Substitute House Bill No. 6666
Public Act No. 21-121
AN ACT CONCERNING THE DEPARTMENT OF PUBLIC HEALTH'S
RECOMMENDATIONS REGARDING VARIOUS REVISIONS TO THE
PUBLIC HEALTH STATUTES.
Be it enacted by the Senate and House of Representatives in General
Assembly convened:
Section 1. Section 73 of public act 19-117 is repealed and the following
is substituted in lieu thereof (Effective October 1, 2021):
Notwithstanding any provision of title 19a or 25 of the general
statutes, [and not later than March 1, 2020,] a director of health of a town,
city or borough or of a district department of health appointed pursuant
to section 19a-200, as amended by this act, or 19a-242 of the general
statutes may issue a permit for a replacement public well if the
Department of Public Health has approved such replacement public
well pursuant to subsection (b) of section 25-33 of the general statutes,
as amended by this act. For purposes of this section, "replacement public
well" means a public well that (1) replaces an existing public well, [in a
town in southeastern Connecticut with a population between fifteen
thousand and fifteen thousand three hundred, as enumerated by the
2010 federal decennial census,] and (2) does not meet the sanitary radius
and minimum setback requirements as specified in the regulations of
Connecticut State Agencies. Substitute House Bill No. 6666
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Sec. 2. Subsection (b) of section 25-33 of the general statutes is
repealed and the following is substituted in lieu thereof (Effective October
1, 2021):
(b) No system of water supply owned or used by a water company
shall be constructed or expanded or a new additional source of water
supply utilized until the plans therefor have been submitted to and
reviewed and approved by the department, except that no such prior
review or approval is required for distribution water main installations
that are constructed in accordance with sound engineering standards
and all applicable laws and regulations. A plan for any proposed new
source of water supply submitted to the department pursuant to this
subsection shall include documentation that provides for: (1) A brief
description of potential effects that the proposed new source of water
supply may have on nearby water supply systems including public and
private wells; and (2) the water company's ownership or control of the
proposed new source of water supply's sanitary radius and minimum
setback requirements as specified in the regulations of Connecticut state
agencies and that such ownership or control shall continue to be
maintained as specified in such regulations. If the department
determines, based upon documentation provided, that the water
company does not own or control the proposed new source of water
supply's sanitary radius or minimum setback requirements as specified
in the regulations of Connecticut state agencies, the department shall
require the water company proposing a new source of water supply to
supply additional documentation to the department that adequately
demonstrates the alternative methods that will be utilized to assure the
proposed new source of water supply's long-term purity and adequacy.
In reviewing any plan for a proposed new source of water supply, the
department shall consider the issues specified in this subsection. The
Commissioner of Public Health may adopt regulations, in accordance
with the provisions of chapter 54, to carry out the provisions of this
subsection and subsection (c) of this section. For purposes of this Substitute House Bill No. 6666
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subsection and subsection (c) of this section, "distribution water main
installations" means installations, extensions, replacements or repairs of
public water supply system mains from which water is or will be
delivered to one or more service connections and which do not require
construction or expansion of pumping stations, storage facilities,
treatment facilities or sources of supply. Notwithstanding the
provisions of this subsection, the department may approve any location
of a replacement public well, if such replacement public well is (A)
necessary for the water company to maintain and provide to its
consumers a safe and adequate water supply, (B) located in an aquifer
of adequate water quality determined by historical water quality data
from the source of water supply it is replacing, and (C) in a more
protected location when compared to the source of water supply it is
replacing, as determined by the department. For purposes of this
subsection, "replacement public well" means a public well that (i)
replaces an existing public well, [in a town in southeastern Connecticut
with a population between fifteen thousand and fifteen thousand three
hundred, as enumerated by the 2010, federal decennial census,] and (ii)
does not meet the sanitary radius and minimum setback requirements
as specified in the regulations of Connecticut state agencies.
Sec. 3. Section 8-3i of the general statutes is repealed and the
following is substituted in lieu thereof (Effective October 1, 2021):
(a) As used in this section "water company" means a water company,
as defined in section 25-32a, and "petition" includes a petition or
proposal to change the regulations, boundaries or classifications of
zoning districts.
(b) When an application, petition, request or plan is filed with the
zoning commission, planning and zoning commission or zoning board
of appeals of any municipality concerning any project on any site that is
within the aquifer protection area delineated pursuant to section 22a-
354c or the watershed of a water company, the applicant or the person Substitute House Bill No. 6666
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making the filing shall: [provide] (1) Provide written notice of the
application, petition, request or plan to the water company and the
[Commissioner of Public Health in a format prescribed by said
commissioner, provided such water company or said commissioner has
filed a map showing the boundaries of the watershed on the land
records of the municipality in which the application, petition, request or
plan is made and with the planning commission, zoning commission,
planning and zoning commission or zoning board of appeals of such
municipality or the aquifer protection area has been delineated in
accordance with section 22a-354c, as the case may be] Department of
Public Health; and (2) determine if the project is within the watershed
of a water company by consulting the maps posted on the department's
Internet web site showing the boundaries of the watershed. Such [notice
shall be made] applicant shall send such notice to the water company
by certified mail, return receipt requested, and to the department by
electronic mail to the electronic mail address designated on its Internet
web site for receipt of such notice. Such applicant shall [be mailed] mail
such notice not later than seven days after the date of the application.
Such water company and the Commissioner of Public Health may,
through a representative, appear and be heard at any hearing on any
such application, petition, request or plan.
(c) Notwithstanding the provisions of subsection (b) of this section,
when an agent of the zoning commission, planning and zoning
commission or zoning board of appeals is authorized to approve an
application, petition, request or plan concerning any site that is within
the aquifer protection area delineated pursuant to section 22a-354c or
the watershed of a water company without the approval of the zoning
commission, planning and zoning commission or zoning board of
appeals, and such agent determines that the proposed activity will not
adversely affect the public water supply, the applicant or person making
the filing shall not be required to notify the water company or the
[Commissioner] Department of Public Health. Substitute House Bill No. 6666
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Sec. 4. Section 22a-42f of the general statutes is repealed and the
following is substituted in lieu thereof (Effective October 1, 2021):
When an application is filed to conduct or cause to be conducted a
regulated activity upon an inland wetland or watercourse, any portion
of which is within the watershed of a water company as defined in
section 25-32a, the applicant shall: [provide] (1) Provide written notice
of the application to the water company and the [Commissioner of
Public Health in a format prescribed by said commissioner, provided
such water company or said commissioner has filed a map showing the
boundaries of the watershed on the land records of the municipality in
which the application is made and with the inland wetlands agency of
such municipality] Department of Public Health; and (2) determine if
the project is within the watershed of a water company by consulting
the maps posted on the department's Internet web site showing the
boundaries of the watershed. Such [notice shall be made] applicant shall
send such notice to the water company by certified mail, return receipt
requested, and to the department by electronic mail to the electronic
mail address designated by the department on its Internet web site for
receipt of such notice. Such applicant shall [be mailed] mail such notice
not later than seven days after the date of the application. The water
company and the Commissioner of Public Health, through a
representative, may appear and be heard at any hearing on the
application.
Sec. 5. Section 19a-111 of the general statutes is repealed and the
following is substituted in lieu thereof (Effective October 1, 2021):
Upon receipt of each report of confirmed venous blood lead level
equal to or greater than twenty micrograms per deciliter of blood, the
local director of health shall make or cause to be made an
epidemiological investigation of the source of the lead causing the
increased lead level or abnormal body burden and shall order action to
be taken by the appropriate person responsible for the condition that Substitute House Bill No. 6666
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brought about such lead poisoning as may be necessary to prevent
further exposure of persons to such poisoning. In the case of any
residential unit where such action will not result in removal of the
hazard within a reasonable time, the local director of health shall utilize
such community resources as are available to effect relocation of any
family occupying such unit. The local director of health may permit
occupancy in said residential unit during abatement if, in such director's
judgment, occupancy would not threaten the health and well-being of
the occupants. The local director of health shall, not later than thirty
days after the conclusion of such director's investigation, report to the
Commissioner of Public Health, using a web-based surveillance system
as prescribed by the commissioner, the result of such investigation and
the action taken to ensure against further lead poisoning from the same
source, including any measures taken to effect relocation of families.
Such report shall include information relevant to the identification and
location of the source of lead poisoning and such other information as
the commissioner may require pursuant to regulations adopted in
accordance with the provisions of chapter 54. The commissioner shall
maintain comprehensive records of all reports submitted pursuant to
this section and section 19a-110. Such records shall be geographically
indexed in order to determine the location of areas of relatively high
incidence of lead poisoning. The commissioner shall establish, in
conjunction with recognized professional medical groups, guidelines
consistent with the National Centers for Disease Control and Prevention
for assessment of the risk of lead poisoning, screening for lead poisoning
and treatment and follow-up care of individuals including children with
lead poisoning, women who are pregnant and women who are planning
pregnancy. Nothing in this section shall be construed to prohibit a local
building official from requiring abatement of sources of lead.
Sec. 6. Section 19a-37 of the general statutes is repealed and the
following is substituted in lieu thereof (Effective October 1, 2021): Substitute House Bill No. 6666
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(a) As used in this section:
(1) "Laboratory or firm" means an environmental laboratory
registered by the Department of Public Health pursuant to section 19a-
29a;
(2) "Private well" means a water supply well that meets all of the
following criteria: (A) Is not a public well; (B) supplies a residential
population of less than twenty-five persons per day; and (C) is owned
or controlled through an easement or by the same entity that owns or
controls the building or parcel that is served by the water supply well;
(3) "Public well" means a water supply well that supplies a public
water system;
(4) "Semipublic well" means a water supply well that (A) does not
meet the definition of a private well or public well, and (B) provides
water for drinking and other domestic purposes; and
(5) "Water supply well" means an artificial excavation constructed by
any method for the purpose of obtaining or providing water for
drinking or other domestic, industrial, commercial, agricultural,
recreational or irrigation use, or other outdoor water use.
(b) The Commissioner of Public Health may adopt regulations in the
[Public Health Code] regulations of Connecticut state agencies for the
preservation of the public health pertaining to (1) protection and
location of new water supply wells or springs for residential or
nonresidential construction or for public or semipublic use, and (2)
inspection for compliance with the provisions of municipal regulations
adopted pursuant to section 22a-354p.
(c) The Commissioner of Public Health shall adopt regulations, in
accordance with chapter 54, for the testing of water quality in private
[residential] wells and semipublic wells. Any laboratory or firm which Substitute House Bill No. 6666
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conducts a water quality test on a private well serving a residential
property or semipublic well shall, not later than thirty days after the
completion of such test, report the results of such test to (1) the public
health authority of the municipality where the property is located, and
(2) the Department of Public Health in a format specified by the
department, provided such report shall only be required if the party for
whom the laboratory or firm conducted such test informs the laboratory
or firm identified on the chain of custody documentation submitted
with the test samples that the test was conducted in connection with the
sale of such property. No regulation may require such a test to be
conducted as a consequence or a condition of the sale, exchange,
transfer, purchase or rental of the real property on which the private
[residential] well or semipublic well is located.
(d) Prior to the sale, exchange, purchase, transfer or rental of real
property on which a [residential] private or semipublic well is located,
the owner shall provide the buyer or tenant notice that educational
material concerning private well testing is available on the Department
of Public Health web site. Failure to provide such notice shall not
invalidate any sale, exchange, purchase, transfer or rental of real
property. If the seller or landlord provides such notice in writing, the
seller or landlord and any real estate licensee shall be deemed to have
fully satisfied any duty to notify the buyer or tenant that the subject real
property is located in an area for which there are reasonable grounds for
testing under subsection (g) or (j) of this section.
(e) The Commissioner of Public Health shall adopt regulations, in
accordance with chapter 54, to clarify the criteria under which the
commissioner may issue a well permit exception and to describe the
terms and conditions that shall be imposed when a well is allowed at a
premises (1) that is connected to a public water supply system, or (2)
whose boundary is located within two hundred feet of an approved
community water supply system, measured along a street, alley or Substitute House Bill No. 6666
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easement. Such regulations shall (A) provide for notification of the
permit to the public water supplier, (B) address the quality of the water
supplied from the well, the means and extent to which the well shall not
be interconnected with the public water supply, the need for a physical
separation, and the installation of a reduced pressure device for
backflow prevention, the inspection and testing requirements of any
such reduced pressure device, and (C) identify the extent and frequency
of water quality testing required for the well supply.
(f) No regulation may require that a certificate of occupancy for a
dwelling unit on such residential property be withheld or revoked on
the basis of a water quality test performed on a private [residential] well
pursuant to this section, unless such test results indicate that any
maximum contaminant level applicable to public water supply systems
for any contaminant listed in the [public health code] regulations of
Connecticut state agencies has been exceeded. No administrative
agency, health district or municipal health officer may withhold or
cause to be withheld such a certificate of occupancy except as provided
in this section.
(g) The local director of health may require a private [residential] well
or semipublic well to be tested for arsenic, radium, uranium, radon or
gross alpha emitters, when there are reasonable grounds to suspect that
such contaminants are present in the groundwater. For purposes of this
subsection, "reasonable grounds" means (1) the existence of a geological
area known to have naturally occurring arsenic, radium, uranium,
radon or gross alpha emitter deposits in the bedrock; or (2) the well is
located in an area in which it is known that arsenic, radium, uranium,
radon or gross alpha emitters are present in the groundwater.
(h) Except as provided in subsection (i) of this section, the collection
of samples for determining the water quality of private [residential]
wells and semipublic wells may be made only by (1) employees of a
laboratory or firm certified or approved by the Department of Public Substitute House Bill No. 6666
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Health to test drinking water, if such employees have been trained in
sample collection techniques, (2) certified water operators, (3) local
health departments and state employees trained in sample collection
techniques, or (4) individuals with training and experience that the
Department of Public Health deems sufficient.
(i) Any owner of a residential construction, including, but not limited
to, a homeowner, on which a private [residential] well is located or any
general contractor of a new residential construction on which a private
[residential] well is located may collect samples of well water for
submission to a laboratory or firm for the purposes of testing water
quality pursuant to this section, provided (1) such laboratory or firm has
provided instructions to said owner or general contractor on how to
collect such samples, and (2) such owner or general contractor is
identified to the subsequent owner on a form to be prescribed by the
Department of Public Health. No regulation may prohibit or impede
such collection or analysis.
(j) The local director of health may require private [residential] wells
and semipublic wells to be tested for pesticides, herbicides or organic
chemicals when there are reasonable grounds to suspect that any such
contaminants might be present in the groundwater. For purposes of this
subsection, "reasonable grounds" means (1) the presence of nitrate-
nitrogen in the groundwater at a concentration greater than ten
milligrams per liter, or (2) that the private [residential] well or
semipublic well is located on land, or in proximity to land, associated
with the past or present production, storage, use or disposal of organic
chemicals as identified in any public record.
(k) Any water transported in bulk by any means to a premises
currently supplied by a private well or semipublic well where the water
is to be used for purposes of drinking or domestic use shall be provided
by a bulk water hauler licensed pursuant to section 20-278h. No bulk
water hauler shall deliver water without first notifying the owner of the Substitute House Bill No. 6666
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premises of such delivery. Bulk water hauling to a premises currently
supplied by a private well or semipublic well shall be permitted only as
a temporary measure to alleviate a water supply shortage.
Sec. 7. (NEW) (Effective October 1, 2021) The owner of any residential
or commercial property shall notify each tenant of any leased or rented
unit located on such property and the lessee of such property whenever
any testing of the water supply for such property indicates that the
water exceeds a maximum contaminant level applicable to water supply
systems for any contaminant listed in the regulations of Connecticut
state agencies or for any contaminant listed on the state drinking water
action level list established pursuant to section 22a-471 of the general
statutes. As soon as practicable, but not later than forty-eight hours after
receiving notification of the results of such testing, the owner shall
forward a copy of such notification to each such tenant and lessee. The
local director of health shall take all reasonable steps to verify that such
owner forwarded the notice required pursuant to this section.
Sec. 8. Section 19a-524 of the general statutes is repealed and the
following is substituted in lieu thereof (Effective October 1, 2021):
If, upon review, investigation or inspection pursuant to section 19a-
498, the Commissioner of Public Health determines that a nursing home
facility or residential care home has violated any provision of section
17a-411, 19a-491a to 19a-491c, inclusive, as amended by this act, 19a-
493a, 19a-521 to 19a-529, inclusive, 19a-531 to 19a-551, inclusive, or 19a-
553 to 19a-555, inclusive, or any provision of any regulation of
Connecticut state agencies relating to licensure, the Fire Safety Code or
the operation or maintenance of a nursing home facility or residential
care home, which violation has been classified in accordance with
section 19a-527, the commissioner may immediately issue or cause to be
issued a citation to the licensee of such nursing home facility or
residential care home. Governmental immunity shall not be a defense to
any citation issued or civil penalty imposed pursuant to this section or Substitute House Bill No. 6666
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sections 19-525 to 19a-528, inclusive. Each such citation shall be in
writing, provide notice of the nature and scope of the alleged violation
or violations, and include, but not be limited to, the citation and notice
of noncompliance issued in accordance with section 19a-496. Each
citation and notice of noncompliance issued under this section shall be
sent to the licensee electronically in a form and manner prescribed by
the commissioner or by certified mail [to the licensee] at the address of
the nursing home facility or residential care home in issue. A copy of
such citation and notice of noncompliance shall also be sent to the
licensed administrator at the address of the nursing home facility or
residential care home.
Sec. 9. Subdivision (2) of subsection (c) of section 19a-491c of the
general statutes is repealed and the following is substituted in lieu
thereof (Effective July 1, 2021):
(2) No long-term care facility shall be required to comply with the
provisions of this subsection if (A) the individual provides evidence to
the long-term care facility that such individual submitted to a
background search conducted pursuant to subdivision (1) of this
subsection not more than three years immediately preceding the date
such individual applies for employment, seeks to enter into a contract
or begins volunteering with the long-term care facility and that the prior
background search confirmed that the individual did not have a
disqualifying offense, or (B) the commissioner determines the need to
temporarily suspend the requirements of this subsection in the event of
an emergency or significant disruption. The commissioner shall inform
the long-term care facility when the commissioner has suspended the
requirements of this subsection pursuant to subparagraph (B) of this
subdivision and when such suspension is rescinded.
