Substitute Senate Bill No. 807
Public Act No. 19-56
AN ACT CONCERNING TH E LEGISLATIVE COMMIS SIONERS'
RECOMMENDATIONS FOR REVISIONS TO THE PUB LIC HEALTH
STATUTES, DENTAL ASS ISTANTS AND DENTAL THERAPY.
Be it enacted by the Senate and House of Representatives in General
Assembly convened:
Section 1. Subsection (b) of section 10a-109gg of the general statutes
is repealed and the following is substituted in lieu thereof (Effective
from passage):
(b) The proceeds of the sale of the bond issuance described in
subsection (a) of this section shall be used by the Office of Policy and
Management, in consultation with the chairperson of the Board of
Trustees of the university, for the purpose of the UConn health
network initiatives in the following manner: (1) Five million dollars of
such proceeds shall be used by Hartford Hospital to develop a
simulation and conference center on the Hartford Hospital campus to
be run exclusively by Hartford Hospital; [,] (2) five million dollars of
such proceeds shall be used to fulfill the initiative for a primary care
institute on the Saint Francis Hospital and Medical Center campus; [,]
(3) five million dollars of such proceeds shall be used to fulfill the
initiatives for a comprehensive cancer center and The University of
Connecticut-sponsored health disparities institute; (4) five million
dollars of such proceeds shall be used to fulfill the initiatives for the Substitute Senate Bill No. 807
Public Act No. 19-56 2 of 24
planning, design, land acquisition, development and construction of
(A) a cancer treatment center to be constructed by, or in partnership
with, The Hospital of Central Connecticut, provided such cancer
treatment center is located entirely within the legal boundaries of the
city of New Britain, (B) renovations and upgrades to the oncology unit
at The Hospital of Central Connecticut, and (C) if certificate of need
approval is received, a Permanent Regional Phase One Clinical Trials
Unit located at The Hospital of Central Connecticut in New Britain;
and (5) two million dollars of such proceeds shall be used to fulfill the
initiatives for patient room renovations at Bristol Hospital. In the event
that the cancer treatment center authorized pursuant to subdivision (4)
of this subsection is built in whole or in part outside the legal
boundaries of the city of New Britain, The Hospital of Central
Connecticut shall repay the entire amount of the proceeds used to
fulfill the initiatives for the planning, design, development and
construction of such center.
Sec. 2. Subsection (a) of section 17a-217a of the general statutes is
repealed and the following is substituted in lieu thereof (Effective from
passage):
(a) There shall be a Camp Harkness Advisory Committee to advise
the Commissioner of Developmental Services with respect to issues
concerning the health and safety of persons who attend and utilize the
facilities at Camp Harkness. The advisory committee shall be
composed of twelve members as follows: (1) Six members appointed
by the Governor, one of whom shall be the director of Camp Harkness,
who shall serve ex officio, one of whom shall represent the
Southeastern Connecticut Association for Developmental Disabilities,
one of whom shall represent the Southbury Training School, one of
whom shall represent the Arc of New London County, one of whom
[who is] shall be a person who uses the camp on a residential basis and
one of whom [is] shall be a relative or guardian of a person who uses Substitute Senate Bill No. 807
Public Act No. 19-56 3 of 24
the camp; and (2) six members appointed by the General Assembly,
one of whom shall be a relative or guardian of a person who uses the
camp, who shall be appointed by the president pro tempore of the
Senate; one of whom shall be a member of the Family Support Council
established pursuant to section 17a-219c and represent persons who
use the camp on a day basis, who shall be appointed by the speaker of
the House of Representatives; one of whom shall represent the board
of selectmen of the town of Waterford, who shall be appointed by the
majority leader of the House of Representatives; one of whom shall
represent a private nonprofit corporation that is: (A) Tax exempt under
Section 501(c)(3) of the Internal Revenue Code of 1986, or any
subsequent internal revenue code of the United States, as amended
from time to time, and (B) established to promote and support Camp
Harkness and its camping programs, who shall be appointed by the
majority leader of the Senate; one of whom shall represent the
Connecticut Institute for the Blind and the Oak Hill School, who shall
be appointed by the minority leader of the House of Representatives;
and one of whom shall represent the United Cerebral Palsy
Association, who shall be appointed by the minority leader of the
Senate.
