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General Assembly Raised Bill No. 1035
January Session, 2019
LCO No. 4609
Referred to Committee on PUBLIC HEALTH
Introduced by:
(PH)
AN ACT AUTHORIZING D EEMED STATUS LICENSE RENEWALS FOR
CERTAIN NONPROFIT CO MMUNITY SERVICE PROV IDERS.
Be it enacted by the Senate and House of Representatives in General
Assembly convened:
Section 1. Section 17a-20 of the general statutes is repealed and the 1
following is substituted in lieu thereof (Effective October 1, 2019, and 2
applicable to applications for renewal submitted after the adoption of 3
regulations in accordance with this section): 4
(a) For the purposes of this section, "psychiatric clinic" means an 5
organization licensed by the Department of Children and Families and 6
staffed by psychiatrists, psychologists, social workers and such other 7
professional, paraprofessional and clerical personnel as local 8
circumstances may require, working in collaboration with other social 9
service agencies, to provide mental health services that are designed to 10
(1) effectively decrease the prevalence and incidence of mental illness, 11
emotional disturbance and social [disfunctioning] dysfunction, and (2) 12
promote mental health in individuals, groups and institutions, and 13
includes a general hospital with such clinic services. The Department 14
of Children and Families shall develop and maintain a program of 15 Raised Bill No. 1035
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outpatient psychiatric clinics for children and youths and their 16
families. 17
(b) For the purposes of this section, "child guidance clinic" means a 18
subset of psychiatric clinics for children designated by the Department 19
of Children and Families pursuant to this section to receive grant 20
funds for the purpose of assisting the department to provide 21
community-based psychiatric services for children, youths and 22
families. In order to meet such mandate, the department shall 23
designate a subset of outpatient psychiatric clinics for children to be 24
known as child guidance clinics. The department shall provide grants 25
to such child guidance clinics in accordance with the provisions of this 26
section. Any town having a population of not less than forty thousand, 27
as most recently determined by the Secretary of the Office of Policy 28
and Management, or any combination of towns with a combined 29
population of not less than forty thousand as similarly determined, or 30
any nonprofit corporation organized or existing for the purpose of 31
establishing or maintaining a psychiatric clinic for children and youths 32
or for children and youths and their families, or any clinic designated 33
by the Department of Children and Families as of January 1, 1995, may 34
apply to the Department of Children and Families for funds to be used 35
to assist in establishing, maintaining or expanding a psychiatric clinic. 36
The applications, and any grant of funds pursuant thereto, shall not be 37
subject to the provisions of section 17a-476, except to the extent 38
required by federal law. The department shall base any grant of funds 39
on the services provided to children and youths under eighteen years 40
of age and on the effectiveness of the services. No grant shall exceed 41
two-thirds of the ordinary recurring operating expenses of the clinic, 42
nor shall any grant be made to pay for any portion of capital 43
expenditures for the clinic. No clinic in existence as of October 1, 1995, 44
shall be eligible for grants of any funds under this section unless it has 45
obtained a license within six months of the adoption of regulations 46
under subsection (c) of this section. No clinic receiving funds under 47
this section shall refuse services to any resident of this state solely 48
because of his or her place of residence. 49 Raised Bill No. 1035
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(c) The Department of Children and Families shall adopt 50
regulations, in accordance with the provisions of chapter 54, defining 51
the minimum requirements for outpatient psychiatric clinics for 52
children to be eligible for licensure under this section in regard to (1) 53
qualification and number of staff members, (2) clinic operation, 54
including, but not limited to physical plant, governing body and 55
recordkeeping, (3) effectiveness of services, [and] (4) populations 56
targeted for priority access, (5) national accrediting organizations that 57
the department finds have standards that are more or at least as 58
stringent for obtaining accreditation as the state requirements for 59
obtaining a license under this section, and (6) any other provisions 60
necessary to implement the provisions of subsection (d) of this section. 61
The regulations shall also govern the granting of the funds to assist in 62
establishing, maintaining and expanding psychiatric clinics. The 63
regulations may also set an administrative fee sufficient to pay for the 64
costs to the department of processing an application for a deemed 65
status license under subsection (d) of this section. The department 66
shall, upon payment of a fee of three hundred dollars, issue to any 67
qualifying clinic a license that shall be in force for twenty-four months 68
from the date of issue and, except as provided in subsection (d) of this 69
section, shall be renewable for additional twenty-four-month periods, 70
upon payment of a fee of three hundred dollars for each such period, 71
provided the clinic continues to meet conditions satisfactory to the 72
department. The department shall make available to child guidance 73
clinics forms to be used in making application for available funds. 74
Upon receipt of proper application, the department shall grant the 75
funds, provided the plans for financing, the standards of operation and 76
the effectiveness of services of the clinics are approved by the 77
department in accordance with the provisions of this section. The 78
grants shall be made on an annual basis. 79
(d) In lieu of applying for renewal of a license under subsection (c) 80
of this section, a clinic may, at the time when any renewal is due, 81
submit evidence, satisfactory to the department, that such clinic has 82
been accredited as a provider of outpatient psychiatric services within 83 Raised Bill No. 1035
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the immediately preceding twelve-month period by a national 84
accrediting organization that the department has listed in regulations 85
adopted pursuant to subsection (c) of this section. The department 86
may waive the inspection and investigation of such clinic required by 87
this section and, in such event, any such clinic shall be deemed to have 88
satisfied the requirements of this section for the purposes of licensure. 89
Such deemed status license shall be valid for two years and shall not 90
be transferable or assignable. The provisions of this subsection shall 91
not be construed to limit the department's authority to inspect any 92
clinic, suspend or revoke any license or deemed status license issued 93
pursuant to this section or take any other legal action authorized by 94
any provision of the general statutes. 95
Sec. 2. Section 17a-145 of the general statutes is repealed and the 96
following is substituted in lieu thereof (Effective October 1, 2019, and 97
applicable to applications for renewal submitted after the adoption of 98
regulations in accordance with this section): 99
(a) No person or entity shall care for or board a child without a 100
license obtained from the Commissioner of Children and Families, 101
except: (1) When a child has been placed by a person or entity holding 102
a license from the commissioner; (2) any residential educational 103
institution exempted by the State Board of Education under the 104
provisions of section 17a-152; (3) residential facilities under contract 105
with or licensed by the Department of Developmen tal Services 106
pursuant to section 17a-227, as amended by this act; (4) facilities 107