Sec. 10. Section 19a-177 of the general statutes is repealed and the
following is substituted in lieu thereof (Effective October 1, 2021): Substitute House Bill No. 6666
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The commissioner shall:
(1) With the advice of the Office of Emergency Medical Services
established pursuant to section 19a-178 and of an advisory committee
on emergency medical services and with the benefit of meetings held
pursuant to subsection (b) of section 19a-184, adopt every five years a
state-wide plan for the coordinated delivery of emergency medical
services;
(2) License or certify the following: (A) Ambulance operations,
[ambulance drivers,] emergency medical services personnel and
communications personnel; (B) emergency room facilities and
communications facilities; and (C) transportation equipment, including
land, sea and air vehicles used for transportation of patients to
emergency facilities and periodically inspect life saving equipment,
emergency facilities and emergency transportation vehicles to ensure
state standards are maintained;
(3) Annually inventory emergency medical services resources within
the state, including facilities, equipment, and personnel, for the
purposes of determining the need for additional services and the
effectiveness of existing services;
(4) Review and evaluate all area-wide plans developed by the
emergency medical services councils pursuant to section 19a-182 in
order to insure conformity with standards issued by the commissioner;
(5) Not later than thirty days after their receipt, review all grant and
contract applications for federal or state funds concerning emergency
medical services or related activities for conformity to policy guidelines
and forward such application to the appropriate agency, when required;
(6) Establish such minimum standards and adopt such regulations in
accordance with the provisions of chapter 54, as may be necessary to
develop the following components of an emergency medical service Substitute House Bill No. 6666
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system: (A) Communications, which shall include, but not be limited to,
equipment, radio frequencies and operational procedures; (B)
transportation services, which shall include, but not be limited to,
vehicle type, design, condition and maintenance, and operational
procedures; (C) training, which shall include, but not be limited to,
emergency medical services personnel, communications personnel,
paraprofessionals associated with emergency medical services,
firefighters and state and local police; (D) emergency medical service
facilities, which shall include, but not be limited to, categorization of
emergency departments as to their treatment capabilities and ancillary
services; and (E) mobile integrated health care programs, which shall
include, but not be limited to, the standards to ensure the health, safety
and welfare of the patients being served by such programs and data
collection and reporting requirements to ensure and measure quality
outcomes of such programs;
(7) Coordinate training of all emergency medical services personnel;
(8) (A) Develop an emergency medical services data collection
system. Each emergency medical service organization licensed or
certified pursuant to this chapter shall submit data to the commissioner,
on a quarterly basis, from each licensed ambulance service, certified
ambulance service or paramedic intercept service that provides
emergency medical services. Such submitted data shall include, but not
be limited to: (i) The total number of calls for emergency medical
services received by such licensed ambulance service, certified
ambulance service or paramedic intercept service through the 9-1-1
system during the reporting period; (ii) each level of emergency medical
services, as defined in regulations adopted pursuant to section 19a-179,
required for each such call; (iii) the response time for each licensed
ambulance service, certified ambulance service or paramedic intercept
service during the reporting period; (iv) the number of passed calls,
cancelled calls and mutual aid calls, both made and received, during the Substitute House Bill No. 6666
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reporting period; and (v) for the reporting period, the prehospital data
for the nonscheduled transport of patients required by regulations
adopted pursuant to subdivision (6) of this section. The data required
under this subdivision may be submitted in any electronic form selected
by such licensed ambulance service, certified ambulance service or
paramedic intercept service and approved by the commissioner,
provided the commissioner shall take into consideration the needs of
such licensed ambulance service, certified ambulance service or
paramedic intercept service in approving such electronic form. The
commissioner may conduct an audit of any such licensed ambulance
service, certified ambulance service or paramedic intercept service as
the commissioner deems necessary in order to verify the accuracy of
such reported data.
(B) On or before December 31, 2018, and annually thereafter, the
commissioner shall prepare a report to the Emergency Medical Services
Advisory Board, established pursuant to section 19a-178a, as amended
by this act, that shall include, but not be limited to, the following data:
(i) The total number of calls for emergency medical services received
during the reporting year by each licensed ambulance service, certified
ambulance service or paramedic intercept service; (ii) the level of
emergency medical services required for each such call; (iii) the name of
the emergency medical service organization that provided each such
level of emergency medical services furnished during the reporting
year; (iv) the response time, by time ranges or fractile response times,
for each licensed ambulance service, certified ambulance service or
paramedic intercept service, using a common definition of response
time, as provided in regulations adopted pursuant to section 19a-179;
and (v) the number of passed calls, cancelled calls and mutual aid calls
during the reporting year. The commissioner shall prepare such report
in a format that categorizes such data for each municipality in which the
emergency medical services were provided, with each such
municipality grouped according to urban, suburban and rural Substitute House Bill No. 6666
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classifications.
(C) If any licensed ambulance service, certified ambulance service or
paramedic intercept service does not submit the data required under
subparagraph (A) of this subdivision for a period of six consecutive
months, or if the commissioner believes that such licensed ambulance
service, certified ambulance service or paramedic intercept service
knowingly or intentionally submitted incomplete or false data, the
commissioner shall issue a written order directing such licensed
ambulance service, certified ambulance service or paramedic intercept
service to comply with the provisions of subparagraph (A) of this
subdivision and submit all missing data or such corrected data as the
commissioner may require. If such licensed ambulance service, certified
ambulance service or paramedic intercept service fails to fully comply
with such order not later than three months from the date such order is
issued, the commissioner (i) shall conduct a hearing, in accordance with
chapter 54, at which such licensed ambulance service, certified
ambulance service or paramedic intercept service shall be required to
show cause why the primary service area assignment of such licensed
ambulance service, certified ambulance service or paramedic intercept
service should not be revoked, and (ii) may take such disciplinary action
under section 19a-17 as the commissioner deems appropriate.
(D) The commissioner shall collect the data required by
subparagraph (A) of this subdivision, in the manner provided in said
subparagraph, from each emergency medical service organization
licensed or certified pursuant to this chapter. Any such emergency
medical service organization that fails to comply with the provisions of
this section shall be liable for a civil penalty not to exceed one hundred
dollars per day for each failure to report the required data regarding
emergency medical services provided to a patient, as determined by the
commissioner. The civil penalties set forth in this subparagraph shall be
assessed only after the department provides a written notice of Substitute House Bill No. 6666
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deficiency and the organization is afforded the opportunity to respond
to such notice. An organization shall have not more than fifteen business
days after the date of receiving such notice to provide a written response
to the department. The commissioner may adopt regulations, in
accordance with chapter 54, concerning the development,
implementation, monitoring and collection of emergency medical
service system data. All state agencies licensed or certified as emergency
medical service organizations shall be exempt from the civil penalties
set forth in this subparagraph.
(E) The commissioner shall, with the recommendation of the
Connecticut Emergency Medical Services Advisory Board established
pursuant to section 19a-178a, as amended by this act, adopt for use in
trauma data collection the most recent version of the National Trauma
Data Bank's National Trauma Data Standards and Data Dictionary and
nationally recognized guidelines for field triage of injured patients;
(9) (A) Establish rates for the conveyance and treatment of patients
by licensed ambulance services and invalid coaches and establish
emergency service rates for certified ambulance services and paramedic
intercept services, provided (i) the present rates established for such
services and vehicles shall remain in effect until such time as the
commissioner establishes a new rate schedule as provided in this
subdivision, and (ii) any rate increase not in excess of the Medical Care
Services Consumer Price Index, as published by the Bureau of Labor
Statistics of the United States Department of Labor, for the prior year,
filed in accordance with subparagraph (B)(iii) of this subdivision shall
be deemed approved by the commissioner. For purposes of this
subdivision, licensed ambulance services and paramedic intercept
services shall not include emergency air transport services or mobile
integrated health care programs.
(B) Adopt regulations, in accordance with the provisions of chapter
54, establishing methods for setting rates and conditions for charging Substitute House Bill No. 6666
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such rates. Such regulations shall include, but not be limited to,
provisions requiring that on and after July 1, 2000: (i) Requests for rate
increases may be filed no more frequently than once a year, except that,
in any case where an agency's schedule of maximum allowable rates
falls below that of the Medicare allowable rates for that agency, the
commissioner shall immediately amend such schedule so that the rates
are at or above the Medicare allowable rates; (ii) only licensed
ambulance services, certified ambulance services and paramedic
intercept services that apply for a rate increase in excess of the Medical
Care Services Consumer Price Index, as published by the Bureau of
Labor Statistics of the United States Department of Labor, for the prior
year, and do not accept the maximum allowable rates contained in any
voluntary state-wide rate schedule established by the commissioner for
the rate application year shall be required to file detailed financial
information with the commissioner, provided any hearing that the
commissioner may hold concerning such application shall be conducted
as a contested case in accordance with chapter 54; (iii) licensed
ambulance services, certified ambulance services and paramedic
intercept services that do not apply for a rate increase in any year in
excess of the Medical Care Services Consumer Price Index, as published
by the Bureau of Labor Statistics of the United States Department of
Labor, for the prior year, or that accept the maximum allowable rates
contained in any voluntary state-wide rate schedule established by the
commissioner for the rate application year shall, not later than the last
business day in August of such year, file with the commissioner a
statement of emergency and nonemergency call volume, and, in the case
of a licensed ambulance service, certified ambulance service or
paramedic intercept service that is not applying for a rate increase, a
written declaration by such licensed ambulance service, certified
ambulance service or paramedic intercept service that no change in its
currently approved maximum allowable rates will occur for the rate
application year; and (iv) detailed financial and operational information
filed by licensed ambulance services, certified ambulance services and Substitute House Bill No. 6666
Public Act No. 21-121 19 of 132
paramedic intercept services to support a request for a rate increase in
excess of the Medical Care Services Consumer Price Index, as published
by the Bureau of Labor Statistics of the United States Department of
Labor, for the prior year, shall cover the time period pertaining to the
most recently completed fiscal year and the rate application year of the
licensed ambulance service, certified ambulance service or paramedic
intercept service.
(C) Establish rates for licensed ambulance services, certified
ambulance services or paramedic intercept services for the following
services and conditions: (i) "Advanced life support assessment" and
"specialty care transports", which terms have the meanings provided in
42 CFR 414.605; and (ii) mileage, which may include mileage for an
ambulance transport when the point of origin and final destination for
a transport is within the boundaries of the same municipality. The rates
established by the commissioner for each such service or condition shall
be equal to (I) the ambulance service's base rate plus its established
advanced life support/paramedic surcharge when advanced life
support assessment services are performed; (II) two hundred twenty-
five per cent of the ambulance service's established base rate for
specialty care transports; and (III) "loaded mileage", as the term is
defined in 42 CFR 414.605, multiplied by the ambulance service's
established rate for mileage. Such rates shall remain in effect until such
time as the commissioner establishes a new rate schedule as provided
in this subdivision.
(D) Establish rates for the treatment and release of patients by a
licensed or certified emergency medical services organization or a
provider who does not transport such patients to an emergency
department and who is operating within the scope of such
organization's or provider's practice and following protocols approved
by the sponsor hospital. The rates established pursuant to this
subparagraph shall not apply to the treatment provided to patients Substitute House Bill No. 6666
Public Act No. 21-121 20 of 132
through mobile integrated health care programs;
(10) Establish primary service areas and assign in writing a primary
service area responder for each primary service area. Each state-owned
campus having an acute care hospital on the premises shall be
designated as the primary service area responder for that campus;
(11) Revoke primary service area assignments upon determination by
the commissioner that it is in the best interests of patient care to do so;
and
(12) Annually issue a list of minimum equipment requirements for
[ambulances and rescue vehicles] authorized emergency medical
services vehicles based upon current national standards. The
commissioner shall distribute such list to all emergency medical service
organizations and sponsor hospital medical directors and make such list
available to other interested stakeholders. Emergency medical service
organizations shall have one year from the date of issuance of such list
to comply with the minimum equipment requirements.
Sec. 11. (NEW) (Effective July 1, 2021) The Commissioner of Public
Health may waive any provisions of the regulations applying to an
emergency medical service organization or emergency medical services
personnel, as such terms are defined in section 19a-175 of the general
statutes, as amended by this act, if the commissioner determines that
such waiver (1) would not endanger the health, safety or welfare of any
patient or resident, and (2) does not affect the maximum allowable rates
for each emergency medical service organization or primary service
area assignments. The commissioner may impose conditions, upon
granting the waiver, that assure the health, safety or welfare of patients
or residents and may terminate the waiver upon a finding that the
health, safety or welfare of any patient or resident has been jeopardized.
The commissioner may adopt regulations, in accordance with the
provisions of chapter 54 of the general statutes, establishing procedures Substitute House Bill No. 6666
Public Act No. 21-121 21 of 132
for an application for a waiver pursuant to this subdivision.
Sec. 12. Section 20-207 of the general statutes is repealed and the
following is substituted in lieu thereof (Effective October 1, 2021):
As used in this chapter, unless the context otherwise requires, the
following terms shall have the meanings specified:
(1) "Board" means the Connecticut Board of Examiners of Embalmers
and Funeral Directors;
(2) "Person" means an individual or corporation, but not a
partnership;
(3) "Funeral directing" means the business, practice or profession, as
commonly practiced, of (A) directing or supervising funerals, or
providing funeral services; (B) handling or encasing or providing
services for handling and encasing dead human bodies, otherwise than
by embalming, for burial or disposal; (C) providing embalming services;
(D) providing transportation, interment and disinterment of dead
human bodies; (E) maintaining an establishment so located, constructed
and equipped as to permit the decent and sanitary handling of dead
human bodies, with suitable equipment in such establishment for such
handling; (F) conducting an establishment from which funerals may be
held; (G) engaging in consultations concerning arrangements for the
disposition of human remains, including, but not limited to,
arrangements for cremation or alkaline hydrolysis; (H) casketing human
remains; (I) making cemetery and cremation arrangements; and (J)
preparing funeral service contracts, as defined in section 42-200;
(4) "Funeral director" means any person engaged or holding himself
or herself out as engaged in funeral directing whether or not he or she
uses in connection with his or her name or business the words "funeral
director," "undertaker" or "mortician" or any other word or title
intended to designate him or her as a funeral director or mortician or as Substitute House Bill No. 6666
Public Act No. 21-121 22 of 132
one so engaged;
(5) "Funeral service business" means the business, practice or
profession of funeral directing;
(6) "Licensed embalmer" means an embalmer holding a license as
provided in this chapter;
(7) "Licensed funeral director" means a funeral director holding a
license as provided in this chapter;
(8) ["Student embalmer"] "Registered apprentice embalmer" means a
person [studying embalming and] registered with the Department of
Public Health as an apprentice pursuant to the provisions of this
chapter;
(9) ["Student funeral director"] "Registered apprentice funeral
director" means a person [studying the funeral service business and]
registered with the Department of Public Health as an apprentice
pursuant to the provisions of this chapter;
(10) "Full-time employment" means regular and steady work during
the normal working hours by any person at the establishment at which
he is employed; and
(11) "Manager" means an individual who (A) is licensed as an
embalmer or funeral director pursuant to this chapter and (B) has direct
and personal responsibility for the daily operation and management of
a funeral service business.
Sec. 13. Section 20-212 of the general statutes is repealed and the
following is substituted in lieu thereof (Effective October 1, 2021):
No person, except a licensed embalmer, shall inject any fluid or
substance into any dead human body, except that a registered [student]
apprentice embalmer may, even if not in the presence of a licensed Substitute House Bill No. 6666
Public Act No. 21-121 23 of 132
embalmer, make such injection or perform any other act under [his]
such licensed embalmer's instruction; and no person, firm or
corporation shall enter, engage in, carry on or manage for another the
business of caring for, preserving or disposing of dead human bodies
until each person, firm or corporation so engaged has obtained from the
Department of Public Health and holds a license as provided in this
chapter; nor shall any person be employed to remove a dead human
body, except a licensed embalmer, a registered [student] apprentice
embalmer, a licensed funeral director, or a person authorized in each
instance by the Chief Medical Examiner, Deputy Medical Examiner or
assistant medical examiner incidental to examining the body of a
deceased person, except that once a dead human body has been
prepared in accordance with the [Public Health Code] regulations of
Connecticut state agencies and the applicable provisions of the general
statutes, an embalmer or funeral director licensed in this state may
authorize an unlicensed employee to transport such body. Nothing in
this section shall be construed to prohibit any person licensed as an
embalmer or as a funeral director under the laws of another state from
bringing into or removing from this state a dead human body, provided
any and all other laws of this state relative to such body have been
complied with. Nothing in this chapter shall be construed to prohibit
any student who is enrolled in a program of education in mortuary
science, approved by the board, with the consent of the Commissioner
of Public Health, from embalming up to ten human bodies under the
supervision of a licensed embalmer and incidental to such student's
course of study. Such embalming shall be counted toward the
embalming requirement outlined in section 20-213, as amended by this
act, when such student becomes a registered apprentice embalmer.
Sec. 14. Subsections (a) and (b) of section 20-213 of the general statutes
are repealed and the following is substituted in lieu thereof (Effective
October 1, 2021): Substitute House Bill No. 6666
Public Act No. 21-121 24 of 132
(a) (1) After a [student] registered apprentice embalmer has (A)
completed a program of education in mortuary science approved by the
board with the consent of the Commissioner of Public Health, (B)
successfully completed an examination prescribed by the Department
of Public Health with the consent of the board, (C) completed one year
of practical training and experience of a grade and character satisfactory
to the commissioner in the state in full-time employment under the
personal supervision and instruction of an embalmer licensed under the
provisions of this chapter, and (D) embalmed fifty human bodies in not
more than two years under the supervision of a licensed embalmer or
embalmers, (2) the [student] registered apprentice embalmer shall (A)
submit to the department an application and fee of two hundred ten
dollars, (B) take a written examination on the Connecticut public health
laws and the regulations of Connecticut state agencies pertaining to the
activities of an embalmer, and (C) take an examination in practical
embalming that shall include an actual demonstration upon a cadaver.
When the [student] registered apprentice embalmer has satisfactorily
passed such examinations, said department shall issue to him or her a
license to practice embalming. At the expiration of such license, if the
holder thereof desires a renewal, said department shall grant it pursuant
to section 20-222a, except for cause.
(b) Examinations for registration as a [student] registered apprentice
embalmer and for an embalmer's license shall be administered to
applicants by the Department of Public Health, under the supervision
of the board, semiannually and at such other times as may be
determined by the department.
Sec. 15. Section 20-215 of the general statutes is repealed and the
following is substituted in lieu thereof (Effective October 1, 2021):
No licensed embalmer shall sign an affidavit attesting the
preparation or embalming of any body unless such body has been
prepared or embalmed by [him] such licensed embalmer, or by a Substitute House Bill No. 6666
Public Act No. 21-121 25 of 132
registered [student] apprentice embalmer under [his] such licensed
embalmer's personal supervision.
Sec. 16. Subsection (a) of section 20-217 of the general statutes is
repealed and the following is substituted in lieu thereof (Effective October
1, 2021):
(a) When a [student] registered apprentice funeral director has
completed a program of education approved by the board with the
consent of the Commissioner of Public Health, has successfully
completed an examination prescribed by the department with the
consent of the board and furnishes the department with satisfactory
proof that he or she has completed one year of practical training and
experience in full-time employment under the personal supervision of
a licensed embalmer or funeral director, and pays to the department a
fee of two hundred ten dollars, [he] such registered apprentice funeral
director shall be entitled to be examined upon the Connecticut state law
and regulations pertaining to his or her professional activities. If found
to be qualified by the Department of Public Health, [he] such registered
apprentice funeral director shall be licensed as a funeral director.
