O F F I C E O F L E G I S L A T I V E R E S E A R C H
P U B L I C A C T S U M M A R Y
Page 1
PA 21-121—sHB 6666
Public Health Committee
Appropriations Committee
AN ACT CONCERNING TH E DEPARTMENT OF PUBL IC HEALTH'S
RECOMMENDATIONS REGA RDING VARIOUS REVISIONS TO THE
PUBLIC HEALTH STATUT ES
TABLE OF CONTENTS:
§§ 1 & 2 — REPLACEMENT PUBLIC W ELLS
Allows (1) DPH to approve the location of replacement public wells if certain conditions are met
and (2) local or district health directors to issue permits for these wells
§§ 3 & 4 — NOTIFICATION OF CERTAIN PROJECTS IN WATERSHEDS
OR AQUIFER PROTECTION AREAS
Broadens the circumstances under which applicants must notify water companies and DPH about
certain projects in watersheds and aquifer protection areas, and requires the applicants to notify
DPH by email
§ 5 — ELECTRONIC REPORTING OF HOME LEAD INSPECTIONS
Requires local health departments and districts to use a DPH-prescribed electronic system to
report home lead inspection findings and resulting actions
§ 6 — PRIVATE WELLS AND SEMIPUBLIC WELLS
Clarifies that “private wells” supply water to residential populations only and requires owners of
property with semipublic wells, not just residential wells, to notify buyers or renters of certain
information on DPH’s website
§ 7 — RESIDENTIAL AND COMM ERCIAL PROPERTY WATE R SUPPLY
TESTING
Requires property owners to notify tenants and lessees whenever a property’s water supply is
tested and exceeds any maximum contaminant level in state regulation or DPH’s state drinking
water action level list
§ 8 — NURSING HOME OR RESIDENTIAL CARE HOME CITATIONS
Allows DPH to electronically submit citation notices to nursing homes and residential care homes
§ 9 — LONG-TERM CARE FACILITY BACKGROUND CHECKS
Exempts long-term care facilities from complying with background check requirements in the
event of an emergency or significant disruption
§§ 10 & 11 — AUTHORITY TO WAIVE EMS REGULATIONS O L R P U B L I C A C T S U M M A R Y
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Under specified conditions, allows DPH to waive regulations that apply to EMS organizations or
personnel
§§ 12-17 — APPRENTICE EMBALMERS AND FUNERAL DIRECTOR S
Updates terminology regarding apprentice embalmers and funeral directors and allows mortuary
science students to embalm up to 10 bodies under certain conditions
§ 18 — PROFESSIONAL COUNSEL OR AND PROFESSIONAL
COUNSELOR ASSOCIATE LICENSURE
Exempts certain professional counselor and professional counselor associate licensure applicants
from specified requirements
§ 19 — MARITAL AND FAMILY THERAPY LICENSURE
Removes the specific statutory requirement that marital and family therapy licensure applicants’
supervised practicum or internship include 500 clinical hours
§§ 20 & 21 — VETERINARIAN INVESTIGATIONS
Gives the complainant access to the investigation file when a complaint regarding a veterinarian
is closed with no finding; specifically extends existing procedures for complaints against other
providers to complaints against veterinarians
§ 22 — ELECTRONIC DEATH REG ISTRY SYSTEM
Requires funeral directors, embalmers, and heath care practitioners certifying deaths to use the
electronic death registry system if it is available
§§ 23-25 — LOCAL AND DISTRICT HEALTH DEPARTMENTS
Makes various changes affecting municipal and district health departments, including making
certain requirements consistent for both types of departments
§§ 26-29 — BEHAVIOR ANALYST ELIGIBILITY FOR THE
PROFESSIONAL ASSISTANCE PROGRAM AND REPO RTING OF
IMPAIRED HEALTH PROFESSIONALS
Adds licensed behavior analysts to the list of providers eligible for the professional assistance
program for health professionals and correspondingly increases their licensure renewal fee by $5;
adds these providers to the list of health professionals who must notify DPH if they are aware that
another professional may be unable to safely practice
§§ 30-32 — BEHAVIOR ANALYSTS AS MANDATORY REPORTERS OF
ELDER ABUSE
Makes behavior analysts mandated reporters of abuse of the elderly or long-term care facility
residents
§ 33 — PALLIATIVE CARE ADVISORY COUNCIL
Requires the DPH commissioner to make an appointment to the Palliative Care Advisory Council
if there is a spot that is vacant for at least one year; decreases the council’s reporting frequency
from annually to biennially
§ 34 — CHRONIC DISEASE REPORTING O L R P U B L I C A C T S U M M A R Y
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Eliminates the requirement for DPH to biennially report on chronic disease and the
implementation of the department’s chronic disease plan, and instead requires her to post the plan
on the department’s website
§ 35 — FACILITY OWNERSHIP CHANGES
Makes a minor change in the law on health care facility ownership changes
§ 36 — TUBERCULOSIS SCREENING
Requires health care facilities to maintain tuberculosis screening policies for their health care
personnel that reflect the CDC’s recommendations
§ 37 — PUBLIC NUISANCES
Specifies that violations of the state Fire Prevention Code are included within the public nuisance
law
§ 38 — PUBLIC HEALTH PREPAREDNESS ADVISORY COMM ITTEE
Allows specified state agency and legislative members of the Public Health Preparedness
Advisory Committee to appoint designees to serve in their place
§ 39 — CLINICAL LABORATORIES
Requires clinical laboratories to give DPH a list of the blood collection facilities they own and
operate
§ 40 — TECHNICAL CHANGES
Makes technical changes in a sanitarian statute
§ 41 — SOCIAL WORKER CONTIN UING EDUCATION
Increases the maximum hours of continuing education that social workers may complete online or
through home study
§ 42 — MANAGEMENT OF SPAS A ND SALONS
Allows massage therapists to manage spas and salons
§ 43 — OUT OF STATE PRACTITIONERS ALLOWED IN EMERGENCY
Expands the types of out-of-state health care providers authorized to temporarily practice in
Connecticut during a declared public health emergency
§ 44 — NURSING HOME ADMINIS TRATOR LICENSURE
Eliminates the requirement that DPH administer the required examination for nursing home
administrator licensure applicants
§§ 45-51 & 53 — HOSPICE AGENCIES
Adds “hospice agencies” to the statutory definition of a “health care institution” and makes
related technical changes; removes “substance abuse treatment facilities” from the statutory
definition of a health care institution
§§ 45, 56, 91 & 92 — ASSISTED LIVING SERVICES AGENCIES
Requires managed residential communities (MRCs) that provide assisted living services to become
licensed as an assisted living services agency (ALSA), requires an MRC that intends to contract O L R P U B L I C A C T S U M M A R Y
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with an ALSA for services to apply to DPH prior to doing so, and requires an ALSA to obtain
DPH approval before providing services as a dementia special care unit or program
§ 52 — HOME HEALTH ORDERS
Allows physician assistants and advanced practice registered nurses to issue orders for home
health care agency services, hospice agency services, and home health aide agency services
§ 54 — NURSING HOME EXPANDE D BED CAPACITY DURING
EMERGENCY
Allows DPH to suspend nursing home licensure requirements to allow homes to temporarily
increase their bed capacity to provide services to patients during a declared public health
emergency
§ 55 — IV CARE IN NURSING HOMES
Allows registered nurses employed by nursing homes to administer medications intravenously or
draw blood from a central line for laboratory purposes under certain conditions
§ 57 — BED POSITIONS IN LONG-TERM CARE FACILITIES
Requires chronic disease hospitals, nursing homes, and residential care homes to position beds in
a manner that promotes resident care and meets certain requirements
§ 58 — REGULATIONS ON AMBUL ANCE STAFFING
Makes a technical change by updating terminology in the statute requiring DPH to adopt
regulations on ambulance staffing
§§ 59 & 95 — CONTINUING EDUCATION FOR EMS PERSONNEL
Requires EMS personnel to document their required continuing education hours in a manner the
DPH commissioner prescribes, instead of using a DPH-approved online database
§ 60 — EMS ADVISORY BOARD
Requires the DPH commissioner to appoint a member to the Connecticut EMS Advisory Board if
the appointment is vacant for more than one year and notify the appointing authority of the
appointment at least 30 days in advance
§§ 61-63 — MODEL FOOD CODE
Extends by three years, from January 1, 2020, to January 1, 2023, the date by which DPH must
implement the FDA’s Model Food Code and makes related conforming changes to these laws
§ 64 — ASBESTOS
Modifies the definition of “asbestos-containing material” to include material that contains
asbestos in amounts equal to or greater than 1% by weight
§ 65 — HAIRDRESSING AND COSMETOLOGY
Expands the statutory definition of “hairdressing and cosmetology” to include removing facial or
neck hair using manual or mechanical means
§§ 66, 73 & 74 — ESTHETICIAN, NAIL TECHNICIAN, AND EYELASH
TECHNICIAN LICENSURE O L R P U B L I C A C T S U M M A R Y
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Limits the time period in which certain applicants for DPH licensure as an esthetician, nail
technician, or eyelash technician may be grandfathered in to those applicants who apply for
licensure before January 1, 2022
§ 67 — HEALTH ASSESSMENTS F OR STUDENTS WITH ASTHMA
Requires school boards to report to DPH and local health departments on the number of students
diagnosed with asthma in grades 9 or 10, instead of grades 10 or 11, to align the reporting
schedule with the schedule for conducting required student health assessments
§ 68 — CERTIFIED STROKE CENTERS
Adds thrombectomy-capable stroke centers to the types of stroke-designated hospitals DPH must
include on its annual list of certified stroke centers
§ 69 — EMS ADDRESS CHANGES
Allows an EMS organization to change its address within its primary service area without having
to complete the certificate of need process
§§ 70-72 — CERTIFIED HOMELESS YOUTH
Modifies the definition of “certified homeless youth,” establishes a definition for “certified
homeless young adult,” and permits the fees to be waived when issuing these individuals certified
copies of birth certificates or state identity cards
§ 75 — NEWBORN SCREENING