providing child care services, as defined in section 19a-77; or (5) any 108
home that houses students participating in a program described in 109
subparagraph (B) of subdivision (8) of section 10a-29. 110
(b) The person or entity seeking a child care facility license shall file 111
with the commissioner an application for a license, in such form as the 112
commissioner furnishes, stating the location where it is proposed to 113
care for such child, the number of children to be cared for, in the case 114
of a corporation, the purpose of the corporation and the names of its 115
chief officers and of the actual person responsible for the child. The 116 Raised Bill No. 1035
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Commissioner of Children and Families is authorized to fix the 117
maximum number of children to be boarded and cared for in any such 118
home or institution or by any person or entity licensed by the 119
commissioner. If the population served at any facility, institution or 120
home operated by any person or entity licensed under this section 121
changes after such license is issued, such person or entity shall file a 122
new license application with the commissioner, and the commissioner 123
shall notify the chief executive officer of the municipality in which the 124
facility is located of such new license application, except that no 125
confidential client information may be disclosed. 126
(c) In lieu of applying for the renewal of a license under this section, 127
a person or entity may, at the time when any renewal is due, submit 128
evidence, satisfactory to the commissioner, that such person or entity 129
has been accredited as a provider of services within the immediately 130
preceding twelve-month period by a national accrediting organization 131
that the department has listed in regulations adopted pursuant to 132
subsection (f) of this section. The commissioner may waive any 133
inspection and investigation of such person or entity and, in such 134
event, any such person or entity shall be deemed to have satisfied the 135
requirements of this section for the purposes of licensure. Such 136
deemed status license shall be valid for two years and shall not be 137
transferable or assignable. The provisions of this subsection shall not 138
be construed to limit the commissioner's authority to inspect any 139
person or entity, suspend or revoke any license or deemed status 140
license issued pursuant to this section or take any other legal action 141
authorized by any provision of the general statutes. 142
[(b)] (d) The Commissioner of Children and Families shall adopt 143
regulations, in accordance with the provisions of chapter 54, (1) setting 144
forth standards for the licensing of child care facilities, and (2) to 145
implement the provisions of subsection (c) of this section. Such 146
regulations setting forth licensing standards shall include, but not be 147
limited to, minimum standards for [(1)] the physical requirements of 148
such facilities, [(2)] the care and treatment of children cared for or 149
boarded in such facilities, and [(3)] the staffing of such facilities. Such 150 Raised Bill No. 1035
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regulations implementing the provision of subsection (c) of this section 151
shall (A) list any national accrediting organizations that the 152
commissioner finds have standards that are more or at least as 153
stringent for obtaining accreditation as the state requirements for 154
obtaining a license under this section, and (B) contain any other 155
provisions necessary to implement the provisions of subsection (c) of 156
this section. The regulations may also set an administrative fee 157
sufficient to pay for the costs to the department of processing an 158
application for a deemed status license under subsection (c) of this 159
section. 160
[(c)] (e) Each person or entity licensed by the commissioner 161
pursuant to subsection (a) of this section shall designate an on-site staff 162
member who shall apply a reasonable and prudent parent standard, as 163
defined in subsection (a) of section 17a-114d, on behalf of the child. 164
[(d)] (f) The Commissioner of Children and Families shall not be 165
responsible for the licensing of any facility that does not board or care 166
for children or youths under eighteen years of age. 167
Sec. 3. Section 17a-147 of the general statutes is repealed and the 168
following is substituted in lieu thereof (Effective October 1, 2019, and 169
applicable to applications for renewal submitted after the adoption of 170
regulations in accordance with this section): 171
(a) For the purposes of this section and section 17a-22, "extended 172
day treatment" means a supplementary care community -based 173
program providing a comprehensive multidisciplinary approach to 174
treatment and rehabilitation of emotionally disturbed, mentally ill, 175
behaviorally disordered or multiply handicapped children and youths 176
during the hours immediately before and after school while they 177
reside with their parents or surrogate family. Extended day treatment 178
programs, except any such program provided by a regional 179
educational service center established in accordance with section 10-180
66a, shall be licensed by the Department of Children and Families. 181
(b) The goal of extended day treatment is to improve the 182 Raised Bill No. 1035
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functioning of the child or youth as an individual and the family as a 183
unit with the least possible interruption of beneficial relationships with 184
the family and the community. An extended day treatment program 185
(1) shall offer the broadest range of therapeutic services consistent with 186
the needs of the children and youths it serves, including, but not 187
limited to, (A) a therapeutic setting, (B) the integration of the family 188
into the treatment and the treatment planning process, (C) support and 189
emergency services to families designed to allow continued residence 190
of the children and youths in their homes, (D) professional clinical 191
services, (E) access to educational services, and (F) the coordination of 192
community services in support of the treatment effort, or (2) if 193
provided for children requiring special education by a regional 194
educational service center, shall offer such services as are specified in 195
the prescribed educational program for each such child in accordance 196
with section 10-76d. 197
(c) The Commissioner of Children and Families shall adopt such 198
regulations, in accordance with chapter 54, as are necessary to establish 199
procedures and requirements for the licensure of extended day 200
treatment programs, except any such program provided by a regional 201
educational service center. Such regulations shall (1) set forth an 202
optional process for the provider of an extended day treatment 203
program to apply for renewal of such license by submitting evidence, 204
satisfactory to the commissioner, that such person or entity has been 205
accredited as a provider of extended day treatment services within the 206
immediately preceding twelve-month period by a national accrediting 207
organization, (2) list the national accrediting organizations that the 208
department finds have standards that are more or at least as stringent 209
for obtaining accreditation as the state requirements for obtaining a 210
license under this section, and (3) contain any other provisions 211
necessary to implement this section. The regulations may also set an 212
administrative fee sufficient to pay for the costs to the department of 213
processing an application for a deemed status license. 214
(d) After the adoption of regulations in accordance with this section, 215
the commissioner may waive any inspection and investigation of a 216 Raised Bill No. 1035
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provider of extended day treatment programs applying for a renewal 217