Renewal licenses shall be issued by the Department of Public Health
pursuant to section 20-222a, unless withheld for cause as herein
provided, upon a payment of a fee of two hundred thirty dollars.
Sec. 17. Section 20-224 of the general statutes is repealed and the
following is substituted in lieu thereof (Effective October 1, 2021):
(a) The provisions of sections 20-217, as amended by this act, 20-220
and 20-227 shall not prohibit the employment of assistants or of
[student] registered apprentice embalmers and [student] registered
apprentice funeral directors as provided in this chapter, provided a
licensed funeral service business may employ no more than two
[student] registered apprentice embalmers at any one time, and any
person, firm, corporation or other organization engaged in the business Substitute House Bill No. 6666
Public Act No. 21-121 26 of 132
of funeral directing may employ no more than one [student] registered
apprentice funeral director at any one time, without the approval of the
Board of Examiners of Embalmers and Funeral Directors.
(b) [Student] Registered apprentice embalmers and [student]
registered apprentice funeral directors shall register as apprentices with
the Department of Public Health, in the manner prescribed by the
commissioner in regulations adopted pursuant to section 20-211, for
purposes of completing practical training and experience pursuant to
the provisions of this chapter.
Sec. 18. Section 20-195dd of the general statutes is repealed and the
following is substituted in lieu thereof (Effective from passage):
(a) Except as otherwise provided in subsections (c) and (d) of this
section, an applicant for a license as a professional counselor shall
submit evidence satisfactory to the commissioner of having: (1) (A)
Earned a graduate degree in clinical mental health counseling as part of
a program of higher learning accredited by the Cou ncil for
Accreditation of Counseling and Related Educational Programs, or a
successor organization, or (B) (i) completed at least sixty graduate
semester hours in counseling or a related mental health field at a
regionally accredited institution of higher education that included
coursework in each of the following areas: (I) Human growth and
development; (II) social and cultural foundations; (III) counseling
theories; (IV) counseling techniques; (V) group counseling; (VI) career
counseling; (VII) appraisals or tests and measurements to individuals
and groups; (VIII) research and evaluation; (IX) professional orientation
to mental health counseling; (X) addiction and substance abuse
counseling; (XI) trauma and crisis counseling; and (XII) diagnosis and
treatment of mental and emotional disorders, (ii) earned from a
regionally accredited institution of higher education a graduate degree
in counseling or a related mental health field, (iii) completed a one-
hundred-hour practicum in counseling taught by a faculty member Substitute House Bill No. 6666
Public Act No. 21-121 27 of 132
licensed or certified as a professional counselor or its equivalent in
another state, and (iv) completed a six-hundred-hour clinical mental
health counseling internship taught by a faculty member licensed or
certified as a professional counselor or its equivalent in another state; (2)
acquired three thousand hours of postgraduate experience under
professional supervision, including a minimum of one hundred hours
of direct professional supervision, in the practice of professional
counseling, performed over a period of not less than two years; and (3)
passed an examination prescribed by the commissioner. The provisions
of subparagraphs (B)(i)(X) to (B)(i)(XII), inclusive, (B)(iii) and (B)(iv) of
this subsection shall not apply to any applicant who, on or before July
1, 2017, was a matriculating student in good standing in a graduate
degree program at a regionally accredited institution of higher
education in one of the fields required under subparagraph (B) of this
subsection.
(b) An applicant for a license as a professional counselor associate
shall submit to the Commissioner of Public Health evidence satisfactory
to the commissioner of having (1) earned a graduate degree in clinical
mental health counseling as part of a program of higher learning
accredited by the Council for Accreditation of Counseling and Related
Educational Programs, or a successor organization, or (2) (A) completed
at least sixty graduate semester hours in counseling or a related mental
health field at a regionally accredited institution of higher education
that included coursework in each of the following areas: Human growth
and development; social and cultural foundations; counseling theories;
counseling techniques; group counseling; career counseling; appraisals
or tests and measurements to individuals and groups; research and
evaluation; professional orientation to mental health counseling;
addiction and substance abuse counseling; trauma and crisis
counseling; and diagnosis and treatment of mental and emotional
disorders, (B) completed a one-hundred-hour practicum in counseling
taught by a faculty member licensed or certified as a professional Substitute House Bill No. 6666
Public Act No. 21-121 28 of 132
counselor or its equivalent in another state, (C) completed a six-
hundred-hour clinical mental health counseling internship taught by a
faculty member licensed or certified as a professional counselor or its
equivalent in another state, and (D) earned from a regionally accredited
institution of higher education a graduate degree in counseling or a
related mental health field. The provisions of subparagraphs (A) to (C),
inclusive, of subdivision (2) of this subsection shall not apply to any
applicant who, on or before July 1, 2022, earned a graduate degree at a
regionally accredited institution of higher education in counseling or a
related mental health field and has accumulated at least three thousand
hours of experience under professional supervision, as defined in
section 20-195aa.
(c) An applicant for licensure by endorsement shall present evidence
satisfactory to the commissioner that the applicant is licensed or
certified as a professional counselor or professional counselor associate,
or as a person entitled to perform similar services under a different
designation, in another state or jurisdiction whose requirements for
practicing in such capacity are substantially similar to or higher than
those of this state and that there are no disciplinary actions or
unresolved complaints pending.
(d) An applicant who is licensed or certified as a professional
counselor or its equivalent in another state, territory or commonwealth
of the United States may substitute three years of licensed or certified
work experience in the practice of professional counseling in lieu of the
requirements of subdivision (2) of subsection (a) of this section,
provided the commissioner finds that such experience is equal to or
greater than the requirements of this state.
Sec. 19. Subsection (a) of section 20-195c of the general statutes is
repealed and the following is substituted in lieu thereof (Effective from
passage): Substitute House Bill No. 6666
Public Act No. 21-121 29 of 132
(a) Each applicant for licensure as a marital and family therapist shall
present to the department satisfactory evidence that such applicant has:
(1) Completed a graduate degree program specializing in marital and
family therapy offered by a regionally accredited college or university
or an accredited postgraduate clinical training program accredited by
the Commission on Accreditation for Marriage and Family Therapy
Education offered by a regionally accredited institution of higher
education; (2) completed a supervised practicum or internship with
emphasis in marital and family therapy supervised by the program
granting the requisite degree or by an accredited postgraduate clinical
training program accredited by the Commission on Accreditation for
Marriage and Family Therapy Education and offered by a regionally
accredited institution of higher education; [, in which the student
received a minimum of five hundred direct clinical hours that included
one hundred hours of clinical supervision;] (3) completed twelve
months of relevant postgraduate experience, including (A) a minimum
of one thousand hours of direct client contact offering marital and
family therapy services subsequent to being awarded a master's degree
or doctorate or subsequent to the training year specified in subdivision
(2) of this subsection, and (B) one hundred hours of postgraduate
clinical supervision provided by a licensed marital and family therapist;
and (4) passed an examination prescribed by the department. The fee
shall be three hundred fifteen dollars for each initial application.
Sec. 20. Subdivision (12) of subsection (a) of section 19a-14 of the
general statutes is repealed and the following is substituted in lieu
thereof (Effective October 1, 2021):
(12) With respect to any complaint filed with the department on or
after October 1, 2010, alleging incompetence, negligence, fraud or deceit
by a person subject to regulation or licensing by any board or
commission described in subdivision (1) to [(5), inclusive, (7),] (8),
inclusive, (12) to (14), inclusive, or subdivision (16) of subsection (b) of Substitute House Bill No. 6666
Public Act No. 21-121 30 of 132
this section:
(A) Upon request of the person who filed the complaint, provide such
person with information on the status of the complaint;
(B) Upon request of the person who filed the complaint, provide such
person with an opportunity to review, at the department, records
compiled as of the date of the request pursuant to any investigation of
the complaint, including, but not limited to, the respondent's written
response to the complaint, except that such person shall not be entitled
to copy such records and the department (i) shall not disclose (I)
information concerning a health care professional's referral to,
participation in or completion of an assistance program in accordance
with sections 19a-12a, as amended by this act, and 19a-12b, that is
confidential pursuant to section 19a-12a, as amended by this act, (II)
information not related to such person's specific complaint, including,
but not limited to, information concerning patients other than such
person, or (III) personnel or medical records and similar files the
disclosure of which would constitute an invasion of personal privacy
pursuant to section 1-210, except for such records or similar files solely
related to such person; (ii) shall not be required to disclose any other
information that is otherwise confidential pursuant to federal law or
state statute, except for information solely related to such person; and
(iii) may require up to ten business days written notice prior to
providing such opportunity for review;
(C) Prior to resolving the complaint with a consent order, provide the
person who filed the complaint with not less than ten business days to
submit a written statement as to whether such person objects to
resolving the complaint with a consent order;
(D) If a hearing is held with respect to such complaint after a finding
of probable cause, provide the person who filed the complaint with a
copy of the notice of hearing issued pursuant to section 4-177, which Substitute House Bill No. 6666
Public Act No. 21-121 31 of 132
shall include information concerning the opportunity to present oral or
written statements pursuant to subsection (b) of section 4-177c; and
(E) Notify the person who filed the complaint of the final disposition
of such complaint not later than seven business days after such final
disposition;
Sec. 21. Subsections (a) to (c), inclusive, of section 20-204a of the
general statutes are repealed and the following is substituted in lieu
thereof (Effective October 1, 2021):
(a) The department shall investigate each allegation of any act or
omission by a veterinarian specified in section 20-202. The investigation
shall be conducted in accordance with the provisions of section 19a-14,
as amended by this act, to determine if probable cause exists to issue a
statement of charges and to institute proceedings against the
veterinarian. Such investigation shall be concluded not later than twelve
months from the date the allegation is submitted to the department.
(b) Except as provided in subsections (c) and (d) of this section, the
investigation shall be confidential and not subject to disclosure under
section 1-210 and no person may disclose knowledge of the
investigation to a third party unless the veterinarian requests that the
investigation be open, [The owner of any animal that is the subject of
such an investigation shall not be deemed a third party to such an
investigation for purposes of disclosure under this section] except that
the department shall provide information to the person who filed the
complaint pursuant to subdivision (12) of subsection (a) of section 19a-
14, as amended by this act.
(c) If the department makes a finding of no probable cause to take
action under section 20-202 or fails to make a finding within the twelve-
month period required by subsection [(b)] (a) of this section, the
allegation submitted pursuant to subsection (a) of this section and the Substitute House Bill No. 6666
Public Act No. 21-121 32 of 132
entire record of the investigation may remain confidential and no
person shall disclose knowledge of such investigation to a third party
unless the veterinarian requests that it be open, except that the
department shall provide information to the person who filed the
complaint pursuant to subdivision (12) of subsection (a) of section 19a-
14, as amended by this act.
Sec. 22. Subsections (b) and (c) of section 7-62b of the general statutes
are repealed and the following is substituted in lieu thereof (Effective
January 1, 2022):
(b) The funeral director or embalmer licensed by the department, or
the funeral director or embalmer licensed in another state and
complying with the terms of a reciprocal agreement on file with the
department, in charge of the burial of the deceased person shall
complete the death certificate through the electronic death registry
system, or, if the electronic death registry system is unavailable, on a
form provided by the department. Said certificate shall be filed by a
licensed embalmer or such embalmer's designee or a funeral director or
such director's designee, in accordance with the provisions of this
section, except when inquiry is required by the Chief Medical
Examiner's Office, in which case the death certificate shall be filed in
accordance with section 19a-409. The Social Security number of the
deceased person shall be recorded on such certificate. Such licensed
funeral director or licensed embalmer shall obtain the personal data
from the next of kin or the best qualified person or source available and
shall obtain a medical certification from the person responsible therefor,
in accordance with the provisions of this section. Only a licensed
embalmer may assume charge of the burial of a deceased person who
had a communicable disease, as designated in the [Public Health Code]
regulations of Connecticut state agencies, at the time of death and such
licensed embalmer shall file an affidavit, on a form provided by the
department, signed and sworn to by such licensed embalmer stating Substitute House Bill No. 6666
Public Act No. 21-121 33 of 132
that the body has been disinfected in accordance with the [Public Health
Code] regulations of Connecticut state agencies.
(c) The medical certification portion of the death certificate shall be
completed, signed and returned to the licensed funeral director or
licensed embalmer no later than twenty-four hours after death by the
physician or advanced practice registered nurse in charge of the
patient's care for the illness or condition which resulted in death, or
upon the death of an infant delivered by a nurse-midwife, by such
nurse-midwife, as provided in section 20-86b. In the absence of such
physician or advanced practice registered nurse, or with the physician's
or advanced practice registered nurse's approval, the medical
certification may be completed and signed by an associate physician, an
advanced practice registered nurse, a physician assistant as provided in
subsection (d) of section 20-12d, a registered nurse as provided in
section 20-101a, the chief medical officer of the institution in which
death occurred, or by the pathologist who performed an autopsy upon
the decedent. No physician, advanced practice registered nurse,
physician assistant, registered nurse, nurse-midwife, chief medical
officer or pathologist shall sign and return the medical certification
unless such physician, advanced practice registered nurse, physician
assistant, registered nurse, nurse-midwife, chief medical officer or
pathologist has personally viewed and examined the body of the person
to whom the medical certification relates and is satisfied that at the time
of the examination such person was in fact dead, except in the event a
medical certification is completed by a physician, advanced practice
registered nurse, physician assistant, registered nurse, nurse-midwife,
chief medical officer or pathologist other than the one who made the
determination and pronouncement of death, an additional viewing and
examination of the body shall not be required. Such physician,
advanced practice registered nurse, physician assistant, registered
nurse, nurse-midwife, chief medical officer or pathologist shall certify
to the facts of death through the electronic death registry system, or, if Substitute House Bill No. 6666
Public Act No. 21-121 34 of 132
the electronic death registry is unavailable, on a form provided by the
department. If a physician, advanced practice registered nurse,
physician assistant, registered nurse, nurse-midwife, chief medical
officer or pathologist refuses or otherwise fails to complete, sign and
return the medical portion of the death certificate to the licensed funeral
director or licensed embalmer within twenty-four hours after death,
such licensed funeral director or embalmer may notify the
Commissioner of Public Health of such refusal. The commissioner may,
upon receipt of notification and investigation, assess a civil penalty
against such physician, advanced practice registered nurse, physician
assistant, registered nurse, chief medical officer or pathologist not to
exceed two hundred fifty dollars. The medical certification shall state
the cause of death, defined so that such death may be classified under
the international list of causes of death, the duration of disease if known
and such additional information as the Department of Public Health
requires. The department shall give due consideration to national
uniformity in vital statistics in prescribing the form and content of such
information.
Sec. 23. Section 19a-200 of the general statutes is repealed and the
following is substituted in lieu thereof (Effective July 1, 2021):
(a) The mayor of each city, the chief executive officer of each town
and the warden of each borough shall, unless the charter of such city,
town or borough otherwise provides, nominate some person to be
director of health for such city, town or borough. [, which] Such person
shall possess the qualifications specified in subsection (b) of this section.
Upon approval of the Commissioner of Public Health, such nomination
shall be confirmed or rejected by the board of selectmen, if there be such
a board, otherwise by the legislative body of such city or town or by the
burgesses of such borough within thirty days thereafter.
(b) Notwithstanding the charter provisions of any city, town or
borough with respect to the qualifications of the director of health, on Substitute House Bill No. 6666
Public Act No. 21-121 35 of 132
and after October 1, 2010, any person nominated to be a director of
health shall (1) be a licensed physician and hold a degree in public health
from an accredited school, college, university or institution, or (2) hold
a graduate degree in public health from an accredited institution of
higher education. The educational requirements of this section shall not
apply to any director of health nominated or otherwise appointed as
director of health prior to October 1, 2010.
(c) In cities, towns or boroughs with a population of forty thousand
or more for five consecutive years, according to the estimated
population figures authorized pursuant to subsection (b) of section
8-159a, such director of health shall serve in a full-time capacity, except
where a town has designated such director as the chief medical advisor
for its public schools under section 10-205. [, and]
(d) No director shall, [not,] during such director's term of office, have
any financial interest in or engage in any employment, transaction or
professional activity that is in substantial conflict with the proper
discharge of the duties required of directors of health by the general
statutes or the regulations of Connecticut state agencies or specified by
the appointing authority of the city, town or borough in its written
agreement with such director. A written agreement with such director
shall be submitted to the Commissioner of Public Health by such
appointing authority upon such director's appointment or
reappointment.
(e) Such director of health shall have and exercise within the limits of
the city, town or borough for which such director is appointed all
powers necessary for enforcing the general statutes, provisions of the
regulations of Connecticut state agencies relating to the preservation
and improvement of the public health and preventing the spread of
diseases therein.
(f) In case of the absence or inability to act of a city, town or borough Substitute House Bill No. 6666
Public Act No. 21-121 36 of 132
director of health or if a vacancy exists in the office of such director, the
appointing authority of such city, town or borough may, with the
approval of the Commissioner of Public Health, designate in writing a
suitable person to serve as acting director of health during the period of
such absence or inability or vacancy [, provided the] and such person's
start date. The commissioner may appoint such acting director if the
city, town or borough fails to do so. The person so designated, when
sworn, shall have all the powers and be subject to all the duties of such
director.
(g) In case of vacancy in the office of such director, if such vacancy
exists for [thirty] sixty days, said commissioner may appoint a director
of health for such city, town or borough. The person so designated,
when sworn, shall (1) be considered an employee of the city, town or
borough, and (2) have all the powers and be subject to all the duties of
such director.
(h) Said commissioner, may, for cause, remove an officer the
commissioner or any predecessor in said office has appointed, and the
common council of such city, town or the burgesses of such borough
may, respectively, for cause, remove a director whose nomination has
been confirmed by them, provided such removal shall be approved by
said commissioner; and, within two days thereafter, notice in writing of
such action shall be given by the clerk of such city, town or borough, as
the case may be, to said commissioner, who shall, within ten days after
receipt, file with the clerk from whom the notice was received, approval
or disapproval.
(i) Each such director of health shall hold office for the term of four
years from the date of appointment and until a successor is nominated
and confirmed in accordance with this section.
(j) Each director of health shall, annually, at the end of the fiscal year,
[of the city, town or borough, file with the Department of Public Health Substitute House Bill No. 6666
Public Act No. 21-121 37 of 132
a report of the doings as such director for the year preceding] submit a
report to the Department of Public Health detailing the activities of such
director during the preceding fiscal year.
[(b)] (k) On and after July 1, 1988, each city, town and borough shall
provide for the services of a sanitarian licensed under chapter 395 to
work under the direction of the local director of health. Where practical,
the local director of health may act as the sanitarian.
[(c)] (l) As used in this chapter, "authorized agent" means a sanitarian
licensed under chapter 395 and any individual certified for a specific
program of environmental health by the Commissioner of Public Health
in accordance with the general statutes and regulations of Connecticut
state agencies.