Extends newborn screening requirements for health care institutions to licensed nurse-midwives
and midwives; requires newborn screenings to be performed using bloodspot specimens; specifies
timeframes for specimen collection and notification; eliminates a requirement that OPM approve
certain conditions that are added to the program’s screening list; requires OPM to approve the
fees DPH charges providers to cover the program’s costs
§§ 76 & 77 — AMENDMENTS TO MARRIA GE OR BIRTH CERTIFICATES
TO REFLECT GENDER CHANGE
Allows individuals who submit certain documentation to change the gender designation and name
on their marriage certificate and adds PAs to the list of providers who may submit an affidavit of
gender transition treatment for purposes of a birth certificate amendment
§§ 78-81 — DPH ACCESS TO ELECTRONIC HOSPITAL RECORDS
Requires hospitals, by October 1, 2022, to provide DPH access, including remote access, to
certain complete electronic medical records related to (1) reportable diseases and emergency
illnesses and health conditions; (2) the Connecticut Tumor Registry; (3) the Maternal Mortality
Review Program; and (4) births, fetal deaths, and death occurrences
§ 82 — ALTERNATIVE DRINKING WATER SOURCES
Requires water companies and small community water systems to update their emergency
contingency plans and emergency response plans, respectively, to include information on
providing temporary alternative drinking water sources during a water supply emergency
§ 83 — WATER COMPANY TIER 1 NOTICES
Requires water companies to provide Tier 1 written communications to customers in the
languages predominantly spoken in their service area and update their emergency response plans
to include information on providing these multilingual communications O L R P U B L I C A C T S U M M A R Y
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§ 84 — COMMUNITY WATER SYST EMS AND DECLARED
EMERGENCIES
Requires community water systems to report their operational status to WebEOC within eight
hours after a declared public health or civil preparedness emergency and any time after that the
system’s status significantly changes
§ 85 — SMALL COMMUNITY WATE R SYSTEMS
Requires small community water systems, by January 1, 2025, to prepare a capacity
implementation plan regarding the system owner’s managerial, technical, and financial capacity
to own and operate the system
§§ 86 & 87 — BOTTLED WATER TESTIN G
Requires water bottlers, by January 1, 2022, to annually collect water samples before any water
treatment from each DPH-approved source and test them for perfluoroalkyl substances and other
unregulated contaminants; establishes related reporting requirements
§ 88 — PUBLIC WATER SYSTEM TESTING
Requires an environmental laboratory that tests a public water system sample to notify DPH and
the test requestor within 24 hours after obtaining a test result that violates EPA national primary
drinking water standards
§ 89 — HEALTH CARE INSTITUTIONS AND WATER SUPPLY
SHORTAGES
Requires health care institutions to obtain potable water from a licensed bulk water hauler or
water bottler as a temporary measure to alleviate a water supply shortage
§ 90 — TECHNICAL CHANGES
Makes technical changes in an EMS statute
§§ 93 & 94 — MINOR AND TECHNICAL CHANGES
Makes minor and technical changes in PA licensure and continuing education requirements
§ 95 — EMS MENTAL HEALTH TR AINING
Extends certain mental health training requirements to advanced EMTs and makes a clarifying
change regarding EMS instructors
§§ 96-98 — TECHNICAL CHANGES
Makes technical and conforming changes in EMS-related statutes
§ 99 — DPH LIST OF FUNERAL DIRECTORS AND EMBALM ERS
Eliminates the requirement that DPH annually provide town clerks and registrars of vital
statistics printed lists of all licensed funeral directors, embalmers, student funeral directors, and
student embalmers
O L R P U B L I C A C T S U M M A R Y
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§§ 1 & 2 — REPLACEMENT PUBLIC W ELLS
Allows (1) DPH to approve the location of replacement public wells if certain conditions are met
and (2) local or district health directors to issue permits for these wells
PA 19-117, §§ 73 & 74, allowed the Department of Public Health (DPH),
under certain conditions, to approve the location of a replacement public well in
Ledyard that did not meet the state’s sanitary radius and minimum setback
requirements for these water sources. This act extends these provisions to the
entire state, under the same conditions.
As under PA 19-117, the act allows DPH to approve the replacement well’s
location if the well is:
1. needed by the water company to maintain and provide safe and adequate
water to customers;
2. located in an aquifer of adequate water quality, as determined by historical
water quality data from the supply source it is replacing; and
3. in a more protected location than the supply source it is replacing, as
determined by DPH.
Under PA 19-117, if DPH approved the well’s location, the local health
director for Ledyard could issue a permit for the replacement well, but by no later
than March 1, 2020. The act instead allows all local or district health directors,
upon DPH’s approval, to issue these permits in their respective jurisdictions,
without a deadline.
EFFECTIVE DATE: October 1, 2021
§§ 3 & 4 — NOTIFICATION OF CERTAIN PROJECTS IN WATERSHEDS
OR AQUIFER PROTECTION AREAS
Broadens the circumstances under which applicants must notify water companies and DPH about
certain projects in watersheds and aquifer protection areas, and requires the applicants to notify
DPH by email
The act broadens the circumstances under which applicants must notify water
companies and DPH about certain projects (see below) in watersheds and aquifer
protection areas.
The act eliminates the prior condition requiring this notice only in cases where
certain maps had been filed. Instead, it generally requires applicants to (1) notify
the water company and DPH and (2) determine if the project is within a water
company’s watershed by consulting the maps on DPH’s website. It requires them
to email the notice to DPH at the address DPH designates on its website.
As under existing law, (1) notice to the water company must still be sent by
certified mail, return receipt requested; (2) the notices must be sent within seven
days after the application; and (3) the company and DPH have the right to be
heard at any hearing on the application.
Applicability
O L R P U B L I C A C T S U M M A R Y
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These provisions generally apply to anyone filing an application, petition, or
plan with the local zoning commission or appeals board for projects on a site
within a water company’s watershed or aquifer protection area. They also apply to
regulated activities on inland wetlands or watercourses within a water company’s
watershed.
The act retains existing’s law exemption from these notice requirements for
the first type of application above (those to a local zoning commission or appeals
board). Specifically, an applicant is exempt if (1) the town allows zoning agents
to approve applications concerning sites within aquifer protection areas or
watersheds and (2) the agent determines that the proposed activity will not
adversely affect the public water supply.
EFFECTIVE DATE: October 1, 2021
§ 5 — ELECTRONIC REPORTING OF HOME LEAD INSPECTIONS
Requires local health departments and districts to use a DPH-prescribed electronic system to
report home lead inspection findings and resulting actions
By law, if a local health director receives a report that a child’s blood lead
level exceeds a certain threshold, the director must conduct an epidemiological
investigation of the lead source. The director must report to DPH on the
investigation’s results and the actions taken to prevent further lead poisoning from
that source.
The act specifically requires local health directors to report using a DPH-
prescribed web-based surveillance system. In practice, DPH uses the MAVEN
surveillance system for this purpose.
EFFECTIVE DATE: October 1, 2021
§ 6 — PRIVATE WELLS AND SEMIPUBLIC WELLS
Clarifies that “private wells” supply water to residential populations only and requires owners of
property with semipublic wells, not just residential wells, to notify buyers or renters of certain
information on DPH’s website
The act makes minor and technical changes to clarify that “private wells”
serve residential populations. As defined under existing law and the act, for
provisions related to water quality testing, permitting, and sale or transfer, among
other things, private wells supply water to a population of less than 25 people per
day.
Existing law requires owners of residential property, before a property
transaction (e.g., sale or rental), to notify the buyer or tenant that DPH’s website
contains educational material on private well testing. The act extends this
requirement to owners of land with semi-public wells (e.g., wells supplying small
businesses with under 25 employees). As under existing law, failure to provide
the notice does not invalidate the transaction.
EFFECTIVE DATE: October 1, 2021
O L R P U B L I C A C T S U M M A R Y
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§ 7 — RESIDENTIAL AND COMM ERCIAL PROPERTY WATE R SUPPLY
TESTING
Requires property owners to notify tenants and lessees whenever a property’s water supply is
tested and exceeds any maximum contaminant level in state regulation or DPH’s state drinking
water action level list
The act requires commercial and residential property owners to notify each
tenant and the lessee of any rented property whenever the property’s water supply
is tested and exceeds any maximum contaminant level in state regulation or
DPH’s state drinking water action level list.
Under the act, the property owner must forward a copy of the test result
notification to each tenant and lessee as soon as practicable, but not later than 48
hours after receiving it. The act also requires the local health director to take all
reasonable steps to verify that the property owner does so.
By law, DPH sets drinking water quality standards (i.e., “action levels”) to
protect residents from health risks. In most cases, these standards mirror the
federal Environmental Protection Agency’s maximum contaminant levels for
public system drinking water.