of such license that is accredited in accordance with, and that satisfies 218
any other requirements of, the regulations adopted under this section, 219
and, in such event, any such provider shall be deemed to have satisfied 220
the requirements of this section for the purposes of licensure. Such 221
license shall not be transferable or assignable. The provisions of this 222
subsection shall not be construed to limit the commissioner's authority 223
to inspect any provider, suspend or revoke any license or deemed 224
status license issued pursuant to this section or take any other legal 225
action authorized by any provision of the general statutes. 226
Sec. 4. Section 17a-149 of the general statutes is repealed and the 227
following is substituted in lieu thereof (Effective October 1, 2019, and 228
applicable to applications for renewal submitted after the adoption of 229
regulations in accordance with section 17a-150): 230
(a) No person or entity except a parent, an adult relative as specified 231
by section 17b-75 or guardian of any child shall place a child without a 232
license obtained from the Commissioner of Children and Families. 233
Application for a child-placing license shall be in a form furnished by 234
the commissioner, and shall state the location of the principal place of 235
business of the applicant, its organization or corporate name, its 236
purposes and the name, title and degree of professional training of 237
each of its staff members engaged in carrying out its stated purposes. 238
Any such applicant shall consent to such inspection, review and 239
supervision of all acts in relation to child placing as are reasonably 240
necessary to enable the commissioner to perform his or her duties 241
under section 17a-151, as amended by this act. The provisions of this 242
section with regard to the commissioner's authority to inspect, review 243
and supervise all acts in relation to child placing under section 17a-151, 244
as amended by this act, shall be limited to inspection, review and 245
supervision of the applicant under this section and shall not include 246
inspection, review or supervision of the homes in which a child is 247
placed. 248
(b) In lieu of applying for renewal of a license under this section, an 249 Raised Bill No. 1035
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applicant may, at the time when any renewal is due, submit evidence, 250
satisfactory to the commissioner, that such applicant has been 251
accredited as a provider of child-placing services within the 252
immediately preceding twelve-month period by a national accrediting 253
organization that the department has listed in regulations adopted 254
pursuant to section 17a-150, as amended by this act. The commissioner 255
may waive any inspection and investigation of such applicant required 256
under this section and, in such event, any such applicant shall be 257
deemed to have satisfied the requirements of this section for the 258
purposes of licensure. Such deemed status license shall be valid for 259
two years and shall not be transferable or assignable. The provisions of 260
this subsection shall not be construed to limit the commissioner's 261
authority to inspect any applicant, suspend or revoke any license or 262
deemed status license issued pursuant to this section or take any other 263
legal action authorized by any provision of the general statutes. 264
Sec. 5. Section 17a-150 of the general statutes is repealed and the 265
following is substituted in lieu thereof (Effective October 1, 2019): 266
The Commissioner of Children and Families shall adopt regulations 267
in accordance with chapter 54 setting forth standards for licensing of 268
child-placing agencies, as defined in section 17a-93. Such regulations 269
shall (1) set minimum standards for homes in which children may be 270
placed, (2) require that a child-placing agency have a minimum of two 271
staff persons who are qualified by a combination of education and 272
work experience, and (3) require that a child-placing agency be a 273
nonprofit organization qualified as a tax-exempt organization under 274
Section 501(c)(3) of the Internal Revenue Code of 1986, or any 275
subsequent corresponding internal revenue code of the United States, 276
as from time to time amended. Such regulations shall (A) set forth an 277
optional process for persons or entities that place children to apply for 278
renewal of their license by submitting evidence, satisfactory to the 279
commissioner, that such person or entity has been accredited as a 280
provider of child placement services within the immediately preceding 281
twelve-month period by a national accrediting organization, (B) list the 282
national accrediting organizations that the department finds have 283 Raised Bill No. 1035
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standards that are more or at least as stringent for obtaining 284
accreditation as the state requirements for obtaining a license under 285
section 17a-149, as amended by this act, and (C) contain any other 286
provisions necessary to implement the provisions of section 17a-149, as 287
amended by this act. The regulations may also set an administrative 288
fee sufficient to pay for the costs to the department of processing an 289
application for a deemed status license under section 17a-149, as 290
amended by this act. 291
Sec. 6. Section 17a-151 of the general statutes is repealed and the 292
following is substituted in lieu thereof (Effective October 1, 2019): 293
(a) [The] Except as provided in subsection (b) of this section, the 294
Commissioner of Children and Families shall investigate the 295
conditions stated in each application made under the provisions of 296
sections 17a-145 and 17a-149, as amended by this act, and shall require 297
any person identified on the application under said sections to submit 298
to state and national criminal history records checks. [The] Except as 299
provided in subsection (b) of this section, the commissioner shall 300
investigate the conditions in each application under the provisions of 301
sections 17a-145 and 17a-149, as amended by this act, and, if the 302
commissioner finds such conditions suitable for the proper care of 303
children, or for the placing out of children, under such standards for 304
the promotion of the health, safety, morality and well-being of such 305
children as the commissioner prescribes, shall issue such license as is 306
required as promptly as possible, without expense to the licensee. If, 307
after such investigation, the commissioner finds that the applicant, 308
notwithstanding good faith efforts, is not able to fully comply with all 309
the requirements the commissioner prescribes, but compliance can be 310
achieved with minimal efforts, the commissioner may issue a 311
provisional license for a period not to exceed sixty days. The 312
provisional license may be renewed for additional sixty-day periods, 313
but in no event shall the total of such periods be for longer than one 314
year. Before issuing any license, the commissioner shall give to the 315
selectmen of the town wherein such licensee proposes to carry on the 316
licensed activity ten days' notice in writing that the issuance of such 317 Raised Bill No. 1035
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license is proposed, but such notice shall not be required in case of 318
intention to issue such license to any corporation incorporated for the 319
purpose of caring for or placing such children. Each license so issued 320
shall specify whether it is granted for child-caring or child-placing 321
purposes, shall state the number of children who may be cared for, 322
shall be in force twenty-four months from date of issue, and shall be 323
renewed for the ensuing twenty-four months, if conditions continue to 324
be satisfactory to the commissioner. The commissioner shall also 325
provide such periodical inspections and review as shall safeguard the 326
well-being, health and morality of all children cared for or placed 327