Sec. 3. Subsection (c) of section 17b-337 of the general statutes is
repealed and the following is substituted in lieu thereof (Effective from
passage):
(c) The Long-Term Care Planning Committee shall consist of: (1)
The chairpersons and ranking members of the joint standing
committees of the General Assembly having cognizance of matters
relating to human services, public health, elderly services and long-
term care; (2) the Commissioner of Social Services, or the
commissioner's designee; (3) one member of the Office of Policy and
Management appointed by the Secretary of the Office of Policy and
Management; (4) one member from the Department of Public Health Substitute Senate Bill No. 807
Public Act No. 19-56 4 of 24
appointed by the Commissioner of Public Health; (5) one member
from the Department of Housing appointed by the Commissioner of
Housing; (6) one member from the Department of Developmental
Services appointed by the Commissioner of Developmental Services;
(7) one member from the Department of Mental Health and Addiction
Services appointed by the Commissioner of Mental Health and
Addiction Services; (8) one member from the Depart ment of
Transportation appointed by the Commissioner of Transportation; (9)
one member from the Department of Children and Families appointed
by the Commissioner of Children and Families; [and] (10) one member
from the Health Systems Planning Unit of the Office of Health Strategy
appointed by the executive director of the Office of Health Strategy;
and (11) one member from the Department of Rehabilitation Services
appointed by the Commissioner of Rehabilitation Services. The
committee shall convene no later than ninety days after June 4, 1998.
Any vacancy shall be filled by the appointing authority. The
chairperson shall be elected from among the members of the
committee. The committee shall seek the advice and participation of
any person, organization or state or federal agency it deems necessary
to carry out the provisions of this section.
Sec. 4. Subsection (d) of section 19a-36i of the general statutes is
repealed and the following is substituted in lieu thereof (Effective from
passage):
(d) Each class 2 food establishment, class 3 food establishment and
class 4 food establishment shall employ a certified food protection
manager. No person shall serve as a certified food protection manager
unless such person has satisfactorily passed a test as part of a food
protection manager certification program that is evaluated and
approved by an accrediting agency recognized by the Conference for
Food Protection as conforming to its standards for accreditation of
food protection manager certification programs. A certified food Substitute Senate Bill No. 807
Public Act No. 19-56 5 of 24
inspector shall verify that the food protection manager is certified
upon inspection of the food establishment. The owner or manager of
the food service establishment shall designate an alternate person or
persons to be in charge at all times when the certified food protection
manager cannot be present. The alternate person or persons in charge
shall be responsible for ensuring the following: [(A)] (1) All employees
are in compliance with the requirements of this section; [(B)] (2) foods
are safely prepared in accordance with the requirements of the food
code; [(C)] (3) emergencies are managed properly; [(D)] (4) a food
inspector is admitted into the food establishment upon request; and
[(E)] (5) he or she receives and signs inspection reports.
Sec. 5. Subsection (c) of section 19a-59i of the general statutes is
repealed and the following is substituted in lieu thereof (Effective from
passage):
(c) The maternal mortality review committee may include, but need
not be limited to, any of the following members, as needed, depending
on the maternal death case being reviewed:
(1) A physician licensed pursuant to chapter 370 who specializes in
obstetrics and gynecology, appointed by the Connecticut State Medical
Society;
(2) A physician licensed pursuant to chapter 370 who is a
pediatrician, appointed by the Connecticut State Medical Society;
(3) A community health worker, appointed by the Commission on
Equity and Opportunity;
(4) A nurse-midwife licensed pursuant to chapter 377, appointed by
the Connecticut Nurses Association;
(5) A clinical social worker licensed pursuant to chapter 383b,
appointed by the Connecticut Chapter of the National Association of Substitute Senate Bill No. 807
Public Act No. 19-56 6 of 24
Social Workers;
(6) A psychiatrist licensed pursuant to chapter 370, appointed by the
Connecticut Psychiatric Society;
(7) A psychologist licensed pursuant to chapter 20-136, appointed
by the Connecticut Psychological Association;
(8) The Chief Medical Examiner, or the Chief Medical Examiner's
designee;
(9) A member of the Connecticut Hospital Association;
(10) A representative of a community or regional program or facility
providing services for persons with psychiatric disabilities or persons
with substance use disorders, appointed by the Commissioner of
Public Health;
(11) A representative of The University of Connecticut-sponsored
health disparities institute; or
(12) Any additional member the cochairpersons determine would be
beneficial to serve as a member of the committee.