EFFECTIVE DATE: October 1, 2021
§ 8 — NURSING HOME OR RESIDENTIAL CARE HOME CITATIONS
Allows DPH to electronically submit citation notices to nursing homes and residential care homes
Under prior law, DPH could only use certified mail to notify a nursing home
or residential care home about a citation for noncompliance with specified laws
and regulations. The act additionally allows DPH to send these notices and
citations electronically, in a form and manner the commissioner sets.
EFFECTIVE DATE: October 1, 2021
§ 9 — LONG-TERM CARE FACILITY BACKGROUND CHECKS
Exempts long-term care facilities from complying with background check requirements in the
event of an emergency or significant disruption
By law, long-term care facilities generally must require background checks
for prospective employees or volunteers who will have direct access to patients or
residents. The act suspends this requirement if the DPH commissioner determines
it is necessary to do so temporarily because of an emergency or significant
disruption. In that case, the commissioner must inform the facility when (1)
suspending the requirement and (2) lifting the suspension.
Under DPH’s current policies and procedures for this background search
program, the department may suspend the background search requirement for a
facility for up to 60 days in an emergency or a significant disruption to (1)
internet capabilities, (2) the functionality of the background search system, or (3)
the state or long-term care facility workforce. O L R P U B L I C A C T S U M M A R Y
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EFFECTIVE DATE: July 1, 2021
§§ 10 & 11 — AUTHORITY TO WAIVE EMS REGULATIONS
Under specified conditions, allows DPH to waive regulations that apply to EMS organizations or
personnel
The act allows the DPH commissioner to waive any regulations that apply to
emergency medical services (“EMS”) organizations or personnel if she
determines that (1) doing so would not endanger the health, safety, or welfare of
any patient or resident and (2) the waiver does not affect maximum allowable
rates for each EMS organization or primary service area assignments.
Under the act, if the commissioner waives EMS regulations, she may:
1. impose waiver conditions assuring patients’ or residents’ health, safety,
and welfare;
2. terminate the waiver if she finds that health, safety, or welfare has been
jeopardized; and
3. adopt regulations establishing a waiver application procedure.
Existing law grants the commissioner generally similar waiver authority
regarding DPH-licensed health care institutions (CGS § 19a-495).
The act also makes technical changes to another EMS statute (§ 10).
EFFECTIVE DATE: July 1, 2021, except for the technical changes, which are
effective October 1, 2021.
§§ 12-17 — APPRENTICE EMBALMERS AND FUNERAL DIRECTOR S
Updates terminology regarding apprentice embalmers and funeral directors and allows mortuary
science students to embalm up to 10 bodies under certain conditions
The act (1) updates statutory terminology by replacing the terms “student
embalmer” and “student funeral director” with “registered apprentice embalmer”
and “registered apprentice funeral director” respectively and (2) makes related
minor and technical changes. Existing law already requires these individuals to
register as apprentices with DPH.
Additionally, the act specifies that (1) students enrolled in approved mortuary
science education programs, with the DPH commissioner’s consent, may embalm
up to 10 human bodies as part of that program under a licensed embalmer’s
supervision and (2) this embalming counts toward the 50-body embalming
requirement for licensure.
EFFECTIVE DATE: October 1, 2021
§ 18 — PROFESSIONAL COUNSEL OR AND PROFESSIONAL
COUNSELOR ASSOCIATE LICENSURE
Exempts certain professional counselor and professional counselor associate licensure applicants
from specified requirements
O L R P U B L I C A C T S U M M A R Y
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Professional Counselor Applicants
The act exempts certain applicants for professional counselor licensure from
specified requirements. In doing so, it generally reinserts a provision removed in
2019 that would grandfather in certain applicants who were already in school
when licensure requirements changed in 2017.
The act applies to applicants who, by July 1, 2017, were matriculating
students in good standing in a qualifying graduate program offered by a regionally
accredited institution. Specifically, the act exempts these applicants from the
requirements to have completed (1) a 100-hour counseling practicum; (2) a 600-
hour clinical mental health counseling internship; and (3) graduate coursework in
addiction and substance abuse counseling, trauma and crisis counseling, and
diagnosing and treating mental and emotional disorders.
Professional Counselor Associate Applicants
Existing law provides alternate paths for professional counselor associate
licensure. On one path, an applicant qualifies by earning a graduate degree in
clinical mental health counseling through a program accredited by the Council for
Accreditation of Counseling and Related Educational Programs.
Alternatively, an applicant qualifies by earning a graduate degree in
counseling or a related mental health field from a regionally accredited institution
and meeting additional requirements, including completing (1) at least 60
graduate semester hours in counseling or a related mental health field, (2) a 100-
hour counseling practicum, and (3) a 600-hour clinical mental health counseling
internship.
Under the act, these additional requirements do not apply to applicants on the
second path above who, by July 1, 2022, earned such a graduate degree, if they
accumulated at least 3,000 hours of experience under professional supervision.
EFFECTIVE DATE: Upon passage
§ 19 — MARITAL AND FAMILY THERAPY LICENSURE
Removes the specific statutory requirement that marital and family therapy licensure applicants’
supervised practicum or internship include 500 clinical hours
Existing law for marriage and family therapist licensure requires, among other
things, an applicant to have completed a supervised practicum or internship
meeting certain standards.
The act removes the prior statutory requirement that the practicum or
internship include at least 500 direct clinical hours, including 100 hours of clinical
supervision. In practice, the Commission on Accreditation for Marriage and
Family Therapy Education currently requires this same minimum number of
hours.
EFFECTIVE DATE: Upon passage
§§ 20 & 21 — VETERINARIAN INVESTIGATIONS O L R P U B L I C A C T S U M M A R Y
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Gives the complainant access to the investigation file when a complaint regarding a veterinarian
is closed with no finding; specifically extends existing procedures for complaints against other
providers to complaints against veterinarians
The act requires DPH to provide information to a person who filed a
complaint against a veterinarian when the case is closed with no finding. This
applies to cases where DPH made a finding of no probable cause or failed to
make a finding within the required 12-month investigation period.
The act also specifically extends to veterinarian investigations certain existing
procedures that apply to investigations of several other DPH-licensed health
professionals. For example, among these procedures:
1. the complainant must be given an opportunity to review, at DPH, certain
records related to the complaint;
2. before resolving the complaint with a consent order, DPH must give the
complainant at least 10 business days to submit an objection; and
3. if a hearing is held after a probable cause finding, DPH must give the
complainant a copy of the hearing notice with information on the
opportunity to present oral or written statements.
EFFECTIVE DATE: October 1, 2021
§ 22 — ELECTRONIC DEATH REG ISTRY SYSTEM
Requires funeral directors, embalmers, and heath care practitioners certifying deaths to use the
electronic death registry system if it is available
The act requires funeral directors or embalmers, when completing death
certificates, to use the state’s electronic death registry system unless that system is
unavailable, in which case they must use DPH-provided forms. Prior law required
them to use the DPH forms.
Existing law authorizes certain health care practitioners to complete the
medical certification portion of a death certificate. The act requires them, when
certifying the facts of a decedent’s death, to use the electronic system or, if it is
unavailable, DPH-provided forms.
EFFECTIVE DATE: January 1, 2022
§§ 23-25 — LOCAL AND DISTRICT HEALTH DEPARTMENTS
Makes various changes affecting municipal and district health departments, including making
certain requirements consistent for both types of departments
The act requires DPH approval for persons nominated for municipal health
director appointments. Existing law already requires this approval for district
health directors (CGS § 19a-242).
In municipalities with a population of at least 40,000 for five consecutive
years, prior law prohibited municipal health directors from having a financial
interest in or engaging in a job, transaction, or professional activity that
substantially conflicted with the director’s duties. The act extends this prohibition O L R P U B L I C A C T S U M M A R Y
Page 13 of 36
to all municipal health directors, regardless of the town’s size. Existing law
already prohibits this for district health directors (CGS § 19a-244).
The act increases, from 30 to 60 days, the minimum vacancy of a municipal
health director position before DPH may appoint someone to fill the vacancy. The
act specifies that this person, when sworn, (1) is considered to be a municipal
employee and (2) has all the powers and duties of municipal health directors.
For municipalities with part-time health departments, the act removes the
requirements for (1) them to submit their public health program plans and budgets
to DPH, (2) DPH to approve these plans and budgets, and (3) DPH to adopt
related regulations.
For both local and district health departments, the act requires the
municipality or district board, as applicable, to submit to DPH its written
agreement with the director. They must do so upon the director’s appointment or
reappointment.
Additionally, the act requires district health directors, at the end of each fiscal
year, to report to DPH on their activities during the prior year. This requirement
already applies to municipal departments (§ 23).
The act also makes minor and technical changes.
EFFECTIVE DATE: July 1, 2021
Background — Related Act
PA 21-35, § 20, contains certain similar provisions as this act on local health
directors.
§§ 26-29 — BEHAVIOR ANALYST ELI GIBILITY FOR THE
PROFESSIONAL ASSISTA NCE PROGRAM AND REPO RTING OF
IMPAIRED HEALTH PROFESSIONALS
Adds licensed behavior analysts to the list of providers eligible for the professional assistance
program for health professionals and correspondingly increases their licensure renewal fee by $5;
adds these providers to the list of health professionals who must notify DPH if they are aware that
another professional may be unable to safely practice
The act adds licensed behavior analysts to the list of providers eligible for the
professional assistance program for health professionals (currently, the Health
Assistance InterVention Education Network (HAVEN); see Background).
