Connecticut 2021 Regular Session

Connecticut House Bill HB06666 Compare Versions

Version 1 (Old)

Version 2 (New)

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4		-	Substitute House Bill No. 6666
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6		-	Public Act No. 21-121
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9	12		AN ACT CONCERNING TH E DEPARTMENT OF PUBL IC HEALTH'S
10	13		RECOMMENDATIONS REGA RDING VARIOUS REVISIONS TO THE
11	14		PUBLIC HEALTH STATUT ES.
12	15		Be it enacted by the Senate and House of Representatives in General
13	16		Assembly convened:
14	17
15		-	Section 1. Section 73 of public act 19-117 is repealed and the following
16		-	is substituted in lieu thereof (Effective October 1, 2021):
17		-	Notwithstanding any provision of title 19a or 25 of the general
18		-	statutes, [and not later than March 1, 2020,] a director of health of a town,
19		-	city or borough or of a district department of health appointed pursuant
20		-	to section 19a-200, as amended by this act, or 19a-242 of the general
21		-	statutes may issue a permit for a replacement public well if the
22		-	Department of Public Health has approved such replacement public
23		-	well pursuant to subsection (b) of section 25-33 of the general statutes,
24		-	as amended by this act. For purposes of this section, "replacement public
25		-	well" means a public well that (1) replaces an existing public well, [in a
26		-	town in southeastern Connecticut with a population between fifteen
27		-	thousand and fifteen thousand three hundred, as enumerated by the
28		-	2010 federal decennial census,] and (2) does not meet the sanitary radius
29		-	and minimum setback requirements as specified in the regulations of
30		-	Connecticut State Agencies. Substitute House Bill No. 6666
31		-
32		-	Public Act No. 21-121 2 of 132
33		-
34		-	Sec. 2. Subsection (b) of section 25-33 of the general statutes is
35		-	repealed and the following is substituted in lieu thereof (Effective October
36		-	1, 2021):
37		-	(b) No system of water supply owned or used by a water company
38		-	shall be constructed or expanded or a new additional source of water
39		-	supply utilized until the plans therefor have been submitted to and
40		-	reviewed and approved by the department, except that no such prior
41		-	review or approval is required for distribution water main installations
42		-	that are constructed in accordance with sound engineering standards
43		-	and all applicable laws and regulations. A plan for any proposed new
44		-	source of water supply submitted to the department pursuant to this
45		-	subsection shall include documentation that provides for: (1) A brief
46		-	description of potential effects that the proposed new source of water
47		-	supply may have on nearby water supply systems including public and
48		-	private wells; and (2) the water company's ownership or control of the
49		-	proposed new source of water supply's sanitary radius and minimum
50		-	setback requirements as specified in the regulations of Connecticut state
51		-	agencies and that such ownership or control shall continue to be
52		-	maintained as specified in such regulations. If the department
53		-	determines, based upon documentation provided, that the water
54		-	company does not own or control the proposed new source of water
55		-	supply's sanitary radius or minimum setback requirements as specified
56		-	in the regulations of Connecticut state agencies, the department shall
57		-	require the water company proposing a new source of water supply to
58		-	supply additional documentation to the department that adequately
59		-	demonstrates the alternative methods that will be utilized to assure the
60		-	proposed new source of water supply's long-term purity and adequacy.
61		-	In reviewing any plan for a proposed new source of water supply, the
62		-	department shall consider the issues specified in this subsection. The
63		-	Commissioner of Public Health may adopt regulations, in accordance
64		-	with the provisions of chapter 54, to carry out the provisions of this
65		-	subsection and subsection (c) of this section. For purposes of this Substitute House Bill No. 6666
66		-
67		-	Public Act No. 21-121 3 of 132
68		-
69		-	subsection and subsection (c) of this section, "distribution water main
70		-	installations" means installations, extensions, replacements or repairs of
71		-	public water supply system mains from which water is or will be
72		-	delivered to one or more service connections and which do not require
73		-	construction or expansion of pumping stations, storage facilities,
74		-	treatment facilities or sources of supply. Notwithstanding the
75		-	provisions of this subsection, the department may approve any location
76		-	of a replacement public well, if such replacement public well is (A)
77		-	necessary for the water company to maintain and provide to its
78		-	consumers a safe and adequate water supply, (B) located in an aquifer
79		-	of adequate water quality determined by historical water quality data
80		-	from the source of water supply it is replacing, and (C) in a more
81		-	protected location when compared to the source of water supply it is
82		-	replacing, as determined by the department. For purposes of this
83		-	subsection, "replacement public well" means a public well that (i)
84		-	replaces an existing public well, [in a town in southeastern Connecticut
85		-	with a population between fifteen thousand and fifteen thousand three
86		-	hundred, as enumerated by the 2010, federal decennial census,] and (ii)
87		-	does not meet the sanitary radius and minimum setback requirements
88		-	as specified in the regulations of Connecticut state agencies.
89		-	Sec. 3. Section 8-3i of the general statutes is repealed and the
90		-	following is substituted in lieu thereof (Effective October 1, 2021):
91		-	(a) As used in this section "water company" means a water company,
92		-	as defined in section 25-32a, and "petition" includes a petition or
93		-	proposal to change the regulations, boundaries or classifications of
94		-	zoning districts.
95		-	(b) When an application, petition, request or plan is filed with the
96		-	zoning commission, planning and zoning commission or zoning board
97		-	of appeals of any municipality concerning any project on any site that is
98		-	within the aquifer protection area delineated pursuant to section 22a-
99		-	354c or the watershed of a water company, the applicant or the person Substitute House Bill No. 6666
100		-
101		-	Public Act No. 21-121 4 of 132
102		-
103		-	making the filing shall: [provide] (1) Provide written notice of the
104		-	application, petition, request or plan to the water company and the
105		-	[Commissioner of Public Health in a format prescribed by said
106		-	commissioner, provided such water company or said commissioner has
107		-	filed a map showing the boundaries of the watershed on the land
108		-	records of the municipality in which the application, petition, request or
109		-	plan is made and with the planning commission, zoning commission,
110		-	planning and zoning commission or zoning board of appeals of such
111		-	municipality or the aquifer protection area has been delineated in
112		-	accordance with section 22a-354c, as the case may be] Department of
113		-	Public Health; and (2) determine if the project is within the watershed
114		-	of a water company by consulting the maps posted on the department's
115		-	Internet web site showing the boundaries of the watershed. Such [notice
116		-	shall be made] applicant shall send such notice to the water company
117		-	by certified mail, return receipt requested, and to the department by
118		-	electronic mail to the electronic mail address designated on its Internet
119		-	web site for receipt of such notice. Such applicant shall [be mailed] mail
120		-	such notice not later than seven days after the date of the application.
121		-	Such water company and the Commissioner of Public Health may,
122		-	through a representative, appear and be heard at any hearing on any
123		-	such application, petition, request or plan.
124		-	(c) Notwithstanding the provisions of subsection (b) of this section,
125		-	when an agent of the zoning commission, planning and zoning
126		-	commission or zoning board of appeals is authorized to approve an
127		-	application, petition, request or plan concerning any site that is within
128		-	the aquifer protection area delineated pursuant to section 22a-354c or
129		-	the watershed of a water company without the approval of the zoning
130		-	commission, planning and zoning commission or zoning board of
131		-	appeals, and such agent determines that the proposed activity will not
132		-	adversely affect the public water supply, the applicant or person making
133		-	the filing shall not be required to notify the water company or the
134		-	[Commissioner] Department of Public Health. Substitute House Bill No. 6666
135		-
136		-	Public Act No. 21-121 5 of 132
137		-
138		-	Sec. 4. Section 22a-42f of the general statutes is repealed and the
139		-	following is substituted in lieu thereof (Effective October 1, 2021):
140		-	When an application is filed to conduct or cause to be conducted a
141		-	regulated activity upon an inland wetland or watercourse, any portion
142		-	of which is within the watershed of a water company as defined in
143		-	section 25-32a, the applicant shall: [provide] (1) Provide written notice
144		-	of the application to the water company and the [Commissioner of
145		-	Public Health in a format prescribed by said commissioner, provided
146		-	such water company or said commissioner has filed a map showing the
147		-	boundaries of the watershed on the land records of the municipality in
148		-	which the application is made and with the inland wetlands agency of
149		-	such municipality] Department of Public Health; and (2) determine if
150		-	the project is within the watershed of a water company by consulting
151		-	the maps posted on the department's Internet web site showing the
152		-	boundaries of the watershed. Such [notice shall be made] applicant shall
153		-	send such notice to the water company by certified mail, return receipt
154		-	requested, and to the department by electronic mail to the electronic
155		-	mail address designated by the department on its Internet web site for
156		-	receipt of such notice. Such applicant shall [be mailed] mail such notice
157		-	not later than seven days after the date of the application. The water
158		-	company and the Commissioner of Public Health, through a
159		-	representative, may appear and be heard at any hearing on the
160		-	application.
161		-	Sec. 5. Section 19a-111 of the general statutes is repealed and the
162		-	following is substituted in lieu thereof (Effective October 1, 2021):
163		-	Upon receipt of each report of confirmed venous blood lead level
164		-	equal to or greater than twenty micrograms per deciliter of blood, the
165		-	local director of health shall make or cause to be made an
166		-	epidemiological investigation of the source of the lead causing the
167		-	increased lead level or abnormal body burden and shall order action to
168		-	be taken by the appropriate person responsible for the condition that Substitute House Bill No. 6666
169		-
170		-	Public Act No. 21-121 6 of 132
171		-
172		-	brought about such lead poisoning as may be necessary to prevent
173		-	further exposure of persons to such poisoning. In the case of any
174		-	residential unit where such action will not result in removal of the
175		-	hazard within a reasonable time, the local director of health shall utilize
176		-	such community resources as are available to effect relocation of any
177		-	family occupying such unit. The local director of health may permit
178		-	occupancy in said residential unit during abatement if, in such director's
179		-	judgment, occupancy would not threaten the health and well-being of
180		-	the occupants. The local director of health shall, not later than thirty
181		-	days after the conclusion of such director's investigation, report to the
182		-	Commissioner of Public Health, using a web-based surveillance system
183		-	as prescribed by the commissioner, the result of such investigation and
184		-	the action taken to ensure against further lead poisoning from the same
185		-	source, including any measures taken to effect relocation of families.
186		-	Such report shall include information relevant to the identification and
187		-	location of the source of lead poisoning and such other information as
188		-	the commissioner may require pursuant to regulations adopted in
189		-	accordance with the provisions of chapter 54. The commissioner shall
190		-	maintain comprehensive records of all reports submitted pursuant to
191		-	this section and section 19a-110. Such records shall be geographically
192		-	indexed in order to determine the location of areas of relatively high
193		-	incidence of lead poisoning. The commissioner shall establish, in
194		-	conjunction with recognized professional medical groups, guidelines
195		-	consistent with the National Centers for Disease Control and Prevention
196		-	for assessment of the risk of lead poisoning, screening for lead poisoning
197		-	and treatment and follow-up care of individuals including children with
198		-	lead poisoning, women who are pregnant and women who are planning
199		-	pregnancy. Nothing in this section shall be construed to prohibit a local
200		-	building official from requiring abatement of sources of lead.
201		-	Sec. 6. Section 19a-37 of the general statutes is repealed and the
202		-	following is substituted in lieu thereof (Effective October 1, 2021): Substitute House Bill No. 6666
203		-
204		-	Public Act No. 21-121 7 of 132
205		-
206		-	(a) As used in this section:
207		-	(1) "Laboratory or firm" means an environmental laboratory
208		-	registered by the Department of Public Health pursuant to section 19a-
209		-	29a;
210		-	(2) "Private well" means a water supply well that meets all of the
211		-	following criteria: (A) Is not a public well; (B) supplies a residential
212		-	population of less than twenty-five persons per day; and (C) is owned
213		-	or controlled through an easement or by the same entity that owns or
214		-	controls the building or parcel that is served by the water supply well;
215		-	(3) "Public well" means a water supply well that supplies a public
216		-	water system;
217		-	(4) "Semipublic well" means a water supply well that (A) does not
218		-	meet the definition of a private well or public well, and (B) provides
219		-	water for drinking and other domestic purposes; and
220		-	(5) "Water supply well" means an artificial excavation constructed by
221		-	any method for the purpose of obtaining or providing water for
222		-	drinking or other domestic, industrial, commercial, agricultural,
223		-	recreational or irrigation use, or other outdoor water use.
224		-	(b) The Commissioner of Public Health may adopt regulations in the
225		-	[Public Health Code] regulations of Connecticut state agencies for the
226		-	preservation of the public health pertaining to (1) protection and
227		-	location of new water supply wells or springs for residential or
228		-	nonresidential construction or for public or semipublic use, and (2)
229		-	inspection for compliance with the provisions of municipal regulations
230		-	adopted pursuant to section 22a-354p.
231		-	(c) The Commissioner of Public Health shall adopt regulations, in
232		-	accordance with chapter 54, for the testing of water quality in private
233		-	[residential] wells and semipublic wells. Any laboratory or firm which Substitute House Bill No. 6666
234		-
235		-	Public Act No. 21-121 8 of 132
236		-
237		-	conducts a water quality test on a private well serving a residential
238		-	property or semipublic well shall, not later than thirty days after the
239		-	completion of such test, report the results of such test to (1) the public
240		-	health authority of the municipality where the property is located, and
241		-	(2) the Department of Public Health in a format specified by the
242		-	department, provided such report shall only be required if the party for
243		-	whom the laboratory or firm conducted such test informs the laboratory
244		-	or firm identified on the chain of custody documentation submitted
245		-	with the test samples that the test was conducted in connection with the
246		-	sale of such property. No regulation may require such a test to be
247		-	conducted as a consequence or a condition of the sale, exchange,
248		-	transfer, purchase or rental of the real property on which the private
249		-	[residential] well or semipublic well is located.
250		-	(d) Prior to the sale, exchange, purchase, transfer or rental of real
251		-	property on which a [residential] private or semipublic well is located,
252		-	the owner shall provide the buyer or tenant notice that educational
253		-	material concerning private well testing is available on the Department
254		-	of Public Health web site. Failure to provide such notice shall not
255		-	invalidate any sale, exchange, purchase, transfer or rental of real
256		-	property. If the seller or landlord provides such notice in writing, the
257		-	seller or landlord and any real estate licensee shall be deemed to have
258		-	fully satisfied any duty to notify the buyer or tenant that the subject real
259		-	property is located in an area for which there are reasonable grounds for
260		-	testing under subsection (g) or (j) of this section.
261		-	(e) The Commissioner of Public Health shall adopt regulations, in
262		-	accordance with chapter 54, to clarify the criteria under which the
263		-	commissioner may issue a well permit exception and to describe the
264		-	terms and conditions that shall be imposed when a well is allowed at a
265		-	premises (1) that is connected to a public water supply system, or (2)
266		-	whose boundary is located within two hundred feet of an approved
267		-	community water supply system, measured along a street, alley or Substitute House Bill No. 6666
268		-
269		-	Public Act No. 21-121 9 of 132
270		-
271		-	easement. Such regulations shall (A) provide for notification of the
272		-	permit to the public water supplier, (B) address the quality of the water
273		-	supplied from the well, the means and extent to which the well shall not
274		-	be interconnected with the public water supply, the need for a physical
275		-	separation, and the installation of a reduced pressure device for
276		-	backflow prevention, the inspection and testing requirements of any
277		-	such reduced pressure device, and (C) identify the extent and frequency
278		-	of water quality testing required for the well supply.
279		-	(f) No regulation may require that a certificate of occupancy for a
280		-	dwelling unit on such residential property be withheld or revoked on
281		-	the basis of a water quality test performed on a private [residential] well
282		-	pursuant to this section, unless such test results indicate that any
283		-	maximum contaminant level applicable to public water supply systems
284		-	for any contaminant listed in the [public health code] regulations of
285		-	Connecticut state agencies has been exceeded. No administrative
286		-	agency, health district or municipal health officer may withhold or
287		-	cause to be withheld such a certificate of occupancy except as provided
288		-	in this section.
289		-	(g) The local director of health may require a private [residential] well
290		-	or semipublic well to be tested for arsenic, radium, uranium, radon or
291		-	gross alpha emitters, when there are reasonable grounds to suspect that
292		-	such contaminants are present in the groundwater. For purposes of this
293		-	subsection, "reasonable grounds" means (1) the existence of a geological
294		-	area known to have naturally occurring arsenic, radium, uranium,
295		-	radon or gross alpha emitter deposits in the bedrock; or (2) the well is
296		-	located in an area in which it is known that arsenic, radium, uranium,
297		-	radon or gross alpha emitters are present in the groundwater.
298		-	(h) Except as provided in subsection (i) of this section, the collection
299		-	of samples for determining the water quality of private [residential]
300		-	wells and semipublic wells may be made only by (1) employees of a
301		-	laboratory or firm certified or approved by the Department of Public Substitute House Bill No. 6666
302		-
303		-	Public Act No. 21-121 10 of 132
304		-
305		-	Health to test drinking water, if such employees have been trained in
306		-	sample collection techniques, (2) certified water operators, (3) local
307		-	health departments and state employees trained in sample collection
308		-	techniques, or (4) individuals with training and experience that the
309		-	Department of Public Health deems sufficient.
310		-	(i) Any owner of a residential construction, including, but not limited
311		-	to, a homeowner, on which a private [residential] well is located or any
312		-	general contractor of a new residential construction on which a private
313		-	[residential] well is located may collect samples of well water for
314		-	submission to a laboratory or firm for the purposes of testing water
315		-	quality pursuant to this section, provided (1) such laboratory or firm has
316		-	provided instructions to said owner or general contractor on how to
317		-	collect such samples, and (2) such owner or general contractor is
318		-	identified to the subsequent owner on a form to be prescribed by the
319		-	Department of Public Health. No regulation may prohibit or impede
320		-	such collection or analysis.
321		-	(j) The local director of health may require private [residential] wells
322		-	and semipublic wells to be tested for pesticides, herbicides or organic
323		-	chemicals when there are reasonable grounds to suspect that any such
324		-	contaminants might be present in the groundwater. For purposes of this
325		-	subsection, "reasonable grounds" means (1) the presence of nitrate-
326		-	nitrogen in the groundwater at a concentration greater than ten
327		-	milligrams per liter, or (2) that the private [residential] well or
328		-	semipublic well is located on land, or in proximity to land, associated
329		-	with the past or present production, storage, use or disposal of organic
330		-	chemicals as identified in any public record.
331		-	(k) Any water transported in bulk by any means to a premises
332		-	currently supplied by a private well or semipublic well where the water
333		-	is to be used for purposes of drinking or domestic use shall be provided
334		-	by a bulk water hauler licensed pursuant to section 20-278h. No bulk
335		-	water hauler shall deliver water without first notifying the owner of the Substitute House Bill No. 6666
336		-
337		-	Public Act No. 21-121 11 of 132
338		-
339		-	premises of such delivery. Bulk water hauling to a premises currently
340		-	supplied by a private well or semipublic well shall be permitted only as
341		-	a temporary measure to alleviate a water supply shortage.
342		-	Sec. 7. (NEW) (Effective October 1, 2021) The owner of any residential
343		-	or commercial property shall notify each tenant of any leased or rented
344		-	unit located on such property and the lessee of such property whenever
345		-	any testing of the water supply for such property indicates that the
346		-	water exceeds a maximum contaminant level applicable to water supply
347		-	systems for any contaminant listed in the regulations of Connecticut
348		-	state agencies or for any contaminant listed on the state drinking water
349		-	action level list established pursuant to section 22a-471 of the general
350		-	statutes. As soon as practicable, but not later than forty-eight hours after
351		-	receiving notification of the results of such testing, the owner shall
352		-	forward a copy of such notification to each such tenant and lessee. The
353		-	local director of health shall take all reasonable steps to verify that such
354		-	owner forwarded the notice required pursuant to this section.
355		-	Sec. 8. Section 19a-524 of the general statutes is repealed and the
356		-	following is substituted in lieu thereof (Effective October 1, 2021):
357		-	If, upon review, investigation or inspection pursuant to section 19a-
358		-	498, the Commissioner of Public Health determines that a nursing home
359		-	facility or residential care home has violated any provision of section
360		-	17a-411, 19a-491a to 19a-491c, inclusive, as amended by this act, 19a-
361		-	493a, 19a-521 to 19a-529, inclusive, 19a-531 to 19a-551, inclusive, or 19a-
362		-	553 to 19a-555, inclusive, or any provision of any regulation of
363		-	Connecticut state agencies relating to licensure, the Fire Safety Code or
364		-	the operation or maintenance of a nursing home facility or residential
365		-	care home, which violation has been classified in accordance with
366		-	section 19a-527, the commissioner may immediately issue or cause to be
367		-	issued a citation to the licensee of such nursing home facility or
368		-	residential care home. Governmental immunity shall not be a defense to
369		-	any citation issued or civil penalty imposed pursuant to this section or Substitute House Bill No. 6666
370		-
371		-	Public Act No. 21-121 12 of 132
372		-
373		-	sections 19-525 to 19a-528, inclusive. Each such citation shall be in
374		-	writing, provide notice of the nature and scope of the alleged violation
375		-	or violations, and include, but not be limited to, the citation and notice
376		-	of noncompliance issued in accordance with section 19a-496. Each
377		-	citation and notice of noncompliance issued under this section shall be
378		-	sent to the licensee electronically in a form and manner prescribed by
379		-	the commissioner or by certified mail [to the licensee] at the address of
380		-	the nursing home facility or residential care home in issue. A copy of
381		-	such citation and notice of noncompliance shall also be sent to the
382		-	licensed administrator at the address of the nursing home facility or
383		-	residential care home.
384		-	Sec. 9. Subdivision (2) of subsection (c) of section 19a-491c of the
385		-	general statutes is repealed and the following is substituted in lieu
386		-	thereof (Effective July 1, 2021):
387		-	(2) No long-term care facility shall be required to comply with the
388		-	provisions of this subsection if (A) the individual provides evidence to
389		-	the long-term care facility that such individual submitted to a
390		-	background search conducted pursuant to subdivision (1) of this
391		-	subsection not more than three years immediately preceding the date
392		-	such individual applies for employment, seeks to enter into a contract
393		-	or begins volunteering with the long-term care facility and that the prior
394		-	background search confirmed that the individual did not have a
395		-	disqualifying offense, or (B) the commissioner determines the need to
396		-	temporarily suspend the requirements of this subsection in the event of
397		-	an emergency or significant disruption. The commissioner shall inform
398		-	the long-term care facility when the commissioner has suspended the
399		-	requirements of this subsection pursuant to subparagraph (B) of this
400		-	subdivision and when such suspension is rescinded.
401		-	Sec. 10. Section 19a-177 of the general statutes is repealed and the
402		-	following is substituted in lieu thereof (Effective October 1, 2021): Substitute House Bill No. 6666
403		-
404		-	Public Act No. 21-121 13 of 132
405		-
406		-	The commissioner shall:
407		-	(1) With the advice of the Office of Emergency Medical Services
408		-	established pursuant to section 19a-178 and of an advisory committee
409		-	on emergency medical services and with the benefit of meetings held
410		-	pursuant to subsection (b) of section 19a-184, adopt every five years a
411		-	state-wide plan for the coordinated delivery of emergency medical
412		-	services;
413		-	(2) License or certify the following: (A) Ambulance operations,
414		-	[ambulance drivers,] emergency medical services personnel and
415		-	communications personnel; (B) emergency room facilities and
416		-	communications facilities; and (C) transportation equipment, including
417		-	land, sea and air vehicles used for transportation of patients to
418		-	emergency facilities and periodically inspect life saving equipment,
419		-	emergency facilities and emergency transportation vehicles to ensure
420		-	state standards are maintained;
421		-	(3) Annually inventory emergency medical services resources within
422		-	the state, including facilities, equipment, and personnel, for the
423		-	purposes of determining the need for additional services and the
424		-	effectiveness of existing services;
425		-	(4) Review and evaluate all area-wide plans developed by the
426		-	emergency medical services councils pursuant to section 19a-182 in
427		-	order to insure conformity with standards issued by the commissioner;
428		-	(5) Not later than thirty days after their receipt, review all grant and
429		-	contract applications for federal or state funds concerning emergency
430		-	medical services or related activities for conformity to policy guidelines
431		-	and forward such application to the appropriate agency, when required;
432		-	(6) Establish such minimum standards and adopt such regulations in
433		-	accordance with the provisions of chapter 54, as may be necessary to
434		-	develop the following components of an emergency medical service Substitute House Bill No. 6666
435		-
436		-	Public Act No. 21-121 14 of 132
437		-
438		-	system: (A) Communications, which shall include, but not be limited to,
439		-	equipment, radio frequencies and operational procedures; (B)
440		-	transportation services, which shall include, but not be limited to,
441		-	vehicle type, design, condition and maintenance, and operational
442		-	procedures; (C) training, which shall include, but not be limited to,
443		-	emergency medical services personnel, communications personnel,
444		-	paraprofessionals associated with emergency medical services,
445		-	firefighters and state and local police; (D) emergency medical service
446		-	facilities, which shall include, but not be limited to, categorization of
447		-	emergency departments as to their treatment capabilities and ancillary
448		-	services; and (E) mobile integrated health care programs, which shall
449		-	include, but not be limited to, the standards to ensure the health, safety
450		-	and welfare of the patients being served by such programs and data
451		-	collection and reporting requirements to ensure and measure quality
452		-	outcomes of such programs;
453		-	(7) Coordinate training of all emergency medical services personnel;
454		-	(8) (A) Develop an emergency medical services data collection
455		-	system. Each emergency medical service organization licensed or
456		-	certified pursuant to this chapter shall submit data to the commissioner,
457		-	on a quarterly basis, from each licensed ambulance service, certified
458		-	ambulance service or paramedic intercept service that provides
459		-	emergency medical services. Such submitted data shall include, but not
460		-	be limited to: (i) The total number of calls for emergency medical
461		-	services received by such licensed ambulance service, certified
462		-	ambulance service or paramedic intercept service through the 9-1-1
463		-	system during the reporting period; (ii) each level of emergency medical
464		-	services, as defined in regulations adopted pursuant to section 19a-179,
465		-	required for each such call; (iii) the response time for each licensed
466		-	ambulance service, certified ambulance service or paramedic intercept
467		-	service during the reporting period; (iv) the number of passed calls,
468		-	cancelled calls and mutual aid calls, both made and received, during the Substitute House Bill No. 6666
469		-
470		-	Public Act No. 21-121 15 of 132
471		-
472		-	reporting period; and (v) for the reporting period, the prehospital data
473		-	for the nonscheduled transport of patients required by regulations
474		-	adopted pursuant to subdivision (6) of this section. The data required
475		-	under this subdivision may be submitted in any electronic form selected
476		-	by such licensed ambulance service, certified ambulance service or
477		-	paramedic intercept service and approved by the commissioner,
478		-	provided the commissioner shall take into consideration the needs of
479		-	such licensed ambulance service, certified ambulance service or
480		-	paramedic intercept service in approving such electronic form. The
481		-	commissioner may conduct an audit of any such licensed ambulance
482		-	service, certified ambulance service or paramedic intercept service as
483		-	the commissioner deems necessary in order to verify the accuracy of
484		-	such reported data.
485		-	(B) On or before December 31, 2018, and annually thereafter, the
486		-	commissioner shall prepare a report to the Emergency Medical Services
487		-	Advisory Board, established pursuant to section 19a-178a, as amended
488		-	by this act, that shall include, but not be limited to, the following data:
489		-	(i) The total number of calls for emergency medical services received
490		-	during the reporting year by each licensed ambulance service, certified
491		-	ambulance service or paramedic intercept service; (ii) the level of
492		-	emergency medical services required for each such call; (iii) the name of
493		-	the emergency medical service organization that provided each such
494		-	level of emergency medical services furnished during the reporting
495		-	year; (iv) the response time, by time ranges or fractile response times,
496		-	for each licensed ambulance service, certified ambulance service or
497		-	paramedic intercept service, using a common definition of response
498		-	time, as provided in regulations adopted pursuant to section 19a-179;
499		-	and (v) the number of passed calls, cancelled calls and mutual aid calls
500		-	during the reporting year. The commissioner shall prepare such report
501		-	in a format that categorizes such data for each municipality in which the
502		-	emergency medical services were provided, with each such
503		-	municipality grouped according to urban, suburban and rural Substitute House Bill No. 6666
504		-
505		-	Public Act No. 21-121 16 of 132
506		-
507		-	classifications.
508		-	(C) If any licensed ambulance service, certified ambulance service or
509		-	paramedic intercept service does not submit the data required under
510		-	subparagraph (A) of this subdivision for a period of six consecutive
511		-	months, or if the commissioner believes that such licensed ambulance
512		-	service, certified ambulance service or paramedic intercept service
513		-	knowingly or intentionally submitted incomplete or false data, the
514		-	commissioner shall issue a written order directing such licensed
515		-	ambulance service, certified ambulance service or paramedic intercept
516		-	service to comply with the provisions of subparagraph (A) of this
517		-	subdivision and submit all missing data or such corrected data as the
518		-	commissioner may require. If such licensed ambulance service, certified
519		-	ambulance service or paramedic intercept service fails to fully comply
520		-	with such order not later than three months from the date such order is
521		-	issued, the commissioner (i) shall conduct a hearing, in accordance with
522		-	chapter 54, at which such licensed ambulance service, certified
523		-	ambulance service or paramedic intercept service shall be required to
524		-	show cause why the primary service area assignment of such licensed
525		-	ambulance service, certified ambulance service or paramedic intercept
526		-	service should not be revoked, and (ii) may take such disciplinary action
527		-	under section 19a-17 as the commissioner deems appropriate.
528		-	(D) The commissioner shall collect the data required by
529		-	subparagraph (A) of this subdivision, in the manner provided in said
530		-	subparagraph, from each emergency medical service organization
531		-	licensed or certified pursuant to this chapter. Any such emergency
532		-	medical service organization that fails to comply with the provisions of
533		-	this section shall be liable for a civil penalty not to exceed one hundred
534		-	dollars per day for each failure to report the required data regarding
535		-	emergency medical services provided to a patient, as determined by the
536		-	commissioner. The civil penalties set forth in this subparagraph shall be
537		-	assessed only after the department provides a written notice of Substitute House Bill No. 6666
538		-
539		-	Public Act No. 21-121 17 of 132
540		-
541		-	deficiency and the organization is afforded the opportunity to respond
542		-	to such notice. An organization shall have not more than fifteen business
543		-	days after the date of receiving such notice to provide a written response
544		-	to the department. The commissioner may adopt regulations, in
545		-	accordance with chapter 54, concerning the development,
546		-	implementation, monitoring and collection of emergency medical
547		-	service system data. All state agencies licensed or certified as emergency
548		-	medical service organizations shall be exempt from the civil penalties
549		-	set forth in this subparagraph.
550		-	(E) The commissioner shall, with the recommendation of the
551		-	Connecticut Emergency Medical Services Advisory Board established
552		-	pursuant to section 19a-178a, as amended by this act, adopt for use in
553		-	trauma data collection the most recent version of the National Trauma
554		-	Data Bank's National Trauma Data Standards and Data Dictionary and
555		-	nationally recognized guidelines for field triage of injured patients;
556		-	(9) (A) Establish rates for the conveyance and treatment of patients
557		-	by licensed ambulance services and invalid coaches and establish
558		-	emergency service rates for certified ambulance services and paramedic
559		-	intercept services, provided (i) the present rates established for such
560		-	services and vehicles shall remain in effect until such time as the
561		-	commissioner establishes a new rate schedule as provided in this
562		-	subdivision, and (ii) any rate increase not in excess of the Medical Care
563		-	Services Consumer Price Index, as published by the Bureau of Labor
564		-	Statistics of the United States Department of Labor, for the prior year,
565		-	filed in accordance with subparagraph (B)(iii) of this subdivision shall
566		-	be deemed approved by the commissioner. For purposes of this
567		-	subdivision, licensed ambulance services and paramedic intercept
568		-	services shall not include emergency air transport services or mobile
569		-	integrated health care programs.
570		-	(B) Adopt regulations, in accordance with the provisions of chapter
571		-	54, establishing methods for setting rates and conditions for charging Substitute House Bill No. 6666
572		-
573		-	Public Act No. 21-121 18 of 132
574		-
575		-	such rates. Such regulations shall include, but not be limited to,
576		-	provisions requiring that on and after July 1, 2000: (i) Requests for rate
577		-	increases may be filed no more frequently than once a year, except that,
578		-	in any case where an agency's schedule of maximum allowable rates
579		-	falls below that of the Medicare allowable rates for that agency, the
580		-	commissioner shall immediately amend such schedule so that the rates
581		-	are at or above the Medicare allowable rates; (ii) only licensed
582		-	ambulance services, certified ambulance services and paramedic
583		-	intercept services that apply for a rate increase in excess of the Medical
584		-	Care Services Consumer Price Index, as published by the Bureau of
585		-	Labor Statistics of the United States Department of Labor, for the prior
586		-	year, and do not accept the maximum allowable rates contained in any
587		-	voluntary state-wide rate schedule established by the commissioner for
588		-	the rate application year shall be required to file detailed financial
589		-	information with the commissioner, provided any hearing that the
590		-	commissioner may hold concerning such application shall be conducted
591		-	as a contested case in accordance with chapter 54; (iii) licensed
592		-	ambulance services, certified ambulance services and paramedic
593		-	intercept services that do not apply for a rate increase in any year in
594		-	excess of the Medical Care Services Consumer Price Index, as published
595		-	by the Bureau of Labor Statistics of the United States Department of
596		-	Labor, for the prior year, or that accept the maximum allowable rates
597		-	contained in any voluntary state-wide rate schedule established by the
598		-	commissioner for the rate application year shall, not later than the last
599		-	business day in August of such year, file with the commissioner a
600		-	statement of emergency and nonemergency call volume, and, in the case
601		-	of a licensed ambulance service, certified ambulance service or
602		-	paramedic intercept service that is not applying for a rate increase, a
603		-	written declaration by such licensed ambulance service, certified
604		-	ambulance service or paramedic intercept service that no change in its
605		-	currently approved maximum allowable rates will occur for the rate
606		-	application year; and (iv) detailed financial and operational information
607		-	filed by licensed ambulance services, certified ambulance services and Substitute House Bill No. 6666
608		-
609		-	Public Act No. 21-121 19 of 132
610		-
611		-	paramedic intercept services to support a request for a rate increase in
612		-	excess of the Medical Care Services Consumer Price Index, as published
613		-	by the Bureau of Labor Statistics of the United States Department of
614		-	Labor, for the prior year, shall cover the time period pertaining to the
615		-	most recently completed fiscal year and the rate application year of the
616		-	licensed ambulance service, certified ambulance service or paramedic
617		-	intercept service.
618		-	(C) Establish rates for licensed ambulance services, certified
619		-	ambulance services or paramedic intercept services for the following
620		-	services and conditions: (i) "Advanced life support assessment" and
621		-	"specialty care transports", which terms have the meanings provided in
622		-	42 CFR 414.605; and (ii) mileage, which may include mileage for an
623		-	ambulance transport when the point of origin and final destination for
624		-	a transport is within the boundaries of the same municipality. The rates
625		-	established by the commissioner for each such service or condition shall
626		-	be equal to (I) the ambulance service's base rate plus its established
627		-	advanced life support/paramedic surcharge when advanced life
628		-	support assessment services are performed; (II) two hundred twenty-
629		-	five per cent of the ambulance service's established base rate for
630		-	specialty care transports; and (III) "loaded mileage", as the term is
631		-	defined in 42 CFR 414.605, multiplied by the ambulance service's
632		-	established rate for mileage. Such rates shall remain in effect until such
633		-	time as the commissioner establishes a new rate schedule as provided
634		-	in this subdivision.
635		-	(D) Establish rates for the treatment and release of patients by a
636		-	licensed or certified emergency medical services organization or a
637		-	provider who does not transport such patients to an emergency
638		-	department and who is operating within the scope of such
639		-	organization's or provider's practice and following protocols approved
640		-	by the sponsor hospital. The rates established pursuant to this
641		-	subparagraph shall not apply to the treatment provided to patients Substitute House Bill No. 6666
642		-
643		-	Public Act No. 21-121 20 of 132
644		-
645		-	through mobile integrated health care programs;
646		-	(10) Establish primary service areas and assign in writing a primary
647		-	service area responder for each primary service area. Each state-owned
648		-	campus having an acute care hospital on the premises shall be
649		-	designated as the primary service area responder for that campus;
650		-	(11) Revoke primary service area assignments upon determination by
651		-	the commissioner that it is in the best interests of patient care to do so;
652		-	and
653		-	(12) Annually issue a list of minimum equipment requirements for
654		-	[ambulances and rescue vehicles] authorized emergency medical
655		-	services vehicles based upon current national standards. The
656		-	commissioner shall distribute such list to all emergency medical service
657		-	organizations and sponsor hospital medical directors and make such list
658		-	available to other interested stakeholders. Emergency medical service
659		-	organizations shall have one year from the date of issuance of such list
660		-	to comply with the minimum equipment requirements.
661		-	Sec. 11. (NEW) (Effective July 1, 2021) The Commissioner of Public
662		-	Health may waive any provisions of the regulations applying to an
663		-	emergency medical service organization or emergency medical services
664		-	personnel, as such terms are defined in section 19a-175 of the general
665		-	statutes, as amended by this act, if the commissioner determines that
666		-	such waiver (1) would not endanger the health, safety or welfare of any
667		-	patient or resident, and (2) does not affect the maximum allowable rates
668		-	for each emergency medical service organization or primary service
669		-	area assignments. The commissioner may impose conditions, upon
670		-	granting the waiver, that assure the health, safety or welfare of patients
671		-	or residents and may terminate the waiver upon a finding that the
672		-	health, safety or welfare of any patient or resident has been jeopardized.
673		-	The commissioner may adopt regulations, in accordance with the
674		-	provisions of chapter 54 of the general statutes, establishing procedures Substitute House Bill No. 6666
675		-
676		-	Public Act No. 21-121 21 of 132
677		-
678		-	for an application for a waiver pursuant to this subdivision.
679		-	Sec. 12. Section 20-207 of the general statutes is repealed and the
680		-	following is substituted in lieu thereof (Effective October 1, 2021):
681		-	As used in this chapter, unless the context otherwise requires, the
682		-	following terms shall have the meanings specified:
683		-	(1) "Board" means the Connecticut Board of Examiners of Embalmers
684		-	and Funeral Directors;
685		-	(2) "Person" means an individual or corporation, but not a
686		-	partnership;
687		-	(3) "Funeral directing" means the business, practice or profession, as
688		-	commonly practiced, of (A) directing or supervising funerals, or
689		-	providing funeral services; (B) handling or encasing or providing
690		-	services for handling and encasing dead human bodies, otherwise than
691		-	by embalming, for burial or disposal; (C) providing embalming services;
692		-	(D) providing transportation, interment and disinterment of dead
693		-	human bodies; (E) maintaining an establishment so located, constructed
694		-	and equipped as to permit the decent and sanitary handling of dead
695		-	human bodies, with suitable equipment in such establishment for such
696		-	handling; (F) conducting an establishment from which funerals may be
697		-	held; (G) engaging in consultations concerning arrangements for the
698		-	disposition of human remains, including, but not limited to,
699		-	arrangements for cremation or alkaline hydrolysis; (H) casketing human
700		-	remains; (I) making cemetery and cremation arrangements; and (J)
701		-	preparing funeral service contracts, as defined in section 42-200;
702		-	(4) "Funeral director" means any person engaged or holding himself
703		-	or herself out as engaged in funeral directing whether or not he or she
704		-	uses in connection with his or her name or business the words "funeral
705		-	director," "undertaker" or "mortician" or any other word or title
706		-	intended to designate him or her as a funeral director or mortician or as Substitute House Bill No. 6666
707		-
708		-	Public Act No. 21-121 22 of 132
709		-
710		-	one so engaged;
711		-	(5) "Funeral service business" means the business, practice or
712		-	profession of funeral directing;
713		-	(6) "Licensed embalmer" means an embalmer holding a license as
714		-	provided in this chapter;
715		-	(7) "Licensed funeral director" means a funeral director holding a
716		-	license as provided in this chapter;
717		-	(8) ["Student embalmer"] "Registered apprentice embalmer" means a
718		-	person [studying embalming and] registered with the Department of
719		-	Public Health as an apprentice pursuant to the provisions of this
720		-	chapter;
721		-	(9) ["Student funeral director"] "Registered apprentice funeral
722		-	director" means a person [studying the funeral service business and]
723		-	registered with the Department of Public Health as an apprentice
724		-	pursuant to the provisions of this chapter;
725		-	(10) "Full-time employment" means regular and steady work during
726		-	the normal working hours by any person at the establishment at which
727		-	he is employed; and
728		-	(11) "Manager" means an individual who (A) is licensed as an
729		-	embalmer or funeral director pursuant to this chapter and (B) has direct
730		-	and personal responsibility for the daily operation and management of
731		-	a funeral service business.
732		-	Sec. 13. Section 20-212 of the general statutes is repealed and the
733		-	following is substituted in lieu thereof (Effective October 1, 2021):
734		-	No person, except a licensed embalmer, shall inject any fluid or
735		-	substance into any dead human body, except that a registered [student]
736		-	apprentice embalmer may, even if not in the presence of a licensed Substitute House Bill No. 6666
737		-
738		-	Public Act No. 21-121 23 of 132
739		-
740		-	embalmer, make such injection or perform any other act under [his]
741		-	such licensed embalmer's instruction; and no person, firm or
742		-	corporation shall enter, engage in, carry on or manage for another the
743		-	business of caring for, preserving or disposing of dead human bodies
744		-	until each person, firm or corporation so engaged has obtained from the
745		-	Department of Public Health and holds a license as provided in this
746		-	chapter; nor shall any person be employed to remove a dead human
747		-	body, except a licensed embalmer, a registered [student] apprentice
748		-	embalmer, a licensed funeral director, or a person authorized in each
749		-	instance by the Chief Medical Examiner, Deputy Medical Examiner or
750		-	assistant medical examiner incidental to examining the body of a
751		-	deceased person, except that once a dead human body has been
752		-	prepared in accordance with the [Public Health Code] regulations of
753		-	Connecticut state agencies and the applicable provisions of the general
754		-	statutes, an embalmer or funeral director licensed in this state may
755		-	authorize an unlicensed employee to transport such body. Nothing in
756		-	this section shall be construed to prohibit any person licensed as an
757		-	embalmer or as a funeral director under the laws of another state from
758		-	bringing into or removing from this state a dead human body, provided
759		-	any and all other laws of this state relative to such body have been
760		-	complied with. Nothing in this chapter shall be construed to prohibit
761		-	any student who is enrolled in a program of education in mortuary
762		-	science, approved by the board, with the consent of the Commissioner
763		-	of Public Health, from embalming up to ten human bodies under the
764		-	supervision of a licensed embalmer and incidental to such student's
765		-	course of study. Such embalming shall be counted toward the
766		-	embalming requirement outlined in section 20-213, as amended by this
767		-	act, when such student becomes a registered apprentice embalmer.
768		-	Sec. 14. Subsections (a) and (b) of section 20-213 of the general statutes
769		-	are repealed and the following is substituted in lieu thereof (Effective
770		-	October 1, 2021): Substitute House Bill No. 6666
771		-
772		-	Public Act No. 21-121 24 of 132
773		-
774		-	(a) (1) After a [student] registered apprentice embalmer has (A)
775		-	completed a program of education in mortuary science approved by the
776		-	board with the consent of the Commissioner of Public Health, (B)
777		-	successfully completed an examination prescribed by the Department
778		-	of Public Health with the consent of the board, (C) completed one year
779		-	of practical training and experience of a grade and character satisfactory
780		-	to the commissioner in the state in full-time employment under the
781		-	personal supervision and instruction of an embalmer licensed under the
782		-	provisions of this chapter, and (D) embalmed fifty human bodies in not
783		-	more than two years under the supervision of a licensed embalmer or
784		-	embalmers, (2) the [student] registered apprentice embalmer shall (A)
785		-	submit to the department an application and fee of two hundred ten
786		-	dollars, (B) take a written examination on the Connecticut public health
787		-	laws and the regulations of Connecticut state agencies pertaining to the
788		-	activities of an embalmer, and (C) take an examination in practical
789		-	embalming that shall include an actual demonstration upon a cadaver.
790		-	When the [student] registered apprentice embalmer has satisfactorily
791		-	passed such examinations, said department shall issue to him or her a
792		-	license to practice embalming. At the expiration of such license, if the
793		-	holder thereof desires a renewal, said department shall grant it pursuant
794		-	to section 20-222a, except for cause.
795		-	(b) Examinations for registration as a [student] registered apprentice
796		-	embalmer and for an embalmer's license shall be administered to
797		-	applicants by the Department of Public Health, under the supervision
798		-	of the board, semiannually and at such other times as may be
799		-	determined by the department.
800		-	Sec. 15. Section 20-215 of the general statutes is repealed and the
801		-	following is substituted in lieu thereof (Effective October 1, 2021):
802		-	No licensed embalmer shall sign an affidavit attesting the
803		-	preparation or embalming of any body unless such body has been
804		-	prepared or embalmed by [him] such licensed embalmer, or by a Substitute House Bill No. 6666
805		-
806		-	Public Act No. 21-121 25 of 132
807		-
808		-	registered [student] apprentice embalmer under [his] such licensed
809		-	embalmer's personal supervision.
810		-	Sec. 16. Subsection (a) of section 20-217 of the general statutes is
811		-	repealed and the following is substituted in lieu thereof (Effective October
812		-	1, 2021):
813		-	(a) When a [student] registered apprentice funeral director has
814		-	completed a program of education approved by the board with the
815		-	consent of the Commissioner of Public Health, has successfully
816		-	completed an examination prescribed by the department with the
817		-	consent of the board and furnishes the department with satisfactory
818		-	proof that he or she has completed one year of practical training and
819		-	experience in full-time employment under the personal supervision of
820		-	a licensed embalmer or funeral director, and pays to the department a
821		-	fee of two hundred ten dollars, [he] such registered apprentice funeral
822		-	director shall be entitled to be examined upon the Connecticut state law
823		-	and regulations pertaining to his or her professional activities. If found
824		-	to be qualified by the Department of Public Health, [he] such registered
825		-	apprentice funeral director shall be licensed as a funeral director.
826		-	Renewal licenses shall be issued by the Department of Public Health
827		-	pursuant to section 20-222a, unless withheld for cause as herein
828		-	provided, upon a payment of a fee of two hundred thirty dollars.
829		-	Sec. 17. Section 20-224 of the general statutes is repealed and the
830		-	following is substituted in lieu thereof (Effective October 1, 2021):
831		-	(a) The provisions of sections 20-217, as amended by this act, 20-220
832		-	and 20-227 shall not prohibit the employment of assistants or of
833		-	[student] registered apprentice embalmers and [student] registered
834		-	apprentice funeral directors as provided in this chapter, provided a
835		-	licensed funeral service business may employ no more than two
836		-	[student] registered apprentice embalmers at any one time, and any
837		-	person, firm, corporation or other organization engaged in the business Substitute House Bill No. 6666
838		-
839		-	Public Act No. 21-121 26 of 132
840		-
841		-	of funeral directing may employ no more than one [student] registered
842		-	apprentice funeral director at any one time, without the approval of the
843		-	Board of Examiners of Embalmers and Funeral Directors.
844		-	(b) [Student] Registered apprentice embalmers and [student]
845		-	registered apprentice funeral directors shall register as apprentices with
846		-	the Department of Public Health, in the manner prescribed by the
847		-	commissioner in regulations adopted pursuant to section 20-211, for
848		-	purposes of completing practical training and experience pursuant to
849		-	the provisions of this chapter.
850		-	Sec. 18. Section 20-195dd of the general statutes is repealed and the
851		-	following is substituted in lieu thereof (Effective from passage):
852		-	(a) Except as otherwise provided in subsections (c) and (d) of this
853		-	section, an applicant for a license as a professional counselor shall
854		-	submit evidence satisfactory to the commissioner of having: (1) (A)
855		-	Earned a graduate degree in clinical mental health counseling as part of
856		-	a program of higher learning accredited by the Cou ncil for
857		-	Accreditation of Counseling and Related Educational Programs, or a
858		-	successor organization, or (B) (i) completed at least sixty graduate
859		-	semester hours in counseling or a related mental health field at a
860		-	regionally accredited institution of higher education that included
861		-	coursework in each of the following areas: (I) Human growth and
862		-	development; (II) social and cultural foundations; (III) counseling
863		-	theories; (IV) counseling techniques; (V) group counseling; (VI) career
864		-	counseling; (VII) appraisals or tests and measurements to individuals
865		-	and groups; (VIII) research and evaluation; (IX) professional orientation
866		-	to mental health counseling; (X) addiction and substance abuse
867		-	counseling; (XI) trauma and crisis counseling; and (XII) diagnosis and
868		-	treatment of mental and emotional disorders, (ii) earned from a
869		-	regionally accredited institution of higher education a graduate degree
870		-	in counseling or a related mental health field, (iii) completed a one-
871		-	hundred-hour practicum in counseling taught by a faculty member Substitute House Bill No. 6666
872		-
873		-	Public Act No. 21-121 27 of 132
874		-
875		-	licensed or certified as a professional counselor or its equivalent in
876		-	another state, and (iv) completed a six-hundred-hour clinical mental
877		-	health counseling internship taught by a faculty member licensed or
878		-	certified as a professional counselor or its equivalent in another state; (2)
879		-	acquired three thousand hours of postgraduate experience under
880		-	professional supervision, including a minimum of one hundred hours
881		-	of direct professional supervision, in the practice of professional
882		-	counseling, performed over a period of not less than two years; and (3)
883		-	passed an examination prescribed by the commissioner. The provisions
884		-	of subparagraphs (B)(i)(X) to (B)(i)(XII), inclusive, (B)(iii) and (B)(iv) of
885		-	this subsection shall not apply to any applicant who, on or before July
886		-	1, 2017, was a matriculating student in good standing in a graduate
887		-	degree program at a regionally accredited institution of higher
888		-	education in one of the fields required under subparagraph (B) of this
889		-	subsection.
890		-	(b) An applicant for a license as a professional counselor associate
891		-	shall submit to the Commissioner of Public Health evidence satisfactory
892		-	to the commissioner of having (1) earned a graduate degree in clinical
893		-	mental health counseling as part of a program of higher learning
894		-	accredited by the Council for Accreditation of Counseling and Related
895		-	Educational Programs, or a successor organization, or (2) (A) completed
896		-	at least sixty graduate semester hours in counseling or a related mental
897		-	health field at a regionally accredited institution of higher education
898		-	that included coursework in each of the following areas: Human growth
899		-	and development; social and cultural foundations; counseling theories;
900		-	counseling techniques; group counseling; career counseling; appraisals
901		-	or tests and measurements to individuals and groups; research and
902		-	evaluation; professional orientation to mental health counseling;
903		-	addiction and substance abuse counseling; trauma and crisis
904		-	counseling; and diagnosis and treatment of mental and emotional
905		-	disorders, (B) completed a one-hundred-hour practicum in counseling
906		-	taught by a faculty member licensed or certified as a professional Substitute House Bill No. 6666
907		-
908		-	Public Act No. 21-121 28 of 132
909		-
910		-	counselor or its equivalent in another state, (C) completed a six-
911		-	hundred-hour clinical mental health counseling internship taught by a
912		-	faculty member licensed or certified as a professional counselor or its
913		-	equivalent in another state, and (D) earned from a regionally accredited
914		-	institution of higher education a graduate degree in counseling or a
915		-	related mental health field. The provisions of subparagraphs (A) to (C),
916		-	inclusive, of subdivision (2) of this subsection shall not apply to any
917		-	applicant who, on or before July 1, 2022, earned a graduate degree at a
918		-	regionally accredited institution of higher education in counseling or a
919		-	related mental health field and has accumulated at least three thousand
920		-	hours of experience under professional supervision, as defined in
921		-	section 20-195aa.
922		-	(c) An applicant for licensure by endorsement shall present evidence
923		-	satisfactory to the commissioner that the applicant is licensed or
924		-	certified as a professional counselor or professional counselor associate,
925		-	or as a person entitled to perform similar services under a different
926		-	designation, in another state or jurisdiction whose requirements for
927		-	practicing in such capacity are substantially similar to or higher than
928		-	those of this state and that there are no disciplinary actions or
929		-	unresolved complaints pending.
930		-	(d) An applicant who is licensed or certified as a professional
931		-	counselor or its equivalent in another state, territory or commonwealth
932		-	of the United States may substitute three years of licensed or certified
933		-	work experience in the practice of professional counseling in lieu of the
934		-	requirements of subdivision (2) of subsection (a) of this section,
935		-	provided the commissioner finds that such experience is equal to or
936		-	greater than the requirements of this state.
937		-	Sec. 19. Subsection (a) of section 20-195c of the general statutes is
938		-	repealed and the following is substituted in lieu thereof (Effective from
939		-	passage): Substitute House Bill No. 6666
940		-
941		-	Public Act No. 21-121 29 of 132
942		-
943		-	(a) Each applicant for licensure as a marital and family therapist shall
944		-	present to the department satisfactory evidence that such applicant has:
945		-	(1) Completed a graduate degree program specializing in marital and
946		-	family therapy offered by a regionally accredited college or university
947		-	or an accredited postgraduate clinical training program accredited by
948		-	the Commission on Accreditation for Marriage and Family Therapy
949		-	Education offered by a regionally accredited institution of higher
950		-	education; (2) completed a supervised practicum or internship with
951		-	emphasis in marital and family therapy supervised by the program
952		-	granting the requisite degree or by an accredited postgraduate clinical
953		-	training program accredited by the Commission on Accreditation for
954		-	Marriage and Family Therapy Education and offered by a regionally
955		-	accredited institution of higher education; [, in which the student
956		-	received a minimum of five hundred direct clinical hours that included
957		-	one hundred hours of clinical supervision;] (3) completed twelve
958		-	months of relevant postgraduate experience, including (A) a minimum
959		-	of one thousand hours of direct client contact offering marital and
960		-	family therapy services subsequent to being awarded a master's degree
961		-	or doctorate or subsequent to the training year specified in subdivision
962		-	(2) of this subsection, and (B) one hundred hours of postgraduate
963		-	clinical supervision provided by a licensed marital and family therapist;
964		-	and (4) passed an examination prescribed by the department. The fee
965		-	shall be three hundred fifteen dollars for each initial application.
966		-	Sec. 20. Subdivision (12) of subsection (a) of section 19a-14 of the
967		-	general statutes is repealed and the following is substituted in lieu
968		-	thereof (Effective October 1, 2021):
969		-	(12) With respect to any complaint filed with the department on or
970		-	after October 1, 2010, alleging incompetence, negligence, fraud or deceit
971		-	by a person subject to regulation or licensing by any board or
972		-	commission described in subdivision (1) to [(5), inclusive, (7),] (8),
973		-	inclusive, (12) to (14), inclusive, or subdivision (16) of subsection (b) of Substitute House Bill No. 6666
974		-
975		-	Public Act No. 21-121 30 of 132
976		-
977		-	this section:
978		-	(A) Upon request of the person who filed the complaint, provide such
979		-	person with information on the status of the complaint;
980		-	(B) Upon request of the person who filed the complaint, provide such
981		-	person with an opportunity to review, at the department, records
982		-	compiled as of the date of the request pursuant to any investigation of
983		-	the complaint, including, but not limited to, the respondent's written
984		-	response to the complaint, except that such person shall not be entitled
985		-	to copy such records and the department (i) shall not disclose (I)
986		-	information concerning a health care professional's referral to,
987		-	participation in or completion of an assistance program in accordance
988		-	with sections 19a-12a, as amended by this act, and 19a-12b, that is
989		-	confidential pursuant to section 19a-12a, as amended by this act, (II)
990		-	information not related to such person's specific complaint, including,
991		-	but not limited to, information concerning patients other than such
992		-	person, or (III) personnel or medical records and similar files the
993		-	disclosure of which would constitute an invasion of personal privacy
994		-	pursuant to section 1-210, except for such records or similar files solely
995		-	related to such person; (ii) shall not be required to disclose any other
996		-	information that is otherwise confidential pursuant to federal law or
997		-	state statute, except for information solely related to such person; and
998		-	(iii) may require up to ten business days written notice prior to
999		-	providing such opportunity for review;
1000		-	(C) Prior to resolving the complaint with a consent order, provide the
1001		-	person who filed the complaint with not less than ten business days to
1002		-	submit a written statement as to whether such person objects to
1003		-	resolving the complaint with a consent order;
1004		-	(D) If a hearing is held with respect to such complaint after a finding
1005		-	of probable cause, provide the person who filed the complaint with a
1006		-	copy of the notice of hearing issued pursuant to section 4-177, which Substitute House Bill No. 6666
1007		-
1008		-	Public Act No. 21-121 31 of 132
1009		-
1010		-	shall include information concerning the opportunity to present oral or
1011		-	written statements pursuant to subsection (b) of section 4-177c; and
1012		-	(E) Notify the person who filed the complaint of the final disposition
1013		-	of such complaint not later than seven business days after such final
1014		-	disposition;
1015		-	Sec. 21. Subsections (a) to (c), inclusive, of section 20-204a of the
1016		-	general statutes are repealed and the following is substituted in lieu
1017		-	thereof (Effective October 1, 2021):
1018		-	(a) The department shall investigate each allegation of any act or
1019		-	omission by a veterinarian specified in section 20-202. The investigation
1020		-	shall be conducted in accordance with the provisions of section 19a-14,
1021		-	as amended by this act, to determine if probable cause exists to issue a
1022		-	statement of charges and to institute proceedings against the
1023		-	veterinarian. Such investigation shall be concluded not later than twelve
1024		-	months from the date the allegation is submitted to the department.