under a license issued by the commissioner under this section and 328
shall visit and consult with each such child and with the licensee as 329
often as the commissioner deems necessary but, for licenses other than 330
deemed status licenses, at intervals of not more than ninety days. Each 331
licensee under the provisions of this section shall file annually with the 332
commissioner a report containing such information concerning its 333
functions, services and operation, including financial data, as the 334
commissioner requires. Any license issued under this section, 335
including a deemed status license, may be revoked, suspended or 336
limited by the commissioner for cause, after notice given to the person 337
or entity concerned and after opportunity for a hearing thereon. Any 338
party whose application is denied or whose license is revoked, 339
suspended or limited by the commissioner may appeal from such 340
adverse decision in accordance with the provisions of section 4-183. 341
Appeals under this section shall be privileged in respect to the order of 342
trial assignment. 343
(b) The criminal history records checks required pursuant to 344
subsection (a) of this section shall be conducted in accordance with 345
section 29-17a. 346
(c) The commissioner may waive any inspection and investigation 347
of a person who is applying or who has obtained a deemed status 348
license in accordance with the provisions of sections 17a-145 and 17a-349
149, as amended by this act. 350 Raised Bill No. 1035
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Sec. 7. Section 17a-227 of the general statutes is repealed and the 351
following is substituted in lieu thereof (Effective October 1, 2019, and 352
applicable to applications for renewal submitted after the adoption of 353
regulations in accordance with this section): 354
(a) No person, firm or corporation shall operate within this state a 355
community living arrangement or community companion home which 356
it owns, leases or rents for the lodging, care or treatment of persons 357
with intellectual disability, Prader-Willi syndrome or autism spectrum 358
disorder unless such person, firm or corporation, upon written 359
application, has obtained a license issued by the Department of 360
Developmental Services. An application for licensure under this 361
section shall be verified by oath, but need not be notarized. 362
(b) The commissioner shall adopt regulations, in accordance with 363
the provisions of chapter 54, to ensure the comfort, safety, adequate 364
medical care and treatment of such persons at the residential facilities 365
described in subsection (a) of this section. Such regulations shall 366
include requirements that: (1) All residential facility staff be certified in 367
cardiopulmonary resuscitation in a manner and time frame prescribed 368
by the commissioner; (2) records of staffing schedules and actual staff 369
hours worked, by residential facility, be available for inspection by the 370
department upon advance notice; (3) each residential facility develop 371
and implement emergency plans and staff training to address 372
emergencies that may pose a threat to the health and safety of the 373
residents of the facility; (4) department staff verify during quality 374
service reviews and licensing inspections, that (A) staff is adequately 375
trained to respond in an emergency, and (B) a summary of information 376
on each resident is available to emergency medical personnel for use in 377
an emergency; (5) all residential facilities serving persons with Down 378
syndrome fifty years of age or older have at least one staff member 379
trained in Alzheimer's disease and dementia symptoms and care; and 380
(6) for community living arrangements, the commissioner shall 381
determine a minimum number of licensure-related visits that are 382
unannounced. Such regulations shall also set forth an optional process 383
for a person, firm or corporation that operates a community living 384 Raised Bill No. 1035
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arrangement or community companion home within this state to apply 385
for renewal of a license under this section by submitting evidence, 386
satisfactory to the commissioner, that such person, firm or corporation 387
has been accredited as a provider of services within the immediately 388
preceding twelve-month period by a national accrediting organization, 389
list the national accrediting organizations that the department finds 390
have standards that are more or at least as stringent for obtaining 391
accreditation as the state requirements for obtaining a license under 392
this section, and contain any other provisions necessary to implement 393
the provisions of this subsection. The regulations may also set an 394
administrative fee sufficient to pay for the costs to the department of 395
processing an application for a deemed status license under this 396
section. 397
(c) After receiving an application and making such investigation as 398
is deemed necessary and after finding the specified requirements to 399
have been fulfilled, the department shall grant a license to such 400
applicant to operate a facility of the character described in such 401
application, which license shall specify the name of the person to have 402
charge and the location of each facility operated under the license. In 403
the case of a renewal of such license, an applicant may, at the time 404
when any such renewal is due, submit evidence, satisfactory to the 405
department, that such applicant has been accredited as a provider of 406
services within the immediately preceding twelve-month period by a 407
national accrediting organization that the department has listed in 408
regulations adopted pursuant to subsection (b) of this section. The 409
department may waive any inspection and investigation of such 410
applicant required under this section and, in such event, any such 411
applicant shall be deemed to have satisfied the requirements of this 412
section for the purposes of licensure. Such deemed status license shall 413
be valid for two years and shall not be transferable or assignable. The 414
provisions of this subsection shall not be construed to limit the 415
department's authority to inspect any applicant, suspend or revoke 416
any license or deemed status license issued pursuant to this section or 417
take any other legal action authorized by any provision of the general 418 Raised Bill No. 1035
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statutes. Any person, firm or corporation aggrieved by any 419
requirement of the regulations or by the refusal to grant any license 420
may request an administrative hearing in accordance with the 421
provisions of chapter 54. If the licensee of any such facility desires to 422
place in charge thereof a person other than the one specified in the 423
license, application shall be made to the Department of Developmental 424
Services, in the same manner as provided for the original application, 425
for permission to make such change. Such application shall be acted 426
upon not later than ten calendar days from the date of the filing of the 427
application. Each such license shall be renewed annually upon such 428
terms as may be established by regulations and may be revoked by the 429
department upon proof that the facility for which such license was 430
issued is being improperly operated, or for the violation of any of the 431
provisions of this section or of the regulations adopted pursuant to this 432
section, provided the licensee shall first be given a reasonable 433
opportunity to be heard in reference to such proposed revocation. Any 434
person, firm or corporation aggrieved by such revocation may request 435
an administrative hearing in accordance with the provisions of chapter 436
54. Each person, firm or corporation, upon filing an application under 437
the provisions of this section for a license for a community living 438
arrangement, shall pay to the State Treasurer the sum of fifty dollars 439