The act increases, from $175 to $180, the annual license renewal fee for
behavior analysts. The increase applies to applications to renew licenses that
expire on or after October 1, 2021. The DPH commissioner must (1) quarterly
certify the amount of revenue received as a result of the fee increase and (2)
transfer it to the professional assistance program account. (In 2015, license
renewal fees were similarly increased for professions already eligible for the
program.)
The act also adds behavior analysts to the list of licensed health care
professionals who must notify DPH if they are aware that another health
professional may be unable to practice with skill and safety for various reasons O L R P U B L I C A C T S U M M A R Y
Page 14 of 36
(e.g., loss of motor skill, drug abuse, or negligence in professional practice). In
some cases, this law also requires licensed health care professionals to report
themselves to the department (e.g., following drug possession arrests).
Under this law, among other things:
1. the reporting professional must file a petition with DPH within 30 days
after obtaining information to support the petition;
2. DPH must investigate all petitions it receives to determine if there is
probable cause to issue charges and institute proceedings against the
reported professional;
3. DPH may not restrict, suspend, or revoke a license until it gives the person
notice and the opportunity for a hearing (except in an emergency requiring
summary suspension); and
4. a health care professional that refers an impaired professional to the
assistance program for intervention satisfies the law’s reporting
requirement in some cases.
EFFECTIVE DATE: July 1, 2021, except for the fee increase provision, which is
effective upon passage, and the provisions on reporting practitioners unable to
safely practice, which are effective October 1, 2021.
Background — Health Professional Assistance Program
By law, this program is an alternative, voluntary, and confidential
rehabilitation program that provides various services to health professionals with
a chemical dependency, emotional or behavioral disorder, or physical or mental
illness.
By law, before a health professional may enter the program, a medical review
committee must (1) determine if he or she is an appropriate candidate for
rehabilitation and participation and (2) establish terms and conditions for
participation. The program must include mandatory, periodic evaluations of each
participant’s ability to practice with skill and safety and without posing a threat to
the health and safety of any person or patient (CGS § 19a-12a).
§§ 30-32 — BEHAVIOR ANALYSTS AS MANDATORY REPORTERS OF
ELDER ABUSE
Makes behavior analysts mandated reporters of abuse of the elderly or long-term care facility
residents
The act adds licensed behavior analysts to the list of professionals who must
report (1) suspected abuse, neglect, abandonment, or exploitation of the elderly or
long-term care facility residents or (2) if they suspect an elderly person needs
protective services. They must report to the Department of Social Services (DSS)
within 72 hours.
By law, a mandated reporter who fails to report to DSS within the deadline is
subject to a $500 fine. If the failure to report is intentional, the reporter can be
charged with a class C misdemeanor for the first offense and a class A
misdemeanor for any subsequent offense (see Table on Penalties). O L R P U B L I C A C T S U M M A R Y
Page 15 of 36
EFFECTIVE DATE: October 1, 2021
§ 33 — PALLIATIVE CARE ADVISORY COUNCIL
Requires the DPH commissioner to make an appointment to the Palliative Care Advisory Council
if there is a spot that is vacant for at least one year; decreases the council’s reporting frequency
from annually to biennially
Under existing law, the Palliative Care Advisory Council includes 13
members: two appointed by the governor, four by the legislative leaders, and
seven by the DPH commissioner.
The act requires the DPH commissioner to make an appointment to the
council if a spot is vacant for at least one year. If this occurs, she must notify the
appointing authority about her selection at least 30 days before making the
appointment.
By law, the council must report to the Public Health Committee. The act
decreases the required reporting frequency from annually to every other year. As
under prior law, the next report is due January 1, 2022.
EFFECTIVE DATE: July 1, 2021
§ 34 — CHRONIC DISEASE REPORTING
Eliminates the requirement for DPH to biennially report on chronic disease and the
implementation of the department’s chronic disease plan, and instead requires her to post the plan
on the department’s website
By law, DPH must consult with the Office of Health Strategy and local health
departments to develop, within available resources, a statewide chronic disease
plan that is consistent with specified state and federal initiatives. DPH must
implement the plan to meet certain objectives (e.g., reducing the incidence and
effects of chronic diseases and improving care coordination).
The act eliminates the requirement for DPH to report biennially to the Public
Health Committee on chronic disease and the plan’s implementation. Instead, it
requires the commissioner to post the plan on the department’s website.
EFFECTIVE DATE: Upon passage
§ 35 — FACILITY OWNERSHIP CHANGES
Makes a minor change in the law on health care facility ownership changes
By law, licensed health care institution ownership changes generally need
prior DPH approval. Transfers to relatives are generally not subject to this
requirement. But one existing exception to this is a transfer of 10% or more of the
stock of a corporation, partnership, or association that owns or operates multiple
facilities. The act specifies that this exception also applies to transfers involving
limited liability companies meeting these same conditions.
EFFECTIVE DATE: July 1, 2021
O L R P U B L I C A C T S U M M A R Y
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§ 36 — TUBERCULOSIS SCREENING
Requires health care facilities to maintain tuberculosis screening policies for their health care
personnel that reflect the CDC’s recommendations
The act requires licensed health care facilities to have policies and procedures
reflecting the National Centers for Disease Control and Prevention’s (CDC)
recommendations for tuberculosis (TB) screening, testing, treatment, and
education for health care personnel.
Under the act, these facilities’ direct patient care employees must receive TB
screening and testing in compliance with these policies and procedures. This
applies despite any contrary state law or regulation.
Among other things, the CDC generally recommends that health care
personnel:
1. be screened for TB upon being hired and if there is a known exposure,
2. not receive annual TB testing unless there is known exposure or ongoing
transmission at the facility, and
3. receive annual education in TB.
Current state regulations require annual tuberculin (skin) testing for
employees of certain types of licensed facilities, such as assisted living services
agencies (Conn. Agencies Reg., § 19-13-D105).
EFFECTIVE DATE: July 1, 2021
§ 37 — PUBLIC NUISANCES
Specifies that violations of the state Fire Prevention Code are included within the public nuisance
law
By law, the state can bring an action to abate a public nuisance on any real
property on which, within the previous year, there have been three or more (1)
arrests for certain crimes, (2) arrest warrants issued for certain crimes indicating a
pattern of criminal activity, or (3) municipal citations issued for certain violations.
Among various other crimes, this applies to fire safety violations under specified
laws. The act specifies that this includes violations under the state’s Fire
Prevention Code. (In doing so, it appears that the act reinserts statutory references
that were inadvertently removed in 2017.)
EFFECTIVE DATE: October 1, 2021
§ 38 — PUBLIC HEALTH PREPAREDNESS ADVISORY COMM ITTEE
Allows specified state agency and legislative members of the Public Health Preparedness
Advisory Committee to appoint designees to serve in their place
By law, the DPH commissioner must establish a Public Health Preparedness
Advisory Committee to advise DPH on responses to public health emergencies.
The act allows several committee members to designate someone to serve in
their place. This applies to the DPH and Department of Emergency Services and O L R P U B L I C A C T S U M M A R Y
Page 17 of 36
Public Protection commissioners; the six legislative leaders; and the chairs and
ranking members of the Public Health, Public Safety and Security, and Judiciary
committees.
By law, the committee also includes (1) representatives of municipal and
district health directors appointed by the DPH commissioner and (2) any other
organizations or individuals the commissioner deems relevant to the effort.
EFFECTIVE DATE: Upon passage
§ 39 — CLINICAL LABORATORIES
Requires clinical laboratories to give DPH a list of the blood collection facilities they own and
operate
The act requires licensed clinical laboratories to report to DPH the name and
address of each blood collection facility they own and operate. They must report
this information, in a form and manner DPH prescribes, (1) before obtaining or
renewing their license and (2) whenever opening or closing a blood collection
facility.
EFFECTIVE DATE: July 1, 2021
§ 40 — TECHNICAL CHANGES
Makes technical changes in a sanitarian statute
The act makes technical changes in a sanitarian statute.
EFFECTIVE DATE: July 1, 2021
§ 41 — SOCIAL WORKER CONTIN UING EDUCATION
Increases the maximum hours of continuing education that social workers may complete online or
through home study
The act increases, from six to 10, the maximum hours of continuing education
that social workers may complete online or through home study during each one-
year registration period. By law, social workers generally must complete 15 hours
of continuing education each registration period, starting with their second license
renewal.
EFFECTIVE DATE: Upon passage
§ 42 — MANAGEMENT OF SPAS A ND SALONS
Allows massage therapists to manage spas and salons
Under prior law, starting on July 1, 2021, each spa or salon that employed
hairdressers, cosmeticians, estheticians, or eyelash or nail technicians had to be
managed by someone with a DPH credential for one of those professions. The act
(1) extends this requirement to spas or salons that employ massage therapists and O L R P U B L I C A C T S U M M A R Y
Page 18 of 36
(2) allows licensed massage therapists to manage a spa or salon employing any of
these individuals.
EFFECTIVE DATE: Upon passage
§ 43 — OUT OF STATE PRACTITIONERS ALLOWED IN EMERGENCY
Expands the types of out-of-state health care providers authorized to temporarily practice in
Connecticut during a declared public health emergency
By law, DPH may temporarily suspend, for up to 60 days, licensing,
certification, and registration requirements to allow various health care
practitioners credentialed in another state, territory, or the District of Columbia to
practice in Connecticut during a declared public health emergency (see
Background).