1025		-	(b) Except as provided in subsections (c) and (d) of this section, the
1026		-	investigation shall be confidential and not subject to disclosure under
1027		-	section 1-210 and no person may disclose knowledge of the
1028		-	investigation to a third party unless the veterinarian requests that the
1029		-	investigation be open, [The owner of any animal that is the subject of
1030		-	such an investigation shall not be deemed a third party to such an
1031		-	investigation for purposes of disclosure under this section] except that
1032		-	the department shall provide information to the person who filed the
1033		-	complaint pursuant to subdivision (12) of subsection (a) of section 19a-
1034		-	14, as amended by this act.
1035		-	(c) If the department makes a finding of no probable cause to take
1036		-	action under section 20-202 or fails to make a finding within the twelve-
1037		-	month period required by subsection [(b)] (a) of this section, the
1038		-	allegation submitted pursuant to subsection (a) of this section and the Substitute House Bill No. 6666
1039		-
1040		-	Public Act No. 21-121 32 of 132
1041		-
1042		-	entire record of the investigation may remain confidential and no
1043		-	person shall disclose knowledge of such investigation to a third party
1044		-	unless the veterinarian requests that it be open, except that the
1045		-	department shall provide information to the person who filed the
1046		-	complaint pursuant to subdivision (12) of subsection (a) of section 19a-
1047		-	14, as amended by this act.
1048		-	Sec. 22. Subsections (b) and (c) of section 7-62b of the general statutes
1049		-	are repealed and the following is substituted in lieu thereof (Effective
1050		-	January 1, 2022):
1051		-	(b) The funeral director or embalmer licensed by the department, or
1052		-	the funeral director or embalmer licensed in another state and
1053		-	complying with the terms of a reciprocal agreement on file with the
1054		-	department, in charge of the burial of the deceased person shall
1055		-	complete the death certificate through the electronic death registry
1056		-	system, or, if the electronic death registry system is unavailable, on a
1057		-	form provided by the department. Said certificate shall be filed by a
1058		-	licensed embalmer or such embalmer's designee or a funeral director or
1059		-	such director's designee, in accordance with the provisions of this
1060		-	section, except when inquiry is required by the Chief Medical
1061		-	Examiner's Office, in which case the death certificate shall be filed in
1062		-	accordance with section 19a-409. The Social Security number of the
1063		-	deceased person shall be recorded on such certificate. Such licensed
1064		-	funeral director or licensed embalmer shall obtain the personal data
1065		-	from the next of kin or the best qualified person or source available and
1066		-	shall obtain a medical certification from the person responsible therefor,
1067		-	in accordance with the provisions of this section. Only a licensed
1068		-	embalmer may assume charge of the burial of a deceased person who
1069		-	had a communicable disease, as designated in the [Public Health Code]
1070		-	regulations of Connecticut state agencies, at the time of death and such
1071		-	licensed embalmer shall file an affidavit, on a form provided by the
1072		-	department, signed and sworn to by such licensed embalmer stating Substitute House Bill No. 6666
1073		-
1074		-	Public Act No. 21-121 33 of 132
1075		-
1076		-	that the body has been disinfected in accordance with the [Public Health
1077		-	Code] regulations of Connecticut state agencies.
1078		-	(c) The medical certification portion of the death certificate shall be
1079		-	completed, signed and returned to the licensed funeral director or
1080		-	licensed embalmer no later than twenty-four hours after death by the
1081		-	physician or advanced practice registered nurse in charge of the
1082		-	patient's care for the illness or condition which resulted in death, or
1083		-	upon the death of an infant delivered by a nurse-midwife, by such
1084		-	nurse-midwife, as provided in section 20-86b. In the absence of such
1085		-	physician or advanced practice registered nurse, or with the physician's
1086		-	or advanced practice registered nurse's approval, the medical
1087		-	certification may be completed and signed by an associate physician, an
1088		-	advanced practice registered nurse, a physician assistant as provided in
1089		-	subsection (d) of section 20-12d, a registered nurse as provided in
1090		-	section 20-101a, the chief medical officer of the institution in which
1091		-	death occurred, or by the pathologist who performed an autopsy upon
1092		-	the decedent. No physician, advanced practice registered nurse,
1093		-	physician assistant, registered nurse, nurse-midwife, chief medical
1094		-	officer or pathologist shall sign and return the medical certification
1095		-	unless such physician, advanced practice registered nurse, physician
1096		-	assistant, registered nurse, nurse-midwife, chief medical officer or
1097		-	pathologist has personally viewed and examined the body of the person
1098		-	to whom the medical certification relates and is satisfied that at the time
1099		-	of the examination such person was in fact dead, except in the event a
1100		-	medical certification is completed by a physician, advanced practice
1101		-	registered nurse, physician assistant, registered nurse, nurse-midwife,
1102		-	chief medical officer or pathologist other than the one who made the
1103		-	determination and pronouncement of death, an additional viewing and
1104		-	examination of the body shall not be required. Such physician,
1105		-	advanced practice registered nurse, physician assistant, registered
1106		-	nurse, nurse-midwife, chief medical officer or pathologist shall certify
1107		-	to the facts of death through the electronic death registry system, or, if Substitute House Bill No. 6666
1108		-
1109		-	Public Act No. 21-121 34 of 132
1110		-
1111		-	the electronic death registry is unavailable, on a form provided by the
1112		-	department. If a physician, advanced practice registered nurse,
1113		-	physician assistant, registered nurse, nurse-midwife, chief medical
1114		-	officer or pathologist refuses or otherwise fails to complete, sign and
1115		-	return the medical portion of the death certificate to the licensed funeral
1116		-	director or licensed embalmer within twenty-four hours after death,
1117		-	such licensed funeral director or embalmer may notify the
1118		-	Commissioner of Public Health of such refusal. The commissioner may,
1119		-	upon receipt of notification and investigation, assess a civil penalty
1120		-	against such physician, advanced practice registered nurse, physician
1121		-	assistant, registered nurse, chief medical officer or pathologist not to
1122		-	exceed two hundred fifty dollars. The medical certification shall state
1123		-	the cause of death, defined so that such death may be classified under
1124		-	the international list of causes of death, the duration of disease if known
1125		-	and such additional information as the Department of Public Health
1126		-	requires. The department shall give due consideration to national
1127		-	uniformity in vital statistics in prescribing the form and content of such
1128		-	information.
1129		-	Sec. 23. Section 19a-200 of the general statutes is repealed and the
1130		-	following is substituted in lieu thereof (Effective July 1, 2021):
1131		-	(a) The mayor of each city, the chief executive officer of each town
1132		-	and the warden of each borough shall, unless the charter of such city,
1133		-	town or borough otherwise provides, nominate some person to be
1134		-	director of health for such city, town or borough. [, which] Such person
1135		-	shall possess the qualifications specified in subsection (b) of this section.
1136		-	Upon approval of the Commissioner of Public Health, such nomination
1137		-	shall be confirmed or rejected by the board of selectmen, if there be such
1138		-	a board, otherwise by the legislative body of such city or town or by the
1139		-	burgesses of such borough within thirty days thereafter.
1140		-	(b) Notwithstanding the charter provisions of any city, town or
1141		-	borough with respect to the qualifications of the director of health, on Substitute House Bill No. 6666
1142		-
1143		-	Public Act No. 21-121 35 of 132
1144		-
1145		-	and after October 1, 2010, any person nominated to be a director of
1146		-	health shall (1) be a licensed physician and hold a degree in public health
1147		-	from an accredited school, college, university or institution, or (2) hold
1148		-	a graduate degree in public health from an accredited institution of
1149		-	higher education. The educational requirements of this section shall not
1150		-	apply to any director of health nominated or otherwise appointed as
1151		-	director of health prior to October 1, 2010.
1152		-	(c) In cities, towns or boroughs with a population of forty thousand
1153		-	or more for five consecutive years, according to the estimated
1154		-	population figures authorized pursuant to subsection (b) of section
1155		-	8-159a, such director of health shall serve in a full-time capacity, except
1156		-	where a town has designated such director as the chief medical advisor
1157		-	for its public schools under section 10-205. [, and]
1158		-	(d) No director shall, [not,] during such director's term of office, have
1159		-	any financial interest in or engage in any employment, transaction or
1160		-	professional activity that is in substantial conflict with the proper
1161		-	discharge of the duties required of directors of health by the general
1162		-	statutes or the regulations of Connecticut state agencies or specified by
1163		-	the appointing authority of the city, town or borough in its written
1164		-	agreement with such director. A written agreement with such director
1165		-	shall be submitted to the Commissioner of Public Health by such
1166		-	appointing authority upon such director's appointment or
1167		-	reappointment.
1168		-	(e) Such director of health shall have and exercise within the limits of
1169		-	the city, town or borough for which such director is appointed all
1170		-	powers necessary for enforcing the general statutes, provisions of the
1171		-	regulations of Connecticut state agencies relating to the preservation
1172		-	and improvement of the public health and preventing the spread of
1173		-	diseases therein.
1174		-	(f) In case of the absence or inability to act of a city, town or borough Substitute House Bill No. 6666
1175		-
1176		-	Public Act No. 21-121 36 of 132
1177		-
1178		-	director of health or if a vacancy exists in the office of such director, the
1179		-	appointing authority of such city, town or borough may, with the
1180		-	approval of the Commissioner of Public Health, designate in writing a
1181		-	suitable person to serve as acting director of health during the period of
1182		-	such absence or inability or vacancy [, provided the] and such person's
1183		-	start date. The commissioner may appoint such acting director if the
1184		-	city, town or borough fails to do so. The person so designated, when
1185		-	sworn, shall have all the powers and be subject to all the duties of such
1186		-	director.
1187		-	(g) In case of vacancy in the office of such director, if such vacancy
1188		-	exists for [thirty] sixty days, said commissioner may appoint a director
1189		-	of health for such city, town or borough. The person so designated,
1190		-	when sworn, shall (1) be considered an employee of the city, town or
1191		-	borough, and (2) have all the powers and be subject to all the duties of
1192		-	such director.
1193		-	(h) Said commissioner, may, for cause, remove an officer the
1194		-	commissioner or any predecessor in said office has appointed, and the
1195		-	common council of such city, town or the burgesses of such borough
1196		-	may, respectively, for cause, remove a director whose nomination has
1197		-	been confirmed by them, provided such removal shall be approved by
1198		-	said commissioner; and, within two days thereafter, notice in writing of
1199		-	such action shall be given by the clerk of such city, town or borough, as
1200		-	the case may be, to said commissioner, who shall, within ten days after
1201		-	receipt, file with the clerk from whom the notice was received, approval
1202		-	or disapproval.
1203		-	(i) Each such director of health shall hold office for the term of four
1204		-	years from the date of appointment and until a successor is nominated
1205		-	and confirmed in accordance with this section.
1206		-	(j) Each director of health shall, annually, at the end of the fiscal year,
1207		-	[of the city, town or borough, file with the Department of Public Health Substitute House Bill No. 6666
1208		-
1209		-	Public Act No. 21-121 37 of 132
1210		-
1211		-	a report of the doings as such director for the year preceding] submit a
1212		-	report to the Department of Public Health detailing the activities of such
1213		-	director during the preceding fiscal year.
1214		-	[(b)] (k) On and after July 1, 1988, each city, town and borough shall
1215		-	provide for the services of a sanitarian licensed under chapter 395 to
1216		-	work under the direction of the local director of health. Where practical,
1217		-	the local director of health may act as the sanitarian.
1218		-	[(c)] (l) As used in this chapter, "authorized agent" means a sanitarian
1219		-	licensed under chapter 395 and any individual certified for a specific
1220		-	program of environmental health by the Commissioner of Public Health
1221		-	in accordance with the general statutes and regulations of Connecticut
1222		-	state agencies.
1223		-	Sec. 24. Section 19a-202a of the general statutes is repealed and the
1224		-	following is substituted in lieu thereof (Effective July 1, 2021):
1225		-	[(a)] Any municipality may designate itself as having a part-time
1226		-	health department if: (1) The municipality has not had a full-time health
1227		-	department or been in a full-time health district [prior to] as of January
1228		-	1, 1998, [;] and (2) the municipality has the equivalent of at least one full-
1229		-	time employee, as determined by the Commissioner of Public Health, [;
1230		-	(3) the municipality annually submits a public health program plan and
1231		-	budget to the commissioner; and (4) the commissioner approves the
1232		-	program plan and budget] who performs public health functions
1233		-	required by the general statutes and the regulations of Connecticut
1234		-	states agencies.
1235		-	[(b) The Commissioner of Public Health shall adopt regulations, in
1236		-	accordance with the provisions of chapter 54, for the development and
1237		-	approval of the program plan and budget required by subdivision (3) of
1238		-	subsection (a) of this section.]
1239		-	Sec. 25. Section 19a-244 of the general statutes is repealed and the Substitute House Bill No. 6666
1240		-
1241		-	Public Act No. 21-121 38 of 132
1242		-
1243		-	following is substituted in lieu thereof (Effective July 1, 2021):
1244		-	On and after October 1, 2010, any person nominated to be the director
1245		-	of health shall (1) be a licensed physician and hold a degree in public
1246		-	health from an accredited school, college, university or institution, or (2)
1247		-	hold a graduate degree in public health from an accredited school,
1248		-	college or institution. The educational requirements of this section shall
1249		-	not apply to any director of health nominated or otherwise appointed
1250		-	as director of health prior to October 1, 2010. The board may specify in
1251		-	a written agreement with such director the term of office, which shall
1252		-	not exceed three years, salary and duties required of and responsibilities
1253		-	assigned to such director in addition to those required by the general
1254		-	statutes or the [Public Health Code] regulations of Connecticut state
1255		-	agencies, if any. Such director shall be removed during the term of such
1256		-	written agreement only for cause after a public hearing by the board on
1257		-	charges preferred, of which reasonable notice shall have been given. No
1258		-	director shall, during such director's term of office, have any financial
1259		-	interest in or engage in any employment, transaction or professional
1260		-	activity that is in substantial conflict with the proper discharge of the
1261		-	duties required of directors of health by the general statutes or the
1262		-	[Public Health Code] regulations of Connecticut state agencies or
1263		-	specified by the board in its written agreement with such director. The
1264		-	board shall submit such written agreement to the Commissioner of
1265		-	Public Health upon such director's appointment or reappointment. Such
1266		-	director shall serve in a full-time capacity and act as secretary and
1267		-	treasurer of the board, without the right to vote. Such director shall give
1268		-	to the district a bond with a surety company authorized to transact
1269		-	business in the state, for the faithful performance of such director's
1270		-	duties as treasurer, in such sum and upon such conditions as the board
1271		-	requires. Such director shall be the executive officer of the district
1272		-	department of health. Full-time employees of a city, town or borough
1273		-	health department at the time such city, town or borough votes to form
1274		-	or join a district department of health shall become employees of such Substitute House Bill No. 6666
1275		-
1276		-	Public Act No. 21-121 39 of 132
1277		-
1278		-	district department of health. Such employees may retain their rights
1279		-	and benefits in the pension system of the town, city or borough by which
1280		-	they were employed and shall continue to retain their active
1281		-	participating membership therein until retired. Such employees shall
1282		-	pay into such pension system the contributions required of them for
1283		-	their class and membership. Any additional employees to be hired by
1284		-	the district or any vacancies to be filled shall be filled in accordance with
1285		-	the rules and regulations of the merit system of the state of Connecticut
1286		-	and the employees who are employees of cities, towns or boroughs
1287		-	which have adopted a local civil service or merit system shall be
1288		-	included in their comparable grade with fully attained seniority in the
1289		-	state merit system. Such employees shall perform such duties as are
1290		-	prescribed by the director of health. In the event of the withdrawal of a
1291		-	town, city or borough from the district department, or in the event of a
1292		-	dissolution of any district department, the employees thereof, originally
1293		-	employed therein, shall automatically become employees of the
1294		-	appropriate town, city or borough's board of health. At the end of each
1295		-	fiscal year, each director of health shall submit a report to the
1296		-	Department of Public Health detailing the activities of such director
1297		-	during the preceding fiscal year.
1298		-	Sec. 26. Subdivision (3) of subsection (a) of section 19a-12a of the
1299		-	general statutes is repealed and the following is substituted in lieu
1300		-	thereof (Effective July 1, 2021):
1301		-	(3) "Health care professionals" includes any person licensed or who
1302		-	holds a permit pursuant to chapter 370, 372, 373, 375, 375a, 376, 376a,
1303		-	376b, 376c, 377, 378, 379, 379a, 380, 381, 381a, 382a, 383, 383a, 383b, 383c,
1304		-	384, 384a, 384b, 384c, 384d, 385, 398 or 399;
1305		-	Sec. 27. Section 19a-12d of the general statutes is repealed and the
1306		-	following is substituted in lieu thereof (Effective July 1, 2021):
1307		-	On or before the last day of January, April, July and October in each Substitute House Bill No. 6666
1308		-
1309		-	Public Act No. 21-121 40 of 132
1310		-
1311		-	year, the Commissioner of Public Health shall certify the amount of
1312		-	revenue received as a result of any fee increase in the amount of five
1313		-	dollars (1) that took effect October 1, 2015, pursuant to sections 19a-88,
1314		-	as amended by this act, 19a-515, 20-65k, 20-74bb, 20-74h, 20-74s, 20-149,
1315		-	20-162o, 20-162bb, 20-191a, 20-195c, as amended by this act, 20-195o, 20-
1316		-	195cc, 20-201, 20-206b, 20-206n, 20-206r, 20-206bb, 20-206ll, 20-222a, 20-
1317		-	275, 20-395d, 20-398 and 20-412, and (2) that took effect October 1, 2021,
1318		-	pursuant to section 20-185k, as amended by this act, and transfer such
1319		-	amount to the professional assistance program account established in
1320		-	section 19a-12c.
1321		-	Sec. 28. Subsection (a) of section 19a-12e of the general statutes is
1322		-	repealed and the following is substituted in lieu thereof (Effective October
1323		-	1, 2021):
1324		-	(a) As used in this section:
1325		-	(1) "Health care professional" means any individual licensed or who
1326		-	holds a permit pursuant to chapter 368v, 370, 372, 373, 375 to 378,
1327		-	inclusive, 379 to 381b, inclusive, 382a, 383 to 385, inclusive, 388 or 397a
1328		-	to 399, inclusive;
1329		-	(2) "Assistance program" means the program established pursuant to
1330		-	section 19a-12a, as amended by this act, to provide education,
1331		-	prevention, intervention, referral assistance, rehabilitation or support
1332		-	services to health care professionals who have a chemical dependency,
1333		-	emotional or behavioral disorder or physical or mental illness; and
1334		-	(3) "Hospital" has the same meaning as provided in section 19a-490.
1335		-	Sec. 29. Subsection (b) of section 20-185k of the general statutes is
1336		-	repealed and the following is substituted in lieu thereof (Effective from
1337		-	passage):
1338		-	(b) A license issued under this section may be renewed annually. The Substitute House Bill No. 6666
1339		-
1340		-	Public Act No. 21-121 41 of 132
1341		-
1342		-	license shall be renewed in accordance with the provisions of section
1343		-	19a-88, as amended by this act, for a fee of one hundred [seventy-five]
1344		-	eighty dollars for applications for renewal of licenses that expire on or
1345		-	after October 1, 2021. Each behavior analyst applying for license renewal
1346		-	shall furnish evidence satisfactory to the commissioner of having
1347		-	current certification with the Behavior Analyst Certification Board.
1348		-	Sec. 30. Subsection (a) of section 17a-412 of the general statutes is
1349		-	repealed and the following is substituted in lieu thereof (Effective October
1350		-	1, 2021):
1351		-	(a) Any physician or surgeon licensed under the provisions of chapter
1352		-	370, any resident physician or intern in any hospital in this state,
1353		-	whether or not so licensed, [and] any registered nurse, licensed practical
1354		-	nurse, medical examiner, dentist, optometrist, chiropractor, podiatrist,
1355		-	social worker, clergyman, police officer, pharmacist, physical therapist,
1356		-	long-term care facility administrator, nurse's aide or orderly in a long-
1357		-	term care facility, any person paid for caring for a patient in a long-term
1358		-	care facility, any staff person employed by a long-term care facility,
1359		-	[and] any person who is a sexual assault counselor or a domestic
1360		-	violence counselor as defined in section 52-146k, and any behavior
1361		-	analyst licensed under the provisions of chapter 382a, who has
1362		-	reasonable cause to suspect or believe that a resident in a long-term care
1363		-	facility has been abused, neglected, exploited or abandoned, or is in a
1364		-	condition that is the result of such abuse, neglect, exploitation or
1365		-	abandonment, shall, not later than seventy-two hours after such
1366		-	suspicion or belief arose, report such information or cause a report to be
1367		-	made in any reasonable manner to the Commissioner of Social Services
1368		-	pursuant to chapter 319dd. Any person required to report under the
1369		-	provision of this section who fails to make such report within the
1370		-	prescribed time period shall be fined not more than five hundred
1371		-	dollars, except that, if such person intentionally fails to make such report
1372		-	within the prescribed time period, such person shall be guilty of a class Substitute House Bill No. 6666
1373		-
1374		-	Public Act No. 21-121 42 of 132
1375		-
1376		-	C misdemeanor for the first offense and a class A misdemeanor for any
1377		-	subsequent offense.
1378		-	Sec. 31. Subsection (a) of section 17b-451 of the general statutes is
1379		-	repealed and the following is substituted in lieu thereof (Effective October
1380		-	1, 2021):
1381		-	(a) A mandatory reporter [, as defined in this section,] who has
1382		-	reasonable cause to suspect or believe that any elderly person has been
1383		-	abused, neglected, exploited or abandoned, or is in a condition that is
1384		-	the result of such abuse, neglect, exploitation or abandonment, or is in
1385		-	need of protective services, shall, not later than seventy-two hours after
1386		-	such suspicion or belief arose, report such information or cause a report
1387		-	to be made in any reasonable manner to the Commissioner of Social
1388		-	Services or to the person or persons designated by the commissioner to
1389		-	receive such reports. [The term] As used in this section, "mandatory
1390		-	reporter" means (1) any physician or surgeon licensed under the
1391		-	provisions of chapter 370, (2) any resident physician or intern in any
1392		-	hospital in this state, whether or not so licensed, (3) any registered nurse,
1393		-	(4) any nursing home administrator, nurse's aide or orderly in a nursing
1394		-	home facility or residential care home, (5) any person paid for caring for
1395		-	a resident in a nursing home facility or residential care home, (6) any
1396		-	staff person employed by a nursing home facility or residential care
1397		-	home, (7) any residents' advocate, other than a representative of the
1398		-	Office of the Long-Term Care Ombudsman, as established under section
1399		-	17a-405, including the State Ombudsman, (8) any licensed practical
1400		-	nurse, medical examiner, dentist, optometrist, chiropractor, podiatrist,
1401		-	behavior analyst, social worker, clergyman, police officer, pharmacist,
1402		-	psychologist or physical therapist, (9) any person paid for caring for an
1403		-	elderly person by any institution, organization, agency or facility,
1404		-	including without limitation, any employee of a community-based
1405		-	services provider, senior center, home care agency, homemaker and
1406		-	companion agency, adult day care center, village-model community Substitute House Bill No. 6666
1407		-
1408		-	Public Act No. 21-121 43 of 132
1409		-
1410		-	and congregate housing facility, and (10) any person licensed or
1411		-	certified as an emergency medical services provider pursuant to chapter
1412		-	368d or chapter 384d, including any such emergency medical services
1413		-	provider who is a member of a municipal fire department. Any
1414		-	mandatory reporter who fails to make such report within the prescribed
1415		-	time period shall be fined not more than five hundred dollars, except
1416		-	that, if such person intentionally fails to make such report within the
1417		-	prescribed time period, such person shall be guilty of a class C
1418		-	misdemeanor for the first offense and a class A misdemeanor for any
1419		-	subsequent offense. Any institution, organization, agency or facility
1420		-	employing individuals to care for persons sixty years of age or older
1421		-	shall provide mandatory training on detecting potential abuse, neglect,
1422		-	exploitation and abandonment of such persons and inform such
1423		-	employees of their obligations under this section. For purposes of this
1424		-	subsection, "person paid for caring for an elderly person by any
1425		-	institution, organization, agency or facility" includes an employee of a
1426		-	community-based services provider, senior center, home health care
1427		-	agency, homemaker and companion agency, adult day care center,
1428		-	village-model community and congregate housing facility.
1429		-	Sec. 32. Subsection (g) of section 17b-451 of the general statutes is
1430		-	repealed and the following is substituted in lieu thereof (Effective October
1431		-	1, 2021):
1432		-	(g) The Commissioner of Social Services shall develop an educational
1433		-	training program to promote and encourage the accurate and prompt
1434		-	identification and reporting of abuse, neglect, exploitation and
1435		-	abandonment of elderly persons. Such training program shall be made
1436		-	available on the Internet web site of the Department of Social Services
1437		-	to [mandated] mandatory reporters and other interested persons. The
1438		-	commissioner shall also make such training available in person or
1439		-	otherwise at various times and locations throughout the state as
1440		-	determined by the commissioner. Substitute House Bill No. 6666
1441		-
1442		-	Public Act No. 21-121 44 of 132
1443		-
1444		-	Sec. 33. Section 19a-6o of the general statutes is repealed and the
1445		-	following is substituted in lieu thereof (Effective July 1, 2021):
1446		-	(a) There is established, within available appropriations, within the
1447		-	Department of Public Health, a Palliative Care Advisory Council. The
1448		-	advisory council shall: (1) Analyze the current state of palliative care in
1449		-	the state; and (2) advise the department on matters relating to the
1450		-	improvement of palliative care and the quality of life for persons with
1451		-	serious or chronic illnesses.
1452		-	(b) The advisory council shall consist of the following members:
1453		-	(1) Two appointed by the Governor, one of whom shall be a physician
1454		-	certified by the American Board of Hospice and Palliative Medicine and
1455		-	one of whom shall be a registered nurse or advanced practice registered
1456		-	nurse certified by the National Board for Certification of Hospice and
1457		-	Palliative Nurses;
1458		-	(2) Seven appointed by the Commissioner of Public Health, each of
1459		-	whom shall be a licensed health care provider, with each appointee
1460		-	having experience or expertise in the provision of one of the following:
1461		-	(A) Inpatient palliative care in a hospital; (B) inpatient palliative care in
1462		-	a nursing home facility; (C) palliative care in the patient's home or a
1463		-	community setting; (D) pediatric palliative care; (E) palliative care for
1464		-	young adults; (F) palliative care for adults or elderly persons; and (G)
1465		-	inpatient palliative care in a psychiatric facility;
1466		-	(3) One appointed by the speaker of the House of Representatives,
1467		-	who shall be a licensed social worker experienced in working with
1468		-	persons with serious or chronic illness and their family members;
1469		-	(4) One appointed by the president pro tempore of the Senate, who
1470		-	shall be a licensed pharmacist experienced in working with persons
1471		-	with serious or chronic illness; Substitute House Bill No. 6666
1472		-
1473		-	Public Act No. 21-121 45 of 132
1474		-
1475		-	(5) One appointed by the minority leader of the House of
1476		-	Representatives, who shall be a spiritual counselor experienced in
1477		-	working with persons with serious or chronic illness and their family
1478		-	members; and
1479		-	(6) One appointed by the minority leader of the Senate, who shall be
1480		-	a representative of the American Cancer Society or a person experienced
1481		-	in advocating for persons with serious or chronic illness and their family
1482		-	members.
1483		-	(c) All appointments to the advisory council shall be made not later
1484		-	than December 31, 2013. Advisory council members shall serve three-
1485		-	year terms. Any vacancy shall be filled by the appointing authority.
1486		-	(d) Any appointment that is vacant for one year or more shall be
1487		-	made by the Commissioner of Public Health. The commissioner shall
1488		-	notify the appointing authority of the identity of the commissioner's
1489		-	choice for appointment not later than thirty days before making such
1490		-	appointment.
1491		-	[(d)] (e) Members shall receive no compensation except for
1492		-	reimbursement for necessary expenses incurred in performing their
1493		-	duties.
1494		-	[(e)] (f) The members shall elect the chairperson of the advisory
1495		-	council from among the members of the advisory council. A majority of
1496		-	the advisory council members shall constitute a quorum. Any action
1497		-	taken by the advisory council shall require a majority vote of those
1498		-	present. The first meeting of the advisory council shall be held not later
1499		-	than December 31, 2013. The advisory council shall meet biannually and
1500		-	at other times upon the call of the chairperson, upon the request of the
1501		-	Commissioner of Public Health or upon the request of a majority of the
1502		-	advisory council members.
1503		-	[(f)] (g) Not later than January 1, [2015] 2022, and [annually] Substitute House Bill No. 6666
1504		-
1505		-	Public Act No. 21-121 46 of 132
1506		-
1507		-	biennially thereafter, the advisory council shall submit a report on its
1508		-	findings and recommendations to the Commissioner of Public Health
1509		-	and the joint standing committee of the General Assembly having
1510		-	cognizance of matters relating to public health, in accordance with the
1511		-	provisions of section 11-4a.
1512		-	Sec. 34. Section 19a-6q of the general statutes is repealed and the
1513		-	following is substituted in lieu thereof (Effective from passage):
1514		-	[(a)] The Commissioner of Public Health, in consultation with the
1515		-	executive director of the Office of Health Strategy, established under
1516		-	section 19a-754a, and local and regional health departments, shall,
1517		-	within available resources, develop a plan that is consistent with the
1518		-	Department of Public Health's Healthy Connecticut 2020 health
1519		-	improvement plan and the state healthcare innovation plan developed
1520		-	pursuant to the State Innovation Model Initiative by the Centers for
1521		-	Medicare and Medicaid Services Innovation Center. The commissioner
1522		-	shall develop and implement such plan to: (1) Reduce the incidence of
1523		-	tobacco use, high blood pressure, health care associated infections,
1524		-	asthma, unintended pregnancy and diabetes; (2) improve chronic
1525		-	disease care coordination in the state; and (3) reduce the incidence and
1526		-	effects of chronic disease and improve outcomes for conditions
1527		-	associated with chronic disease in the state. The commissioner shall post
1528		-	such plan on the Department of Public Health's Internet web site.
1529		-	[(b) The commissioner shall, on or before January 15, 2015, and
1530		-	biennially thereafter, submit a report, in consultation with the executive
1531		-	director of the Office of Health Strategy, in accordance with the
1532		-	provisions of section 11-4a to the joint standing committee of the
1533		-	General Assembly having cognizance of matters relating to public
1534		-	health concerning chronic disease and implementation of the plan
1535		-	described in subsection (a) of this section. The commissioner shall post
1536		-	each report on the Department of Public Health's Internet web site not
1537		-	later than thirty days after submitting such report. Each report shall Substitute House Bill No. 6666
1538		-
1539		-	Public Act No. 21-121 47 of 132
1540		-
1541		-	include, but need not be limited to: (1) A description of the chronic
1542		-	diseases that are most likely to cause a person's death or disability, the
1543		-	approximate number of persons affected by such chronic diseases and
1544		-	an assessment of the financial effects of each such disease on the state
1545		-	and on hospitals and health care facilities; (2) a description and
1546		-	assessment of programs and actions that have been implemented by the
1547		-	department and health care providers to improve chronic disease care
1548		-	coordination and prevent chronic disease; (3) the sources and amounts
1549		-	of funding received by the department to treat persons with multiple
1550		-	chronic diseases and to treat or reduce the most prevalent chronic
1551		-	diseases in the state; (4) a description of chronic disease care
1552		-	coordination between the department and health care providers, to
1553		-	prevent and treat chronic disease; and (5) recommendations concerning
1554		-	actions that health care providers and persons with chronic disease may
1555		-	take to reduce the incidence and effects of chronic disease.]
1556		-	Sec. 35. Subsection (b) of section 19a-493 of the general statutes is
1557		-	repealed and the following is substituted in lieu thereof (Effective July 1,
1558		-	2021):
1559		-	(b) (1) A nursing home license may be renewed biennially after (A)
1560		-	an unscheduled inspection conducted by the department, (B)
1561		-	submission of the information required by section 19a-491a, and (C)
1562		-	submission of evidence satisfactory to the department that the nursing
1563		-	home is in compliance with the provisions of this chapter, the [Public
1564		-	Health Code] regulations of Connecticut state agencies and licensing
1565		-	regulations.
1566		-	(2) Any change in the ownership of a facility or institution, as defined
1567		-	in section 19a-490, owned by an individual, partnership or association
1568		-	or the change in ownership or beneficial ownership of ten per cent or
1569		-	more of the stock of a corporation which owns, conducts, operates or
1570		-	maintains such facility or institution, shall be subject to prior approval
1571		-	of the department after a scheduled inspection of such facility or Substitute House Bill No. 6666
1572		-
1573		-	Public Act No. 21-121 48 of 132
1574		-
1575		-	institution is conducted by the department, provided such approval
1576		-	shall be conditioned upon a showing by such facility or institution to the
1577		-	commissioner that it has complied with all requirements of this chapter,
1578		-	the regulations relating to licensure and all applicable requirements of
1579		-	the [Public Health Code] regulations of Connecticut state agencies. Any
1580		-	such change in ownership or beneficial ownership resulting in a transfer
1581		-	to a person related by blood or marriage to such an owner or beneficial
1582		-	owner shall not be subject to prior approval of the department unless:
1583		-	(A) Ownership or beneficial ownership of ten per cent or more of the
1584		-	stock of a corporation, limited liability company, partnership or
1585		-	association which owns, conducts, operates or maintains more than one
1586		-	facility or institution is transferred; (B) ownership or beneficial
1587		-	ownership is transferred in more than one facility or institution; or (C)
1588		-	the facility or institution is the subject of a pending complaint,
1589		-	investigation or licensure action. If the facility or institution is not in
1590		-	compliance, the commissioner may require the new owner to sign a
1591		-	consent order providing reasonable assurances that the violations shall
1592		-	be corrected within a specified period of time. Notice of any such
1593		-	proposed change of ownership shall be given to the department at least
1594		-	one hundred twenty days prior to the effective date of such proposed
1595		-	change. For the purposes of this subdivision, "a person related by blood
1596		-	or marriage" means a parent, spouse, child, brother, sister, aunt, uncle,
1597		-	niece or nephew. For the purposes of this subdivision, a change in the
1598		-	legal form of the ownership entity, including, but not limited to, changes
1599		-	from a corporation to a limited liability company, a partnership to a
1600		-	limited liability partnership, a sole proprietorship to a corporation and
1601		-	similar changes, shall not be considered a change of ownership if the
1602		-	beneficial ownership remains unchanged and the owner provides such
1603		-	information regarding the change to the department as may be required
1604		-	by the department in order to properly identify the current status of
1605		-	ownership and beneficial ownership of the facility or institution. For the
1606		-	purposes of this subdivision, a public offering of the stock of any
1607		-	corporation that owns, conducts, operates or maintains any such facility Substitute House Bill No. 6666
1608		-
1609		-	Public Act No. 21-121 49 of 132
1610		-
1611		-	or institution shall not be considered a change in ownership or beneficial
1612		-	ownership of such facility or institution if the licensee and the officers
1613		-	and directors of such corporation remain unchanged, such public
1614		-	offering cannot result in an individual or entity owning ten per cent or
1615		-	more of the stock of such corporation, and the owner provides such
1616		-	information to the department as may be required by the department in
1617		-	order to properly identify the current status of ownership and beneficial
1618		-	ownership of the facility or institution.
1619		-	Sec. 36. (NEW) (Effective July 1, 2021) A health care facility licensed
1620		-	pursuant to chapter 368v of the general statutes shall have policies and
1621		-	procedures in place that reflect the National Centers for Disease Control
1622		-	and Prevention's recommendations for tuberculosis screening, testing,
1623		-	treatment and education for health care personnel. Notwithstanding
1624		-	any provision of the general statutes or any regulations adopted
1625		-	thereunder, any employee providing direct patient care in a facility
1626		-	licensed pursuant to chapter 368v of the general statutes shall receive
1627		-	tuberculosis screening and testing in compliance with the licensed
1628		-	health care facility's policies and procedures.
1629		-	Sec. 37. Subsection (c) of section 19a-343 of the general statutes is
1630		-	repealed and the following is substituted in lieu thereof (Effective October
1631		-	1, 2021):
1632		-	(c) Three or more arrests, the issuance of three or more arrest
1633		-	warrants indicating a pattern of criminal activity and not isolated
1634		-	incidents or the issuance of three or more citations for a violation of a
1635		-	municipal ordinance as described in subdivision (14) of this subsection,
1636		-	for the following offenses shall constitute the basis for bringing an action
1637		-	to abate a public nuisance:
1638		-	(1) Prostitution under section 53a-82, 53a-83, 53a-86, 53a-87, 53a-88 or
1639		-	53a-89. Substitute House Bill No. 6666
1640		-
1641		-	Public Act No. 21-121 50 of 132
1642		-
1643		-	(2) Promoting an obscene performance or obscene material under
1644		-	section 53a-196 or 53a-196b, employing a minor in an obscene
1645		-	performance under section 53a-196a, importing child pornography
1646		-	under section 53a-196c, possessing child pornography in the first degree
1647		-	under section 53a-196d, possessing child pornography in the second
1648		-	degree under section 53a-196e or possessing child pornography in the
1649		-	third degree under section 53a-196f.
1650		-	(3) Transmission of gambling information under section 53-278b or
1651		-	53-278d or maintaining of a gambling premises under section 53-278e.
1652		-	(4) Offenses for the sale of controlled substances, possession of
1653		-	controlled substances with intent to sell, or maintaining a drug factory
1654		-	under section 21a-277, 21a-278 or 21a-278a or use of the property by
1655		-	persons possessing controlled substances under section 21a-279.
1656		-	Nothing in this section shall prevent the state from also proceeding
1657		-	against property under section 21a-259 or 54-36h.
1658		-	(5) Unauthorized sale of alcoholic liquor under section 30-74 or
1659		-	disposing of liquor without a permit under section 30-77, or sale or
1660		-	delivery of alcoholic liquor to any minor under subdivision (1) of
1661		-	subsection (b) of section 30-86 or the sale, delivery or giving of alcoholic
1662		-	liquor to a minor under subdivision (2) of subsection (b) of section 30-
1663		-	86.
1664		-	(6) Maintaining a motor vehicle chop shop under section 14-149a.
1665		-	(7) Inciting injury to persons or property under section 53a-179a.
1666		-	(8) Murder or manslaughter under section 53a-54a, 53a-54b, 53a-55,
1667		-	53a-56 or 53a-56a.
1668		-	(9) Assault under section 53a-59, 53a-59a, subdivision (1) of
1669		-	subsection (a) of section 53a-60 or section 53a-60a or 53a-61. Substitute House Bill No. 6666
1670		-
1671		-	Public Act No. 21-121 51 of 132
1672		-
1673		-	(10) Sexual assault under section 53a-70 or 53a-70a.
1674		-	(11) Fire safety violations under section 29-291a, 29-291c, 29-292,
1675		-	subsection (b) of section 29-310, or section 29-315, 29-349 or 29-357.
1676		-	(12) Firearm offenses under section 29-35, 53-202aa, 53-203, 53a-211,
1677		-	53a-212, 53a-216, 53a-217 or 53a-217c.
1678		-	(13) Illegal manufacture, sale, possession or dispensing of a drug
1679		-	under subdivision (2) of section 21a-108.
1680		-	(14) Violation of a municipal ordinance resulting in the issuance of a
1681		-	citation for (A) excessive noise on nonresidential real property that
1682		-	significantly impacts the surrounding area, provided the municipality's
1683		-	excessive noise ordinance is based on an objective standard, (B) owning
1684		-	or leasing a dwelling unit that provides residence to an excessive
1685		-	number of unrelated persons resulting in dangerous or unsanitary
1686		-	conditions that significantly impact the safety of the surrounding area,
1687		-	or (C) impermissible operation of (i) a business that permits persons
1688		-	who are not licensed pursuant to section 20-206b to engage in the
1689		-	practice of massage therapy, or (ii) a massage parlor, as defined by the
1690		-	applicable municipal ordinance, that significantly impacts the safety of
1691		-	the surrounding area.
1692		-	Sec. 38. Section 19a-131g of the general statutes is repealed and the
1693		-	following is substituted in lieu thereof (Effective from passage):
1694		-	The Commissioner of Public Health shall establish a Public Health
1695		-	Preparedness Advisory Committee for purposes of advising the
1696		-	Department of Public Health on matters concerning emergency
1697		-	responses to a public health emergency. The advisory committee shall
1698		-	consist of the Commissioner of Public Health, or his or her designee, the
1699		-	Commissioner of Emergency Services and Public Protection, or his or
1700		-	her designee, the president pro tempore of the Senate, or his or her
1701		-	designee, the speaker of the House of Representatives, or his or her Substitute House Bill No. 6666
1702		-
1703		-	Public Act No. 21-121 52 of 132
1704		-
1705		-	designee, the majority and minority leaders of both houses of the
1706		-	General Assembly, [and] or their designees, the chairpersons and
1707		-	ranking members of the joint standing committees of the General
1708		-	Assembly having cognizance of matters relating to public health, public
1709		-	safety and the judiciary, [and] or their designees, representatives of
1710		-	town, city, borough and district directors of health, as appointed by the
1711		-	commissioner, and any other organization or persons that the
1712		-	commissioner deems relevant to the issues of public health
1713		-	preparedness. Upon the request of the commissioner, the Public Health
1714		-	Preparedness Advisory Committee may meet to review the plan for
1715		-	emergency responses to a public health emergency and other matters as
1716		-	deemed necessary by the commissioner.
1717		-	Sec. 39. Subsection (d) of section 19a-30 of the general statutes is
1718		-	repealed and the following is substituted in lieu thereof (Effective July 1,
1719		-	2021):
1720		-	(d) A nonrefundable fee of two hundred dollars shall accompany
1721		-	each application for a license or for renewal thereof, except in the case
1722		-	of a clinical laboratory owned and operated by a municipality, the state,
1723		-	the United States or any agency of said municipality, state or United
1724		-	States. Each license shall be issued for a period of not less than twenty-
1725		-	four nor more than twenty-seven months from the deadline for
1726		-	applications established by the commissioner. Renewal applications
1727		-	shall be made (1) biennially within the twenty-fourth month of the
1728		-	current license; (2) before any change in ownership or change in director
1729		-	is made; and (3) prior to any major expansion or alteration in quarters.
1730		-	The licensed clinical laboratory shall report to the Department of Public
1731		-	Health, in a form and manner prescribed by the commissioner, the name
1732		-	and address of each blood collection facility owned and operated by the
1733		-	clinical laboratory, prior to the issuance of a new license, prior to the
1734		-	issuance of a renewal license or whenever a blood collection facility
1735		-	opens or closes. Substitute House Bill No. 6666
1736		-
1737		-	Public Act No. 21-121 53 of 132
1738		-
1739		-	Sec. 40. Subsection (b) of section 20-365 of the general statutes is
1740		-	repealed and the following is substituted in lieu thereof (Effective July 1,
1741		-	2021):
1742		-	(b) Nothing in section 19a-200, as amended by this act, subsection (a)
1743		-	of section 19a-206, or sections 19a-207, 19a-242, 20-358 or 20-360 to 20-
1744		-	365, inclusive, shall prevent any of the following persons from engaging
1745		-	in the performance of their duties: (1) Any person certified by the
1746		-	Department of Public Health as a food or sewage inspector in
1747		-	accordance with regulations adopted pursuant to section 19a-36, (2) any
1748		-	person employed by a local health department performing the duties of
1749		-	a lead inspector who complies with training standards established
1750		-	pursuant to section 20-479, (3) a director of health acting pursuant to
1751		-	[subsection (a) of] section 19a-200, as amended by this act, or section
1752		-	19a-244, as amended by this act, (4) any employee of a water utility or
1753		-	federal or state agency performing his duties in accordance with
1754		-	applicable statutes and regulations, (5) any person employed by a local
1755		-	health department working under the direct supervision of a licensed
1756		-	sanitarian, (6) any person licensed or certified by the Department of
1757		-	Public Health in a specific program performing certain duties that are
1758		-	included within the duties of a sanitarian, or (7) a student enrolled in an
1759		-	accredited academic program leading to a degree in environmental
1760		-	health or completing a special training course in environmental health
1761		-	approved by the commissioner, provided such student is clearly
1762		-	identified by a title which indicates [his] such student's status as a
1763		-	student.
1764		-	Sec. 41. Subsection (b) of section 20-195u of the general statutes is
1765		-	repealed and the following is substituted in lieu thereof (Effective from
1766		-	passage):
1767		-	(b) Continuing education required pursuant to this section shall be
1768		-	related to the practice of social work and shall include not less than one
1769		-	contact hour of training or education each registration period on the Substitute House Bill No. 6666
1770		-
1771		-	Public Act No. 21-121 54 of 132
1772		-
1773		-	topic of cultural competency and, on and after January 1, 2016, not less
1774		-	than two contact hours of training or education during the first renewal
1775		-	period in which continuing education is required and not less than once
1776		-	every six years thereafter on the topic of mental health conditions
1777		-	common to veterans and family members of veterans, including (1)
1778		-	determining whether a patient is a veteran or family member of a
1779		-	veteran, (2) screening for conditions such as post-traumatic stress
1780		-	disorder, risk of suicide, depression and grief, and (3) suicide prevention
1781		-	training. Such continuing education shall consist of courses, workshops
1782		-	and conferences offered or approved by the Association of Social Work
1783		-	Boards, the National Association of Social Workers or a school or
1784		-	department of social work accredited by the Council on Social Work
1785		-	Education. A licensee's ability to engage in on-line and home study
1786		-	continuing education shall be limited to not more than [six] ten hours
1787		-	per registration period. Within the registration period, an initial
1788		-	presentation by a licensee of an original paper, essay or formal lecture
1789		-	in social work to a recognized group of fellow professionals may
1790		-	account for five hours of continuing education hours of the aggregate
1791		-	continuing education requirements prescribed in this section.
1792		-	Sec. 42. Subsection (a) of section 20-265h of the general statutes is
1793		-	repealed and the following is substituted in lieu thereof (Effective from
1794		-	passage):
1795		-	(a) On and after July 1, 2021, each spa or salon that employs
1796		-	hairdressers and cosmeticians, estheticians, eyelash technicians, [or] nail
1797		-	technicians or massage therapists shall be under the management of a
1798		-	hairdresser and cosmetician registered under this chapter, an esthetician
1799		-	licensed under section 20-265b or 20-265f, an eyelash technician licensed
1800		-	under section 20-265c, as amended by this act, or 20-265f, [or] a nail
1801		-	technician licensed under section 20-265d, as amended by this act, or 20-
1802		-	265f or a massage therapist licensed under chapter 384a.
1803		-	Sec. 43. Subsection (a) of section 19a-131j of the general statutes is Substitute House Bill No. 6666
1804		-
1805		-	Public Act No. 21-121 55 of 132
1806		-
1807		-	repealed and the following is substituted in lieu thereof (Effective from
1808		-	passage):
1809		-	(a) The commissioner may issue an order to temporarily suspend, for
1810		-	a period not to exceed sixty consecutive days, the requirements for
1811		-	licensure, certification or registration, pursuant to chapters 368d, 370,
1812		-	376 to 376c, inclusive, 378, 378a, 379, 379a, 381a, 382a, 383 to 383c,
1813		-	inclusive, 383d, 383f, 383g, 384b, 384d, 385, 395, 399, 400a, 400j and 474,
1814		-	to allow persons who are appropriately licensed, certified or registered
1815		-	in another state or territory of the United States or the District of
1816		-	Columbia, to render temporary assistance within the scope of the
1817		-	profession for which a person is licensed, certified or registered, in
1818		-	managing a public health emergency in this state, declared by the
1819		-	Governor pursuant to section 19a-131a. Nothing in this section shall be
1820		-	construed to permit a person to provide services beyond the scope
1821		-	allowed in the chapter specified in this section that pertains to such
1822		-	person's profession.
1823		-	Sec. 44. Subsection (a) of section 19a-512 of the general statutes is
1824		-	repealed and the following is substituted in lieu thereof (Effective July 1,
1825		-	2021):
1826		-	(a) In order to be eligible for licensure by examination pursuant to
1827		-	sections 19a-511 to 19a-520, inclusive, a person shall submit an
1828		-	application, together with a fee of two hundred dollars, and proof
1829		-	satisfactory to the Department of Public Health that [he] such person (1)
1830		-	is physically and emotionally capable of administering a nursing home;
1831		-	(2) has satisfactorily completed a program of instruction and training,
1832		-	including residency training which meets the requirements of
1833		-	subsection (b) of this section and which is approved by the
1834		-	Commissioner of Public Health; and (3) has passed an examination
1835		-	prescribed [and administered] by the Department of Public Health
1836		-	designed to test the applicant's knowledge and competence in the
1837		-	subject matter referred to in subsection (b) of this section. Passing scores Substitute House Bill No. 6666
1838		-
1839		-	Public Act No. 21-121 56 of 132
1840		-
1841		-	shall be established by the department.
1842		-	Sec. 45. Section 19a-490 of the general statutes is repealed and the
1843		-	following is substituted in lieu thereof (Effective July 1, 2021):
1844		-	(a) "Institution" means a hospital, short-term hospital special hospice,
1845		-	hospice inpatient facility, residential care home, nursing home facility,
1846		-	home health care agency, hospice agency, home health aide agency,
1847		-	behavioral health facility, assisted living services agency, [substance
1848		-	abuse treatment facility,] outpatient surgical facility, outpatient clinic,
1849		-	an infirmary operated by an educational institution for the care of
1850		-	students enrolled in, and faculty and employees of, such institution; a
1851		-	facility engaged in providing services for the prevention, diagnosis,
1852		-	treatment or care of human health conditions, including facilities
1853		-	operated and maintained by any state agency; and a residential facility
1854		-	for persons with intellectual disability licensed pursuant to section 17a-
1855		-	227 and certified to participate in the Title XIX Medicaid program as an
1856		-	intermediate care facility for individuals with intellectual disability.
1857		-	"Institution" does not include any facility for the care and treatment of
1858		-	persons with mental illness or substance use disorder operated or
1859		-	maintained by any state agency, except Whiting Forensic Hospital;
1860		-	(b) "Hospital" means an establishment for the lodging, care and
1861		-	treatment of persons suffering from disease or other abnormal physical
1862		-	or mental conditions and includes inpatient psychiatric services in
1863		-	general hospitals;
1864		-	(c) "Residential care home" or "rest home" means a community
1865		-	residence that furnishes, in single or multiple facilities, food and shelter
1866		-	to two or more persons unrelated to the proprietor and, in addition,
1867		-	provides services that meet a need beyond the basic provisions of food,
1868		-	shelter and laundry and may qualify as a setting that allows residents to
1869		-	receive home and community-based services funded by state and
1870		-	federal programs; Substitute House Bill No. 6666
1871		-
1872		-	Public Act No. 21-121 57 of 132
1873		-
1874		-	(d) "Home health care agency" means a public or private
1875		-	organization, or a subdivision thereof, engaged in providing
1876		-	professional nursing services and the following services, available
1877		-	twenty-four hours per day, in the patient's home or a substantially
1878		-	equivalent environment: Home health aide services as defined in this
1879		-	section, physical therapy, speech therapy, occupational therapy or
1880		-	medical social services. The agency shall provide professional nursing
1881		-	services and at least one additional service directly and all others
1882		-	directly or through contract. An agency shall be available to enroll new
1883		-	patients seven days a week, twenty-four hours per day;
1884		-	(e) "Home health aide agency" means a public or private
1885		-	organization, except a home health care agency, which provides in the
1886		-	patient's home or a substantially equivalent environment supportive
1887		-	services which may include, but are not limited to, assistance with
1888		-	personal hygiene, dressing, feeding and incidental household tasks
1889		-	essential to achieving adequate household and family management.
1890		-	Such supportive services shall be provided under the supervision of a
1891		-	registered nurse and, if such nurse determines appropriate, shall be
1892		-	provided by a social worker, physical therapist, speech therapist or
1893		-	occupational therapist. Such supervision may be provided directly or
1894		-	through contract;
1895		-	(f) "Home health aide services" as defined in this section shall not
1896		-	include services provided to assist individuals with activities of daily
1897		-	living when such individuals have a disease or condition that is chronic
1898		-	and stable as determined by a physician licensed in the state;
1899		-	(g) "Behavioral health facility" means any facility that provides
1900		-	mental health services to persons eighteen years of age or older or
1901		-	substance use disorder services to persons of any age in an outpatient
1902		-	treatment or residential setting to ameliorate mental, emotional,
1903		-	behavioral or substance use disorder issues; Substitute House Bill No. 6666
1904		-
1905		-	Public Act No. 21-121 58 of 132
1906		-
1907		-	(h) "Alcohol or drug treatment facility" means any facility for the care
1908		-	or treatment of persons suffering from alcoholism or other drug
1909		-	addiction;
1910		-	(i) "Person" means any individual, firm, partnership, corporation,
1911		-	limited liability company or association;
1912		-	(j) "Commissioner" means the Commissioner of Public Health or the
1913		-	commissioner's designee;
1914		-	(k) "Home health agency" means an agency licensed as a home health
1915		-	care agency or a home health aide agency;
1916		-	(l) "Assisted living services agency" means an agency that provides,
1917		-	among other things, nursing services and assistance with activities of
1918		-	daily living to a population that is chronic and stable and that may have
1919		-	a dementia special care unit or program as defined in section 19a-562, as
1920		-	amended by this act;
1921		-	(m) "Outpatient clinic" means an organization operated by a
1922		-	municipality or a corporation, other than a hospital, that provides (1)
1923		-	ambulatory medical care, including preventive and health promotion
1924		-	services, (2) dental care, or (3) mental health services in conjunction with
1925		-	medical or dental care for the purpose of diagnosing or treating a health
1926		-	condition that does not require the patient's overnight care;
1927		-	(n) "Multicare institution" means a hospital that provides outpatient
1928		-	behavioral health services or other health care services, psychiatric
1929		-	outpatient clinic for adults, free-standing facility for the care or
1930		-	treatment of substance abusive or dependent persons, hospital for
1931		-	psychiatric disabilities, as defined in section 17a-495, or a general acute
1932		-	care hospital that provides outpatient behavioral health services that (1)
1933		-	is licensed in accordance with this chapter, (2) has more than one facility
1934		-	or one or more satellite units owned and operated by a single licensee,
1935		-	and (3) offers complex patient health care services at each facility or Substitute House Bill No. 6666
1936		-
1937		-	Public Act No. 21-121 59 of 132
1938		-
1939		-	satellite unit. For purposes of this subsection, "satellite unit" means a
1940		-	location where a segregated unit of services is provided by the multicare
1941		-	institution;
1942		-	(o) "Nursing home" or "nursing home facility" means (1) any chronic
1943		-	and convalescent nursing home or any rest home with nursing
1944		-	supervision that provides nursing supervision under a medical director
1945		-	twenty-four hours per day, or (2) any chronic and convalescent nursing
1946		-	home that provides skilled nursing care under medical supervision and
1947		-	direction to carry out nonsurgical treatment and dietary procedures for
1948		-	chronic diseases, convalescent stages, acute diseases or injuries; [and]
1949		-	(p) "Outpatient dialysis unit" means (1) an out-of-hospital out-patient
1950		-	dialysis unit that is licensed by the department to provide (A) services
1951		-	on an out-patient basis to persons requiring dialysis on a short-term
1952		-	basis or for a chronic condition, or (B) training for home dialysis, or (2)
1953		-	an in-hospital dialysis unit that is a special unit of a licensed hospital
1954		-	designed, equipped and staffed to (A) offer dialysis therapy on an out-
1955		-	patient basis, (B) provide training for home dialysis, and (C) perform
1956		-	renal transplantations; [.] and
1957		-	(q) "Hospice agency" means a public or private organization that
1958		-	provides home care and hospice services to terminally ill patients.
1959		-	Sec. 46. Subsections (b) to (i), inclusive, of section 19a-491 of the
1960		-	general statutes are repealed and the following is substituted in lieu
1961		-	thereof (Effective July 1, 2021):
1962		-	(b) If any person acting individually or jointly with any other person
1963		-	owns real property or any improvements thereon, upon or within which
1964		-	an institution, as defined in subsections (c) and (o) of section 19a-490, is
1965		-	established, conducted, operated or maintained and is not the licensee
1966		-	of the institution, such person shall submit a copy of the lease agreement
1967		-	to the department at the time of any change of ownership and with each Substitute House Bill No. 6666
1968		-
1969		-	Public Act No. 21-121 60 of 132
1970		-
1971		-	license renewal application. The lease agreement shall, at a minimum,
1972		-	identify the person or entity responsible for the maintenance and repair
1973		-	of all buildings and structures within which such an institution is
1974		-	established, conducted or operated. If a violation is found as a result of
1975		-	an inspection or investigation, the commissioner may require the owner
1976		-	to sign a consent order providing assurances that repairs or
1977		-	improvements necessary for compliance with the provisions of the
1978		-	[Public Health Code] regulations of Connecticut state agencies shall be
1979		-	completed within a specified period of time or may assess a civil penalty
1980		-	of not more than one thousand dollars for each day that such owner is
1981		-	in violation of the [Public Health Code] regulations of Connecticut state
1982		-	agencies or a consent order. A consent order may include a provision
1983		-	for the establishment of a temporary manager of such real property who
1984		-	has the authority to complete any repairs or improvements required by
1985		-	such order. Upon request of the Commissioner of Public Health, the
1986		-	Attorney General may petition the Superior Court for such equitable
1987		-	and injunctive relief as such court deems appropriate to ensure
1988		-	compliance with the provisions of a consent order. The provisions of
1989		-	this subsection shall not apply to any property or improvements owned
1990		-	by a person licensed in accordance with the provisions of subsection (a)
1991		-	of this section to establish, conduct, operate or maintain an institution
1992		-	on or within such property or improvements.