unless such fee is waived by the commissioner. 440
(d) The Department of Developmental Services may contract, within 441
available appropriations, with any qualified provider for the operation 442
of a community-based residential facility, provided the qualified 443
provider is licensed by the department to operate such facilities, 444
including a deemed status license. The department shall include in all 445
contracts with such licensed qualified providers, provisions requiring 446
the department to (1) conduct periodic reviews of contract 447
performance, and (2) take progressive enforcement actions if the 448
department finds poor performance or noncompliance with the 449
contract, as follows: (A) The licensed qualified provider may be placed 450
on a strict schedule of monitoring and oversight by the department; (B) 451
the licensed qualified provider may be placed on a partial-year 452 Raised Bill No. 1035
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contract; and (C) payments due under the contract may be reduced by 453
specific amounts on a monthly basis until the licensed qualified 454
provider complies with the contract. If compliance cannot be achieved, 455
the department shall terminate the contract. 456
(e) The department may contract with any person, firm or 457
corporation to provide residential support services for persons with 458
intellectual disability, Prader-Willi syndrome or autism spectrum 459
disorder who reside in settings which are not licensed by the 460
department. The commissioner shall adopt regulations, in accordance 461
with the provisions of chapter 54, to ensure the safety, adequate 462
supervision and support of persons receiving such residential support 463
services. 464
(f) Any person, firm or corporation who operates any facility 465
contrary to the provisions of this section shall be fined not more than 466
one thousand dollars or imprisoned not more than six months or both. 467
Any person, firm or corporation who operates any facility contrary to 468
the regulations adopted pursuant to subsection (b) of this section shall 469
be fined not more than one thousand dollars. 470
Sec. 8. Subsections (a) to (e), inclusive, of section 19a-491 of the 471
general statutes are repealed and the following is substituted in lieu 472
thereof (Effective October 1, 2019, and applicable to applications for renewal 473
submitted after the adoption of regulations in accordance with this section): 474
(a) No person acting individually or jointly with any other person 475
shall establish, conduct, operate or maintain an institution in [this] the 476
state without a license as required by this chapter, except for persons 477
issued a license by the Commissioner of Children and Families 478
pursuant to section 17a-145, as amended by this act, for the operation 479
of (1) a substance abuse treatment facility, or (2) a facility for the 480
purpose of caring for women during pregnancies and for women and 481
their infants following such pregnancies. Application for such license 482
shall (A) be made to the Department of Public Health upon forms 483
provided by it, (B) be accompanied by the fee required under 484 Raised Bill No. 1035
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subsection (c), (d) or (e) of this section, (C) contain such information as 485
the department requires, which may include affirmative evidence of 486
ability to comply with reasonable standards and regulations 487
prescribed under the provisions of this chapter or of a national 488
accrediting organization listed in regulations adopted by the 489
commissioner under subsection (b) of section 19a-493, as amended by 490
this act, and (D) not be required to be notarized. The commissioner 491
may require as a condition of licensure that an applicant sign a consent 492
order providing reasonable assurances of compliance with the Public 493
Health Code. The commissioner may issue more than one chronic 494
disease hospital license to a single institution until such time as the 495
state offers a rehabilitation hospital license. 496
(b) If any person acting individually or jointly with any other person 497
owns real property or any improvements thereon, upon or within 498
which an institution, as defined in subsection (c) of section 19a-490, is 499
established, conducted, operated or maintained and is not the licensee 500
of the institution, such person shall submit a copy of the lease 501
agreement to the department at the time of any change of ownership 502
and with each license renewal application. The lease agreement shall, 503
at a minimum, identify the person or entity responsible for the 504
maintenance and repair of all buildings and structures within which 505
such an institution is established, conducted or operated. If a violation 506
is found as a result of an inspection or investigation, the commissioner 507
may require the owner to sign a consent order providing assurances 508
that repairs or improvements necessary for compliance with the 509
provisions of the Public Health Code shall be completed within a 510
specified period of time or may assess a civil penalty of not more than 511
one thousand dollars for each day that such owner is in violation of the 512
Public Health Code or a consent order. A consent order may include a 513
provision for the establishment of a temporary manager of such real 514
property who has the authority to complete any repairs or 515
improvements required by such order. Upon request of the 516
Commissioner of Public Health, the Attorney General may petition the 517
Superior Court for such equitable and injunctive relief as such court 518 Raised Bill No. 1035
LCO No. 4609 17 of 28
deems appropriate to ensure compliance with the provisions of a 519
consent order. The provisions of this subsection shall not apply to any 520
property or improvements owned by a person licensed in accordance 521
with the provisions of subsection (a) of this section to establish, 522
conduct, operate or maintain an institution on or within such property 523
or improvements. 524
(c) Notwithstanding any regulation other than the regulations 525
adopted under subsection (b) of section 19a-493, as amended by this 526
act, the Commissioner of Public Health shall charge the following fees 527
for the biennial licensing and inspection of the following institutions: 528
(1) Chronic and convalescent nursing homes, per site, four hundred 529
forty dollars; (2) chronic and convalescent nursing homes, per bed, five 530
dollars; (3) rest homes with nursing supervision, per site, four hundred 531
forty dollars; (4) rest homes with nursing supervision, per bed, five 532
dollars; (5) outpatient dialysis units and outpatient surgical facilities, 533
six hundred twenty-five dollars; (6) mental health residential facilities, 534
per site, three hundred seventy-five dollars; (7) mental health 535
residential facilities, per bed, five dollars; (8) hospitals, per site, nine 536
hundred forty dollars; (9) hospitals, per bed, seven dollars and fifty 537
cents; (10) nonstate agency educational institutions, per infirmary, one 538
hundred fifty dollars; (11) nonstate agency educational institutions, per 539
infirmary bed, twenty-five dollars; (12) home health care agencies, 540
except certified home health care agencies described in subsection (d) 541
of this section, per agency, three hundred dollars; (13) home health 542
care agencies, except certified home health care agencies described in 543
subsection (d) of this section, per satellite patient service office, one 544
hundred dollars; (14) assisted living services agencies, except such 545
agencies participating in the congregate housing facility pilot program 546
described in section 8-119n, per site, five hundred dollars; (15) short-547
term hospitals special hospice, per site, nine hundred forty dollars; (16) 548
short-term hospitals special hospice, per bed, seven dollars and fifty 549
cents; (17) hospice inpatient facility, per site, four hundred forty 550
dollars; and (18) hospice inpatient facility, per bed, five dollars. 551