Sec. 24. Section 19a-202a of the general statutes is repealed and the
following is substituted in lieu thereof (Effective July 1, 2021):
[(a)] Any municipality may designate itself as having a part-time
health department if: (1) The municipality has not had a full-time health
department or been in a full-time health district [prior to] as of January
1, 1998, [;] and (2) the municipality has the equivalent of at least one full-
time employee, as determined by the Commissioner of Public Health, [;
(3) the municipality annually submits a public health program plan and
budget to the commissioner; and (4) the commissioner approves the
program plan and budget] who performs public health functions
required by the general statutes and the regulations of Connecticut
states agencies.
[(b) The Commissioner of Public Health shall adopt regulations, in
accordance with the provisions of chapter 54, for the development and
approval of the program plan and budget required by subdivision (3) of
subsection (a) of this section.]
Sec. 25. Section 19a-244 of the general statutes is repealed and the Substitute House Bill No. 6666
Public Act No. 21-121 38 of 132
following is substituted in lieu thereof (Effective July 1, 2021):
On and after October 1, 2010, any person nominated to be the director
of health shall (1) be a licensed physician and hold a degree in public
health from an accredited school, college, university or institution, or (2)
hold a graduate degree in public health from an accredited school,
college or institution. The educational requirements of this section shall
not apply to any director of health nominated or otherwise appointed
as director of health prior to October 1, 2010. The board may specify in
a written agreement with such director the term of office, which shall
not exceed three years, salary and duties required of and responsibilities
assigned to such director in addition to those required by the general
statutes or the [Public Health Code] regulations of Connecticut state
agencies, if any. Such director shall be removed during the term of such
written agreement only for cause after a public hearing by the board on
charges preferred, of which reasonable notice shall have been given. No
director shall, during such director's term of office, have any financial
interest in or engage in any employment, transaction or professional
activity that is in substantial conflict with the proper discharge of the
duties required of directors of health by the general statutes or the
[Public Health Code] regulations of Connecticut state agencies or
specified by the board in its written agreement with such director. The
board shall submit such written agreement to the Commissioner of
Public Health upon such director's appointment or reappointment. Such
director shall serve in a full-time capacity and act as secretary and
treasurer of the board, without the right to vote. Such director shall give
to the district a bond with a surety company authorized to transact
business in the state, for the faithful performance of such director's
duties as treasurer, in such sum and upon such conditions as the board
requires. Such director shall be the executive officer of the district
department of health. Full-time employees of a city, town or borough
health department at the time such city, town or borough votes to form
or join a district department of health shall become employees of such Substitute House Bill No. 6666
Public Act No. 21-121 39 of 132
district department of health. Such employees may retain their rights
and benefits in the pension system of the town, city or borough by which
they were employed and shall continue to retain their active
participating membership therein until retired. Such employees shall
pay into such pension system the contributions required of them for
their class and membership. Any additional employees to be hired by
the district or any vacancies to be filled shall be filled in accordance with
the rules and regulations of the merit system of the state of Connecticut
and the employees who are employees of cities, towns or boroughs
which have adopted a local civil service or merit system shall be
included in their comparable grade with fully attained seniority in the
state merit system. Such employees shall perform such duties as are
prescribed by the director of health. In the event of the withdrawal of a
town, city or borough from the district department, or in the event of a
dissolution of any district department, the employees thereof, originally
employed therein, shall automatically become employees of the
appropriate town, city or borough's board of health. At the end of each
fiscal year, each director of health shall submit a report to the
Department of Public Health detailing the activities of such director
during the preceding fiscal year.
Sec. 26. Subdivision (3) of subsection (a) of section 19a-12a of the
general statutes is repealed and the following is substituted in lieu
thereof (Effective July 1, 2021):
(3) "Health care professionals" includes any person licensed or who
holds a permit pursuant to chapter 370, 372, 373, 375, 375a, 376, 376a,
376b, 376c, 377, 378, 379, 379a, 380, 381, 381a, 382a, 383, 383a, 383b, 383c,
384, 384a, 384b, 384c, 384d, 385, 398 or 399;
Sec. 27. Section 19a-12d of the general statutes is repealed and the
following is substituted in lieu thereof (Effective July 1, 2021):
On or before the last day of January, April, July and October in each Substitute House Bill No. 6666
Public Act No. 21-121 40 of 132
year, the Commissioner of Public Health shall certify the amount of
revenue received as a result of any fee increase in the amount of five
dollars (1) that took effect October 1, 2015, pursuant to sections 19a-88,
as amended by this act, 19a-515, 20-65k, 20-74bb, 20-74h, 20-74s, 20-149,
20-162o, 20-162bb, 20-191a, 20-195c, as amended by this act, 20-195o, 20-
195cc, 20-201, 20-206b, 20-206n, 20-206r, 20-206bb, 20-206ll, 20-222a, 20-
275, 20-395d, 20-398 and 20-412, and (2) that took effect October 1, 2021,
pursuant to section 20-185k, as amended by this act, and transfer such
amount to the professional assistance program account established in
section 19a-12c.
Sec. 28. Subsection (a) of section 19a-12e of the general statutes is
repealed and the following is substituted in lieu thereof (Effective October
1, 2021):
(a) As used in this section:
(1) "Health care professional" means any individual licensed or who
holds a permit pursuant to chapter 368v, 370, 372, 373, 375 to 378,
inclusive, 379 to 381b, inclusive, 382a, 383 to 385, inclusive, 388 or 397a
to 399, inclusive;
(2) "Assistance program" means the program established pursuant to
section 19a-12a, as amended by this act, to provide education,
prevention, intervention, referral assistance, rehabilitation or support
services to health care professionals who have a chemical dependency,
emotional or behavioral disorder or physical or mental illness; and
(3) "Hospital" has the same meaning as provided in section 19a-490.
Sec. 29. Subsection (b) of section 20-185k of the general statutes is
repealed and the following is substituted in lieu thereof (Effective from
passage):
(b) A license issued under this section may be renewed annually. The Substitute House Bill No. 6666
Public Act No. 21-121 41 of 132
license shall be renewed in accordance with the provisions of section
19a-88, as amended by this act, for a fee of one hundred [seventy-five]
eighty dollars for applications for renewal of licenses that expire on or
after October 1, 2021. Each behavior analyst applying for license renewal
shall furnish evidence satisfactory to the commissioner of having
current certification with the Behavior Analyst Certification Board.
Sec. 30. Subsection (a) of section 17a-412 of the general statutes is
repealed and the following is substituted in lieu thereof (Effective October
1, 2021):
(a) Any physician or surgeon licensed under the provisions of chapter
370, any resident physician or intern in any hospital in this state,
whether or not so licensed, [and] any registered nurse, licensed practical
nurse, medical examiner, dentist, optometrist, chiropractor, podiatrist,
social worker, clergyman, police officer, pharmacist, physical therapist,
long-term care facility administrator, nurse's aide or orderly in a long-
term care facility, any person paid for caring for a patient in a long-term
care facility, any staff person employed by a long-term care facility,
[and] any person who is a sexual assault counselor or a domestic
violence counselor as defined in section 52-146k, and any behavior
analyst licensed under the provisions of chapter 382a, who has
reasonable cause to suspect or believe that a resident in a long-term care
facility has been abused, neglected, exploited or abandoned, or is in a
condition that is the result of such abuse, neglect, exploitation or
abandonment, shall, not later than seventy-two hours after such
suspicion or belief arose, report such information or cause a report to be
made in any reasonable manner to the Commissioner of Social Services
pursuant to chapter 319dd. Any person required to report under the
provision of this section who fails to make such report within the
prescribed time period shall be fined not more than five hundred
dollars, except that, if such person intentionally fails to make such report
within the prescribed time period, such person shall be guilty of a class Substitute House Bill No. 6666
Public Act No. 21-121 42 of 132
C misdemeanor for the first offense and a class A misdemeanor for any
subsequent offense.
Sec. 31. Subsection (a) of section 17b-451 of the general statutes is
repealed and the following is substituted in lieu thereof (Effective October
1, 2021):
(a) A mandatory reporter [, as defined in this section,] who has
reasonable cause to suspect or believe that any elderly person has been
abused, neglected, exploited or abandoned, or is in a condition that is
the result of such abuse, neglect, exploitation or abandonment, or is in
need of protective services, shall, not later than seventy-two hours after
such suspicion or belief arose, report such information or cause a report
to be made in any reasonable manner to the Commissioner of Social
Services or to the person or persons designated by the commissioner to
receive such reports. [The term] As used in this section, "mandatory
reporter" means (1) any physician or surgeon licensed under the
provisions of chapter 370, (2) any resident physician or intern in any
hospital in this state, whether or not so licensed, (3) any registered nurse,
(4) any nursing home administrator, nurse's aide or orderly in a nursing
home facility or residential care home, (5) any person paid for caring for
a resident in a nursing home facility or residential care home, (6) any
staff person employed by a nursing home facility or residential care
home, (7) any residents' advocate, other than a representative of the
Office of the Long-Term Care Ombudsman, as established under section
17a-405, including the State Ombudsman, (8) any licensed practical
nurse, medical examiner, dentist, optometrist, chiropractor, podiatrist,
behavior analyst, social worker, clergyman, police officer, pharmacist,
psychologist or physical therapist, (9) any person paid for caring for an
elderly person by any institution, organization, agency or facility,
including without limitation, any employee of a community-based
services provider, senior center, home care agency, homemaker and
companion agency, adult day care center, village-model community Substitute House Bill No. 6666
Public Act No. 21-121 43 of 132
and congregate housing facility, and (10) any person licensed or
certified as an emergency medical services provider pursuant to chapter
368d or chapter 384d, including any such emergency medical services
provider who is a member of a municipal fire department. Any
mandatory reporter who fails to make such report within the prescribed
time period shall be fined not more than five hundred dollars, except
that, if such person intentionally fails to make such report within the
prescribed time period, such person shall be guilty of a class C
misdemeanor for the first offense and a class A misdemeanor for any
subsequent offense. Any institution, organization, agency or facility
employing individuals to care for persons sixty years of age or older
shall provide mandatory training on detecting potential abuse, neglect,
exploitation and abandonment of such persons and inform such
employees of their obligations under this section. For purposes of this
subsection, "person paid for caring for an elderly person by any
institution, organization, agency or facility" includes an employee of a
community-based services provider, senior center, home health care
agency, homemaker and companion agency, adult day care center,
village-model community and congregate housing facility.
Sec. 32. Subsection (g) of section 17b-451 of the general statutes is
repealed and the following is substituted in lieu thereof (Effective October
1, 2021):
(g) The Commissioner of Social Services shall develop an educational
training program to promote and encourage the accurate and prompt
identification and reporting of abuse, neglect, exploitation and
abandonment of elderly persons. Such training program shall be made
available on the Internet web site of the Department of Social Services
to [mandated] mandatory reporters and other interested persons. The
commissioner shall also make such training available in person or
otherwise at various times and locations throughout the state as
determined by the commissioner. Substitute House Bill No. 6666
Public Act No. 21-121 44 of 132
Sec. 33. Section 19a-6o of the general statutes is repealed and the
following is substituted in lieu thereof (Effective July 1, 2021):
(a) There is established, within available appropriations, within the
Department of Public Health, a Palliative Care Advisory Council. The
advisory council shall: (1) Analyze the current state of palliative care in
the state; and (2) advise the department on matters relating to the
improvement of palliative care and the quality of life for persons with
serious or chronic illnesses.
(b) The advisory council shall consist of the following members:
(1) Two appointed by the Governor, one of whom shall be a physician
certified by the American Board of Hospice and Palliative Medicine and
one of whom shall be a registered nurse or advanced practice registered
nurse certified by the National Board for Certification of Hospice and
Palliative Nurses;
(2) Seven appointed by the Commissioner of Public Health, each of
whom shall be a licensed health care provider, with each appointee
having experience or expertise in the provision of one of the following:
(A) Inpatient palliative care in a hospital; (B) inpatient palliative care in
a nursing home facility; (C) palliative care in the patient's home or a
community setting; (D) pediatric palliative care; (E) palliative care for
young adults; (F) palliative care for adults or elderly persons; and (G)
inpatient palliative care in a psychiatric facility;
(3) One appointed by the speaker of the House of Representatives,
who shall be a licensed social worker experienced in working with
persons with serious or chronic illness and their family members;
(4) One appointed by the president pro tempore of the Senate, who
shall be a licensed pharmacist experienced in working with persons
with serious or chronic illness; Substitute House Bill No. 6666
Public Act No. 21-121 45 of 132
(5) One appointed by the minority leader of the House of
Representatives, who shall be a spiritual counselor experienced in
working with persons with serious or chronic illness and their family
members; and
(6) One appointed by the minority leader of the Senate, who shall be
a representative of the American Cancer Society or a person experienced
in advocating for persons with serious or chronic illness and their family
members.
(c) All appointments to the advisory council shall be made not later
than December 31, 2013. Advisory council members shall serve three-
year terms. Any vacancy shall be filled by the appointing authority.
(d) Any appointment that is vacant for one year or more shall be
made by the Commissioner of Public Health. The commissioner shall
notify the appointing authority of the identity of the commissioner's
choice for appointment not later than thirty days before making such
appointment.
[(d)] (e) Members shall receive no compensation except for
reimbursement for necessary expenses incurred in performing their
duties.
[(e)] (f) The members shall elect the chairperson of the advisory
council from among the members of the advisory council. A majority of
the advisory council members shall constitute a quorum. Any action
taken by the advisory council shall require a majority vote of those
present. The first meeting of the advisory council shall be held not later
than December 31, 2013. The advisory council shall meet biannually and
at other times upon the call of the chairperson, upon the request of the
Commissioner of Public Health or upon the request of a majority of the
advisory council members.
[(f)] (g) Not later than January 1, [2015] 2022, and [annually] Substitute House Bill No. 6666
Public Act No. 21-121 46 of 132
biennially thereafter, the advisory council shall submit a report on its
findings and recommendations to the Commissioner of Public Health
and the joint standing committee of the General Assembly having
cognizance of matters relating to public health, in accordance with the
provisions of section 11-4a.
Sec. 34. Section 19a-6q of the general statutes is repealed and the
following is substituted in lieu thereof (Effective from passage):
[(a)] The Commissioner of Public Health, in consultation with the
executive director of the Office of Health Strategy, established under
section 19a-754a, and local and regional health departments, shall,
within available resources, develop a plan that is consistent with the
Department of Public Health's Healthy Connecticut 2020 health
improvement plan and the state healthcare innovation plan developed
pursuant to the State Innovation Model Initiative by the Centers for
Medicare and Medicaid Services Innovation Center. The commissioner
shall develop and implement such plan to: (1) Reduce the incidence of
tobacco use, high blood pressure, health care associated infections,
asthma, unintended pregnancy and diabetes; (2) improve chronic
disease care coordination in the state; and (3) reduce the incidence and
effects of chronic disease and improve outcomes for conditions
associated with chronic disease in the state. The commissioner shall post
such plan on the Department of Public Health's Internet web site.
[(b) The commissioner shall, on or before January 15, 2015, and
biennially thereafter, submit a report, in consultation with the executive
director of the Office of Health Strategy, in accordance with the
provisions of section 11-4a to the joint standing committee of the
General Assembly having cognizance of matters relating to public
health concerning chronic disease and implementation of the plan
described in subsection (a) of this section. The commissioner shall post
each report on the Department of Public Health's Internet web site not
later than thirty days after submitting such report. Each report shall Substitute House Bill No. 6666
Public Act No. 21-121 47 of 132
include, but need not be limited to: (1) A description of the chronic
diseases that are most likely to cause a person's death or disability, the
approximate number of persons affected by such chronic diseases and
an assessment of the financial effects of each such disease on the state
and on hospitals and health care facilities; (2) a description and
assessment of programs and actions that have been implemented by the
department and health care providers to improve chronic disease care
coordination and prevent chronic disease; (3) the sources and amounts
of funding received by the department to treat persons with multiple
chronic diseases and to treat or reduce the most prevalent chronic
diseases in the state; (4) a description of chronic disease care
coordination between the department and health care providers, to
prevent and treat chronic disease; and (5) recommendations concerning
actions that health care providers and persons with chronic disease may
take to reduce the incidence and effects of chronic disease.]
Sec. 35. Subsection (b) of section 19a-493 of the general statutes is
repealed and the following is substituted in lieu thereof (Effective July 1,
2021):
(b) (1) A nursing home license may be renewed biennially after (A)
an unscheduled inspection conducted by the department, (B)
submission of the information required by section 19a-491a, and (C)
submission of evidence satisfactory to the department that the nursing
home is in compliance with the provisions of this chapter, the [Public
Health Code] regulations of Connecticut state agencies and licensing
regulations.
(2) Any change in the ownership of a facility or institution, as defined
in section 19a-490, owned by an individual, partnership or association
or the change in ownership or beneficial ownership of ten per cent or
more of the stock of a corporation which owns, conducts, operates or
maintains such facility or institution, shall be subject to prior approval
of the department after a scheduled inspection of such facility or Substitute House Bill No. 6666
Public Act No. 21-121 48 of 132
institution is conducted by the department, provided such approval
shall be conditioned upon a showing by such facility or institution to the
commissioner that it has complied with all requirements of this chapter,
the regulations relating to licensure and all applicable requirements of
the [Public Health Code] regulations of Connecticut state agencies. Any
such change in ownership or beneficial ownership resulting in a transfer
to a person related by blood or marriage to such an owner or beneficial
owner shall not be subject to prior approval of the department unless:
(A) Ownership or beneficial ownership of ten per cent or more of the
stock of a corporation, limited liability company, partnership or
association which owns, conducts, operates or maintains more than one
facility or institution is transferred; (B) ownership or beneficial
ownership is transferred in more than one facility or institution; or (C)
the facility or institution is the subject of a pending complaint,
investigation or licensure action. If the facility or institution is not in
compliance, the commissioner may require the new owner to sign a
consent order providing reasonable assurances that the violations shall
be corrected within a specified period of time. Notice of any such
proposed change of ownership shall be given to the department at least
one hundred twenty days prior to the effective date of such proposed
change. For the purposes of this subdivision, "a person related by blood
or marriage" means a parent, spouse, child, brother, sister, aunt, uncle,
niece or nephew. For the purposes of this subdivision, a change in the
legal form of the ownership entity, including, but not limited to, changes
from a corporation to a limited liability company, a partnership to a
limited liability partnership, a sole proprietorship to a corporation and
similar changes, shall not be considered a change of ownership if the
beneficial ownership remains unchanged and the owner provides such
information regarding the change to the department as may be required
by the department in order to properly identify the current status of
ownership and beneficial ownership of the facility or institution. For the
purposes of this subdivision, a public offering of the stock of any
corporation that owns, conducts, operates or maintains any such facility Substitute House Bill No. 6666
Public Act No. 21-121 49 of 132
or institution shall not be considered a change in ownership or beneficial
ownership of such facility or institution if the licensee and the officers
and directors of such corporation remain unchanged, such public
offering cannot result in an individual or entity owning ten per cent or
more of the stock of such corporation, and the owner provides such
information to the department as may be required by the department in
order to properly identify the current status of ownership and beneficial
ownership of the facility or institution.