1993		-	(c) Notwithstanding any regulation, the Commissioner of Public
1994		-	Health shall charge the following fees for the biennial licensing and
1995		-	inspection of the following institutions: (1) Chronic and convalescent
1996		-	nursing homes, per site, four hundred forty dollars; (2) chronic and
1997		-	convalescent nursing homes, per bed, five dollars; (3) rest homes with
1998		-	nursing supervision, per site, four hundred forty dollars; (4) rest homes
1999		-	with nursing supervision, per bed, five dollars; (5) outpatient dialysis
2000		-	units and outpatient surgical facilities, six hundred twenty-five dollars;
2001		-	(6) mental health residential facilities, per site, three hundred seventy-
2002		-	five dollars; (7) mental health residential facilities, per bed, five dollars; Substitute House Bill No. 6666
2003		-
2004		-	Public Act No. 21-121 61 of 132
2005		-
2006		-	(8) hospitals, per site, nine hundred forty dollars; (9) hospitals, per bed,
2007		-	seven dollars and fifty cents; (10) nonstate agency educational
2008		-	institutions, per infirmary, one hundred fifty dollars; (11) nonstate
2009		-	agency educational institutions, per infirmary bed, twenty-five dollars;
2010		-	(12) home health care agencies, except certified home health care
2011		-	agencies described in subsection (d) of this section, per agency, three
2012		-	hundred dollars; (13) home health care agencies, hospice agencies, or
2013		-	home health aide agencies, except certified home health care agencies,
2014		-	hospice agencies or home health aide agencies described in subsection
2015		-	(d) of this section, per satellite patient service office, one hundred
2016		-	dollars; (14) assisted living services agencies, except such agencies
2017		-	participating in the congregate housing facility pilot program described
2018		-	in section 8-119n, per site, five hundred dollars; (15) short-term hospitals
2019		-	special hospice, per site, nine hundred forty dollars; (16) short-term
2020		-	hospitals special hospice, per bed, seven dollars and fifty cents; (17)
2021		-	hospice inpatient facility, per site, four hundred forty dollars; and (18)
2022		-	hospice inpatient facility, per bed, five dollars.
2023		-	(d) Notwithstanding any regulation, the commissioner shall charge
2024		-	the following fees for the triennial licensing and inspection of the
2025		-	following institutions: (1) Residential care homes, per site, five hundred
2026		-	sixty-five dollars; (2) residential care homes, per bed, four dollars and
2027		-	fifty cents; (3) home health care agencies that are certified as a provider
2028		-	of services by the United States Department of Health and Human
2029		-	Services under the Medicare or Medicaid program, three hundred
2030		-	dollars; and (4) certified home health care agencies or hospice agencies,
2031		-	as described in section 19a-493, as amended by this act, per satellite
2032		-	patient service office, one hundred dollars.
2033		-	(e) The commissioner shall charge one thousand dollars for the
2034		-	licensing and inspection of outpatient clinics that provide either medical
2035		-	or mental health service, urgent care services and well-child clinical
2036		-	services, except those operated by a municipal health department, Substitute House Bill No. 6666
2037		-
2038		-	Public Act No. 21-121 62 of 132
2039		-
2040		-	health district or licensed nonprofit nursing or community health
2041		-	agency. Such licensing and inspection shall be performed every three
2042		-	years, except those outpatient clinics that have obtained accreditation
2043		-	from a national accrediting organization within the immediately
2044		-	preceding twelve-month period may be inspected by the commissioner
2045		-	once every four years, provided the outpatient clinic has not committed
2046		-	any violation that the commissioner determines would pose an
2047		-	immediate threat to the health, safety or welfare of the patients of the
2048		-	outpatient clinic. The provisions of this subsection shall not be
2049		-	construed to limit the commissioner's authority to inspect any applicant
2050		-	for licensure or renewal of licensure as an outpatient clinic, suspend or
2051		-	revoke any license granted to an outpatient clinic pursuant to this
2052		-	section or take any other legal action against an outpatient clinic that is
2053		-	authorized by any provision of the general statutes.
2054		-	(f) Any institution that is planning a project for construction or
2055		-	building alteration shall provide the plan for such project to the
2056		-	Department of Public Health for review. Any such project shall comply
2057		-	with nationally established facility guidelines for health care
2058		-	construction, as approved by the commissioner, that are in place at the
2059		-	time the institution provides the plan to the department. The
2060		-	commissioner shall post a reference to such guidelines, including the
2061		-	effective date of such guidelines, on the Department of Public Health's
2062		-	Internet web site. No institution shall be required to include matters
2063		-	outside the scope and applicability of such guidelines in the institution's
2064		-	plan.
2065		-	(g) The commissioner shall charge a fee of five hundred sixty-five
2066		-	dollars for the technical assistance provided for the design, review and
2067		-	development of an institution's construction, renovation, building
2068		-	alteration, sale or change in ownership when the cost of the project is
2069		-	one million dollars or less and shall charge a fee of one-quarter of one
2070		-	per cent of the total construction cost when the cost of the project is more Substitute House Bill No. 6666
2071		-
2072		-	Public Act No. 21-121 63 of 132
2073		-
2074		-	than one million dollars. Such fee shall include all department reviews
2075		-	and on-site inspections. For purposes of this subsection, "institution"
2076		-	does not include a facility owned by the state.
2077		-	(h) The commissioner may require as a condition of the licensure of a
2078		-	home health care [agencies] agency, hospice agency and home health
2079		-	aide [agencies] agency that each agency meet minimum service quality
2080		-	standards. In the event the commissioner requires such agencies to meet
2081		-	minimum service quality standards as a condition of their licensure, the
2082		-	commissioner shall adopt regulations, in accordance with the
2083		-	provisions of chapter 54, to define such minimum service quality
2084		-	standards, which shall (1) allow for training of home health aides by
2085		-	adult continuing education, (2) require a registered nurse to visit and
2086		-	assess each patient receiving home health aide services as often as
2087		-	necessary based on the patient's condition, but not less than once every
2088		-	sixty days, and (3) require the assessment prescribed by subdivision (2)
2089		-	of this subsection to be completed while the home health aide is
2090		-	providing services in the patient's home.
2091		-	(i) No person acting individually or jointly with any other person
2092		-	shall establish, conduct, operate or maintain a home health care agency,
2093		-	hospice agency or home health aide agency without maintaining
2094		-	professional liability insurance or other indemnity against liability for
2095		-	professional malpractice. The amount of insurance which such person
2096		-	shall maintain as insurance or indemnity against claims for injury or
2097		-	death for professional malpractice shall be not less than one million
2098		-	dollars for one person, per occurrence, with an aggregate of not less than
2099		-	three million dollars.
2100		-	Sec. 47. Subdivision (4) of subsection (a) of section 19a-491c of the
2101		-	general statutes is repealed and the following is substituted in lieu
2102		-	thereof (Effective July 1, 2021):
2103		-	(4) "Long-term care facility" means any facility, agency or provider Substitute House Bill No. 6666
2104		-
2105		-	Public Act No. 21-121 64 of 132
2106		-
2107		-	that is a nursing home, as defined in section 19a-521, a residential care
2108		-	home, as defined in section 19a-521, a home health care agency, hospice
2109		-	agency or home health aide agency, as defined in section 19a-490, as
2110		-	amended by this act, an assisted living services agency, as defined in
2111		-	section 19a-490, as amended by this act, an intermediate care facility for
2112		-	individuals with intellectual disabilities, as defined in 42 USC 1396d(d),
2113		-	except any such facility operated by a Department of Developmental
2114		-	Services' program subject to background checks pursuant to section 17a-
2115		-	227a, a chronic disease hospital, as defined in section 19a-550, or an
2116		-	agency providing hospice care which is licensed to provide such care by
2117		-	the Department of Public Health or certified to provide such care
2118		-	pursuant to 42 USC 1395x.
2119		-	Sec. 48. Section 19a-492b of the general statutes is repealed and the
2120		-	following is substituted in lieu thereof (Effective July 1, 2021):
2121		-	(a) A home health care agency or hospice agency that receives
2122		-	payment for rendering care to persons receiving medical assistance
2123		-	from the state, assistance from the Connecticut home-care program for
2124		-	the elderly pursuant to section 17b-342, or funds obtained through Title
2125		-	XVIII of the Social Security Amendments of 1965 shall be prohibited
2126		-	from discriminating against such persons who apply for enrollment to
2127		-	such home health care agency on the basis of source of payment.
2128		-	(b) Any home health care agency or hospice agency which violates
2129		-	the provisions of this section shall be subject to suspension or revocation
2130		-	of license.
2131		-	Sec. 49. Subsection (b) of section 19a-492c of the general statutes is
2132		-	repealed and the following is substituted in lieu thereof (Effective July 1,
2133		-	2021):
2134		-	(b) A home health care agency or hospice agency licensed pursuant
2135		-	to this chapter that provides hospice services in a rural town and is Substitute House Bill No. 6666
2136		-
2137		-	Public Act No. 21-121 65 of 132
2138		-
2139		-	unable to access licensed or Medicare-certified hospice care to
2140		-	consistently provide adequate services to patients in the rural town may
2141		-	apply to the Commissioner of Public Health for a waiver from the
2142		-	regulations licensing such agency adopted pursuant to this chapter. The
2143		-	waiver may authorize one or more of the following: (1) The agency's
2144		-	supervisor of clinical services may also serve as the supervisor of clinical
2145		-	services assigned to the hospice program; (2) the hospice volunteer
2146		-	coordinator and the hospice program director may be permanent part-
2147		-	time employees; and (3) the program director may perform other
2148		-	services at the agency, including, but not limited to, hospice volunteer
2149		-	coordinator. The commissioner shall not grant a waiver unless the
2150		-	commissioner determines that such waiver will not adversely impact
2151		-	the health, safety and welfare of hospice patients and their families. The
2152		-	waiver shall be in effect for two years. An agency may reapply for such
2153		-	a waiver.
2154		-	Sec. 50. Section 19a-492d of the general statutes is repealed and the
2155		-	following is substituted in lieu thereof (Effective July 1, 2021):
2156		-	On and after October 1, 2007, a nurse who is employed by an agency
2157		-	licensed by the Department of Public Health as a home health care
2158		-	agency, hospice agency or [a] home health aide agency may administer
2159		-	influenza and pneumococcal vaccines to persons in their homes, after
2160		-	an assessment for contraindications, without a physician's order in
2161		-	accordance with a physician-approved agency policy that includes an
2162		-	anaphylaxis protocol. In the event of an adverse reaction to the vaccine,
2163		-	such nurse may also administer epinephrine or other anaphylaxis
2164		-	medication without a physician's order in accordance with the
2165		-	physician-approved agency policy. For purposes of this section, "nurse"
2166		-	means an advanced practice registered nurse, registered nurse or
2167		-	practical nurse licensed under chapter 378.
2168		-	Sec. 51. Section 19a-492e of the general statutes is repealed and the
2169		-	following is substituted in lieu thereof (Effective July 1, 2021): Substitute House Bill No. 6666
2170		-
2171		-	Public Act No. 21-121 66 of 132
2172		-
2173		-	(a) For purposes of this section "home health care agency" [has] and
2174		-	"hospice agency" have the same [meaning] meanings as provided in
2175		-	section 19a-490, as amended by this act. Notwithstanding the provisions
2176		-	of chapter 378, a registered nurse may delegate the administration of
2177		-	medications that are not administered by injection to home health aides
2178		-	and hospice aides who have obtained certification and recertification
2179		-	every three years thereafter for medication administration in accordance
2180		-	with regulations adopted pursuant to subsection (b) of this section,
2181		-	unless the prescribing practitioner specifies that a medication shall only
2182		-	be administered by a licensed nurse. Any home health aide or hospice
2183		-	aide who obtained certification in the administration of medications on
2184		-	or before June 30, 2015, shall obtain recertification on or before July 1,
2185		-	2018.
2186		-	(b) (1) The Commissioner of Public Health shall adopt regulations, in
2187		-	accordance with the provisions of chapter 54, to carry out the provisions
2188		-	of this section. Such regulations shall require each home health care
2189		-	agency or hospice agency that serves clients requiring assistance with
2190		-	medication administration to (A) adopt practices that increase and
2191		-	encourage client choice, dignity and independence; (B) establish policies
2192		-	and procedures to ensure that a registered nurse may delegate allowed
2193		-	tasks of nursing care, to include medication administration, to home
2194		-	health aides or hospice aides when the registered nurse determines that
2195		-	it is in the best interest of the client and the home health aide or hospice
2196		-	aide has been deemed competent to perform the task; (C) designate
2197		-	home health aides and hospice aides to obtain certification and
2198		-	recertification for the administration of medication; and (D) ensure that
2199		-	such home health aides receive such certification and recertification.
2200		-	(2) The regulations shall establish certification and recertification
2201		-	requirements for medication administration and the criteria to be used
2202		-	by home health care agencies and hospice agencies that provide services
2203		-	for clients requiring assistance with medication administration in Substitute House Bill No. 6666
2204		-
2205		-	Public Act No. 21-121 67 of 132
2206		-
2207		-	determining (A) which home health aides and hospice aides shall obtain
2208		-	such certification and recertification, and (B) education and skill training
2209		-	requirements, including ongoing training requirements for such
2210		-	certification and recertification.
2211		-	(3) Education and skill training requirements for initial certification
2212		-	and recertification shall include, but not be limited to, initial orientation,
2213		-	training in client rights and identification of the types of medication that
2214		-	may be administered by unlicensed personnel, behavioral management,
2215		-	personal care, nutrition and food safety, and health and safety in
2216		-	general.
2217		-	(c) Each home health care agency and, on or before January 1, 2022,
2218		-	each hospice agency shall ensure that, on or before January 1, 2013,
2219		-	delegation of nursing care tasks in the home care setting is allowed
2220		-	within such agency and that policies are adopted to employ home health
2221		-	aides or hospice aides for the purposes of allowing nurses to delegate
2222		-	such tasks.
2223		-	(d) A registered nurse licensed pursuant to the provisions of chapter
2224		-	378 who delegates the task of medication administration to a home
2225		-	health aide or hospice aide pursuant to this section shall not be subject
2226		-	to disciplinary action based on the performance of the home health aide
2227		-	or hospice aide to whom tasks are delegated, unless the home health
2228		-	aide or hospice aide is acting pursuant to specific instructions from the
2229		-	registered nurse or the registered nurse fails to leave instructions when
2230		-	the nurse should have done so, provided the registered nurse: (1)
2231		-	Documented in the patient's care plan that the medication
2232		-	administration could be properly and safely performed by the home
2233		-	health aide or hospice aide to whom it is delegated, (2) provided initial
2234		-	direction to the home health aide or hospice aide, and (3) provided
2235		-	ongoing supervision of the home health aide or hospice aide, including
2236		-	the periodic assessment and evaluation of the patient's health and safety
2237		-	related to medication administration. Substitute House Bill No. 6666
2238		-
2239		-	Public Act No. 21-121 68 of 132
2240		-
2241		-	(e) A registered nurse who delegates the provision of nursing care to
2242		-	another person pursuant to this section shall not be subject to an action
2243		-	for civil damages for the performance of the person to whom nursing
2244		-	care is delegated unless the person is acting pursuant to specific
2245		-	instructions from the nurse or the nurse fails to leave instructions when
2246		-	the nurse should have done so.
2247		-	(f) No person may coerce a registered nurse into compromising
2248		-	patient safety by requiring the nurse to delegate the administration of
2249		-	medication if the nurse's assessment of the patient documents a need for
2250		-	a nurse to administer medication and identifies why the need cannot be
2251		-	safely met through utilization of assistive technology or administration
2252		-	of medication by certified home health aides or hospice aides. No
2253		-	registered nurse who has made a reasonable determination based on
2254		-	such assessment that delegation may compromise patient safety shall be
2255		-	subject to any employer reprisal or disciplinary action pursuant to
2256		-	chapter 378 for refusing to delegate or refusing to provide the required
2257		-	training for such delegation. The Department of Social Services, in
2258		-	consultation with the Department of Public Health, [and] home health
2259		-	care agencies and hospice agencies, shall develop protocols for
2260		-	documentation pursuant to the requirements of this subsection. The
2261		-	Department of Social Services shall notify all licensed home health care
2262		-	agencies and hospice agencies of such protocols prior to the
2263		-	implementation of this section.
2264		-	(g) The Commissioner of Public Health may implement policies and
2265		-	procedures necessary to administer the provisions of this section while
2266		-	in the process of adopting such policies and procedures as regulations,
2267		-	provided notice of intent to adopt regulations is published in the
2268		-	Connecticut Law Journal not later than twenty days after the date of
2269		-	implementation. Policies and procedures implemented pursuant to this
2270		-	section shall be valid until the time final regulations are adopted.
2271		-	Sec. 52. Section 19a-496a of the general statutes is repealed and the Substitute House Bill No. 6666
2272		-
2273		-	Public Act No. 21-121 69 of 132
2274		-
2275		-	following is substituted in lieu thereof (Effective July 1, 2021):
2276		-	(a) Notwithstanding any provision of the regulations of Connecticut
2277		-	state agencies, all home health care agency, hospice agency and home
2278		-	health aide agency services shall be performed upon the order of a
2279		-	physician or physician assistant licensed pursuant to chapter 370 or an
2280		-	advanced practice registered nurse licensed pursuant to chapter 378.
2281		-	(b) All home health care agency services which are required by law
2282		-	to be performed upon the order of a licensed physician may be
2283		-	performed upon the order of a physician, physician assistant or
2284		-	advanced practice registered nurse licensed in a state which borders
2285		-	Connecticut.
2286		-	Sec. 53. Section 19a-504d of the general statutes is repealed and the
2287		-	following is substituted in lieu thereof (Effective July 1, 2021):
2288		-	(a) If a hospital recommends home health care to a patient, the
2289		-	hospital discharge plan shall include two or more available options of
2290		-	home health care agencies or hospice agencies.
2291		-	(b) A hospital which (1) has an ownership or investment interest in a
2292		-	home health care agency or hospice agency, or (2) receives
2293		-	compensation or remuneration for referral of patients to a home health
2294		-	care agency or hospice agency shall disclose such interest to any patient
2295		-	prior to including such agency as an option in a hospital discharge plan.
2296		-	Such information shall be verbally disclosed to each patient or shall be
2297		-	posted in a conspicuous place visible to patients. As used in this
2298		-	subsection, "ownership or investment interest" does not include
2299		-	ownership of investment securities purchased by the practitioner on
2300		-	terms available to the general public and which are publicly traded.
2301		-	Sec. 54. (NEW) (Effective July 1, 2021) (a) The Commissioner of Public
2302		-	Health may suspend the requirements for licensure to authorize a
2303		-	licensed chronic and convalescent nursing home to provide services to Substitute House Bill No. 6666
2304		-
2305		-	Public Act No. 21-121 70 of 132
2306		-
2307		-	patients with a reportable disease, emergency illness or health
2308		-	condition, pursuant to section 19-91 of the general statutes, under their
2309		-	existing license if such licensed chronic and convalescent nursing home
2310		-	(1) provides services to such patients in a building that is not physically
2311		-	connected to its licensed facility, or (2) expands its bed capacity in a
2312		-	portion of a facility that is separate from the licensed facility. Such
2313		-	services may only be provided in order to render temporary assistance
2314		-	in managing a public health emergency in this state, declared by the
2315		-	Governor pursuant to section 19a-131a of the general statutes.
2316		-	(b) Each chronic and convalescent nursing home that intends to
2317		-	provide services pursuant to subsection (a) of this section shall submit
2318		-	an application to the Department of Public Health in a form and manner
2319		-	prescribed by the commissioner. Such application shall include, but
2320		-	need not be limited to: (1) Information regarding the facility's ability to
2321		-	sufficiently address the health, safety or welfare of such chronic and
2322		-	convalescent nursing home's residents and staff; (2) the address of such
2323		-	facility; (3) an attestation that all equipment located at such facility is
2324		-	maintained according to the manufacturers' specifications, and is
2325		-	capable of meeting the needs of such facility's residents; (4) information
2326		-	regarding such facility's maximum bed capacity; and (5) information
2327		-	indicating that such facility is in compliance with any provisions of the
2328		-	general statutes or regulations of Connecticut state agencies pertaining
2329		-	to the operation of such facility.
2330		-	(c) Upon receipt of an application pursuant to subsection (a) of this
2331		-	section, the Department of Public Health shall conduct a scheduled
2332		-	inspection and investigation of the applicant's facilities to ensure
2333		-	compliance with any provisions of the general statutes or regulations of
2334		-	Connecticut state agencies pertaining to the licensing of such facilities.
2335		-	After conducting such inspection and investigation, the department
2336		-	shall notify the applicant of the department's approval or denial of such
2337		-	application. Substitute House Bill No. 6666
2338		-
2339		-	Public Act No. 21-121 71 of 132
2340		-
2341		-	Sec. 55. Section 19a-522f of the general statutes is repealed and the
2342		-	following is substituted in lieu thereof (Effective July 1, 2021):
2343		-	(a) As used in this section:
2344		-	(1) "Administer" means to initiate the venipuncture and deliver an IV
2345		-	fluid or IV admixture into the blood stream through a vein, and to
2346		-	monitor and care for the venipuncture site, terminate the procedure and
2347		-	record pertinent events and observations;
2348		-	(2) "IV admixture" means an IV fluid to which one or more additional
2349		-	drug products have been added;
2350		-	(3) "IV fluid" means sterile solutions of fifty milliliters or more,
2351		-	intended for intravenous infusion, but does not include blood and blood
2352		-	products;
2353		-	(4) "IV therapy" means the introduction of an IV fluid or IV admixture
2354		-	into the blood stream through a vein for the purpose of correcting water
2355		-	deficit and electrolyte imbalances, providing nutrition, and delivering
2356		-	antibiotics and other therapeutic agents approved by a chronic and
2357		-	convalescent nursing home's or a rest home with nursing supervision's
2358		-	medical staff;
2359		-	(5) "IV therapy program" means the overall plan by which a chronic
2360		-	and convalescent nursing home or a rest home with nursing supervision
2361		-	implements, monitors and safeguards the administration of IV therapy
2362		-	to patients; and
2363		-	(6) "IV therapy nurse" means a registered nurse who is qualified by
2364		-	education and training and has demonstrated proficiency in the
2365		-	theoretical and clinical aspects of IV therapy to administer an IV fluid
2366		-	or IV admixture.
2367		-	(b) An IV therapy nurse or a physician assistant licensed pursuant to Substitute House Bill No. 6666
2368		-
2369		-	Public Act No. 21-121 72 of 132
2370		-
2371		-	section 20-12b, who is employed by, or operating under a contract to
2372		-	provide services in, a chronic and convalescent nursing home or a rest
2373		-	home with nursing supervision that operates an IV therapy program
2374		-	may administer a peripherally inserted central catheter as part of such
2375		-	facility's IV therapy program. The Department of Public Health shall
2376		-	adopt regulations in accordance with the provisions of chapter 54 to
2377		-	carry out the purposes of this section.
2378		-	(c) A chronic and convalescent nursing home may allow a registered
2379		-	nurse licensed pursuant to chapter 378 and employed by such chronic
2380		-	and convalescent nursing home who has been properly trained by the
2381		-	director of nursing or by an intravenous infusion company to (1)
2382		-	administer IV therapy or a dose of medication by intravenous injection,
2383		-	provided such medication is on a list of medications approved by the
2384		-	facility's governing body, pharmacist and medical director for
2385		-	intravenous injection by a registered nurse, or (2) draw blood from a
2386		-	central line for laboratory purposes, provided the facility has an
2387		-	agreement with a laboratory to process such specimens. Such chronic
2388		-	and convalescent nursing home shall notify the Commissioner of Public
2389		-	Health of any such services being provided under subdivisions (1) and
2390		-	(2) of this subsection. The administrator of each chronic and
2391		-	convalescent nursing home shall ensure that each registered nurse who
2392		-	is permitted to perform the services described in subdivisions (1) and
2393		-	(2) of this subsection is appropriately trained and competent to perform
2394		-	such services. Each administrator shall provide documentation
2395		-	regarding the training and competency of such registered nurses to the
2396		-	department upon the department's request.
2397		-	Sec. 56. (NEW) (Effective July 1, 2021) (a) The Commissioner of Public
2398		-	Health shall license assisted living services agencies, as defined in
2399		-	section 19a-490 of the general statutes, as amended by this act. A
2400		-	managed residential community wishing to provide assisted living
2401		-	services shall become licensed as an assisted living services agency or Substitute House Bill No. 6666
2402		-
2403		-	Public Act No. 21-121 73 of 132
2404		-
2405		-	shall arrange for assisted living services to be provided by another entity
2406		-	that is licensed as an assisted living services agency.
2407		-	(b) A managed residential care community that intends to arrange for
2408		-	assisted living services shall only do so with a currently licensed assisted
2409		-	living services agency. Such managed residential community shall
2410		-	submit an application to arrange for the assisted living services to the
2411		-	Department of Public Health in a form and manner prescribed by the
2412		-	commissioner.
2413		-	(c) An assisted living services agency providing services as a
2414		-	dementia special care unit or program, as defined in section 19a-562 of
2415		-	the general statutes, as amended by this act, shall obtain approval for
2416		-	such unit or program from the Department of Public Health. Such
2417		-	assisted living services agencies shall ensure that they have adequate
2418		-	staff to meet the needs of the residents. Each assisted living services
2419		-	agency that provides services as a dementia special care unit or
2420		-	program, as defined in section 19a-562 of the general statutes, as
2421		-	amended by this act, shall submit to the Department of Public Health a
2422		-	list of dementia special care units or locations and their staffing plans
2423		-	for any such units and locations when completing an initial or a renewal
2424		-	licensure application, or upon request from the department.
2425		-	(d) An assisted living services agency shall ensure that (1) all services
2426		-	being provided on an individual basis to clients are fully understood
2427		-	and agreed upon between either the client or the client's representative,
2428		-	and (2) the client or the client's representative are made aware of the cost
2429		-	of any such services.
2430		-	(e) The Department of Public Health may adopt regulations, in
2431		-	accordance with the provisions of chapter 54 of the general statutes, to
2432		-	carry out the purposes of this section.
2433		-	Sec. 57. Section 19a-521b of the general statutes is repealed and the Substitute House Bill No. 6666
2434		-
2435		-	Public Act No. 21-121 74 of 132
2436		-
2437		-	following is substituted in lieu thereof (Effective July 1, 2021):
2438		-	[In each] Each licensed chronic and convalescent nursing home,
2439		-	chronic disease hospital associated with a chronic and convalescent
2440		-	nursing home, rest home with nursing supervision and residential care
2441		-	home [, at least a three-foot clearance shall be provided at the sides and
2442		-	the foot of each bed] shall position beds in a manner that promotes
2443		-	resident care and that provides at least a three-foot clearance at the sides
2444		-	and foot of each bed. Such bed position shall (1) not act as a restraint to
2445		-	the resident, (2) not create a hazardous situation, including, but not
2446		-	limited to, an entrapment possibility, or obstacle to evacuation or being
2447		-	close to or blocking a heat source, and (3) allow for infection control.
2448		-	Sec. 58. Section 19a-195 of the general statutes is repealed and the
2449		-	following is substituted in lieu thereof (Effective October 1, 2021):
2450		-	The commissioner shall adopt regulations in accordance with the
2451		-	provisions of chapter 54 to require all [emergency medical response
2452		-	services] ambulances to be staffed by at least one certified emergency
2453		-	medical technician, who shall be in the patient compartment attending
2454		-	the patient during all periods in which a patient is being transported,
2455		-	and one certified [medical response technician] emergency medical
2456		-	responder.
2457		-	Sec. 59. Section 20-206jj of the general statutes is repealed and the
2458		-	following is substituted in lieu thereof (Effective from passage):
2459		-	As used in this section and sections 20-206kk to 20-206oo, inclusive:
2460		-	(1) "Advanced emergency medical technician" means an individual
2461		-	who is certified as an advanced emergency medical technician by the
2462		-	Department of Public Health;
2463		-	(2) "Commissioner" means the Commissioner of Public Health; Substitute House Bill No. 6666
2464		-
2465		-	Public Act No. 21-121 75 of 132
2466		-
2467		-	(3) "Emergency medical services instructor" means a person who is
2468		-	certified under the provisions of section 20-206ll or 20-206mm, as
2469		-	amended by this act, by the Department of Public Health to teach
2470		-	courses, the completion of which is required in order to become an
2471		-	emergency medical technician;
2472		-	(4) "Emergency medical responder" means an individual who is
2473		-	certified to practice as an emergency medical responder under the
2474		-	provisions of section 20-206ll or 20-206mm, as amended by this act;
2475		-	(5) "Emergency medical services personnel" means an individual
2476		-	certified to practice as an emergency medical responder, emergency
2477		-	medical technician, advanced emergency medical technician,
2478		-	emergency medical services instructor or an individual licensed as a
2479		-	paramedic;
2480		-	(6) "Emergency medical technician" means a person who is certified
2481		-	to practice as an emergency medical technician under the provisions of
2482		-	section 20-206ll or 20-206mm, as amended by this act;
2483		-	(7) "National organization for emergency medical certification"
2484		-	means a national organization approved by the Department of Public
2485		-	Health and identified on the department's Internet web site, or such
2486		-	national organization's successor organization, that tests and provides
2487		-	certification to emergency medical responders, emergency medical
2488		-	technicians, advanced medical technicians and paramedics;
2489		-	(8) "Office of Emergency Medical Services" means the office
2490		-	established within the Department of Public Health pursuant to section
2491		-	19a-178;
2492		-	(9) "Paramedicine" means the carrying out of (A) all phases of
2493		-	cardiopulmonary resuscitation and defibrillation, (B) the administration
2494		-	of drugs and intravenous solutions under written or oral authorization
2495		-	from a licensed physician or a licensed advanced practice registered Substitute House Bill No. 6666
2496		-
2497		-	Public Act No. 21-121 76 of 132
2498		-
2499		-	nurse, and (C) the administration of controlled substances, as defined in
2500		-	section 21a-240, in accordance with written protocols or standing orders
2501		-	of a licensed physician or a licensed advanced practice registered nurse;
2502		-	and
2503		-	(10) "Paramedic" means a person licensed to practice as a paramedic
2504		-	under the provisions of section 20-206ll. [; and]
2505		-	[(11) "Continuing education platform Internet web site" means an
2506		-	online database, approved by the Commissioner of Public Health, for
2507		-	emergency medical services personnel to enter, track and reconcile the
2508		-	hours and topics of continuing education completed by such personnel.]
2509		-	Sec. 60. Subsection (b) of section 19a-178a of the general statutes is
2510		-	repealed and the following is substituted in lieu thereof (Effective from
2511		-	passage):
2512		-	(b) The advisory board shall consist of members appointed in
2513		-	accordance with the provisions of this subsection and shall include the
2514		-	Commissioner of Public Health, the department's emergency medical
2515		-	services medical director and the president of each of the regional
2516		-	emergency medical services councils, or their designees. The Governor
2517		-	shall appoint the following members: (1) One person from the
2518		-	Connecticut Association of Directors of Health; (2) three persons from
2519		-	the Connecticut College of Emergency Physicians; (3) one person from
2520		-	the Connecticut Committee on Trauma of the American College of
2521		-	Surgeons; (4) one person from the Connecticut Medical Advisory
2522		-	Committee; (5) one person from the Emergency Nurses Association; (6)
2523		-	one person from the Connecticut Association of Emergency Medical
2524		-	Services Instructors; (7) one person from the Connecticut Hospital
2525		-	Association; (8) two persons representing commercial ambulance
2526		-	services; (9) one person from the Connecticut State Firefighters
2527		-	Association; (10) one person from the Connecticut Fire Chiefs
2528		-	Association; (11) one person from the Connecticut Police Chiefs Substitute House Bill No. 6666
2529		-
2530		-	Public Act No. 21-121 77 of 132
2531		-
2532		-	Association; (12) one person from the Connecticut State Police; and (13)
2533		-	one person from the Connecticut Commission on Fire Prevention and
2534		-	Control. An additional eighteen members shall be appointed as follows:
2535		-	(A) Three by the president pro tempore of the Senate; (B) three by the
2536		-	majority leader of the Senate; (C) four by the minority leader of the
2537		-	Senate; (D) three by the speaker of the House of Representatives; (E) two
2538		-	by the majority leader of the House of Representatives; and (F) three by
2539		-	the minority leader of the House of Representatives. The appointees
2540		-	shall include a person with experience in municipal ambulance services;
2541		-	a person with experience in for-profit ambulance services; three persons
2542		-	with experience in volunteer ambulance services; a paramedic; an
2543		-	emergency medical technician; an advanced emergency medical
2544		-	technician; three consumers and four persons from state-wide
2545		-	organizations with interests in emergency medical services as well as
2546		-	any other areas of expertise that may be deemed necessary for the
2547		-	proper functioning of the advisory board. Any appointment to the
2548		-	advisory board that is vacant for more than one year shall be filled by
2549		-	the Commissioner of Public Health. The commissioner shall notify the
2550		-	appointing authority of the identity of the commissioner's appointment
2551		-	not later than thirty days before making such appointment.
2552		-	Sec. 61. Subsection (a) of section 19a-36h of the general statutes is
2553		-	repealed and the following is substituted in lieu thereof (Effective from
2554		-	passage):
2555		-	(a) Not later than January 1, [2020] 2023, the commissioner shall adopt
2556		-	and administer by reference the United States Food and Drug
2557		-	Administration's Food Code, as amended from time to time, and any
2558		-	Food Code Supplement published by said administration as the state's
2559		-	food code for the purpose of regulating food establishments.
2560		-	Sec. 62. Subsection (a) of section 19a-36j of the general statutes is
2561		-	repealed and the following is substituted in lieu thereof (Effective from
2562		-	passage): Substitute House Bill No. 6666
2563		-
2564		-	Public Act No. 21-121 78 of 132
2565		-
2566		-	(a) On and after January 1, [2019] 2023, no person shall engage in the
2567		-	practice of a food inspector unless such person has obtained a
2568		-	certification from the commissioner in accordance with the provisions
2569		-	of this section. The commissioner shall develop a training and
2570		-	verification program for food inspector certification that shall be
2571		-	administered by the food inspection training officer at a local health
2572		-	department.
2573		-	(1) Each person seeking certification as a food inspector shall submit
2574		-	an application to the department on a form prescribed by the
2575		-	commissioner and present to the department satisfactory evidence that
2576		-	such person (A) is sponsored by the director of health in the jurisdiction
2577		-	in which the applicant is employed to conduct food inspections, (B)
2578		-	possesses a bachelor's degree or three years of experience in a regulatory
2579		-	food protection program, (C) has successfully completed a training and
2580		-	verification program, (D) has successfully completed the field
2581		-	standardization inspection prescribed by the commissioner, and (E) is
2582		-	not involved in the ownership or management of a food establishment
2583		-	located in the applicant's jurisdiction.
2584		-	(2) Each director of health sponsoring an applicant for certification as
2585		-	a food inspector shall submit to the commissioner a form documenting
2586		-	the applicant's qualifications and successful completion of the
2587		-	requirements described in subdivision (1) of this subsection.
2588		-	(3) Certifications issued under this section shall be subject to renewal
2589		-	once every three years. A food inspector applying for renewal of his or
2590		-	her certification shall demonstrate successful completion of twenty
2591		-	contact hours in food protection training, as approved by the
2592		-	commissioner, and reassessment by the food inspection training officer.
2593		-	Sec. 63. Section 19a-36o of the general statutes is repealed and the
2594		-	following is substituted in lieu thereof (Effective from passage): Substitute House Bill No. 6666
2595		-
2596		-	Public Act No. 21-121 79 of 132
2597		-
2598		-	Notwithstanding any provision of the general statutes, from June 30,
2599		-	2017, until December 31, [2018] 2022, a food service establishment may
2600		-	request a variance from the Commissioner of Public Health from the
2601		-	requirements of the [Public Health Code] regulations of Connecticut
2602		-	state agencies, established under section 19a-36, to utilize the process of
2603		-	sous vide and acidification of sushi rice, as defined in section 3-502.11 of
2604		-	the United States Food and Drug Administration's Food Code, as
2605		-	amended from time to time. The Commissioner of Public Health shall
2606		-	review the request for a variance and provide the food establishment
2607		-	with notification regarding the status of its request not later than thirty
2608		-	days after the commissioner receives such request. The commissioner
2609		-	may grant such variance if he or she determines that such variance
2610		-	would not result in a health hazard or nuisance.
2611		-	Sec. 64. Subdivision (5) of section 19a-332 of the general statutes is
2612		-	repealed and the following is substituted in lieu thereof (Effective October
2613		-	1, 2021):
2614		-	(5) "Asbestos-containing material" means material composed of
2615		-	asbestos of any type and in an amount equal to or greater than one per
2616		-	cent by weight, either alone or mixed with other fibrous or nonfibrous
2617		-	material;
2618		-	Sec. 65. Subdivision (4) of section 20-250 of the general statutes is
2619		-	repealed and the following is substituted in lieu thereof (Effective from
2620		-	passage):
2621		-	(4) "Hairdressing and cosmetology" means the art of dressing,
2622		-	arranging, curling, waving, weaving, cutting, singeing, bleaching and
2623		-	coloring the hair and treating the scalp of any person, and massaging,
2624		-	cleansing, stimulating, manipulating, exercising or beautifying with the
2625		-	use of the hands, appliances, cosmetic preparations, antiseptics, tonics,
2626		-	lotions, creams, powders, oils or clays and doing similar work on the
2627		-	face, neck and arms for compensation, removing hair from the face or Substitute House Bill No. 6666
2628		-
2629		-	Public Act No. 21-121 80 of 132
2630		-
2631		-	neck using manual or mechanical means, excluding esthetics, as defined
2632		-	in section 20-265a or any of the actions listed in this subdivision
2633		-	performed on the nails of the hands or feet, provided nothing in this
2634		-	subdivision shall prohibit an unlicensed person from performing
2635		-	shampooing or braiding hair;
2636		-	Sec. 66. Subsection (b) of section 20-265b of the general statutes is
2637		-	repealed and the following is substituted in lieu thereof (Effective July 1,
2638		-	2021):
2639		-	(b) On and after January 1, 2020, each person seeking an initial license
2640		-	as an esthetician shall apply to the department on a form prescribed by
2641		-	the department, accompanied by an application fee of one hundred
2642		-	dollars and evidence that the applicant (1) has completed a course of not
2643		-	less than six hundred hours of study and received a certification of
2644		-	completion from a school approved under section 20-265g or section 20-
2645		-	26 or in a school outside of the state whose requirements are equivalent
2646		-	to a school approved under section 20-265g, or (2) (A) if applying before
2647		-	January 1, 2022, has practiced esthetics continuously in this state for a
2648		-	period of not less than two years prior to July 1, 2020, and (B) is in
2649		-	compliance with the infection prevention and control plan guidelines
2650		-	prescribed by the department under section 19a-231 in the form of an
2651		-	attestation.
2652		-	Sec. 67. Subsection (f) of section 10-206 of the general statutes is
2653		-	repealed and the following is substituted in lieu thereof (Effective July 1,
2654		-	2021):
2655		-	(f) On and after October 1, 2017, each local or regional board of
2656		-	education shall report to the local health department and the
2657		-	Department of Public Health, on an triennial basis, the total number of
2658		-	pupils per school and per school district having a diagnosis of asthma
2659		-	(1) at the time of public school enrollment, (2) in grade six or seven, and
2660		-	(3) in grade nine or ten. [or eleven.] The report shall contain the asthma Substitute House Bill No. 6666
2661		-
2662		-	Public Act No. 21-121 81 of 132
2663		-
2664		-	information collected as required under subsections (b) and (c) of this
2665		-	section and shall include pupil age, gender, race, ethnicity and school.
2666		-	Beginning on October 1, 2021, and every three years thereafter, the
2667		-	Department of Public Health shall review the asthma screening
2668		-	information reported pursuant to this section and shall submit a report
2669		-	to the joint standing committees of the General Assembly having
2670		-	cognizance of matters relating to public health and education
2671		-	concerning asthma trends and distributions among pupils enrolled in
2672		-	the public schools. The report shall be submitted in accordance with the
2673		-	provisions of section 11-4a and shall include, but not be limited to, (A)
2674		-	trends and findings based on pupil age, gender, race, ethnicity, school
2675		-	and the education reference group, as determined by the Department of
2676		-	Education for the town or regional school district in which such school
2677		-	is located, and (B) activities of the asthma screening monitoring system
2678		-	maintained under section 19a-62a.
2679		-	Sec. 68. Section 19a-490w of the general statutes is repealed and the
2680		-	following is substituted in lieu thereof (Effective October 1, 2021):
2681		-	(a) Not later than October 1, 2017, and annually thereafter, any
2682		-	hospital that has been certified as a comprehensive stroke center, a
2683		-	primary stroke center, a thrombectomy-capable stroke center or an
2684		-	acute stroke-ready hospital by the American Heart Association, the Joint
2685		-	Commission or any other nationally recognized certifying organization
2686		-	shall submit an attestation of such certification to the Commissioner of
2687		-	Public Health, in a form and manner prescribed by the commissioner.
2688		-	Not later than October 15, 2017, and annually thereafter, the Department
2689		-	of Public Health shall post a list of certified stroke centers on its Internet
2690		-	web site.
2691		-	(b) The department may remove a hospital from the list posted
2692		-	pursuant to subsection (a) of this section if (1) the hospital requests such
2693		-	removal, (2) the department is informed by the American Heart
2694		-	Association, the Joint Commission or other nationally recognized Substitute House Bill No. 6666
2695		-
2696		-	Public Act No. 21-121 82 of 132
2697		-
2698		-	certifying organization that a hospital's certification has expired or been
2699		-	suspended or revoked, or (3) the department does not receive attestation
2700		-	of certification from a hospital on or before October first. The
2701		-	department shall report to the nationally recognized certifying
2702		-	organization any complaint it receives related to the certification of a
2703		-	hospital as a comprehensive stroke center, a primary stroke center, a
2704		-	thrombectomy-capable stroke center or an acute stroke-ready hospital.
2705		-	The department shall provide the complainant with the name and
2706		-	contact information of the nationally recognized certifying organization
2707		-	if the complainant seeks to pursue a complaint with such organization.
2708		-	Sec. 69. Subsection (k) of section 19a-180 of the general statutes is
2709		-	repealed and the following is substituted in lieu thereof (Effective from
2710		-	passage):
2711		-	(k) Notwithstanding the provisions of subsection (a) of this section,
2712		-	any [volunteer, hospital-based or municipal ambulance service]
2713		-	emergency medical services organization that is licensed or certified and
2714		-	a primary service area responder may apply to the commissioner, on a
2715		-	short form application prescribed by the commissioner, to change the
2716		-	address of a principal or branch location or to add a branch location
2717		-	within its primary service area. Upon making such application, the
2718		-	applicant shall notify in writing all other primary service area
2719		-	responders in any municipality or abutting municipality in which the
2720		-	applicant proposes to change principal or branch locations. Unless a
2721		-	primary service area responder entitled to receive notification of such
2722		-	application objects, in writing, to the commissioner and requests a
2723		-	hearing on such application not later than fifteen calendar days after
2724		-	receiving such notice, the application shall be deemed approved thirty
2725		-	calendar days after filing. If any such primary service area responder
2726		-	files an objection with the commissioner within the fifteen-calendar-day
2727		-	time period and requests a hearing, the applicant shall be required to
2728		-	demonstrate need to change the address of a principal or branch Substitute House Bill No. 6666
2729		-
2730		-	Public Act No. 21-121 83 of 132
2731		-
2732		-	location within its primary service area at a public hearing as required
2733		-	under subsection (a) of this section.
2734		-	Sec. 70. Section 7-36 of the general statutes is repealed and the
2735		-	following is substituted in lieu thereof (Effective July 1, 2021):
2736		-	As used in this chapter and sections 19a-40 to 19a-45, inclusive, unless
2737		-	the context otherwise requires:
2738		-	(1) "Registrar of vital statistics" or "registrar" means the registrar of
2739		-	births, marriages, deaths and fetal deaths or any public official charged
2740		-	with the care of returns relating to vital statistics;
2741		-	(2) "Registration" means the process by which vital records are
2742		-	completed, filed and incorporated into the official records of the
2743		-	department;
2744		-	(3) "Institution" means any public or private facility that provides
2745		-	inpatient medical, surgical or diagnostic care or treatment, or nursing,
2746		-	custodial or domiciliary care, or to which persons are committed by law;
2747		-	(4) "Vital records" means a certificate of birth, death, fetal death or
2748		-	marriage;
2749		-	(5) "Certified copy" means a copy of a birth, death, fetal death or
2750		-	marriage certificate that (A) includes all information on the certificate
2751		-	except such information that is nondisclosable by law, (B) is issued or
2752		-	transmitted by any registrar of vital statistics, (C) includes an attested
2753		-	signature and the raised seal of an authorized person, and (D) if
2754		-	submitted to the department, includes all information required by the
2755		-	commissioner;
2756		-	(6) "Uncertified copy" means a copy of a birth, death, fetal death or
2757		-	marriage certificate that includes all information contained in a certified
2758		-	copy except an original attested signature and a raised seal of an Substitute House Bill No. 6666
2759		-
2760		-	Public Act No. 21-121 84 of 132
2761		-
2762		-	authorized person;
2763		-	(7) "Authenticate" or "authenticated" means to affix to a vital record
2764		-	in paper format the official seal, or to affix to a vital record in electronic
2765		-	format the user identification, password, or other means of electronic
2766		-	identification, as approved by the department, of the creator of the vital
2767		-	record, or the creator's designee, by which affixing the creator of such
2768		-	paper or electronic vital record, or the creator's designee, affirms the
2769		-	integrity of such vital record;
2770		-	(8) "Attest" means to verify a vital record in accordance with the
2771		-	provisions of subdivision (5) of this section;
2772		-	(9) "Correction" means to change or enter new information on a
2773		-	certificate of birth, marriage, death or fetal death, within one year of the
2774		-	date of the vital event recorded in such certificate, in order to accurately
2775		-	reflect the facts existing at the time of the recording of such vital event,
2776		-	where such changes or entries are to correct errors on such certificate
2777		-	due to inaccurate or incomplete information provided by the informant
2778		-	at the time the certificate was prepared, or to correct transcribing,
2779		-	typographical or clerical errors;
2780		-	(10) "Amendment" means to (A) change or enter new information on
2781		-	a certificate of birth, marriage, death or fetal death, more than one year
2782		-	after the date of the vital event recorded in such certificate, in order to
2783		-	accurately reflect the facts existing at the time of the recording of the
2784		-	event, (B) create a replacement certificate of birth for matters pertaining
2785		-	to parentage and gender change, or (C) reflect a legal name change in
2786		-	accordance with section 19a-42, as amended by this act, or make a
2787		-	modification to a cause of death;
2788		-	(11) "Acknowledgment of paternity" means to legally acknowledge
2789		-	paternity of a child pursuant to section 46b-172;
2790		-	(12) "Adjudication of paternity" means to legally establish paternity Substitute House Bill No. 6666
2791		-
2792		-	Public Act No. 21-121 85 of 132
2793		-
2794		-	through an order of a court of competent jurisdiction;
2795		-	(13) "Parentage" includes matters relating to adoption, gestational
2796		-	agreements, paternity and maternity;
2797		-	(14) "Department" means the Department of Public Health;
2798		-	(15) "Commissioner" means the Commissioner of Public Health or the
2799		-	commissioner's designee;
2800		-	(16) "Gestational agreement" means a written agreement for assisted
2801		-	reproduction in which a woman agrees to carry a child to birth for an
2802		-	intended parent or intended parents, which woman contributed no
2803		-	genetic material to the child and which agreement (A) names each party
2804		-	to the agreement and indicates each party's respective obligations under
2805		-	the agreement, (B) is signed by each party to the agreement and the
2806		-	spouse of each such party, if any, and (C) is witnessed by at least two
2807		-	disinterested adults and acknowledged in the manner prescribed by
2808		-	law;
2809		-	(17) "Intended parent" means a party to a gestational agreement who
2810		-	agrees, under the gestational agreement, to be the parent of a child born
2811		-	to a woman by means of assisted reproduction, regardless of whether
2812		-	the party has a genetic relationship to the child;
2813		-	(18) "Foundling" means (A) a child of unknown parentage, or (B) an
2814		-	infant voluntarily surrendered pursuant to the provisions of section 17a-
2815		-	58; [and]
2816		-	(19) "Certified homeless youth" means a person who is at least fifteen
2817		-	years of age but less than eighteen years of age, is not in the physical
2818		-	custody of a parent or legal guardian, who is a homeless child or youth,
2819		-	as defined in 42 USC 11434a, as amended from time to time, and who
2820		-	has been certified as homeless by (A) a school district homeless liaison,
2821		-	(B) the director of an emergency shelter program funded by the United Substitute House Bill No. 6666
2822		-
2823		-	Public Act No. 21-121 86 of 132
2824		-
2825		-	States Department of Housing and Urban Development, or the
2826		-	director's designee, [or] (C) the director of a runaway or homeless youth
2827		-	basic center or transitional living program funded by the United States
2828		-	Department of Health and Human Services, or the director's designee,
2829		-	[.] or (D) the director of a program of a nonprofit organization or
2830		-	municipality that is contracted with the homeless youth program
2831		-	established pursuant to section 17a-62a; and
2832		-	(20) "Certified homeless young adult" means a person who is at least
2833		-	eighteen years of age but less than twenty-five years of age who has
2834		-	been certified as homeless by (A) a school district homeless liaison, (B)
2835		-	the director of an emergency shelter program funded by the United
2836		-	States Department of Housing and Urban Development, or the
2837		-	director's designee, (C) the director of a runaway or homeless youth
2838		-	basic center or transitional living program funded by the United States
2839		-	Department of Health and Human Services, or the director's designee,
2840		-	or (D) the director of a program of a nonprofit organization or
2841		-	municipality that is contracted with the homeless youth program
2842		-	established pursuant to section 17a-62a.
2843		-	Sec. 71. Subsection (c) of section 7-51 of the general statutes is
2844		-	repealed and the following is substituted in lieu thereof (Effective July 1,
2845		-	2021):
2846		-	(c) (1) The registrar of the town in which the birth or fetal death
2847		-	occurred or of the town in which the [mother] birth parent resided at the
2848		-	time of the birth or fetal death, or the department, may issue a certified
2849		-	copy of the certificate of birth or fetal death of any person born in this
2850		-	state that is kept in paper form in the custody of the registrar. Except as
2851		-	provided in subdivision (2) of this subsection, such certificate shall be
2852		-	issued upon the written request of an eligible party listed in subsection
2853		-	(a) of this section. Any registrar of vital statistics in this state with access,
2854		-	as authorized by the department, to the electronic vital records system
2855		-	of the department may issue a certified copy of the electronically filed Substitute House Bill No. 6666
2856		-
2857		-	Public Act No. 21-121 87 of 132
2858		-
2859		-	certificate of birth or fetal death of any person born in this state upon
2860		-	the written request of an eligible party listed in subsection (a) of this
2861		-	section. The registrar and the department may waive the fee for the
2862		-	issuance of a certified copy of the certificate of birth of a certified
2863		-	homeless young adult to such young adult under this subsection.
2864		-	(2) In the case of a certified homeless youth, such certified homeless
2865		-	youth and the person who is certifying the certified homeless youth as
2866		-	homeless, as described in section 7-36, as amended by this act, shall
2867		-	appear in person when the certified homeless youth is presenting the
2868		-	written request described in subdivision (1) of this subsection at (A) the
2869		-	office of the registrar of the town in which the certified homeless youth
2870		-	was born, (B) the office of the registrar of the town in which the [mother]
2871		-	birth parent of the certified homeless youth resided at the time of the
2872		-	birth, (C) if the birth certificate of the certified homeless youth has been
2873		-	electronically filed, any registrar of vital statistics in the state with
2874		-	access, as authorized by the department, to the electronic vital records
2875		-	system, or (D) the state vital records office of the department. The
2876		-	certified homeless youth shall present to the registrar or the department
2877		-	information sufficient to identify himself or herself as may be required
2878		-	by regulations adopted by the commissioner pursuant to section 7-41.
2879		-	The person who is certifying the certified homeless youth as homeless
2880		-	shall present to the registrar or the department information sufficient to
2881		-	identify himself or herself as meeting the certification requirements of
2882		-	section 7-36, as amended by this act. The registrar and the department
2883		-	may waive the fee for the issuance of a certified copy of the certificate of
2884		-	birth of a homeless youth to such youth under this subsection.
2885		-	Sec. 72. Subsection (a) of section 1-1h of the general statutes is
2886		-	repealed and the following is substituted in lieu thereof (Effective July 1,
2887		-	2021):
2888		-	(a) Any person who does not possess a valid motor vehicle operator's
2889		-	license may apply to the Department of Motor Vehicles for an identity Substitute House Bill No. 6666
2890		-
2891		-	Public Act No. 21-121 88 of 132
2892		-
2893		-	card. The application for an identity card shall be accompanied by the
2894		-	birth certificate of the applicant or a certificate of identification of the
2895		-	applicant issued and authorized for such use by the Department of
2896		-	Correction and a fee of twenty-eight dollars. Such application shall
2897		-	include: (1) The applicant's name; (2) the applicant's address; (3)
2898		-	whether the address is permanent or temporary; (4) the applicant's date
2899		-	of birth; (5) notice to the applicant that false statements on such
2900		-	application are punishable under section 53a-157b; and (6) such other
2901		-	pertinent information as the Commissioner of Motor Vehicles deems
2902		-	necessary. The applicant shall sign the application in the presence of an
2903		-	official of the Department of Motor Vehicles. The commissioner may
2904		-	waive the fee for any applicant (A) who has voluntarily surrendered
2905		-	such applicant's motor vehicle operator's license, (B) whose license has
2906		-	been refused by the commissioner pursuant to subdivision (4) of
2907		-	subsection (e) of section 14-36, (C) who is both a veteran, as defined in
2908		-	subsection (a) of section 27-103, and blind, as defined in subsection (a)
2909		-	of section 1-1f, or (D) who is a resident of a homeless shelter or other
2910		-	facility for homeless persons or a certified homeless youth or certified
2911		-	homeless young adult. The commissioner shall adopt regulations, in
2912		-	accordance with the provisions of chapter 54, to establish the procedure
2913		-	and qualifications for the issuance of an identity card to any such
2914		-	homeless applicant. For the purposes of this subsection, "certified
2915		-	homeless youth" and "certified homeless young adult" have the same
2916		-	meanings as provided in section 7-36, as amended by this act.
2917		-	Sec. 73. Subsection (b) of section 20-265d of the general statutes is
2918		-	repealed and the following is substituted in lieu thereof (Effective July 1,
2919		-	2021):
2920		-	(b) On and after October 1, 2020, each person seeking an initial license
2921		-	as a nail technician shall apply to the department on a form prescribed
2922		-	by the department, accompanied by an application fee of one hundred
2923		-	dollars and evidence that the applicant (1) has completed a course of not Substitute House Bill No. 6666
2924		-
2925		-	Public Act No. 21-121 89 of 132
2926		-
2927		-	less than one hundred hours of study and received a certificate of
2928		-	completion from a school approved under section 20-265g or section 20-
2929		-	262 or in a school outside of the state whose requirements are equivalent
2930		-	to a school approved under section 20-265g, or (2) (A) if the applicant is
2931		-	applying on or before January 1, 2022, has practiced as a nail technician
2932		-	continuously in this state for a period of not less than two years prior to
2933		-	January 1, 2021, and is in compliance with the infection prevention and
2934		-	control plan guidelines prescribed by the department under section 19a-
2935		-	231 in the form of an attestation, or (B) has obtained a license as a nail
2936		-	technician trainee and a statement signed by the applicant's supervisor
2937		-	at the spa or salon where the licensed nail technician trainee is employed
2938		-	documenting completion of the minimum requirements specified in
2939		-	section 20-265e. If an applicant employed as a nail technician on or after
2940		-	September 30, 2020, does not have evidence satisfactory to the
2941		-	commissioner of continuous practice as a nail technician for not less than
2942		-	two years, such applicant may apply to the department for a nail
2943		-	technician trainee license, under section 20-265e, provided such person
2944		-	applies for an initial trainee license not later than January 1, 2021.
2945		-	Sec. 74. Subsection (b) of section 20-265c of the general statutes is
2946		-	repealed and the following is substituted in lieu thereof (Effective July 1,
2947		-	2021):
2948		-	(b) On and after January 1, 2020, each person seeking an initial license
2949		-	as an eyelash technician shall apply to the department on a form
2950		-	prescribed by the department, accompanied by an application fee of one
2951		-	hundred dollars and evidence that the applicant (1) has completed a
2952		-	course of not less than fifty hours of study and received a certificate of
2953		-	completion from a school approved under section 20-265g or section 20-
2954		-	262 or in a school outside of the state whose requirements are equivalent
2955		-	to a school approved under section 20-265g, or (2) (A) if the applicant is
2956		-	applying on or before January 1, 2022, has practiced as an eyelash
2957		-	technician continuously in this state for a period of not less than two Substitute House Bill No. 6666
2958		-
2959		-	Public Act No. 21-121 90 of 132
2960		-
2961		-	years prior to July 1, 2020, and (B) is in compliance with the infection
2962		-	prevention and control plan guidelines prescribed by the department
2963		-	under section 19a-231 in the form of an attestation.