(d) Notwithstanding any regulation other than the regulations 552 Raised Bill No. 1035
LCO No. 4609 18 of 28
adopted under subsection (b) of section 19a-493, as amended by this 553
act, the commissioner shall charge the following fees for the triennial 554
licensing and inspection of the following institutions: (1) Residential 555
care homes, per site, five hundred sixty-five dollars; (2) residential care 556
homes, per bed, four dollars and fifty cents; (3) home health care 557
agencies that are certified as a provider of services by the United States 558
Department of Health and Human Services under the Medicare or 559
Medicaid program, three hundred dollars; and (4) certified home 560
health care agencies, as described in section 19a-493, as amended by 561
this act, per satellite patient service office, one hundred dollars. 562
(e) The commissioner shall charge one thousand dollars for the 563
licensing and inspection every three years of outpatient clinics that 564
provide either medical or mental health service, urgent care services 565
and well-child clinical services, except those that have a deemed status 566
license under section 19a-493, as amended by this act, or those 567
operated by a municipal health [departments] department, health 568
[districts] district or licensed nonprofit nursing or community health 569
[agencies] agency. 570
Sec. 9. Section 19a-493 of the general statutes is repealed and the 571
following is substituted in lieu thereof (Effective October 1, 2019, and 572
applicable to applications for renewal submitted after the adoption of 573
regulations in accordance with this section): 574
(a) Upon receipt of an application for an initial license, the 575
Department of Public Health, subject to the provisions of section 19a-576
491a, shall issue such license if, upon conducting a scheduled 577
inspection and investigation, the department finds that the applicant 578
and facilities meet the requirements established under section 19a-495, 579
provided a license shall be issued to or renewed for an institution, as 580
defined in section 19a-490, only if such institution is not otherwise 581
required to be licensed by the state. If an institution, (1) as defined in 582
subsections (b), (d), (e) and (f) of section 19a-490, applies for license 583
renewal and has been certified as a provider of services by the United 584
States Department of Health and Human Services under Medicare or 585 Raised Bill No. 1035
LCO No. 4609 19 of 28
Medicaid programs within the immediately preceding twelve-month 586
period, [or if an institution,] (2) as defined in subsection (b) of section 587
19a-490, is currently certified, or (3) as defined in subsections (g), (h) 588
and (m) of section 19a-490, applies for license renewal and has been 589
accredited as a provider of services within the immediately preceding 590
twelve-month period by a national accrediting organization that the 591
department has listed in regulations adopted pursuant to subsection 592
(b) of this section, the commissioner or the commissioner's designee 593
may waive on renewal the inspection and investigation of such facility 594
required by this section and, in such event, any such facility shall be 595
deemed to have satisfied the requirements of section 19a-495 for the 596
purposes of licensure. Such license shall be valid for two years or a 597
fraction thereof and shall terminate on March thirty-first, June 598
thirtieth, September thirtieth or December thirty-first of the 599
appropriate year. A license issued pursuant to this chapter, unless 600
sooner suspended or revoked, shall be renewable biennially [(1)] (A) 601
after an unscheduled inspection is conducted by the department, and 602
[(2)] (B) upon the filing by the licensee, and approval by the 603
department, of a report upon such date and containing such 604
information in such form as the department prescribes and satisfactory 605
evidence of continuing compliance with requirements established 606
under section 19a-495. In the case of an institution, as defined in 607
subsection (d) of section 19a-490, that is also certified as a provider 608
under the Medicare program, the license shall be issued for a period 609
not to exceed three years, to run concurrently with the certification 610
period. Except in the case of a multicare institution, each license shall 611
be issued only for the premises and persons named in the application. 612
Such license shall not be transferable or assignable. Licenses shall be 613
posted in a conspicuous place in the licensed premises. 614
(b) The Commissioner of Public Health shall adopt regulations, in 615
accordance with the provisions of chapter 54, to implement the 616
provisions of subsection (a) of this section concerning licensure 617
renewal for an institution, as defined in subsections (g), (h) and (m) of 618
section 19a-490. Such regulations shall (1) list any national accrediting 619 Raised Bill No. 1035
LCO No. 4609 20 of 28
organizations that the department finds have standards that are more 620
or at least as stringent for obtaining accreditation as the state 621
requirements for obtaining a license under this section, and (2) contain 622
any other provisions necessary to implement the provisions of 623
subsection (a) of this section. The regulations may also set an 624
administrative fee sufficient to pay for the costs to the department of 625
processing an application for a deemed status license under subsection 626
(a) of this section. 627
[(b)] (c) (1) A nursing home license may be renewed biennially after 628
(A) an unscheduled inspection conducted by the department, (B) 629
submission of the information required by section 19a-491a, and (C) 630
submission of evidence satisfactory to the department that the nursing 631
home is in compliance with the provisions of this chapter, the Public 632
Health Code and licensing regulations. 633
(2) Any change in the ownership of a facility or institution, as 634
defined in subsection (c) of section 19a-490, owned by an individual, 635
partnership or association or the change in ownership or beneficial 636
ownership of ten per cent or more of the stock of a corporation which 637
owns, conducts, operates or maintains such facility or institution, shall 638
be subject to prior approval of the department after a scheduled 639
inspection of such facility or institution is conducted by the 640
department, provided such approval shall be conditioned upon a 641
showing by such facility or institution to the commissioner that it has 642
complied with all requirements of this chapter, the regulations relating 643
to licensure and all applicable requirements of the Public Health Code. 644
Any such change in ownership or beneficial ownership resulting in a 645
transfer to a person related by blood or marriage to such an owner or 646
beneficial owner shall not be subject to prior approval of the 647
department unless: (A) Ownership or beneficial ownership of ten per 648
cent or more of the stock of a corporation, partnership or association 649
which owns, conducts, operates or maintains more than one facility or 650
institution is transferred; (B) ownership or beneficial ownership is 651
transferred in more than one facility or institution; or (C) the facility or 652
institution is the subject of a pending complaint, investigation or 653 Raised Bill No. 1035
LCO No. 4609 21 of 28
licensure action. If the facility or institution is not in compliance, the 654
commissioner may require the new owner to sign a consent order 655
providing reasonable assurances that the violations shall be corrected 656
within a specified period of time. Notice of any such proposed change 657
of ownership shall be given to the department at least ninety days 658
prior to the effective date of such proposed change. For the purposes of 659
this subdivision, "a person related by blood or marriage" means a 660
parent, spouse, child, brother, sister, aunt, uncle, niece or nephew. For 661
the purposes of this subdivision, a change in the legal form of the 662