Sec. 6. Subparagraphs (D) and (E) of subdivision (8) of section 19a-
177 of the general statutes are repealed and the following is substituted
in lieu thereof (Effective from passage):
(D) The commissioner shall collect the data required by
subparagraph (A) of this subdivision, in the manner provided in said
subparagraph, from each emergency medical service organization
licensed or certified pursuant to this chapter. Any such emergency
medical service organization that fails to comply with the provisions of
this section shall be liable for a civil penalty not to exceed one hundred
dollars per day for each failure to report the required data regarding
emergency medical services provided to a patient, as determined by Substitute Senate Bill No. 807
Public Act No. 19-56 7 of 24
the commissioner. The civil penalties set forth in this subparagraph
shall be assessed only after the department provides a written notice of
deficiency and the organization is afforded the opportunity to respond
to such notice. An organization shall have not more than fifteen
business days after the date of receiving such notice to provide a
written response to the department. The commissioner may adopt
regulations, in accordance with chapter 54, concerning the
development, implementation, monitoring and collection of
emergency medical service system data. All state agencies licensed or
certified as emergency medical service organizations shall be exempt
from the civil penalties set forth in this subparagraph. [;]
(E) The commissioner shall, with the recommendation of the
Connecticut Emergency Medical Services Advisory Board established
pursuant to section 19a-178a, adopt for use in trauma data collection
the most recent version of the National Trauma Data Bank's National
Trauma Data Standards and Data Dictionary and nationally
recognized guidelines for field triage of injured patients; [.]
Sec. 7. Section 19a-575 of the general statutes is repealed and the
following is substituted in lieu thereof (Effective from passage):
Any person eighteen years of age or older may execute a document
that contains directions as to any aspect of health care, including the
withholding or withdrawal of life support systems. Such document
shall be signed and dated by the maker with at least two witnesses and
may be in substantially the following form:
DOCUMENT CONCERNING HEALTH CARE AND
WITHHOLDING OR WITHDRAWAL OF LIFE SUPPORT SYSTEMS.
If the time comes when I am incapacitated to the point when I can
no longer actively take part in decisions for my own life, and am
unable to direct my physician or advanced practice registered nurse as Substitute Senate Bill No. 807
Public Act No. 19-56 8 of 24
to my own medical care, I wish this statement to stand as a testament
of my wishes.
"I, .... (Name), request that, if my condition is deemed terminal or if
it is determined that I will be permanently unconscious, I be allowed to
die and not be kept alive through life support systems. By terminal
condition, I mean that I have an incurable or irreversible medical
condition which, without the administration of life support systems,
will, in the opinion of my attending physician or advanced practice
registered nurse, result in death within a relatively short time. By
permanently unconscious I mean that I am in a permanent coma or
persistent vegetative state which is an irreversible condition in which I
am at no time aware of myself or the environment and show no
behavioral response to the environment. The life support systems
which I do not want include, but are not limited to:
Artificial respiration
Cardiopulmonary resuscitation
Artificial means of providing nutrition and hydration
(Cross out and initial life support systems you want administered)
I do not intend any direct taking of my life, but only that my dying
not be unreasonably prolonged.
If I am pregnant:
(Place a check to indicate option (1) or (2) or specify alternative
instructions after (3))
.... (1) I intend to accept life support systems if my doctor
believes that doing so would allow my fetus to reach a live birth.
.... (2) I intend this document to apply without modifications.
(3) I intend this document to apply as follows: …." Substitute Senate Bill No. 807
Public Act No. 19-56 9 of 24
Other specific requests:
"This request is made, after careful reflection, while I am of sound
mind."
.... (Signature)
.... (Date)
This document was signed in our presence, by the above-named ....
(Name) who appeared to be eighteen years of age or older, of sound
mind and able to understand the nature and consequences of health
care decisions at the time the document was signed.
.... (Witness)
.... (Address)
.... (Witness)
.... (Address)
Sec. 8. Subsection (a) of section 19a-575a of the general statutes is
repealed and the following is substituted in lieu thereof (Effective from
passage):
(a) Any person eighteen years of age or older may execute a
document that contains health care instructions, the appointment of a
health care representative, the designation of a conservator of the
person for future incapacity and a document of anatomical gift. Any
such document shall be signed and dated by the maker with at least
two witnesses and may be in the substantially following form:
THESE ARE MY HEALTH CARE INSTRUCTIONS.