The act expands the types of out-of-state practitioners allowed to practice in
Connecticut under these circumstances to include: alcohol and drug counselors;
art and music therapists; behavior analysts; certified dietician-nutritionists;
dentists and dental hygienists; genetic counselors; occupational therapists;
radiographers, radiologic technologists, radiologist assistants, and nuclear
medicine technologists; and speech and language pathologists. (In doing so, it
codifies certain provisions in the governor’s 2020 executive orders 7O, 7DD, and
7HHH).
As under existing law, the act permits these practitioners to work only within
their scope of practice as permitted by Connecticut law.
EFFECTIVE DATE: Upon passage
Background — Out-of-State Practitioners Allowed During Emergency
Existing law allows the following health care practitioners to temporarily
practice in Connecticut during a declared public health emergency, upon the
issuance of a DPH order: emergency medical personnel, physicians and physician
assistants, physical therapists, nurses and nurses’ aides, respiratory care
practitioners, psychologists, marital and family therapists, clinical social workers,
professional counselors, paramedics, embalmers and funeral directors, sanitarians,
asbestos contractors and consultants, and pharmacists.
§ 44 — NURSING HOME ADMINIS TRATOR LICENSURE
Eliminates the requirement that DPH administer the required examination for nursing home
administrator licensure applicants
By law, an applicant for a nursing home administrator license must meet
specified education and training requirements and pass a DPH-prescribed
examination. The act eliminates the requirement that DPH also administer the
examination. (In practice, these examinations are administered by national
organizations.)
EFFECTIVE DATE: July 1, 2021
O L R P U B L I C A C T S U M M A R Y
Page 19 of 36
§§ 45-51 & 53 — HOSPICE AGENCIES
Adds “hospice agencies” to the statutory definition of a “health care institution” and makes
related technical changes; removes “substance abuse treatment facilities” from the statutory
definition of a health care institution
Definitions
The act adds to the statutory definition of a “health care institution” a “hospice
agency,” which it defines as a public or private organization that provides home
care and hospice services to terminally ill patients.
In doing so, it extends to these agencies statutory requirements for health care
institutions regarding, among other things, licensure and inspections, access to
patient records, and disclosure of HIV-related information. Previously, a hospice
agency had to be licensed as a home health care agency.
The act also makes related technical and conforming changes to long-term
care statutes on, among other things, the state’s long-term care facility
background check program and the administration of medication by certified
unlicensed personnel.
Additionally, the act removes “substance abuse treatment facilities” from the
definition of “health care institution” to conform to current practice. (DPH
currently licenses these facilities as “behavioral health facilities.”)
Licensure Fees
The act extends to hospice agencies and home health aide agencies the
licensure and inspection fee of $100 per satellite office that existing law requires
for home health care agencies. (It does not set a corresponding agency licensure
and inspection fee.) As under existing law, the fee must be paid biennially to
DPH, except for Medicare- and Medicaid-certified agencies, which are licensed
and inspected every three years.
EFFECTIVE DATE: July 1, 2021
§§ 45, 56, 91 & 92 — ASSISTED LIVING SERVICES AGENCIES
Requires managed residential communities (MRCs) that provide assisted living services to become
licensed as an assisted living services agency (ALSA), requires an MRC that intends to contract
with an ALSA for services to apply to DPH prior to doing so, and requires an ALSA to obtain
DPH approval before providing services as a dementia special care unit or program
Licensure
Under existing law, the state does not license assisted living facilities. Instead,
it licenses and regulates assisted living service agencies (ALSAs) that provide
assisted living services. ALSAs can only provide these services at a managed
residential community (MRC). MRCs are not licensed by the state but must
provide certain core services and meet regulatory requirements.
The act requires an MRC that wishes to provide assisted living services to
obtain a DPH license as an ALSA, or arrange for the services with a licensed O L R P U B L I C A C T S U M M A R Y
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ALSA. For the latter, the MRC must apply to DPH in a manner the commissioner
prescribes, as under current regulation (Conn. Agencies Reg., § 19-13-D105).
Dementia Special Care Units and Programs
The act prohibits an ALSA from providing services as a dementia special care
unit or program unless they obtain DPH approval.
An ALSA that provides services as a dementia special care unit or program
must (1) ensure they have adequate staff to meet residents’ needs and (2) submit
to DPH a list of dementia special care units or locations and their staffing plans
when applying for an initial or renewal license or upon DPH request.
The act also requires an ALSA to ensure all services provided individually to
clients are fully understood by the client or the client’s representative, and that the
client or representative is made aware of their cost.
Additionally, the act makes technical changes, renaming “Alzheimer’s special
care units or programs” “dementia special care units or programs” in various
public health statutes.
By law, a dementia special care unit or program is one that locks, secures, or
segregates residents with a diagnosis of probable Alzheimer’s disease, dementia,
or other similar disorder. The unit or program must be one that prevents or limits
access by a resident outside the designated or separated area and advertises or
markets itself as providing specialized care or services for those with Alzheimer’s
disease or dementia.
Regulations
The act permits the DPH commissioner to adopt regulations to implement the
act’s provisions.
EFFECTIVE DATE: July 1, 2021, except upon passage for certain technical
changes.
§ 52 — HOME HEALTH ORDERS
Allows physician assistants and advanced practice registered nurses to issue orders for home
health care agency services, hospice agency services, and home health aide agency services
The act allows physician assistants (PAs) and advanced practice registered
nurses (APRNs) licensed in Connecticut to issue orders for home health care
agency services, hospice agency services, and home health aide agency services.
It also allows PAs and APRNs licensed in bordering states to order home health
care agency services.
Under prior law, only a physician could issue these orders.
EFFECTIVE DATE: July 1, 2021
Background — Related Act
PA 21-133, § 2 allows APRNs and PAs licensed in Connecticut and bordering O L R P U B L I C A C T S U M M A R Y
Page 21 of 36
states to order home health care agency, hospice home health care agency, and
home health aide agency services.
§ 54 — NURSING HOME EXPANDE D BED CAPACITY DURIN G
EMERGENCY
Allows DPH to suspend nursing home licensure requirements to allow homes to temporarily
increase their bed capacity to provide services to patients during a declared public health
emergency
The act allows the DPH commissioner to suspend licensure requirements for
chronic and convalescent nursing homes to allow them to temporarily provide
services to patients with a reportable disease, emergency illness, or health
condition during a declared public health emergency.
Under the act, nursing homes may provide these services under their existing
license if they (1) provide services to patients in a building that is not physically
connected to its licensed facility or (2) expand their bed capacity in a part of a
facility that is separate from the licensed facility.
A nursing home that intends to provide services in this manner must first
apply to DPH in a form and manner the commissioner prescribes. The application
must include:
1. information on the facility’s ability to sufficiently address residents’ and
staff’s health, safety, or welfare;
2. the facility’s address;
3. an attestation that all equipment located at the facility is maintained
according to the manufacturer’s specifications and can meet residents’
needs;
4. information on the facility’s maximum bed capacity; and
5. information indicating that the facility is compliant with state laws and
regulations for its operation.
The act requires the department, upon receiving the application, to conduct a
scheduled inspection and investigation of the applicant’s facilities to ensure that
they comply with state licensing laws and regulations. After doing so, the
department must notify the applicant of its decision to approve or deny the
application.
EFFECTIVE DATE: July 1, 2021
§ 55 — IV CARE IN NURSING HOMES
Allows registered nurses employed by nursing homes to administer medications intravenously or
draw blood from a central line for laboratory purposes under certain conditions
The act allows chronic and convalescent nursing homes to allow a licensed
registered nurse (RN) they employ to:
1. draw blood from a central line for laboratory purposes, provided the
facility has an agreement with a laboratory to process the specimens or
2. administer IV therapy or a medication dose by intravenous injection, if the O L R P U B L I C A C T S U M M A R Y
Page 22 of 36
medication is on a list approved by the facility’s governing body,
pharmacist, and medical director for intravenous injection by an RN.
Under the act, an RN may perform these services only if he or she has been
properly trained to do so by the home’s nursing director or an intravenous
infusion company. It requires the home’s administrator to ensure that the RN is
appropriately trained and competent and provide related documentation to DPH
upon request.
The act also requires the nursing home to notify the DPH commissioner if it
employs RNs who provide these services.
EFFECTIVE DATE: July 1, 2021
§ 57 — BED POSITIONS IN LONG-TERM CARE FACILITIES
Requires chronic disease hospitals, nursing homes, and residential care homes to position beds in
a manner that promotes resident care and meets certain requirements
The act requires chronic disease hospitals, nursing homes, and residential care
homes to position beds in a manner that promotes resident care. Specifically, the
bed position:
1. cannot act as a restraint to the resident;
2. cannot create a hazardous situation, including the possibility of
entrapment, an obstacle to evacuation, or blocking or being close to a heat
source;
3. must allow for infection control; and
4. must provide at least a three-foot clearance at the sides and foot of each
bed, as under existing law.
EFFECTIVE DATE: July 1, 2021
§ 58 — REGULATIONS ON AMBUL ANCE STAFFING
Makes a technical change by updating terminology in the statute requiring DPH to adopt
regulations on ambulance staffing
The act makes a technical change to the statute requiring the DPH
commissioner to adopt regulations requiring ambulances to be staffed with at least
one certified emergency medical technician (EMT) and one certified emergency
medical responder (EMR). It updates terminology by replacing the terms
“emergency medical response services” with “ambulance” and “medical response
technician” with “emergency medical responder.”