Sec. 36. (NEW) (Effective July 1, 2021) A health care facility licensed
pursuant to chapter 368v of the general statutes shall have policies and
procedures in place that reflect the National Centers for Disease Control
and Prevention's recommendations for tuberculosis screening, testing,
treatment and education for health care personnel. Notwithstanding
any provision of the general statutes or any regulations adopted
thereunder, any employee providing direct patient care in a facility
licensed pursuant to chapter 368v of the general statutes shall receive
tuberculosis screening and testing in compliance with the licensed
health care facility's policies and procedures.
Sec. 37. Subsection (c) of section 19a-343 of the general statutes is
repealed and the following is substituted in lieu thereof (Effective October
1, 2021):
(c) Three or more arrests, the issuance of three or more arrest
warrants indicating a pattern of criminal activity and not isolated
incidents or the issuance of three or more citations for a violation of a
municipal ordinance as described in subdivision (14) of this subsection,
for the following offenses shall constitute the basis for bringing an action
to abate a public nuisance:
(1) Prostitution under section 53a-82, 53a-83, 53a-86, 53a-87, 53a-88 or
53a-89. Substitute House Bill No. 6666
Public Act No. 21-121 50 of 132
(2) Promoting an obscene performance or obscene material under
section 53a-196 or 53a-196b, employing a minor in an obscene
performance under section 53a-196a, importing child pornography
under section 53a-196c, possessing child pornography in the first degree
under section 53a-196d, possessing child pornography in the second
degree under section 53a-196e or possessing child pornography in the
third degree under section 53a-196f.
(3) Transmission of gambling information under section 53-278b or
53-278d or maintaining of a gambling premises under section 53-278e.
(4) Offenses for the sale of controlled substances, possession of
controlled substances with intent to sell, or maintaining a drug factory
under section 21a-277, 21a-278 or 21a-278a or use of the property by
persons possessing controlled substances under section 21a-279.
Nothing in this section shall prevent the state from also proceeding
against property under section 21a-259 or 54-36h.
(5) Unauthorized sale of alcoholic liquor under section 30-74 or
disposing of liquor without a permit under section 30-77, or sale or
delivery of alcoholic liquor to any minor under subdivision (1) of
subsection (b) of section 30-86 or the sale, delivery or giving of alcoholic
liquor to a minor under subdivision (2) of subsection (b) of section 30-
86.
(6) Maintaining a motor vehicle chop shop under section 14-149a.
(7) Inciting injury to persons or property under section 53a-179a.
(8) Murder or manslaughter under section 53a-54a, 53a-54b, 53a-55,
53a-56 or 53a-56a.
(9) Assault under section 53a-59, 53a-59a, subdivision (1) of
subsection (a) of section 53a-60 or section 53a-60a or 53a-61. Substitute House Bill No. 6666
Public Act No. 21-121 51 of 132
(10) Sexual assault under section 53a-70 or 53a-70a.
(11) Fire safety violations under section 29-291a, 29-291c, 29-292,
subsection (b) of section 29-310, or section 29-315, 29-349 or 29-357.
(12) Firearm offenses under section 29-35, 53-202aa, 53-203, 53a-211,
53a-212, 53a-216, 53a-217 or 53a-217c.
(13) Illegal manufacture, sale, possession or dispensing of a drug
under subdivision (2) of section 21a-108.
(14) Violation of a municipal ordinance resulting in the issuance of a
citation for (A) excessive noise on nonresidential real property that
significantly impacts the surrounding area, provided the municipality's
excessive noise ordinance is based on an objective standard, (B) owning
or leasing a dwelling unit that provides residence to an excessive
number of unrelated persons resulting in dangerous or unsanitary
conditions that significantly impact the safety of the surrounding area,
or (C) impermissible operation of (i) a business that permits persons
who are not licensed pursuant to section 20-206b to engage in the
practice of massage therapy, or (ii) a massage parlor, as defined by the
applicable municipal ordinance, that significantly impacts the safety of
the surrounding area.
Sec. 38. Section 19a-131g of the general statutes is repealed and the
following is substituted in lieu thereof (Effective from passage):
The Commissioner of Public Health shall establish a Public Health
Preparedness Advisory Committee for purposes of advising the
Department of Public Health on matters concerning emergency
responses to a public health emergency. The advisory committee shall
consist of the Commissioner of Public Health, or his or her designee, the
Commissioner of Emergency Services and Public Protection, or his or
her designee, the president pro tempore of the Senate, or his or her
designee, the speaker of the House of Representatives, or his or her Substitute House Bill No. 6666
Public Act No. 21-121 52 of 132
designee, the majority and minority leaders of both houses of the
General Assembly, [and] or their designees, the chairpersons and
ranking members of the joint standing committees of the General
Assembly having cognizance of matters relating to public health, public
safety and the judiciary, [and] or their designees, representatives of
town, city, borough and district directors of health, as appointed by the
commissioner, and any other organization or persons that the
commissioner deems relevant to the issues of public health
preparedness. Upon the request of the commissioner, the Public Health
Preparedness Advisory Committee may meet to review the plan for
emergency responses to a public health emergency and other matters as
deemed necessary by the commissioner.
Sec. 39. Subsection (d) of section 19a-30 of the general statutes is
repealed and the following is substituted in lieu thereof (Effective July 1,
2021):
(d) A nonrefundable fee of two hundred dollars shall accompany
each application for a license or for renewal thereof, except in the case
of a clinical laboratory owned and operated by a municipality, the state,
the United States or any agency of said municipality, state or United
States. Each license shall be issued for a period of not less than twenty-
four nor more than twenty-seven months from the deadline for
applications established by the commissioner. Renewal applications
shall be made (1) biennially within the twenty-fourth month of the
current license; (2) before any change in ownership or change in director
is made; and (3) prior to any major expansion or alteration in quarters.
The licensed clinical laboratory shall report to the Department of Public
Health, in a form and manner prescribed by the commissioner, the name
and address of each blood collection facility owned and operated by the
clinical laboratory, prior to the issuance of a new license, prior to the
issuance of a renewal license or whenever a blood collection facility
opens or closes. Substitute House Bill No. 6666
Public Act No. 21-121 53 of 132
Sec. 40. Subsection (b) of section 20-365 of the general statutes is
repealed and the following is substituted in lieu thereof (Effective July 1,
2021):
(b) Nothing in section 19a-200, as amended by this act, subsection (a)
of section 19a-206, or sections 19a-207, 19a-242, 20-358 or 20-360 to 20-
365, inclusive, shall prevent any of the following persons from engaging
in the performance of their duties: (1) Any person certified by the
Department of Public Health as a food or sewage inspector in
accordance with regulations adopted pursuant to section 19a-36, (2) any
person employed by a local health department performing the duties of
a lead inspector who complies with training standards established
pursuant to section 20-479, (3) a director of health acting pursuant to
[subsection (a) of] section 19a-200, as amended by this act, or section
19a-244, as amended by this act, (4) any employee of a water utility or
federal or state agency performing his duties in accordance with
applicable statutes and regulations, (5) any person employed by a local
health department working under the direct supervision of a licensed
sanitarian, (6) any person licensed or certified by the Department of
Public Health in a specific program performing certain duties that are
included within the duties of a sanitarian, or (7) a student enrolled in an
accredited academic program leading to a degree in environmental
health or completing a special training course in environmental health
approved by the commissioner, provided such student is clearly
identified by a title which indicates [his] such student's status as a
student.
Sec. 41. Subsection (b) of section 20-195u of the general statutes is
repealed and the following is substituted in lieu thereof (Effective from
passage):
(b) Continuing education required pursuant to this section shall be
related to the practice of social work and shall include not less than one
contact hour of training or education each registration period on the Substitute House Bill No. 6666
Public Act No. 21-121 54 of 132
topic of cultural competency and, on and after January 1, 2016, not less
than two contact hours of training or education during the first renewal
period in which continuing education is required and not less than once
every six years thereafter on the topic of mental health conditions
common to veterans and family members of veterans, including (1)
determining whether a patient is a veteran or family member of a
veteran, (2) screening for conditions such as post-traumatic stress
disorder, risk of suicide, depression and grief, and (3) suicide prevention
training. Such continuing education shall consist of courses, workshops
and conferences offered or approved by the Association of Social Work
Boards, the National Association of Social Workers or a school or
department of social work accredited by the Council on Social Work
Education. A licensee's ability to engage in on-line and home study
continuing education shall be limited to not more than [six] ten hours
per registration period. Within the registration period, an initial
presentation by a licensee of an original paper, essay or formal lecture
in social work to a recognized group of fellow professionals may
account for five hours of continuing education hours of the aggregate
continuing education requirements prescribed in this section.
Sec. 42. Subsection (a) of section 20-265h of the general statutes is
repealed and the following is substituted in lieu thereof (Effective from
passage):
(a) On and after July 1, 2021, each spa or salon that employs
hairdressers and cosmeticians, estheticians, eyelash technicians, [or] nail
technicians or massage therapists shall be under the management of a
hairdresser and cosmetician registered under this chapter, an esthetician
licensed under section 20-265b or 20-265f, an eyelash technician licensed
under section 20-265c, as amended by this act, or 20-265f, [or] a nail
technician licensed under section 20-265d, as amended by this act, or 20-
265f or a massage therapist licensed under chapter 384a.
Sec. 43. Subsection (a) of section 19a-131j of the general statutes is Substitute House Bill No. 6666
Public Act No. 21-121 55 of 132
repealed and the following is substituted in lieu thereof (Effective from
passage):
(a) The commissioner may issue an order to temporarily suspend, for
a period not to exceed sixty consecutive days, the requirements for
licensure, certification or registration, pursuant to chapters 368d, 370,
376 to 376c, inclusive, 378, 378a, 379, 379a, 381a, 382a, 383 to 383c,
inclusive, 383d, 383f, 383g, 384b, 384d, 385, 395, 399, 400a, 400j and 474,
to allow persons who are appropriately licensed, certified or registered
in another state or territory of the United States or the District of
Columbia, to render temporary assistance within the scope of the
profession for which a person is licensed, certified or registered, in
managing a public health emergency in this state, declared by the
Governor pursuant to section 19a-131a. Nothing in this section shall be
construed to permit a person to provide services beyond the scope
allowed in the chapter specified in this section that pertains to such
person's profession.
Sec. 44. Subsection (a) of section 19a-512 of the general statutes is
repealed and the following is substituted in lieu thereof (Effective July 1,
2021):
(a) In order to be eligible for licensure by examination pursuant to
sections 19a-511 to 19a-520, inclusive, a person shall submit an
application, together with a fee of two hundred dollars, and proof
satisfactory to the Department of Public Health that [he] such person (1)
is physically and emotionally capable of administering a nursing home;
(2) has satisfactorily completed a program of instruction and training,
including residency training which meets the requirements of
subsection (b) of this section and which is approved by the
Commissioner of Public Health; and (3) has passed an examination
prescribed [and administered] by the Department of Public Health
designed to test the applicant's knowledge and competence in the
subject matter referred to in subsection (b) of this section. Passing scores Substitute House Bill No. 6666
Public Act No. 21-121 56 of 132
shall be established by the department.
Sec. 45. Section 19a-490 of the general statutes is repealed and the
following is substituted in lieu thereof (Effective July 1, 2021):
(a) "Institution" means a hospital, short-term hospital special hospice,
hospice inpatient facility, residential care home, nursing home facility,
home health care agency, hospice agency, home health aide agency,
behavioral health facility, assisted living services agency, [substance
abuse treatment facility,] outpatient surgical facility, outpatient clinic,
an infirmary operated by an educational institution for the care of
students enrolled in, and faculty and employees of, such institution; a
facility engaged in providing services for the prevention, diagnosis,
treatment or care of human health conditions, including facilities
operated and maintained by any state agency; and a residential facility
for persons with intellectual disability licensed pursuant to section 17a-
227 and certified to participate in the Title XIX Medicaid program as an
intermediate care facility for individuals with intellectual disability.
"Institution" does not include any facility for the care and treatment of
persons with mental illness or substance use disorder operated or
maintained by any state agency, except Whiting Forensic Hospital;
(b) "Hospital" means an establishment for the lodging, care and
treatment of persons suffering from disease or other abnormal physical
or mental conditions and includes inpatient psychiatric services in
general hospitals;
(c) "Residential care home" or "rest home" means a community
residence that furnishes, in single or multiple facilities, food and shelter
to two or more persons unrelated to the proprietor and, in addition,
provides services that meet a need beyond the basic provisions of food,
shelter and laundry and may qualify as a setting that allows residents to
receive home and community-based services funded by state and
federal programs; Substitute House Bill No. 6666
Public Act No. 21-121 57 of 132
(d) "Home health care agency" means a public or private
organization, or a subdivision thereof, engaged in providing
professional nursing services and the following services, available
twenty-four hours per day, in the patient's home or a substantially
equivalent environment: Home health aide services as defined in this
section, physical therapy, speech therapy, occupational therapy or
medical social services. The agency shall provide professional nursing
services and at least one additional service directly and all others
directly or through contract. An agency shall be available to enroll new
patients seven days a week, twenty-four hours per day;
(e) "Home health aide agency" means a public or private
organization, except a home health care agency, which provides in the
patient's home or a substantially equivalent environment supportive
services which may include, but are not limited to, assistance with
personal hygiene, dressing, feeding and incidental household tasks
essential to achieving adequate household and family management.
Such supportive services shall be provided under the supervision of a
registered nurse and, if such nurse determines appropriate, shall be
provided by a social worker, physical therapist, speech therapist or
occupational therapist. Such supervision may be provided directly or
through contract;
(f) "Home health aide services" as defined in this section shall not
include services provided to assist individuals with activities of daily
living when such individuals have a disease or condition that is chronic
and stable as determined by a physician licensed in the state;
(g) "Behavioral health facility" means any facility that provides
mental health services to persons eighteen years of age or older or
substance use disorder services to persons of any age in an outpatient
treatment or residential setting to ameliorate mental, emotional,
behavioral or substance use disorder issues; Substitute House Bill No. 6666
Public Act No. 21-121 58 of 132
(h) "Alcohol or drug treatment facility" means any facility for the care
or treatment of persons suffering from alcoholism or other drug
addiction;
(i) "Person" means any individual, firm, partnership, corporation,
limited liability company or association;
(j) "Commissioner" means the Commissioner of Public Health or the
commissioner's designee;
(k) "Home health agency" means an agency licensed as a home health
care agency or a home health aide agency;
(l) "Assisted living services agency" means an agency that provides,
among other things, nursing services and assistance with activities of
daily living to a population that is chronic and stable and that may have
a dementia special care unit or program as defined in section 19a-562, as
amended by this act;
(m) "Outpatient clinic" means an organization operated by a
municipality or a corporation, other than a hospital, that provides (1)
ambulatory medical care, including preventive and health promotion
services, (2) dental care, or (3) mental health services in conjunction with
medical or dental care for the purpose of diagnosing or treating a health
condition that does not require the patient's overnight care;
(n) "Multicare institution" means a hospital that provides outpatient
behavioral health services or other health care services, psychiatric
outpatient clinic for adults, free-standing facility for the care or
treatment of substance abusive or dependent persons, hospital for
psychiatric disabilities, as defined in section 17a-495, or a general acute
care hospital that provides outpatient behavioral health services that (1)
is licensed in accordance with this chapter, (2) has more than one facility
or one or more satellite units owned and operated by a single licensee,
and (3) offers complex patient health care services at each facility or Substitute House Bill No. 6666
Public Act No. 21-121 59 of 132
satellite unit. For purposes of this subsection, "satellite unit" means a
location where a segregated unit of services is provided by the multicare
institution;
(o) "Nursing home" or "nursing home facility" means (1) any chronic
and convalescent nursing home or any rest home with nursing
supervision that provides nursing supervision under a medical director
twenty-four hours per day, or (2) any chronic and convalescent nursing
home that provides skilled nursing care under medical supervision and
direction to carry out nonsurgical treatment and dietary procedures for
chronic diseases, convalescent stages, acute diseases or injuries; [and]
(p) "Outpatient dialysis unit" means (1) an out-of-hospital out-patient
dialysis unit that is licensed by the department to provide (A) services
on an out-patient basis to persons requiring dialysis on a short-term
basis or for a chronic condition, or (B) training for home dialysis, or (2)
an in-hospital dialysis unit that is a special unit of a licensed hospital
designed, equipped and staffed to (A) offer dialysis therapy on an out-
patient basis, (B) provide training for home dialysis, and (C) perform
renal transplantations; [.] and
(q) "Hospice agency" means a public or private organization that
provides home care and hospice services to terminally ill patients.
Sec. 46. Subsections (b) to (i), inclusive, of section 19a-491 of the
general statutes are repealed and the following is substituted in lieu
thereof (Effective July 1, 2021):
(b) If any person acting individually or jointly with any other person
owns real property or any improvements thereon, upon or within which
an institution, as defined in subsections (c) and (o) of section 19a-490, is
established, conducted, operated or maintained and is not the licensee
of the institution, such person shall submit a copy of the lease agreement
to the department at the time of any change of ownership and with each Substitute House Bill No. 6666
Public Act No. 21-121 60 of 132
license renewal application. The lease agreement shall, at a minimum,
identify the person or entity responsible for the maintenance and repair
of all buildings and structures within which such an institution is
established, conducted or operated. If a violation is found as a result of
an inspection or investigation, the commissioner may require the owner
to sign a consent order providing assurances that repairs or
improvements necessary for compliance with the provisions of the
[Public Health Code] regulations of Connecticut state agencies shall be
completed within a specified period of time or may assess a civil penalty
of not more than one thousand dollars for each day that such owner is
in violation of the [Public Health Code] regulations of Connecticut state
agencies or a consent order. A consent order may include a provision
for the establishment of a temporary manager of such real property who
has the authority to complete any repairs or improvements required by
such order. Upon request of the Commissioner of Public Health, the
Attorney General may petition the Superior Court for such equitable
and injunctive relief as such court deems appropriate to ensure
compliance with the provisions of a consent order. The provisions of
this subsection shall not apply to any property or improvements owned
by a person licensed in accordance with the provisions of subsection (a)
of this section to establish, conduct, operate or maintain an institution
on or within such property or improvements.
