-	(b) No person shall engage in the practice of dental therapy unless
674		-	such person (1) is a dental hygienist licensed pursuant to chapter 379a
675		-	of the general statutes; (2) has obtained a dental therapist certification
676		-	that is (A) in writing, on a form issued by an institution of higher
677		-	education accredited by the Commission on Dental Accreditation after
678		-	successful completion of a dental therapy program that includes, in
679		-	accordance with the Commission on Dental Accreditation's standards
680		-	for dental therapy education programs, full-time instruction or its
681		-	equivalent at the postsecondary college level and incorporates all
682		-	dental therapy practice competencies, (B) signed by the dental
683		-	therapist and the director of the dental therapy education program, Substitute Senate Bill No. 807
	600	+	a report on its findings and recommendations to the joint standing 425
	601	+	committee of the General Assembly having cognizance of matters 426
	602	+	relating to public health, in accordance with the provisions of section 427
	603	+	11-4a of the general statutes. The task force shall terminate on the date 428
	604	+	that it submits such report or January 1, [2019] 2020, whichever is later. 429
	605	+	Sec. 13. Subdivision (3) of subsection (c) of section 20-112a of the 430
	606	+	general statutes is repealed and the following is substituted in lieu 431
	607	+	thereof (Effective from passage): 432
	608	+	(3) On or after July 1, 2018, (A) no licensed dentist may delegate 433
	609	+	dental procedures to a dental assistant or expanded function dental 434
	610	+	assistant unless the dental assistant or expanded function dental 435
	611	+	assistant provides records demonstrating successful completion of the 436
	612	+	Dental Assisting National Board's infection control examination, 437
	613	+	except as provided in subdivision (2) of this subsection, (B) a dental 438
	614	+	assistant may receive not more than [nine] fifteen months of on-the-job 439
	615	+	training by a licensed dentist for purposes of preparing the dental 440
	616	+	assistant for the Dental Assisting National Board's infection control 441
	617	+	examination, and (C) any licensed dentist who delegates dental 442
	618	+	procedures to a dental assistant shall retain and make such records 443
	619	+	available for inspection upon request of the Department of Public 444
	620	+	Health. 445
	621	+	This act shall take effect as follows and shall amend the following
	622	+	sections:
684	623
685		-	Public Act No. 19-56 22 of 24
	624	+	Section 1 from passage 10a-109gg(b)
	625	+	Sec. 2 from passage 17a-217a(a)
	626	+	Sec. 3 from passage 17b-337(c)
	627	+	Sec. 4 from passage 19a-36i(d)
	628	+	Sec. 5 from passage 19a-59i(c)
	629	+	Sec. 6 from passage 19a-177(8)(D) and (E)
	630	+	Sec. 7 from passage 19a-575
	631	+	Sec. 8 from passage 19a-575a(a)
	632	+	Sec. 9 from passage 19a-639a(f)(2)
	633	+	Sec. 10 from passage 19a-754a(b)(4) Substitute Bill No. 807
686	634
687		-	and (C) made available to the Department of Public Health upon
688		-	request; (3) has successfully completed a comprehensive examination
689		-	prescribed by the Commission on Dental Competency Assessments, or
690		-	its equivalent, and administered independently of any institution of
691		-	higher education that offers a program in dental therapy; (4) prior to
692		-	entering the first collaborative agreement, (A) has received a certificate
693		-	of completion, signed by a dentist licensed pursuant to chapter 379 of
694		-	the general statutes, that verifies completion of one thousand hours of
695		-	clinical training under the direct supervision of such dentist, and (B)
696		-	has successfully completed six hours of continuing education related
697		-	to dental therapy; and (5) has entered into a collaborative agreement
698		-	with a dentist.
699		-	(c) A dental therapist shall practice in a public health facility under
700		-	the general supervision of a dentist licensed pursuant to chapter 379 of
701		-	the general statutes in accordance with a collaborative agreement.
702		-	(d) No provision of this section shall be construed to prohibit a
703		-	dental hygienist enrolled in a dental therapy program, as described in
704		-	subdivision (2) of subsection (b) of this section, from performing dental
705		-	therapy work as a required component of his or her course of study in
706		-	such program, provided such dental hygienist (1) performs such work
707		-	under the direct supervision of a dentist licensed pursuant to chapter
708		-	379 of the general statutes, (2) shall not hold himself or herself out as a
709		-	certified dental therapist, and (3) shall not receive compensation for
710		-	such work.