ownership entity, including, but not limited to, changes from a 663
corporation to a limited liability company, a partnership to a limited 664
liability partnership, a sole proprietorship to a corporation and similar 665
changes, shall not be considered a change of ownership if the 666
beneficial ownership remains unchanged and the owner provides such 667
information regarding the change to the department as may be 668
required by the department in order to properly identify the current 669
status of ownership and beneficial ownership of the facility or 670
institution. For the purposes of this subdivision, a public offering of 671
the stock of any corporation that owns, conducts, operates or 672
maintains any such facility or institution shall not be considered a 673
change in ownership or beneficial ownership of such facility or 674
institution if the licensee and the officers and directors of such 675
corporation remain unchanged, such public offering cannot result in 676
an individual or entity owning ten per cent or more of the stock of 677
such corporation, and the owner provides such information to the 678
department as may be required by the department in order to properly 679
identify the current status of ownership and beneficial ownership of 680
the facility or institution. 681
[(c)] (d) (1) A multicare institution may, under the terms of its 682
existing license, provide behavioral health services or substance use 683
disorder treatment services on the premises of more than one facility, 684
at a satellite unit or at another location outside of its facilities or 685
satellite units that is acceptable to the patient receiving services and is 686
consistent with the patient's assessment and treatment plan. 687 Raised Bill No. 1035
LCO No. 4609 22 of 28
(2) Any multicare institution that intends to offer services at a 688
satellite unit or other location outside of its facilities or satellite units 689
shall submit an application for approval to offer services at such 690
location to the Department of Public Health. Such application shall be 691
submitted on a form and in the manner prescribed by the 692
Commissioner of Public Health. Not later than forty-five days after 693
receipt of such application, the commissioner shall notify the multicare 694
institution of the approval or denial of such application. If the satellite 695
unit or other location is approved, that satellite unit or location shall be 696
deemed to be licensed in accordance with this section and shall comply 697
with the applicable requirements of this chapter and regulations 698
adopted under this chapter. 699
(3) The Commissioner of Public Health may adopt regulations, in 700
accordance with the provisions of chapter 54, to carry out the 701
provisions of this subsection. The Commissioner of Public Health may 702
implement policies and procedures necessary to administer the 703
provisions of this subsection while in the process of adopting such 704
policies and procedures as regulation, provided the commissioner 705
prints notice of intent to adopt regulations in the Connecticut Law 706
Journal not later than twenty days after the date of implementation. 707
Policies and procedures implemented pursuant to this section shall be 708
valid until the time final regulations are adopted. 709
Sec. 10. Section 19a-493c of the general statutes is repealed and the 710
following is substituted in lieu thereof (Effective October 1, 2019, and 711
applicable to applications for renewal submitted after the adoption of 712
regulations in accordance with this section): 713
(a) The Commissioner of Public Health shall license outpatient 714
clinics, as defined in section 19a-490. In lieu of applying for the 715
renewal of such license, an applicant may, at the time when any such 716
renewal is due, submit evidence, satisfactory to the commissioner, that 717
such applicant has been accredited as a provider of outpatient clinic 718
services within the immediately preceding twelve-month period by a 719
national accrediting organization that the commissioner has listed in 720 Raised Bill No. 1035
LCO No. 4609 23 of 28
regulations adopted pursuant to this section. Any such applicant shall 721
be deemed to have satisfied the requirements of this section for the 722
purposes of licensure. Such deemed status license shall be valid for 723
two years and shall not be transferable or assignable. The provisions of 724
this subsection shall not be construed to limit the commissioner's 725
authority to inspect any applicant, suspend or revoke any license or 726
deemed status license issued pursuant to this section or take any other 727
legal action authorized by any provision of the general statutes. 728
(b) The commissioner [may] shall adopt regulations, in accordance 729
with the provisions of chapter 54, to implement the provisions of this 730
section. Such regulations shall (1) list any national accrediting 731
organizations that the commissioner finds have standards that are 732
more or at least as stringent for obtaining accreditation as the state 733
requirements for obtaining a license under this section, and (2) contain 734
any other provisions necessary to implement the provisions of 735
subsection (a) of this section. The regulations may also set an 736
administrative fee sufficient to pay for the costs to the department of 737
processing an application for a deemed status license under subsection 738
(a) of this section. The commissioner may waive any provision of the 739
regulations for outpatient clinics. The commissioner may implement 740
policies and procedures necessary to administer the provisions of this 741
section while in the process of adopting such policies and procedures 742
as regulations, except the regulations concerned deemed status 743
licenses, provided notice of intent to adopt regulations is published in 744
the Connecticut Law Journal not later than twenty days after the date 745
of implementation. Policies and procedures implemented pursuant to 746
this section shall be valid until the time final regulations are adopted. 747
Sec. 11. Section 19a-507b of the general statutes is repealed and the 748
following is substituted in lieu thereof (Effective October 1, 2019, and 749
applicable to applications for renewal submitted after the adoption of 750
regulations in accordance with this section): 751
(a) No community residence shall be established on or after July 1, 752
1984, within one thousand feet of any other community residence. If 753 Raised Bill No. 1035
LCO No. 4609 24 of 28
more than one community residence is proposed to be established in 754
any municipality, the total capacity of all community residences in the 755
municipality in which such residence is proposed to be established 756
shall not exceed one-tenth of one per cent of the population of such 757
municipality. 758
(b) Any resident of a municipality in which a community residence 759
is or will be located may, through the chief executive officer of the 760
municipality, or the legislative body of such municipality may, petition 761
the Commissioner of Public Health to deny an application for a license 762
to operate a community residence on the grounds that the operation of 763
such a community residence would be in violation of the limits 764
established under subsection (a) of this section. 765
(c) An applicant for a license to operate a community residence shall 766
mail a copy of the application made to the Department of Public 767
Health to the regional mental health board and the governing body of 768
the municipality in which the community residence is to be located, by 769
certified mail, return receipt requested. All applications shall specify 770
the number of community residences in the municipality, the address 771
of each such residence and the number of residents in each and the 772
address of the proposed community residence, and shall include 773
population and occupancy statistics reflecting compliance with the 774
limits established pursuant to subsection (a) of this section. 775