MY APPOINTMENT OF A HEALTH CARE REPRESENTATIVE,
THE DESIGNATION OF MY CONSERVATOR OF THE PERSON Substitute Senate Bill No. 807
Public Act No. 19-56 10 of 24
FOR MY FUTURE INCAPACITY
AND
MY DOCUMENT OF ANATOMICAL GIFT
To any physician or advanced practice registered nurse who is
treating me: These are my health care instructions including those
concerning the withholding or withdrawal of life support systems,
together with the appointment of my health care representative, the
designation of my conservator of the person for future incapacity and
my document of anatomical gift. As my physician or advanced
practice registered nurse, you may rely on these health care
instructions and any decision made by my health care representative
or conservator of my person, if I am incapacitated to the point when I
can no longer actively take part in decisions for my own life, and am
unable to direct my physician or advanced practice registered nurse as
to my own medical care.
I, ...., the author of this document, request that, if my condition is
deemed terminal or if I am determined to be permanently
unconscious, I be allowed to die and not be kept alive through life
support systems. By terminal condition, I mean that I have an
incurable or irreversible medical condition which, without the
administration of life support systems, will, in the opinion of my
attending physician or advanced practice registered nurse, result in
death within a relatively short time. By permanently unconscious I
mean that I am in a permanent coma or persistent vegetative state
which is an irreversible condition in which I am at no time aware of
myself or the environment and show no behavioral response to the
environment. The life support systems which I do not want include,
but are not limited to: Artificial respiration, cardiopulmonary
resuscitation and artificial means of providing nutrition and hydration.
I do want sufficient pain medication to maintain my physical comfort. Substitute Senate Bill No. 807
Public Act No. 19-56 11 of 24
I do not intend any direct taking of my life, but only that my dying not
be unreasonably prolonged.
If I am pregnant:
(Place a check to indicate option (1) or (2) or specify alternative
instructions after (3))
.... (1) I intend to accept life support systems if my doctor
believes that doing so would allow my fetus to reach a live
birth.
.... (2) I intend this document to apply without modifications.
(3) I intend this document to apply as follows: ....
I appoint .... to be my health care representative. If my attending
physician or advanced practice registered nurse determines that I am
unable to understand and appreciate the nature and consequences of
health care decisions and unable to reach and communicate an
informed decision regarding treatment, my health care representative
is authorized to make any and all health care decisions for me,
including (1) the decision to accept or refuse any treatment, service or
procedure used to diagnose or treat my physical or mental condition,
except as otherwise provided by law such as for psychosurgery or
shock therapy, as defined in section 17a-540, and (2) the decision to
provide, withhold or withdraw life support systems. I direct my health
care representative to make decisions on my behalf in accordance with
my wishes, as stated in this document or as otherwise known to my
health care representative. In the event my wishes are not clear or a
situation arises that I did not anticipate, my health care representative
may make a decision in my best interests, based upon what is known
of my wishes.
If .... is unwilling or unable to serve as my health care
representative, I appoint .... to be my alternative health care Substitute Senate Bill No. 807
Public Act No. 19-56 12 of 24
representative.
If a conservator of my person should need to be appointed, I
designate .... be appointed my conservator. If .... is unwilling or unable
to serve as my conservator, [I designate ....] I designate .... to be
successor conservator. No bond shall be required of either of them in
any jurisdiction.
I hereby make this anatomical gift, if medically acceptable, to take
effect upon my death.
I give: (check one)
.... (1) any needed organs or parts
.... (2) only the following organs or parts ….
to be donated for: (check one)
(1) .... any of the purposes stated in subsection (a) of section 19a-289j
(2) .... these limited purposes ....
These requests, appointments, and designations are made after
careful reflection, while I am of sound mind. Any party receiving a
duly executed copy or facsimile of this document may rely upon it
unless such party has received actual notice of my revocation of it.
Date ...., 20..
.... L.S.
This document was signed in our presence by .... the author of this
document, who appeared to be eighteen years of age or older, of sound
mind and able to understand the nature and consequences of health
care decisions at the time this document was signed. The author
appeared to be under no improper influence. We have subscribed this
document in the author's presence and at the author's request and in Substitute Senate Bill No. 807
Public Act No. 19-56 13 of 24
the presence of each other.
.... ....
(Witness) (Witness)
.... ....
(Number and Street) (Number and Street)
.... ....
(City, State and Zip Code) (City, State and Zip Code)
STATE OF CONNECTICUT
}
ss. ....
COUNTY OF ....