2964		-	Sec. 75. Section 19a-55 of the general statutes is repealed and the
2965		-	following is substituted in lieu thereof (Effective from passage):
2966		-	(a) [The administrative officer or other person in charge of each
2967		-	institution caring for newborn infants shall cause to have administered
2968		-	to every such infant in its care an HIV-related test, as defined in section
2969		-	19a-581, a test for phenylketonuria and other metabolic diseases,
2970		-	hypothyroidism, galactosemia, sickle cell disease, maple syrup urine
2971		-	disease, homocystinuria, biotinidase deficiency, congenital adrenal
2972		-	hyperplasia, severe combined immunodeficiency disease,
2973		-	adrenoleukodystrophy and such other tests for inborn errors of
2974		-	metabolism as shall be prescribed by the Department of Public Health.
2975		-	The tests shall be administered as soon after birth as is medically
2976		-	appropriate. If the mother has had an HIV-related test pursuant to
2977		-	section 19a-90 or 19a-593, the person responsible for testing under this
2978		-	section may omit an HIV-related test.] There is established a newborn
2979		-	screening program. The Commissioner of Public Health shall (1)
2980		-	administer the newborn screening program, (2) direct persons identified
2981		-	through the screening program to appropriate specialty centers for
2982		-	treatments, consistent with any applicable confidentiality requirements,
2983		-	and (3) set the fees to be charged to institutions to cover all expenses of
2984		-	the comprehensive screening program including testing, tracking and
2985		-	treatment, subject to the approval of the Secretary of the Office of Policy
2986		-	and Management. The fees to be charged pursuant to subdivision (3) of
2987		-	this subsection shall be set at a minimum of ninety-eight dollars.
2988		-	(b) The administrative officer or other person in charge of each
2989		-	institution caring for newborn infants, a nurse-midwife licensed
2990		-	pursuant to chapter 377 or a midwife shall cause to have administered
2991		-	to every such newborn infant in his or her care a blood spot specimen Substitute House Bill No. 6666
2992		-
2993		-	Public Act No. 21-121 91 of 132
2994		-
2995		-	and an HIV-related test, as defined in section 19a-581, except that the
2996		-	person responsible for testing may omit such test if the mother has had
2997		-	an HIV-related test pursuant to section 19a-90 or 19a-593. The blood spot
2998		-	specimen shall be collected not earlier than twenty-four hours after the
2999		-	birth of the newborn infant and not later than forty-eight hours after the
3000		-	birth of such infant, unless the institution caring for newborn infants,
3001		-	nurse-midwife licensed pursuant to chapter 377 or midwife determines
3002		-	that a situation exists to warrant an early collection of the specimen or if
3003		-	collection of the specimen is medically contraindicated. Situations that
3004		-	warrant early collection of the specimen shall include, but not be limited
3005		-	to, the imminent transfusion of blood products, dialysis, early discharge
3006		-	of the newborn infant from the institution, transfer of the newborn
3007		-	infant to another institution or imminent death. If the newborn infant
3008		-	dies before a blood spot specimen can be obtained, the specimen shall
3009		-	be collected as soon as practicable after death. The institution licensed
3010		-	to care for newborn infants, nurse-midwife or midwife shall notify the
3011		-	Department of Public Health when a specimen is not collected within
3012		-	forty-eight hours after the birth of such infant due to: (1) The infant's
3013		-	medical fragility, (2) refusal by the parents when newborn infant
3014		-	screening is in conflict with their religious tenets and practice, (3) the
3015		-	newborn infant receiving comfort measures only, or (4) any other
3016		-	reason. Such notification shall be documented in the department's
3017		-	newborn screening system pursuant to section 19a-53 by the institution
3018		-	caring for newborn infants, nurse-midwife or midwife or sent in writing
3019		-	to the department not later than seventy-two hours after the birth of the
3020		-	newborn infant. The institution caring for newborn infants, nurse-
3021		-	midwife or midwife shall send the blood spot specimen to the state
3022		-	public health laboratory not later than twenty-four hours after the time
3023		-	of collection. The department may request an additional blood spot
3024		-	specimen if: (A) There was an early collection of the specimen, (B) the
3025		-	specimen was collected following a transfusion of blood products, (C)
3026		-	the specimen is unsatisfactory for testing, or (D) the department
3027		-	determines that there is an abnormal result. The state public health Substitute House Bill No. 6666
3028		-
3029		-	Public Act No. 21-121 92 of 132
3030		-
3031		-	laboratory shall make and maintain a record of the date and time of its
3032		-	receipt of each blood spot specimen and make such record available for
3033		-	inspection by the institution caring for newborn infants, nurse-midwife
3034		-	or midwife that sent the blood spot specimen not later than forty-eight
3035		-	hours after such institution, nurse-midwife or midwife submits a
3036		-	request to inspect such record.
3037		-	(c) The Commissioner of Public Health shall publish a list of all the
3038		-	abnormal conditions for which the department screens newborns under
3039		-	the newborn screening program, which shall include, [screening] but
3040		-	need not be limited to, testing for amino acid disorders, including
3041		-	phenylketonuria, organic acid disorders, fatty acid oxidation disorders,
3042		-	including, but not limited to, long-chain 3-hydroxyacyl CoA
3043		-	dehydrogenase (L-CHAD) and medium -chain acyl-CoA
3044		-	dehydrogenase (MCAD), hypothyroidism, galactosemia, sickle cell
3045		-	disease, maple syrup urine disease, homocystinuria, biotinidase
3046		-	deficiency, congenital adrenal hyperplasia, severe combined
3047		-	immunodeficiency disease, adrenoleukodystrophy, spinal muscular
3048		-	atrophy and [, subject to the approval of the Secretary of the Office of
3049		-	Policy and Management,] any other disorder included on the
3050		-	recommended uniform screening panel pursuant to 42 USC 300b-10, as
3051		-	amended from time to time, and as prescribed by the Commissioner of
3052		-	Public Health.
3053		-	[(b)] (d) In addition to the testing requirements prescribed in
3054		-	subsection [(a)] (b) of this section, the administrative officer or other
3055		-	person in charge of each institution caring for newborn infants shall
3056		-	cause to have administered to (1) every such infant in its care a screening
3057		-	test for (A) cystic fibrosis, and (B) critical congenital heart disease, [and
3058		-	(C) on and after January 1, 2020, spinal muscular atrophy, and] (2) any
3059		-	newborn infant who fails a newborn hearing screening, as described in
3060		-	section 19a-59, a screening test for cytomegalovirus. [, provided such
3061		-	screening test shall be administered within available appropriations. Substitute House Bill No. 6666
3062		-
3063		-	Public Act No. 21-121 93 of 132
3064		-
3065		-	The administrative officer or other person in charge of each institution
3066		-	caring for newborn infants who performs the testing for critical
3067		-	congenital heart disease shall enter the results of such test into the
3068		-	newborn screening system pursuant to section 19a-53.] Such screening
3069		-	tests shall be administered as soon after birth as is medically
3070		-	appropriate.
3071		-	(e) (1) The clinical laboratory that completes the testing for cystic
3072		-	fibrosis, shall report the number of newborn infants screened and the
3073		-	results of such testing, not less than annually, to the Department of
3074		-	Public Health into the newborn screening system pursuant to section
3075		-	19a-53. The administrative officer or other person in charge of each
3076		-	institution caring for newborn infants who performs the testing for
3077		-	critical congenital heart disease shall enter the results of such test into
3078		-	the newborn screening system pursuant to section 19a-53.
3079		-	[(c)] (2) The administrative officer or other person in charge of each
3080		-	institution caring for newborn infants shall [report] enter any case of
3081		-	cytomegalovirus that is confirmed as a result of a screening test
3082		-	administered pursuant to subdivision (2) of subsection [(b)] (d) of this
3083		-	section to the Department of Public Health [in a form and manner
3084		-	prescribed by the Commissioner of Public Health] into the newborn
3085		-	screening system pursuant to section 19a-53. The provisions of this
3086		-	subsection shall apply regardless of the patient's insurance status or
3087		-	source of payment, including self-pay status.
3088		-	[(d)] (f) The provisions of this section shall not apply to any infant
3089		-	whose parents object to the test or treatment as being in conflict with
3090		-	their religious tenets and practice. The commissioner shall adopt
3091		-	regulations, in accordance with the provisions of chapter 54, to
3092		-	implement the provisions of this section.
3093		-	Sec. 76. Subdivision (10) of section 7-36 of the general statutes is
3094		-	repealed and the following is substituted in lieu thereof (Effective October Substitute House Bill No. 6666
3095		-
3096		-	Public Act No. 21-121 94 of 132
3097		-
3098		-	1, 2021):
3099		-	(10) "Amendment" means to (A) change or enter new information on
3100		-	a certificate of birth, marriage, death or fetal death, more than one year
3101		-	after the date of the vital event recorded in such certificate, in order to
3102		-	accurately reflect the facts existing at the time of the recording of the
3103		-	event, (B) create a replacement certificate of birth for matters pertaining
3104		-	to parentage and gender change, [or] (C) create a replacement certificate
3105		-	of marriage for matters pertaining to gender change, or (D) reflect a legal
3106		-	name change in accordance with section 19a-42, as amended by this act,
3107		-	or make a modification to a cause of death;
3108		-	Sec. 77. Section 19a-42 of the general statutes is repealed and the
3109		-	following is substituted in lieu thereof (Effective October 1, 2021):
3110		-	(a) To protect the integrity and accuracy of vital records, a certificate
3111		-	registered under chapter 93 may be amended only in accordance with
3112		-	sections 19a-41 to 19a-45, inclusive, chapter 93, regulations adopted by
3113		-	the Commissioner of Public Health pursuant to chapter 54 and uniform
3114		-	procedures prescribed by the commissioner. Only the commissioner
3115		-	may amend birth certificates to reflect changes concerning parentage or
3116		-	birth or marriage certificates to reflect changes concerning gender
3117		-	change. Amendments related to parentage or gender change shall result
3118		-	in the creation of a replacement certificate that supersedes the original,
3119		-	and shall in no way reveal the original language changed by the
3120		-	amendment. Any amendment to a vital record made by the registrar of
3121		-	vital statistics of the town in which the vital event occurred or by the
3122		-	commissioner shall be in accordance with such regulations and uniform
3123		-	procedures.
3124		-	(b) The commissioner and the registrar of vital statistics shall
3125		-	maintain sufficient documentation, as prescribed by the commissioner,
3126		-	to support amendments and shall ensure the confidentiality of such
3127		-	documentation as required by law. The date of amendment and a Substitute House Bill No. 6666
3128		-
3129		-	Public Act No. 21-121 95 of 132
3130		-
3131		-	summary description of the evidence submitted in support of the
3132		-	amendment shall be endorsed on or made part of the record and the
3133		-	original certificate shall be marked "Amended", except for amendments
3134		-	due to parentage or gender change. When the registrar of the town in
3135		-	which the vital event occurred amends a certificate, such registrar shall,
3136		-	within ten days of making such amendment, forward an amended
3137		-	certificate to the commissioner and to any registrar having a copy of the
3138		-	certificate. When the commissioner amends a birth certificate, including
3139		-	changes due to parentage or gender, the commissioner shall forward an
3140		-	amended certificate to the registrars of vital statistics affected and their
3141		-	records shall be amended accordingly.
3142		-	(c) An amended certificate shall supersede the original certificate that
3143		-	has been changed and shall be marked "Amended", except for
3144		-	amendments due to parentage or gender change. The original certificate
3145		-	in the case of parentage or gender change shall be physically or
3146		-	electronically sealed and kept in a confidential file by the department
3147		-	and the registrar of any town in which the birth was recorded, and may
3148		-	be unsealed for issuance only as provided in section 7-53 with regard to
3149		-	an original birth certificate or upon a written order of a court of
3150		-	competent jurisdiction. The amended certificate shall become the official
3151		-	record.
3152		-	(d) (1) Upon receipt of (A) an acknowledgment of paternity executed
3153		-	in accordance with the provisions of subsection (a) of section 46b-172 by
3154		-	both parents of a child born out of wedlock, or (B) a certified copy of an
3155		-	order of a court of competent jurisdiction establishing the paternity of a
3156		-	child born out of wedlock, the commissioner shall include on or amend,
3157		-	as appropriate, such child's birth certificate to show such paternity if
3158		-	paternity is not already shown on such birth certificate and to change
3159		-	the name of the child under eighteen years of age if so indicated on the
3160		-	acknowledgment of paternity form or within the certified court order as
3161		-	part of the paternity action. If a person who is the subject of a voluntary Substitute House Bill No. 6666
3162		-
3163		-	Public Act No. 21-121 96 of 132
3164		-
3165		-	acknowledgment of paternity, as described in this subdivision, is
3166		-	eighteen years of age or older, the commissioner shall obtain a notarized
3167		-	affidavit from such person affirming that he or she agrees to the
3168		-	commissioner's amendment of such person's birth certificate as such
3169		-	amendment relates to the acknowledgment of paternity. The
3170		-	commissioner shall amend the birth certificate for an adult child to
3171		-	change his or her name only pursuant to a court order.
3172		-	(2) If another father is listed on the birth certificate, the commissioner
3173		-	shall not remove or replace the father's information unless presented
3174		-	with a certified court order that meets the requirements specified in
3175		-	section 7-50, or upon the proper filing of a rescission, in accordance with
3176		-	the provisions of section 46b-172. The commissioner shall thereafter
3177		-	amend such child's birth certificate to remove or change the father's
3178		-	name and to change the name of the child, as requested at the time of
3179		-	the filing of a rescission, in accordance with the provisions of section
3180		-	46b-172. Birth certificates amended under this subsection shall not be
3181		-	marked "Amended".
3182		-	(e) When the parent or parents of a child request the amendment of
3183		-	the child's birth certificate to reflect a new mother's name because the
3184		-	name on the original certificate is fictitious, such parent or parents shall
3185		-	obtain an order of a court of competent jurisdiction declaring the
3186		-	putative mother to be the child's mother. Upon receipt of a certified copy
3187		-	of such order, the department shall amend the child's birth certificate to
3188		-	reflect the mother's true name.
3189		-	(f) Upon receipt of a certified copy of an order of a court of competent
3190		-	jurisdiction changing the name of a person born in this state and upon
3191		-	request of such person or such person's parents, guardian, or legal
3192		-	representative, the commissioner or the registrar of vital statistics of the
3193		-	town in which the vital event occurred shall amend the birth certificate
3194		-	to show the new name by a method prescribed by the department. Substitute House Bill No. 6666
3195		-
3196		-	Public Act No. 21-121 97 of 132
3197		-
3198		-	(g) When an applicant submits the documentation required by the
3199		-	regulations to amend a vital record, the commissioner shall hold a
3200		-	hearing, in accordance with chapter 54, if the commissioner has
3201		-	reasonable cause to doubt the validity or adequacy of such
3202		-	documentation.
3203		-	(h) When an amendment under this section involves the changing of
3204		-	existing language on a death certificate due to an error pertaining to the
3205		-	cause of death, the death certificate shall be amended in such a manner
3206		-	that the original language is still visible. A copy of the death certificate
3207		-	shall be made. The original death certificate shall be sealed and kept in
3208		-	a confidential file at the department and only the commissioner may
3209		-	order it unsealed. The copy shall be amended in such a manner that the
3210		-	language to be changed is no longer visible. The copy shall be a public
3211		-	document.
3212		-	(i) The commissioner shall issue a new birth certificate to reflect a
3213		-	gender change upon receipt of the following documents submitted in
3214		-	the form and manner prescribed by the commissioner: (1) A written
3215		-	request from the applicant, signed under penalty of law, for a
3216		-	replacement birth certificate to reflect that the applicant's gender differs
3217		-	from the sex designated on the original birth certificate; (2) a notarized
3218		-	affidavit by a physician licensed pursuant to chapter 370 or holding a
3219		-	current license in good standing in another state, a physician assistant
3220		-	licensed pursuant to chapter 370 or holding a current license in good
3221		-	standing in another state, an advanced practice registered nurse
3222		-	licensed pursuant to chapter 378 or holding a current license in good
3223		-	standing in another state, or a psychologist licensed pursuant to chapter
3224		-	383 or holding a current license in good standing in another state, stating
3225		-	that the applicant has undergone surgical, hormonal or other treatment
3226		-	clinically appropriate for the applicant for the purpose of gender
3227		-	transition; and (3) if an applicant is also requesting a change of name
3228		-	listed on the original birth certificate, proof of a legal name change. The Substitute House Bill No. 6666
3229		-
3230		-	Public Act No. 21-121 98 of 132
3231		-
3232		-	new birth certificate shall reflect the new gender identity by way of a
3233		-	change in the sex designation on the original birth certificate and, if
3234		-	applicable, the legal name change.
3235		-	(j) The commissioner shall issue a new marriage certificate to reflect
3236		-	a gender change upon receipt of the following documents, submitted in
3237		-	a form and manner prescribed by the commissioner: (1) A written
3238		-	request from the applicant, signed under penalty of law, for a
3239		-	replacement marriage certificate to reflect that the applicant's gender
3240		-	differs from the sex designated on the original marriage certificate,
3241		-	along with an affirmation that the marriage is still legally intact; (2) a
3242		-	notarized statement from the spouse named on the marriage certificate
3243		-	to be amended, consenting to the amendment; (3) (A) a United States
3244		-	passport or amended birth certificate or court order reflecting the
3245		-	applicant's gender as of the date of the request or (B) a notarized
3246		-	affidavit by a physician licensed pursuant to chapter 370 or holding a
3247		-	current license in good standing in another state, physician assistant
3248		-	licensed pursuant to chapter 370 or holding a current license in good
3249		-	standing in another state, an advanced practice registered nurse
3250		-	licensed pursuant to chapter 378 or holding a current license in good
3251		-	standing in another state or a psychologist licensed pursuant to chapter
3252		-	383 or holding a current license in good standing in another state stating
3253		-	that the applicant has undergone surgical, hormonal or other treatment
3254		-	clinically appropriate for the applicant for the purpose of gender
3255		-	transition; and (4) if an applicant is also requesting a change of name
3256		-	listed on the original marriage certificate, proof of a legal name change.
3257		-	The new marriage certificate shall reflect the new gender identity by
3258		-	way of a change in the sex designation on the original marriage
3259		-	certificate and, if applicable, the legal name change.
3260		-	Sec. 78. Section 19a-215 of the general statutes is repealed and the
3261		-	following is substituted in lieu thereof (Effective October 1, 2021):
3262		-	(a) For the purposes of this section: Substitute House Bill No. 6666
3263		-
3264		-	Public Act No. 21-121 99 of 132
3265		-
3266		-	(1) "Clinical laboratory" means any facility or other area used for
3267		-	microbiological, serological, chemical, hematological,
3268		-	immunohematological, biophysical, cytological, pathological or other
3269		-	examinations of human body fluids, secretions, excretions or excised or
3270		-	exfoliated tissues, for the purpose of providing information for the
3271		-	diagnosis, prevention or treatment of any human disease or
3272		-	impairment, for the assessment of human health or for the presence of
3273		-	drugs, poisons or other toxicological substances.
3274		-	(2) "Commissioner's list of reportable diseases, emergency illnesses
3275		-	and health conditions" and "commissioner's list of reportable laboratory
3276		-	findings" means the lists developed pursuant to section 19a-2a.
3277		-	(3) "Confidential" means confidentiality of information pursuant to
3278		-	section 19a-25.
3279		-	(4) "Health care provider" means a person who has direct or
3280		-	supervisory responsibility for the delivery of health care or medical
3281		-	services, including licensed physicians, nurse practitioners, nurse
3282		-	midwives, physician assistants, nurses, dentists, medical examiners and
3283		-	administrators, superintendents and managers of health care facilities.
3284		-	(5) "Reportable diseases, emergency illnesses and health conditions"
3285		-	means the diseases, illnesses, conditions or syndromes designated by
3286		-	the Commissioner of Public Health on the list required pursuant to
3287		-	section 19a-2a.
3288		-	(b) A health care provider shall report each case occurring in such
3289		-	provider's practice, of any disease on the commissioner's list of
3290		-	reportable diseases, emergency illnesses and health conditions to the
3291		-	director of health of the town, city or borough in which such case resides
3292		-	and to the Department of Public Health, no later than twelve hours after
3293		-	such provider's recognition of the disease. Such reports shall be in
3294		-	writing, by telephone or in an electronic format approved by the Substitute House Bill No. 6666
3295		-
3296		-	Public Act No. 21-121 100 of 132
3297		-
3298		-	commissioner. [Such reports of disease shall be confidential and not
3299		-	open to public inspection except as provided for in section 19a-25.]
3300		-	(c) A clinical laboratory shall report each finding identified by such
3301		-	laboratory of any disease identified on the commissioner's list of
3302		-	reportable laboratory findings to the Department of Public Health not
3303		-	later than forty-eight hours after such laboratory's finding. A clinical
3304		-	laboratory that reports an average of more than thirty findings per
3305		-	month shall make such reports electronically in a format approved by
3306		-	the commissioner. Any clinical laboratory that reports an average of less
3307		-	than thirty findings per month shall submit such reports, in writing, by
3308		-	telephone or in an electronic format approved by the commissioner. [All
3309		-	such reports shall be confidential and not open to public inspection
3310		-	except as provided for in section 19a-25.] The Department of Public
3311		-	Health shall provide a copy of all such reports to the director of health
3312		-	of the town, city or borough in which the affected person resides or, in
3313		-	the absence of such information, the town where the specimen
3314		-	originated.
3315		-	(d) When a local director of health, the local director's authorized
3316		-	agent or the Department of Public Health receives a report of a disease
3317		-	or laboratory finding on the commissioner's lists of reportable diseases,
3318		-	emergency illnesses and health conditions and laboratory findings, the
3319		-	local director of health, the local director's authorized agent or the
3320		-	Department of Public Health may contact first the reporting health care
3321		-	provider and then the person with the reportable finding to obtain such
3322		-	information as may be necessary to lead to the effective control of
3323		-	further spread of such disease. In the case of reportable communicable
3324		-	diseases and laboratory findings, this information may include
3325		-	obtaining the identification of persons who may be the source or
3326		-	subsequent contacts of such infection.
3327		-	(e) A hospital, as defined in section 19a-490 and licensed pursuant to
3328		-	chapter 368v, shall provide the Department of Public Health with access, Substitute House Bill No. 6666
3329		-
3330		-	Public Act No. 21-121 101 of 132
3331		-
3332		-	including remote access, in a manner approved by the Commissioner of
3333		-	Public Health, to the entirety of each electronic medical record that
3334		-	concerns a reportable disease, emergency illness or health condition
3335		-	listed by the commissioner pursuant to subdivision (9) of section 19a-2a
3336		-	that occurs at such hospital. Such remote access shall take place on or
3337		-	before October 1, 2022, if technically feasible.
3338		-	[(e)] (f) All personal information obtained from disease prevention
3339		-	and control investigations [as performed in subsections (c) and (d) of]
3340		-	pursuant to this section including the health care provider's name and
3341		-	the identity of the reported case of disease and suspected source persons
3342		-	and contacts shall not be divulged to anyone and shall be held strictly
3343		-	confidential pursuant to section 19a-25, by the local director of health
3344		-	and the director's authorized agent and by the Department of Public
3345		-	Health.
3346		-	[(f)] (g) Any person who violates any reporting or confidentiality
3347		-	provision of this section shall be fined not more than five hundred
3348		-	dollars. No provision of this section shall be deemed to supersede
3349		-	section 19a-584.
3350		-	Sec. 79. Subsection (c) of section 19a-72 of the general statutes is
3351		-	repealed and the following is substituted in lieu thereof (Effective October
3352		-	1, 2021):
3353		-	(c) [The] (1) A health care provider shall provide the Department of
3354		-	Public Health, [shall be provided such] at the request of the department,
3355		-	access to the clinical records of any [health care provider] patient, as the
3356		-	department deems necessary, to perform case finding or other quality
3357		-	improvement audits to ensure completeness of reporting and data
3358		-	accuracy consistent with the purposes of this section.
3359		-	(2) A hospital shall provide the Department of Public Health with
3360		-	access, including remote access, to the entirety of a patient's medical Substitute House Bill No. 6666
3361		-
3362		-	Public Act No. 21-121 102 of 132
3363		-
3364		-	record, as the department deems necessary, to perform case finding or
3365		-	other quality improvement audits to ensure completeness of reporting
3366		-	and data accuracy consistent with the purposes of this section. Such
3367		-	remote access shall be provided on or before October 1, 2022, if
3368		-	technically feasible. The department shall not divulge any personal
3369		-	information obtained from the medical record to anyone and shall hold
3370		-	any such personal information strictly confidential pursuant to section
3371		-	19a-25.
3372		-	Sec. 80. (NEW) (Effective October 1, 2021) A hospital shall provide the
3373		-	Department of Public Health with access, including remote access, to
3374		-	the entirety of a patient's medical record, as the department deems
3375		-	necessary, to perform quality improvement audits to ensure
3376		-	completeness of reporting and data accuracy of birth, fetal death and
3377		-	death occurrences. Such remote access shall take place on or before
3378		-	October 1, 2022, if technically feasible. No personal information
3379		-	obtained from the medical record shall be divulged to anyone and shall
3380		-	be held strictly confidential pursuant to section 19a-25 of the general
3381		-	statutes by the Department of Public Health.
3382		-	Sec. 81. Section 19a-59h of the general statutes is repealed and the
3383		-	following is substituted in lieu thereof (Effective October 1, 2021):
3384		-	(a) As used in this section and section 19a-59i, "maternal death"
3385		-	means the death of a woman while pregnant or not later than one year
3386		-	after the date on which the woman ceases to be pregnant, regardless of
3387		-	whether the woman's death is related to her pregnancy, and
3388		-	"department" means the Department of Public Health.
3389		-	(b) There is established, within the department, a maternal mortality
3390		-	review program. The program shall be responsible for identifying
3391		-	maternal death cases in Connecticut and reviewing medical records and
3392		-	other relevant data related to each maternal death case, including, but
3393		-	not limited to, information collected from death and birth records, files Substitute House Bill No. 6666
3394		-
3395		-	Public Act No. 21-121 103 of 132
3396		-
3397		-	from the Office of the Chief Medical Examiner, and physician office and
3398		-	hospital records.
3399		-	(c) Licensed health care providers, health care facilities and
3400		-	pharmacies shall provide the maternal mortality review program,
3401		-	established under this section with reasonable access to all relevant
3402		-	medical records associated with a maternal death case under review by
3403		-	the program.
3404		-	(d) A hospital shall provide the department with access, including
3405		-	remote access, to the entirety of a patient's medical record, as the
3406		-	department deems necessary, to review case information related to a
3407		-	maternal death case under review by the program. Such remote access
3408		-	shall be provided on or before October 1, 2022, if technically feasible. All
3409		-	personal information obtained from the medical record shall not be
3410		-	divulged to anyone and shall be held strictly confidential pursuant to
3411		-	section 19a-25 by the department.
3412		-	[(d)] (e) All information obtained by the department for the maternal
3413		-	mortality review program shall be confidential pursuant to section 19a-
3414		-	25.
3415		-	[(e)] (f) Notwithstanding subsection [(d)] (e) of this section, the
3416		-	department may provide the maternal mortality review committee,
3417		-	established pursuant to section 19a-59i, with information as is necessary,
3418		-	in the department's discretion, for the committee to make
3419		-	recommendations regarding the prevention of maternal death.
3420		-	Sec. 82. (NEW) (Effective October 1, 2021) (a) As used in this section:
3421		-	(1) "Bottled water" has the same meaning as defined in section 21a-
3422		-	150 of the general statutes;
3423		-	(2) "Commissioner" means the Commissioner of Public Health, or his
3424		-	or her designee; Substitute House Bill No. 6666
3425		-
3426		-	Public Act No. 21-121 104 of 132
3427		-
3428		-	(3) "Department" means the Department of Public Health;
3429		-	(4) "Fill station" means a location at which customers of a water
3430		-	company may obtain potable water;
3431		-	(5) "Small community water system" has the same meaning as
3432		-	provided in section 19a-37e of the general statutes; and
3433		-	(6) "Water company" has the same meaning as provided in section 25-
3434		-	32a of the general statutes.
3435		-	(b) A water company shall update its emergency contingency plan
3436		-	prepared pursuant to section 25-32d of the general statutes and section
3437		-	25-32d-3 of the regulations of Connecticut state agencies, to include
3438		-	information regarding the provision of alternative sources of potable
3439		-	water for human consumption that can be utilized as a temporary
3440		-	measure when there is a water supply emergency. Such plan shall
3441		-	identify alternative sources of potable water for possible use at various
3442		-	stages of an emergency, including, but not limited to, bulk water
3443		-	provided by a bulk water hauler licensed pursuant to section 20-278h of
3444		-	the general statutes, bottled water, a fill station, interconnection or
3445		-	agreement with a nearby public water system for supplemental water
3446		-	supplies in the event of an emergency, other approved public water
3447		-	supply source or mechanism for providing water identified in the
3448		-	emergency contingency plan, or as otherwise approved by the
3449		-	commissioner. The commissioner, in consultation with water
3450		-	companies, shall prepare materials and provide guidance to such water
3451		-	companies to implement the provisions of this subsection. Nothing in
3452		-	this section shall prevent a water company from providing an
3453		-	alternative source of potable water for an event lasting less than twelve
3454		-	hours that may adversely impact the quality or quantity of potable
3455		-	water supplies. As used in this subsection, "water supply emergency"
3456		-	means any event lasting more than twelve consecutive hours that results
3457		-	in the water supplied from the water company to residents that is not in Substitute House Bill No. 6666
3458		-
3459		-	Public Act No. 21-121 105 of 132
3460		-
3461		-	compliance with the regulations of Connecticut state agencies
3462		-	concerning the purity and adequacy of drinking water.
3463		-	(c) A small community water system shall update its emergency
3464		-	response plan required pursuant to section 19-13-B102 of the regulations
3465		-	of Connecticut state agencies to include information regarding the
3466		-	provision of alternative sources of potable water for human
3467		-	consumption that can be utilized as a temporary measure when there is
3468		-	a water supply emergency. Such plan shall identify alternative sources
3469		-	of potable water for possible use at various stages of an emergency,
3470		-	including, but not limited to, bulk water provided by a bulk water
3471		-	hauler licensed pursuant to section 20-278h of the general statutes,
3472		-	bottled water, a fill station, interconnection or agreement with a nearby
3473		-	public water system for supplemental water supplies in the event of an
3474		-	emergency, or other approved public water supply source or
3475		-	mechanism for providing water identified in the emergency
3476		-	contingency plan. The commissioner, in consultation with small
3477		-	community water systems, shall prepare materials and provide
3478		-	guidance to such water systems to implement the provisions of this
3479		-	section. Nothing in this section shall prevent a small community water
3480		-	system from providing an alternative source of potable water for an
3481		-	event lasting less than twelve hours that may adversely impact the
3482		-	quality or quantity of potable water supplies. As used in this subsection,
3483		-	"water supply emergency" means any event lasting more than twelve
3484		-	consecutive hours that results in the water supplied from the small
3485		-	community water system to residents that is not in compliance with the
3486		-	regulations of Connecticut state agencies concerning the purity and
3487		-	adequacy of drinking water.
3488		-	Sec. 83. (NEW) (Effective October 1, 2021) A water company shall
3489		-	provide tier 1 notices to its consumers in the languages predominantly
3490		-	spoken by the consumers in the water company's service area. A water
3491		-	company shall update its emergency response plan prepared pursuant Substitute House Bill No. 6666
3492		-
3493		-	Public Act No. 21-121 106 of 132
3494		-
3495		-	to section 25-32d of the general statutes or pursuant to section 19-13-
3496		-	B102 of the regulations of Connecticut state agencies to include
3497		-	information regarding the provision of such multilingual
3498		-	communications. As used in this section, "water company" has the same
3499		-	meaning as provided in section 25-32a of the general statutes and "tier 1
3500		-	notices" has the same meaning as provided in section 19-13-B102 of the
3501		-	regulations of Connecticut state agencies.
3502		-	Sec. 84. (NEW) (Effective October 1, 2021) In the event that the
3503		-	Governor declares a state of civil preparedness emergency pursuant to
3504		-	section 28-9 of the general statutes, or a public health emergency,
3505		-	pursuant to section 19a-131 of the general statutes, each community
3506		-	water system shall report the community water system's operational
3507		-	status to WebEOC as soon as practicable, but not later than eight hours
3508		-	after the time reporting on WebEOC is made available regarding such
3509		-	declaration, and at any time thereafter that the status of such system
3510		-	significantly changes. As used in this section, "community water
3511		-	system" means a public water system that serves at least twenty-five
3512		-	residents, and "WebEOC" means a web-based emergency management
3513		-	information system used by the state to document routine and
3514		-	emergency events or incidents and provide a real-time common
3515		-	operating picture and resource request management tool for emergency
3516		-	managers at the local and state levels during exercises, drills, local or
3517		-	regional emergencies or state-wide emergencies.
3518		-	Sec. 85. (NEW) (Effective October 1, 2021) (a) As used in this section:
3519		-	(1) "Consumer" has the same meaning as provided in section 25-32a
3520		-	of the general statutes;
3521		-	(2) "Owner" means the person or entity that owns or controls the
3522		-	small community water system; and
3523		-	(3) "Small community water system" has the same meaning as Substitute House Bill No. 6666
3524		-
3525		-	Public Act No. 21-121 107 of 132
3526		-
3527		-	provided in section 19a-37e of the general statutes.
3528		-	(b) Not later than January 1, 2025, each owner of a small community
3529		-	water system shall complete a small community water system capacity
3530		-	implementation plan on a form prescribed by the Department of Public
3531		-	Health demonstrating that such owner has the managerial, technical
3532		-	and financial capacity to continue to own and operate such system and
3533		-	shall implement such plan. Following the completion of the initial small
3534		-	community water system capacity implementation plan, each small
3535		-	community water system shall update such small community water
3536		-	system capacity implementation plan annually and make such small
3537		-	community water system capacity implementation plan available to the
3538		-	department upon request. Such plan shall include:
3539		-	(1) A description of the small community water system, including the
3540		-	number of consumers and persons served and sources of drinking
3541		-	water;
3542		-	(2) Ownership and management information, including the type of
3543		-	ownership structure and the current names, addresses and telephone
3544		-	numbers of the owners, certified operators and emergency contact
3545		-	persons for the small community water system;
3546		-	(3) Service area maps;
3547		-	(4) Facilities maps, including the location of and specific information
3548		-	regarding sources, storage facilities, treatment facilities, pressure zones,
3549		-	booster pumps, hydrants, distribution lines, valves and sampling
3550		-	points;
3551		-	(5) A description of such system's cross-connection control program;
3552		-	(6) A description of such system's source water protection program;
3553		-	(7) A copy of such system's emergency response plan required Substitute House Bill No. 6666
3554		-
3555		-	Public Act No. 21-121 108 of 132
3556		-
3557		-	pursuant to section 19-13-B102 of the regulations of Connecticut state
3558		-	agencies;
3559		-	(8) A capital improvement program, including the schedule that
3560		-	identifies all capital improvements scheduled for a five-year planning
3561		-	period and capital improvements or major projects scheduled for a
3562		-	twenty-year planning period;
3563		-	(9) Water production and consumption information;
3564		-	(10) Information regarding public water systems that are nearby,
3565		-	including the distance from the small community water system and type
3566		-	of public water system, if any. Such information shall be based on the
3567		-	coordinated water system plan approved by the Commissioner of
3568		-	Public Health pursuant to section 25-33h of the general statutes for the
3569		-	water utility coordinating committee in which such small community
3570		-	water system is located; and
3571		-	(11) Financial capacity information, including:
3572		-	(A) An evaluation of the small community water system's fiscal and
3573		-	assessment management plan prepared pursuant to section 19a-37e of
3574		-	the general statutes;
3575		-	(B) A summary of the income and expenses for the five years
3576		-	preceding the date of submission of the plan;
3577		-	(C) A five-year balanced operation budget;
3578		-	(D) Water rate structure and fees charged, including information
3579		-	regarding how such rates and fees are updated and whether such rates
3580		-	and fees are sufficient to maintain cash flow stability and to fund the
3581		-	capital improvement program, as well as any emergency
3582		-	improvements; and
3583		-	(E) An evaluation that has considered the affordability of water rates. Substitute House Bill No. 6666
3584		-
3585		-	Public Act No. 21-121 109 of 132
3586		-
3587		-	(c) On or before July 1, 2025, and annually thereafter, the small
3588		-	community water system shall provide a summary of its small
3589		-	community water system capacity plan in the small community water
3590		-	system's consumer confidence report required by section 19-13-B102 of
3591		-	the regulations of Connecticut state agencies.
3592		-	(d) The provisions of this section shall not apply to a small
3593		-	community water system that is (1) regulated by the Public Utilities
3594		-	Regulatory Authority, (2) subject to the requirements set forth in section
3595		-	25-32d of the general statutes, or (3) a state agency.
3596		-	(e) The provisions of this section shall be deemed to relate to the
3597		-	purity and adequacy of water supplies for the purposes of the
3598		-	imposition of a penalty under section 25-32e of the general statutes.
3599		-	(f) The commissioner may adopt regulations, in accordance with the
3600		-	provisions of chapter 54 of the general statutes, to carry out the
3601		-	provisions of this section.
3602		-	Sec. 86. Section 21a-150b of the general statutes is repealed and the
3603		-	following is substituted in lieu thereof (Effective October 1, 2021):
3604		-	(a) Qualified employees of a bottler shall collect samples of water
3605		-	from each approved source used by such bottler not less than once
3606		-	annually to test for contaminants for which allowable levels have been
3607		-	established in accordance with 21 CFR 165.110 and regulations adopted
3608		-	pursuant to sections 21a-150 to 21a-150j, inclusive, and not less than
3609		-	once every three years to test for contaminants for which monitoring is
3610		-	required pursuant to sections 21a-150 to 21a-150j, inclusive, but for
3611		-	which no allowable level has been established. Qualified employees of
3612		-	an approved laboratory shall analyze such samples to determine
3613		-	whether such source complies with the provisions of sections 21a-150 to
3614		-	21a-150j, inclusive, any regulation adopted pursuant to said sections
3615		-	and any allowable contaminant level set forth in 21 CFR 165.110. Substitute House Bill No. 6666
3616		-
3617		-	Public Act No. 21-121 110 of 132
3618		-
3619		-	Microbiological analysis shall be conducted not less than once each
3620		-	calendar quarter if the source of such water is other than a public water
3621		-	supply and shall be in addition to any sampling and analysis conducted
3622		-	by any government agency or laboratory.
3623		-	(b) Qualified employees of a bottler shall collect samples of water
3624		-	from any source used by such bottler when such bottler knows or has
3625		-	reason to believe that water obtained from such source contains an
3626		-	unregulated contaminant in an amount which may adversely affect the
3627		-	health or welfare of the public. Qualified employees of an approved
3628		-	laboratory shall analyze such samples periodically to determine
3629		-	whether water obtained from any such source is safe for public
3630		-	consumption or use.
3631		-	(c) On or before January 1, 2022, and annually thereafter, qualified
3632		-	employees of a bottler shall (1) collect samples of water from each
3633		-	approved source that is located in the state, that has been inspected and
3634		-	approved by the Department of Public Health pursuant to subdivision
3635		-	(2) of subsection (a) of section 21a-150a and is used by such bottler, prior
3636		-	to any treatment, to test for perfluoroalkyl substances and other
3637		-	unregulated contaminants, and (2) have such samples analyzed by an
3638		-	environmental laboratory registered by the Department of Public
3639		-	Health pursuant to section 19a-29a that has the Environmental
3640		-	Protection Agency approved certification to conduct such analysis. As
3641		-	used in this subsection, "unregulated contaminant" means a
3642		-	contaminant for which the Commissioner of Public Health, pursuant to
3643		-	section 22a-471, has set a level at which such contaminant creates or can
3644		-	reasonably be expected to create an unacceptable risk of injury to the
3645		-	health or safety of persons drinking such source of water.
3646		-	Sec. 87. Section 21a-150d of the general statutes is repealed and the
3647		-	following is substituted in lieu thereof (Effective October 1, 2021):
3648		-	(a) A laboratory which analyzes any water sample in accordance with Substitute House Bill No. 6666
3649		-
3650		-	Public Act No. 21-121 111 of 132
3651		-
3652		-	any provision of sections 21a-150 to 21a-150j, inclusive, shall report the
3653		-	results of such analysis to the bottler of such water.
3654		-	(b) Such results shall be available for inspection by the Department
3655		-	of Consumer Protection.
3656		-	(c) A bottler shall report any result which indicates that a water
3657		-	sample contains contaminants in an amount exceeding any applicable
3658		-	standard to the Department of Consumer Protection not later than
3659		-	twenty-four hours after learning of such result.
3660		-	(d) A bottler shall report the results of the analysis conducted
3661		-	pursuant to subsection (c) of section 21a-150b, as amended by this act,
3662		-	to the Department of Public Health and the Department of Consumer
3663		-	Protection not later than nine calendar days after receipt of the results
3664		-	from the environmental laboratory. If such results exceed the level set
3665		-	by the Commissioner of Public Health pursuant to section 22a-471 for
3666		-	such perfluoroalkyl substances and other unregulated contaminants,
3667		-	the Department of Public Health may require such bottler to discontinue
3668		-	use of its approved source until such source no longer creates an
3669		-	unacceptable risk of injury to the health or safety of persons drinking
3670		-	the bottled water that comes from such source. The Department of
3671		-	Public Health shall notify the Department of Consumer Protection of
3672		-	any source for which the Department of Public Health has discontinued
3673		-	use until such source no longer creates an unacceptable risk of injury to
3674		-	the health or safety of the persons drinking the bottled water that comes
3675		-	from such source. As used in this subsection, "unregulated
3676		-	contaminant" means a contaminant for which the Commissioner of
3677		-	Public Health, pursuant to section 22a-471, has set a level at which such
3678		-	contaminant creates or can reasonably be expected to create an
3679		-	unacceptable risk of injury to the health or safety of the persons drinking
3680		-	such source of water.
3681		-	[(d)] (e) All records of any sampling or analysis conducted in Substitute House Bill No. 6666
3682		-
3683		-	Public Act No. 21-121 112 of 132
3684		-
3685		-	accordance with the provisions of sections 21a-150 to 21a-150j, inclusive,
3686		-	shall be maintained on the premises of the bottler for not less than five
3687		-	years.
3688		-	Sec. 88. Section 25-40a of the general statutes is repealed and the
3689		-	following is substituted in lieu thereof (Effective October 1, 2021):
3690		-	(a) Not later than twenty-four hours after obtaining a public water
3691		-	system test result that shows a contaminant at a level that is in violation
3692		-	of the federal Environmental Protection Agency national primary
3693		-	drinking water standards for a public water system that does not submit
3694		-	a water supply plan pursuant to section 25-32d of the general statutes,
3695		-	the environmental laboratory that performed the test shall notify any
3696		-	persons who requested such test or such person's designee, in a form
3697		-	and manner prescribed by the Commissioner of Public Health, of such
3698		-	test result. Such person shall notify the Department of Public Health in
3699		-	a form and manner prescribed by the Commissioner of Public Health
3700		-	not later than twenty-four hours after obtaining such notification. As
3701		-	used in this subsection, "contaminant" means e. coli, lead, nitrate and
3702		-	nitrite.
3703		-	(b) Not later than five business days after receiving notice that a
3704		-	public water system is in violation of the federal Environmental
3705		-	Protection Agency national primary drinking water standards, the
3706		-	Commissioner of Public Health, or the commissioner's designee, shall
3707		-	give written or electronic notification of such violation to the chief
3708		-	elected official of the municipality where such public water system is
3709		-	located and of any municipality that is served by such public water
3710		-	system.
3711		-	Sec. 89. (NEW) (Effective October 1, 2021) Each health care institution,
3712		-	as defined in section 19a-490 of the general statutes, required to obtain
3713		-	potable water as a temporary measure to alleviate a water supply
3714		-	shortage shall obtain such potable water from (1) a bulk water hauler, Substitute House Bill No. 6666
3715		-
3716		-	Public Act No. 21-121 113 of 132
3717		-
3718		-	licensed pursuant to section 20-278h of the general statutes, or (2) a
3719		-	bottler, as defined in section 21a-150 of the general statutes.
3720		-	Sec. 90. Section 19a-175 of the general statutes is repealed and the
3721		-	following is substituted in lieu thereof (Effective from passage):
3722		-	As used in this chapter and section 19a-906, unless the context
3723		-	otherwise requires:
3724		-	(1) "Emergency medical service system" means a system which
3725		-	provides for (A) the arrangement of personnel, facilities and equipment
3726		-	for the efficient, effective and coordinated delivery of health care
3727		-	services under emergency conditions, and (B) mobile integrated health
3728		-	care;
3729		-	(2) "Patient" means an injured or ill person or a person with a physical
3730		-	disability requiring assistance and transportation;
3731		-	(3) "Ambulance" means a motor vehicle specifically designed to carry
3732		-	patients;
3733		-	(4) "Ambulance service" means an organization which transports
3734		-	patients;
3735		-	(5) "Emergency medical technician" means a person who is certified
3736		-	pursuant to chapter 384d;
3737		-	[(6) "Ambulance driver" means a person whose primary function is
3738		-	driving an ambulance;]
3739		-	[(7)] (6) "Emergency medical services instructor" means a person who
3740		-	is certified pursuant to chapter 384d;
3741		-	[(8)] (7) "Communications facility" means any facility housing the
3742		-	personnel and equipment for handling the emergency communications
3743		-	needs of a particular geographic area; Substitute House Bill No. 6666
3744		-
3745		-	Public Act No. 21-121 114 of 132
3746		-
3747		-	[(9)] (8) "Life saving equipment" means equipment used by
3748		-	emergency medical personnel for the stabilization and treatment of
3749		-	patients;
3750		-	[(10)] (9) "Emergency medical service organization" means any
3751		-	corporation or organization whether public, private or voluntary that
3752		-	(A) is licensed or certified by the Department of Public Health's Office
3753		-	of Emergency Medical Services, and (B) offers ambulance transportation
3754		-	or treatment services to patients primarily under emergency conditions
3755		-	or a mobile integrated health care program;
3756		-	[(11)] (10) "Invalid coach" means a vehicle used exclusively for the
3757		-	transportation of nonambulatory patients, who are not confined to
3758		-	stretchers, to or from either a medical facility or the patient's home in
3759		-	nonemergency situations or utilized in emergency situations as a
3760		-	backup vehicle when insufficient emergency vehicles exist;
3761		-	[(12)] (11) "Rescue service" means any organization, whether for-
3762		-	profit or nonprofit, whose primary purpose is to search for persons who
3763		-	have become lost or to render emergency service to persons who are in
3764		-	dangerous or perilous circumstances;
3765		-	[(13)] (12) "Commissioner" means the Commissioner of Public
3766		-	Health;
3767		-	[(14)] (13) "Paramedic" means a person licensed pursuant to chapter
3768		-	384d;
3769		-	[(15)] (14) "Commercial ambulance service" means an ambulance
3770		-	service which primarily operates for profit;
3771		-	[(16)] (15) "Licensed ambulance service" means a commercial
3772		-	ambulance service or a volunteer or municipal ambulance service issued
3773		-	a license by the commissioner; Substitute House Bill No. 6666
3774		-
3775		-	Public Act No. 21-121 115 of 132
3776		-
3777		-	[(17)] (16) "Certified ambulance service" means a municipal,
3778		-	volunteer or nonprofit ambulance service issued a certificate by the
3779		-	commissioner;
3780		-	[(18)] (17) "Automatic external defibrillator" means a device that: (A)
3781		-	Is used to administer an electric shock through the chest wall to the
3782		-	heart; (B) contains internal decision -making electronics,
3783		-	microcomputers or special software that allows it to interpret
3784		-	physiologic signals, make medical diagnosis and, if necessary, apply
3785		-	therapy; (C) guides the user through the process of using the device by
3786		-	audible or visual prompts; and (D) does not require the user to employ
3787		-	any discretion or judgment in its use;
3788		-	[(19)] (18) "Mutual aid call" means a call for emergency medical
3789		-	services that, pursuant to the terms of a written agreement, is responded
3790		-	to by a secondary or alternate emergency medical service organization
3791		-	if the primary or designated emergency medical service organization is
3792		-	unable to respond because such primary or designated emergency
3793		-	medical service organization is responding to another call for
3794		-	emergency medical services or the ambulance or nontransport
3795		-	emergency vehicle operated by such primary or designated emergency
3796		-	medical service organization is out of service. For purposes of this
3797		-	subdivision, "nontransport emergency vehicle" means a vehicle used by
3798		-	emergency medical technicians or paramedics in responding to
3799		-	emergency calls that is not used to carry patients;
3800		-	[(20)] (19) "Municipality" means the legislative body of a municipality
3801		-	or the board of selectmen in the case of a municipality in which the
3802		-	legislative body is a town meeting;
3803		-	[(21)] (20) "Primary service area" means a specific geographic area to
3804		-	which one designated emergency medical service organization is
3805		-	assigned for each category of emergency medical response services; Substitute House Bill No. 6666
3806		-
3807		-	Public Act No. 21-121 116 of 132
3808		-
3809		-	[(22)] (21) "Primary service area responder" means an emergency
3810		-	medical service organization who is designated to respond to a victim
3811		-	of sudden illness or injury in a primary service area;
3812		-	[(23)] (22) "Interfacility critical care transport" means the interfacility
3813		-	transport of a patient between licensed health care institutions;
3814		-	[(24)] (23) "Advanced emergency medical technician" means an
3815		-	individual who is certified as an advanced emergency medical
3816		-	technician pursuant to chapter 384d;
3817		-	[(25)] (24) "Emergency medical responder" means an individual who
3818		-	is certified pursuant to chapter 384d;
3819		-	[(26)] (25) "Medical oversight" means the active surveillance by
3820		-	physicians of the provision of emergency medical services sufficient for
3821		-	the assessment of overall emergency medical service practice levels, as
3822		-	defined by state-wide protocols;
3823		-	[(27)] (26) "Office of Emergency Medical Services" means the office
3824		-	established within the Department of Public Health pursuant to section
3825		-	19a-178;
3826		-	[(28)] (27) "Sponsor hospital" means a hospital that has agreed to
3827		-	maintain staff for the provision of medical oversight, supervision and
3828		-	direction to an emergency medical service organization and its
3829		-	personnel and has been approved for such activity by the Department
3830		-	of Public Health;
3831		-	[(29)] (28) "Paramedic intercept service" means paramedic treatment
3832		-	services provided by an entity that does not provide the ground
3833		-	ambulance transport;
3834		-	[(30)] (29) "Authorized emergency medical services vehicle" means an
3835		-	ambulance, invalid coach or advanced emergency technician-staffed Substitute House Bill No. 6666
3836		-
3837		-	Public Act No. 21-121 117 of 132
3838		-
3839		-	intercept vehicle or a paramedic-staffed intercept vehicle licensed or
3840		-	certified by the Department of Public Health for purposes of providing
3841		-	emergency medical care to patients; [and]
3842		-	[(31)] (30) "Emergency medical services personnel" means an
3843		-	individual certified to practice as an emergency medical responder,
3844		-	emergency medical technician, advanced emergency medical
3845		-	technician, emergency medical services instructor or an individual
3846		-	licensed as a paramedic; [.]
3847		-	[(32)] (31) "Mobile integrated health care program" means a program
3848		-	approved by the commissioner in which a licensed or certified
3849		-	ambulance service or paramedic intercept service provides services,
3850		-	including clinically appropriate medical evaluations, treatment,
3851		-	transport or referrals to other health care providers under
3852		-	nonemergency conditions by a paramedic acting within the scope of his
3853		-	or her practice as part of an emergency medical services organization
3854		-	within the emergency medical services system; and
3855		-	[(33)] (32) "Alternate destination" means a destination other than an
3856		-	emergency department that is a medically appropriate facility.
3857		-	Sec. 91. Section 19a-562 of the general statutes is repealed and the
3858		-	following is substituted in lieu thereof (Effective from passage):
3859		-	(a) As used in this section and section 19a-562a, as amended by this
3860		-	act, ["Alzheimer's special care unit or program"] "dementia special care
3861		-	unit or program" means any nursing facility, residential care home,
3862		-	assisted living facility, adult congregate living facility, adult day care
3863		-	center, hospice or adult foster home that locks, secures, segregates or
3864		-	provides a special program or unit for residents with a diagnosis of
3865		-	probable Alzheimer's disease, dementia or other similar disorder, in
3866		-	order to prevent or limit access by a resident outside the designated or
3867		-	separated area, or that advertises or markets the facility as providing Substitute House Bill No. 6666
3868		-
3869		-	Public Act No. 21-121 118 of 132
3870		-
3871		-	specialized care or services for persons suffering from Alzheimer's
3872		-	disease or dementia.
3873		-	(b) On and after January 1, 2007, each [Alzheimer's] dementia special
3874		-	care unit or program shall provide written disclosure to any person who
3875		-	will be placed in such a unit or program or to that person's legal
3876		-	representative or other responsible party. Such disclosure shall be
3877		-	signed by the patient or responsible party and shall explain what
3878		-	additional care and treatment or specialized program will be provided
3879		-	in the [Alzheimer's] dementia special care unit or program that is
3880		-	distinct from the care and treatment required by applicable licensing
3881		-	rules and regulations, including, but not limited to:
3882		-	(1) Philosophy. A written statement of the overall philosophy and
3883		-	mission of the [Alzheimer's] dementia special care unit or program that
3884		-	reflects the needs of residents with Alzheimer's disease, dementia or
3885		-	other similar disorders.
3886		-	(2) Preadmission, admission and discharge. The process and criteria
3887		-	for placement within or transfer or discharge from the [Alzheimer's]
3888		-	dementia special care unit or program.
3889		-	(3) Assessment, care planning and implementation. The process used
3890		-	for assessing and establishing and implementing the plan of care,
3891		-	including the method by which the plan of care is modified in response
3892		-	to changes in condition.
3893		-	(4) Staffing patterns and training ratios. The nature and extent of staff
3894		-	coverage, including staff to patient ratios and staff training and
3895		-	continuing education.
3896		-	(5) Physical environment. The physical environment and design
3897		-	features appropriate to support the functioning of cognitively impaired
3898		-	adult residents. Substitute House Bill No. 6666
3899		-
3900		-	Public Act No. 21-121 119 of 132
3901		-
3902		-	(6) Residents' activities. The frequency and types of resident activities
3903		-	and the ratio of residents to recreation staff.
3904		-	(7) Family role in care. The involvement of families and family
3905		-	support programs.
3906		-	(8) Program costs. The cost of care and any additional fees.
3907		-	(c) Each [Alzheimer's] dementia special care unit or program shall
3908		-	develop a standard disclosure form for compliance with subsection (b)
3909		-	of this section and shall annually review and verify the accuracy of the
3910		-	information provided by [Alzheimer's] dementia special care units or
3911		-	programs. Each [Alzheimer's] dementia special care unit or program
3912		-	shall update any significant change to the information reported
3913		-	pursuant to subsection (b) of this section not later than thirty days after
3914		-	such change.
3915		-	Sec. 92. Section 19a-562a of the general statutes is repealed and the
3916		-	following is substituted in lieu thereof (Effective from passage):
3917		-	(a) Each nursing home facility that is not a residential care home or
3918		-	an [Alzheimer's] dementia special care unit or program shall (1)
3919		-	annually provide a minimum of two hours of training in pain
3920		-	recognition and administration of pain management techniques, and (2)
3921		-	provide a minimum of one hour of training in oral health and oral
3922		-	hygiene techniques not later than one year after the date of hire and
3923		-	subsequent training in said techniques annually thereafter, to all
3924		-	licensed and registered direct care staff and nurse's aides who provide
3925		-	direct patient care to residents.
3926		-	(b) Each [Alzheimer's] dementia special care unit or program shall
3927		-	annually provide Alzheimer's and dementia specific training to all
3928		-	licensed and registered direct care staff and nurse's aides who provide
3929		-	direct patient care to residents enrolled in the [Alzheimer's] dementia
3930		-	special care unit or program. Such requirements shall include, but not Substitute House Bill No. 6666
3931		-
3932		-	Public Act No. 21-121 120 of 132
3933		-
3934		-	be limited to, (1) not less than eight hours of dementia-specific training,
3935		-	which shall be completed not later than six months after the date of
3936		-	employment or, if the date of employment is on or after October 1, 2014,
3937		-	not later than one hundred twenty days after the date of employment
3938		-	and not less than eight hours of such training annually thereafter, and
3939		-	(2) annual training of not less than two hours in pain recognition and
3940		-	administration of pain management techniques for direct care staff.
3941		-	(c) Each [Alzheimer's] dementia special care unit or program shall
3942		-	annually provide a minimum of one hour of Alzheimer's and dementia
3943		-	specific training to all unlicensed and unregistered staff, except nurse's
3944		-	aides, who provide services and care to residents enrolled in the
3945		-	[Alzheimer's] dementia special care unit or program. For such staff
3946		-	hired on or after October 1, 2007, such training shall be completed not
3947		-	later than six months after the date of employment and, for such staff
3948		-	hired on or after October 1, 2014, not later than one hundred twenty
3949		-	days after the date of employment.
3950		-	Sec. 93. Section 2 of substitute senate bill 2 of public act 21-46 is
3951		-	repealed and the following is substituted in lieu thereof (Effective July 1,
3952		-	2021):
3953		-	(a) As used in this section:
3954		-	(1) "Contact hour" means a minimum of fifty minutes of continuing
3955		-	education and activities; and
3956		-	(2) "Registration period" means the one-year period for which a
3957		-	license has been renewed in accordance with section 19a-88 of the
3958		-	general statutes, as amended by this act, and is current and valid.