(c) Notwithstanding any regulation, the Commissioner of Public
Health shall charge the following fees for the biennial licensing and
inspection of the following institutions: (1) Chronic and convalescent
nursing homes, per site, four hundred forty dollars; (2) chronic and
convalescent nursing homes, per bed, five dollars; (3) rest homes with
nursing supervision, per site, four hundred forty dollars; (4) rest homes
with nursing supervision, per bed, five dollars; (5) outpatient dialysis
units and outpatient surgical facilities, six hundred twenty-five dollars;
(6) mental health residential facilities, per site, three hundred seventy-
five dollars; (7) mental health residential facilities, per bed, five dollars; Substitute House Bill No. 6666
Public Act No. 21-121 61 of 132
(8) hospitals, per site, nine hundred forty dollars; (9) hospitals, per bed,
seven dollars and fifty cents; (10) nonstate agency educational
institutions, per infirmary, one hundred fifty dollars; (11) nonstate
agency educational institutions, per infirmary bed, twenty-five dollars;
(12) home health care agencies, except certified home health care
agencies described in subsection (d) of this section, per agency, three
hundred dollars; (13) home health care agencies, hospice agencies, or
home health aide agencies, except certified home health care agencies,
hospice agencies or home health aide agencies described in subsection
(d) of this section, per satellite patient service office, one hundred
dollars; (14) assisted living services agencies, except such agencies
participating in the congregate housing facility pilot program described
in section 8-119n, per site, five hundred dollars; (15) short-term hospitals
special hospice, per site, nine hundred forty dollars; (16) short-term
hospitals special hospice, per bed, seven dollars and fifty cents; (17)
hospice inpatient facility, per site, four hundred forty dollars; and (18)
hospice inpatient facility, per bed, five dollars.
(d) Notwithstanding any regulation, the commissioner shall charge
the following fees for the triennial licensing and inspection of the
following institutions: (1) Residential care homes, per site, five hundred
sixty-five dollars; (2) residential care homes, per bed, four dollars and
fifty cents; (3) home health care agencies that are certified as a provider
of services by the United States Department of Health and Human
Services under the Medicare or Medicaid program, three hundred
dollars; and (4) certified home health care agencies or hospice agencies,
as described in section 19a-493, as amended by this act, per satellite
patient service office, one hundred dollars.
(e) The commissioner shall charge one thousand dollars for the
licensing and inspection of outpatient clinics that provide either medical
or mental health service, urgent care services and well-child clinical
services, except those operated by a municipal health department, Substitute House Bill No. 6666
Public Act No. 21-121 62 of 132
health district or licensed nonprofit nursing or community health
agency. Such licensing and inspection shall be performed every three
years, except those outpatient clinics that have obtained accreditation
from a national accrediting organization within the immediately
preceding twelve-month period may be inspected by the commissioner
once every four years, provided the outpatient clinic has not committed
any violation that the commissioner determines would pose an
immediate threat to the health, safety or welfare of the patients of the
outpatient clinic. The provisions of this subsection shall not be
construed to limit the commissioner's authority to inspect any applicant
for licensure or renewal of licensure as an outpatient clinic, suspend or
revoke any license granted to an outpatient clinic pursuant to this
section or take any other legal action against an outpatient clinic that is
authorized by any provision of the general statutes.
(f) Any institution that is planning a project for construction or
building alteration shall provide the plan for such project to the
Department of Public Health for review. Any such project shall comply
with nationally established facility guidelines for health care
construction, as approved by the commissioner, that are in place at the
time the institution provides the plan to the department. The
commissioner shall post a reference to such guidelines, including the
effective date of such guidelines, on the Department of Public Health's
Internet web site. No institution shall be required to include matters
outside the scope and applicability of such guidelines in the institution's
plan.
(g) The commissioner shall charge a fee of five hundred sixty-five
dollars for the technical assistance provided for the design, review and
development of an institution's construction, renovation, building
alteration, sale or change in ownership when the cost of the project is
one million dollars or less and shall charge a fee of one-quarter of one
per cent of the total construction cost when the cost of the project is more Substitute House Bill No. 6666
Public Act No. 21-121 63 of 132
than one million dollars. Such fee shall include all department reviews
and on-site inspections. For purposes of this subsection, "institution"
does not include a facility owned by the state.
(h) The commissioner may require as a condition of the licensure of a
home health care [agencies] agency, hospice agency and home health
aide [agencies] agency that each agency meet minimum service quality
standards. In the event the commissioner requires such agencies to meet
minimum service quality standards as a condition of their licensure, the
commissioner shall adopt regulations, in accordance with the
provisions of chapter 54, to define such minimum service quality
standards, which shall (1) allow for training of home health aides by
adult continuing education, (2) require a registered nurse to visit and
assess each patient receiving home health aide services as often as
necessary based on the patient's condition, but not less than once every
sixty days, and (3) require the assessment prescribed by subdivision (2)
of this subsection to be completed while the home health aide is
providing services in the patient's home.
(i) No person acting individually or jointly with any other person
shall establish, conduct, operate or maintain a home health care agency,
hospice agency or home health aide agency without maintaining
professional liability insurance or other indemnity against liability for
professional malpractice. The amount of insurance which such person
shall maintain as insurance or indemnity against claims for injury or
death for professional malpractice shall be not less than one million
dollars for one person, per occurrence, with an aggregate of not less than
three million dollars.
Sec. 47. Subdivision (4) of subsection (a) of section 19a-491c of the
general statutes is repealed and the following is substituted in lieu
thereof (Effective July 1, 2021):
(4) "Long-term care facility" means any facility, agency or provider Substitute House Bill No. 6666
Public Act No. 21-121 64 of 132
that is a nursing home, as defined in section 19a-521, a residential care
home, as defined in section 19a-521, a home health care agency, hospice
agency or home health aide agency, as defined in section 19a-490, as
amended by this act, an assisted living services agency, as defined in
section 19a-490, as amended by this act, an intermediate care facility for
individuals with intellectual disabilities, as defined in 42 USC 1396d(d),
except any such facility operated by a Department of Developmental
Services' program subject to background checks pursuant to section 17a-
227a, a chronic disease hospital, as defined in section 19a-550, or an
agency providing hospice care which is licensed to provide such care by
the Department of Public Health or certified to provide such care
pursuant to 42 USC 1395x.
Sec. 48. Section 19a-492b of the general statutes is repealed and the
following is substituted in lieu thereof (Effective July 1, 2021):
(a) A home health care agency or hospice agency that receives
payment for rendering care to persons receiving medical assistance
from the state, assistance from the Connecticut home-care program for
the elderly pursuant to section 17b-342, or funds obtained through Title
XVIII of the Social Security Amendments of 1965 shall be prohibited
from discriminating against such persons who apply for enrollment to
such home health care agency on the basis of source of payment.
(b) Any home health care agency or hospice agency which violates
the provisions of this section shall be subject to suspension or revocation
of license.
Sec. 49. Subsection (b) of section 19a-492c of the general statutes is
repealed and the following is substituted in lieu thereof (Effective July 1,
2021):
(b) A home health care agency or hospice agency licensed pursuant
to this chapter that provides hospice services in a rural town and is Substitute House Bill No. 6666
Public Act No. 21-121 65 of 132
unable to access licensed or Medicare-certified hospice care to
consistently provide adequate services to patients in the rural town may
apply to the Commissioner of Public Health for a waiver from the
regulations licensing such agency adopted pursuant to this chapter. The
waiver may authorize one or more of the following: (1) The agency's
supervisor of clinical services may also serve as the supervisor of clinical
services assigned to the hospice program; (2) the hospice volunteer
coordinator and the hospice program director may be permanent part-
time employees; and (3) the program director may perform other
services at the agency, including, but not limited to, hospice volunteer
coordinator. The commissioner shall not grant a waiver unless the
commissioner determines that such waiver will not adversely impact
the health, safety and welfare of hospice patients and their families. The
waiver shall be in effect for two years. An agency may reapply for such
a waiver.
Sec. 50. Section 19a-492d of the general statutes is repealed and the
following is substituted in lieu thereof (Effective July 1, 2021):
On and after October 1, 2007, a nurse who is employed by an agency
licensed by the Department of Public Health as a home health care
agency, hospice agency or [a] home health aide agency may administer
influenza and pneumococcal vaccines to persons in their homes, after
an assessment for contraindications, without a physician's order in
accordance with a physician-approved agency policy that includes an
anaphylaxis protocol. In the event of an adverse reaction to the vaccine,
such nurse may also administer epinephrine or other anaphylaxis
medication without a physician's order in accordance with the
physician-approved agency policy. For purposes of this section, "nurse"
means an advanced practice registered nurse, registered nurse or
practical nurse licensed under chapter 378.
Sec. 51. Section 19a-492e of the general statutes is repealed and the
following is substituted in lieu thereof (Effective July 1, 2021): Substitute House Bill No. 6666
Public Act No. 21-121 66 of 132
(a) For purposes of this section "home health care agency" [has] and
"hospice agency" have the same [meaning] meanings as provided in
section 19a-490, as amended by this act. Notwithstanding the provisions
of chapter 378, a registered nurse may delegate the administration of
medications that are not administered by injection to home health aides
and hospice aides who have obtained certification and recertification
every three years thereafter for medication administration in accordance
with regulations adopted pursuant to subsection (b) of this section,
unless the prescribing practitioner specifies that a medication shall only
be administered by a licensed nurse. Any home health aide or hospice
aide who obtained certification in the administration of medications on
or before June 30, 2015, shall obtain recertification on or before July 1,
2018.
(b) (1) The Commissioner of Public Health shall adopt regulations, in
accordance with the provisions of chapter 54, to carry out the provisions
of this section. Such regulations shall require each home health care
agency or hospice agency that serves clients requiring assistance with
medication administration to (A) adopt practices that increase and
encourage client choice, dignity and independence; (B) establish policies
and procedures to ensure that a registered nurse may delegate allowed
tasks of nursing care, to include medication administration, to home
health aides or hospice aides when the registered nurse determines that
it is in the best interest of the client and the home health aide or hospice
aide has been deemed competent to perform the task; (C) designate
home health aides and hospice aides to obtain certification and
recertification for the administration of medication; and (D) ensure that
such home health aides receive such certification and recertification.
(2) The regulations shall establish certification and recertification
requirements for medication administration and the criteria to be used
by home health care agencies and hospice agencies that provide services
for clients requiring assistance with medication administration in Substitute House Bill No. 6666
Public Act No. 21-121 67 of 132
determining (A) which home health aides and hospice aides shall obtain
such certification and recertification, and (B) education and skill training
requirements, including ongoing training requirements for such
certification and recertification.
(3) Education and skill training requirements for initial certification
and recertification shall include, but not be limited to, initial orientation,
training in client rights and identification of the types of medication that
may be administered by unlicensed personnel, behavioral management,
personal care, nutrition and food safety, and health and safety in
general.
(c) Each home health care agency and, on or before January 1, 2022,
each hospice agency shall ensure that, on or before January 1, 2013,
delegation of nursing care tasks in the home care setting is allowed
within such agency and that policies are adopted to employ home health
aides or hospice aides for the purposes of allowing nurses to delegate
such tasks.
(d) A registered nurse licensed pursuant to the provisions of chapter
378 who delegates the task of medication administration to a home
health aide or hospice aide pursuant to this section shall not be subject
to disciplinary action based on the performance of the home health aide
or hospice aide to whom tasks are delegated, unless the home health
aide or hospice aide is acting pursuant to specific instructions from the
registered nurse or the registered nurse fails to leave instructions when
the nurse should have done so, provided the registered nurse: (1)
Documented in the patient's care plan that the medication
administration could be properly and safely performed by the home
health aide or hospice aide to whom it is delegated, (2) provided initial
direction to the home health aide or hospice aide, and (3) provided
ongoing supervision of the home health aide or hospice aide, including
the periodic assessment and evaluation of the patient's health and safety
related to medication administration. Substitute House Bill No. 6666
Public Act No. 21-121 68 of 132
(e) A registered nurse who delegates the provision of nursing care to
another person pursuant to this section shall not be subject to an action
for civil damages for the performance of the person to whom nursing
care is delegated unless the person is acting pursuant to specific
instructions from the nurse or the nurse fails to leave instructions when
the nurse should have done so.
(f) No person may coerce a registered nurse into compromising
patient safety by requiring the nurse to delegate the administration of
medication if the nurse's assessment of the patient documents a need for
a nurse to administer medication and identifies why the need cannot be
safely met through utilization of assistive technology or administration
of medication by certified home health aides or hospice aides. No
registered nurse who has made a reasonable determination based on
such assessment that delegation may compromise patient safety shall be
subject to any employer reprisal or disciplinary action pursuant to
chapter 378 for refusing to delegate or refusing to provide the required
training for such delegation. The Department of Social Services, in
consultation with the Department of Public Health, [and] home health
care agencies and hospice agencies, shall develop protocols for
documentation pursuant to the requirements of this subsection. The
Department of Social Services shall notify all licensed home health care
agencies and hospice agencies of such protocols prior to the
implementation of this section.
(g) The Commissioner of Public Health may implement policies and
procedures necessary to administer the provisions of this section while
in the process of adopting such policies and procedures as regulations,
provided notice of intent to adopt regulations is published in the
Connecticut Law Journal not later than twenty days after the date of
implementation. Policies and procedures implemented pursuant to this
section shall be valid until the time final regulations are adopted.
Sec. 52. Section 19a-496a of the general statutes is repealed and the Substitute House Bill No. 6666
Public Act No. 21-121 69 of 132
following is substituted in lieu thereof (Effective July 1, 2021):
(a) Notwithstanding any provision of the regulations of Connecticut
state agencies, all home health care agency, hospice agency and home
health aide agency services shall be performed upon the order of a
physician or physician assistant licensed pursuant to chapter 370 or an
advanced practice registered nurse licensed pursuant to chapter 378.
(b) All home health care agency services which are required by law
to be performed upon the order of a licensed physician may be
performed upon the order of a physician, physician assistant or
advanced practice registered nurse licensed in a state which borders
Connecticut.
Sec. 53. Section 19a-504d of the general statutes is repealed and the
following is substituted in lieu thereof (Effective July 1, 2021):
(a) If a hospital recommends home health care to a patient, the
hospital discharge plan shall include two or more available options of
home health care agencies or hospice agencies.
(b) A hospital which (1) has an ownership or investment interest in a
home health care agency or hospice agency, or (2) receives
compensation or remuneration for referral of patients to a home health
care agency or hospice agency shall disclose such interest to any patient
prior to including such agency as an option in a hospital discharge plan.
Such information shall be verbally disclosed to each patient or shall be
posted in a conspicuous place visible to patients. As used in this
subsection, "ownership or investment interest" does not include
ownership of investment securities purchased by the practitioner on
terms available to the general public and which are publicly traded.
Sec. 54. (NEW) (Effective July 1, 2021) (a) The Commissioner of Public
Health may suspend the requirements for licensure to authorize a
licensed chronic and convalescent nursing home to provide services to Substitute House Bill No. 6666
Public Act No. 21-121 70 of 132
patients with a reportable disease, emergency illness or health
condition, pursuant to section 19-91 of the general statutes, under their
existing license if such licensed chronic and convalescent nursing home
(1) provides services to such patients in a building that is not physically
connected to its licensed facility, or (2) expands its bed capacity in a
portion of a facility that is separate from the licensed facility. Such
services may only be provided in order to render temporary assistance
in managing a public health emergency in this state, declared by the
Governor pursuant to section 19a-131a of the general statutes.
(b) Each chronic and convalescent nursing home that intends to
provide services pursuant to subsection (a) of this section shall submit
an application to the Department of Public Health in a form and manner
prescribed by the commissioner. Such application shall include, but
need not be limited to: (1) Information regarding the facility's ability to
sufficiently address the health, safety or welfare of such chronic and
convalescent nursing home's residents and staff; (2) the address of such
facility; (3) an attestation that all equipment located at such facility is
maintained according to the manufacturers' specifications, and is
capable of meeting the needs of such facility's residents; (4) information
regarding such facility's maximum bed capacity; and (5) information
indicating that such facility is in compliance with any provisions of the
general statutes or regulations of Connecticut state agencies pertaining
to the operation of such facility.
(c) Upon receipt of an application pursuant to subsection (a) of this
section, the Department of Public Health shall conduct a scheduled
inspection and investigation of the applicant's facilities to ensure
compliance with any provisions of the general statutes or regulations of
Connecticut state agencies pertaining to the licensing of such facilities.
After conducting such inspection and investigation, the department
shall notify the applicant of the department's approval or denial of such
application. Substitute House Bill No. 6666
Public Act No. 21-121 71 of 132
Sec. 55. Section 19a-522f of the general statutes is repealed and the
following is substituted in lieu thereof (Effective July 1, 2021):
(a) As used in this section:
(1) "Administer" means to initiate the venipuncture and deliver an IV
fluid or IV admixture into the blood stream through a vein, and to
monitor and care for the venipuncture site, terminate the procedure and
record pertinent events and observations;
(2) "IV admixture" means an IV fluid to which one or more additional
drug products have been added;
(3) "IV fluid" means sterile solutions of fifty milliliters or more,
intended for intravenous infusion, but does not include blood and blood
products;
(4) "IV therapy" means the introduction of an IV fluid or IV admixture
into the blood stream through a vein for the purpose of correcting water
deficit and electrolyte imbalances, providing nutrition, and delivering
antibiotics and other therapeutic agents approved by a chronic and
convalescent nursing home's or a rest home with nursing supervision's
medical staff;
(5) "IV therapy program" means the overall plan by which a chronic
and convalescent nursing home or a rest home with nursing supervision
implements, monitors and safeguards the administration of IV therapy
to patients; and
(6) "IV therapy nurse" means a registered nurse who is qualified by
education and training and has demonstrated proficiency in the
theoretical and clinical aspects of IV therapy to administer an IV fluid
or IV admixture.
(b) An IV therapy nurse or a physician assistant licensed pursuant to Substitute House Bill No. 6666
Public Act No. 21-121 72 of 132
section 20-12b, who is employed by, or operating under a contract to
provide services in, a chronic and convalescent nursing home or a rest
home with nursing supervision that operates an IV therapy program
may administer a peripherally inserted central catheter as part of such
facility's IV therapy program. The Department of Public Health shall
adopt regulations in accordance with the provisions of chapter 54 to
carry out the purposes of this section.
(c) A chronic and convalescent nursing home may allow a registered
nurse licensed pursuant to chapter 378 and employed by such chronic
and convalescent nursing home who has been properly trained by the
director of nursing or by an intravenous infusion company to (1)
administer IV therapy or a dose of medication by intravenous injection,
provided such medication is on a list of medications approved by the
facility's governing body, pharmacist and medical director for
intravenous injection by a registered nurse, or (2) draw blood from a
central line for laboratory purposes, provided the facility has an
agreement with a laboratory to process such specimens. Such chronic
and convalescent nursing home shall notify the Commissioner of Public
Health of any such services being provided under subdivisions (1) and
(2) of this subsection. The administrator of each chronic and
convalescent nursing home shall ensure that each registered nurse who
is permitted to perform the services described in subdivisions (1) and
(2) of this subsection is appropriately trained and competent to perform
such services. Each administrator shall provide documentation
regarding the training and competency of such registered nurses to the
department upon the department's request.