We, the subscribing witnesses, being duly sworn, say that we
witnessed the execution of these health care instructions, the
appointments of a health care representative, the designation of a
conservator for future incapacity and a document of anatomical gift by
the author of this document; that the author subscribed, published and
declared the same to be the author's instructions, appointments and
designation in our presence; that we thereafter subscribed the
document as witnesses in the author's presence, at the author's request,
and in the presence of each other; that at the time of the execution of
said document the author appeared to us to be eighteen years of age or
older, of sound mind, able to understand the nature and consequences
of said document, and under no improper influence, and we make this
affidavit at the author's request this .... day of .... 20....
.... ....
(Witness) (Witness)
Subscribed and sworn to before me this .... day of .... 20..
.... Substitute Senate Bill No. 807
Public Act No. 19-56 14 of 24
Commissioner of the Superior Court
Notary Public
My commission expires: ....
(Print or type name of all persons signing under all signatures)
Sec. 9. Subdivision (2) of subsection (f) of section 19a-639a of the
general statutes is repealed and the following is substituted in lieu
thereof (Effective from passage):
(2) The unit may hold a public hearing with respect to any certificate
of need application submitted under this chapter. The unit shall
provide not less than two weeks' advance notice to the applicant, in
writing, and to the public by publication in a newspaper having a
substantial circulation in the area served by the health care facility or
provider. In conducting its activities under this chapter, the unit may
hold [hearing on] hearings with respect to applications of a similar
nature at the same time.
Sec. 10. Subdivision (4) of subsection (b) of section 19a-754a of the
general statutes is repealed and the following is substituted in lieu
thereof (Effective from passage):
(4) (A) Coordinating the state's health information technology
initiatives, (B) seeking funding for and overseeing the planning,
implementation and development of policies and procedures for the
administration of the all-payer claims database program established
under section 19a-775a, (C) establishing and maintaining a consumer
health information Internet web site under section 19a-755b, and (D)
designating an unclassified individual from the office to perform the
duties of a health information technology officer as set forth in sections
17b-59f and 17b-59g;
Sec. 11. Subdivisions (1) and (2) of subsection (j) of section 21a-252 Substitute Senate Bill No. 807
Public Act No. 19-56 15 of 24
of the general statutes are repealed and the following is substituted in
lieu thereof (Effective from passage):
(j) (1) A prescribing practitioner, as defined in section 20-14c, shall
not, except in an emergency, prescribe, dispense or administer
controlled substances in schedules II to IV, inclusive, to [a member of]
his or her immediate family member. For purposes of this section,
"immediate family member" means a spouse, parent, child, sibling,
parent-in-law, son or daughter-in-law, brother or sister-in-law, step-
parent, step-child, step-sibling or other relative residing in the same
residence as the prescribing practitioner and shall not include an
animal in the residence. In an emergency, a prescribing practitioner
may prescribe, dispense or administer not more than a seventy-two-
hour supply of such controlled substances to an immediate family
member only when there is no other qualified prescribing practitioner
available.
(2) A prescribing practitioner who prescribes, dispenses or
administers any controlled substance to [a member of] his or her
immediate family member pursuant to subdivision (1) of this
subsection shall perform an assessment for the care and treatment of
the patient, medically evaluate the patient's need for such controlled
substance and document such assessment and need in the normal
course of his or her business. The prescribing practitioner shall
document the emergency that gave rise to the prescription, dispensing
or administering of such controlled substance to the immediate family
member.
Sec. 12. Section 1 of special act 18-2 is amended to read as follows
(Effective from passage):
(a) There is established a task force to study (1) the short-term and
long-term needs of adults with intellectual disability, including, but
not limited to, such adults with significant behavioral health issues or Substitute Senate Bill No. 807
Public Act No. 19-56 16 of 24
significant issues related to aging, including Alzheimer's disease,
dementia and related disorders, and (2) ways in which the services and
support such adults need may be provided.
(b) The task force shall consist of the following members:
(1) Two appointed by the speaker of the House of Representatives,
one of whom has expertise in the diagnosis, care and treatment of
persons with intellectual disability and one of whom has expertise in
the provision of residential services to persons with intellectual
disability;
(2) Two appointed by the president pro tempore of the Senate, one
of whom has expertise in the provision of day services for persons
with intellectual disability and one of whom has expertise in the
provision of program support services to persons with intellectual
disability;
(3) One appointed by the majority leader of the House of
Representatives, who is the parent, guardian or relative of a person
with intellectual disability who has high-level needs;
(4) One appointed by the majority leader of the Senate, who is the
parent, guardian or relative of a person with intellectual disability;
(5) One appointed by the minority leader of the House of
Representatives, who is the parent, guardian or relative of a person
with intellectual disability;
(6) One appointed by the minority leader of the Senate, who is the
parent, guardian or relative of a person with intellectual disability who
has high-level needs;
(7) The chairpersons and ranking members of the joint standing
committee of the General Assembly having cognizance of matters Substitute Senate Bill No. 807
Public Act No. 19-56 17 of 24
relating to public health, or their designees;
(8) The Commissioner of Developmental Services, or the
commissioner's designee; and
(9) The Secretary of the Office of Policy and Management, or the
secretary's designee.