711		-	(e) (1) A collaborative agreement entered into pursuant to
712		-	subsection (b) of this section shall include: (A) Identification of public
713		-	health facilities where services may be provided and the populations
714		-	to be served; (B) any limitations on the services that may be provided
715		-	by the dental therapist; (C) age and procedure-specific practice
716		-	protocols, including case selection criteria, assessment guidelines and
717		-	imaging frequency; (D) a procedure for creating and maintaining Substitute Senate Bill No. 807
718	635
719		-	Public Act No. 19-56 23 of 24
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	637	+	R01-SB.docx }
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720	639
721		-	dental records for the patients that are treated by the dental therapist;
722		-	(E) a plan to manage medical emergencies in each public health facility
723		-	where the dental therapist provides care; (F) a quality assurance plan
724		-	for monitoring care provided by the dental therapist, including patient
725		-	care review, referral follow-up and a quality assurance chart review;
726		-	(G) protocols for dispensing and administering medications, including
727		-	the specific conditions and circumstances under which these
728		-	medications may be dispensed and administered; (H) criteria relating
729		-	to the provision of care to patients with specific medical conditions or
730		-	complex medication histories, including requirements for consultation
731		-	prior to the initiation of care; (I) criteria for the supervision of dental
732		-	assistants, expanded function dental assistants, as defined in section
733		-	20-112a of the general statutes, as amended by this act, and dental
734		-	hygienists in accordance with subsection (g) of this section; and (J) a
735		-	plan for the provision of referrals in situations that are beyond the
736		-	capabilities or the scope of practice of the dental therapist.
737		-	(2) A collaborative agreement shall be (A) signed and maintained by
738		-	the supervising dentist and the dental therapist and kept on file at the
739		-	locations where such dental therapist is employed; (B) reviewed by the
740		-	dentist and dental therapist on an annual basis and revised as needed;
741		-	and (C) available for inspection upon the request of the Department of
742		-	Public Health.
743		-	(f) A dentist who enters into a collaborative agreement with a dental
744		-	therapist (1) shall be professionally responsible and legally liable for all
745		-	services authorized and performed by the dental therapist pursuant to
746		-	a collaborative agreement, and (2) may not enter into a collaborative
747		-	agreement with more than two dental therapists at any one time.
748		-	Nothing in this section shall be construed to require a dentist to enter
749		-	into a collaborative agreement with a dental therapist.
750		-	(g) A dental therapist may directly supervise not more than two
751		-	dental assistants or expanded function dental assistants, as defined in Substitute Senate Bill No. 807
	640	+	Sec. 11 from passage 21a-252(j)(1) and (2)
	641	+	Sec. 12 from passage SA 18-2, Sec. 1
	642	+	Sec. 13 from passage 20-112a(c)(3)
752	643
753		-	Public Act No. 19-56 24 of 24
754		-
755		-	section 20-112a of the general statutes, as amended by this act, or
756		-	dental hygienists licensed pursuant to chapter 379a of the general
757		-	statutes to the extent permitted in the collaborative agreement.
758		-	(h) (1) Each dental therapist shall complete, in addition to the
759		-	continuing education requirements of subsection (g) of section 20-126l
760		-	of the general statutes, six hours of continuing education in dental
761		-	therapy within the twelve-month period after such dental therapist
762		-	enters into a collaborative agreement with a dentist and within each
763		-	subsequent twenty-four-month period thereafter.
764		-	(2) Each dental therapist applying for a renewal of a dental hygiene
765		-	license pursuant to chapter 379a of the general statutes and in
766		-	accordance with section 19a-88 of the general statutes shall sign a
767		-	statement attesting that he or she has satisfied the continuing
768		-	education requirements described in subdivision (1) of this subsection
769		-	on a form prescribed by the Department of Public Health. Each dental
770		-	therapist shall retain records of attendance or certificates of completion
771		-	that demonstrate compliance with the continuing education
772		-	requirements described in subdivision (1) of this subsection for not less
773		-	than three years following the date on which the continuing education
774		-	was completed or the license was renewed. Each dental therapist shall
775		-	submit such records to the department for inspection not later than
776		-	forty-five days after a request by the department for such records. A
777		-	dental therapist who fails to comply with the provisions of this section
778		-	may be subject to disciplinary action pursuant to section 20-126o of the
779		-	general statutes.
	644	+	PH Joint Favorable Subst.
780	645