(d) The Commissioner of Public Health shall not issue a license for a 776
community residence until the applicant has submitted proof that the 777
mailing required by subsection (c) of this section has been made and 778
until at least thirty days have elapsed since the receipt of such mailing 779
by all required recipients. 780
(e) In the case of a renewal of such license, an applicant may, at the 781
time when any renewal is due, submit evidence, satisfactory to the 782
commissioner, that such applicant has been accredited as a provider of 783
community residence services within the immediately preceding 784
twelve-month period by a national accrediting organization that the 785 Raised Bill No. 1035
LCO No. 4609 25 of 28
commissioner has listed in regulations adopted pursuant to this 786
section. The commissioner may waive any inspection and investigation 787
of such applicant required under this section and, in such event, any 788
such applicant shall be deemed to have satisfied the requirements of 789
this section for the purposes of licensure. Such license shall be valid for 790
two years and shall not be transferable or assignable. The provisions of 791
this subsection shall not be construed to limit the commissioner's 792
authority to inspect any applicant, suspend or revoke any license or 793
deemed status license issued pursuant to this section or take any other 794
legal action authorized by any provision of the general statutes. 795
(f) The Commissioner of Public Health shall adopt regulations, in 796
accordance with the provisions of chapter 54, to implement the 797
provisions of subsection (e) of this section concerning deemed status 798
licensure for a community residence. Such regulations shall (1) list any 799
national accrediting organizations that the commissioner finds have 800
standards that are more or at least as stringent for obtaining 801
accreditation as the state requirements for obtaining a license under 802
this section, and (2) contain any other provisions necessary to 803
implement the provisions of subsection (e) of this section. The 804
regulations may also set an administrative fee sufficient to pay for the 805
costs to the department of processing an application for a deemed 806
status license under subsection (e) of this section. 807
Sec. 12. Section 19a-507c of the general statutes is repealed and the 808
following is substituted in lieu thereof (Effective October 1, 2019): 809
A community residence shall be evaluated twice a year by the 810
Department of Mental Health and Addiction Services, except that a 811
community residence that has obtained deemed status licensure under 812
section 19a-507b, as amended by this act, may be evaluated less 813
frequently by the department or the accrediting organization listed by 814
the Commissioner of Public Health in regulations adopted under 815
subsection (f) of section 19a-507b, as amended by this act. Evaluations 816
by said department shall include a review of individual client records 817
and shall be sent to the Department of Public Health upon its request. 818 Raised Bill No. 1035
LCO No. 4609 26 of 28
Sec. 13. Section 19a-507g of the general statutes is repealed and the 819
following is substituted in lieu thereof (Effective October 1, 2019, and 820
applicable to applications for renewal submitted after the adoption of 821
regulations in accordance with this section): 822
(a) The Department of Social Services shall adopt regulations, in 823
accordance with chapter 54, for the certification of adult day health 824
care facilities. In establishing such regulations, the Department of 825
Social Services shall consult with the Connecticut Association of Adult 826
Day Centers and such other persons or entities it deems appropriate. 827
In the case of a renewal of such certification, an applicant may, at the 828
time when any renewal is due, submit evidence, satisfactory to the 829
commissioner, that such applicant has been accredited as a provider of 830
adult day health care services within the immediately preceding 831
twelve-month period by a national accrediting organization that the 832
department has listed in regulations adopted pursuant to this section. 833
The department may waive any inspection and investigation of such 834
applicant required under this section and, in such event, any such 835
applicant shall be deemed to have satisfied the requirements of this 836
section for the purposes of certification. Such certificate shall be valid 837
for two years and shall not be transferable or assignable. The 838
provisions of this subsection shall not be construed to limit the 839
department's authority to inspect any applicant, suspend or revoke 840
any certificate or deemed status certificate issued pursuant to this 841
section or take any other legal action authorized by any provision of 842
the general statutes. 843
(b) The Department of Social Services shall adopt regulations, in 844
accordance with the provisions of chapter 54, to implement the 845
provisions of subsection (a) of this section concerning certification 846
renewal for adult day health care facilities. Such regulations shall (1) 847
list any national accrediting organizations that the department finds 848
have standards that are more or at least as stringent for obtaining 849
accreditation as the state requirements for obtaining certification under 850
this section, and (2) contain any other provisions necessary to 851
implement the provisions of subsection (a) of this section. The 852 Raised Bill No. 1035
LCO No. 4609 27 of 28
regulations may also set an administrative fee sufficient to pay for the 853
costs to the department of processing an application for a deemed 854
status certificate under subsection (a) of this section. 855
This act shall take effect as follows and shall amend the following
sections:
Section 1 October 1, 2019, and
applicable to applications
for renewal submitted after
the adoption of regulations
in accordance with this
section
17a-20
Sec. 2 October 1, 2019, and
applicable to applications
for renewal submitted after
the adoption of regulations
in accordance with this
section
17a-145
Sec. 3 October 1, 2019, and
applicable to applications
for renewal submitted after
the adoption of regulations
in accordance with this
section
17a-147
Sec. 4 October 1, 2019, and
applicable to applications
for renewal submitted after
the adoption of regulations
in accordance with section
17a-150
17a-149
Sec. 5 October 1, 2019 17a-150
Sec. 6 October 1, 2019 17a-151
Sec. 7 October 1, 2019, and
applicable to applications
for renewal submitted after
the adoption of regulations
in accordance with this
section
17a-227 Raised Bill No. 1035
LCO No. 4609 28 of 28
Sec. 8 October 1, 2019, and
applicable to applications
for renewal submitted after
the adoption of regulations
in accordance with this
section
19a-491(a) to (e)
Sec. 9 October 1, 2019, and
applicable to applications
for renewal submitted after
the adoption of regulations
in accordance with this
section
19a-493
Sec. 10 October 1, 2019, and
applicable to applications
for renewal submitted after
the adoption of regulations
in accordance with this
section
19a-493c
Sec. 11 October 1, 2019, and
applicable to applications
for renewal submitted after
the adoption of regulations
in accordance with this
section
19a-507b
Sec. 12 October 1, 2019 19a-507c
Sec. 13 October 1, 2019, and
applicable to applications
for renewal submitted after
the adoption of regulations
in accordance with this
section
19a-507g
Statement of Purpose:
To reduce costs for nonprofit providers by providing a means for them
to forgo duplicative state licensing requirements for certain license and
certificate renewals if they are accredited by an accepted national
accrediting body that has requirements more stringent than the state's
requirements.
[Proposed deletions are enclosed in brackets. Proposed additions are indicated by underline,
except that when the entire text of a bill or resolution or a section of a bill or resolution is new, it is
not underlined.]