(c) Any member of the task force appointed under subdivision (1),
(2), (3), (4), (5), (6) or (7) of subsection (b) of this section may be a
member of the General Assembly.
(d) All appointments to the task force shall be made not later than
thirty days after the effective date of this section. Any vacancy shall be
filled by the appointing authority.
(e) The speaker of the House of Representatives and the president
pro tempore of the Senate shall select the chairpersons of the task force
from among the members of the task force. Such chairpersons shall
schedule the first meeting of the task force, which shall be held not
later than sixty days after the effective date of this section.
(f) The administrative staff of the joint standing committee of the
General Assembly having cognizance of matters relating to public
health shall serve as administrative staff of the task force.
(g) Not later than January 1, [2019] 2020, the task force shall submit
a report on its findings and recommendations to the joint standing
committee of the General Assembly having cognizance of matters
relating to public health, in accordance with the provisions of section
11-4a of the general statutes. The task force shall terminate on the date
that it submits such report or January 1, [2019] 2020, whichever is later.
Sec. 13. Subsections (c) and (d) of section 20-112a of the general
statutes are repealed and the following is substituted in lieu thereof Substitute Senate Bill No. 807
Public Act No. 19-56 18 of 24
(Effective July 1, 2019):
(c) (1) A licensed dentist may delegate to dental assistants such
dental procedures as the dentist may deem advisable, including: (A)
The taking of dental x-rays if the dental assistant can demonstrate
successful completion of the dental radiation health and safety
examination administered by the Dental Assisting National Board; (B)
the taking of impressions of teeth for study models; and (C) the
provision of fluoride varnish treatments. Such procedures shall be
performed under the direct supervision of a licensed dentist and the
dentist providing direct supervision shall assume responsibility for
such procedures.
(2) A licensed dentist may delegate to an expanded function dental
assistant such dental procedures as the dentist may deem advisable,
including: (A) The placing, finishing and adjustment of temporary
restorations and long-term individual fillings, capping materials and
cement bases; (B) oral health education for patients; (C) dental sealants;
[and] (D) coronal polishing, provided the procedure is not represented
or billed as prophylaxis; (E) administration of topical anesthetic under
the direct supervision of the dentist prior to the administration of local
anesthetic by a dentist or dental hygienist; and (F) taking alginate
impressions of teeth, under the direct supervision of the dentist, for
use in study models, orthodontic appliances, whitening trays, mouth
guards or fabrication of temporary crowns. Such procedures shall be
performed under [the] either direct or indirect supervision, except as
specifically provided in this subdivision, and the dentist providing
such supervision shall assume responsibility for such procedures.
(3) [On or after July 1, 2018, (A) no] (A) No licensed dentist may
delegate dental procedures to a dental assistant or expanded function
dental assistant unless the dental assistant or expanded function dental
assistant provides records demonstrating successful completion of the
Dental Assisting National Board's infection control examination or an Substitute Senate Bill No. 807
Public Act No. 19-56 19 of 24
infection control competency assessment administered by a dental
education program in the state that is accredited by the American
Dental Association's Commission on Dental Accreditation, except as
provided in subdivision (2) of this subsection, (B) a dental assistant
may receive not more than [nine] fifteen months of on-the-job training
by a licensed dentist for purposes of preparing the dental assistant for
the [Dental Assisting National Board's] infection control examination
or infection control competency assessment, and (C) any licensed
dentist who delegates dental procedures to a dental assistant shall
retain and make such records available for inspection upon request of
the Department of Public Health.