EFFECTIVE DATE: October 1, 2021
§§ 59 & 95 — CONTINUING EDUCATION FOR EMS PERSONNEL
Requires EMS personnel to document their required continuing education hours in a manner the
DPH commissioner prescribes, instead of using a DPH-approved online database
The act requires EMS personnel to enter, track, and reconcile their required O L R P U B L I C A C T S U M M A R Y
Page 23 of 36
continuing education hours in a form and manner the DPH commissioner
prescribes, instead of using a DPH-approved online database. It also makes a
related conforming change.
By law, EMS personnel include EMRs, EMTs, advanced EMTs, and EMS
instructors.
EFFECTIVE DATE: July 1, 2021, except a conforming change is effective upon
passage.
§ 60 — EMS ADVISORY BOARD
Requires the DPH commissioner to appoint a member to the Connecticut EMS Advisory Board if
the appointment is vacant for more than one year and notify the appointing authority of the
appointment at least 30 days in advance
The act requires the DPH commissioner to appoint a member to the
Connecticut EMS Advisory Board if the appointment is vacant for more than one
year. The commissioner must notify the appointing authority of her appointee’s
identity at least 30 days before making the appointment.
By law, the EMS Advisory Board reviews and comments on all DPH
regulations, medical guidelines, and EMS-related policies before they are
implemented. It also assists and advises state agencies in coordinating the EMS
system. The board must annually report to the DPH commissioner and make
recommendations to the governor and legislature on legislation it believes will
improve EMS delivery.
EFFECTIVE DATE: Upon passage
§§ 61-63 — MODEL FOOD CODE
Extends by three years, from January 1, 2020, to January 1, 2023, the date by which DPH must
implement the FDA’s Model Food Code and makes related conforming changes to these laws
The act extends by three years, from January 1, 2020, to January 1, 2023, the
date by which DPH must adopt the federal Food and Drug Administration’s
(FDA) Model Food Code as the state’s food code for regulating food
establishments.
The act also makes related conforming changes to statutes regarding certified
food inspectors and restaurant requests to use the sous vide cooking technique or
the acidification of sushi rice.
EFFECTIVE DATE: Upon passage
§ 64 — ASBESTOS
Modifies the definition of “asbestos-containing material” to include material that contains
asbestos in amounts equal to or greater than 1% by weight
The act expands the definition of “asbestos-containing material” in the statutes
pertaining to asbestos abatement. It specifies that such material qualifies as such if
it contains asbestos in amounts equal to or greater than 1.0% by weight, instead of
only amounts greater than 1.0% by weight, as under prior law. O L R P U B L I C A C T S U M M A R Y
Page 24 of 36
EFFECTIVE DATE: October 1, 2021
§ 65 — HAIRDRESSING AND COSMETOLOGY
Expands the statutory definition of “hairdressing and cosmetology” to include removing facial or
neck hair using manual or mechanical means
The act expands the statutory definition of “hairdressing and cosmetology” for
purposes of licensure to include removing facial or neck hair using manual or
mechanical means.
Under existing law, hairdressing and cosmetology also includes (1) dressing,
arranging, curling, waving, weaving, cutting, singeing, bleaching, or coloring
hair; (2) scalp treatments; and (3) massaging, stimulating, cleansing,
manipulating, exercising or beautifying with the use of the hands, appliances,
cosmetic preparations, antiseptics, tonics, lotions, creams, powders, oils, or clays
and doing similar work on the face, neck, and arms.
EFFECTIVE DATE: Upon passage
§§ 66, 73 & 74 — ESTHETICIAN, NAIL TECHNICIAN, AND EYELAS H
TECHNICIAN LICENSURE
Limits the time period in which certain applicants for DPH licensure as an esthetician, nail
technician, or eyelash technician may be grandfathered in to those applicants who apply for
licensure before January 1, 2022
By law, individuals seeking an initial DPH license as an esthetician, nail
technician, or eyelash technician must provide evidence that he or she (1)
completed the minimum hours of required study in an approved school, or an out-
of-state school with equivalent requirements, and (2) received a certification of
completion from the school.
Prior law grandfathered in an applicant who provided evidence that he or she:
1. practiced as one of these professionals continuously in the state for at least
two years before (a) July 1, 2020, for estheticians and eyelash technicians
and (b) January 1, 2021, for nail technicians and
2. attested to compliance with specified infection prevention and control
guidelines.
The act limits this grandfathering in to those who apply before January 1,
2022.
EFFECTIVE DATE: July 1, 2021
§ 67 — HEALTH ASSESSMENTS F OR STUDENTS WITH ASTHMA
Requires school boards to report to DPH and local health departments on the number of students
diagnosed with asthma in grades 9 or 10, instead of grades 10 or 11, to align the reporting
schedule with the schedule for conducting required student health assessments
By law, local or regional boards of education (“school boards”) must report to
DPH and local health departments triennially on the number of students in each O L R P U B L I C A C T S U M M A R Y
Page 25 of 36
school and school district who are diagnosed with asthma at specified timeframes.
The act requires school boards to report on students who are diagnosed with
asthma in grades 9 or 10, instead of grades 10 or 11, as under prior law. In doing
so, it aligns the reporting schedule with the schedule school boards must follow
for conducting student health assessments required under existing law.
Under existing law, and unchanged by the act, school boards must also report
on students diagnosed with asthma at the time they enroll in school and in grades
six or seven.
EFFECTIVE DATE: July 1, 2021
§ 68 — CERTIFIED STROKE CENTERS
Adds thrombectomy-capable stroke centers to the types of stroke-designated hospitals DPH must
include on its annual list of certified stroke centers
By law, a hospital may apply to DPH to be designated as a stroke center, and
the department must annually send a list of these stroke-designated hospitals to
the medical director of each EMS provider in the state and post the list on the
DPH website.
The act adds thrombectomy-capable stroke centers to the types of stroke-
designated hospitals DPH must include on its annually posted list. Under existing
law, DPH already includes hospitals designated as comprehensive stroke centers,
primary stroke centers, or acute stroke-ready hospitals.
As under existing law, a hospital may apply to DPH for designation as a
thrombectomy-capable stroke center if it is certified as such by (1) the American
Hospital Association, (2) the Joint Commission (an independent, nonprofit
organization that accredits and certifies hospitals and other health care
organizations and programs), or (3) another DPH-approved, nationally recognized
certifying organization.
Under the act, DPH must report to the national certifying organization any
complaint it receives related to a thrombectomy-capable stroke center’s
certification, as it must already do for other types of stroke centers.
EFFECTIVE DATE: October 1, 2021
§ 69 — EMS ADDRESS CHANGES
Allows an EMS organization to change its address within its primary service area without having
to complete the certificate of need process
The act allows an EMS organization, instead of only an ambulance service, to
apply to DPH to change its address or add a branch location within its primary
service area. Prior law required an EMS organization to complete the certificate
of need process in order to make this change.
EFFECTIVE DATE: Upon passage
§§ 70-72 — CERTIFIED HOMELESS YOUTH
O L R P U B L I C A C T S U M M A R Y
Page 26 of 36
Modifies the definition of “certified homeless youth,” establishes a definition for “certified
homeless young adult,” and permits the fees to be waived when issuing these individuals certified
copies of birth certificates or state identity cards
Definitions
The act expands the statutory definition of “certified homeless youth” to
include youth certified as homeless by the director of a municipal or nonprofit
program that contracts with the Department of Housing’s homeless youth
program. Existing law also includes youth certified as homeless by one of the
following:
1. a school district homeless liaison;
2. the director of an emergency shelter program funded by the
U.S. Department of Housing and Urban Development, or the director’s
designee; or
3. the director of a runaway or homeless youth basic center or transitional
living program funded by the U.S. Department of Health and Human
Services, or the director’s designee.
By law, a certified homeless youth is a 15- to 17-year-old person, not in the
physical custody of a parent or legal guardian, who is a homeless child or youth as
defined in specified federal law.
The act also establishes a definition for a “certified homeless young adult,”
which is an 18- to 25-year-old person certified as homeless by the same
individuals as for certified homeless youth listed above.
Records Access
The act authorizes DPH and local registrars of vital records to waive the fee
for issuing a certified copy of a birth certificate to a certified homeless youth or
certified homeless young adult. It similarly allows the Department of Motor
Vehicles to waive the fee for issuing a state identity card to these individuals.
EFFECTIVE DATE: July 1, 2021
§ 75 — NEWBORN SCREENING
Extends newborn screening requirements for health care institutions to licensed nurse-midwives
and midwives; requires newborn screenings to be performed using bloodspot specimens; specifies
timeframes for specimen collection and notification; eliminates a requirement that OPM approve
certain conditions that are added to the program’s screening list; requires OPM to approve the
fees DPH charges providers to cover the program’s costs
The act extends newborn screening requirements for health care institutions to
licensed nurse-midwives and midwives. It requires health care institutions, nurse-
midwives, and midwives (hereinafter “providers”) to generally perform newborn
screenings using bloodspot specimens and establishes related specimen collection
and notification requirements.
Testing Timeframes O L R P U B L I C A C T S U M M A R Y
Page 27 of 36
The act requires providers to collect the blood spot specimen between 24 and
48 hours after the infant’s birth, unless the provider determines a situation exists
that warrants its early collection or that it is medically contraindicated.
Under the act, conditions that warrant early collection of the specimen
include:
1. imminent transfusion of blood products,
2. dialysis,
3. the infant’s early discharge from a health care institution or transfer from
one institution to another; or
4. imminent death.