3959		-	(b) [For registration periods beginning on and after January 1, 2022, a
3960		-	physician assistant licensed pursuant to chapter 370 of the general
3961		-	statutes applying for license renewal shall, during the first renewal
3962		-	period and not less than once every six years thereafter, earn not less Substitute House Bill No. 6666
3963		-
3964		-	Public Act No. 21-121 121 of 132
3965		-
3966		-	than two contact hours of training or education administered by the
3967		-	American Association of Physician Assistants, a hospital or other
3968		-	licensed health care institution or a regionally accredited institution of
3969		-	higher education, on (1) screening for post-traumatic stress disorder,
3970		-	risk of suicide, depression and grief, and (2) suicide prevention
3971		-	training.] Each person holding a license as a physician assistant shall,
3972		-	annually, during the month of such person's birth, register with the
3973		-	Department of Public Health, upon payment of a fee of one hundred
3974		-	fifty dollars, on blanks to be furnished by the department for such
3975		-	purpose, giving such person's name in full, such person's residence and
3976		-	business address and such other information as the department
3977		-	requests. No such license shall be renewed unless the department is
3978		-	satisfied that the practitioner (1) has met the mandatory continuing
3979		-	medical education requirements of the National Commission on
3980		-	Certification of Physician Assistants or a successor organization for the
3981		-	certification or recertification of physician assistants that may be
3982		-	approved by the department; (2) has passed any examination or
3983		-	continued competency assessment the passage of which may be
3984		-	required by said commission for maintenance of current certification by
3985		-	said commission; (3) has completed not less than one contact hour of
3986		-	training or education in prescribing controlled substances and pain
3987		-	management in the preceding two-year period; and (4) for registration
3988		-	periods beginning on or before January 1, 2022, during the first renewal
3989		-	period and not less than once every six years thereafter, earn not less
3990		-	than two contact hours of training or education screening for post-
3991		-	traumatic stress disorder, risk of suicide, depression and grief and
3992		-	suicide prevention training administered by the American Association
3993		-	of Physician Assistants, a hospital or other licensed health care
3994		-	institution or a regionally accredited institution of higher education.
3995		-	(c) Each physician assistant applying for license renewal pursuant to
3996		-	section 19a-88 of the general statutes, as amended by this act, shall sign
3997		-	a statement attesting that he or she has satisfied the continuing Substitute House Bill No. 6666
3998		-
3999		-	Public Act No. 21-121 122 of 132
4000		-
4001		-	education requirements of subsection (b) of this section on a form
4002		-	prescribed by the Department of Health. Each licensee shall retain
4003		-	records of attendance or certificates of completion that demonstrate
4004		-	compliance with the continuing education requirements of subsection
4005		-	(b) of this section for a minimum of three years following the year in
4006		-	which the continuing education was completed and shall submit such
4007		-	records or certificates to the department for inspection not later than
4008		-	forty-five days after a request by the department for such records or
4009		-	certificates.
4010		-	Sec. 94. Subsection (c) of section 19a-88 of the general statutes is
4011		-	repealed and the following is substituted in lieu thereof (Effective July 1,
4012		-	2021):
4013		-	(c) (1) Each person holding a license to practice as a registered nurse,
4014		-	shall, annually, during the month of such person's birth, register with
4015		-	the Department of Public Health, upon payment of one hundred ten
4016		-	dollars, on blanks to be furnished by the department for such purpose,
4017		-	giving such person's name in full, such person's residence and business
4018		-	address and such other information as the department requests. Each
4019		-	person holding a license to practice as a registered nurse who has retired
4020		-	from the profession may renew such license, but the fee shall be ten per
4021		-	cent of the professional services fee for class B, as defined in section 33-
4022		-	182l, plus five dollars. Any license provided by the department at a
4023		-	reduced fee shall indicate that the registered nurse is retired.
4024		-	(2) Each person holding a license as an advanced practice registered
4025		-	nurse shall, annually, during the month of such person's birth, register
4026		-	with the Department of Public Health, upon payment of one hundred
4027		-	thirty dollars, on blanks to be furnished by the department for such
4028		-	purpose, giving such person's name in full, such person's residence and
4029		-	business address and such other information as the department
4030		-	requests. No such license shall be renewed unless the department is
4031		-	satisfied that the person maintains current certification as either a nurse Substitute House Bill No. 6666
4032		-
4033		-	Public Act No. 21-121 123 of 132
4034		-
4035		-	practitioner, a clinical nurse specialist or a nurse anesthetist from one of
4036		-	the following national certifying bodies which certify nurses in
4037		-	advanced practice: The American Nurses' Association, the Nurses'
4038		-	Association of the American College of Obstetricians and Gynecologists
4039		-	Certification Corporation, the National Board of Pediatric Nurse
4040		-	Practitioners and Associates or the American Association of Nurse
4041		-	Anesthetists. Each person holding a license to practice as an advanced
4042		-	practice registered nurse who has retired from the profession may
4043		-	renew such license, but the fee shall be ten per cent of the professional
4044		-	services fee for class C, as defined in section 33-182l, plus five dollars.
4045		-	Any license provided by the department at a reduced fee shall indicate
4046		-	that the advanced practice registered nurse is retired.
4047		-	(3) Each person holding a license as a licensed practical nurse shall,
4048		-	annually, during the month of such person's birth, register with the
4049		-	Department of Public Health, upon payment of seventy dollars, on
4050		-	blanks to be furnished by the department for such purpose, giving such
4051		-	person's name in full, such person's residence and business address and
4052		-	such other information as the department requests. Each person holding
4053		-	a license to practice as a licensed practical nurse who has retired from
4054		-	the profession may renew such license, but the fee shall be ten per cent
4055		-	of the professional services fee for class A, as defined in section 33-182l,
4056		-	plus five dollars. Any license provided by the department at a reduced
4057		-	fee shall indicate that the licensed practical nurse is retired.
4058		-	(4) Each person holding a license as a nurse-midwife shall, annually,
4059		-	during the month of such person's birth, register with the Department
4060		-	of Public Health, upon payment of one hundred thirty dollars, on blanks
4061		-	to be furnished by the department for such purpose, giving such
4062		-	person's name in full, such person's residence and business address and
4063		-	such other information as the department requests. No such license shall
4064		-	be renewed unless the department is satisfied that the person maintains
4065		-	current certification from the Accreditation Midwifery Certification Substitute House Bill No. 6666
4066		-
4067		-	Public Act No. 21-121 124 of 132
4068		-
4069		-	Board.
4070		-	(5) (A) Each person holding a license to practice physical therapy
4071		-	shall, annually, during the month of such person's birth, register with
4072		-	the Department of Public Health, upon payment of the professional
4073		-	services fee for class B, as defined in section 33-182l, plus five dollars, on
4074		-	blanks to be furnished by the department for such purpose, giving such
4075		-	person's name in full, such person's residence and business address and
4076		-	such other information as the department requests.
4077		-	(B) Each person holding a physical therapist assistant license shall,
4078		-	annually, during the month of such person's birth, register with the
4079		-	Department of Public Health, upon payment of the professional services
4080		-	fee for class A, as defined in section 33-182l, plus five dollars, on blanks
4081		-	to be furnished by the department for such purpose, giving such
4082		-	person's name in full, such person's residence and business address and
4083		-	such other information as the department requests.
4084		-	[(6) Each person holding a license as a physician assistant shall,
4085		-	annually, during the month of such person's birth, register with the
4086		-	Department of Public Health, upon payment of a fee of one hundred
4087		-	fifty-five dollars, on blanks to be furnished by the department for such
4088		-	purpose, giving such person's name in full, such person's residence and
4089		-	business address and such other information as the department
4090		-	requests. No such license shall be renewed unless the department is
4091		-	satisfied that the practitioner (A) has met the mandatory continuing
4092		-	medical education requirements of the National Commission on
4093		-	Certification of Physician Assistants or a successor organization for the
4094		-	certification or recertification of physician assistants that may be
4095		-	approved by the department, (B) has passed any examination or
4096		-	continued competency assessment the passage of which may be
4097		-	required by said commission for maintenance of current certification by
4098		-	said commission, and (C) has completed not less than one contact hour
4099		-	of training or education in prescribing controlled substances and pain Substitute House Bill No. 6666
4100		-
4101		-	Public Act No. 21-121 125 of 132
4102		-
4103		-	management in the preceding two-year period.]
4104		-	Sec. 95. Section 20-206mm of the general statutes, as amended by
4105		-	section 9 of substitute senate bill 2 of public act 21-46, is repealed and
4106		-	the following is substituted in lieu thereof (Effective July 1, 2021):
4107		-	(a) Except as provided in subsections (b) and (c) of this section, an
4108		-	applicant for a license as a paramedic shall submit evidence satisfactory
4109		-	to the Commissioner of Public Health that the applicant has successfully
4110		-	(1) completed a paramedic training program approved by the
4111		-	commissioner, (2) for applicants applying on and after January 1, 2020,
4112		-	completed mental health first aid training as part of a program provided
4113		-	by an instructor certified by the National Council for Behavioral Health,
4114		-	and (3) passed an examination prescribed by the commissioner.
4115		-	(b) An applicant for licensure by endorsement shall present evidence
4116		-	satisfactory to the commissioner that the applicant (1) is licensed or
4117		-	certified as a paramedic in another state or jurisdiction whose
4118		-	requirements for practicing in such capacity are substantially similar to
4119		-	or higher than those of this state and that the applicant has no pending
4120		-	disciplinary action or unresolved complaint against him or her, or (2)
4121		-	(A) is currently licensed or certified as a paramedic in good standing in
4122		-	any New England state, New York or New Jersey, (B) has completed an
4123		-	initial training program consistent with the National Emergency
4124		-	Medical Services Education Standards, as promulgated by the National
4125		-	Highway Traffic Safety Administration for the paramedic scope of
4126		-	practice model conducted by an organization offering a program that is
4127		-	recognized by the national emergency medical services program
4128		-	accrediting organization, (C) for applicants applying on or after January
4129		-	1, 2020, has completed mental health first aid training as part of a
4130		-	program provided by an instructor certified by the National Council for
4131		-	Behavioral Health, and (D) has no pending disciplinary action or
4132		-	unresolved complaint against him or her. Substitute House Bill No. 6666
4133		-
4134		-	Public Act No. 21-121 126 of 132
4135		-
4136		-	(c) Any person who is certified as an emergency medical technician-
4137		-	paramedic by the Department of Public Health on October 1, 1997, shall
4138		-	be deemed a licensed paramedic. Any person so deemed shall renew his
4139		-	license pursuant to section 19a-88, as amended by this act, for a fee of
4140		-	one hundred fifty-five dollars.
4141		-	(d) On or after January 1, 2020, each person seeking certification as an
4142		-	emergency medical responder, emergency medical technician or
4143		-	advanced emergency medical technician shall apply to the department
4144		-	on forms prescribed by the commissioner. Applicants for certification
4145		-	shall comply with the following requirements: (1) For initial
4146		-	certification, an applicant shall present evidence satisfactory to the
4147		-	commissioner that the applicant (A) has completed an initial training
4148		-	program consistent with the National Emergency Medical Services
4149		-	Education Standards, as promulgated by the National Highway Traffic
4150		-	Safety Administration for the emergency medical responder, emergency
4151		-	medical technician or advanced emergency medical technician
4152		-	curriculum, (B) has passed the examination administered by the
4153		-	national organization for emergency medical certification for an
4154		-	emergency medical responder, emergency medical technician or
4155		-	advanced emergency medical technician as necessary for the type of
4156		-	certification sought by the applicant or an examination approved by the
4157		-	department, and (C) has no pending disciplinary action or unresolved
4158		-	complaints against such applicant, (2) a certificate issued under this
4159		-	subsection shall be renewed once every two years in accordance with
4160		-	the provisions of section 19a-88, as amended by this act, upon
4161		-	presentation of evidence satisfactory to the commissioner that the
4162		-	applicant (A) has successfully completed continuing education for an
4163		-	emergency medical responder, emergency medical technician or
4164		-	advanced emergency medical technician as required by the national
4165		-	organization for emergency medical certification or as approved by the
4166		-	department, or (B) presents a current certification as an emergency
4167		-	medical responder, emergency medical technician or advanced Substitute House Bill No. 6666
4168		-
4169		-	Public Act No. 21-121 127 of 132
4170		-
4171		-	emergency medical technician from the national organization for
4172		-	emergency medical certification, or (3) for certification by endorsement
4173		-	from another state, an applicant shall present evidence satisfactory to
4174		-	the commissioner that the applicant (A) is currently certified as an
4175		-	emergency medical responder, emergency medical technician or
4176		-	advanced emergency medical technician in good standing by a state that
4177		-	maintains certification or licensing requirements that the commissioner
4178		-	determines are equal to or greater than those in this state, or (B) holds a
4179		-	current certification as an emergency medical responder, emergency
4180		-	medical technician or advanced emergency medical technician from the
4181		-	national organization for emergency medical certification.
4182		-	(e) On or after January 1, 2022, each person seeking renewal of a
4183		-	certification as an emergency medical responder, [or] emergency
4184		-	medical technician or advanced emergency medical technician under
4185		-	subdivision (2) of subsection (d) of this section, shall present evidence
4186		-	satisfactory to the commissioner that such person has, in the previous
4187		-	six year period, completed (1) the evidence-based youth suicide
4188		-	prevention training program administered pursuant to section 1 of
4189		-	substitute senate bill 2 of public act 21-46, or (2) not less than two hours
4190		-	of training or education, approved by the Commissioner of Public
4191		-	Health, on (A) screening for post-traumatic stress disorder, risk of
4192		-	suicide, depression and grief, and (B) suicide prevention.
4193		-	(f) On or after January 1, 2020, each person seeking certification as an
4194		-	emergency medical services instructor shall apply to the department on
4195		-	forms prescribed by the commissioner. Applicants for certification shall
4196		-	comply with the following requirements: (1) For initial certification, an
4197		-	applicant shall present evidence satisfactory to the commissioner that
4198		-	the applicant (A) is currently certified by the department as an
4199		-	emergency medical technician or advanced emergency medical
4200		-	technician or licensed by the department as a paramedic, (B) has
4201		-	completed a program of training as an emergency medical instructor Substitute House Bill No. 6666
4202		-
4203		-	Public Act No. 21-121 128 of 132
4204		-
4205		-	based on current national education standards within the prior two
4206		-	years, (C) has completed twenty-five hours of teaching activity under
4207		-	the supervision of a currently certified emergency medical services
4208		-	instructor, (D) has completed written and practical examinations as
4209		-	prescribed by the commissioner, (E) has no pending disciplinary action
4210		-	or unresolved complaints against the applicant, and (F) effective on a
4211		-	date prescribed by the commissioner, presents documentation
4212		-	satisfactory to the commissioner that the applicant is currently certified
4213		-	as an emergency medical technician, advanced emergency medical
4214		-	technician or paramedic by the national organization for emergency
4215		-	medical certification, or (2) for renewal certification, an applicant shall
4216		-	present evidence satisfactory to the commissioner that the applicant (A)
4217		-	has successfully completed continuing education and teaching activity
4218		-	as required by the department, [which, on and after January 1, 2022,
4219		-	shall include not less than two hours of training or education, approved
4220		-	by the Commissioner of Public Health, on (i) screening for post-
4221		-	traumatic stress disorder, risk of suicide, depression and grief, and (ii)
4222		-	suicide prevention training, during the first renewal period and not less
4223		-	than once every six years thereafter,] (B) maintains current certification
4224		-	by the department as an emergency medical technician, advanced
4225		-	emergency medical technician or licensure by the department as a
4226		-	paramedic, and (C) effective on a date as prescribed by the
4227		-	commissioner, presents documentation satisfactory to the
4228		-	commissioner that the applicant is currently certified as an emergency
4229		-	medical technician, advanced emergency medical technician or
4230		-	paramedic by the national organization for emergency medical
4231		-	certification.
4232		-	(g) A certified emergency medical responder, emergency medical
4233		-	technician, advanced emergency medical technician or emergency
4234		-	medical services instructor shall document the completion of his or her
4235		-	continuing educational requirements [through the continuing education
4236		-	platform Internet web site] in a form and manner prescribed by the Substitute House Bill No. 6666
4237		-
4238		-	Public Act No. 21-121 129 of 132
4239		-
4240		-	commissioner. A certified emergency medical responder, emergency
4241		-	medical technician, advanced emergency medical technician or
4242		-	emergency medical services instructor who is not engaged in active
4243		-	professional practice in any form during a certification period shall be
4244		-	exempt from the continuing education requirements of this section,
4245		-	provided the emergency medical responder, emergency m edical
4246		-	technician, advanced emergency medical technician or emergency
4247		-	medical services instructor submits to the department, prior to the
4248		-	expiration of the certification period, an application for inactive status
4249		-	on a form prescribed by the department and such other documentation
4250		-	as may be required by the department. The application for inactive
4251		-	status pursuant to this subsection shall contain a statement that the
4252		-	emergency medical responder, emergency medical technician,
4253		-	advanced emergency medical technician or emergency medical services
4254		-	instructor may not engage in professional practice until the continuing
4255		-	education requirements of this section have been met.
4256		-	(h) The commissioner may issue a temporary emergency medical
4257		-	technician certificate to an applicant who presents evidence satisfactory
4258		-	to the commissioner that (1) the applicant was certified by the
4259		-	department as an emergency medical technician prior to becoming
4260		-	licensed as a paramedic pursuant to section 20-206ll, or (2) the
4261		-	applicant's certification as an emergency medical technician has expired
4262		-	and the applicant's license as a paramedic has become void pursuant to
4263		-	section 19a-88, as amended by this act. Such temporary certificate shall
4264		-	be valid for a period not to exceed one year and shall not be renewable.
4265		-	(i) An applicant who is issued a temporary emergency medical
4266		-	technician certificate pursuant to subsection (h) of this section may,
4267		-	prior to the expiration of such temporary certificate, apply to the
4268		-	department for: (1) Renewal of such person's paramedic license, giving
4269		-	such person's name in full, such person's residence and business address
4270		-	and such other information as the department requests, provided the Substitute House Bill No. 6666
4271		-
4272		-	Public Act No. 21-121 130 of 132
4273		-
4274		-	application for license renewal is accompanied by evidence satisfactory
4275		-	to the commissioner that the applicant was under the medical oversight
4276		-	of a sponsor hospital, as those terms are defined in section 19a-175, as
4277		-	amended by this act, on the date the applicant's paramedic license
4278		-	became void for nonrenewal; or (2) recertification as an emergency
4279		-	medical technician, provided the application for recertification is
4280		-	accompanied by evidence satisfactory to the commissioner that the
4281		-	applicant completed emergency medical technician refresher training
4282		-	approved by the commissioner not later than one year after issuance of
4283		-	the temporary emergency medical technician certificate. The
4284		-	department shall recertify such person as an emergency medical
4285		-	technician without the examination required for initial certification
4286		-	specified in regulations adopted by the commissioner pursuant to
4287		-	section 20-206oo.
4288		-	(j) Any person certified as an emergency medical responder,
4289		-	emergency medical technician, advanced emergency medical technician
4290		-	or emergency medical services instructor pursuant to this chapter and
4291		-	the regulations adopted pursuant to section 20-206oo whose
4292		-	certification has expired may apply to the Department of Public Health
4293		-	for reinstatement of such certification, provided such person completes
4294		-	the requirements for renewal certification specified in this section. Any
4295		-	certificate issued pursuant to this section shall remain valid for ninety
4296		-	days after the expiration date of such certificate and become void upon
4297		-	the expiration of such ninety-day period.
4298		-	(k) The Commissioner of Public Health shall issue an emergency
4299		-	medical technician certification to an applicant who is a member of the
4300		-	armed forces or the National Guard or a veteran and who (1) presents
4301		-	evidence satisfactory to the commissioner that such applicant holds a
4302		-	current certification as a person entitled to perform similar services
4303		-	under a different designation by the National Registry of Emergency
4304		-	Medical Technicians, or (2) satisfies the regulations promulgated Substitute House Bill No. 6666
4305		-
4306		-	Public Act No. 21-121 131 of 132
4307		-
4308		-	pursuant to subdivision (3) of subsection (a) of section 19a-179. Such
4309		-	applicant shall be exempt from any written or practical examination
4310		-	requirement for certification.
4311		-	(l) For the purposes of this section, "veteran" means any person who
4312		-	was discharged or released under conditions other than dishonorable
4313		-	from active service in the armed forces and "armed forces" has the same
4314		-	meaning as provided in section 27-103.
4315		-	Sec. 96. Subdivision (2) of subsection (e) of section 14-100a of the
4316		-	general statutes is repealed and the following is substituted in lieu
4317		-	thereof (Effective from passage):
4318		-	(2) The following motor vehicles registered in this state for the first
4319		-	time on or after October 1, 2007, that transport individuals who remain
4320		-	in wheelchairs while being transported, shall, in addition to the
4321		-	requirements of subdivision (1) of this subsection, install or provide and
4322		-	require the use of a device that secures the wheelchair to the motor
4323		-	vehicle's mechanical lift or otherwise prevents or seeks to prevent an
4324		-	individual in a wheelchair from falling from such mechanical lift or
4325		-	motor vehicle: (A) Motor vehicles in livery service, as defined in section
4326		-	13b-101, (B) service buses, as defined in section 14-1, (C) invalid coaches,
4327		-	as defined in [subdivision (11) of] section 19a-175, as amended by this
4328		-	act, (D) vanpool vehicles, as defined in section 14-1, (E) school buses, as
4329		-	defined in section 14-1, (F) motor buses, as defined in section 14-1, (G)
4330		-	student transportation vehicles, as defined in section 14-212, and (H)
4331		-	camp vehicles, as defined in section 14-1. The provisions of this
4332		-	subsection shall also apply to all motor vehicles used by municipal,
4333		-	volunteer and commercial ambulance services and rescue services, as
4334		-	defined in section 19a-175, as amended by this act.
4335		-	Sec. 97. Subdivision (14) of subsection (b) of section 20-9 of the general
4336		-	statutes is repealed and the following is substituted in lieu thereof
4337		-	(Effective from passage): Substitute House Bill No. 6666
4338		-
4339		-	Public Act No. 21-121 132 of 132
4340		-
4341		-	(14) Any person rendering service as a physician assistant licensed
4342		-	pursuant to section 20-12b, a registered nurse, a licensed practical nurse
4343		-	or a paramedic, as defined in [subdivision (14) of] section 19a-175, as
4344		-	amended by this act, acting within the scope of regulations adopted
4345		-	pursuant to section 19a-179, if such service is rendered under the
4346		-	supervision, control and responsibility of a licensed physician;
4347		-	Sec. 98. Section 20-195ff of the general statutes is repealed and the
4348		-	following is substituted in lieu thereof (Effective from passage):
4349		-	The Commissioner of Public Health may adopt regulations, in
4350		-	accordance with the provisions of chapter 54, to further the purposes of
4351		-	subdivision (18) of subsection (c) of section 19a-14, subsection (e) of
4352		-	section 19a-88, subdivision [(14)] (13) of section 19a-175, as amended by
4353		-	this act, subsection (b) of section 20-9, as amended by this act, sections
4354		-	20-195aa to 20-195ee, inclusive, and section 20-195gg.
4355		-	Sec. 99. Section 20-226 of the general statutes is repealed. (Effective
4356		-	from passage)
	18	+	Section 1. Section 73 of public act 19-117 is repealed and the following 1
	19	+	is substituted in lieu thereof (Effective October 1, 2021): 2
	20	+	Notwithstanding any provision of title 19a or 25 of the general 3
	21	+	statutes, [and not later than March 1, 2020,] a director of health of a town, 4
	22	+	city or borough or of a district department of health appointed pursuant 5
	23	+	to section 19a-200 or 19a-242 of the general statutes may issue a permit 6
	24	+	for a replacement public well if the Department of Public Health has 7
	25	+	approved such replacement public well pursuant to subsection (b) of 8
	26	+	section 25-33 of the general statutes, as amended by this act. For 9
	27	+	purposes of this section, "replacement public well" means a public well 10
	28	+	that (1) replaces an existing public well, [in a town in southeastern 11
	29	+	Connecticut with a population between fifteen thousand and fifteen 12
	30	+	thousand three hundred, as enumerated by the 2010 federal decennial 13
	31	+	census,] and (2) does not meet the sanitary radius and minimum setback 14
	32	+	requirements as specified in the regulations of Connecticut State 15
	33	+	Agencies. 16
	34	+	Sec. 2. Subsection (b) of section 25-33 of the general statutes is 17
	35	+	repealed and the following is substituted in lieu thereof (Effective October 18 Substitute Bill No. 6666
	36	+
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	41	+
	42	+	1, 2021): 19
	43	+	(b) No system of water supply owned or used by a water company 20
	44	+	shall be constructed or expanded or a new additional source of water 21
	45	+	supply utilized until the plans therefor have been submitted to and 22
	46	+	reviewed and approved by the department, except that no such prior 23
	47	+	review or approval is required for distribution water main installations 24
	48	+	that are constructed in accordance with sound engineering standards 25
	49	+	and all applicable laws and regulations. A plan for any proposed new 26
	50	+	source of water supply submitted to the department pursuant to this 27
	51	+	subsection shall include documentation that provides for: (1) A brief 28
	52	+	description of potential effects that the proposed new source of water 29
	53	+	supply may have on nearby water supply systems including public and 30
	54	+	private wells; and (2) the water company's ownership or control of the 31
	55	+	proposed new source of water supply's sanitary radius and minimum 32
	56	+	setback requirements as specified in the regulations of Connecticut state 33
	57	+	agencies and that such ownership or control shall continue to be 34
	58	+	maintained as specified in such regulations. If the department 35
	59	+	determines, based upon documentation provided, that the water 36
	60	+	company does not own or control the proposed new source of water 37
	61	+	supply's sanitary radius or minimum setback requirements as specified 38
	62	+	in the regulations of Connecticut state agencies, the department shall 39
	63	+	require the water company proposing a new source of water supply to 40
	64	+	supply additional documentation to the department that adequately 41
	65	+	demonstrates the alternative methods that will be utilized to assure the 42
	66	+	proposed new source of water supply's long-term purity and adequacy. 43
	67	+	In reviewing any plan for a proposed new source of water supply, the 44
	68	+	department shall consider the issues specified in this subsection. The 45
	69	+	Commissioner of Public Health may adopt regulations, in accordance 46
	70	+	with the provisions of chapter 54, to carry out the provisions of this 47
	71	+	subsection and subsection (c) of this section. For purposes of this 48
	72	+	subsection and subsection (c) of this section, "distribution water main 49
	73	+	installations" means installations, extensions, replacements or repairs of 50
	74	+	public water supply system mains from which water is or will be 51
	75	+	delivered to one or more service connections and which do not require 52 Substitute Bill No. 6666
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	81	+
	82	+	construction or expansion of pumping stations, storage facilities, 53
	83	+	treatment facilities or sources of supply. Notwithstanding the 54
	84	+	provisions of this subsection, the department may approve any location 55
	85	+	of a replacement public well, if such replacement public well is (A) 56
	86	+	necessary for the water company to maintain and provide to its 57
	87	+	consumers a safe and adequate water supply, (B) located in an aquifer 58
	88	+	of adequate water quality determined by historical water quality data 59
	89	+	from the source of water supply it is replacing, and (C) in a more 60
	90	+	protected location when compared to the source of water supply it is 61
	91	+	replacing, as determined by the department. For purposes of this 62
	92	+	subsection, "replacement public well" means a public well that (i) 63
	93	+	replaces an existing public well, [in a town in southeastern Connecticut 64
	94	+	with a population between fifteen thousand and fifteen thousand three 65
	95	+	hundred, as enumerated by the 2010, federal decennial census,] and (ii) 66
	96	+	does not meet the sanitary radius and minimum setback requirements 67
	97	+	as specified in the regulations of Connecticut state agencies. 68
	98	+	Sec. 3. Section 8-3i of the general statutes is repealed and the 69
	99	+	following is substituted in lieu thereof (Effective October 1, 2021): 70
	100	+	(a) As used in this section "water company" means a water company, 71
	101	+	as defined in section 25-32a, and "petition" includes a petition or 72
	102	+	proposal to change the regulations, boundaries or classifications of 73
	103	+	zoning districts. 74
	104	+	(b) When an application, petition, request or plan is filed with the 75
	105	+	zoning commission, planning and zoning commission or zoning board 76
	106	+	of appeals of any municipality concerning any project on any site that is 77
	107	+	within the aquifer protection area delineated pursuant to section 22a-78
	108	+	354c or the watershed of a water company, the applicant or the person 79
	109	+	making the filing shall: (1) [provide] Provide written notice of the 80
	110	+	application, petition, request or plan to the water company and the 81
	111	+	[Commissioner of Public Health in a format prescribed by said 82
	112	+	commissioner, provided such water company or said commissioner has 83
	113	+	filed a map showing the boundaries of the watershed on the land 84
	114	+	records of the municipality in which the application, petition, request or 85 Substitute Bill No. 6666
	115	+
	116	+
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	120	+
	121	+	plan is made and with the planning commission, zoning commission, 86
	122	+	planning and zoning commission or zoning board of appeals of such 87
	123	+	municipality or the aquifer protection area has been delineated in 88
	124	+	accordance with section 22a-354c, as the case may be] Department of 89
	125	+	Public Health; and (2) determine if the project is within the watershed 90
	126	+	of a water company by consulting the maps posted on the department's 91
	127	+	Internet web site showing the boundaries of the watershed. Such [notice 92
	128	+	shall be made] applicant shall send such notice to the water company 93
	129	+	by certified mail, return receipt requested, and to the department by 94
	130	+	electronic mail to the electronic mail address designated on its Internet 95
	131	+	web site for receipt of such notice. Such applicant shall [be mailed] mail 96
	132	+	such notice not later than seven days after the date of the application. 97
	133	+	Such water company and the Commissioner of Public Health may, 98
	134	+	through a representative, appear and be heard at any hearing on any 99
	135	+	such application, petition, request or plan. 100
	136	+	(c) Notwithstanding the provisions of subsection (b) of this section, 101
	137	+	when an agent of the zoning commission, planning and zoning 102
	138	+	commission or zoning board of appeals is authorized to approve an 103
	139	+	application, petition, request or plan concerning any site that is within 104
	140	+	the aquifer protection area delineated pursuant to section 22a-354c or 105
	141	+	the watershed of a water company without the approval of the zoning 106
	142	+	commission, planning and zoning commission or zoning board of 107
	143	+	appeals, and such agent determines that the proposed activity will not 108
	144	+	adversely affect the public water supply, the applicant or person making 109
	145	+	the filing shall not be required to notify the water company or the 110
	146	+	[Commissioner] Department of Public Health. 111
	147	+	Sec. 4. Section 22a-42f of the general statutes is repealed and the 112
	148	+	following is substituted in lieu thereof (Effective October 1, 2021): 113
	149	+	When an application is filed to conduct or cause to be conducted a 114
	150	+	regulated activity upon an inland wetland or watercourse, any portion 115
	151	+	of which is within the watershed of a water company as defined in 116
	152	+	section 25-32a, the applicant shall: (1) [provide] Provide written notice 117
	153	+	of the application to the water company and the [Commissioner of 118 Substitute Bill No. 6666
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	159	+
	160	+	Public Health in a format prescribed by said commissioner, provided 119
	161	+	such water company or said commissioner has filed a map showing the 120
	162	+	boundaries of the watershed on the land records of the municipality in 121
	163	+	which the application is made and with the inland wetlands agency of 122
	164	+	such municipality] Department of Public Health; and (2) determine if 123
	165	+	the project is within the watershed of a water company by consulting 124
	166	+	the maps posted on the department's Internet web site showing the 125
	167	+	boundaries of the watershed. Such [notice shall be made] applicant shall 126
	168	+	send such notice to the water company by certified mail, return receipt 127
	169	+	requested, and to the department by electronic mail to the electronic 128
	170	+	mail address designated by the department on its Internet web site for 129
	171	+	receipt of such notice. Such applicant shall [be mailed] mail such notice 130
	172	+	not later than seven days after the date of the application. The water 131
	173	+	company and the Commissioner of Public Health, through a 132
	174	+	representative, may appear and be heard at any hearing on the 133
	175	+	application. 134
	176	+	Sec. 5. Section 19a-111 of the general statutes is repealed and the 135
	177	+	following is substituted in lieu thereof (Effective October 1, 2021): 136
	178	+	Upon receipt of each report of confirmed venous blood lead level 137
	179	+	equal to or greater than twenty micrograms per deciliter of blood, the 138
	180	+	local director of health shall make or cause to be made an 139
	181	+	epidemiological investigation of the source of the lead causing the 140
	182	+	increased lead level or abnormal body burden and shall order action to 141
	183	+	be taken by the appropriate person responsible for the condition that 142
	184	+	brought about such lead poisoning as may be necessary to prevent 143
	185	+	further exposure of persons to such poisoning. In the case of any 144
	186	+	residential unit where such action will not result in removal of the 145
	187	+	hazard within a reasonable time, the local director of health shall utilize 146
	188	+	such community resources as are available to effect relocation of any 147
	189	+	family occupying such unit. The local director of health may permit 148
	190	+	occupancy in said residential unit during abatement if, in such director's 149
	191	+	judgment, occupancy would not threaten the health and well-being of 150
	192	+	the occupants. The local director of health shall, not later than thirty 151 Substitute Bill No. 6666
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	198	+
	199	+	days after the conclusion of such director's investigation, report to the 152
	200	+	Commissioner of Public Health, using a web-based surveillance system 153
	201	+	as prescribed by the commissioner, the result of such investigation and 154
	202	+	the action taken to ensure against further lead poisoning from the same 155
	203	+	source, including any measures taken to effect relocation of families. 156
	204	+	Such report shall include information relevant to the identification and 157
	205	+	location of the source of lead poisoning and such other information as 158
	206	+	the commissioner may require pursuant to regulations adopted in 159
	207	+	accordance with the provisions of chapter 54. The commissioner shall 160
	208	+	maintain comprehensive records of all reports submitted pursuant to 161
	209	+	this section and section 19a-110. Such records shall be geographically 162
	210	+	indexed in order to determine the location of areas of relatively high 163
	211	+	incidence of lead poisoning. The commissioner shall establish, in 164
	212	+	conjunction with recognized professional medical groups, guidelines 165
	213	+	consistent with the National Centers for Disease Control and Prevention 166
	214	+	for assessment of the risk of lead poisoning, screening for lead poisoning 167
	215	+	and treatment and follow-up care of individuals including children with 168
	216	+	lead poisoning, women who are pregnant and women who are planning 169
	217	+	pregnancy. Nothing in this section shall be construed to prohibit a local 170
	218	+	building official from requiring abatement of sources of lead. 171
	219	+	Sec. 6. Section 19a-37 of the general statutes is repealed and the 172
	220	+	following is substituted in lieu thereof (Effective October 1, 2021): 173
	221	+	(a) As used in this section: 174
	222	+	(1) "Laboratory or firm" means an environmental laboratory 175
	223	+	registered by the Department of Public Health pursuant to section 19a-176
	224	+	29a; 177
	225	+	(2) "Private well" means a water supply well that meets all of the 178
	226	+	following criteria: (A) Is not a public well; (B) supplies a residential 179
	227	+	population of less than twenty-five persons per day; and (C) is owned 180
	228	+	or controlled through an easement or by the same entity that owns or 181
	229	+	controls the building or parcel that is served by the water supply well; 182 Substitute Bill No. 6666
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	236	+	(3) "Public well" means a water supply well that supplies a public 183
	237	+	water system; 184
	238	+	(4) "Semipublic well" means a water supply well that (A) does not 185
	239	+	meet the definition of a private well or public well, and (B) provides 186
	240	+	water for drinking and other domestic purposes; and 187
	241	+	(5) "Water supply well" means an artificial excavation constructed by 188
	242	+	any method for the purpose of obtaining or providing water for 189
	243	+	drinking or other domestic, industrial, commercial, agricultural, 190
	244	+	recreational or irrigation use, or other outdoor water use. 191
	245	+	(b) The Commissioner of Public Health may adopt regulations in the 192
	246	+	[Public Health Code] regulations of Connecticut state agencies for the 193
	247	+	preservation of the public health pertaining to (1) protection and 194
	248	+	location of new water supply wells or springs for residential or 195
	249	+	nonresidential construction or for public or semipublic use, and (2) 196
	250	+	inspection for compliance with the provisions of municipal regulations 197
	251	+	adopted pursuant to section 22a-354p. 198
	252	+	(c) The Commissioner of Public Health shall adopt regulations, in 199
	253	+	accordance with chapter 54, for the testing of water quality in private 200
	254	+	[residential] wells and semipublic wells. Any laboratory or firm which 201
	255	+	conducts a water quality test on a private well serving a residential 202
	256	+	property or semipublic well shall, not later than thirty days after the 203
	257	+	completion of such test, report the results of such test to (1) the public 204
	258	+	health authority of the municipality where the property is located, and 205
	259	+	(2) the Department of Public Health in a format specified by the 206
	260	+	department, provided such report shall only be required if the party for 207
	261	+	whom the laboratory or firm conducted such test informs the laboratory 208
	262	+	or firm identified on the chain of custody documentation submitted 209
	263	+	with the test samples that the test was conducted in connection with the 210
	264	+	sale of such property. No regulation may require such a test to be 211
	265	+	conducted as a consequence or a condition of the sale, exchange, 212
	266	+	transfer, purchase or rental of the real property on which the private 213
	267	+	[residential] well or semipublic well is located. 214 Substitute Bill No. 6666
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	273	+
	274	+	(d) Prior to the sale, exchange, purchase, transfer or rental of real 215
	275	+	property on which a [residential] private or semipublic well is located, 216
	276	+	the owner shall provide the buyer or tenant notice that educational 217
	277	+	material concerning private well testing is available on the Department 218
	278	+	of Public Health web site. Failure to provide such notice shall not 219
	279	+	invalidate any sale, exchange, purchase, transfer or rental of real 220
	280	+	property. If the seller or landlord provides such notice in writing, the 221
	281	+	seller or landlord and any real estate licensee shall be deemed to have 222
	282	+	fully satisfied any duty to notify the buyer or tenant that the subject real 223
	283	+	property is located in an area for which there are reasonable grounds for 224
	284	+	testing under subsection (g) or (j) of this section. 225
	285	+	(e) The Commissioner of Public Health shall adopt regulations, in 226
	286	+	accordance with chapter 54, to clarify the criteria under which the 227
	287	+	commissioner may issue a well permit exception and to describe the 228
	288	+	terms and conditions that shall be imposed when a well is allowed at a 229
	289	+	premises (1) that is connected to a public water supply system, or (2) 230
	290	+	whose boundary is located within two hundred feet of an approved 231
	291	+	community water supply system, measured along a street, alley or 232
	292	+	easement. Such regulations shall (A) provide for notification of the 233
	293	+	permit to the public water supplier, (B) address the quality of the water 234
	294	+	supplied from the well, the means and extent to which the well shall not 235
	295	+	be interconnected with the public water supply, the need for a physical 236
	296	+	separation, and the installation of a reduced pressure device for 237
	297	+	backflow prevention, the inspection and testing requirements of any 238
	298	+	such reduced pressure device, and (C) identify the extent and frequency 239
	299	+	of water quality testing required for the well supply. 240
	300	+	(f) No regulation may require that a certificate of occupancy for a 241
	301	+	dwelling unit on such residential property be withheld or revoked on 242
	302	+	the basis of a water quality test performed on a private [residential] well 243
	303	+	pursuant to this section, unless such test results indicate that any 244
	304	+	maximum contaminant level applicable to public water supply systems 245
	305	+	for any contaminant listed in the [public health code] regulations of 246
	306	+	Connecticut state agencies has been exceeded. No administrative 247 Substitute Bill No. 6666
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	312	+
	313	+	agency, health district or municipal health officer may withhold or 248
	314	+	cause to be withheld such a certificate of occupancy except as provided 249
	315	+	in this section. 250
	316	+	(g) The local director of health may require a private [residential] well 251
	317	+	or semipublic well to be tested for arsenic, radium, uranium, radon or 252
	318	+	gross alpha emitters, when there are reasonable grounds to suspect that 253
	319	+	such contaminants are present in the groundwater. For purposes of this 254
	320	+	subsection, "reasonable grounds" means (1) the existence of a geological 255
	321	+	area known to have naturally occurring arsenic, radium, uranium, 256
	322	+	radon or gross alpha emitter deposits in the bedrock; or (2) the well is 257
	323	+	located in an area in which it is known that arsenic, radium, uranium, 258
	324	+	radon or gross alpha emitters are present in the groundwater. 259
	325	+	(h) Except as provided in subsection (i) of this section, the collection 260
	326	+	of samples for determining the water quality of private [residential] 261
	327	+	wells and semipublic wells may be made only by (1) employees of a 262
	328	+	laboratory or firm certified or approved by the Department of Public 263
	329	+	Health to test drinking water, if such employees have been trained in 264
	330	+	sample collection techniques, (2) certified water operators, (3) local 265
	331	+	health departments and state employees trained in sample collection 266
	332	+	techniques, or (4) individuals with training and experience that the 267
	333	+	Department of Public Health deems sufficient. 268
	334	+	(i) Any owner of a residential construction, including, but not limited 269
	335	+	to, a homeowner, on which a private [residential] well is located or any 270
	336	+	general contractor of a new residential construction on which a private 271
	337	+	[residential] well is located may collect samples of well water for 272
	338	+	submission to a laboratory or firm for the purposes of testing water 273
	339	+	quality pursuant to this section, provided (1) such laboratory or firm has 274
	340	+	provided instructions to said owner or general contractor on how to 275
	341	+	collect such samples, and (2) such owner or general contractor is 276
	342	+	identified to the subsequent owner on a form to be prescribed by the 277
	343	+	Department of Public Health. No regulation may prohibit or impede 278
	344	+	such collection or analysis. 279 Substitute Bill No. 6666
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	351	+	(j) The local director of health may require private [residential] wells 280
	352	+	and semipublic wells to be tested for pesticides, herbicides or organic 281
	353	+	chemicals when there are reasonable grounds to suspect that any such 282
	354	+	contaminants might be present in the groundwater. For purposes of this 283
	355	+	subsection, "reasonable grounds" means (1) the presence of nitrate-284
	356	+	nitrogen in the groundwater at a concentration greater than ten 285
	357	+	milligrams per liter, or (2) that the private [residential] well or 286
	358	+	semipublic well is located on land, or in proximity to land, associated 287
	359	+	with the past or present production, storage, use or disposal of organic 288
	360	+	chemicals as identified in any public record. 289
	361	+	(k) Any water transported in bulk by any means to a premises 290
	362	+	currently supplied by a private well or semipublic well where the water 291
	363	+	is to be used for purposes of drinking or domestic use shall be provided 292
	364	+	by a bulk water hauler licensed pursuant to section 20-278h. No bulk 293
	365	+	water hauler shall deliver water without first notifying the owner of the 294
	366	+	premises of such delivery. Bulk water hauling to a premises currently 295
	367	+	supplied by a private well or semipublic well shall be permitted only as 296
	368	+	a temporary measure to alleviate a water supply shortage. 297
	369	+	Sec. 7. Section 19a-524 of the general statutes is repealed and the 298
	370	+	following is substituted in lieu thereof (Effective October 1, 2021): 299
	371	+	If, upon review, investigation or inspection pursuant to section 19a-300
	372	+	498, the Commissioner of Public Health determines that a nursing home 301
	373	+	facility or residential care home has violated any provision of section 302
	374	+	17a-411, 19a-491a to 19a-491c, inclusive, as amended by this act, 19a-303
	375	+	493a, 19a-521 to 19a-529, inclusive, 19a-531 to 19a-551, inclusive, or 19a-304
	376	+	553 to 19a-555, inclusive, or any provision of any regulation of 305
	377	+	Connecticut state agencies relating to licensure, the Fire Safety Code or 306
	378	+	the operation or maintenance of a nursing home facility or residential 307
	379	+	care home, which violation has been classified in accordance with 308
	380	+	section 19a-527, the commissioner may immediately issue or cause to be 309
	381	+	issued a citation to the licensee of such nursing home facility or 310
	382	+	residential care home. Governmental immunity shall not be a defense to 311
	383	+	any citation issued or civil penalty imposed pursuant to this section or 312 Substitute Bill No. 6666
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	390	+	sections 19-525 to 19a-528, inclusive. Each such citation shall be in 313
	391	+	writing, provide notice of the nature and scope of the alleged violation 314
	392	+	or violations, and include, but not be limited to, the citation and notice 315
	393	+	of noncompliance issued in accordance with section 19a-496. Each 316
	394	+	citation and notice of noncompliance issued under this section shall be 317
	395	+	sent to the licensee electronically in a form and manner prescribed by 318
	396	+	the commissioner or by certified mail [to the licensee] at the address of 319
	397	+	the nursing home facility or residential care home in issue. A copy of 320
	398	+	such citation and notice of noncompliance shall also be sent to the 321
	399	+	licensed administrator at the address of the nursing home facility or 322
	400	+	residential care home. 323
	401	+	Sec. 8. Subdivision (2) of subsection (c) of section 19a-491c of the 324
	402	+	general statutes is repealed and the following is substituted in lieu 325
	403	+	thereof (Effective July 1, 2021): 326
	404	+	(2) No long-term care facility shall be required to comply with the 327
	405	+	provisions of this subsection if (A) the individual provides evidence to 328
	406	+	the long-term care facility that such individual submitted to a 329
	407	+	background search conducted pursuant to subdivision (1) of this 330
	408	+	subsection not more than three years immediately preceding the date 331
	409	+	such individual applies for employment, seeks to enter into a contract 332
	410	+	or begins volunteering with the long-term care facility and that the prior 333
	411	+	background search confirmed that the individual did not have a 334
	412	+	disqualifying offense, or (B) the commissioner determines the need to 335
	413	+	temporarily suspend the requirements of this subsection in the event of 336
	414	+	an emergency or significant disruption. The commissioner shall inform 337
	415	+	the long-term care facility when the commissioner has suspended the 338
	416	+	requirements of this subsection pursuant to subparagraph (B) of this 339
	417	+	subdivision and when such suspension is rescinded. 340
	418	+	Sec. 9. Section 19a-177 of the general statutes is repealed and the 341
	419	+	following is substituted in lieu thereof (Effective October 1, 2021): 342
	420	+	The commissioner shall: 343 Substitute Bill No. 6666
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	427	+	(1) With the advice of the Office of Emergency Medical Services 344
	428	+	established pursuant to section 19a-178 and of an advisory committee 345
	429	+	on emergency medical services and with the benefit of meetings held 346
	430	+	pursuant to subsection (b) of section 19a-184, adopt every five years a 347
	431	+	state-wide plan for the coordinated delivery of emergency medical 348
	432	+	services; 349
	433	+	(2) License or certify the following: (A) Ambulance operations, 350
	434	+	ambulance drivers, emergency medical services personnel and 351
	435	+	communications personnel; (B) emergency room facilities and 352
	436	+	communications facilities; and (C) transportation equipment, including 353
	437	+	land, sea and air vehicles used for transportation of patients to 354
	438	+	emergency facilities and periodically inspect life saving equipment, 355
	439	+	emergency facilities and emergency transportation vehicles to ensure 356
	440	+	state standards are maintained; 357
	441	+	(3) Annually inventory emergency medical services resources within 358
	442	+	the state, including facilities, equipment, and personnel, for the 359
	443	+	purposes of determining the need for additional services and the 360
	444	+	effectiveness of existing services; 361
	445	+	(4) Review and evaluate all area-wide plans developed by the 362
	446	+	emergency medical services councils pursuant to section 19a-182 in 363
	447	+	order to insure conformity with standards issued by the commissioner; 364
	448	+	(5) Not later than thirty days after their receipt, review all grant and 365
	449	+	contract applications for federal or state funds concerning emergency 366
	450	+	medical services or related activities for conformity to policy guidelines 367
	451	+	and forward such application to the appropriate agency, when required; 368
	452	+	(6) Establish such minimum standards and adopt such regulations in 369
	453	+	accordance with the provisions of chapter 54, as may be necessary to 370
	454	+	develop the following components of an emergency medical service 371
	455	+	system: (A) Communications, which shall include, but not be limited to, 372
	456	+	equipment, radio frequencies and operational procedures; (B) 373
	457	+	transportation services, which shall include, but not be limited to, 374 Substitute Bill No. 6666
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	464	+	vehicle type, design, condition and maintenance, and operational 375
	465	+	procedures; (C) training, which shall include, but not be limited to, 376
	466	+	emergency medical services personnel, communications personnel, 377
	467	+	paraprofessionals associated with emergency medical services, 378
	468	+	firefighters and state and local police; (D) emergency medical service 379
	469	+	facilities, which shall include, but not be limited to, categorization of 380
	470	+	emergency departments as to their treatment capabilities and ancillary 381
	471	+	services; and (E) mobile integrated health care programs, which shall 382
	472	+	include, but not be limited to, the standards to ensure the health, safety 383
	473	+	and welfare of the patients being served by such programs and data 384
	474	+	collection and reporting requirements to ensure and measure quality 385
	475	+	outcomes of such programs; 386
	476	+	(7) Coordinate training of all emergency medical services personnel; 387
	477	+	(8) (A) Develop an emergency medical services data collection 388
	478	+	system. Each emergency medical service organization licensed or 389
	479	+	certified pursuant to this chapter shall submit data to the commissioner, 390
	480	+	on a quarterly basis, from each licensed ambulance service, certified 391
	481	+	ambulance service or paramedic intercept service that provides 392
	482	+	emergency medical services. Such submitted data shall include, but not 393
	483	+	be limited to: (i) The total number of calls for emergency medical 394
	484	+	services received by such licensed ambulance service, certified 395
	485	+	ambulance service or paramedic intercept service through the 9-1-1 396
	486	+	system during the reporting period; (ii) each level of emergency medical 397
	487	+	services, as defined in regulations adopted pursuant to section 19a-179, 398
	488	+	required for each such call; (iii) the response time for each licensed 399
	489	+	ambulance service, certified ambulance service or paramedic intercept 400
	490	+	service during the reporting period; (iv) the number of passed calls, 401
	491	+	cancelled calls and mutual aid calls, both made and received, during the 402
	492	+	reporting period; and (v) for the reporting period, the prehospital data 403
	493	+	for the nonscheduled transport of patients required by regulations 404
	494	+	adopted pursuant to subdivision (6) of this section. The data required 405
	495	+	under this subdivision may be submitted in any electronic form selected 406
	496	+	by such licensed ambulance service, certified ambulance service or 407 Substitute Bill No. 6666
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	503	+	paramedic intercept service and approved by the commissioner, 408
	504	+	provided the commissioner shall take into consideration the needs of 409
	505	+	such licensed ambulance service, certified ambulance service or 410
	506	+	paramedic intercept service in approving such electronic form. The 411
	507	+	commissioner may conduct an audit of any such licensed ambulance 412
	508	+	service, certified ambulance service or paramedic intercept service as 413
	509	+	the commissioner deems necessary in order to verify the accuracy of 414
	510	+	such reported data. 415
	511	+	(B) On or before December 31, 2018, and annually thereafter, the 416
	512	+	commissioner shall prepare a report to the Emergency Medical Services 417
	513	+	Advisory Board, established pursuant to section 19a-178a, as amended 418
	514	+	by this act, that shall include, but not be limited to, the following data: 419
	515	+	(i) The total number of calls for emergency medical services received 420
	516	+	during the reporting year by each licensed ambulance service, certified 421
	517	+	ambulance service or paramedic intercept service; (ii) the level of 422
	518	+	emergency medical services required for each such call; (iii) the name of 423
	519	+	the emergency medical service organization that provided each such 424
	520	+	level of emergency medical services furnished during the reporting 425
	521	+	year; (iv) the response time, by time ranges or fractile response times, 426
	522	+	for each licensed ambulance service, certified ambulance service or 427
	523	+	paramedic intercept service, using a common definition of response 428
	524	+	time, as provided in regulations adopted pursuant to section 19a-179; 429
	525	+	and (v) the number of passed calls, cancelled calls and mutual aid calls 430
	526	+	during the reporting year. The commissioner shall prepare such report 431
	527	+	in a format that categorizes such data for each municipality in which the 432
	528	+	emergency medical services were provided, with each such 433
	529	+	municipality grouped according to urban, suburban and rural 434
	530	+	classifications. 435
	531	+	(C) If any licensed ambulance service, certified ambulance service or 436
	532	+	paramedic intercept service does not submit the data required under 437
	533	+	subparagraph (A) of this subdivision for a period of six consecutive 438
	534	+	months, or if the commissioner believes that such licensed ambulance 439
	535	+	service, certified ambulance service or paramedic intercept service 440 Substitute Bill No. 6666
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	541	+
	542	+	knowingly or intentionally submitted incomplete or false data, the 441
	543	+	commissioner shall issue a written order directing such licensed 442
	544	+	ambulance service, certified ambulance service or paramedic intercept 443
	545	+	service to comply with the provisions of subparagraph (A) of this 444
	546	+	subdivision and submit all missing data or such corrected data as the 445
	547	+	commissioner may require. If such licensed ambulance service, certified 446
	548	+	ambulance service or paramedic intercept service fails to fully comply 447
	549	+	with such order not later than three months from the date such order is 448
	550	+	issued, the commissioner (i) shall conduct a hearing, in accordance with 449
	551	+	chapter 54, at which such licensed ambulance service, certified 450
	552	+	ambulance service or paramedic intercept service shall be required to 451
	553	+	show cause why the primary service area assignment of such licensed 452
	554	+	ambulance service, certified ambulance service or paramedic intercept 453
	555	+	service should not be revoked, and (ii) may take such disciplinary action 454
	556	+	under section 19a-17 as the commissioner deems appropriate. 455
	557	+	(D) The commissioner shall collect the data required by 456