Sec. 56. (NEW) (Effective July 1, 2021) (a) The Commissioner of Public
Health shall license assisted living services agencies, as defined in
section 19a-490 of the general statutes, as amended by this act. A
managed residential community wishing to provide assisted living
services shall become licensed as an assisted living services agency or Substitute House Bill No. 6666
Public Act No. 21-121 73 of 132
shall arrange for assisted living services to be provided by another entity
that is licensed as an assisted living services agency.
(b) A managed residential care community that intends to arrange for
assisted living services shall only do so with a currently licensed assisted
living services agency. Such managed residential community shall
submit an application to arrange for the assisted living services to the
Department of Public Health in a form and manner prescribed by the
commissioner.
(c) An assisted living services agency providing services as a
dementia special care unit or program, as defined in section 19a-562 of
the general statutes, as amended by this act, shall obtain approval for
such unit or program from the Department of Public Health. Such
assisted living services agencies shall ensure that they have adequate
staff to meet the needs of the residents. Each assisted living services
agency that provides services as a dementia special care unit or
program, as defined in section 19a-562 of the general statutes, as
amended by this act, shall submit to the Department of Public Health a
list of dementia special care units or locations and their staffing plans
for any such units and locations when completing an initial or a renewal
licensure application, or upon request from the department.
(d) An assisted living services agency shall ensure that (1) all services
being provided on an individual basis to clients are fully understood
and agreed upon between either the client or the client's representative,
and (2) the client or the client's representative are made aware of the cost
of any such services.
(e) The Department of Public Health may adopt regulations, in
accordance with the provisions of chapter 54 of the general statutes, to
carry out the purposes of this section.
Sec. 57. Section 19a-521b of the general statutes is repealed and the Substitute House Bill No. 6666
Public Act No. 21-121 74 of 132
following is substituted in lieu thereof (Effective July 1, 2021):
[In each] Each licensed chronic and convalescent nursing home,
chronic disease hospital associated with a chronic and convalescent
nursing home, rest home with nursing supervision and residential care
home [, at least a three-foot clearance shall be provided at the sides and
the foot of each bed] shall position beds in a manner that promotes
resident care and that provides at least a three-foot clearance at the sides
and foot of each bed. Such bed position shall (1) not act as a restraint to
the resident, (2) not create a hazardous situation, including, but not
limited to, an entrapment possibility, or obstacle to evacuation or being
close to or blocking a heat source, and (3) allow for infection control.
Sec. 58. Section 19a-195 of the general statutes is repealed and the
following is substituted in lieu thereof (Effective October 1, 2021):
The commissioner shall adopt regulations in accordance with the
provisions of chapter 54 to require all [emergency medical response
services] ambulances to be staffed by at least one certified emergency
medical technician, who shall be in the patient compartment attending
the patient during all periods in which a patient is being transported,
and one certified [medical response technician] emergency medical
responder.
Sec. 59. Section 20-206jj of the general statutes is repealed and the
following is substituted in lieu thereof (Effective from passage):
As used in this section and sections 20-206kk to 20-206oo, inclusive:
(1) "Advanced emergency medical technician" means an individual
who is certified as an advanced emergency medical technician by the
Department of Public Health;
(2) "Commissioner" means the Commissioner of Public Health; Substitute House Bill No. 6666
Public Act No. 21-121 75 of 132
(3) "Emergency medical services instructor" means a person who is
certified under the provisions of section 20-206ll or 20-206mm, as
amended by this act, by the Department of Public Health to teach
courses, the completion of which is required in order to become an
emergency medical technician;
(4) "Emergency medical responder" means an individual who is
certified to practice as an emergency medical responder under the
provisions of section 20-206ll or 20-206mm, as amended by this act;
(5) "Emergency medical services personnel" means an individual
certified to practice as an emergency medical responder, emergency
medical technician, advanced emergency medical technician,
emergency medical services instructor or an individual licensed as a
paramedic;
(6) "Emergency medical technician" means a person who is certified
to practice as an emergency medical technician under the provisions of
section 20-206ll or 20-206mm, as amended by this act;
(7) "National organization for emergency medical certification"
means a national organization approved by the Department of Public
Health and identified on the department's Internet web site, or such
national organization's successor organization, that tests and provides
certification to emergency medical responders, emergency medical
technicians, advanced medical technicians and paramedics;
(8) "Office of Emergency Medical Services" means the office
established within the Department of Public Health pursuant to section
19a-178;
(9) "Paramedicine" means the carrying out of (A) all phases of
cardiopulmonary resuscitation and defibrillation, (B) the administration
of drugs and intravenous solutions under written or oral authorization
from a licensed physician or a licensed advanced practice registered Substitute House Bill No. 6666
Public Act No. 21-121 76 of 132
nurse, and (C) the administration of controlled substances, as defined in
section 21a-240, in accordance with written protocols or standing orders
of a licensed physician or a licensed advanced practice registered nurse;
and
(10) "Paramedic" means a person licensed to practice as a paramedic
under the provisions of section 20-206ll. [; and]
[(11) "Continuing education platform Internet web site" means an
online database, approved by the Commissioner of Public Health, for
emergency medical services personnel to enter, track and reconcile the
hours and topics of continuing education completed by such personnel.]
Sec. 60. Subsection (b) of section 19a-178a of the general statutes is
repealed and the following is substituted in lieu thereof (Effective from
passage):
(b) The advisory board shall consist of members appointed in
accordance with the provisions of this subsection and shall include the
Commissioner of Public Health, the department's emergency medical
services medical director and the president of each of the regional
emergency medical services councils, or their designees. The Governor
shall appoint the following members: (1) One person from the
Connecticut Association of Directors of Health; (2) three persons from
the Connecticut College of Emergency Physicians; (3) one person from
the Connecticut Committee on Trauma of the American College of
Surgeons; (4) one person from the Connecticut Medical Advisory
Committee; (5) one person from the Emergency Nurses Association; (6)
one person from the Connecticut Association of Emergency Medical
Services Instructors; (7) one person from the Connecticut Hospital
Association; (8) two persons representing commercial ambulance
services; (9) one person from the Connecticut State Firefighters
Association; (10) one person from the Connecticut Fire Chiefs
Association; (11) one person from the Connecticut Police Chiefs Substitute House Bill No. 6666
Public Act No. 21-121 77 of 132
Association; (12) one person from the Connecticut State Police; and (13)
one person from the Connecticut Commission on Fire Prevention and
Control. An additional eighteen members shall be appointed as follows:
(A) Three by the president pro tempore of the Senate; (B) three by the
majority leader of the Senate; (C) four by the minority leader of the
Senate; (D) three by the speaker of the House of Representatives; (E) two
by the majority leader of the House of Representatives; and (F) three by
the minority leader of the House of Representatives. The appointees
shall include a person with experience in municipal ambulance services;
a person with experience in for-profit ambulance services; three persons
with experience in volunteer ambulance services; a paramedic; an
emergency medical technician; an advanced emergency medical
technician; three consumers and four persons from state-wide
organizations with interests in emergency medical services as well as
any other areas of expertise that may be deemed necessary for the
proper functioning of the advisory board. Any appointment to the
advisory board that is vacant for more than one year shall be filled by
the Commissioner of Public Health. The commissioner shall notify the
appointing authority of the identity of the commissioner's appointment
not later than thirty days before making such appointment.
Sec. 61. Subsection (a) of section 19a-36h of the general statutes is
repealed and the following is substituted in lieu thereof (Effective from
passage):
(a) Not later than January 1, [2020] 2023, the commissioner shall adopt
and administer by reference the United States Food and Drug
Administration's Food Code, as amended from time to time, and any
Food Code Supplement published by said administration as the state's
food code for the purpose of regulating food establishments.
Sec. 62. Subsection (a) of section 19a-36j of the general statutes is
repealed and the following is substituted in lieu thereof (Effective from
passage): Substitute House Bill No. 6666
Public Act No. 21-121 78 of 132
(a) On and after January 1, [2019] 2023, no person shall engage in the
practice of a food inspector unless such person has obtained a
certification from the commissioner in accordance with the provisions
of this section. The commissioner shall develop a training and
verification program for food inspector certification that shall be
administered by the food inspection training officer at a local health
department.
(1) Each person seeking certification as a food inspector shall submit
an application to the department on a form prescribed by the
commissioner and present to the department satisfactory evidence that
such person (A) is sponsored by the director of health in the jurisdiction
in which the applicant is employed to conduct food inspections, (B)
possesses a bachelor's degree or three years of experience in a regulatory
food protection program, (C) has successfully completed a training and
verification program, (D) has successfully completed the field
standardization inspection prescribed by the commissioner, and (E) is
not involved in the ownership or management of a food establishment
located in the applicant's jurisdiction.
(2) Each director of health sponsoring an applicant for certification as
a food inspector shall submit to the commissioner a form documenting
the applicant's qualifications and successful completion of the
requirements described in subdivision (1) of this subsection.
(3) Certifications issued under this section shall be subject to renewal
once every three years. A food inspector applying for renewal of his or
her certification shall demonstrate successful completion of twenty
contact hours in food protection training, as approved by the
commissioner, and reassessment by the food inspection training officer.
Sec. 63. Section 19a-36o of the general statutes is repealed and the
following is substituted in lieu thereof (Effective from passage): Substitute House Bill No. 6666
Public Act No. 21-121 79 of 132
Notwithstanding any provision of the general statutes, from June 30,
2017, until December 31, [2018] 2022, a food service establishment may
request a variance from the Commissioner of Public Health from the
requirements of the [Public Health Code] regulations of Connecticut
state agencies, established under section 19a-36, to utilize the process of
sous vide and acidification of sushi rice, as defined in section 3-502.11 of
the United States Food and Drug Administration's Food Code, as
amended from time to time. The Commissioner of Public Health shall
review the request for a variance and provide the food establishment
with notification regarding the status of its request not later than thirty
days after the commissioner receives such request. The commissioner
may grant such variance if he or she determines that such variance
would not result in a health hazard or nuisance.
Sec. 64. Subdivision (5) of section 19a-332 of the general statutes is
repealed and the following is substituted in lieu thereof (Effective October
1, 2021):
(5) "Asbestos-containing material" means material composed of
asbestos of any type and in an amount equal to or greater than one per
cent by weight, either alone or mixed with other fibrous or nonfibrous
material;
Sec. 65. Subdivision (4) of section 20-250 of the general statutes is
repealed and the following is substituted in lieu thereof (Effective from
passage):
(4) "Hairdressing and cosmetology" means the art of dressing,
arranging, curling, waving, weaving, cutting, singeing, bleaching and
coloring the hair and treating the scalp of any person, and massaging,
cleansing, stimulating, manipulating, exercising or beautifying with the
use of the hands, appliances, cosmetic preparations, antiseptics, tonics,
lotions, creams, powders, oils or clays and doing similar work on the
face, neck and arms for compensation, removing hair from the face or Substitute House Bill No. 6666
Public Act No. 21-121 80 of 132
neck using manual or mechanical means, excluding esthetics, as defined
in section 20-265a or any of the actions listed in this subdivision
performed on the nails of the hands or feet, provided nothing in this
subdivision shall prohibit an unlicensed person from performing
shampooing or braiding hair;
Sec. 66. Subsection (b) of section 20-265b of the general statutes is
repealed and the following is substituted in lieu thereof (Effective July 1,
2021):
(b) On and after January 1, 2020, each person seeking an initial license
as an esthetician shall apply to the department on a form prescribed by
the department, accompanied by an application fee of one hundred
dollars and evidence that the applicant (1) has completed a course of not
less than six hundred hours of study and received a certification of
completion from a school approved under section 20-265g or section 20-
26 or in a school outside of the state whose requirements are equivalent
to a school approved under section 20-265g, or (2) (A) if applying before
January 1, 2022, has practiced esthetics continuously in this state for a
period of not less than two years prior to July 1, 2020, and (B) is in
compliance with the infection prevention and control plan guidelines
prescribed by the department under section 19a-231 in the form of an
attestation.
Sec. 67. Subsection (f) of section 10-206 of the general statutes is
repealed and the following is substituted in lieu thereof (Effective July 1,
2021):
(f) On and after October 1, 2017, each local or regional board of
education shall report to the local health department and the
Department of Public Health, on an triennial basis, the total number of
pupils per school and per school district having a diagnosis of asthma
(1) at the time of public school enrollment, (2) in grade six or seven, and
(3) in grade nine or ten. [or eleven.] The report shall contain the asthma Substitute House Bill No. 6666
Public Act No. 21-121 81 of 132
information collected as required under subsections (b) and (c) of this
section and shall include pupil age, gender, race, ethnicity and school.
Beginning on October 1, 2021, and every three years thereafter, the
Department of Public Health shall review the asthma screening
information reported pursuant to this section and shall submit a report
to the joint standing committees of the General Assembly having
cognizance of matters relating to public health and education
concerning asthma trends and distributions among pupils enrolled in
the public schools. The report shall be submitted in accordance with the
provisions of section 11-4a and shall include, but not be limited to, (A)
trends and findings based on pupil age, gender, race, ethnicity, school
and the education reference group, as determined by the Department of
Education for the town or regional school district in which such school
is located, and (B) activities of the asthma screening monitoring system
maintained under section 19a-62a.
Sec. 68. Section 19a-490w of the general statutes is repealed and the
following is substituted in lieu thereof (Effective October 1, 2021):
(a) Not later than October 1, 2017, and annually thereafter, any
hospital that has been certified as a comprehensive stroke center, a
primary stroke center, a thrombectomy-capable stroke center or an
acute stroke-ready hospital by the American Heart Association, the Joint
Commission or any other nationally recognized certifying organization
shall submit an attestation of such certification to the Commissioner of
Public Health, in a form and manner prescribed by the commissioner.
Not later than October 15, 2017, and annually thereafter, the Department
of Public Health shall post a list of certified stroke centers on its Internet
web site.
(b) The department may remove a hospital from the list posted
pursuant to subsection (a) of this section if (1) the hospital requests such
removal, (2) the department is informed by the American Heart
Association, the Joint Commission or other nationally recognized Substitute House Bill No. 6666
Public Act No. 21-121 82 of 132
certifying organization that a hospital's certification has expired or been
suspended or revoked, or (3) the department does not receive attestation
of certification from a hospital on or before October first. The
department shall report to the nationally recognized certifying
organization any complaint it receives related to the certification of a
hospital as a comprehensive stroke center, a primary stroke center, a
thrombectomy-capable stroke center or an acute stroke-ready hospital.
The department shall provide the complainant with the name and
contact information of the nationally recognized certifying organization
if the complainant seeks to pursue a complaint with such organization.
Sec. 69. Subsection (k) of section 19a-180 of the general statutes is
repealed and the following is substituted in lieu thereof (Effective from
passage):
(k) Notwithstanding the provisions of subsection (a) of this section,
any [volunteer, hospital-based or municipal ambulance service]
emergency medical services organization that is licensed or certified and
a primary service area responder may apply to the commissioner, on a
short form application prescribed by the commissioner, to change the
address of a principal or branch location or to add a branch location
within its primary service area. Upon making such application, the
applicant shall notify in writing all other primary service area
responders in any municipality or abutting municipality in which the
applicant proposes to change principal or branch locations. Unless a
primary service area responder entitled to receive notification of such
application objects, in writing, to the commissioner and requests a
hearing on such application not later than fifteen calendar days after
receiving such notice, the application shall be deemed approved thirty
calendar days after filing. If any such primary service area responder
files an objection with the commissioner within the fifteen-calendar-day
time period and requests a hearing, the applicant shall be required to
demonstrate need to change the address of a principal or branch Substitute House Bill No. 6666
Public Act No. 21-121 83 of 132
location within its primary service area at a public hearing as required
under subsection (a) of this section.
Sec. 70. Section 7-36 of the general statutes is repealed and the
following is substituted in lieu thereof (Effective July 1, 2021):
As used in this chapter and sections 19a-40 to 19a-45, inclusive, unless
the context otherwise requires:
(1) "Registrar of vital statistics" or "registrar" means the registrar of
births, marriages, deaths and fetal deaths or any public official charged
with the care of returns relating to vital statistics;
(2) "Registration" means the process by which vital records are
completed, filed and incorporated into the official records of the
department;
(3) "Institution" means any public or private facility that provides
inpatient medical, surgical or diagnostic care or treatment, or nursing,
custodial or domiciliary care, or to which persons are committed by law;
(4) "Vital records" means a certificate of birth, death, fetal death or
marriage;
(5) "Certified copy" means a copy of a birth, death, fetal death or
marriage certificate that (A) includes all information on the certificate
except such information that is nondisclosable by law, (B) is issued or
transmitted by any registrar of vital statistics, (C) includes an attested
signature and the raised seal of an authorized person, and (D) if
submitted to the department, includes all information required by the
commissioner;
(6) "Uncertified copy" means a copy of a birth, death, fetal death or
marriage certificate that includes all information contained in a certified
copy except an original attested signature and a raised seal of an Substitute House Bill No. 6666
Public Act No. 21-121 84 of 132
authorized person;
(7) "Authenticate" or "authenticated" means to affix to a vital record
in paper format the official seal, or to affix to a vital record in electronic
format the user identification, password, or other means of electronic
identification, as approved by the department, of the creator of the vital
record, or the creator's designee, by which affixing the creator of such
paper or electronic vital record, or the creator's designee, affirms the
integrity of such vital record;
(8) "Attest" means to verify a vital record in accordance with the
provisions of subdivision (5) of this section;
(9) "Correction" means to change or enter new information on a
certificate of birth, marriage, death or fetal death, within one year of the
date of the vital event recorded in such certificate, in order to accurately
reflect the facts existing at the time of the recording of such vital event,
where such changes or entries are to correct errors on such certificate
due to inaccurate or incomplete information provided by the informant
at the time the certificate was prepared, or to correct transcribing,
typographical or clerical errors;
(10) "Amendment" means to (A) change or enter new information on
a certificate of birth, marriage, death or fetal death, more than one year
after the date of the vital event recorded in such certificate, in order to
accurately reflect the facts existing at the time of the recording of the
event, (B) create a replacement certificate of birth for matters pertaining
to parentage and gender change, or (C) reflect a legal name change in
accordance with section 19a-42, as amended by this act, or make a
modification to a cause of death;
(11) "Acknowledgment of paternity" means to legally acknowledge
paternity of a child pursuant to section 46b-172;
(12) "Adjudication of paternity" means to legally establish paternity Substitute House Bill No. 6666
Public Act No. 21-121 85 of 132
through an order of a court of competent jurisdiction;
(13) "Parentage" includes matters relating to adoption, gestational
agreements, paternity and maternity;
(14) "Department" means the Department of Public Health;
(15) "Commissioner" means the Commissioner of Public Health or the
commissioner's designee;
(16) "Gestational agreement" means a written agreement for assisted
reproduction in which a woman agrees to carry a child to birth for an
intended parent or intended parents, which woman contributed no
genetic material to the child and which agreement (A) names each party
to the agreement and indicates each party's respective obligations under
the agreement, (B) is signed by each party to the agreement and the
spouse of each such party, if any, and (C) is witnessed by at least two
disinterested adults and acknowledged in the manner prescribed by
law;
(17) "Intended parent" means a party to a gestational agreement who
agrees, under the gestational agreement, to be the parent of a child born
to a woman by means of assisted reproduction, regardless of whether
the party has a genetic relationship to the child;
(18) "Foundling" means (A) a child of unknown parentage, or (B) an
infant voluntarily surrendered pursuant to the provisions of section 17a-
58; [and]
(19) "Certified homeless youth" means a person who is at least fifteen
years of age but less than eighteen years of age, is not in the physical
custody of a parent or legal guardian, who is a homeless child or youth,
as defined in 42 USC 11434a, as amended from time to time, and who
has been certified as homeless by (A) a school district homeless liaison,
(B) the director of an emergency shelter program funded by the United Substitute House Bill No. 6666
Public Act No. 21-121 86 of 132
States Department of Housing and Urban Development, or the
director's designee, [or] (C) the director of a runaway or homeless youth
basic center or transitional living program funded by the United States
Department of Health and Human Services, or the director's designee,
[.] or (D) the director of a program of a nonprofit organization or
municipality that is contracted with the homeless youth program
established pursuant to section 17a-62a; and
(20) "Certified homeless young adult" means a person who is at least
eighteen years of age but less than twenty-five years of age who has
been certified as homeless by (A) a school district homeless liaison, (B)
the director of an emergency shelter program funded by the United
States Department of Housing and Urban Development, or the
director's designee, (C) the director of a runaway or homeless youth
basic center or transitional living program funded by the United States
Department of Health and Human Services, or the director's designee,
or (D) the director of a program of a nonprofit organization or
municipality that is contracted with the homeless youth program
established pursuant to section 17a-62a.