(4) On and after January 1, 2018, upon successful completion of the
Dental Assisting National Board's infection control examination or an
infection control competency assessment administered by a dental
education program in the state that is accredited by the American
Dental Association's Commission on Dental Accreditation, each dental
assistant or expanded function dental assistant shall complete not less
than one hour of training or education in infection control in a dental
setting every two years, including, but not limited to, courses,
including online courses, offered or approved by a dental school or
another institution of higher education that is accredited or recognized
by the Commission on Dental Accreditation, a regional accrediting
organization, the American Dental Association or a state, district or
local dental association or society affiliated with the American Dental
Association or the American Dental Assistants Association.
(d) [Under] Except as provided in subsection (c) of this section,
under no circumstances may a dental assistant or expanded function
dental assistant engage in: (1) Diagnosis for dental procedures or
dental treatment; (2) the cutting or removal of any hard or soft tissue
or suturing; (3) the prescribing of drugs or medications that require the
written or oral order of a licensed dentist or physician; (4) the Substitute Senate Bill No. 807
Public Act No. 19-56 20 of 24
administration of local, parenteral, inhalation or general anesthetic
agents in connection with any dental operative procedure; (5) the
taking of any final impression of the teeth or jaws or the relationship of
the teeth or jaws for the purpose of fabricating any appliance or
prosthesis; or (6) the practice of dental hygiene as defined in section
20-126l.
Sec. 14. (NEW) (Effective January 1, 2020) (a) As used in this section:
(1) "Practice of dental therapy" means the performance of
educational, preventive and therapeutic services through any one or
more of the following practices and procedures: (A) Identification of
oral and systemic conditions requiring evaluation or treatment by
dentists, physicians or other health care providers, and management of
referrals to dentists, physicians and other health care providers; (B)
diagnosis and treatment of oral diseases and conditions that are within
the dental therapist scope of practice; (C) comprehensive charting of
the oral cavity; (D) oral health instruction and disease prevention
education, including nutritional counseling and dietary analysis; (E)
dispensing and administering of nonnarcotic analgesics and anti-
inflammatory and antibiotic medications as prescribed by a licensed
health care provider, except schedule II, III or IV controlled substances;
(F) applying topical preventive or prophylactic agents, including
fluoride varnish, antimicrobial agents and pit and fissure sealants; (G)
pulp vitality testing; (H) applying desensitizing medication or resin in
the oral cavity; (I) interim therapeutic restorations; (J) fabricating
athletic mouth guards; (K) changing periodontal dressings; (L)
administering local anesthetics in the oral cavity under the general
supervision of a dentist; (M) simple extraction of erupted primary
teeth; (N) nonsurgical extraction of periodontally diseased permanent
teeth with tooth mobility of three or greater, except a tooth that is
unerupted, impacted, fractured or needs to be sectioned for removal;
(O) emergency palliative treatment of dental pain; (P) preparation and Substitute Senate Bill No. 807
Public Act No. 19-56 21 of 24
placement of direct restoration in primary and permanent teeth that
does not require the fabrication of crowns, bridges, veneers or
dentures; (Q) fabrication and placement of single-tooth temporary
crowns; (R) preparation and placement of preformed crowns on
primary teeth; (S) indirect and direct pulp capping on permanent teeth;
(T) indirect pulp capping on primary teeth; (U) dental suture removal;
(V) minor adjustments and repairs on removable prostheses; (W)
placement and removal of space maintainers; and (X) recementing
permanent crowns;
(2) "Collaborative agreement" means a written agreement between a
dental therapist and a dentist licensed pursuant to chapter 379 of the
general statutes, that defines the working relationship between the
dental therapist and the dentist and the parameters of the practice of
dental therapy;
(3) "Dental therapist" means a licensed dental hygienist authorized
to engage in the practice of dental therapy under a collaborative
agreement; and
(4) "Public health facility" has the same meaning as provided in
section 20-126l of the general statutes.
(b) No person shall engage in the practice of dental therapy unless
such person (1) is a dental hygienist licensed pursuant to chapter 379a
of the general statutes; (2) has obtained a dental therapist certification
that is (A) in writing, on a form issued by an institution of higher
education accredited by the Commission on Dental Accreditation after
successful completion of a dental therapy program that includes, in
accordance with the Commission on Dental Accreditation's standards
for dental therapy education programs, full-time instruction or its
equivalent at the postsecondary college level and incorporates all
dental therapy practice competencies, (B) signed by the dental
therapist and the director of the dental therapy education program, Substitute Senate Bill No. 807
Public Act No. 19-56 22 of 24
and (C) made available to the Department of Public Health upon
request; (3) has successfully completed a comprehensive examination
prescribed by the Commission on Dental Competency Assessments, or
its equivalent, and administered independently of any institution of
higher education that offers a program in dental therapy; (4) prior to
entering the first collaborative agreement, (A) has received a certificate
of completion, signed by a dentist licensed pursuant to chapter 379 of
the general statutes, that verifies completion of one thousand hours of
clinical training under the direct supervision of such dentist, and (B)
has successfully completed six hours of continuing education related
to dental therapy; and (5) has entered into a collaborative agreement
with a dentist.