	558	+	subparagraph (A) of this subdivision, in the manner provided in said 457
	559	+	subparagraph, from each emergency medical service organization 458
	560	+	licensed or certified pursuant to this chapter. Any such emergency 459
	561	+	medical service organization that fails to comply with the provisions of 460
	562	+	this section shall be liable for a civil penalty not to exceed one hundred 461
	563	+	dollars per day for each failure to report the required data regarding 462
	564	+	emergency medical services provided to a patient, as determined by the 463
	565	+	commissioner. The civil penalties set forth in this subparagraph shall be 464
	566	+	assessed only after the department provides a written notice of 465
	567	+	deficiency and the organization is afforded the opportunity to respond 466
	568	+	to such notice. An organization shall have not more than fifteen business 467
	569	+	days after the date of receiving such notice to provide a written response 468
	570	+	to the department. The commissioner may adopt regulations, in 469
	571	+	accordance with chapter 54, concerning the development, 470
	572	+	implementation, monitoring and collection of emergency medical 471
	573	+	service system data. All state agencies licensed or certified as emergency 472
	574	+	medical service organizations shall be exempt from the civil penalties 473
	575	+	set forth in this subparagraph. 474 Substitute Bill No. 6666
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	582	+	(E) The commissioner shall, with the recommendation of the 475
	583	+	Connecticut Emergency Medical Services Advisory Board established 476
	584	+	pursuant to section 19a-178a, as amended by this act, adopt for use in 477
	585	+	trauma data collection the most recent version of the National Trauma 478
	586	+	Data Bank's National Trauma Data Standards and Data Dictionary and 479
	587	+	nationally recognized guidelines for field triage of injured patients; 480
	588	+	(9) (A) Establish rates for the conveyance and treatment of patients 481
	589	+	by licensed ambulance services and invalid coaches and establish 482
	590	+	emergency service rates for certified ambulance services and paramedic 483
	591	+	intercept services, provided (i) the present rates established for such 484
	592	+	services and vehicles shall remain in effect until such time as the 485
	593	+	commissioner establishes a new rate schedule as provided in this 486
	594	+	subdivision, and (ii) any rate increase not in excess of the Medical Care 487
	595	+	Services Consumer Price Index, as published by the Bureau of Labor 488
	596	+	Statistics of the United States Department of Labor, for the prior year, 489
	597	+	filed in accordance with subparagraph (B)(iii) of this subdivision shall 490
	598	+	be deemed approved by the commissioner. For purposes of this 491
	599	+	subdivision, licensed ambulance services and paramedic intercept 492
	600	+	services shall not include emergency air transport services or mobile 493
	601	+	integrated health care programs. 494
	602	+	(B) Adopt regulations, in accordance with the provisions of chapter 495
	603	+	54, establishing methods for setting rates and conditions for charging 496
	604	+	such rates. Such regulations shall include, but not be limited to, 497
	605	+	provisions requiring that on and after July 1, 2000: (i) Requests for rate 498
	606	+	increases may be filed no more frequently than once a year, except that, 499
	607	+	in any case where an agency's schedule of maximum allowable rates 500
	608	+	falls below that of the Medicare allowable rates for that agency, the 501
	609	+	commissioner shall immediately amend such schedule so that the rates 502
	610	+	are at or above the Medicare allowable rates; (ii) only licensed 503
	611	+	ambulance services, certified ambulance services and paramedic 504
	612	+	intercept services that apply for a rate increase in excess of the Medical 505
	613	+	Care Services Consumer Price Index, as published by the Bureau of 506
	614	+	Labor Statistics of the United States Department of Labor, for the prior 507 Substitute Bill No. 6666
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	620	+
	621	+	year, and do not accept the maximum allowable rates contained in any 508
	622	+	voluntary state-wide rate schedule established by the commissioner for 509
	623	+	the rate application year shall be required to file detailed financial 510
	624	+	information with the commissioner, provided any hearing that the 511
	625	+	commissioner may hold concerning such application shall be conducted 512
	626	+	as a contested case in accordance with chapter 54; (iii) licensed 513
	627	+	ambulance services, certified ambulance services and paramedic 514
	628	+	intercept services that do not apply for a rate increase in any year in 515
	629	+	excess of the Medical Care Services Consumer Price Index, as published 516
	630	+	by the Bureau of Labor Statistics of the United States Department of 517
	631	+	Labor, for the prior year, or that accept the maximum allowable rates 518
	632	+	contained in any voluntary state-wide rate schedule established by the 519
	633	+	commissioner for the rate application year shall, not later than the last 520
	634	+	business day in August of such year, file with the commissioner a 521
	635	+	statement of emergency and nonemergency call volume, and, in the case 522
	636	+	of a licensed ambulance service, certified ambulance service or 523
	637	+	paramedic intercept service that is not applying for a rate increase, a 524
	638	+	written declaration by such licensed ambulance service, certified 525
	639	+	ambulance service or paramedic intercept service that no change in its 526
	640	+	currently approved maximum allowable rates will occur for the rate 527
	641	+	application year; and (iv) detailed financial and operational information 528
	642	+	filed by licensed ambulance services, certified ambulance services and 529
	643	+	paramedic intercept services to support a request for a rate increase in 530
	644	+	excess of the Medical Care Services Consumer Price Index, as published 531
	645	+	by the Bureau of Labor Statistics of the United States Department of 532
	646	+	Labor, for the prior year, shall cover the time period pertaining to the 533
	647	+	most recently completed fiscal year and the rate application year of the 534
	648	+	licensed ambulance service, certified ambulance service or paramedic 535
	649	+	intercept service. 536
	650	+	(C) Establish rates for licensed ambulance services, certified 537
	651	+	ambulance services or paramedic intercept services for the following 538
	652	+	services and conditions: (i) "Advanced life support assessment" and 539
	653	+	"specialty care transports", which terms have the meanings provided in 540
	654	+	42 CFR 414.605; and (ii) mileage, which may include mileage for an 541 Substitute Bill No. 6666
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	660	+
	661	+	ambulance transport when the point of origin and final destination for 542
	662	+	a transport is within the boundaries of the same municipality. The rates 543
	663	+	established by the commissioner for each such service or condition shall 544
	664	+	be equal to (I) the ambulance service's base rate plus its established 545
	665	+	advanced life support/paramedic surcharge when advanced life 546
	666	+	support assessment services are performed; (II) two hundred twenty-547
	667	+	five per cent of the ambulance service's established base rate for 548
	668	+	specialty care transports; and (III) "loaded mileage", as the term is 549
	669	+	defined in 42 CFR 414.605, multiplied by the ambulance service's 550
	670	+	established rate for mileage. Such rates shall remain in effect until such 551
	671	+	time as the commissioner establishes a new rate schedule as provided 552
	672	+	in this subdivision. 553
	673	+	(D) Establish rates for the treatment and release of patients by a 554
	674	+	licensed or certified emergency medical services organization or a 555
	675	+	provider who does not transport such patients to an emergency 556
	676	+	department and who is operating within the scope of such 557
	677	+	organization's or provider's practice and following protocols approved 558
	678	+	by the sponsor hospital. The rates established pursuant to this 559
	679	+	subparagraph shall not apply to the treatment provided to patients 560
	680	+	through mobile integrated health care programs; 561
	681	+	(10) Establish primary service areas and assign in writing a primary 562
	682	+	service area responder for each primary service area. Each state-owned 563
	683	+	campus having an acute care hospital on the premises shall be 564
	684	+	designated as the primary service area responder for that campus; 565
	685	+	(11) Revoke primary service area assignments upon determination by 566
	686	+	the commissioner that it is in the best interests of patient care to do so; 567
	687	+	and 568
	688	+	(12) Annually issue a list of minimum equipment requirements for 569
	689	+	[ambulances and rescue vehicles] authorized emergency medical 570
	690	+	services vehicles based upon current national standards. The 571
	691	+	commissioner shall distribute such list to all emergency medical service 572
	692	+	organizations and sponsor hospital medical directors and make such list 573 Substitute Bill No. 6666
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	699	+	available to other interested stakeholders. Emergency medical service 574
	700	+	organizations shall have one year from the date of issuance of such list 575
	701	+	to comply with the minimum equipment requirements. 576
	702	+	Sec. 10. (NEW) (Effective July 1, 2021) The Commissioner of Public 577
	703	+	Health may waive any provisions of the regulations affecting an 578
	704	+	emergency medical service organization, as defined in section 19a-175 579
	705	+	of the general statutes, if the commissioner determines that such waiver 580
	706	+	would not endanger the health, safety or welfare of any patient or 581
	707	+	resident. The commissioner may impose conditions, upon granting the 582
	708	+	waiver, that assure the health, safety or welfare of patients or residents 583
	709	+	and may revoke the waiver upon a finding that the health, safety or 584
	710	+	welfare of any patient or resident has been jeopardized. The 585
	711	+	commissioner may adopt regulations, in accordance with the provisions 586
	712	+	of chapter 54 of the general statutes, establishing procedures for an 587
	713	+	application for a waiver pursuant to this subdivision. 588
	714	+	Sec. 11. Section 20-207 of the general statutes is repealed and the 589
	715	+	following is substituted in lieu thereof (Effective October 1, 2021): 590
	716	+	As used in this chapter, unless the context otherwise requires, the 591
	717	+	following terms shall have the meanings specified: 592
	718	+	(1) "Board" means the Connecticut Board of Examiners of Embalmers 593
	719	+	and Funeral Directors; 594
	720	+	(2) "Person" means an individual or corporation, but not a 595
	721	+	partnership; 596
	722	+	(3) "Funeral directing" means the business, practice or profession, as 597
	723	+	commonly practiced, of (A) directing or supervising funerals, or 598
	724	+	providing funeral services; (B) handling or encasing or providing 599
	725	+	services for handling and encasing dead human bodies, otherwise than 600
	726	+	by embalming, for burial or disposal; (C) providing embalming services; 601
	727	+	(D) providing transportation, interment and disinterment of dead 602
	728	+	human bodies; (E) maintaining an establishment so located, constructed 603
	729	+	and equipped as to permit the decent and sanitary handling of dead 604 Substitute Bill No. 6666
	730	+
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	735	+
	736	+	human bodies, with suitable equipment in such establishment for such 605
	737	+	handling; (F) conducting an establishment from which funerals may be 606
	738	+	held; (G) engaging in consultations concerning arrangements for the 607
	739	+	disposition of human remains, including, but not limited to, 608
	740	+	arrangements for cremation or alkaline hydrolysis; (H) casketing human 609
	741	+	remains; (I) making cemetery and cremation arrangements; and (J) 610
	742	+	preparing funeral service contracts, as defined in section 42-200; 611
	743	+	(4) "Funeral director" means any person engaged or holding himself 612
	744	+	or herself out as engaged in funeral directing whether or not he or she 613
	745	+	uses in connection with his or her name or business the words "funeral 614
	746	+	director," "undertaker" or "mortician" or any other word or title 615
	747	+	intended to designate him or her as a funeral director or mortician or as 616
	748	+	one so engaged; 617
	749	+	(5) "Funeral service business" means the business, practice or 618
	750	+	profession of funeral directing; 619
	751	+	(6) "Licensed embalmer" means an embalmer holding a license as 620
	752	+	provided in this chapter; 621
	753	+	(7) "Licensed funeral director" means a funeral director holding a 622
	754	+	license as provided in this chapter; 623
	755	+	(8) ["Student embalmer"] "Registered apprentice embalmer" means a 624
	756	+	person [studying embalming and] registered with the Department of 625
	757	+	Public Health as an apprentice pursuant to the provisions of this 626
	758	+	chapter; 627
	759	+	(9) ["Student funeral director"] "Registered apprentice funeral 628
	760	+	director" means a person [studying the funeral service business and] 629
	761	+	registered with the Department of Public Health as an apprentice 630
	762	+	pursuant to the provisions of this chapter; 631
	763	+	(10) "Full-time employment" means regular and steady work during 632
	764	+	the normal working hours by any person at the establishment at which 633
	765	+	he is employed; and 634 Substitute Bill No. 6666
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	771	+
	772	+	(11) "Manager" means an individual who (A) is licensed as an 635
	773	+	embalmer or funeral director pursuant to this chapter and (B) has direct 636
	774	+	and personal responsibility for the daily operation and management of 637
	775	+	a funeral service business. 638
	776	+	Sec. 12. Section 20-212 of the general statutes is repealed and the 639
	777	+	following is substituted in lieu thereof (Effective October 1, 2021): 640
	778	+	No person, except a licensed embalmer, shall inject any fluid or 641
	779	+	substance into any dead human body, except that a registered [student] 642
	780	+	apprentice embalmer may, even if not in the presence of a licensed 643
	781	+	embalmer, make such injection or perform any other act under [his] 644
	782	+	such licensed embalmer's instruction; and no person, firm or 645
	783	+	corporation shall enter, engage in, carry on or manage for another the 646
	784	+	business of caring for, preserving or disposing of dead human bodies 647
	785	+	until each person, firm or corporation so engaged has obtained from the 648
	786	+	Department of Public Health and holds a license as provided in this 649
	787	+	chapter; nor shall any person be employed to remove a dead human 650
	788	+	body, except a licensed embalmer, a registered [student] apprentice 651
	789	+	embalmer, a licensed funeral director, or a person authorized in each 652
	790	+	instance by the Chief Medical Examiner, Deputy Medical Examiner or 653
	791	+	assistant medical examiner incidental to examining the body of a 654
	792	+	deceased person, except that once a dead human body has been 655
	793	+	prepared in accordance with the [Public Health Code] regulations of 656
	794	+	Connecticut state agencies and the applicable provisions of the general 657
	795	+	statutes, an embalmer or funeral director licensed in this state may 658
	796	+	authorize an unlicensed employee to transport such body. Nothing in 659
	797	+	this section shall be construed to prohibit any person licensed as an 660
	798	+	embalmer or as a funeral director under the laws of another state from 661
	799	+	bringing into or removing from this state a dead human body, provided 662
	800	+	any and all other laws of this state relative to such body have been 663
	801	+	complied with. Nothing in this chapter shall be construed to prohibit 664
	802	+	any student who is enrolled in a program of education in mortuary 665
	803	+	science, approved by the board, with the consent of the Commissioner 666
	804	+	of Public Health, from embalming up to ten human bodies under the 667 Substitute Bill No. 6666
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	810	+
	811	+	supervision of a licensed embalmer and incidental to such student's 668
	812	+	course of study. 669
	813	+	Sec. 13. Subsections (a) and (b) of section 20-213 of the general statutes 670
	814	+	are repealed and the following is substituted in lieu thereof (Effective 671
	815	+	October 1, 2021): 672
	816	+	(a) (1) After a [student] registered apprentice embalmer has (A) 673
	817	+	completed a program of education in mortuary science approved by the 674
	818	+	board with the consent of the Commissioner of Public Health, (B) 675
	819	+	successfully completed an examination prescribed by the Department 676
	820	+	of Public Health with the consent of the board, (C) completed one year 677
	821	+	of practical training and experience of a grade and character satisfactory 678
	822	+	to the commissioner in the state in full-time employment under the 679
	823	+	personal supervision and instruction of an embalmer licensed under the 680
	824	+	provisions of this chapter, and (D) embalmed fifty human bodies in not 681
	825	+	more than two years under the supervision of a licensed embalmer or 682
	826	+	embalmers, (2) the [student] registered apprentice embalmer shall (A) 683
	827	+	submit to the department an application and fee of two hundred ten 684
	828	+	dollars, (B) take a written examination on the Connecticut public health 685
	829	+	laws and the regulations of Connecticut state agencies pertaining to the 686
	830	+	activities of an embalmer, and (C) take an examination in practical 687
	831	+	embalming that shall include an actual demonstration upon a cadaver. 688
	832	+	When the [student] registered apprentice embalmer has satisfactorily 689
	833	+	passed such examinations, said department shall issue to him or her a 690
	834	+	license to practice embalming. At the expiration of such license, if the 691
	835	+	holder thereof desires a renewal, said department shall grant it pursuant 692
	836	+	to section 20-222a, except for cause. 693
	837	+	(b) Examinations for registration as a [student] registered apprentice 694
	838	+	embalmer and for an embalmer's license shall be administered to 695
	839	+	applicants by the Department of Public Health, under the supervision 696
	840	+	of the board, semiannually and at such other times as may be 697
	841	+	determined by the department. 698
	842	+	Sec. 14. Section 20-215 of the general statutes is repealed and the 699 Substitute Bill No. 6666
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	848	+
	849	+	following is substituted in lieu thereof (Effective October 1, 2021): 700
	850	+	No licensed embalmer shall sign an affidavit attesting the 701
	851	+	preparation or embalming of any body unless such body has been 702
	852	+	prepared or embalmed by [him] such licensed embalmer, or by a 703
	853	+	registered [student] apprentice embalmer under [his] such licensed 704
	854	+	embalmer's personal supervision. 705
	855	+	Sec. 15. Subsection (a) of section 20-217 of the general statutes is 706
	856	+	repealed and the following is substituted in lieu thereof (Effective October 707
	857	+	1, 2021): 708
	858	+	(a) When a [student] registered apprentice funeral director has 709
	859	+	completed a program of education approved by the board with the 710
	860	+	consent of the Commissioner of Public Health, has successfully 711
	861	+	completed an examination prescribed by the department with the 712
	862	+	consent of the board and furnishes the department with satisfactory 713
	863	+	proof that he or she has completed one year of practical training and 714
	864	+	experience in full-time employment under the personal supervision of 715
	865	+	a licensed embalmer or funeral director, and pays to the department a 716
	866	+	fee of two hundred ten dollars, [he] such registered apprentice funeral 717
	867	+	director shall be entitled to be examined upon the Connecticut state law 718
	868	+	and regulations pertaining to his or her professional activities. If found 719
	869	+	to be qualified by the Department of Public Health, [he] such registered 720
	870	+	apprentice funeral director shall be licensed as a funeral director. 721
	871	+	Renewal licenses shall be issued by the Department of Public Health 722
	872	+	pursuant to section 20-222a, unless withheld for cause as herein 723
	873	+	provided, upon a payment of a fee of two hundred thirty dollars. 724
	874	+	Sec. 16. Section 20-224 of the general statutes is repealed and the 725
	875	+	following is substituted in lieu thereof (Effective October 1, 2021): 726
	876	+	(a) The provisions of sections 20-217, as amended by this act, 20-220 727
	877	+	and 20-227 shall not prohibit the employment of assistants or of 728
	878	+	[student] registered apprentice embalmers and [student] registered 729
	879	+	apprentice funeral directors as provided in this chapter, provided a 730 Substitute Bill No. 6666
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	885	+
	886	+	licensed funeral service business may employ no more than two 731
	887	+	[student] registered apprentice embalmers at any one time, and any 732
	888	+	person, firm, corporation or other organization engaged in the business 733
	889	+	of funeral directing may employ no more than one [student] registered 734
	890	+	apprentice funeral director at any one time, without the approval of the 735
	891	+	Board of Examiners of Embalmers and Funeral Directors. 736
	892	+	(b) [Student] Registered apprentice embalmers and [student] 737
	893	+	registered apprentice funeral directors shall register as apprentices with 738
	894	+	the Department of Public Health, in the manner prescribed by the 739
	895	+	commissioner in regulations adopted pursuant to section 20-211, for 740
	896	+	purposes of completing practical training and experience pursuant to 741
	897	+	the provisions of this chapter. 742
	898	+	Sec. 17. Section 20-195dd of the general statutes is repealed and the 743
	899	+	following is substituted in lieu thereof (Effective October 1, 2021): 744
	900	+	(a) Except as otherwise provided in subsections (c) and (d) of this 745
	901	+	section, an applicant for a license as a professional counselor shall 746
	902	+	submit evidence satisfactory to the commissioner of having: (1) (A) 747
	903	+	Earned a graduate degree in clinical mental health counseling as part of 748
	904	+	a program of higher learning accredited by the Council for 749
	905	+	Accreditation of Counseling and Related Educational Programs, or a 750
	906	+	successor organization, or (B) (i) completed at least sixty graduate 751
	907	+	semester hours in counseling or a related mental health field at a 752
	908	+	regionally accredited institution of higher education that included 753
	909	+	coursework in each of the following areas: (I) Human growth and 754
	910	+	development; (II) social and cultural foundations; (III) counseling 755
	911	+	theories; (IV) counseling techniques; (V) group counseling; (VI) career 756
	912	+	counseling; (VII) appraisals or tests and measurements to individuals 757
	913	+	and groups; (VIII) research and evaluation; (IX) professional orientation 758
	914	+	to mental health counseling; (X) addiction and substance abuse 759
	915	+	counseling; (XI) trauma and crisis counseling; and (XII) diagnosis and 760
	916	+	treatment of mental and emotional disorders, (ii) earned from a 761
	917	+	regionally accredited institution of higher education a graduate degree 762
	918	+	in counseling or a related mental health field, (iii) completed a one-763 Substitute Bill No. 6666
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	925	+	hundred-hour practicum in counseling taught by a faculty member 764
	926	+	licensed or certified as a professional counselor or its equivalent in 765
	927	+	another state, and (iv) completed a six-hundred-hour clinical mental 766
	928	+	health counseling internship taught by a faculty member licensed or 767
	929	+	certified as a professional counselor or its equivalent in another state; (2) 768
	930	+	acquired three thousand hours of postgraduate experience under 769
	931	+	professional supervision, including a minimum of one hundred hours 770
	932	+	of direct professional supervision, in the practice of professional 771
	933	+	counseling, performed over a period of not less than two years; and (3) 772
	934	+	passed an examination prescribed by the commissioner. The provisions 773
	935	+	of subparagraphs (B)(i)(X) to (B)(i)(XII), inclusive, (B)(iii) and (B)(iv) of 774
	936	+	this subsection shall not apply to any applicant who, on or before July 775
	937	+	1, 2017, was a matriculating student in good standing in a graduate 776
	938	+	degree program at a regionally accredited institution of higher 777
	939	+	education in one of the fields required under subparagraph (B) of this 778
	940	+	subsection. 779
	941	+	(b) An applicant for a license as a professional counselor associate 780
	942	+	shall submit to the Commissioner of Public Health evidence satisfactory 781
	943	+	to the commissioner of having (1) earned a graduate degree in clinical 782
	944	+	mental health counseling as part of a program of higher learning 783
	945	+	accredited by the Council for Accreditation of Counseling and Related 784
	946	+	Educational Programs, or a successor organization, or (2) (A) completed 785
	947	+	at least sixty graduate semester hours in counseling or a related mental 786
	948	+	health field at a regionally accredited institution of higher education 787
	949	+	that included coursework in each of the following areas: Human growth 788
	950	+	and development; social and cultural foundations; counseling theories; 789
	951	+	counseling techniques; group counseling; career counseling; appraisals 790
	952	+	or tests and measurements to individuals and groups; research and 791
	953	+	evaluation; professional orientation to mental health counseling; 792
	954	+	addiction and substance abuse counseling; trauma and crisis 793
	955	+	counseling; and diagnosis and treatment of mental and emotional 794
	956	+	disorders, (B) completed a one-hundred-hour practicum in counseling 795
	957	+	taught by a faculty member licensed or certified as a professional 796
	958	+	counselor or its equivalent in another state, (C) completed a six-797 Substitute Bill No. 6666
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	963	+	26 of 89
	964	+
	965	+	hundred-hour clinical mental health counseling internship taught by a 798
	966	+	faculty member licensed or certified as a professional counselor or its 799
	967	+	equivalent in another state, and (D) earned from a regionally accredited 800
	968	+	institution of higher education a graduate degree in counseling or a 801
	969	+	related mental health field. The provisions of subparagraphs (A) to (C), 802
	970	+	inclusive, of subdivision (2) of this subsection shall not apply to any 803
	971	+	applicant who, on or before July 1, 2022, earned a graduate degree at a 804
	972	+	regionally accredited institution of higher education in counseling or a 805
	973	+	related mental health field and has accumulated at least three thousand 806
	974	+	hours of experience under professional supervision, as defined in 807
	975	+	section 20-195aa. 808
	976	+	(c) An applicant for licensure by endorsement shall present evidence 809
	977	+	satisfactory to the commissioner that the applicant is licensed or 810
	978	+	certified as a professional counselor or professional counselor associate, 811
	979	+	or as a person entitled to perform similar services under a different 812
	980	+	designation, in another state or jurisdiction whose requirements for 813
	981	+	practicing in such capacity are substantially similar to or higher than 814
	982	+	those of this state and that there are no disciplinary actions or 815
	983	+	unresolved complaints pending. 816
	984	+	(d) An applicant who is licensed or certified as a professional 817
	985	+	counselor or its equivalent in another state, territory or commonwealth 818
	986	+	of the United States may substitute three years of licensed or certified 819
	987	+	work experience in the practice of professional counseling in lieu of the 820
	988	+	requirements of subdivision (2) of subsection (a) of this section, 821
	989	+	provided the commissioner finds that such experience is equal to or 822
	990	+	greater than the requirements of this state. 823
	991	+	Sec. 18. Subsection (a) of section 20-195c of the general statutes is 824
	992	+	repealed and the following is substituted in lieu thereof (Effective October 825
	993	+	1, 2021): 826
	994	+	(a) Each applicant for licensure as a marital and family therapist shall 827
	995	+	present to the department satisfactory evidence that such applicant has: 828
	996	+	(1) Completed a graduate degree program specializing in marital and 829 Substitute Bill No. 6666
	997	+
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	1001	+	27 of 89
	1002	+
	1003	+	family therapy offered by a regionally accredited college or university 830
	1004	+	or an accredited postgraduate clinical training program accredited by 831
	1005	+	the Commission on Accreditation for Marriage and Family Therapy 832
	1006	+	Education offered by a regionally accredited institution of higher 833
	1007	+	education; (2) completed a supervised practicum or internship with 834
	1008	+	emphasis in marital and family therapy supervised by the program 835
	1009	+	granting the requisite degree or by an accredited postgraduate clinical 836
	1010	+	training program accredited by the Commission on Accreditation for 837
	1011	+	Marriage and Family Therapy Education and offered by a regionally 838
	1012	+	accredited institution of higher education; [, in which the student 839
	1013	+	received a minimum of five hundred direct clinical hours that included 840
	1014	+	one hundred hours of clinical supervision;] (3) completed twelve 841
	1015	+	months of relevant postgraduate experience, including (A) a minimum 842
	1016	+	of one thousand hours of direct client contact offering marital and 843
	1017	+	family therapy services subsequent to being awarded a master's degree 844
	1018	+	or doctorate or subsequent to the training year specified in subdivision 845
	1019	+	(2) of this subsection, and (B) one hundred hours of postgraduate 846
	1020	+	clinical supervision provided by a licensed marital and family therapist; 847
	1021	+	and (4) passed an examination prescribed by the department. The fee 848
	1022	+	shall be three hundred fifteen dollars for each initial application. 849
	1023	+	Sec. 19. Subdivision (12) of subsection (a) of section 19a-14 of the 850
	1024	+	general statutes is repealed and the following is substituted in lieu 851
	1025	+	thereof (Effective October 1, 2021): 852
	1026	+	(12) With respect to any complaint filed with the department on or 853
	1027	+	after October 1, 2010, alleging incompetence, negligence, fraud or deceit 854
	1028	+	by a person subject to regulation or licensing by any board or 855
	1029	+	commission described in subdivision (1) to [(5), inclusive, (7),] (8), 856
	1030	+	inclusive, (12) to (14), inclusive, or subdivision (16) of subsection (b) of 857
	1031	+	this section: 858
	1032	+	(A) Upon request of the person who filed the complaint, provide such 859
	1033	+	person with information on the status of the complaint; 860
	1034	+	(B) Upon request of the person who filed the complaint, provide such 861 Substitute Bill No. 6666
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	1039	+	28 of 89
	1040	+
	1041	+	person with an opportunity to review, at the department, records 862
	1042	+	compiled as of the date of the request pursuant to any investigation of 863
	1043	+	the complaint, including, but not limited to, the respondent's written 864
	1044	+	response to the complaint, except that such person shall not be entitled 865
	1045	+	to copy such records and the department (i) shall not disclose (I) 866
	1046	+	information concerning a health care professional's referral to, 867
	1047	+	participation in or completion of an assistance program in accordance 868
	1048	+	with sections 19a-12a and 19a-12b, that is confidential pursuant to 869
	1049	+	section 19a-12a, (II) information not related to such person's specific 870
	1050	+	complaint, including, but not limited to, information concerning 871
	1051	+	patients other than such person, or (III) personnel or medical records 872
	1052	+	and similar files the disclosure of which would constitute an invasion of 873
	1053	+	personal privacy pursuant to section 1-210, except for such records or 874
	1054	+	similar files solely related to such person; (ii) shall not be required to 875
	1055	+	disclose any other information that is otherwise confidential pursuant 876
	1056	+	to federal law or state statute, except for information solely related to 877
	1057	+	such person; and (iii) may require up to ten business days written notice 878
	1058	+	prior to providing such opportunity for review; 879
	1059	+	(C) Prior to resolving the complaint with a consent order, provide the 880
	1060	+	person who filed the complaint with not less than ten business days to 881
	1061	+	submit a written statement as to whether such person objects to 882
	1062	+	resolving the complaint with a consent order; 883
	1063	+	(D) If a hearing is held with respect to such complaint after a finding 884
	1064	+	of probable cause, provide the person who filed the complaint with a 885
	1065	+	copy of the notice of hearing issued pursuant to section 4-177, which 886
	1066	+	shall include information concerning the opportunity to present oral or 887
	1067	+	written statements pursuant to subsection (b) of section 4-177c; and 888
	1068	+	(E) Notify the person who filed the complaint of the final disposition 889
	1069	+	of such complaint not later than seven business days after such final 890
	1070	+	disposition; 891
	1071	+	Sec. 20. Subsections (a) to (c), inclusive, of section 20-204a of the 892
	1072	+	general statutes are repealed and the following is substituted in lieu 893 Substitute Bill No. 6666
	1073	+
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	1077	+	29 of 89
	1078	+
	1079	+	thereof (Effective October 1, 2021): 894
	1080	+	(a) The department shall investigate each allegation of any act or 895
	1081	+	omission by a veterinarian specified in section 20-202. The investigation 896
	1082	+	shall be conducted in accordance with the provisions of section 19a-14, 897
	1083	+	as amended by this act, to determine if probable cause exists to issue a 898
	1084	+	statement of charges and to institute proceedings against the 899
	1085	+	veterinarian. Such investigation shall be concluded not later than twelve 900
	1086	+	months from the date the allegation is submitted to the department. 901
	1087	+	(b) Except as provided in subsections (c) and (d) of this section, the 902
	1088	+	investigation shall be confidential and not subject to disclosure under 903
	1089	+	section 1-210 and no person may disclose knowledge of the 904
	1090	+	investigation to a third party unless the veterinarian requests that the 905
	1091	+	investigation be open, [The owner of any animal that is the subject of 906
	1092	+	such an investigation shall not be deemed a third party to such an 907
	1093	+	investigation for purposes of disclosure under this section] except that 908
	1094	+	the department shall provide information to the person who filed the 909
	1095	+	complaint pursuant to subdivision (12) of subsection (a) of section 19a-910
	1096	+	14, as amended by this act. 911
	1097	+	(c) If the department makes a finding of no probable cause to take 912
	1098	+	action under section 20-202 or fails to make a finding within the twelve-913
	1099	+	month period required by subsection [(b)] (a) of this section, the 914
	1100	+	allegation submitted pursuant to subsection (a) of this section and the 915
	1101	+	entire record of the investigation may remain confidential and no 916
	1102	+	person shall disclose knowledge of such investigation to a third party 917
	1103	+	unless the veterinarian requests that it be open, except that the 918
	1104	+	department shall provide information to the person who filed the 919
	1105	+	complaint pursuant to subdivision (12) of subsection (a) of section 19a-920
	1106	+	14, as amended by this act. 921
	1107	+	Sec. 21. Subsections (b) and (c) of section 7-62b of the general statutes 922
	1108	+	are repealed and the following is substituted in lieu thereof (Effective 923
	1109	+	January 1, 2022): 924 Substitute Bill No. 6666
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	1114	+	30 of 89
	1115	+
	1116	+	(b) The funeral director or embalmer licensed by the department, or 925
	1117	+	the funeral director or embalmer licensed in another state and 926
	1118	+	complying with the terms of a reciprocal agreement on file with the 927
	1119	+	department, in charge of the burial of the deceased person shall 928
	1120	+	complete the death certificate through the electronic death registry 929
	1121	+	system, or, if the electronic death registry system is unavailable, on a 930
	1122	+	form provided by the department. Said certificate shall be filed by a 931
	1123	+	licensed embalmer or such embalmer's designee or a funeral director or 932
	1124	+	such director's designee, in accordance with the provisions of this 933
	1125	+	section, except when inquiry is required by the Chief Medical 934
	1126	+	Examiner's Office, in which case the death certificate shall be filed in 935
	1127	+	accordance with section 19a-409. The Social Security number of the 936
	1128	+	deceased person shall be recorded on such certificate. Such licensed 937
	1129	+	funeral director or licensed embalmer shall obtain the personal data 938
	1130	+	from the next of kin or the best qualified person or source available and 939
	1131	+	shall obtain a medical certification from the person responsible therefor, 940
	1132	+	in accordance with the provisions of this section. Only a licensed 941
	1133	+	embalmer may assume charge of the burial of a deceased person who 942
	1134	+	had a communicable disease, as designated in the [Public Health Code] 943
	1135	+	regulations of Connecticut state agencies, at the time of death and such 944
	1136	+	licensed embalmer shall file an affidavit, on a form provided by the 945
	1137	+	department, signed and sworn to by such licensed embalmer stating 946
	1138	+	that the body has been disinfected in accordance with the [Public Health 947
	1139	+	Code] regulations of Connecticut State Agencies. 948
	1140	+	(c) The medical certification portion of the death certificate shall be 949
	1141	+	completed, signed and returned to the licensed funeral director or 950
	1142	+	licensed embalmer no later than twenty-four hours after death by the 951
	1143	+	physician or advanced practice registered nurse in charge of the 952
	1144	+	patient's care for the illness or condition which resulted in death, or 953
	1145	+	upon the death of an infant delivered by a nurse-midwife, by such 954
	1146	+	nurse-midwife, as provided in section 20-86b. In the absence of such 955
	1147	+	physician or advanced practice registered nurse, or with the physician's 956
	1148	+	or advanced practice registered nurse's approval, the medical 957
	1149	+	certification may be completed and signed by an associate physician, an 958 Substitute Bill No. 6666
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	1154	+	31 of 89
	1155	+
	1156	+	advanced practice registered nurse, a physician assistant as provided in 959
	1157	+	subsection (d) of section 20-12d, a registered nurse as provided in 960
	1158	+	section 20-101a, the chief medical officer of the institution in which 961
	1159	+	death occurred, or by the pathologist who performed an autopsy upon 962
	1160	+	the decedent. No physician, advanced practice registered nurse, 963
	1161	+	physician assistant, registered nurse, nurse-midwife, chief medical 964
	1162	+	officer or pathologist shall sign and return the medical certification 965
	1163	+	unless such physician, advanced practice registered nurse, physician 966
	1164	+	assistant, registered nurse, nurse-midwife, chief medical officer or 967
	1165	+	pathologist has personally viewed and examined the body of the person 968
	1166	+	to whom the medical certification relates and is satisfied that at the time 969
	1167	+	of the examination such person was in fact dead, except in the event a 970
	1168	+	medical certification is completed by a physician, advanced practice 971
	1169	+	registered nurse, physician assistant, registered nurse, nurse-midwife, 972
	1170	+	chief medical officer or pathologist other than the one who made the 973
	1171	+	determination and pronouncement of death, an additional viewing and 974
	1172	+	examination of the body shall not be required. Such physician, 975
	1173	+	advanced practice registered nurse, physician assistant, registered 976
	1174	+	nurse, nurse-midwife, chief medical officer or pathologist shall certify 977
	1175	+	to the facts of death through the electronic death registry system, or, if 978
	1176	+	the electronic death registry is unavailable, on a form provided by the 979
	1177	+	department. If a physician, advanced practice registered nurse, 980
	1178	+	physician assistant, registered nurse, nurse-midwife, chief medical 981
	1179	+	officer or pathologist refuses or otherwise fails to complete, sign and 982
	1180	+	return the medical portion of the death certificate to the licensed funeral 983
	1181	+	director or licensed embalmer within twenty-four hours after death, 984
	1182	+	such licensed funeral director or embalmer may notify the 985
	1183	+	Commissioner of Public Health of such refusal. The commissioner may, 986
	1184	+	upon receipt of notification and investigation, assess a civil penalty 987
	1185	+	against such physician, advanced practice registered nurse, physician 988
	1186	+	assistant, registered nurse, chief medical officer or pathologist not to 989
	1187	+	exceed two hundred fifty dollars. The medical certification shall state 990
	1188	+	the cause of death, defined so that such death may be classified under 991
	1189	+	the international list of causes of death, the duration of disease if known 992
	1190	+	and such additional information as the Department of Public Health 993 Substitute Bill No. 6666
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	1195	+	32 of 89
	1196	+
	1197	+	requires. The department shall give due consideration to national 994
	1198	+	uniformity in vital statistics in prescribing the form and content of such 995
	1199	+	information. 996
	1200	+	Sec. 22. Section 19a-200 of the general statutes is repealed and the 997
	1201	+	following is substituted in lieu thereof (Effective July 1, 2021): 998
	1202	+	(a) The mayor of each city, the chief executive officer of each town 999
	1203	+	and the warden of each borough shall, unless the charter of such city, 1000
	1204	+	town or borough otherwise provides, nominate some person to be 1001
	1205	+	director of health for such city, town or borough. [, which] Such person 1002
	1206	+	shall possess the qualifications specified in subsection (b) of this section. 1003
	1207	+	Upon approval of the commissioner, such nomination shall be 1004
	1208	+	confirmed or rejected by the board of selectmen, if there be such a board, 1005
	1209	+	otherwise by the legislative body of such city or town or by the 1006
	1210	+	burgesses of such borough within thirty days thereafter. 1007
	1211	+	(b) Notwithstanding the charter provisions of any city, town or 1008
	1212	+	borough with respect to the qualifications of the director of health, on 1009
	1213	+	and after October 1, 2010, any person nominated to be a director of 1010
	1214	+	health shall (1) be a licensed physician and hold a degree in public health 1011
	1215	+	from an accredited school, college, university or institution, or (2) hold 1012
	1216	+	a graduate degree in public health from an accredited institution of 1013
	1217	+	higher education. The educational requirements of this section shall not 1014
	1218	+	apply to any director of health nominated or otherwise appointed as 1015
	1219	+	director of health prior to October 1, 2010. 1016
	1220	+	(c) In cities, towns or boroughs with a population of forty thousand 1017
	1221	+	or more for five consecutive years, according to the estimated 1018
	1222	+	population figures authorized pursuant to subsection (b) of section 1019
	1223	+	8-159a, such director of health shall serve in a full-time capacity, except 1020
	1224	+	where a town has designated such director as the chief medical advisor 1021
	1225	+	for its public schools under section 10-205. [, and] 1022
	1226	+	(d) No director shall, [not,] during such director's term of office, have 1023
	1227	+	any financial interest in or engage in any employment, transaction or 1024 Substitute Bill No. 6666
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	1232	+	33 of 89
	1233	+
	1234	+	professional activity that is in substantial conflict with the proper 1025
	1235	+	discharge of the duties required of directors of health by the general 1026
	1236	+	statutes or the regulations of Connecticut state agencies or specified by 1027
	1237	+	the appointing authority of the city, town or borough in its written 1028
	1238	+	agreement with such director. A written agreement with such director 1029
	1239	+	shall be submitted to the Commissioner of Public Health upon such 1030
	1240	+	director's appointment or reappointment. 1031
	1241	+	(e) Such director of health shall have and exercise within the limits of 1032
	1242	+	the city, town or borough for which such director is appointed all 1033
	1243	+	powers necessary for enforcing the general statutes, provisions of the 1034
	1244	+	regulations of Connecticut state agencies relating to the preservation 1035
	1245	+	and improvement of the public health and preventing the spread of 1036
	1246	+	diseases therein. 1037
	1247	+	(f) In case of the absence or inability to act of a city, town or borough 1038
	1248	+	director of health or if a vacancy exists in the office of such director, the 1039
	1249	+	appointing authority of such city, town or borough may, with the 1040
	1250	+	approval of the Commissioner of Public Health, designate in writing a 1041
	1251	+	suitable person to serve as acting director of health during the period of 1042
	1252	+	such absence or inability or vacancy, provided the commissioner may 1043
	1253	+	appoint such acting director if the city, town or borough fails to do so. 1044
	1254	+	The person so designated, when sworn, shall have all the powers and 1045
	1255	+	be subject to all the duties of such director. In case of vacancy in the 1046
	1256	+	office of such director, if such vacancy exists for [thirty] sixty days, said 1047
	1257	+	commissioner may appoint a director of health for such city, town or 1048
	1258	+	borough. Said commissioner, may, for cause, remove an officer the 1049
	1259	+	commissioner or any predecessor in said office has appointed, and the 1050
	1260	+	common council of such city, town or the burgesses of such borough 1051
	1261	+	may, respectively, for cause, remove a director whose nomination has 1052
	1262	+	been confirmed by them, provided such removal shall be approved by 1053
	1263	+	said commissioner; and, within two days thereafter, notice in writing of 1054
	1264	+	such action shall be given by the clerk of such city, town or borough, as 1055
	1265	+	the case may be, to said commissioner, who shall, within ten days after 1056
	1266	+	receipt, file with the clerk from whom the notice was received, approval 1057 Substitute Bill No. 6666
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	1271	+	34 of 89
	1272	+
	1273	+	or disapproval. 1058
	1274	+	(g) Each such director of health shall hold office for the term of four 1059
	1275	+	years from the date of appointment and until a successor is nominated 1060
	1276	+	and confirmed in accordance with this section. 1061
	1277	+	(h) Each director of health shall, annually, at the end of the fiscal year 1062
	1278	+	of the city, town or borough, file with the Department of Public Health 1063
	1279	+	a report of the doings as such director for the year preceding. 1064
	1280	+	[(b)] (i) On and after July 1, 1988, each city, town and borough shall 1065
	1281	+	provide for the services of a sanitarian licensed under chapter 395 to 1066
	1282	+	work under the direction of the local director of health. Where practical, 1067
	1283	+	the local director of health may act as the sanitarian. 1068
	1284	+	[(c)] (j) As used in this chapter, "authorized agent" means a sanitarian 1069
	1285	+	licensed under chapter 395 and any individual certified for a specific 1070
	1286	+	program of environmental health by the Commissioner of Public Health 1071
	1287	+	in accordance with the general statutes and regulations of Connecticut 1072
	1288	+	state agencies. 1073
	1289	+	Sec. 23. Section 19a-202a of the general statutes is repealed and the 1074
	1290	+	following is substituted in lieu thereof (Effective July 1, 2021): 1075
	1291	+	(a) Any municipality may designate itself as having a part-time 1076
	1292	+	health department if: (1) The municipality has not had a full-time health 1077
	1293	+	department or been in a full-time health district prior to January 1, 1998; 1078
	1294	+	(2) the municipality has the equivalent of at least one full-time 1079
	1295	+	employee, as determined by the Commissioner of Public Health, who 1080
	1296	+	performs public health functions required by the general statutes and 1081
	1297	+	the regulations of Connecticut states agencies; and (3) the municipality 1082
	1298	+	annually submits a public health program plan and budget to the 1083
	1299	+	commissioner. [; and (4) the commissioner approves the program plan 1084
	1300	+	and budget.] 1085
	1301	+	(b) The Commissioner of Public Health [shall] may adopt regulations, 1086
	1302	+	in accordance with the provisions of chapter 54, for the development 1087 Substitute Bill No. 6666
	1303	+
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	1307	+	35 of 89
	1308	+
	1309	+	and approval of the program plan and budget required by subdivision 1088
	1310	+	(3) of subsection (a) of this section. 1089
	1311	+	Sec. 24. Section 19a-244 of the general statutes is repealed and the 1090
	1312	+	following is substituted in lieu thereof (Effective July 1, 2021): 1091
	1313	+	On and after October 1, 2010, any person nominated to be the director 1092
	1314	+	of health shall (1) be a licensed physician and hold a degree in public 1093
	1315	+	health from an accredited school, college, university or institution, or (2) 1094
	1316	+	hold a graduate degree in public health from an accredited school, 1095
	1317	+	college or institution. The educational requirements of this section shall 1096
	1318	+	not apply to any director of health nominated or otherwise appointed 1097
	1319	+	as director of health prior to October 1, 2010. The board may specify in 1098
	1320	+	a written agreement with such director the term of office, which shall 1099
	1321	+	not exceed three years, salary and duties required of and responsibilities 1100
	1322	+	assigned to such director in addition to those required by the general 1101
	1323	+	statutes or the [Public Health Code] regulations of Connecticut state 1102
	1324	+	agencies, if any. Such director shall be removed during the term of such 1103
	1325	+	written agreement only for cause after a public hearing by the board on 1104
	1326	+	charges preferred, of which reasonable notice shall have been given. No 1105
	1327	+	director shall, during such director's term of office, have any financial 1106
	1328	+	interest in or engage in any employment, transaction or professional 1107
	1329	+	activity that is in substantial conflict with the proper discharge of the 1108
	1330	+	duties required of directors of health by the general statutes or the 1109
	1331	+	[Public Health Code] regulations of Connecticut state agencies or 1110
	1332	+	specified by the board in its written agreement with such director. The 1111
	1333	+	board shall submit such written agreement to the Commissioner of 1112
	1334	+	Public Health upon such director's appointment or reappointment. Such 1113
	1335	+	director shall serve in a full-time capacity and act as secretary and 1114
	1336	+	treasurer of the board, without the right to vote. Such director shall give 1115
	1337	+	to the district a bond with a surety company authorized to transact 1116
	1338	+	business in the state, for the faithful performance of such director's 1117
	1339	+	duties as treasurer, in such sum and upon such conditions as the board 1118
	1340	+	requires. Such director shall be the executive officer of the district 1119
	1341	+	department of health. Full-time employees of a city, town or borough 1120 Substitute Bill No. 6666
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	1346	+	36 of 89
	1347	+
	1348	+	health department at the time such city, town or borough votes to form 1121
	1349	+	or join a district department of health shall become employees of such 1122
	1350	+	district department of health. Such employees may retain their rights 1123
	1351	+	and benefits in the pension system of the town, city or borough by which 1124
	1352	+	they were employed and shall continue to retain their active 1125
	1353	+	participating membership therein until retired. Such employees shall 1126
	1354	+	pay into such pension system the contributions required of them for 1127
	1355	+	their class and membership. Any additional employees to be hired by 1128
	1356	+	the district or any vacancies to be filled shall be filled in accordance with 1129
	1357	+	the rules and regulations of the merit system of the state of Connecticut 1130
	1358	+	and the employees who are employees of cities, towns or boroughs 1131
	1359	+	which have adopted a local civil service or merit system shall be 1132
	1360	+	included in their comparable grade with fully attained seniority in the 1133
	1361	+	state merit system. Such employees shall perform such duties as are 1134
	1362	+	prescribed by the director of health. In the event of the withdrawal of a 1135
	1363	+	town, city or borough from the district department, or in the event of a 1136
	1364	+	dissolution of any district department, the employees thereof, originally 1137
	1365	+	employed therein, shall automatically become employees of the 1138
	1366	+	appropriate town, city or borough's board of health. At the end of each 1139
	1367	+	fiscal year, each director of health shall submit a report to the 1140
	1368	+	Department of Public Health detailing the activities of such director 1141
	1369	+	during the preceding fiscal year. 1142
	1370	+	Sec. 25. Subdivision (3) of subsection (a) of section 19a-12a of the 1143
	1371	+	general statutes is repealed and the following is substituted in lieu 1144
	1372	+	thereof (Effective July 1, 2021): 1145
	1373	+	(3) "Health care professionals" includes any person licensed or who 1146
	1374	+	holds a permit pursuant to chapter 370, 372, 373, 375, 375a, 376, 376a, 1147
	1375	+	376b, 376c, 377, 378, 379, 379a, 380, 381, 381a, 382a, 383, 383a, 383b, 383c, 1148
	1376	+	384, 384a, 384b, 384c, 384d, 385, 398 or 399; 1149
	1377	+	Sec. 26. Section 19a-12d of the general statutes is repealed and the 1150
	1378	+	following is substituted in lieu thereof (Effective July 1, 2021): 1151
	1379	+	On or before the last day of January, April, July and October in each 1152 Substitute Bill No. 6666
	1380	+
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	1384	+	37 of 89
	1385	+
	1386	+	year, the Commissioner of Public Health shall certify the amount of 1153
	1387	+	revenue received as a result of any fee increase in the amount of five 1154
	1388	+	dollars (1) that took effect October 1, 2015, pursuant to sections 19a-88, 1155
	1389	+	19a-515, 20-65k, 20-74bb, 20-74h, 20-74s, 20-149, 20-162o, 20-162bb, 20-1156
	1390	+	191a, 20-195c, as amended by this act, 20-195o, 20-195cc, 20-201, 20-206b, 1157
	1391	+	20-206n, 20-206r, 20-206bb, 20-206ll, 20-222a, 20-275, 20-395d, 20-398 and 1158
	1392	+	20-412, and (2) that took effect October 1, 2021, pursuant to section 20-1159
	1393	+	185k, as amended by this act, and transfer such amount to the 1160
	1394	+	professional assistance program account established in section 19a-12c. 1161
	1395	+	Sec. 27. Subsection (a) of section 19a-12e of the general statutes is 1162
	1396	+	repealed and the following is substituted in lieu thereof (Effective October 1163
	1397	+	1, 2021): 1164
	1398	+	(a) As used in this section: 1165
	1399	+	(1) "Health care professional" means any individual licensed or who 1166
	1400	+	holds a permit pursuant to chapter 368v, 370, 372, 373, 375 to 378, 1167
	1401	+	inclusive, 379 to 381b, inclusive, 382a, 383 to 385, inclusive, 388 or 397a 1168
	1402	+	to 399, inclusive; 1169
	1403	+	(2) "Assistance program" means the program established pursuant to 1170
	1404	+	section 19a-12a, as amended by this act, to provide education, 1171
	1405	+	prevention, intervention, referral assistance, rehabilitation or support 1172
	1406	+	services to health care professionals who have a chemical dependency, 1173
	1407	+	emotional or behavioral disorder or physical or mental illness; and 1174
	1408	+	(3) "Hospital" has the same meaning as provided in section 19a-490. 1175
	1409	+	Sec. 28. Subsection (b) of section 20-185k of the general statutes is 1176
	1410	+	repealed and the following is substituted in lieu thereof (Effective from 1177
	1411	+	passage): 1178
	1412	+	(b) A license issued under this section may be renewed annually. The 1179
	1413	+	license shall be renewed in accordance with the provisions of section 1180
	1414	+	19a-88, for a fee of one hundred [seventy-five] eighty dollars for 1181
	1415	+	applications for renewal of licenses that expire on or after October 1, 1182 Substitute Bill No. 6666
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	1420	+	38 of 89
	1421	+
	1422	+	2021. Each behavior analyst applying for license renewal shall furnish 1183
	1423	+	evidence satisfactory to the commissioner of having current certification 1184
	1424	+	with the Behavior Analyst Certification Board. 1185
	1425	+	Sec. 29. Subsection (a) of section 17a-412 of the general statutes is 1186
	1426	+	repealed and the following is substituted in lieu thereof (Effective October 1187
	1427	+	1, 2021): 1188
	1428	+	(a) Any physician or surgeon licensed under the provisions of chapter 1189
	1429	+	370, any resident physician or intern in any hospital in this state, 1190
	1430	+	whether or not so licensed, [and] any registered nurse, licensed practical 1191
	1431	+	nurse, medical examiner, dentist, optometrist, chiropractor, podiatrist, 1192
	1432	+	social worker, clergyman, police officer, pharmacist, physical therapist, 1193
	1433	+	long-term care facility administrator, nurse's aide or orderly in a long-1194
	1434	+	term care facility, any person paid for caring for a patient in a long-term 1195
	1435	+	care facility, any staff person employed by a long-term care facility, 1196
	1436	+	[and] any person who is a sexual assault counselor or a domestic 1197
	1437	+	violence counselor as defined in section 52-146k, and any behavior 1198
	1438	+	analyst licensed under the provisions of chapter 382a, who has 1199
	1439	+	reasonable cause to suspect or believe that a resident in a long-term care 1200
	1440	+	facility has been abused, neglected, exploited or abandoned, or is in a 1201
	1441	+	condition that is the result of such abuse, neglect, exploitation or 1202
	1442	+	abandonment, shall, not later than seventy-two hours after such 1203
	1443	+	suspicion or belief arose, report such information or cause a report to be 1204
	1444	+	made in any reasonable manner to the Commissioner of Social Services 1205
	1445	+	pursuant to chapter 319dd. Any person required to report under the 1206
	1446	+	provision of this section who fails to make such report within the 1207
	1447	+	prescribed time period shall be fined not more than five hundred 1208
	1448	+	dollars, except that, if such person intentionally fails to make such report 1209
	1449	+	within the prescribed time period, such person shall be guilty of a class 1210
	1450	+	C misdemeanor for the first offense and a class A misdemeanor for any 1211
	1451	+	subsequent offense. 1212
	1452	+	Sec. 30. Subsection (a) of section 17b-451 of the general statutes is 1213
	1453	+	repealed and the following is substituted in lieu thereof (Effective October 1214
	1454	+	1, 2021): 1215 Substitute Bill No. 6666
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	1459	+	39 of 89
	1460	+
	1461	+	(a) A mandatory reporter [, as defined in this section,] who has 1216
	1462	+	reasonable cause to suspect or believe that any elderly person has been 1217
	1463	+	abused, neglected, exploited or abandoned, or is in a condition that is 1218
	1464	+	the result of such abuse, neglect, exploitation or abandonment, or is in 1219
	1465	+	need of protective services, shall, not later than seventy-two hours after 1220
	1466	+	such suspicion or belief arose, report such information or cause a report 1221
	1467	+	to be made in any reasonable manner to the Commissioner of Social 1222
	1468	+	Services or to the person or persons designated by the commissioner to 1223
	1469	+	receive such reports. [The term] As used in this section, "mandatory 1224
	1470	+	reporter" means (1) any physician or surgeon licensed under the 1225
	1471	+	provisions of chapter 370, (2) any resident physician or intern in any 1226
	1472	+	hospital in this state, whether or not so licensed, (3) any registered nurse, 1227
	1473	+	(4) any nursing home administrator, nurse's aide or orderly in a nursing 1228
	1474	+	home facility or residential care home, (5) any person paid for caring for 1229
	1475	+	a resident in a nursing home facility or residential care home, (6) any 1230
	1476	+	staff person employed by a nursing home facility or residential care 1231
	1477	+	home, (7) any residents' advocate, other than a representative of the 1232
	1478	+	Office of the Long-Term Care Ombudsman, as established under section 1233
	1479	+	17a-405, including the State Ombudsman, (8) any licensed practical 1234
	1480	+	nurse, medical examiner, dentist, optometrist, chiropractor, podiatrist, 1235
	1481	+	behavior analyst, social worker, clergyman, police officer, pharmacist, 1236
	1482	+	psychologist or physical therapist, (9) any person paid for caring for an 1237
	1483	+	elderly person by any institution, organization, agency or facility, 1238
	1484	+	including without limitation, any employee of a community-based 1239
	1485	+	services provider, senior center, home care agency, homemaker and 1240
	1486	+	companion agency, adult day care center, village-model community 1241
	1487	+	and congregate housing facility, and (10) any person licensed or 1242
	1488	+	certified as an emergency medical services provider pursuant to chapter 1243
	1489	+	368d or chapter 384d, including any such emergency medical services 1244
	1490	+	provider who is a member of a municipal fire department. Any 1245
	1491	+	mandatory reporter who fails to make such report within the prescribed 1246
	1492	+	time period shall be fined not more than five hundred dollars, except 1247
	1493	+	that, if such person intentionally fails to make such report within the 1248
	1494	+	prescribed time period, such person shall be guilty of a class C 1249
	1495	+	misdemeanor for the first offense and a class A misdemeanor for any 1250 Substitute Bill No. 6666
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	1501	+
	1502	+	subsequent offense. Any institution, organization, agency or facility 1251
	1503	+	employing individuals to care for persons sixty years of age or older 1252
	1504	+	shall provide mandatory training on detecting potential abuse, neglect, 1253
	1505	+	exploitation and abandonment of such persons and inform such 1254