Under the act, if a newborn dies before a blood spot specimen is obtained, it
must be collected as soon as practicable after death.
Notification Requirements
The act requires providers to notify DPH when a specimen is not collected
within the required 48 hours after birth for any reason, including (1) medical
fragility, (2) the parent’s refusal of the screening due to religious conflict, or (3) a
newborn receiving comfort measures only.
Under the act, providers must document the reason in the state’s newborn
screening system or send written notification to DPH within 72 hours after the
newborn’s birth.
Specimen Processing
The act requires providers to send the blood spot specimen to the state’s
public health laboratory within 24 hours after collecting it. DPH may request an
additional blood spot specimen if the specimen (1) was collected early or after a
blood transfusion, (2) is unsatisfactory for testing, or (3) yields an abnormal
result, as determined by the department.
The act requires the laboratory to maintain a record of the date and time it
received each specimen and make the record available for inspection, within 48
hours after the provider who sent the specimen requests it.
Office of Policy and Management (OPM) Approval
The act eliminates the requirement that OPM approve a disorder included on
the federal Recommended Uniform Screening Panel (RUSP) (see Background)
before DPH adds it to the list of conditions for which the program screens. It
instead allows the department to add any RUSP disorder the commissioner
prescribes.
It also requires OPM to approve the fees DPH charges providers to cover the
program’s costs, including testing, tracking, and treatment. By law, the fee must
be at least $98.
O L R P U B L I C A C T S U M M A R Y
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Non-Program Screenings for Other Conditions
Separate from the Newborn Screening Program, existing law requires health
care institutions to test newborns for other specified conditions. The act eliminates
the requirement that institutions test newborns for spinal muscular atrophy and
instead requires this testing as part of the Newborn Screening Program. It
continues to require that health care institutions test for critical congenital heart
disease; cystic fibrosis; and when a newborn fails a hearing test, cytomegalovirus.
It also eliminates the requirement that testing for cytomegalovirus be performed
within available appropriations.
Additionally, the act requires clinical laboratories that complete the newborn
screening test for cystic fibrosis to annually report to DPH the number and results
of the screenings into the newborn screening system. Existing law already
requires health care institutions to enter these test results into the state’s newborn
screening system.
By law, health care institutions must report confirmed cases of
cytomegalovirus cases to DPH. The act specifies that they must do so by entering
the information in the state’s newborn screening system, and regardless of the
patient’s insurance status or payment source, including self-payment.
EFFECTIVE DATE: Upon passage
Background — Recommended Uniform Screening Panel
RUSP is a list of health conditions that the federal Department of Health and
Human Services recommends states screen for as part of their newborn screening
programs. Conditions are included on the list based on evidence of the potential
benefit of screening, states’ ability to screen, and the availability of effective
treatments (42 U.S.C. § 300b-10).
§§ 76 & 77 — AMENDMENTS TO MARRIA GE OR BIRTH CERTIFICATES
TO REFLECT GENDER CHANGE
Allows individuals who submit certain documentation to change the gender designation and name
on their marriage certificate and adds PAs to the list of providers who may submit an affidavit of
gender transition treatment for purposes of a birth certificate amendment
The act allows people who submit certain documentation to change the gender
designation and name on their marriage certificate.
Specifically, the act requires the DPH commissioner to issue a new marriage
certificate to a person who:
1. requests in writing, signed under penalty of law, a replacement marriage
certificate that reflects a gender different from the sex designated on their
original certificate, along with an affirmation that the couple is still
married;
2. provides a notarized statement from the person’s spouse, consenting to the
amendment;
3. provides a (a) U.S. passport, amended birth certificate, or court order O L R P U B L I C A C T S U M M A R Y
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reflecting the applicant’s gender or (b) notarized affidavit from a
physician, PA, APRN, or psychologist (whether licensed in Connecticut or
another state) stating that the applicant has undergone surgical, hormonal,
or other clinically appropriate treatment for gender transition; and
4. provides, if applicable, proof of a legal name change.
The act generally extends to these amended marriage certificates existing
procedures for amended birth certificates reflecting gender change (e.g., allowing
only the DPH commissioner, and not local registrars, to amend the certificate, and
providing that the replacement certificate is not marked “amended”).
Under existing law, individuals seeking to change the gender designation on
their birth certificates must submit a notarized affidavit from an eligible health
care provider stating that the applicant underwent clinically appropriate gender
transition treatment. The act adds PAs to the list of providers who may submit this
affidavit. Under existing law, the list also includes physicians, APRNs, and
psychologists.
EFFECTIVE DATE: October 1, 2021
§§ 78-81 — DPH ACCESS TO ELECTRONIC HOSPITAL RECORDS
Requires hospitals, by October 1, 2022, to provide DPH access, including remote access, to
certain complete electronic medical records related to (1) reportable diseases and emergency
illnesses and health conditions; (2) the Connecticut Tumor Registry; (3) the Maternal Mortality
Review Program; and (4) births, fetal deaths, and death occurrences
The act requires hospitals to provide DPH access, including remote access, to
complete electronic medical records on reportable diseases and emergency
illnesses and health conditions, in a manner the commissioner approves (see
Background).
It also requires hospitals to grant DPH access, including remote access, to
complete patient medical records related to the:
1. Connecticut Tumor Registry, if the department deems it necessary to
perform case findings or other quality improvement audits (see
Background);
2. Maternal Mortality Review Program, if DPH deems it necessary to review
case information related to a death under review by the program (see
Background); and
3. births, fetal deaths, and death occurrences, if the department deems it
necessary to perform quality improvement audits and ensure completeness
of reporting and data accuracy.
(Existing law already grants DPH access to health care provider records for
Connecticut Tumor Registry and Maternal Mortality Review Program purposes.)
The act requires hospitals to grant DPH access to the above records by
October 1, 2022, if technically feasible.
Under the act, as under existing law, these records generally (1) are
confidential and not subject to disclosure, (2) are not admissible as evidence in
any court or agency proceeding, and (3) must be used solely for medical or
scientific research or disease control and prevention purposes. O L R P U B L I C A C T S U M M A R Y
Page 30 of 36
EFFECTIVE DATE: October 1, 2021
Background — DPH Reportable Disease List
By law, DPH maintains an annual list of reportable diseases and emergency
illnesses and conditions and reportable lab findings. Health care providers and
clinical laboratories must report cases of the listed conditions within certain
timeframes to the department and the local health director where the case occurs.
Background — Connecticut Tumor Registry
By law, the Connecticut Tumor Registry includes reports of all tumors and
conditions that are diagnosed or treated in the state for which DPH requires
reports. Hospitals, various health care providers, and clinical laboratories must
provide these reports to DPH for inclusion in the registry.
Background — Maternity Mortality Review Program
DPH’s Maternity Mortality Review Program identifies maternal deaths in
Connecticut, and reviews related medical records and other relevant data,
including death and birth records, the Office of the Chief Medical Examiner’s
files, and physician office and hospital records. The program’s review committee
conducts comprehensive, multidisciplinary reviews of maternal deaths to identify
associated factors and make recommendations to reduce these deaths.
§ 82 — ALTERNATIVE DRINKING WATER SOURCES
Requires water companies and small community water systems to update their emergency
contingency plans and emergency response plans, respectively, to include information on
providing temporary alternative drinking water sources during a water supply emergency
The act requires water companies and small community water systems (i.e.,
those regularly serving between 25 and 1,000 year-round residents) to update their
emergency contingency plans and emergency response plans, respectively, to
include information on providing their consumers an alternative drinking water
source as a temporary measure when there is a water supply emergency. (They
must submit these plans to DPH under existing law and regulation.)
Under the act, a “water supply emergency” is an event lasting longer than 12
hours that causes a company’s water supply to become non-compliant with DPH
regulations on drinking water quality or quantity. The act specifies that this
section does not prevent a water company or small community water system from
providing an alternative source of potable water for an event lasting less than 12
hours that may adversely impact the quality or quantity of potable water supplies.
The act requires these emergency plans to identify alternative drinking water
sources for possible use at various stages of an emergency, including:
1. bulk water provided by licensed bulk water haulers,
2. bottled water,
3. a fill station, O L R P U B L I C A C T S U M M A R Y
Page 31 of 36
4. interconnection or agreement with a nearby public water system for
supplemental water supplies during an emergency, and
5. other approved public water supply sources or mechanisms for providing
water identified in the plan or approved by the DPH commissioner.
The act also requires the DPH commissioner, in consultation with water
companies and small community water systems, to prepare materials and provide
guidance to these companies and systems to implement the act’s provisions.
Under the act, as under existing law, “water company” means any individual,
municipality, or entity that owns, maintains, operates, manages, controls, or
employs any pond, lake, reservoir, well, stream, or distributing plant or system
that supplies water to two or more consumers or to 25 or more people on a regular
basis.
EFFECTIVE DATE: October 1, 2021
§ 83 — WATER COMPANY TIER 1 NOTICES
Requires water companies to provide Tier 1 written communications to customers in the
languages predominantly spoken in their service area and update their emergency response plans
to include information on providing these multilingual communications
The act requires water companies to provide “tier 1” written communications
to customers in the languages predominantly spoken in their service area and
update their emergency response plans that they submit to DPH under existing
law and regulation to include information on the provision of these multilingual
communications.
State regulations require water companies to send a “tier 1” notice to
customers to communicate certain water quality or quantity issues or concerns
with customers, such as when a water source exceeds the state’s maximum
contaminant levels (Conn. Agencies Reg., § 19-13-B102).