(c) A dental therapist shall practice in a public health facility under
the general supervision of a dentist licensed pursuant to chapter 379 of
the general statutes in accordance with a collaborative agreement.
(d) No provision of this section shall be construed to prohibit a
dental hygienist enrolled in a dental therapy program, as described in
subdivision (2) of subsection (b) of this section, from performing dental
therapy work as a required component of his or her course of study in
such program, provided such dental hygienist (1) performs such work
under the direct supervision of a dentist licensed pursuant to chapter
379 of the general statutes, (2) shall not hold himself or herself out as a
certified dental therapist, and (3) shall not receive compensation for
such work.
(e) (1) A collaborative agreement entered into pursuant to
subsection (b) of this section shall include: (A) Identification of public
health facilities where services may be provided and the populations
to be served; (B) any limitations on the services that may be provided
by the dental therapist; (C) age and procedure-specific practice
protocols, including case selection criteria, assessment guidelines and
imaging frequency; (D) a procedure for creating and maintaining Substitute Senate Bill No. 807
Public Act No. 19-56 23 of 24
dental records for the patients that are treated by the dental therapist;
(E) a plan to manage medical emergencies in each public health facility
where the dental therapist provides care; (F) a quality assurance plan
for monitoring care provided by the dental therapist, including patient
care review, referral follow-up and a quality assurance chart review;
(G) protocols for dispensing and administering medications, including
the specific conditions and circumstances under which these
medications may be dispensed and administered; (H) criteria relating
to the provision of care to patients with specific medical conditions or
complex medication histories, including requirements for consultation
prior to the initiation of care; (I) criteria for the supervision of dental
assistants, expanded function dental assistants, as defined in section
20-112a of the general statutes, as amended by this act, and dental
hygienists in accordance with subsection (g) of this section; and (J) a
plan for the provision of referrals in situations that are beyond the
capabilities or the scope of practice of the dental therapist.
(2) A collaborative agreement shall be (A) signed and maintained by
the supervising dentist and the dental therapist and kept on file at the
locations where such dental therapist is employed; (B) reviewed by the
dentist and dental therapist on an annual basis and revised as needed;
and (C) available for inspection upon the request of the Department of
Public Health.
(f) A dentist who enters into a collaborative agreement with a dental
therapist (1) shall be professionally responsible and legally liable for all
services authorized and performed by the dental therapist pursuant to
a collaborative agreement, and (2) may not enter into a collaborative
agreement with more than two dental therapists at any one time.
Nothing in this section shall be construed to require a dentist to enter
into a collaborative agreement with a dental therapist.
(g) A dental therapist may directly supervise not more than two
dental assistants or expanded function dental assistants, as defined in Substitute Senate Bill No. 807
Public Act No. 19-56 24 of 24
section 20-112a of the general statutes, as amended by this act, or
dental hygienists licensed pursuant to chapter 379a of the general
statutes to the extent permitted in the collaborative agreement.
(h) (1) Each dental therapist shall complete, in addition to the
continuing education requirements of subsection (g) of section 20-126l
of the general statutes, six hours of continuing education in dental
therapy within the twelve-month period after such dental therapist
enters into a collaborative agreement with a dentist and within each
subsequent twenty-four-month period thereafter.
(2) Each dental therapist applying for a renewal of a dental hygiene
license pursuant to chapter 379a of the general statutes and in
accordance with section 19a-88 of the general statutes shall sign a
statement attesting that he or she has satisfied the continuing
education requirements described in subdivision (1) of this subsection
on a form prescribed by the Department of Public Health. Each dental
therapist shall retain records of attendance or certificates of completion
that demonstrate compliance with the continuing education
requirements described in subdivision (1) of this subsection for not less
than three years following the date on which the continuing education
was completed or the license was renewed. Each dental therapist shall
submit such records to the department for inspection not later than
forty-five days after a request by the department for such records. A
dental therapist who fails to comply with the provisions of this section
may be subject to disciplinary action pursuant to section 20-126o of the
general statutes.