	1506	+	employees of their obligations under this section. For purposes of this 1255
	1507	+	subsection, "person paid for caring for an elderly person by any 1256
	1508	+	institution, organization, agency or facility" includes an employee of a 1257
	1509	+	community-based services provider, senior center, home health care 1258
	1510	+	agency, homemaker and companion agency, adult day care center, 1259
	1511	+	village-model community and congregate housing facility. 1260
	1512	+	Sec. 31. Subsection (g) of section 17b-451 of the general statutes is 1261
	1513	+	repealed and the following is substituted in lieu thereof (Effective October 1262
	1514	+	1, 2021): 1263
	1515	+	(g) The Commissioner of Social Services shall develop an educational 1264
	1516	+	training program to promote and encourage the accurate and prompt 1265
	1517	+	identification and reporting of abuse, neglect, exploitation and 1266
	1518	+	abandonment of elderly persons. Such training program shall be made 1267
	1519	+	available on the Internet web site of the Department of Social Services 1268
	1520	+	to [mandated] mandatory reporters and other interested persons. The 1269
	1521	+	commissioner shall also make such training available in person or 1270
	1522	+	otherwise at various times and locations throughout the state as 1271
	1523	+	determined by the commissioner. 1272
	1524	+	Sec. 32. Section 19a-6o of the general statutes is repealed and the 1273
	1525	+	following is substituted in lieu thereof (Effective July 1, 2021): 1274
	1526	+	(a) There is established, within available appropriations, within the 1275
	1527	+	Department of Public Health, a Palliative Care Advisory Council. The 1276
	1528	+	advisory council shall: (1) Analyze the current state of palliative care in 1277
	1529	+	the state; and (2) advise the department on matters relating to the 1278
	1530	+	improvement of palliative care and the quality of life for persons with 1279
	1531	+	serious or chronic illnesses. 1280
	1532	+	(b) The advisory council shall consist of the following members: 1281 Substitute Bill No. 6666
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	1538	+
	1539	+	(1) Two appointed by the Governor, one of whom shall be a physician 1282
	1540	+	certified by the American Board of Hospice and Palliative Medicine and 1283
	1541	+	one of whom shall be a registered nurse or advanced practice registered 1284
	1542	+	nurse certified by the National Board for Certification of Hospice and 1285
	1543	+	Palliative Nurses; 1286
	1544	+	(2) Seven appointed by the Commissioner of Public Health, each of 1287
	1545	+	whom shall be a licensed health care provider, with each appointee 1288
	1546	+	having experience or expertise in the provision of one of the following: 1289
	1547	+	(A) Inpatient palliative care in a hospital; (B) inpatient palliative care in 1290
	1548	+	a nursing home facility; (C) palliative care in the patient's home or a 1291
	1549	+	community setting; (D) pediatric palliative care; (E) palliative care for 1292
	1550	+	young adults; (F) palliative care for adults or elderly persons; and (G) 1293
	1551	+	inpatient palliative care in a psychiatric facility; 1294
	1552	+	(3) One appointed by the speaker of the House of Representatives, 1295
	1553	+	who shall be a licensed social worker experienced in working with 1296
	1554	+	persons with serious or chronic illness and their family members; 1297
	1555	+	(4) One appointed by the president pro tempore of the Senate, who 1298
	1556	+	shall be a licensed pharmacist experienced in working with persons 1299
	1557	+	with serious or chronic illness; 1300
	1558	+	(5) One appointed by the minority leader of the House of 1301
	1559	+	Representatives, who shall be a spiritual counselor experienced in 1302
	1560	+	working with persons with serious or chronic illness and their family 1303
	1561	+	members; and 1304
	1562	+	(6) One appointed by the minority leader of the Senate, who shall be 1305
	1563	+	a representative of the American Cancer Society or a person experienced 1306
	1564	+	in advocating for persons with serious or chronic illness and their family 1307
	1565	+	members. 1308
	1566	+	(c) All appointments to the advisory council shall be made not later 1309
	1567	+	than December 31, 2013. Advisory council members shall serve three-1310
	1568	+	year terms. Any vacancy shall be filled by the appointing authority. 1311 Substitute Bill No. 6666
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	1573	+	42 of 89
	1574	+
	1575	+	(d) Any appointment that is vacant for one year or more shall be 1312
	1576	+	made by the Commissioner of Public Health. The commissioner shall 1313
	1577	+	notify the appointing authority of the identity of the commissioner's 1314
	1578	+	choice for appointment not later than thirty days before making such 1315
	1579	+	appointment. 1316
	1580	+	[(d)] (e) Members shall receive no compensation except for 1317
	1581	+	reimbursement for necessary expenses incurred in performing their 1318
	1582	+	duties. 1319
	1583	+	[(e)] (f) The members shall elect the chairperson of the advisory 1320
	1584	+	council from among the members of the advisory council. A majority of 1321
	1585	+	the advisory council members shall constitute a quorum. Any action 1322
	1586	+	taken by the advisory council shall require a majority vote of those 1323
	1587	+	present. The first meeting of the advisory council shall be held not later 1324
	1588	+	than December 31, 2013. The advisory council shall meet biannually and 1325
	1589	+	at other times upon the call of the chairperson, upon the request of the 1326
	1590	+	Commissioner of Public Health or upon the request of a majority of the 1327
	1591	+	advisory council members. 1328
	1592	+	[(f)] (g) Not later than January 1, [2015] 2022, and [annually] 1329
	1593	+	biennially thereafter, the advisory council shall submit a report on its 1330
	1594	+	findings and recommendations to the Commissioner of Public Health 1331
	1595	+	and the joint standing committee of the General Assembly having 1332
	1596	+	cognizance of matters relating to public health, in accordance with the 1333
	1597	+	provisions of section 11-4a. 1334
	1598	+	Sec. 33. Section 19a-6q of the general statutes is repealed and the 1335
	1599	+	following is substituted in lieu thereof (Effective from passage): 1336
	1600	+	[(a)] The Commissioner of Public Health, in consultation with the 1337
	1601	+	executive director of the Office of Health Strategy, established under 1338
	1602	+	section 19a-754a, and local and regional health departments, shall, 1339
	1603	+	within available resources, develop a plan that is consistent with the 1340
	1604	+	Department of Public Health's Healthy Connecticut 2020 health 1341
	1605	+	improvement plan and the state healthcare innovation plan developed 1342 Substitute Bill No. 6666
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	1611	+
	1612	+	pursuant to the State Innovation Model Initiative by the Centers for 1343
	1613	+	Medicare and Medicaid Services Innovation Center. The commissioner 1344
	1614	+	shall develop and implement such plan to: (1) Reduce the incidence of 1345
	1615	+	tobacco use, high blood pressure, health care associated infections, 1346
	1616	+	asthma, unintended pregnancy and diabetes; (2) improve chronic 1347
	1617	+	disease care coordination in the state; and (3) reduce the incidence and 1348
	1618	+	effects of chronic disease and improve outcomes for conditions 1349
	1619	+	associated with chronic disease in the state. The commissioner shall post 1350
	1620	+	such plan on the Department of Public Health's Internet web site. 1351
	1621	+	[(b) The commissioner shall, on or before January 15, 2015, and 1352
	1622	+	biennially thereafter, submit a report, in consultation with the executive 1353
	1623	+	director of the Office of Health Strategy, in accordance with the 1354
	1624	+	provisions of section 11-4a to the joint standing committee of the 1355
	1625	+	General Assembly having cognizance of matters relating to public 1356
	1626	+	health concerning chronic disease and implementation of the plan 1357
	1627	+	described in subsection (a) of this section. The commissioner shall post 1358
	1628	+	each report on the Department of Public Health's Internet web site not 1359
	1629	+	later than thirty days after submitting such report. Each report shall 1360
	1630	+	include, but need not be limited to: (1) A description of the chronic 1361
	1631	+	diseases that are most likely to cause a person's death or disability, the 1362
	1632	+	approximate number of persons affected by such chronic diseases and 1363
	1633	+	an assessment of the financial effects of each such disease on the state 1364
	1634	+	and on hospitals and health care facilities; (2) a description and 1365
	1635	+	assessment of programs and actions that have been implemented by the 1366
	1636	+	department and health care providers to improve chronic disease care 1367
	1637	+	coordination and prevent chronic disease; (3) the sources and amounts 1368
	1638	+	of funding received by the department to treat persons with multiple 1369
	1639	+	chronic diseases and to treat or reduce the most prevalent chronic 1370
	1640	+	diseases in the state; (4) a description of chronic disease care 1371
	1641	+	coordination between the department and health care providers, to 1372
	1642	+	prevent and treat chronic disease; and (5) recommendations concerning 1373
	1643	+	actions that health care providers and persons with chronic disease may 1374
	1644	+	take to reduce the incidence and effects of chronic disease.] 1375 Substitute Bill No. 6666
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	1649	+	44 of 89
	1650	+
	1651	+	Sec. 34. Subsection (b) of section 19a-493 of the general statutes is 1376
	1652	+	repealed and the following is substituted in lieu thereof (Effective July 1, 1377
	1653	+	2021): 1378
	1654	+	(b) (1) A nursing home license may be renewed biennially after (A) 1379
	1655	+	an unscheduled inspection conducted by the department, (B) 1380
	1656	+	submission of the information required by section 19a-491a, and (C) 1381
	1657	+	submission of evidence satisfactory to the department that the nursing 1382
	1658	+	home is in compliance with the provisions of this chapter, the [Public 1383
	1659	+	Health Code] regulations of Connecticut state agencies and licensing 1384
	1660	+	regulations. 1385
	1661	+	(2) Any change in the ownership of a facility or institution, as defined 1386
	1662	+	in section 19a-490, owned by an individual, partnership or association 1387
	1663	+	or the change in ownership or beneficial ownership of ten per cent or 1388
	1664	+	more of the stock of a corporation which owns, conducts, operates or 1389
	1665	+	maintains such facility or institution, shall be subject to prior approval 1390
	1666	+	of the department after a scheduled inspection of such facility or 1391
	1667	+	institution is conducted by the department, provided such approval 1392
	1668	+	shall be conditioned upon a showing by such facility or institution to the 1393
	1669	+	commissioner that it has complied with all requirements of this chapter, 1394
	1670	+	the regulations relating to licensure and all applicable requirements of 1395
	1671	+	the [Public Health Code] regulations of Connecticut state agencies. Any 1396
	1672	+	such change in ownership or beneficial ownership resulting in a transfer 1397
	1673	+	to a person related by blood or marriage to such an owner or beneficial 1398
	1674	+	owner shall not be subject to prior approval of the department unless: 1399
	1675	+	(A) Ownership or beneficial ownership of ten per cent or more of the 1400
	1676	+	stock of a corporation, limited liability company, partnership or 1401
	1677	+	association which owns, conducts, operates or maintains more than one 1402
	1678	+	facility or institution is transferred; (B) ownership or beneficial 1403
	1679	+	ownership is transferred in more than one facility or institution; or (C) 1404
	1680	+	the facility or institution is the subject of a pending complaint, 1405
	1681	+	investigation or licensure action. If the facility or institution is not in 1406
	1682	+	compliance, the commissioner may require the new owner to sign a 1407
	1683	+	consent order providing reasonable assurances that the violations shall 1408 Substitute Bill No. 6666
	1684	+
	1685	+
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	1688	+	45 of 89
	1689	+
	1690	+	be corrected within a specified period of time. Notice of any such 1409
	1691	+	proposed change of ownership shall be given to the department at least 1410
	1692	+	one hundred twenty days prior to the effective date of such proposed 1411
	1693	+	change. For the purposes of this subdivision, "a person related by blood 1412
	1694	+	or marriage" means a parent, spouse, child, brother, sister, aunt, uncle, 1413
	1695	+	niece or nephew. For the purposes of this subdivision, a change in the 1414
	1696	+	legal form of the ownership entity, including, but not limited to, changes 1415
	1697	+	from a corporation to a limited liability company, a partnership to a 1416
	1698	+	limited liability partnership, a sole proprietorship to a corporation and 1417
	1699	+	similar changes, shall not be considered a change of ownership if the 1418
	1700	+	beneficial ownership remains unchanged and the owner provides such 1419
	1701	+	information regarding the change to the department as may be required 1420
	1702	+	by the department in order to properly identify the current status of 1421
	1703	+	ownership and beneficial ownership of the facility or institution. For the 1422
	1704	+	purposes of this subdivision, a public offering of the stock of any 1423
	1705	+	corporation that owns, conducts, operates or maintains any such facility 1424
	1706	+	or institution shall not be considered a change in ownership or beneficial 1425
	1707	+	ownership of such facility or institution if the licensee and the officers 1426
	1708	+	and directors of such corporation remain unchanged, such public 1427
	1709	+	offering cannot result in an individual or entity owning ten per cent or 1428
	1710	+	more of the stock of such corporation, and the owner provides such 1429
	1711	+	information to the department as may be required by the department in 1430
	1712	+	order to properly identify the current status of ownership and beneficial 1431
	1713	+	ownership of the facility or institution. 1432
	1714	+	Sec. 35. (NEW) (Effective July 1, 2021) A health care facility licensed 1433
	1715	+	pursuant to chapter 368v of the general statutes shall have policies and 1434
	1716	+	procedures in place that reflect the National Centers for Disease Control 1435
	1717	+	and Prevention's recommendations for tuberculosis screening, testing, 1436
	1718	+	treatment and education for health care personnel. Notwithstanding 1437
	1719	+	any provision of the general statutes or any regulations adopted 1438
	1720	+	thereunder, any employee providing direct patient care in a facility 1439
	1721	+	licensed pursuant to chapter 368v of the general statutes shall receive 1440
	1722	+	tuberculosis screening and testing in compliance with the licensed 1441
	1723	+	health care facility's policies and procedures. 1442 Substitute Bill No. 6666
	1724	+
	1725	+
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	1728	+	46 of 89
	1729	+
	1730	+	Sec. 36. Subsection (c) of section 19a-343 of the general statutes is 1443
	1731	+	repealed and the following is substituted in lieu thereof (Effective October 1444
	1732	+	1, 2021): 1445
	1733	+	(c) Three or more arrests, the issuance of three or more arrest 1446
	1734	+	warrants indicating a pattern of criminal activity and not isolated 1447
	1735	+	incidents or the issuance of three or more citations for a violation of a 1448
	1736	+	municipal ordinance as described in subdivision (14) of this subsection, 1449
	1737	+	for the following offenses shall constitute the basis for bringing an action 1450
	1738	+	to abate a public nuisance: 1451
	1739	+	(1) Prostitution under section 53a-82, 53a-83, 53a-86, 53a-87, 53a-88 or 1452
	1740	+	53a-89. 1453
	1741	+	(2) Promoting an obscene performance or obscene material under 1454
	1742	+	section 53a-196 or 53a-196b, employing a minor in an obscene 1455
	1743	+	performance under section 53a-196a, importing child pornography 1456
	1744	+	under section 53a-196c, possessing child pornography in the first degree 1457
	1745	+	under section 53a-196d, possessing child pornography in the second 1458
	1746	+	degree under section 53a-196e or possessing child pornography in the 1459
	1747	+	third degree under section 53a-196f. 1460
	1748	+	(3) Transmission of gambling information under section 53-278b or 1461
	1749	+	53-278d or maintaining of a gambling premises under section 53-278e. 1462
	1750	+	(4) Offenses for the sale of controlled substances, possession of 1463
	1751	+	controlled substances with intent to sell, or maintaining a drug factory 1464
	1752	+	under section 21a-277, 21a-278 or 21a-278a or use of the property by 1465
	1753	+	persons possessing controlled substances under section 21a-279. 1466
	1754	+	Nothing in this section shall prevent the state from also proceeding 1467
	1755	+	against property under section 21a-259 or 54-36h. 1468
	1756	+	(5) Unauthorized sale of alcoholic liquor under section 30-74 or 1469
	1757	+	disposing of liquor without a permit under section 30-77, or sale or 1470
	1758	+	delivery of alcoholic liquor to any minor under subdivision (1) of 1471
	1759	+	subsection (b) of section 30-86 or the sale, delivery or giving of alcoholic 1472
	1760	+	liquor to a minor under subdivision (2) of subsection (b) of section 30-1473 Substitute Bill No. 6666
	1761	+
	1762	+
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	1765	+	47 of 89
	1766	+
	1767	+	86. 1474
	1768	+	(6) Maintaining a motor vehicle chop shop under section 14-149a. 1475
	1769	+	(7) Inciting injury to persons or property under section 53a-179a. 1476
	1770	+	(8) Murder or manslaughter under section 53a-54a, 53a-54b, 53a-55, 1477
	1771	+	53a-56 or 53a-56a. 1478
	1772	+	(9) Assault under section 53a-59, 53a-59a, subdivision (1) of 1479
	1773	+	subsection (a) of section 53a-60 or section 53a-60a or 53a-61. 1480
	1774	+	(10) Sexual assault under section 53a-70 or 53a-70a. 1481
	1775	+	(11) Fire safety violations under section 29-291a, 29-291c, 29-292, 1482
	1776	+	subsection (b) of section 29-310, or section 29-315, 29-349 or 29-357. 1483
	1777	+	(12) Firearm offenses under section 29-35, 53-202aa, 53-203, 53a-211, 1484
	1778	+	53a-212, 53a-216, 53a-217 or 53a-217c. 1485
	1779	+	(13) Illegal manufacture, sale, possession or dispensing of a drug 1486
	1780	+	under subdivision (2) of section 21a-108. 1487
	1781	+	(14) Violation of a municipal ordinance resulting in the issuance of a 1488
	1782	+	citation for (A) excessive noise on nonresidential real property that 1489
	1783	+	significantly impacts the surrounding area, provided the municipality's 1490
	1784	+	excessive noise ordinance is based on an objective standard, (B) owning 1491
	1785	+	or leasing a dwelling unit that provides residence to an excessive 1492
	1786	+	number of unrelated persons resulting in dangerous or unsanitary 1493
	1787	+	conditions that significantly impact the safety of the surrounding area, 1494
	1788	+	or (C) impermissible operation of (i) a business that permits persons 1495
	1789	+	who are not licensed pursuant to section 20-206b to engage in the 1496
	1790	+	practice of massage therapy, or (ii) a massage parlor, as defined by the 1497
	1791	+	applicable municipal ordinance, that significantly impacts the safety of 1498
	1792	+	the surrounding area. 1499
	1793	+	Sec. 37. Section 19a-131g of the general statutes is repealed and the 1500
	1794	+	following is substituted in lieu thereof (Effective from passage): 1501 Substitute Bill No. 6666
	1795	+
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	1799	+	48 of 89
	1800	+
	1801	+	The Commissioner of Public Health shall establish a Public Health 1502
	1802	+	Preparedness Advisory Committee for purposes of advising the 1503
	1803	+	Department of Public Health on matters concerning emergency 1504
	1804	+	responses to a public health emergency. The advisory committee shall 1505
	1805	+	consist of the Commissioner of Public Health, or his or her designee, the 1506
	1806	+	Commissioner of Emergency Services and Public Protection, or his or 1507
	1807	+	her designee, the president pro tempore of the Senate, or his or her 1508
	1808	+	designee, the speaker of the House of Representatives, or his or her 1509
	1809	+	designee, the majority and minority leaders of both houses of the 1510
	1810	+	General Assembly, or their designees, and the chairpersons and ranking 1511
	1811	+	members of the joint standing committees of the General Assembly 1512
	1812	+	having cognizance of matters relating to public health, public safety and 1513
	1813	+	the judiciary, or their designees, and representatives of town, city, 1514
	1814	+	borough and district directors of health, as appointed by the 1515
	1815	+	commissioner, and any other organization or persons that the 1516
	1816	+	commissioner deems relevant to the issues of public health 1517
	1817	+	preparedness. Upon the request of the commissioner, the Public Health 1518
	1818	+	Preparedness Advisory Committee may meet to review the plan for 1519
	1819	+	emergency responses to a public health emergency and other matters as 1520
	1820	+	deemed necessary by the commissioner. 1521
	1821	+	Sec. 38. Subsection (d) of section 19a-30 of the general statutes is 1522
	1822	+	repealed and the following is substituted in lieu thereof (Effective July 1, 1523
	1823	+	2021): 1524
	1824	+	(d) A nonrefundable fee of two hundred dollars shall accompany 1525
	1825	+	each application for a license or for renewal thereof, except in the case 1526
	1826	+	of a clinical laboratory owned and operated by a municipality, the state, 1527
	1827	+	the United States, [or] any agency of said municipality, state or United 1528
	1828	+	States or any hospital. Each license shall be issued for a period of not 1529
	1829	+	less than twenty-four nor more than twenty-seven months from the 1530
	1830	+	deadline for applications established by the commissioner. Renewal 1531
	1831	+	applications shall be made (1) biennially within the twenty-fourth 1532
	1832	+	month of the current license; (2) before any change in ownership or 1533
	1833	+	change in director is made; and (3) prior to any major expansion or 1534 Substitute Bill No. 6666
	1834	+
	1835	+
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	1838	+	49 of 89
	1839	+
	1840	+	alteration in quarters. The licensed clinical laboratory shall report to the 1535
	1841	+	Department of Public Health, in a form and manner prescribed by the 1536
	1842	+	commissioner, the name and address of each blood collection facility 1537
	1843	+	owned and operated by the clinical laboratory, prior to the issuance of 1538
	1844	+	a new license, prior to the issuance of a renewal license or whenever a 1539
	1845	+	blood collection facility opens or closes. 1540
	1846	+	Sec. 39. Subsection (b) of section 20-365 of the general statutes is 1541
	1847	+	repealed and the following is substituted in lieu thereof (Effective July 1, 1542
	1848	+	2021): 1543
	1849	+	(b) Nothing in section 19a-200, as amended by this act, subsection (a) 1544
	1850	+	of section 19a-206, or sections 19a-207, 19a-242, 20-358 or 20-360 to 20-1545
	1851	+	365, inclusive, shall prevent any of the following persons from engaging 1546
	1852	+	in the performance of their duties: (1) Any person certified by the 1547
	1853	+	Department of Public Health as a food or sewage inspector in 1548
	1854	+	accordance with regulations adopted pursuant to section 19a-36, (2) any 1549
	1855	+	person employed by a local health department performing the duties of 1550
	1856	+	a lead inspector who complies with training standards established 1551
	1857	+	pursuant to section 20-479, (3) a director of health acting pursuant to 1552
	1858	+	[subsection (a) of] section 19a-200, as amended by this act, or section 1553
	1859	+	19a-244, as amended by this act, (4) any employee of a water utility or 1554
	1860	+	federal or state agency performing his duties in accordance with 1555
	1861	+	applicable statutes and regulations, (5) any person employed by a local 1556
	1862	+	health department working under the direct supervision of a licensed 1557
	1863	+	sanitarian, (6) any person licensed or certified by the Department of 1558
	1864	+	Public Health in a specific program performing certain duties that are 1559
	1865	+	included within the duties of a sanitarian, or (7) a student enrolled in an 1560
	1866	+	accredited academic program leading to a degree in environmental 1561
	1867	+	health or completing a special training course in environmental health 1562
	1868	+	approved by the commissioner, provided such student is clearly 1563
	1869	+	identified by a title which indicates his or her status as a student. 1564
	1870	+	Sec. 40. Subsection (b) of section 20-195u of the general statutes is 1565
	1871	+	repealed and the following is substituted in lieu thereof (Effective from 1566
	1872	+	passage): 1567 Substitute Bill No. 6666
	1873	+
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	1877	+	50 of 89
	1878	+
	1879	+	(b) Continuing education required pursuant to this section shall be 1568
	1880	+	related to the practice of social work and shall include not less than one 1569
	1881	+	contact hour of training or education each registration period on the 1570
	1882	+	topic of cultural competency and, on and after January 1, 2016, not less 1571
	1883	+	than two contact hours of training or education during the first renewal 1572
	1884	+	period in which continuing education is required and not less than once 1573
	1885	+	every six years thereafter on the topic of mental health conditions 1574
	1886	+	common to veterans and family members of veterans, including (1) 1575
	1887	+	determining whether a patient is a veteran or family member of a 1576
	1888	+	veteran, (2) screening for conditions such as post-traumatic stress 1577
	1889	+	disorder, risk of suicide, depression and grief, and (3) suicide prevention 1578
	1890	+	training. Such continuing education shall consist of courses, workshops 1579
	1891	+	and conferences offered or approved by the Association of Social Work 1580
	1892	+	Boards, the National Association of Social Workers or a school or 1581
	1893	+	department of social work accredited by the Council on Social Work 1582
	1894	+	Education. A licensee's ability to engage in on-line and home study 1583
	1895	+	continuing education shall be limited to not more than [six] ten hours 1584
	1896	+	per registration period. Within the registration period, an initial 1585
	1897	+	presentation by a licensee of an original paper, essay or formal lecture 1586
	1898	+	in social work to a recognized group of fellow professionals may 1587
	1899	+	account for five hours of continuing education hours of the aggregate 1588
	1900	+	continuing education requirements prescribed in this section. 1589
	1901	+	Sec. 41. Subsection (a) of section 20-265h of the general statutes is 1590
	1902	+	repealed and the following is substituted in lieu thereof (Effective from 1591
	1903	+	passage): 1592
	1904	+	(a) On and after July 1, 2021, each spa or salon that employs 1593
	1905	+	hairdressers and cosmeticians, estheticians, eyelash technicians, [or] nail 1594
	1906	+	technicians or massage therapists shall be under the management of a 1595
	1907	+	hairdresser and cosmetician registered under this chapter, an esthetician 1596
	1908	+	licensed under section 20-265b or 20-265f, an eyelash technician licensed 1597
	1909	+	under section 20-265c or 20-265f, [or] a nail technician licensed under 1598
	1910	+	section 20-265d or 20-265f or a massage therapist licensed under chapter 1599
	1911	+	384a. 1600 Substitute Bill No. 6666
	1912	+
	1913	+
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	1916	+	51 of 89
	1917	+
	1918	+	Sec. 42. Subsection (a) of section 19a-131j of the general statutes is 1601
	1919	+	repealed and the following is substituted in lieu thereof (Effective from 1602
	1920	+	passage): 1603
	1921	+	(a) The commissioner may issue an order to temporarily suspend, for 1604
	1922	+	a period not to exceed sixty consecutive days, the requirements for 1605
	1923	+	licensure, certification or registration, pursuant to chapters 368d, 370, 1606
	1924	+	376 to 376c, inclusive, 378, 378a, 379, 379a, 381a, 382a, 383 to 383c, 1607
	1925	+	inclusive, 383d, 383f, 383g, 384b, 384d, 385, 395, 399, 400a, 400j and 474, 1608
	1926	+	to allow persons who are appropriately licensed, certified or registered 1609
	1927	+	in another state or territory of the United States or the District of 1610
	1928	+	Columbia, to render temporary assistance within the scope of the 1611
	1929	+	profession for which a person is licensed, certified or registered, in 1612
	1930	+	managing a public health emergency in this state, declared by the 1613
	1931	+	Governor pursuant to section 19a-131a. Nothing in this section shall be 1614
	1932	+	construed to permit a person to provide services beyond the scope 1615
	1933	+	allowed in the chapter specified in this section that pertains to such 1616
	1934	+	person's profession. 1617
	1935	+	Sec. 43. Subsection (a) of section 19a-512 of the general statutes is 1618
	1936	+	repealed and the following is substituted in lieu thereof (Effective July 1, 1619
	1937	+	2021): 1620
	1938	+	(a) In order to be eligible for licensure by examination pursuant to 1621
	1939	+	sections 19a-511 to 19a-520, inclusive, a person shall submit an 1622
	1940	+	application, together with a fee of two hundred dollars, and proof 1623
	1941	+	satisfactory to the Department of Public Health that he or she (1) is 1624
	1942	+	physically and emotionally capable of administering a nursing home; 1625
	1943	+	(2) has satisfactorily completed a program of instruction and training, 1626
	1944	+	including residency training which meets the requirements of 1627
	1945	+	subsection (b) of this section and which is approved by the 1628
	1946	+	Commissioner of Public Health; and (3) has passed an examination 1629
	1947	+	prescribed [and administered] by the Department of Public Health 1630
	1948	+	designed to test the applicant's knowledge and competence in the 1631
	1949	+	subject matter referred to in subsection (b) of this section. Passing scores 1632
	1950	+	shall be established by the department. 1633 Substitute Bill No. 6666
	1951	+
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	1955	+	52 of 89
	1956	+
	1957	+	Sec. 44. Section 19a-490 of the general statutes is repealed and the 1634
	1958	+	following is substituted in lieu thereof (Effective July 1, 2021): 1635
	1959	+	(a) "Institution" means a hospital, short-term hospital special hospice, 1636
	1960	+	hospice inpatient facility, residential care home, nursing home facility, 1637
	1961	+	home health care agency, hospice home health care agency, home health 1638
	1962	+	aide agency, behavioral health facility, assisted living services agency, 1639
	1963	+	[substance abuse treatment facility,] outpatient surgical facility, 1640
	1964	+	outpatient clinic, an infirmary operated by an educational institution for 1641
	1965	+	the care of students enrolled in, and faculty and employees of, such 1642
	1966	+	institution; a facility engaged in providing services for the prevention, 1643
	1967	+	diagnosis, treatment or care of human health conditions, including 1644
	1968	+	facilities operated and maintained by any state agency; and a residential 1645
	1969	+	facility for persons with intellectual disability licensed pursuant to 1646
	1970	+	section 17a-227 and certified to participate in the Title XIX Medicaid 1647
	1971	+	program as an intermediate care facility for individuals with intellectual 1648
	1972	+	disability. "Institution" does not include any facility for the care and 1649
	1973	+	treatment of persons with mental illness or substance use disorder 1650
	1974	+	operated or maintained by any state agency, except Whiting Forensic 1651
	1975	+	Hospital; 1652
	1976	+	(b) "Hospital" means an establishment for the lodging, care and 1653
	1977	+	treatment of persons suffering from disease or other abnormal physical 1654
	1978	+	or mental conditions and includes inpatient psychiatric services in 1655
	1979	+	general hospitals; 1656
	1980	+	(c) "Residential care home" or "rest home" means a community 1657
	1981	+	residence that furnishes, in single or multiple facilities, food and shelter 1658
	1982	+	to two or more persons unrelated to the proprietor and, in addition, 1659
	1983	+	provides services that meet a need beyond the basic provisions of food, 1660
	1984	+	shelter and laundry and may qualify as a setting that allows residents to 1661
	1985	+	receive home and community-based services funded by state and 1662
	1986	+	federal programs; 1663
	1987	+	(d) "Home health care agency" means a public or private 1664
	1988	+	organization, or a subdivision thereof, engaged in providing 1665 Substitute Bill No. 6666
	1989	+
	1990	+
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	1993	+	53 of 89
	1994	+
	1995	+	professional nursing services and the following services, available 1666
	1996	+	twenty-four hours per day, in the patient's home or a substantially 1667
	1997	+	equivalent environment: Home health aide services as defined in this 1668
	1998	+	section, physical therapy, speech therapy, occupational therapy or 1669
	1999	+	medical social services. The agency shall provide professional nursing 1670
	2000	+	services and at least one additional service directly and all others 1671
	2001	+	directly or through contract. An agency shall be available to enroll new 1672
	2002	+	patients seven days a week, twenty-four hours per day; 1673
	2003	+	(e) "Home health aide agency" means a public or private 1674
	2004	+	organization, except a home health care agency, which provides in the 1675
	2005	+	patient's home or a substantially equivalent environment supportive 1676
	2006	+	services which may include, but are not limited to, assistance with 1677
	2007	+	personal hygiene, dressing, feeding and incidental household tasks 1678
	2008	+	essential to achieving adequate household and family management. 1679
	2009	+	Such supportive services shall be provided under the supervision of a 1680
	2010	+	registered nurse and, if such nurse determines appropriate, shall be 1681
	2011	+	provided by a social worker, physical therapist, speech therapist or 1682
	2012	+	occupational therapist. Such supervision may be provided directly or 1683
	2013	+	through contract; 1684
	2014	+	(f) "Home health aide services" as defined in this section shall not 1685
	2015	+	include services provided to assist individuals with activities of daily 1686
	2016	+	living when such individuals have a disease or condition that is chronic 1687
	2017	+	and stable as determined by a physician licensed in the state; 1688
	2018	+	(g) "Behavioral health facility" means any facility that provides 1689
	2019	+	mental health services to persons eighteen years of age or older or 1690
	2020	+	substance use disorder services to persons of any age in an outpatient 1691
	2021	+	treatment or residential setting to ameliorate mental, emotional, 1692
	2022	+	behavioral or substance use disorder issues; 1693
	2023	+	(h) "Alcohol or drug treatment facility" means any facility for the care 1694
	2024	+	or treatment of persons suffering from alcoholism or other drug 1695
	2025	+	addiction; 1696 Substitute Bill No. 6666
	2026	+
	2027	+
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	2030	+	54 of 89
	2031	+
	2032	+	(i) "Person" means any individual, firm, partnership, corporation, 1697
	2033	+	limited liability company or association; 1698
	2034	+	(j) "Commissioner" means the Commissioner of Public Health or the 1699
	2035	+	commissioner's designee; 1700
	2036	+	(k) "Home health agency" means an agency licensed as a home health 1701
	2037	+	care agency or a home health aide agency; 1702
	2038	+	(l) "Assisted living services agency" means an agency that provides, 1703
	2039	+	among other things, nursing services and assistance with activities of 1704
	2040	+	daily living and that may provide memory care to a population that is 1705
	2041	+	chronic and stable; 1706
	2042	+	(m) "Outpatient clinic" means an organization operated by a 1707
	2043	+	municipality or a corporation, other than a hospital, that provides (1) 1708
	2044	+	ambulatory medical care, including preventive and health promotion 1709
	2045	+	services, (2) dental care, or (3) mental health services in conjunction with 1710
	2046	+	medical or dental care for the purpose of diagnosing or treating a health 1711
	2047	+	condition that does not require the patient's overnight care; 1712
	2048	+	(n) "Multicare institution" means a hospital that provides outpatient 1713
	2049	+	behavioral health services or other health care services, psychiatric 1714
	2050	+	outpatient clinic for adults, free-standing facility for the care or 1715
	2051	+	treatment of substance abusive or dependent persons, hospital for 1716
	2052	+	psychiatric disabilities, as defined in section 17a-495, or a general acute 1717
	2053	+	care hospital that provides outpatient behavioral health services that (1) 1718
	2054	+	is licensed in accordance with this chapter, (2) has more than one facility 1719
	2055	+	or one or more satellite units owned and operated by a single licensee, 1720
	2056	+	and (3) offers complex patient health care services at each facility or 1721
	2057	+	satellite unit. For purposes of this subsection, "satellite unit" means a 1722
	2058	+	location where a segregated unit of services is provided by the multicare 1723
	2059	+	institution; 1724
	2060	+	(o) "Nursing home" or "nursing home facility" means (1) any chronic 1725
	2061	+	and convalescent nursing home or any rest home with nursing 1726
	2062	+	supervision that provides nursing supervision under a medical director 1727 Substitute Bill No. 6666
	2063	+
	2064	+
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	2067	+	55 of 89
	2068	+
	2069	+	twenty-four hours per day, or (2) any chronic and convalescent nursing 1728
	2070	+	home that provides skilled nursing care under medical supervision and 1729
	2071	+	direction to carry out nonsurgical treatment and dietary procedures for 1730
	2072	+	chronic diseases, convalescent stages, acute diseases or injuries; [and] 1731
	2073	+	(p) "Outpatient dialysis unit" means (1) an out-of-hospital out-patient 1732
	2074	+	dialysis unit that is licensed by the department to provide (A) services 1733
	2075	+	on an out-patient basis to persons requiring dialysis on a short-term 1734
	2076	+	basis or for a chronic condition, or (B) training for home dialysis, or (2) 1735
	2077	+	an in-hospital dialysis unit that is a special unit of a licensed hospital 1736
	2078	+	designed, equipped and staffed to (A) offer dialysis therapy on an out-1737
	2079	+	patient basis, (B) provide training for home dialysis, and (C) perform 1738
	2080	+	renal transplantations; [.] and 1739
	2081	+	(q) "Hospice home health care agency" means a public or private 1740
	2082	+	organization that provides home care and hospice services to terminally 1741
	2083	+	ill patients. 1742
	2084	+	Sec. 45. Subsections (b) to (i), inclusive, of section 19a-491 of the 1743
	2085	+	general statutes are repealed and the following is substituted in lieu 1744
	2086	+	thereof (Effective July 1, 2021): 1745
	2087	+	(b) If any person acting individually or jointly with any other person 1746
	2088	+	owns real property or any improvements thereon, upon or within which 1747
	2089	+	an institution, as defined in subsections (c) and (o) of section 19a-490, is 1748
	2090	+	established, conducted, operated or maintained and is not the licensee 1749
	2091	+	of the institution, such person shall submit a copy of the lease agreement 1750
	2092	+	to the department at the time of any change of ownership and with each 1751
	2093	+	license renewal application. The lease agreement shall, at a minimum, 1752
	2094	+	identify the person or entity responsible for the maintenance and repair 1753
	2095	+	of all buildings and structures within which such an institution is 1754
	2096	+	established, conducted or operated. If a violation is found as a result of 1755
	2097	+	an inspection or investigation, the commissioner may require the owner 1756
	2098	+	to sign a consent order providing assurances that repairs or 1757
	2099	+	improvements necessary for compliance with the provisions of the 1758
	2100	+	[Public Health Code] regulations of Connecticut state agencies shall be 1759 Substitute Bill No. 6666
	2101	+
	2102	+
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	2105	+	56 of 89
	2106	+
	2107	+	completed within a specified period of time or may assess a civil penalty 1760
	2108	+	of not more than one thousand dollars for each day that such owner is 1761
	2109	+	in violation of the [Public Health Code] regulations of Connecticut state 1762
	2110	+	agencies or a consent order. A consent order may include a provision 1763
	2111	+	for the establishment of a temporary manager of such real property who 1764
	2112	+	has the authority to complete any repairs or improvements required by 1765
	2113	+	such order. Upon request of the Commissioner of Public Health, the 1766
	2114	+	Attorney General may petition the Superior Court for such equitable 1767
	2115	+	and injunctive relief as such court deems appropriate to ensure 1768
	2116	+	compliance with the provisions of a consent order. The provisions of 1769
	2117	+	this subsection shall not apply to any property or improvements owned 1770
	2118	+	by a person licensed in accordance with the provisions of subsection (a) 1771
	2119	+	of this section to establish, conduct, operate or maintain an institution 1772
	2120	+	on or within such property or improvements. 1773
	2121	+	(c) Notwithstanding any regulation, the Commissioner of Public 1774
	2122	+	Health shall charge the following fees for the biennial licensing and 1775
	2123	+	inspection of the following institutions: (1) Chronic and convalescent 1776
	2124	+	nursing homes, per site, four hundred forty dollars; (2) chronic and 1777
	2125	+	convalescent nursing homes, per bed, five dollars; (3) rest homes with 1778
	2126	+	nursing supervision, per site, four hundred forty dollars; (4) rest homes 1779
	2127	+	with nursing supervision, per bed, five dollars; (5) outpatient dialysis 1780
	2128	+	units and outpatient surgical facilities, six hundred twenty-five dollars; 1781
	2129	+	(6) mental health residential facilities, per site, three hundred seventy-1782
	2130	+	five dollars; (7) mental health residential facilities, per bed, five dollars; 1783
	2131	+	(8) hospitals, per site, nine hundred forty dollars; (9) hospitals, per bed, 1784
	2132	+	seven dollars and fifty cents; (10) nonstate agency educational 1785
	2133	+	institutions, per infirmary, one hundred fifty dollars; (11) nonstate 1786
	2134	+	agency educational institutions, per infirmary bed, twenty-five dollars; 1787
	2135	+	(12) home health care agencies, except certified home health care 1788
	2136	+	agencies described in subsection (d) of this section, per agency, three 1789
	2137	+	hundred dollars; (13) home health care agencies, hospice home health 1790
	2138	+	care agencies, or home health aide agencies, except certified home 1791
	2139	+	health care agencies, hospice home health care agencies or home health 1792
	2140	+	aide agencies described in subsection (d) of this section, per satellite 1793 Substitute Bill No. 6666
	2141	+
	2142	+
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	2145	+	57 of 89
	2146	+
	2147	+	patient service office, one hundred dollars; (14) assisted living services 1794
	2148	+	agencies, except such agencies participating in the congregate housing 1795
	2149	+	facility pilot program described in section 8-119n, per site, five hundred 1796
	2150	+	dollars; (15) short-term hospitals special hospice, per site, nine hundred 1797
	2151	+	forty dollars; (16) short-term hospitals special hospice, per bed, seven 1798
	2152	+	dollars and fifty cents; (17) hospice inpatient facility, per site, four 1799
	2153	+	hundred forty dollars; and (18) hospice inpatient facility, per bed, five 1800
	2154	+	dollars. 1801
	2155	+	(d) Notwithstanding any regulation, the commissioner shall charge 1802
	2156	+	the following fees for the triennial licensing and inspection of the 1803
	2157	+	following institutions: (1) Residential care homes, per site, five hundred 1804
	2158	+	sixty-five dollars; (2) residential care homes, per bed, four dollars and 1805
	2159	+	fifty cents; (3) home health care agencies that are certified as a provider 1806
	2160	+	of services by the United States Department of Health and Human 1807
	2161	+	Services under the Medicare or Medicaid program, three hundred 1808
	2162	+	dollars; and (4) certified home health care agencies or hospice home 1809
	2163	+	health care agencies, as described in section 19a-493, as amended by this 1810
	2164	+	act, per satellite patient service office, one hundred dollars. 1811
	2165	+	(e) The commissioner shall charge one thousand dollars for the 1812
	2166	+	licensing and inspection of outpatient clinics that provide either medical 1813
	2167	+	or mental health service, urgent care services and well-child clinical 1814
	2168	+	services, except those operated by a municipal health department, 1815
	2169	+	health district or licensed nonprofit nursing or community health 1816
	2170	+	agency. Such licensing and inspection shall be performed every three 1817
	2171	+	years, except those outpatient clinics that have obtained accreditation 1818
	2172	+	from a national accrediting organization within the immediately 1819
	2173	+	preceding twelve-month period may be inspected by the commissioner 1820
	2174	+	once every four years, provided the outpatient clinic has not committed 1821
	2175	+	any violation that the commissioner determines would pose an 1822
	2176	+	immediate threat to the health, safety or welfare of the patients of the 1823
	2177	+	outpatient clinic. The provisions of this subsection shall not be 1824
	2178	+	construed to limit the commissioner's authority to inspect any applicant 1825
	2179	+	for licensure or renewal of licensure as an outpatient clinic, suspend or 1826 Substitute Bill No. 6666
	2180	+
	2181	+
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	2184	+	58 of 89
	2185	+
	2186	+	revoke any license granted to an outpatient clinic pursuant to this 1827
	2187	+	section or take any other legal action against an outpatient clinic that is 1828
	2188	+	authorized by any provision of the general statutes. 1829
	2189	+	(f) Any institution that is planning a project for construction or 1830
	2190	+	building alteration shall provide the plan for such project to the 1831
	2191	+	Department of Public Health for review. Any such project shall comply 1832
	2192	+	with nationally established facility guidelines for health care 1833
	2193	+	construction, as approved by the commissioner, that are in place at the 1834
	2194	+	time the institution provides the plan to the department. The 1835
	2195	+	commissioner shall post a reference to such guidelines, including the 1836
	2196	+	effective date of such guidelines, on the Department of Public Health's 1837
	2197	+	Internet web site. No institution shall be required to include matters 1838
	2198	+	outside the scope and applicability of such guidelines in the institution's 1839
	2199	+	plan. 1840
	2200	+	(g) The commissioner shall charge a fee of five hundred sixty-five 1841
	2201	+	dollars for the technical assistance provided for the design, review and 1842
	2202	+	development of an institution's construction, renovation, building 1843
	2203	+	alteration, sale or change in ownership when the cost of the project is 1844
	2204	+	one million dollars or less and shall charge a fee of one-quarter of one 1845
	2205	+	per cent of the total construction cost when the cost of the project is more 1846
	2206	+	than one million dollars. Such fee shall include all department reviews 1847
	2207	+	and on-site inspections. For purposes of this subsection, "institution" 1848
	2208	+	does not include a facility owned by the state. 1849
	2209	+	(h) The commissioner may require as a condition of the licensure of a 1850
	2210	+	home health care [agencies] agency, hospice home health care agency 1851
	2211	+	and home health aide [agencies] agency that each agency meet 1852
	2212	+	minimum service quality standards. In the event the commissioner 1853
	2213	+	requires such agencies to meet minimum service quality standards as a 1854
	2214	+	condition of their licensure, the commissioner shall adopt regulations, 1855
	2215	+	in accordance with the provisions of chapter 54, to define such 1856
	2216	+	minimum service quality standards, which shall (1) allow for training of 1857
	2217	+	home health aides by adult continuing education, (2) require a 1858
	2218	+	registered nurse to visit and assess each patient receiving home health 1859 Substitute Bill No. 6666
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	2223	+	59 of 89
	2224	+
	2225	+	aide services as often as necessary based on the patient's condition, but 1860
	2226	+	not less than once every sixty days, and (3) require the assessment 1861
	2227	+	prescribed by subdivision (2) of this subsection to be completed while 1862
	2228	+	the home health aide is providing services in the patient's home. 1863
	2229	+	(i) No person acting individually or jointly with any other person 1864
	2230	+	shall establish, conduct, operate or maintain a home health care agency, 1865
	2231	+	hospice home health care agency or home health aide agency without 1866
	2232	+	maintaining professional liability insurance or other indemnity against 1867
	2233	+	liability for professional malpractice. The amount of insurance which 1868
	2234	+	such person shall maintain as insurance or indemnity against claims for 1869
	2235	+	injury or death for professional malpractice shall be not less than one 1870
	2236	+	million dollars for one person, per occurrence, with an aggregate of not 1871
	2237	+	less than three million dollars. 1872
	2238	+	Sec. 46. Subdivision (4) of subsection (a) of section 19a-491c of the 1873
	2239	+	general statutes is repealed and the following is substituted in lieu 1874
	2240	+	thereof (Effective July 1, 2021): 1875
	2241	+	(4) "Long-term care facility" means any facility, agency or provider 1876
	2242	+	that is a nursing home, as defined in section 19a-521, a residential care 1877
	2243	+	home, as defined in section 19a-521, a home health care agency, hospice 1878
	2244	+	home health care agency or home health aide agency, as defined in 1879
	2245	+	section 19a-490, as amended by this act, an assisted living services 1880
	2246	+	agency, as defined in section 19a-490, as amended by this act, an 1881
	2247	+	intermediate care facility for individuals with intellectual disabilities, as 1882
	2248	+	defined in 42 USC 1396d(d), except any such facility operated by a 1883
	2249	+	Department of Developmental Services' program subject to background 1884
	2250	+	checks pursuant to section 17a-227a, a chronic disease hospital, as 1885
	2251	+	defined in section 19a-550, or an agency providing hospice care which 1886
	2252	+	is licensed to provide such care by the Department of Public Health or 1887
	2253	+	certified to provide such care pursuant to 42 USC 1395x. 1888
	2254	+	Sec. 47. Section 19a-492b of the general statutes is repealed and the 1889
	2255	+	following is substituted in lieu thereof (Effective July 1, 2021): 1890 Substitute Bill No. 6666
	2256	+
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	2260	+	60 of 89
	2261	+
	2262	+	(a) A home health care agency or hospice home health care agency 1891
	2263	+	that receives payment for rendering care to persons receiving medical 1892
	2264	+	assistance from the state, assistance from the Connecticut home-care 1893
	2265	+	program for the elderly pursuant to section 17b-342, or funds obtained 1894
	2266	+	through Title XVIII of the Social Security Amendments of 1965 shall be 1895
	2267	+	prohibited from discriminating against such persons who apply for 1896
	2268	+	enrollment to such home health care agency on the basis of source of 1897
	2269	+	payment. 1898
	2270	+	(b) Any home health care agency or hospice home health care agency 1899
	2271	+	which violates the provisions of this section shall be subject to 1900
	2272	+	suspension or revocation of license. 1901
	2273	+	Sec. 48. Subsection (b) of section 19a-492c of the general statutes is 1902
	2274	+	repealed and the following is substituted in lieu thereof (Effective July 1, 1903
	2275	+	2021): 1904
	2276	+	(b) A home health care agency or hospice home health care agency 1905
	2277	+	licensed pursuant to this chapter that provides hospice services in a 1906
	2278	+	rural town and is unable to access licensed or Medicare-certified hospice 1907
	2279	+	care to consistently provide adequate services to patients in the rural 1908
	2280	+	town may apply to the Commissioner of Public Health for a waiver from 1909
	2281	+	the regulations licensing such agency adopted pursuant to this chapter. 1910
	2282	+	The waiver may authorize one or more of the following: (1) The agency's 1911
	2283	+	supervisor of clinical services may also serve as the supervisor of clinical 1912
	2284	+	services assigned to the hospice program; (2) the hospice volunteer 1913
	2285	+	coordinator and the hospice program director may be permanent part-1914
	2286	+	time employees; and (3) the program director may perform other 1915
	2287	+	services at the agency, including, but not limited to, hospice volunteer 1916
	2288	+	coordinator. The commissioner shall not grant a waiver unless the 1917
	2289	+	commissioner determines that such waiver will not adversely impact 1918
	2290	+	the health, safety and welfare of hospice patients and their families. The 1919
	2291	+	waiver shall be in effect for two years. An agency may reapply for such 1920
	2292	+	a waiver. 1921
	2293	+	Sec. 49. Section 19a-492d of the general statutes is repealed and the 1922 Substitute Bill No. 6666
	2294	+
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	2298	+	61 of 89
	2299	+
	2300	+	following is substituted in lieu thereof (Effective July 1, 2021): 1923
	2301	+	On and after October 1, 2007, a nurse who is employed by an agency 1924
	2302	+	licensed by the Department of Public Health as a home health care 1925
	2303	+	agency, hospice home health care agency or [a] home health aide agency 1926
	2304	+	may administer influenza and pneumococcal vaccines to persons in 1927
	2305	+	their homes, after an assessment for contraindications, without a 1928
	2306	+	physician's order in accordance with a physician-approved agency 1929
	2307	+	policy that includes an anaphylaxis protocol. In the event of an adverse 1930
	2308	+	reaction to the vaccine, such nurse may also administer epinephrine or 1931
	2309	+	other anaphylaxis medication without a physician's order in accordance 1932
	2310	+	with the physician-approved agency policy. For purposes of this 1933
	2311	+	section, "nurse" means an advanced practice registered nurse, registered 1934
	2312	+	nurse or practical nurse licensed under chapter 378. 1935
	2313	+	Sec. 50. Section 19a-492e of the general statutes is repealed and the 1936
	2314	+	following is substituted in lieu thereof (Effective July 1, 2021): 1937
	2315	+	(a) For purposes of this section "home health care agency" and 1938
	2316	+	"hospice home health care agency" [has] have the same [meaning] 1939
	2317	+	meanings as provided in section 19a-490, as amended by this act. 1940
	2318	+	Notwithstanding the provisions of chapter 378, a registered nurse may 1941
	2319	+	delegate the administration of medications that are not administered by 1942
	2320	+	injection to home health aides and hospice home health care aides who 1943
	2321	+	have obtained certification and recertification every three years 1944
	2322	+	thereafter for medication administration in accordance with regulations 1945
	2323	+	adopted pursuant to subsection (b) of this section, unless the prescribing 1946
	2324	+	practitioner specifies that a medication shall only be administered by a 1947
	2325	+	licensed nurse. Any home health aide or hospice home health care aide 1948
	2326	+	who obtained certification in the administration of medications on or 1949
	2327	+	before June 30, 2015, shall obtain recertification on or before July 1, 2018. 1950
	2328	+	(b) (1) The Commissioner of Public Health shall adopt regulations, in 1951
	2329	+	accordance with the provisions of chapter 54, to carry out the provisions 1952
	2330	+	of this section. Such regulations shall require each home health care 1953
	2331	+	agency or hospice home health care agency that serves clients requiring 1954 Substitute Bill No. 6666
	2332	+
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	2336	+	62 of 89
	2337	+
	2338	+	assistance with medication administration to (A) adopt practices that 1955
	2339	+	increase and encourage client choice, dignity and independence; (B) 1956
	2340	+	establish policies and procedures to ensure that a registered nurse may 1957
	2341	+	delegate allowed tasks of nursing care, to include medication 1958
	2342	+	administration, to home health aides or hospice home health care aides 1959
	2343	+	when the registered nurse determines that it is in the best interest of the 1960
	2344	+	client and the home health aide or hospice home health care aide has 1961
	2345	+	been deemed competent to perform the task; (C) designate home health 1962
	2346	+	aides and hospice home health care aides to obtain certification and 1963
	2347	+	recertification for the administration of medication; and (D) ensure that 1964
	2348	+	such home health aides receive such certification and recertification. 1965
	2349	+	(2) The regulations shall establish certification and recertification 1966
	2350	+	requirements for medication administration and the criteria to be used 1967
	2351	+	by home health care agencies and hospice home health care agencies 1968
	2352	+	that provide services for clients requiring assistance with medication 1969
	2353	+	administration in determining (A) which home health aides and hospice 1970
	2354	+	home health care aides shall obtain such certification and recertification, 1971
	2355	+	and (B) education and skill training requirements, including ongoing 1972
	2356	+	training requirements for such certification and recertification. 1973
	2357	+	(3) Education and skill training requirements for initial certification 1974
	2358	+	and recertification shall include, but not be limited to, initial orientation, 1975
	2359	+	training in client rights and identification of the types of medication that 1976
	2360	+	may be administered by unlicensed personnel, behavioral management, 1977
	2361	+	personal care, nutrition and food safety, and health and safety in 1978
	2362	+	general. 1979
	2363	+	(c) Each home health care agency and, on or before January 1, 2022, 1980
	2364	+	each hospice home health care agency shall ensure that, on or before 1981
	2365	+	January 1, 2013, delegation of nursing care tasks in the home care setting 1982
	2366	+	is allowed within such agency and that policies are adopted to employ 1983
	2367	+	home health aides or hospice home health care aides for the purposes of 1984
	2368	+	allowing nurses to delegate such tasks. 1985
	2369	+	(d) A registered nurse licensed pursuant to the provisions of chapter 1986 Substitute Bill No. 6666
	2370	+
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	2374	+	63 of 89
	2375	+
	2376	+	378 who delegates the task of medication administration to a home 1987
	2377	+	health aide or hospice home health care aide pursuant to this section 1988
	2378	+	shall not be subject to disciplinary action based on the performance of 1989
	2379	+	the home health aide or hospice home health care aide to whom tasks 1990
	2380	+	are delegated, unless the home health aide or hospice home health care 1991
	2381	+	aide is acting pursuant to specific instructions from the registered nurse 1992
	2382	+	or the registered nurse fails to leave instructions when the nurse should 1993
	2383	+	have done so, provided the registered nurse: (1) Documented in the 1994
	2384	+	patient's care plan that the medication administration could be properly 1995
	2385	+	and safely performed by the home health aide or hospice home health 1996
	2386	+	care aide to whom it is delegated, (2) provided initial direction to the 1997
	2387	+	home health aide or hospice home health care aide, and (3) provided 1998
	2388	+	ongoing supervision of the home health aide or hospice home health 1999
	2389	+	care aide, including the periodic assessment and evaluation of the 2000
	2390	+	patient's health and safety related to medication administration. 2001
	2391	+	(e) A registered nurse who delegates the provision of nursing care to 2002
	2392	+	another person pursuant to this section shall not be subject to an action 2003
	2393	+	for civil damages for the performance of the person to whom nursing 2004
	2394	+	care is delegated unless the person is acting pursuant to specific 2005
	2395	+	instructions from the nurse or the nurse fails to leave instructions when 2006
	2396	+	the nurse should have done so. 2007
	2397	+	(f) No person may coerce a registered nurse into compromising 2008
	2398	+	patient safety by requiring the nurse to delegate the administration of 2009
	2399	+	medication if the nurse's assessment of the patient documents a need for 2010
	2400	+	a nurse to administer medication and identifies why the need cannot be 2011
	2401	+	safely met through utilization of assistive technology or administration 2012
	2402	+	of medication by certified home health aides or hospice home health 2013
	2403	+	care aides. No registered nurse who has made a reasonable 2014
	2404	+	determination based on such assessment that delegation may 2015
	2405	+	compromise patient safety shall be subject to any employer reprisal or 2016
	2406	+	disciplinary action pursuant to chapter 378 for refusing to delegate or 2017
	2407	+	refusing to provide the required training for such delegation. The 2018
	2408	+	Department of Social Services, in consultation with the Department of 2019 Substitute Bill No. 6666
	2409	+
	2410	+
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	2413	+	64 of 89
	2414	+
	2415	+	Public Health, [and] home health care agencies and hospice home health 2020
	2416	+	care agencies, shall develop protocols for documentation pursuant to 2021
	2417	+	the requirements of this subsection. The Department of Social Services 2022
	2418	+	shall notify all licensed home health care agencies and hospice home 2023
	2419	+	health care agencies of such protocols prior to the implementation of 2024
	2420	+	this section. 2025
	2421	+	(g) The Commissioner of Public Health may implement policies and 2026
	2422	+	procedures necessary to administer the provisions of this section while 2027
	2423	+	in the process of adopting such policies and procedures as regulations, 2028
	2424	+	provided notice of intent to adopt regulations is published in the 2029
	2425	+	Connecticut Law Journal not later than twenty days after the date of 2030
	2426	+	implementation. Policies and procedures implemented pursuant to this 2031
	2427	+	section shall be valid until the time final regulations are adopted. 2032
	2428	+	Sec. 51. Section 19a-496a of the general statutes is repealed and the 2033
	2429	+	following is substituted in lieu thereof (Effective July 1, 2021): 2034
	2430	+	(a) Notwithstanding any provision of the regulations of Connecticut 2035
	2431	+	state agencies, all home health care agency, hospice home health care 2036
	2432	+	agency and home health aide agency services shall be performed upon 2037
	2433	+	the order of a physician or physician assistant licensed pursuant to 2038
	2434	+	chapter 370 or an advanced practice registered nurse licensed pursuant 2039
	2435	+	to chapter 378. 2040
	2436	+	(b) All home health care agency services which are required by law 2041
	2437	+	to be performed upon the order of a licensed physician may be 2042