EFFECTIVE DATE: October 1, 2021
§ 84 — COMMUNITY WATER SYST EMS AND DECLARED
EMERGENCIES
Requires community water systems to report their operational status to WebEOC within eight
hours after a declared public health or civil preparedness emergency and any time after that the
system’s status significantly changes
The act requires community water systems that serve at least 25 residents to
promptly report their operational status to WebEOC after the governor declares a
civil preparedness or public health emergency. They must do so within eight
hours after WebEOC reporting is available on the declared emergency, and any
time after that the community water system’s status significantly changes.
Under the act, “WebEOC” is the state’s online emergency management
information system used to document routine and emergency events or incidents.
It provides a real-time operating picture and resource request management tool for
local and state emergency managers during exercises; drills; or local, regional, or O L R P U B L I C A C T S U M M A R Y
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statewide emergencies.
EFFECTIVE DATE: October 1, 2021
§ 85 — SMALL COMMUNITY WATE R SYSTEMS
Requires small community water systems, by January 1, 2025, to prepare a capacity
implementation plan regarding the system owner’s managerial, technical, and financial capacity
to own and operate the system
Starting by January 1, 2025, the act requires each owner of a small community
water system (i.e., those regularly serving between 25 and 1,000 year-round
residents) to complete and implement a “capacity implementation plan” that
demonstrates that the owner has the managerial, technical, and financial capacity
to continue to own and operate the system. The plan must be updated annually
and made available to DPH upon request.
Under the act, the plan must include:
1. a description of the small community water system, including the number
of consumers and persons it serves, and its drinking water sources;
2. ownership and management information, including the system’s type of
ownership structure and the current contact information for the owners,
certified operators, and emergency contact persons;
3. service area maps and facilities maps, including the location of and
specific information on sources, storage and treatment facilities, pressure
zones, booster pumps, hydrants, distribution lines, valves, and sampling
points;
4. a description of the system’s cross-connection control program and source
water protection program;
5. a copy of the system’s emergency response plan required under existing
DPH regulations;
6. a capital improvement program, including the schedule that identifies all
capital improvements scheduled for a five-year planning period and
capital improvements or major projects scheduled for a 20-year planning
period;
7. water production and consumption information; and
8. information on nearby public water systems, including their type and
distance, based on the coordinated water system plan approved by DPH
for the water utility coordinating committee where the small community
water system is located.
The act also requires the plan to include financial capacity information,
including:
1. an evaluation of the small community water system’s fiscal plan required
under existing law;
2. a summary of the system’s income and expenses for the five years
preceding the date the plan is submitted;
3. a five-year balanced operation budget;
4. the system’s water rate structure and fees charged, including information
on how the rates and fees are updated and whether they are sufficient to O L R P U B L I C A C T S U M M A R Y
Page 33 of 36
maintain cash flow stability and fund the capital improvement plan and
any emergency improvements; and
5. an evaluation that has considered the affordability of water rates.
The act requires each small community water system, starting by July 1, 2025,
to annually summarize its capacity plan in its consumer confidence report
required under existing DPH regulations.
Exceptions
The plan requirement does not apply to a small community water system that
is (1) regulated by the Public Utilities Regulatory Authority (i.e., investor-owned
water companies), (2) required to submit a water supply plan to DPH (e.g.,
generally, those serving 1,000 or more people or 250 or more customers), or (3) a
state agency.
The act deems the plan requirement to relate to the purity and adequacy of
water supplies for the purpose of imposing a penalty for violating statutory or
regulatory requirements on public water supply purity, adequacy, or testing
described further below.
Regulations
The act authorizes DPH to adopt regulations to implement the act’s
requirements for small community water systems.
EFFECTIVE DATE: October 1, 2021
§§ 86 & 87 — BOTTLED WATER TESTIN G
Requires water bottlers, by January 1, 2022, to annually collect water samples before any water
treatment from each DPH-approved source and test them for perfluoroalkyl substances and other
unregulated contaminants; establishes related reporting requirements
The act requires water bottlers, by January 1, 2022, to annually collect water
samples before any water treatment from each DPH-approved source and test
them for perfluoroalkyl substances (PFAS) and other unregulated contaminants. A
DPH-registered environmental laboratory that has EPA-approved certification
must test the samples.
Under the act, water bottlers must report the test results to DPH and the
Department of Consumer Protection (DCP) within nine calendar days after
receiving them. If the results exceed DPH standards for PFAS and other
unregulated contaminants, the department may require the water bottler to stop
using the approved source until it no longer poses an unacceptable health or safety
risk to consumers. The act requires DPH to notify DCP when it takes this action.
The act defines an “unregulated contaminant” as a contaminant for which
DPH has set a level at which it creates, or can be reasonably expected to create, an
unacceptable risk of injury to the consumer’s health or safety.
Existing law requires water bottlers, among other things, to collect samples
from each approved source at least once a year to test for regulated contaminants O L R P U B L I C A C T S U M M A R Y
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and at least once every three years for unregulated contaminants for which
allowable levels have not been established.
EFFECTIVE DATE: October 1, 2021
§ 88 — PUBLIC WATER SYSTEM TESTING
Requires an environmental laboratory that tests a public water system sample to notify DPH and
the test requestor within 24 hours after obtaining a test result that violates EPA national primary
drinking water standards
The act requires an environmental laboratory that tests a public water system
sample to notify the test requestor, or the requestor’s designee, within 24 hours
after obtaining a test result that shows a contaminant at a level that violates EPA
national primary drinking water standards. The requestor or designee must notify
DPH within 24 hours of being notified. Under the act, a contaminant means E.
Coli, lead, nitrate, and nitrite.
The act’s notification requirement applies only to public water systems that do
not submit a water supply plan to DPH (e.g., generally, those serving 1,000 or
more people or 250 or more customers).
Under existing law, if a public water system violates EPA national primary
drinking water standards, DPH must notify the chief elected official in the
municipality where the water system is located and any municipality the water
system serves. The act allows the commissioner’s designee, instead of only the
commissioner, to make the notification. As under existing law, the
commissioner’s designee must do this within five business days after receiving
notice of the violation.
EFFECTIVE DATE: October 1, 2021
§ 89 — HEALTH CARE INSTITUT IONS AND WATER SUPPL Y
SHORTAGES
Requires health care institutions to obtain potable water from a licensed bulk water hauler or
water bottler as a temporary measure to alleviate a water supply shortage
The act requires health care institutions to obtain potable water from a
licensed bulk water hauler or water bottler if they are required to temporarily
obtain potable water to alleviate a water supply shortage.
EFFECTIVE DATE: October 1, 2021
§ 90 — TECHNICAL CHANGES
Makes technical changes in an EMS statute
The act makes technical changes in an EMS statute.
EFFECTIVE DATE: Upon passage
§§ 93 & 94 — MINOR AND TECHNICAL CHANGES O L R P U B L I C A C T S U M M A R Y
Page 35 of 36
Makes minor and technical changes in PA licensure and continuing education requirements
The act makes technical changes in PA continuing education requirements in
existing law and PA 21-46 (§ 2).
The act also decreases, from $155 to $150, the annual licensure renewal fee
for PAs. (PA 21-2, June Special Session, § 199, restores the fee to $155.)
EFFECTIVE DATE: July 1, 2021
§ 95 — EMS MENTAL HEALTH TR AINING
Extends certain mental health training requirements to advanced EMTs and makes a clarifying
change regarding EMS instructors
PA 21-46, § 9, requires EMRs, EMTs, and emergency medical services
instructors seeking certification renewal to complete specified mental health and
suicide prevention training. The act extends this requirement to advanced EMTs.
Thus, the act requires advanced EMTs seeking certification renewal to present
evidence that, within the prior six years, they have completed (1) the evidence-
based youth suicide prevention training program established by PA 21-46 (see
Background) or (2) at least two hours of DPH-approved training in screening for
post-traumatic stress disorder, suicide risk, depression, and grief and suicide
prevention. This requirement applies starting January 1, 2022.
The act also removes the separate requirement under PA 21-46 for EMS
instructors to take this training; but under existing law, EMS instructors seeking
renewal of their certification must also maintain EMT or advanced EMT
certification or paramedic licensure.
EFFECTIVE DATE: July 1, 2021
Background — Related Act
PA 21-46, § 1, requires the Youth Suicide Advisory Board and the Office of
the Child Advocate to jointly administer an evidence-based youth suicide
prevention training program, with specified components, in each local and district
health department and offer it at least once every three years, starting by July 1,
2022.
§§ 96-98 — TECHNICAL CHANGES
Makes technical and conforming changes in EMS-related statutes
The act makes technical and conforming changes in EMS-related statutes.
EFFECTIVE DATE: Upon passage
§ 99 — DPH LIST OF FUNERAL DIRECTORS AND EMBALM ERS
O L R P U B L I C A C T S U M M A R Y
Page 36 of 36
Eliminates the requirement that DPH annually provide town clerks and registrars of vital
statistics printed lists of all licensed funeral directors, embalmers, student funeral directors, and
student embalmers
The act repeals a provision that required DPH to annually provide town clerks
and registrars of vital statistics printed lists of all licensed funeral directors,
embalmers, student funeral directors, and student embalmers. (In practice, these
lists are available on the state’s eLicense website.) The act also repeals a
provision that required DPH to issue cards to those listed stating their license or
registration status.
EFFECTIVE DATE: Upon passage