	2438	+	performed upon the order of a physician, physician assistant or 2043
	2439	+	advanced practice registered nurse licensed in a state which borders 2044
	2440	+	Connecticut. 2045
	2441	+	Sec. 52. Section 19a-504d of the general statutes is repealed and the 2046
	2442	+	following is substituted in lieu thereof (Effective July 1, 2021): 2047
	2443	+	(a) If a hospital recommends home health care to a patient, the 2048
	2444	+	hospital discharge plan shall include two or more available options of 2049
	2445	+	home health care agencies or hospice home health care agencies. 2050 Substitute Bill No. 6666
	2446	+
	2447	+
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	2450	+	65 of 89
	2451	+
	2452	+	(b) A hospital which (1) has an ownership or investment interest in a 2051
	2453	+	home health care agency or hospice home health care agency, or (2) 2052
	2454	+	receives compensation or remuneration for referral of patients to a home 2053
	2455	+	health care agency or hospice home health care agency shall disclose 2054
	2456	+	such interest to any patient prior to including such agency as an option 2055
	2457	+	in a hospital discharge plan. Such information shall be verbally 2056
	2458	+	disclosed to each patient or shall be posted in a conspicuous place visible 2057
	2459	+	to patients. As used in this subsection, "ownership or investment 2058
	2460	+	interest" does not include ownership of investment securities purchased 2059
	2461	+	by the practitioner on terms available to the general public and which 2060
	2462	+	are publicly traded. 2061
	2463	+	Sec. 53. (NEW) (Effective July 1, 2021) (a) The Commissioner of Public 2062
	2464	+	Health may suspend the requirements for licensure to authorize a 2063
	2465	+	licensed chronic and convalescent nursing home to provide services to 2064
	2466	+	patients with a reportable disease, emergency illness or health 2065
	2467	+	condition, pursuant to section 19-91 of the general statutes, under their 2066
	2468	+	existing license if such licensed chronic and convalescent nursing home 2067
	2469	+	(1) provides services to such patients in a building that is not physically 2068
	2470	+	connected to its licensed facility, or (2) expands its bed capacity in a 2069
	2471	+	portion of a facility that is separate from the licensed facility. Such 2070
	2472	+	services may only be provided in order to render temporary assistance 2071
	2473	+	in managing a public health emergency in this state, declared by the 2072
	2474	+	Governor pursuant to section 19a-131a of the general statutes. 2073
	2475	+	(b) Each chronic and convalescent nursing home that intends to 2074
	2476	+	provide services pursuant to subsection (a) of this section shall submit 2075
	2477	+	an application to the Department of Public Health in a form and manner 2076
	2478	+	prescribed by the commissioner. Such application shall include, but 2077
	2479	+	need not be limited to: (1) Information regarding the facility's ability to 2078
	2480	+	sufficiently address the health, safety or welfare of such chronic and 2079
	2481	+	convalescent nursing home's residents and staff; (2) the address of such 2080
	2482	+	facility; (3) an attestation that all equipment located at such facility is 2081
	2483	+	maintained according to the manufacturers' specifications, and is 2082
	2484	+	capable of meeting the needs of such facility's residents; (4) information 2083 Substitute Bill No. 6666
	2485	+
	2486	+
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	2489	+	66 of 89
	2490	+
	2491	+	regarding such facility's maximum bed capacity; and (5) information 2084
	2492	+	indicating that such facility is in compliance with any provisions of the 2085
	2493	+	general statutes or regulations of Connecticut state agencies pertaining 2086
	2494	+	to the operation of such facility. 2087
	2495	+	(c) Upon receipt of an application pursuant to subsection (a) of this 2088
	2496	+	section, the Department of Public Health shall conduct a scheduled 2089
	2497	+	inspection and investigation of the applicant's facilities to ensure 2090
	2498	+	compliance with any provisions of the general statutes or regulations of 2091
	2499	+	Connecticut state agencies pertaining to the licensing of such facilities. 2092
	2500	+	After conducting such inspection and investigation, the department 2093
	2501	+	shall notify the applicant of the department's approval or denial of such 2094
	2502	+	application. 2095
	2503	+	Sec. 54. Section 19a-522f of the general statutes is repealed and the 2096
	2504	+	following is substituted in lieu thereof (Effective July 1, 2021): 2097
	2505	+	(a) As used in this section: 2098
	2506	+	(1) "Administer" means to initiate the venipuncture and deliver an IV 2099
	2507	+	fluid or IV admixture into the blood stream through a vein, and to 2100
	2508	+	monitor and care for the venipuncture site, terminate the procedure and 2101
	2509	+	record pertinent events and observations; 2102
	2510	+	(2) "IV admixture" means an IV fluid to which one or more additional 2103
	2511	+	drug products have been added; 2104
	2512	+	(3) "IV fluid" means sterile solutions of fifty milliliters or more, 2105
	2513	+	intended for intravenous infusion, but does not include blood and blood 2106
	2514	+	products; 2107
	2515	+	(4) "IV therapy" means the introduction of an IV fluid or IV admixture 2108
	2516	+	into the blood stream through a vein for the purpose of correcting water 2109
	2517	+	deficit and electrolyte imbalances, providing nutrition, and delivering 2110
	2518	+	antibiotics and other therapeutic agents approved by a chronic and 2111
	2519	+	convalescent nursing home's or a rest home with nursing supervision's 2112
	2520	+	medical staff; 2113 Substitute Bill No. 6666
	2521	+
	2522	+
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	2525	+	67 of 89
	2526	+
	2527	+	(5) "IV therapy program" means the overall plan by which a chronic 2114
	2528	+	and convalescent nursing home or a rest home with nursing supervision 2115
	2529	+	implements, monitors and safeguards the administration of IV therapy 2116
	2530	+	to patients; and 2117
	2531	+	(6) "IV therapy nurse" means a registered nurse who is qualified by 2118
	2532	+	education and training and has demonstrated proficiency in the 2119
	2533	+	theoretical and clinical aspects of IV therapy to administer an IV fluid 2120
	2534	+	or IV admixture. 2121
	2535	+	(b) An IV therapy nurse or a physician assistant licensed pursuant to 2122
	2536	+	section 20-12b, who is employed by, or operating under a contract to 2123
	2537	+	provide services in, a chronic and convalescent nursing home or a rest 2124
	2538	+	home with nursing supervision that operates an IV therapy program 2125
	2539	+	may administer a peripherally inserted central catheter as part of such 2126
	2540	+	facility's IV therapy program. The Department of Public Health shall 2127
	2541	+	adopt regulations in accordance with the provisions of chapter 54 to 2128
	2542	+	carry out the purposes of this section. 2129
	2543	+	(c) A chronic and convalescent nursing home may permit a registered 2130
	2544	+	nurse licensed pursuant to chapter 378 and employed by such chronic 2131
	2545	+	and convalescent nursing home who has been properly trained by the 2132
	2546	+	director of nursing or by an intravenous infusion company to (1) draw 2133
	2547	+	blood from a central line for laboratory purposes, provided the facility 2134
	2548	+	has an agreement with a laboratory to process such specimens, or (2) 2135
	2549	+	administer a dose of medication by intravenous injection, provided such 2136
	2550	+	medication is on a list of medications approved by the Commissioner of 2137
	2551	+	Public Health for intravenous injection by a registered nurse. Such 2138
	2552	+	chronic and convalescent nursing home shall notify the Commissioner 2139
	2553	+	of Public Health of any such services being provided under subdivisions 2140
	2554	+	(1) and (2) of this subsection. The Commissioner of Public Health shall 2141
	2555	+	notify all chronic and convalescent nursing homes of the list of 2142
	2556	+	medications approved for intravenous injection by a registered nurse. 2143
	2557	+	The administrator of each chronic and convalescent nursing home shall 2144
	2558	+	ensure that each registered nurse who is permitted to perform the 2145
	2559	+	services described in subdivisions (1) and (2) of this subsection is 2146 Substitute Bill No. 6666
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	2564	+	68 of 89
	2565	+
	2566	+	appropriately trained and competent to perform such services. Each 2147
	2567	+	administrator shall provide documentation regarding the training and 2148
	2568	+	competency of such registered nurses to the department upon the 2149
	2569	+	department's request. 2150
	2570	+	Sec. 55. (NEW) (Effective July 1, 2021) (a) The Commissioner of Public 2151
	2571	+	Health shall license assisted living services agencies, as defined in 2152
	2572	+	section 19a-490 of the general statutes, as amended by this act. A 2153
	2573	+	managed residential community wishing to provide assisted living 2154
	2574	+	services shall become licensed as an assisted living services agency. 2155
	2575	+	(b) A managed residential care community that intends to arrange for 2156
	2576	+	assisted living services shall only do so with a currently licensed assisted 2157
	2577	+	living services agency. Such managed residential community shall 2158
	2578	+	submit an application to arrange for the assisted living services to the 2159
	2579	+	Department of Public Health in a form and manner prescribed by the 2160
	2580	+	commissioner. 2161
	2581	+	(c) No assisted living services agency shall provide memory care to 2162
	2582	+	residents with early to mid-stage cognitive impairment from 2163
	2583	+	Alzheimer's disease or other dementias unless they have obtained 2164
	2584	+	approval from the Department of Public Health. Such assisted living 2165
	2585	+	services agencies shall ensure that they have adequate staff to meet the 2166
	2586	+	needs of the residents. Each assisted living services agency that offers 2167
	2587	+	memory care services shall submit to the Department of Public Health a 2168
	2588	+	list of memory care units or locations and their staffing plans for any 2169
	2589	+	such units and locations when completing an initial or a renewal 2170
	2590	+	licensure application, or upon request from the department. 2171
	2591	+	(d) An assisted living services agency shall ensure that (1) all services 2172
	2592	+	being provided on an individual basis to clients are fully understood 2173
	2593	+	and agreed upon between either the client or the client's representative, 2174
	2594	+	and (2) the client or the client's representative are made aware of the cost 2175
	2595	+	of any such services. 2176
	2596	+	(e) The Department of Public Health may adopt regulations, in 2177 Substitute Bill No. 6666
	2597	+
	2598	+
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	2602	+
	2603	+	accordance with the provisions of chapter 54 of the general statutes, to 2178
	2604	+	carry out the purposes of this section. 2179
	2605	+	Sec. 56. Section 19a-521b of the general statutes is repealed and the 2180
	2606	+	following is substituted in lieu thereof (Effective July 1, 2021): 2181
	2607	+	[In each] Each licensed chronic and convalescent nursing home, 2182
	2608	+	chronic disease hospital associated with a chronic and convalescent 2183
	2609	+	nursing home, rest home with nursing supervision and residential care 2184
	2610	+	home [, at least a three-foot clearance shall be provided at the sides and 2185
	2611	+	the foot of each bed.] shall position beds in a manner that promotes 2186
	2612	+	resident care. Such bed position shall (1) not act as a restraint to the 2187
	2613	+	resident, (2) ensure that the resident's call bell, overhead bed light and 2188
	2614	+	privacy curtain function and are readily useable by such resident, (3) not 2189
	2615	+	create a hazardous situation, including, but not limited to, an 2190
	2616	+	entrapment possibility, or obstacle to evacuation or being close to or 2191
	2617	+	blocking a heat source, (4) prevent the spread of pathogens, (5) allow for 2192
	2618	+	infection control, (6) ensure residence privacy, and (7) provide at least 2193
	2619	+	six-foot clearance at the sides and foot of each bed. 2194
	2620	+	Sec. 57. Section 19a-195 of the general statutes is repealed and the 2195
	2621	+	following is substituted in lieu thereof (Effective October 1, 2021): 2196
	2622	+	The commissioner shall adopt regulations in accordance with the 2197
	2623	+	provisions of chapter 54 to require all [emergency medical response 2198
	2624	+	services] ambulances to be staffed by at least one certified emergency 2199
	2625	+	medical technician, who shall be in the patient compartment attending 2200
	2626	+	the patient during all periods in which a patient is being transported, 2201
	2627	+	and one certified [medical response technician] emergency medical 2202
	2628	+	responder. 2203
	2629	+	Sec. 58. Section 20-206jj of the general statutes is repealed and the 2204
	2630	+	following is substituted in lieu thereof (Effective from passage): 2205
	2631	+	As used in this section and sections 20-206kk to 20-206oo, inclusive: 2206
	2632	+	(1) "Advanced emergency medical technician" means an individual 2207 Substitute Bill No. 6666
	2633	+
	2634	+
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	2638	+
	2639	+	who is certified as an advanced emergency medical technician by the 2208
	2640	+	Department of Public Health; 2209
	2641	+	(2) "Commissioner" means the Commissioner of Public Health; 2210
	2642	+	(3) "Emergency medical services instructor" means a person who is 2211
	2643	+	certified under the provisions of section 20-206ll or 20-206mm, as 2212
	2644	+	amended by this act, by the Department of Public Health to teach 2213
	2645	+	courses, the completion of which is required in order to become an 2214
	2646	+	emergency medical technician; 2215
	2647	+	(4) "Emergency medical responder" means an individual who is 2216
	2648	+	certified to practice as an emergency medical responder under the 2217
	2649	+	provisions of section 20-206ll or 20-206mm, as amended by this act; 2218
	2650	+	(5) "Emergency medical services personnel" means an individual 2219
	2651	+	certified to practice as an emergency medical responder, emergency 2220
	2652	+	medical technician, advanced emergency medical technician, 2221
	2653	+	emergency medical services instructor or an individual licensed as a 2222
	2654	+	paramedic; 2223
	2655	+	(6) "Emergency medical technician" means a person who is certified 2224
	2656	+	to practice as an emergency medical technician under the provisions of 2225
	2657	+	section 20-206ll or 20-206mm, as amended by this act; 2226
	2658	+	(7) "National organization for emergency medical certification" 2227
	2659	+	means a national organization approved by the Department of Public 2228
	2660	+	Health and identified on the department's Internet web site, or such 2229
	2661	+	national organization's successor organization, that tests and provides 2230
	2662	+	certification to emergency medical responders, emergency medical 2231
	2663	+	technicians, advanced medical technicians and paramedics; 2232
	2664	+	(8) "Office of Emergency Medical Services" means the office 2233
	2665	+	established within the Department of Public Health pursuant to section 2234
	2666	+	19a-178; 2235
	2667	+	(9) "Paramedicine" means the carrying out of (A) all phases of 2236 Substitute Bill No. 6666
	2668	+
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	2672	+	71 of 89
	2673	+
	2674	+	cardiopulmonary resuscitation and defibrillation, (B) the administration 2237
	2675	+	of drugs and intravenous solutions under written or oral authorization 2238
	2676	+	from a licensed physician or a licensed advanced practice registered 2239
	2677	+	nurse, and (C) the administration of controlled substances, as defined in 2240
	2678	+	section 21a-240, in accordance with written protocols or standing orders 2241
	2679	+	of a licensed physician or a licensed advanced practice registered nurse; 2242
	2680	+	and 2243
	2681	+	(10) "Paramedic" means a person licensed to practice as a paramedic 2244
	2682	+	under the provisions of section 20-206ll. [; and] 2245
	2683	+	[(11) "Continuing education platform Internet web site" means an 2246
	2684	+	online database, approved by the Commissioner of Public Health, for 2247
	2685	+	emergency medical services personnel to enter, track and reconcile the 2248
	2686	+	hours and topics of continuing education completed by such personnel.] 2249
	2687	+	Sec. 59. Subsection (f) of section 20-206mm of the general statutes is 2250
	2688	+	repealed and the following is substituted in lieu thereof (Effective from 2251
	2689	+	passage): 2252
	2690	+	(f) A certified emergency medical responder, emergency medical 2253
	2691	+	technician, advanced emergency medical technician or emergency 2254
	2692	+	medical services instructor shall document the completion of his or her 2255
	2693	+	continuing educational requirements [through the continuing education 2256
	2694	+	platform Internet web site] in a form and manner prescribed by the 2257
	2695	+	commissioner. A certified emergency medical responder, emergency 2258
	2696	+	medical technician, advanced emergency medical technician or 2259
	2697	+	emergency medical services instructor who is not engaged in active 2260
	2698	+	professional practice in any form during a certification period shall be 2261
	2699	+	exempt from the continuing education requirements of this section, 2262
	2700	+	provided the emergency medical responder, emergency medical 2263
	2701	+	technician, advanced emergency medical technician or emergency 2264
	2702	+	medical services instructor submits to the department, prior to the 2265
	2703	+	expiration of the certification period, an application for inactive status 2266
	2704	+	on a form prescribed by the department and such other documentation 2267
	2705	+	as may be required by the department. The application for inactive 2268 Substitute Bill No. 6666
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	2707	+
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	2710	+	72 of 89
	2711	+
	2712	+	status pursuant to this subsection shall contain a statement that the 2269
	2713	+	emergency medical responder, emergency medical technic ian, 2270
	2714	+	advanced emergency medical technician or emergency medical services 2271
	2715	+	instructor may not engage in professional practice until the continuing 2272
	2716	+	education requirements of this section have been met. 2273
	2717	+	Sec. 60. Subsection (b) of section 19a-178a of the general statutes is 2274
	2718	+	repealed and the following is substituted in lieu thereof (Effective from 2275
	2719	+	passage): 2276
	2720	+	(b) The advisory board shall consist of members appointed in 2277
	2721	+	accordance with the provisions of this subsection and shall include the 2278
	2722	+	Commissioner of Public Health, the department's emergency medical 2279
	2723	+	services medical director and the president of each of the regional 2280
	2724	+	emergency medical services councils, or their designees. The Governor 2281
	2725	+	shall appoint the following members: (1) One person from the 2282
	2726	+	Connecticut Association of Directors of Health; (2) three persons from 2283
	2727	+	the Connecticut College of Emergency Physicians; (3) one person from 2284
	2728	+	the Connecticut Committee on Trauma of the American College of 2285
	2729	+	Surgeons; (4) one person from the Connecticut Medical Advisory 2286
	2730	+	Committee; (5) one person from the Emergency Nurses Association; (6) 2287
	2731	+	one person from the Connecticut Association of Emergency Medical 2288
	2732	+	Services Instructors; (7) one person from the Connecticut Hospital 2289
	2733	+	Association; (8) two persons representing commercial ambulance 2290
	2734	+	services; (9) one person from the Connecticut State Firefighters 2291
	2735	+	Association; (10) one person from the Connecticut Fire Chiefs 2292
	2736	+	Association; (11) one person from the Connecticut Police Chiefs 2293
	2737	+	Association; (12) one person from the Connecticut State Police; and (13) 2294
	2738	+	one person from the Connecticut Commission on Fire Prevention and 2295
	2739	+	Control. An additional eighteen members shall be appointed as follows: 2296
	2740	+	(A) Three by the president pro tempore of the Senate; (B) three by the 2297
	2741	+	majority leader of the Senate; (C) four by the minority leader of the 2298
	2742	+	Senate; (D) three by the speaker of the House of Representatives; (E) two 2299
	2743	+	by the majority leader of the House of Representatives; and (F) three by 2300
	2744	+	the minority leader of the House of Representatives. The appointees 2301 Substitute Bill No. 6666
	2745	+
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	2750	+
	2751	+	shall include a person with experience in municipal ambulance services; 2302
	2752	+	a person with experience in for-profit ambulance services; three persons 2303
	2753	+	with experience in volunteer ambulance services; a paramedic; an 2304
	2754	+	emergency medical technician; an advanced emergency medical 2305
	2755	+	technician; three consumers and four persons from state-wide 2306
	2756	+	organizations with interests in emergency medical services as well as 2307
	2757	+	any other areas of expertise that may be deemed necessary for the 2308
	2758	+	proper functioning of the advisory board. Any appointment to the 2309
	2759	+	advisory board that is vacant for more than one year shall be filled by 2310
	2760	+	the Commissioner of Public Health. The commissioner shall notify the 2311
	2761	+	appointing authority of the identity of the commissioner's appointment 2312
	2762	+	not later than thirty days before making such appointment. 2313
	2763	+	Sec. 61. Subsection (a) of section 19a-36h of the general statutes is 2314
	2764	+	repealed and the following is substituted in lieu thereof (Effective from 2315
	2765	+	passage): 2316
	2766	+	(a) Not later than January 1, [2020] 2022, the commissioner shall adopt 2317
	2767	+	and administer by reference the United States Food and Drug 2318
	2768	+	Administration's Food Code, as amended from time to time, and any 2319
	2769	+	Food Code Supplement published by said administration as the state's 2320
	2770	+	food code for the purpose of regulating food establishments. 2321
	2771	+	Sec. 62. Subsection (a) of section 19a-36j of the general statutes is 2322
	2772	+	repealed and the following is substituted in lieu thereof (Effective from 2323
	2773	+	passage): 2324
	2774	+	(a) On and after January 1, [2019] 2022, no person shall engage in the 2325
	2775	+	practice of a food inspector unless such person has obtained a 2326
	2776	+	certification from the commissioner in accordance with the provisions 2327
	2777	+	of this section. The commissioner shall develop a training and 2328
	2778	+	verification program for food inspector certification that shall be 2329
	2779	+	administered by the food inspection training officer at a local health 2330
	2780	+	department. 2331
	2781	+	(1) Each person seeking certification as a food inspector shall submit 2332 Substitute Bill No. 6666
	2782	+
	2783	+
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	2786	+	74 of 89
	2787	+
	2788	+	an application to the department on a form prescribed by the 2333
	2789	+	commissioner and present to the department satisfactory evidence that 2334
	2790	+	such person (A) is sponsored by the director of health in the jurisdiction 2335
	2791	+	in which the applicant is employed to conduct food inspections, (B) 2336
	2792	+	possesses a bachelor's degree or three years of experience in a regulatory 2337
	2793	+	food protection program, (C) has successfully completed a training and 2338
	2794	+	verification program, (D) has successfully completed the field 2339
	2795	+	standardization inspection prescribed by the commissioner, and (E) is 2340
	2796	+	not involved in the ownership or management of a food establishment 2341
	2797	+	located in the applicant's jurisdiction. 2342
	2798	+	(2) Each director of health sponsoring an applicant for certification as 2343
	2799	+	a food inspector shall submit to the commissioner a form documenting 2344
	2800	+	the applicant's qualifications and successful completion of the 2345
	2801	+	requirements described in subdivision (1) of this subsection. 2346
	2802	+	(3) Certifications issued under this section shall be subject to renewal 2347
	2803	+	once every three years. A food inspector applying for renewal of his or 2348
	2804	+	her certification shall demonstrate successful completion of twenty 2349
	2805	+	contact hours in food protection training, as approved by the 2350
	2806	+	commissioner, and reassessment by the food inspection training officer. 2351
	2807	+	Sec. 63. Section 19a-36o of the general statutes is repealed and the 2352
	2808	+	following is substituted in lieu thereof (Effective from passage): 2353
	2809	+	Notwithstanding any provision of the general statutes, from June 30, 2354
	2810	+	2017, until December 31, [2018] 2021, a food service establishment may 2355
	2811	+	request a variance from the Commissioner of Public Health from the 2356
	2812	+	requirements of the Public Health Code, established under section 19a-2357
	2813	+	36, to utilize the process of sous vide and acidification of sushi rice, as 2358
	2814	+	defined in section 3-502.11 of the United States Food and Drug 2359
	2815	+	Administration's Food Code, as amended from time to time. The 2360
	2816	+	Commissioner of Public Health shall review the request for a variance 2361
	2817	+	and provide the food establishment with notification regarding the 2362
	2818	+	status of its request not later than thirty days after the commissioner 2363
	2819	+	receives such request. The commissioner may grant such variance if he 2364 Substitute Bill No. 6666
	2820	+
	2821	+
	2822	+	LCO {\\PRDFS1\HCOUSERS\BARRYJN\WS\2021HB-06666-
	2823	+	R02-HB.docx }
	2824	+	75 of 89
	2825	+
	2826	+	or she determines that such variance would not result in a health hazard 2365
	2827	+	or nuisance. 2366
	2828	+	Sec. 64. Subdivision (5) of section 19a-332 of the general statutes is 2367
	2829	+	repealed and the following is substituted in lieu thereof (Effective October 2368
	2830	+	1, 2021): 2369
	2831	+	(5) "Asbestos-containing material" means material composed of 2370
	2832	+	asbestos of any type and in an amount equal to or greater than one per 2371
	2833	+	cent by weight, either alone or mixed with other fibrous or nonfibrous 2372
	2834	+	material; 2373
	2835	+	Sec. 65. Subdivision (4) of section 20-250 of the general statutes is 2374
	2836	+	repealed and the following is substituted in lieu thereof (Effective from 2375
	2837	+	passage): 2376
	2838	+	(4) "Hairdressing and cosmetology" means the art of dressing, 2377
	2839	+	arranging, curling, waving, weaving, cutting, singeing, bleaching and 2378
	2840	+	coloring the hair and treating the scalp of any person, and massaging, 2379
	2841	+	cleansing, stimulating, manipulating, exercising or beautifying with the 2380
	2842	+	use of the hands, appliances, cosmetic preparations, antiseptics, tonics, 2381
	2843	+	lotions, creams, powders, oils or clays and doing similar work on the 2382
	2844	+	face, neck and arms for compensation, removing hair from the face or 2383
	2845	+	neck using manual or mechanical means, excluding esthetics, as defined 2384
	2846	+	in section 20-265a or any of the actions listed in this subdivision 2385
	2847	+	performed on the nails of the hands or feet, provided nothing in this 2386
	2848	+	subdivision shall prohibit an unlicensed person from performing 2387
	2849	+	shampooing or braiding hair; 2388
	2850	+	Sec. 66. Subsection (b) of section 20-265b of the general statutes is 2389
	2851	+	repealed and the following is substituted in lieu thereof (Effective July 1, 2390
	2852	+	2021): 2391
	2853	+	(b) On and after January 1, 2020, each person seeking an initial license 2392
	2854	+	as an esthetician shall apply to the department on a form prescribed by 2393
	2855	+	the department, accompanied by an application fee of one hundred 2394
	2856	+	dollars and evidence that the applicant (1) has completed a course of not 2395 Substitute Bill No. 6666
	2857	+
	2858	+
	2859	+	LCO {\\PRDFS1\HCOUSERS\BARRYJN\WS\2021HB-06666-
	2860	+	R02-HB.docx }
	2861	+	76 of 89
	2862	+
	2863	+	less than six hundred hours of study and received a certification of 2396
	2864	+	completion from a school approved under section 20-265g or section 20-2397
	2865	+	26 or in a school outside of the state whose requirements are equivalent 2398
	2866	+	to a school approved under section 20-265g, or (2) (A), if applying before 2399
	2867	+	January 1, 2022, has practiced esthetics continuously in this state for a 2400
	2868	+	period of not less than two years prior to July 1, 2020, and (B) is in 2401
	2869	+	compliance with the infection prevention and control plan guidelines 2402
	2870	+	prescribed by the department under section 19a-231 in the form of an 2403
	2871	+	attestation. 2404
	2872	+	Sec. 67. Subsection (f) of section 10-206 of the general statutes is 2405
	2873	+	repealed and the following is substituted in lieu thereof (Effective July 1, 2406
	2874	+	2021): 2407
	2875	+	(f) On and after October 1, 2017, each local or regional board of 2408
	2876	+	education shall report to the local health department and the 2409
	2877	+	Department of Public Health, on an triennial basis, the total number of 2410
	2878	+	pupils per school and per school district having a diagnosis of asthma 2411
	2879	+	(1) at the time of public school enrollment, (2) in grade six or seven, and 2412
	2880	+	(3) in grade nine or ten. [or eleven.] The report shall contain the asthma 2413
	2881	+	information collected as required under subsections (b) and (c) of this 2414
	2882	+	section and shall include pupil age, gender, race, ethnicity and school. 2415
	2883	+	Beginning on October 1, 2021, and every three years thereafter, the 2416
	2884	+	Department of Public Health shall review the asthma screening 2417
	2885	+	information reported pursuant to this section and shall submit a report 2418
	2886	+	to the joint standing committees of the General Assembly having 2419
	2887	+	cognizance of matters relating to public health and education 2420
	2888	+	concerning asthma trends and distributions among pupils enrolled in 2421
	2889	+	the public schools. The report shall be submitted in accordance with the 2422
	2890	+	provisions of section 11-4a and shall include, but not be limited to, (A) 2423
	2891	+	trends and findings based on pupil age, gender, race, ethnicity, school 2424
	2892	+	and the education reference group, as determined by the Department of 2425
	2893	+	Education for the town or regional school district in which such school 2426
	2894	+	is located, and (B) activities of the asthma screening monitoring system 2427
	2895	+	maintained under section 19a-62a. 2428 Substitute Bill No. 6666
	2896	+
	2897	+
	2898	+	LCO {\\PRDFS1\HCOUSERS\BARRYJN\WS\2021HB-06666-
	2899	+	R02-HB.docx }
	2900	+	77 of 89
	2901	+
	2902	+	Sec. 68. Subsections (b) to (f), inclusive, of section 19a-215 of the 2429
	2903	+	general statutes are repealed and the following is substituted in lieu 2430
	2904	+	thereof (Effective from passage): 2431
	2905	+	(b) A health care provider shall report each case occurring in such 2432
	2906	+	provider's practice, of any disease on the commissioner's list of 2433
	2907	+	reportable diseases, emergency illnesses and health conditions to the 2434
	2908	+	director of health of the town, city or borough in which such case resides 2435
	2909	+	and to the Department of Public Health, no later than twelve hours after 2436
	2910	+	such provider's recognition of the disease. Such reports shall be [in 2437
	2911	+	writing, by telephone or] in an electronic format approved by the 2438
	2912	+	commissioner. Such reports of disease shall be confidential and not open 2439
	2913	+	to public inspection except as provided for in section 19a-25. 2440
	2914	+	(c) A clinical laboratory shall report each finding identified by such 2441
	2915	+	laboratory of any disease identified on the commissioner's list of 2442
	2916	+	reportable laboratory findings to the Department of Public Health not 2443
	2917	+	later than forty-eight hours after such laboratory's finding. A clinical 2444
	2918	+	laboratory [that reports an average of more than thirty findings per 2445
	2919	+	month] shall make such reports electronically in a format approved by 2446
	2920	+	the commissioner. [Any clinical laboratory that reports an average of 2447
	2921	+	less than thirty findings per month shall submit such reports, in writing, 2448
	2922	+	by telephone or in an electronic format approved by the commissioner.] 2449
	2923	+	All such reports shall be confidential and not open to public inspection 2450
	2924	+	except as provided for in section 19a-25. The Department of Public 2451
	2925	+	Health shall provide a copy of all such reports to the director of health 2452
	2926	+	of the town, city or borough in which the affected person resides or, in 2453
	2927	+	the absence of such information, the town where the specimen 2454
	2928	+	originated. 2455
	2929	+	(d) When a local director of health, the local director's authorized 2456
	2930	+	agent or the Department of Public Health receives a report of a disease 2457
	2931	+	or laboratory finding on the commissioner's lists of reportable diseases, 2458
	2932	+	emergency illnesses and health conditions and laboratory findings, the 2459
	2933	+	local director of health, the local director's authorized agent or the 2460
	2934	+	Department of Public Health may contact first the reporting health care 2461 Substitute Bill No. 6666
	2935	+
	2936	+
	2937	+	LCO {\\PRDFS1\HCOUSERS\BARRYJN\WS\2021HB-06666-
	2938	+	R02-HB.docx }
	2939	+	78 of 89
	2940	+
	2941	+	provider and then the person with the reportable finding to obtain such 2462
	2942	+	information as may be necessary to lead to the effective control of 2463
	2943	+	further spread of such disease. In the case of reportable communicable 2464
	2944	+	diseases and laboratory findings, this information may include 2465
	2945	+	obtaining the identification of persons who may be the source or 2466
	2946	+	subsequent contacts of such infection. 2467
	2947	+	(e) All personal information obtained from disease prevention and 2468
	2948	+	control investigations as performed in subsections (c) and (d) of this 2469
	2949	+	section including the health care provider's name and the identity of the 2470
	2950	+	reported case of disease and suspected source persons and contacts shall 2471
	2951	+	not be divulged to anyone and shall be held strictly confidential 2472
	2952	+	pursuant to section 19a-25, by the local director of health and the 2473
	2953	+	director's authorized agent and by the Department of Public Health. 2474
	2954	+	(f) [Any person who violates any reporting or confidentiality 2475
	2955	+	provision of this section shall be fined not more than five hundred 2476
	2956	+	dollars.] The Commissioner of Public Health may impose a civil penalty 2477
	2957	+	not to exceed one thousand dollars on any person who violates any 2478
	2958	+	reporting provision of this section for each such violation. Each failure 2479
	2959	+	to report a case or finding of a disease as required by this section shall 2480
	2960	+	constitute a separate violation. 2481
	2961	+	(g) If the Commissioner of Public Health has reason to believe that a 2482
	2962	+	violation has occurred for which a civil penalty is authorized by 2483
	2963	+	subsection (f) of this section, he or she may send to such person by 2484
	2964	+	certified mail, return receipt requested, or personally serve upon such 2485
	2965	+	person, a notice which shall include: (1) A short and plain statement of 2486
	2966	+	the matters asserted or charged; (2) a statement of the maximum civil 2487
	2967	+	penalty which may be imposed for such violation; and (3) a statement 2488
	2968	+	of the party's right to request a hearing, which such request shall 2489
	2969	+	submitted in writing to the commissioner not later than ten days after 2490
	2970	+	the notice is mailed or served. 2491
	2971	+	(h) If such person so requests, the commissioner shall cause a hearing 2492
	2972	+	to be held, in accordance with the provisions of chapter 54. If such 2493 Substitute Bill No. 6666
	2973	+
	2974	+
	2975	+	LCO {\\PRDFS1\HCOUSERS\BARRYJN\WS\2021HB-06666-
	2976	+	R02-HB.docx }
	2977	+	79 of 89
	2978	+
	2979	+	person fails to request a hearing or fails to appear at the hearing or if, 2494
	2980	+	after the hearing, the commissioner finds that the person has committed 2495
	2981	+	such violation, the commissioner may, in his or her discretion, order that 2496
	2982	+	a civil penalty be imposed that is not greater than the penalty stated in 2497
	2983	+	the notice. The commissioner shall send a copy of any order issued 2498
	2984	+	pursuant to this subsection by certified mail, return receipt requested, 2499
	2985	+	to the person named in such order. 2500
	2986	+	(i) No provision of this section shall be deemed to supersede section 2501
	2987	+	19a-584. 2502
	2988	+	Sec. 69. Section 19a-490w of the general statutes is repealed and the 2503
	2989	+	following is substituted in lieu thereof (Effective October 1, 2021): 2504
	2990	+	(a) Not later than October 1, 2017, and annually thereafter, any 2505
	2991	+	hospital that has been certified as a comprehensive stroke center, a 2506
	2992	+	primary stroke center, a thrombectomy-capable stroke center or an 2507
	2993	+	acute stroke-ready hospital by the American Heart Association, the Joint 2508
	2994	+	Commission or any other nationally recognized certifying organization 2509
	2995	+	shall submit an attestation of such certification to the Commissioner of 2510
	2996	+	Public Health, in a form and manner prescribed by the commissioner. 2511
	2997	+	Not later than October 15, 2017, and annually thereafter, the Department 2512
	2998	+	of Public Health shall post a list of certified stroke centers on its Internet 2513
	2999	+	web site. 2514
	3000	+	(b) The department may remove a hospital from the list posted 2515
	3001	+	pursuant to subsection (a) of this section if (1) the hospital requests such 2516
	3002	+	removal, (2) the department is informed by the American Heart 2517
	3003	+	Association, the Joint Commission or other nationally recognized 2518
	3004	+	certifying organization that a hospital's certification has expired or been 2519
	3005	+	suspended or revoked, or (3) the department does not receive attestation 2520
	3006	+	of certification from a hospital on or before October first. The 2521
	3007	+	department shall report to the nationally recognized certifying 2522
	3008	+	organization any complaint it receives related to the certification of a 2523
	3009	+	hospital as a comprehensive stroke center, a primary stroke center, a 2524
	3010	+	thrombectomy-capable stroke center or an acute stroke-ready hospital. 2525 Substitute Bill No. 6666
	3011	+
	3012	+
	3013	+	LCO {\\PRDFS1\HCOUSERS\BARRYJN\WS\2021HB-06666-
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	3015	+	80 of 89
	3016	+
	3017	+	The department shall provide the complainant with the name and 2526
	3018	+	contact information of the nationally recognized certifying organization 2527
	3019	+	if the complainant seeks to pursue a complaint with such organization. 2528
	3020	+	Sec. 70. (NEW) (Effective October 1, 2021) (a) The Department of Public 2529
	3021	+	Health shall maintain and operate a state-wide stroke registry. Said 2530
	3022	+	registry shall use the American Heart Association's Get With The 2531
	3023	+	Guidelines–Stroke program's data set platform and include information 2532
	3024	+	and data on stroke care in the state that align with the stroke consensus 2533
	3025	+	metrics developed and approved by the American Heart Association 2534
	3026	+	and American Stroke Association. 2535
	3027	+	(b) On and after January 1, 2022, each comprehensive stroke center, 2536
	3028	+	thrombectomy-capable stroke center, primary stroke center or acute 2537
	3029	+	stroke-ready hospital shall, on a quarterly basis, submit to the 2538
	3030	+	Department of Public Health data concerning stroke care that are 2539
	3031	+	necessary for including in the state-wide stroke registry, as determined 2540
	3032	+	by the Commissioner of Public Health, and that, at a minimum, align 2541
	3033	+	with the stroke consensus metrics developed and approved by the 2542
	3034	+	American Heart Association and American Stroke Association. 2543
	3035	+	(c) The Department of Public Health shall be provided access to 2544
	3036	+	records of any comprehensive stroke center, thrombectomy-capable 2545
	3037	+	stroke center, primary stroke center or acute stroke-ready hospital, as 2546
	3038	+	the department deems necessary, to perform case finding or other 2547
	3039	+	quality improvement audits to ensure completeness of reporting and 2548
	3040	+	data accuracy consistent with the purposes of this section. 2549
	3041	+	(d) The Department of Public Health may enter into a contract for the 2550
	3042	+	receipt, storage, holding or maintenance of the data or files under its 2551
	3043	+	control and management. 2552
	3044	+	(e) The Department of Public Health may enter into reciprocal 2553
	3045	+	reporting agreements with the appropriate agencies of other states to 2554
	3046	+	exchange stroke care data. 2555
	3047	+	(f) (1) Failure by a comprehensive stroke center, thrombectomy-2556 Substitute Bill No. 6666
	3048	+
	3049	+
	3050	+	LCO {\\PRDFS1\HCOUSERS\BARRYJN\WS\2021HB-06666-
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	3052	+	81 of 89
	3053	+
	3054	+	capable stroke center, primary stroke center or acute stroke-ready 2557
	3055	+	hospital to comply with the reporting requirements prescribed in this 2558
	3056	+	section may result in the department electing to perform the registry 2559
	3057	+	services for such comprehensive stroke center, thrombectomy-capable 2560
	3058	+	stroke center, primary stroke center or acute stroke-ready hospital. In 2561
	3059	+	such case, the comprehensive stroke center, thrombectomy-capable 2562
	3060	+	stroke center, primary stroke center or acute stroke-ready hospital shall 2563
	3061	+	reimburse the department for actual expenses incurred in performing 2564
	3062	+	such services. 2565
	3063	+	(2) Any comprehensive stroke center, thrombectomy-capable stroke 2566
	3064	+	center, primary stroke center or acute stroke-ready hospital that fails to 2567
	3065	+	comply with the provisions of this section shall be liable for a civil 2568
	3066	+	penalty not to exceed five hundred dollars for each failure to disclose a 2569
	3067	+	stroke care data, as determined by the commissioner. 2570
	3068	+	(3) The reimbursements, expenses and civil penalties set forth in this 2571
	3069	+	section shall be assessed only after the Department of Public Health has 2572
	3070	+	provided a comprehensive stroke center, thrombectomy-capable stroke 2573
	3071	+	center, primary stroke center or acute stroke-ready hospital with written 2574
	3072	+	notice of deficiency and such comprehensive stroke center, 2575
	3073	+	thrombectomy-capable stroke center, primary stroke center or acute 2576
	3074	+	stroke-ready hospital has been afforded not less than fourteen business 2577
	3075	+	days after the date of receiving such notice to provide a written response 2578
	3076	+	to the department. Such written response shall include any information 2579
	3077	+	requested by the department. 2580
	3078	+	(g) The Commissioner of Public Health may request that the Attorney 2581
	3079	+	General initiate an action to collect any civil penalties assessed pursuant 2582
	3080	+	to this section and obtain such orders as necessary to enforce any 2583
	3081	+	provision of this section. 2584
	3082	+	(h) Not later than January 1, 2022, the Department of Public Health, 2585
	3083	+	in consultation with the State of Connecticut Stroke Advisory Council, 2586
	3084	+	shall establish a stroke registry data oversight committee. Such 2587
	3085	+	committee shall monitor the operations of the state-wide stroke registry, 2588 Substitute Bill No. 6666
	3086	+
	3087	+
	3088	+	LCO {\\PRDFS1\HCOUSERS\BARRYJN\WS\2021HB-06666-
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	3090	+	82 of 89
	3091	+
	3092	+	provide advice regarding the oversight of such registry, develop a plan 2589
	3093	+	to improve quality of stroke care and address disparities in the 2590
	3094	+	provision of such care and develop short and long-term goals for 2591
	3095	+	improvement of stroke care in comprehensive stroke centers, 2592
	3096	+	thrombectomy-capable stroke centers, primary stroke centers and acute 2593
	3097	+	stroke-ready hospitals. 2594
	3098	+	(i) The Commissioner of Public Health may adopt regulations, in 2595
	3099	+	accordance with the provisions of chapter 54 of the general statutes, to 2596
	3100	+	implement the provisions of this section. 2597
	3101	+	Sec. 71. Subsection (k) of section 19a-180 of the general statutes is 2598
	3102	+	repealed and the following is substituted in lieu thereof (Effective from 2599
	3103	+	passage): 2600
	3104	+	(k) Notwithstanding the provisions of subsection (a) of this section, 2601
	3105	+	any [volunteer, hospital-based or municipal ambulance service] 2602
	3106	+	emergency medical services organization that is licensed or certified and 2603
	3107	+	a primary service area responder may apply to the commissioner, on a 2604
	3108	+	short form application prescribed by the commissioner, to change the 2605
	3109	+	address of a principal or branch location or to add a branch location 2606
	3110	+	within its primary service area. Upon making such application, the 2607
	3111	+	applicant shall notify in writing all other primary service area 2608
	3112	+	responders in any municipality or abutting municipality in which the 2609
	3113	+	applicant proposes to change principal or branch locations. Unless a 2610
	3114	+	primary service area responder entitled to receive notification of such 2611
	3115	+	application objects, in writing, to the commissioner and requests a 2612
	3116	+	hearing on such application not later than fifteen calendar days after 2613
	3117	+	receiving such notice, the application shall be deemed approved thirty 2614
	3118	+	calendar days after filing. If any such primary service area responder 2615
	3119	+	files an objection with the commissioner within the fifteen-calendar-day 2616
	3120	+	time period and requests a hearing, the applicant shall be required to 2617
	3121	+	demonstrate need to change the address of a principal or branch 2618
	3122	+	location within its primary service area at a public hearing as required 2619
	3123	+	under subsection (a) of this section. 2620 Substitute Bill No. 6666
	3124	+
	3125	+
	3126	+	LCO {\\PRDFS1\HCOUSERS\BARRYJN\WS\2021HB-06666-
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	3128	+	83 of 89
	3129	+
	3130	+	Sec. 72. Section 7-36 of the general statutes is repealed and the 2621
	3131	+	following is substituted in lieu thereof (Effective July 1, 2021): 2622
	3132	+	As used in this chapter and sections 19a-40 to 19a-45, inclusive, unless 2623
	3133	+	the context otherwise requires: 2624
	3134	+	(1) "Registrar of vital statistics" or "registrar" means the registrar of 2625
	3135	+	births, marriages, deaths and fetal deaths or any public official charged 2626
	3136	+	with the care of returns relating to vital statistics; 2627
	3137	+	(2) "Registration" means the process by which vital records are 2628
	3138	+	completed, filed and incorporated into the official records of the 2629
	3139	+	department; 2630
	3140	+	(3) "Institution" means any public or private facility that provides 2631
	3141	+	inpatient medical, surgical or diagnostic care or treatment, or nursing, 2632
	3142	+	custodial or domiciliary care, or to which persons are committed by law; 2633
	3143	+	(4) "Vital records" means a certificate of birth, death, fetal death or 2634
	3144	+	marriage; 2635
	3145	+	(5) "Certified copy" means a copy of a birth, death, fetal death or 2636
	3146	+	marriage certificate that (A) includes all information on the certificate 2637
	3147	+	except such information that is nondisclosable by law, (B) is issued or 2638
	3148	+	transmitted by any registrar of vital statistics, (C) includes an attested 2639
	3149	+	signature and the raised seal of an authorized person, and (D) if 2640
	3150	+	submitted to the department, includes all information required by the 2641
	3151	+	commissioner; 2642
	3152	+	(6) "Uncertified copy" means a copy of a birth, death, fetal death or 2643
	3153	+	marriage certificate that includes all information contained in a certified 2644
	3154	+	copy except an original attested signature and a raised seal of an 2645
	3155	+	authorized person; 2646
	3156	+	(7) "Authenticate" or "authenticated" means to affix to a vital record 2647
	3157	+	in paper format the official seal, or to affix to a vital record in electronic 2648
	3158	+	format the user identification, password, or other means of electronic 2649 Substitute Bill No. 6666
	3159	+
	3160	+
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	3163	+	84 of 89
	3164	+
	3165	+	identification, as approved by the department, of the creator of the vital 2650
	3166	+	record, or the creator's designee, by which affixing the creator of such 2651
	3167	+	paper or electronic vital record, or the creator's designee, affirms the 2652
	3168	+	integrity of such vital record; 2653
	3169	+	(8) "Attest" means to verify a vital record in accordance with the 2654
	3170	+	provisions of subdivision (5) of this section; 2655
	3171	+	(9) "Correction" means to change or enter new information on a 2656
	3172	+	certificate of birth, marriage, death or fetal death, within one year of the 2657
	3173	+	date of the vital event recorded in such certificate, in order to accurately 2658
	3174	+	reflect the facts existing at the time of the recording of such vital event, 2659
	3175	+	where such changes or entries are to correct errors on such certificate 2660
	3176	+	due to inaccurate or incomplete information provided by the informant 2661
	3177	+	at the time the certificate was prepared, or to correct transcribing, 2662
	3178	+	typographical or clerical errors; 2663
	3179	+	(10) "Amendment" means to (A) change or enter new information on 2664
	3180	+	a certificate of birth, marriage, death or fetal death, more than one year 2665
	3181	+	after the date of the vital event recorded in such certificate, in order to 2666
	3182	+	accurately reflect the facts existing at the time of the recording of the 2667
	3183	+	event, (B) create a replacement certificate of birth for matters pertaining 2668
	3184	+	to parentage and gender change, or (C) reflect a legal name change in 2669
	3185	+	accordance with section 19a-42 or make a modification to a cause of 2670
	3186	+	death; 2671
	3187	+	(11) "Acknowledgment of paternity" means to legally acknowledge 2672
	3188	+	paternity of a child pursuant to section 46b-172; 2673
	3189	+	(12) "Adjudication of paternity" means to legally establish paternity 2674
	3190	+	through an order of a court of competent jurisdiction; 2675
	3191	+	(13) "Parentage" includes matters relating to adoption, gestational 2676
	3192	+	agreements, paternity and maternity; 2677
	3193	+	(14) "Department" means the Department of Public Health; 2678 Substitute Bill No. 6666
	3194	+
	3195	+
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	3198	+	85 of 89
	3199	+
	3200	+	(15) "Commissioner" means the Commissioner of Public Health or the 2679
	3201	+	commissioner's designee; 2680
	3202	+	(16) "Gestational agreement" means a written agreement for assisted 2681
	3203	+	reproduction in which a woman agrees to carry a child to birth for an 2682
	3204	+	intended parent or intended parents, which woman contributed no 2683
	3205	+	genetic material to the child and which agreement (A) names each party 2684
	3206	+	to the agreement and indicates each party's respective obligations under 2685
	3207	+	the agreement, (B) is signed by each party to the agreement and the 2686
	3208	+	spouse of each such party, if any, and (C) is witnessed by at least two 2687
	3209	+	disinterested adults and acknowledged in the manner prescribed by 2688
	3210	+	law; 2689
	3211	+	(17) "Intended parent" means a party to a gestational agreement who 2690
	3212	+	agrees, under the gestational agreement, to be the parent of a child born 2691
	3213	+	to a woman by means of assisted reproduction, regardless of whether 2692
	3214	+	the party has a genetic relationship to the child; 2693
	3215	+	(18) "Foundling" means (A) a child of unknown parentage, or (B) an 2694
	3216	+	infant voluntarily surrendered pursuant to the provisions of section 17a-2695
	3217	+	58; [and] 2696
	3218	+	(19) "Certified homeless youth" means a person who is at least fifteen 2697
	3219	+	years of age but less than eighteen years of age, is not in the physical 2698
	3220	+	custody of a parent or legal guardian, who is a homeless child or youth, 2699
	3221	+	as defined in 42 USC 11434a, as amended from time to time, and who 2700
	3222	+	has been certified as homeless by (A) a school district homeless liaison, 2701
	3223	+	(B) the director of an emergency shelter program funded by the United 2702
	3224	+	States Department of Housing and Urban Devel opment, or the 2703
	3225	+	director's designee, [or] (C) the director of a runaway or homeless youth 2704
	3226	+	basic center or transitional living program funded by the United States 2705
	3227	+	Department of Health and Human Services, or the director's designee, 2706
	3228	+	or (D) the director of a program of a nonprofit organization or 2707
	3229	+	municipality that is contracted with the homeless youth program 2708
	3230	+	established pursuant to section 17a-62a; and 2709 Substitute Bill No. 6666
	3231	+
	3232	+
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	3235	+	86 of 89
	3236	+
	3237	+	(20) "Certified homeless young adult" means a person who is at least 2710
	3238	+	eighteen years of age but less than twenty-five years of age who has 2711
	3239	+	been certified as homeless by (A) a school district homeless liaison, (B) 2712
	3240	+	the director of an emergency shelter program funded by the United 2713
	3241	+	States Department of Housing and Urban Development, or the 2714
	3242	+	director's designee, (C) the director of a runaway or homeless youth 2715
	3243	+	basic center or transitional living program funded by the United States 2716
	3244	+	Department of Health and Human Services, or the director's designee, 2717
	3245	+	or (D) the director of a program of a nonprofit organization or 2718
	3246	+	municipality that is contracted with the homeless youth program 2719
	3247	+	established pursuant to section 17a-62a. 2720
	3248	+	Sec. 73. Subsection (c) of section 7-51 of the general statutes is 2721
	3249	+	repealed and the following is substituted in lieu thereof (Effective July 1, 2722
	3250	+	2021): 2723
	3251	+	(c) (1) The registrar of the town in which the birth or fetal death 2724
	3252	+	occurred or of the town in which the mother resided at the time of the 2725
	3253	+	birth or fetal death, or the department, may issue a certified copy of the 2726
	3254	+	certificate of birth or fetal death of any person born in this state that is 2727
	3255	+	kept in paper form in the custody of the registrar. Except as provided in 2728
	3256	+	subdivision (2) of this subsection, such certificate shall be issued upon 2729
	3257	+	the written request of an eligible party listed in subsection (a) of this 2730
	3258	+	section. Any registrar of vital statistics in this state with access, as 2731
	3259	+	authorized by the department, to the electronic vital records system of 2732
	3260	+	the department may issue a certified copy of the electronically filed 2733
	3261	+	certificate of birth or fetal death of any person born in this state upon 2734
	3262	+	the written request of an eligible party listed in subsection (a) of this 2735
	3263	+	section. The registrar and the department may waive the fee for the 2736
	3264	+	issuance of a certified copy of the certificate of birth of a certified 2737
	3265	+	homeless young adult to such young adult under this subsection. 2738
	3266	+	(2) In the case of a certified homeless youth, such certified homeless 2739
	3267	+	youth and the person who is certifying the certified homeless youth as 2740
	3268	+	homeless, as described in section 7-36, as amended by this act, shall 2741
	3269	+	appear in person when the certified homeless youth is presenting the 2742 Substitute Bill No. 6666
	3270	+
	3271	+
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	3274	+	87 of 89
	3275	+
	3276	+	written request described in subdivision (1) of this subsection at (A) the 2743
	3277	+	office of the registrar of the town in which the certified homeless youth 2744
	3278	+	was born, (B) the office of the registrar of the town in which the mother 2745
	3279	+	of the certified homeless youth resided at the time of the birth, (C) if the 2746
	3280	+	birth certificate of the certified homeless youth has been electronically 2747
	3281	+	filed, any registrar of vital statistics in the state with access, as 2748
	3282	+	authorized by the department, to the electronic vital records system, or 2749
	3283	+	(D) the state vital records office of the department. The certified 2750
	3284	+	homeless youth shall present to the registrar or the department 2751
	3285	+	information sufficient to identify himself or herself as may be required 2752
	3286	+	by regulations adopted by the commissioner pursuant to section 7-41. 2753
	3287	+	The person who is certifying the certified homeless youth as homeless 2754
	3288	+	shall present to the registrar or the department information sufficient to 2755
	3289	+	identify himself or herself as meeting the certification requirements of 2756
	3290	+	section 7-36, as amended by this act. The registrar and the department 2757
	3291	+	may waive the fee for the issuance of a certified copy of the certificate of 2758
	3292	+	birth of a homeless youth to such youth under this subsection. 2759
	3293	+	Sec. 74. Subsection (a) of section 1-1h of the general statutes is 2760
	3294	+	repealed and the following is substituted in lieu thereof (Effective July 1, 2761
	3295	+	2021): 2762
	3296	+	(a) Any person who does not possess a valid motor vehicle operator's 2763
	3297	+	license may apply to the Department of Motor Vehicles for an identity 2764
	3298	+	card. The application for an identity card shall be accompanied by the 2765
	3299	+	birth certificate of the applicant or a certificate of identification of the 2766
	3300	+	applicant issued and authorized for such use by the Department of 2767
	3301	+	Correction and a fee of twenty-eight dollars. Such application shall 2768
	3302	+	include: (1) The applicant's name; (2) the applicant's address; (3) 2769
	3303	+	whether the address is permanent or temporary; (4) the applicant's date 2770
	3304	+	of birth; (5) notice to the applicant that false statements on such 2771
	3305	+	application are punishable under section 53a-157b; and (6) such other 2772
	3306	+	pertinent information as the Commissioner of Motor Vehicles deems 2773
	3307	+	necessary. The applicant shall sign the application in the presence of an 2774
	3308	+	official of the Department of Motor Vehicles. The commissioner may 2775 Substitute Bill No. 6666
	3309	+
	3310	+
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	3313	+	88 of 89
	3314	+
	3315	+	waive the fee for any applicant (A) who has voluntarily surrendered 2776
	3316	+	such applicant's motor vehicle operator's license, (B) whose license has 2777
	3317	+	been refused by the commissioner pursuant to subdivision (4) of 2778
	3318	+	subsection (e) of section 14-36, (C) who is both a veteran, as defined in 2779
	3319	+	subsection (a) of section 27-103, and blind, as defined in subsection (a) 2780
	3320	+	of section 1-1f, or (D) who is a resident of a homeless shelter or other 2781
	3321	+	facility for homeless persons or a certified homeless youth or certified 2782
	3322	+	homeless young adult. The commissioner shall adopt regulations, in 2783
	3323	+	accordance with the provisions of chapter 54, to establish the procedure 2784
	3324	+	and qualifications for the issuance of an identity card to any such 2785
	3325	+	homeless applicant. For the purposes of this subsection, "certified 2786
	3326	+	homeless youth" and "certified homeless young adult" have the same 2787
	3327	+	meanings as provided in section 7-36, as amended by this act. 2788
	3328	+	Sec. 75. Section 20-226 of the general statutes is repealed. (Effective 2789
	3329	+	from passage) 2790
	3330	+	This act shall take effect as follows and shall amend the following
	3331	+	sections:
	3332	+
	3333	+	Section 1 October 1, 2021 PA 19-117, Sec. 73
	3334	+	Sec. 2 October 1, 2021 25-33(b)
	3335	+	Sec. 3 October 1, 2021 8-3i
	3336	+	Sec. 4 October 1, 2021 22a-42f
	3337	+	Sec. 5 October 1, 2021 19a-111
	3338	+	Sec. 6 October 1, 2021 19a-37
	3339	+	Sec. 7 October 1, 2021 19a-524
	3340	+	Sec. 8 July 1, 2021 19a-491c(c)(2)
	3341	+	Sec. 9 October 1, 2021 19a-177
	3342	+	Sec. 10 July 1, 2021 New section
	3343	+	Sec. 11 October 1, 2021 20-207
	3344	+	Sec. 12 October 1, 2021 20-212
	3345	+	Sec. 13 October 1, 2021 20-213(a) and (b)
	3346	+	Sec. 14 October 1, 2021 20-215
	3347	+	Sec. 15 October 1, 2021 20-217(a)
	3348	+	Sec. 16 October 1, 2021 20-224
	3349	+	Sec. 17 October 1, 2021 20-195dd
	3350	+	Sec. 18 October 1, 2021 20-195c(a) Substitute Bill No. 6666
	3351	+
	3352	+
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	3355	+	89 of 90
	3356	+
	3357	+	Sec. 19 October 1, 2021 19a-14(a)(12)
	3358	+	Sec. 20 October 1, 2021 20-204a(a) to (c)
	3359	+	Sec. 21 January 1, 2022 7-62b(b) and (c)
	3360	+	Sec. 22 July 1, 2021 19a-200
	3361	+	Sec. 23 July 1, 2021 19a-202a
	3362	+	Sec. 24 July 1, 2021 19a-244
	3363	+	Sec. 25 July 1, 2021 19a-12a(a)(3)
	3364	+	Sec. 26 July 1, 2021 19a-12d
	3365	+	Sec. 27 October 1, 2021 19a-12e(a)
	3366	+	Sec. 28 from passage 20-185k(b)
	3367	+	Sec. 29 October 1, 2021 17a-412(a)
	3368	+	Sec. 30 October 1, 2021 17b-451(a)
	3369	+	Sec. 31 October 1, 2021 17b-451(g)
	3370	+	Sec. 32 July 1, 2021 19a-6o
	3371	+	Sec. 33 from passage 19a-6q
	3372	+	Sec. 34 July 1, 2021 19a-493(b)
	3373	+	Sec. 35 July 1, 2021 New section
	3374	+	Sec. 36 October 1, 2021 19a-343(c)
	3375	+	Sec. 37 from passage 19a-131g
	3376	+	Sec. 38 July 1, 2021 19a-30(d)
	3377	+	Sec. 39 July 1, 2021 20-365(b)
	3378	+	Sec. 40 from passage 20-195u(b)
	3379	+	Sec. 41 from passage 20-265h(a)
	3380	+	Sec. 42 from passage 19a-131j(a)
	3381	+	Sec. 43 July 1, 2021 19a-512(a)
	3382	+	Sec. 44 July 1, 2021 19a-490
	3383	+	Sec. 45 July 1, 2021 19a-491(b) to (i)
	3384	+	Sec. 46 July 1, 2021 19a-491c(a)(4)
	3385	+	Sec. 47 July 1, 2021 19a-492b
	3386	+	Sec. 48 July 1, 2021 19a-492c(b)
	3387	+	Sec. 49 July 1, 2021 19a-492d
	3388	+	Sec. 50 July 1, 2021 19a-492e
	3389	+	Sec. 51 July 1, 2021 19a-496a
	3390	+	Sec. 52 July 1, 2021 19a-504d
	3391	+	Sec. 53 July 1, 2021 New section
	3392	+	Sec. 54 July 1, 2021 19a-522f
	3393	+	Sec. 55 July 1, 2021 New section
	3394	+	Sec. 56 July 1, 2021 19a-521b
	3395	+	Sec. 57 October 1, 2021 19a-195
	3396	+	Sec. 58 from passage 20-206jj Substitute Bill No. 6666
	3397	+
	3398	+
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	3401	+	90 of 90
	3402	+
	3403	+	Sec. 59 from passage 20-206mm(f)
	3404	+	Sec. 60 from passage 19a-178a(b)
	3405	+	Sec. 61 from passage 19a-36h(a)
	3406	+	Sec. 62 from passage 19a-36j(a)
	3407	+	Sec. 63 from passage 19a-36o
	3408	+	Sec. 64 October 1, 2021 19a-332(5)
	3409	+	Sec. 65 from passage 20-250(4)
	3410	+	Sec. 66 July 1, 2021 20-265b(b)
	3411	+	Sec. 67 July 1, 2021 10-206(f)
	3412	+	Sec. 68 from passage 19a-215(b) to (f)
	3413	+	Sec. 69 October 1, 2021 19a-490w
	3414	+	Sec. 70 October 1, 2021 New section
	3415	+	Sec. 71 from passage 19a-180(k)
	3416	+	Sec. 72 July 1, 2021 7-36
	3417	+	Sec. 73 July 1, 2021 7-51(c)
	3418	+	Sec. 74 July 1, 2021 1-1h(a)
	3419	+	Sec. 75 from passage Repealer section
	3420	+
	3421	+
	3422	+
	3423	+	PH Joint Favorable Subst. -LCO
	3424	+	APP Joint Favorable
4357	3425