Sec. 71. Subsection (c) of section 7-51 of the general statutes is
repealed and the following is substituted in lieu thereof (Effective July 1,
2021):
(c) (1) The registrar of the town in which the birth or fetal death
occurred or of the town in which the [mother] birth parent resided at the
time of the birth or fetal death, or the department, may issue a certified
copy of the certificate of birth or fetal death of any person born in this
state that is kept in paper form in the custody of the registrar. Except as
provided in subdivision (2) of this subsection, such certificate shall be
issued upon the written request of an eligible party listed in subsection
(a) of this section. Any registrar of vital statistics in this state with access,
as authorized by the department, to the electronic vital records system
of the department may issue a certified copy of the electronically filed Substitute House Bill No. 6666
Public Act No. 21-121 87 of 132
certificate of birth or fetal death of any person born in this state upon
the written request of an eligible party listed in subsection (a) of this
section. The registrar and the department may waive the fee for the
issuance of a certified copy of the certificate of birth of a certified
homeless young adult to such young adult under this subsection.
(2) In the case of a certified homeless youth, such certified homeless
youth and the person who is certifying the certified homeless youth as
homeless, as described in section 7-36, as amended by this act, shall
appear in person when the certified homeless youth is presenting the
written request described in subdivision (1) of this subsection at (A) the
office of the registrar of the town in which the certified homeless youth
was born, (B) the office of the registrar of the town in which the [mother]
birth parent of the certified homeless youth resided at the time of the
birth, (C) if the birth certificate of the certified homeless youth has been
electronically filed, any registrar of vital statistics in the state with
access, as authorized by the department, to the electronic vital records
system, or (D) the state vital records office of the department. The
certified homeless youth shall present to the registrar or the department
information sufficient to identify himself or herself as may be required
by regulations adopted by the commissioner pursuant to section 7-41.
The person who is certifying the certified homeless youth as homeless
shall present to the registrar or the department information sufficient to
identify himself or herself as meeting the certification requirements of
section 7-36, as amended by this act. The registrar and the department
may waive the fee for the issuance of a certified copy of the certificate of
birth of a homeless youth to such youth under this subsection.
Sec. 72. Subsection (a) of section 1-1h of the general statutes is
repealed and the following is substituted in lieu thereof (Effective July 1,
2021):
(a) Any person who does not possess a valid motor vehicle operator's
license may apply to the Department of Motor Vehicles for an identity Substitute House Bill No. 6666
Public Act No. 21-121 88 of 132
card. The application for an identity card shall be accompanied by the
birth certificate of the applicant or a certificate of identification of the
applicant issued and authorized for such use by the Department of
Correction and a fee of twenty-eight dollars. Such application shall
include: (1) The applicant's name; (2) the applicant's address; (3)
whether the address is permanent or temporary; (4) the applicant's date
of birth; (5) notice to the applicant that false statements on such
application are punishable under section 53a-157b; and (6) such other
pertinent information as the Commissioner of Motor Vehicles deems
necessary. The applicant shall sign the application in the presence of an
official of the Department of Motor Vehicles. The commissioner may
waive the fee for any applicant (A) who has voluntarily surrendered
such applicant's motor vehicle operator's license, (B) whose license has
been refused by the commissioner pursuant to subdivision (4) of
subsection (e) of section 14-36, (C) who is both a veteran, as defined in
subsection (a) of section 27-103, and blind, as defined in subsection (a)
of section 1-1f, or (D) who is a resident of a homeless shelter or other
facility for homeless persons or a certified homeless youth or certified
homeless young adult. The commissioner shall adopt regulations, in
accordance with the provisions of chapter 54, to establish the procedure
and qualifications for the issuance of an identity card to any such
homeless applicant. For the purposes of this subsection, "certified
homeless youth" and "certified homeless young adult" have the same
meanings as provided in section 7-36, as amended by this act.
Sec. 73. Subsection (b) of section 20-265d of the general statutes is
repealed and the following is substituted in lieu thereof (Effective July 1,
2021):
(b) On and after October 1, 2020, each person seeking an initial license
as a nail technician shall apply to the department on a form prescribed
by the department, accompanied by an application fee of one hundred
dollars and evidence that the applicant (1) has completed a course of not Substitute House Bill No. 6666
Public Act No. 21-121 89 of 132
less than one hundred hours of study and received a certificate of
completion from a school approved under section 20-265g or section 20-
262 or in a school outside of the state whose requirements are equivalent
to a school approved under section 20-265g, or (2) (A) if the applicant is
applying on or before January 1, 2022, has practiced as a nail technician
continuously in this state for a period of not less than two years prior to
January 1, 2021, and is in compliance with the infection prevention and
control plan guidelines prescribed by the department under section 19a-
231 in the form of an attestation, or (B) has obtained a license as a nail
technician trainee and a statement signed by the applicant's supervisor
at the spa or salon where the licensed nail technician trainee is employed
documenting completion of the minimum requirements specified in
section 20-265e. If an applicant employed as a nail technician on or after
September 30, 2020, does not have evidence satisfactory to the
commissioner of continuous practice as a nail technician for not less than
two years, such applicant may apply to the department for a nail
technician trainee license, under section 20-265e, provided such person
applies for an initial trainee license not later than January 1, 2021.
Sec. 74. Subsection (b) of section 20-265c of the general statutes is
repealed and the following is substituted in lieu thereof (Effective July 1,
2021):
(b) On and after January 1, 2020, each person seeking an initial license
as an eyelash technician shall apply to the department on a form
prescribed by the department, accompanied by an application fee of one
hundred dollars and evidence that the applicant (1) has completed a
course of not less than fifty hours of study and received a certificate of
completion from a school approved under section 20-265g or section 20-
262 or in a school outside of the state whose requirements are equivalent
to a school approved under section 20-265g, or (2) (A) if the applicant is
applying on or before January 1, 2022, has practiced as an eyelash
technician continuously in this state for a period of not less than two Substitute House Bill No. 6666
Public Act No. 21-121 90 of 132
years prior to July 1, 2020, and (B) is in compliance with the infection
prevention and control plan guidelines prescribed by the department
under section 19a-231 in the form of an attestation.
Sec. 75. Section 19a-55 of the general statutes is repealed and the
following is substituted in lieu thereof (Effective from passage):
(a) [The administrative officer or other person in charge of each
institution caring for newborn infants shall cause to have administered
to every such infant in its care an HIV-related test, as defined in section
19a-581, a test for phenylketonuria and other metabolic diseases,
hypothyroidism, galactosemia, sickle cell disease, maple syrup urine
disease, homocystinuria, biotinidase deficiency, congenital adrenal
hyperplasia, severe combined immunodeficiency disease,
adrenoleukodystrophy and such other tests for inborn errors of
metabolism as shall be prescribed by the Department of Public Health.
The tests shall be administered as soon after birth as is medically
appropriate. If the mother has had an HIV-related test pursuant to
section 19a-90 or 19a-593, the person responsible for testing under this
section may omit an HIV-related test.] There is established a newborn
screening program. The Commissioner of Public Health shall (1)
administer the newborn screening program, (2) direct persons identified
through the screening program to appropriate specialty centers for
treatments, consistent with any applicable confidentiality requirements,
and (3) set the fees to be charged to institutions to cover all expenses of
the comprehensive screening program including testing, tracking and
treatment, subject to the approval of the Secretary of the Office of Policy
and Management. The fees to be charged pursuant to subdivision (3) of
this subsection shall be set at a minimum of ninety-eight dollars.
(b) The administrative officer or other person in charge of each
institution caring for newborn infants, a nurse-midwife licensed
pursuant to chapter 377 or a midwife shall cause to have administered
to every such newborn infant in his or her care a blood spot specimen Substitute House Bill No. 6666
Public Act No. 21-121 91 of 132
and an HIV-related test, as defined in section 19a-581, except that the
person responsible for testing may omit such test if the mother has had
an HIV-related test pursuant to section 19a-90 or 19a-593. The blood spot
specimen shall be collected not earlier than twenty-four hours after the
birth of the newborn infant and not later than forty-eight hours after the
birth of such infant, unless the institution caring for newborn infants,
nurse-midwife licensed pursuant to chapter 377 or midwife determines
that a situation exists to warrant an early collection of the specimen or if
collection of the specimen is medically contraindicated. Situations that
warrant early collection of the specimen shall include, but not be limited
to, the imminent transfusion of blood products, dialysis, early discharge
of the newborn infant from the institution, transfer of the newborn
infant to another institution or imminent death. If the newborn infant
dies before a blood spot specimen can be obtained, the specimen shall
be collected as soon as practicable after death. The institution licensed
to care for newborn infants, nurse-midwife or midwife shall notify the
Department of Public Health when a specimen is not collected within
forty-eight hours after the birth of such infant due to: (1) The infant's
medical fragility, (2) refusal by the parents when newborn infant
screening is in conflict with their religious tenets and practice, (3) the
newborn infant receiving comfort measures only, or (4) any other
reason. Such notification shall be documented in the department's
newborn screening system pursuant to section 19a-53 by the institution
caring for newborn infants, nurse-midwife or midwife or sent in writing
to the department not later than seventy-two hours after the birth of the
newborn infant. The institution caring for newborn infants, nurse-
midwife or midwife shall send the blood spot specimen to the state
public health laboratory not later than twenty-four hours after the time
of collection. The department may request an additional blood spot
specimen if: (A) There was an early collection of the specimen, (B) the
specimen was collected following a transfusion of blood products, (C)
the specimen is unsatisfactory for testing, or (D) the department
determines that there is an abnormal result. The state public health Substitute House Bill No. 6666
Public Act No. 21-121 92 of 132
laboratory shall make and maintain a record of the date and time of its
receipt of each blood spot specimen and make such record available for
inspection by the institution caring for newborn infants, nurse-midwife
or midwife that sent the blood spot specimen not later than forty-eight
hours after such institution, nurse-midwife or midwife submits a
request to inspect such record.
(c) The Commissioner of Public Health shall publish a list of all the
abnormal conditions for which the department screens newborns under
the newborn screening program, which shall include, [screening] but
need not be limited to, testing for amino acid disorders, including
phenylketonuria, organic acid disorders, fatty acid oxidation disorders,
including, but not limited to, long-chain 3-hydroxyacyl CoA
dehydrogenase (L-CHAD) and medium -chain acyl-CoA
dehydrogenase (MCAD), hypothyroidism, galactosemia, sickle cell
disease, maple syrup urine disease, homocystinuria, biotinidase
deficiency, congenital adrenal hyperplasia, severe combined
immunodeficiency disease, adrenoleukodystrophy, spinal muscular
atrophy and [, subject to the approval of the Secretary of the Office of
Policy and Management,] any other disorder included on the
recommended uniform screening panel pursuant to 42 USC 300b-10, as
amended from time to time, and as prescribed by the Commissioner of
Public Health.
[(b)] (d) In addition to the testing requirements prescribed in
subsection [(a)] (b) of this section, the administrative officer or other
person in charge of each institution caring for newborn infants shall
cause to have administered to (1) every such infant in its care a screening
test for (A) cystic fibrosis, and (B) critical congenital heart disease, [and
(C) on and after January 1, 2020, spinal muscular atrophy, and] (2) any
newborn infant who fails a newborn hearing screening, as described in
section 19a-59, a screening test for cytomegalovirus. [, provided such
screening test shall be administered within available appropriations. Substitute House Bill No. 6666
Public Act No. 21-121 93 of 132
The administrative officer or other person in charge of each institution
caring for newborn infants who performs the testing for critical
congenital heart disease shall enter the results of such test into the
newborn screening system pursuant to section 19a-53.] Such screening
tests shall be administered as soon after birth as is medically
appropriate.
(e) (1) The clinical laboratory that completes the testing for cystic
fibrosis, shall report the number of newborn infants screened and the
results of such testing, not less than annually, to the Department of
Public Health into the newborn screening system pursuant to section
19a-53. The administrative officer or other person in charge of each
institution caring for newborn infants who performs the testing for
critical congenital heart disease shall enter the results of such test into
the newborn screening system pursuant to section 19a-53.
[(c)] (2) The administrative officer or other person in charge of each
institution caring for newborn infants shall [report] enter any case of
cytomegalovirus that is confirmed as a result of a screening test
administered pursuant to subdivision (2) of subsection [(b)] (d) of this
section to the Department of Public Health [in a form and manner
prescribed by the Commissioner of Public Health] into the newborn
screening system pursuant to section 19a-53. The provisions of this
subsection shall apply regardless of the patient's insurance status or
source of payment, including self-pay status.
[(d)] (f) The provisions of this section shall not apply to any infant
whose parents object to the test or treatment as being in conflict with
their religious tenets and practice. The commissioner shall adopt
regulations, in accordance with the provisions of chapter 54, to
implement the provisions of this section.
Sec. 76. Subdivision (10) of section 7-36 of the general statutes is
repealed and the following is substituted in lieu thereof (Effective October Substitute House Bill No. 6666
Public Act No. 21-121 94 of 132
1, 2021):
(10) "Amendment" means to (A) change or enter new information on
a certificate of birth, marriage, death or fetal death, more than one year
after the date of the vital event recorded in such certificate, in order to
accurately reflect the facts existing at the time of the recording of the
event, (B) create a replacement certificate of birth for matters pertaining
to parentage and gender change, [or] (C) create a replacement certificate
of marriage for matters pertaining to gender change, or (D) reflect a legal
name change in accordance with section 19a-42, as amended by this act,
or make a modification to a cause of death;
Sec. 77. Section 19a-42 of the general statutes is repealed and the
following is substituted in lieu thereof (Effective October 1, 2021):
(a) To protect the integrity and accuracy of vital records, a certificate
registered under chapter 93 may be amended only in accordance with
sections 19a-41 to 19a-45, inclusive, chapter 93, regulations adopted by
the Commissioner of Public Health pursuant to chapter 54 and uniform
procedures prescribed by the commissioner. Only the commissioner
may amend birth certificates to reflect changes concerning parentage or
birth or marriage certificates to reflect changes concerning gender
change. Amendments related to parentage or gender change shall result
in the creation of a replacement certificate that supersedes the original,
and shall in no way reveal the original language changed by the
amendment. Any amendment to a vital record made by the registrar of
vital statistics of the town in which the vital event occurred or by the
commissioner shall be in accordance with such regulations and uniform
procedures.
(b) The commissioner and the registrar of vital statistics shall
maintain sufficient documentation, as prescribed by the commissioner,
to support amendments and shall ensure the confidentiality of such
documentation as required by law. The date of amendment and a Substitute House Bill No. 6666
Public Act No. 21-121 95 of 132
summary description of the evidence submitted in support of the
amendment shall be endorsed on or made part of the record and the
original certificate shall be marked "Amended", except for amendments
due to parentage or gender change. When the registrar of the town in
which the vital event occurred amends a certificate, such registrar shall,
within ten days of making such amendment, forward an amended
certificate to the commissioner and to any registrar having a copy of the
certificate. When the commissioner amends a birth certificate, including
changes due to parentage or gender, the commissioner shall forward an
amended certificate to the registrars of vital statistics affected and their
records shall be amended accordingly.
(c) An amended certificate shall supersede the original certificate that
has been changed and shall be marked "Amended", except for
amendments due to parentage or gender change. The original certificate
in the case of parentage or gender change shall be physically or
electronically sealed and kept in a confidential file by the department
and the registrar of any town in which the birth was recorded, and may
be unsealed for issuance only as provided in section 7-53 with regard to
an original birth certificate or upon a written order of a court of
competent jurisdiction. The amended certificate shall become the official
record.
(d) (1) Upon receipt of (A) an acknowledgment of paternity executed
in accordance with the provisions of subsection (a) of section 46b-172 by
both parents of a child born out of wedlock, or (B) a certified copy of an
order of a court of competent jurisdiction establishing the paternity of a
child born out of wedlock, the commissioner shall include on or amend,
as appropriate, such child's birth certificate to show such paternity if
paternity is not already shown on such birth certificate and to change
the name of the child under eighteen years of age if so indicated on the
acknowledgment of paternity form or within the certified court order as
part of the paternity action. If a person who is the subject of a voluntary Substitute House Bill No. 6666
Public Act No. 21-121 96 of 132
acknowledgment of paternity, as described in this subdivision, is
eighteen years of age or older, the commissioner shall obtain a notarized
affidavit from such person affirming that he or she agrees to the
commissioner's amendment of such person's birth certificate as such
amendment relates to the acknowledgment of paternity. The
commissioner shall amend the birth certificate for an adult child to
change his or her name only pursuant to a court order.
(2) If another father is listed on the birth certificate, the commissioner
shall not remove or replace the father's information unless presented
with a certified court order that meets the requirements specified in
section 7-50, or upon the proper filing of a rescission, in accordance with
the provisions of section 46b-172. The commissioner shall thereafter
amend such child's birth certificate to remove or change the father's
name and to change the name of the child, as requested at the time of
the filing of a rescission, in accordance with the provisions of section
46b-172. Birth certificates amended under this subsection shall not be
marked "Amended".
(e) When the parent or parents of a child request the amendment of
the child's birth certificate to reflect a new mother's name because the
name on the original certificate is fictitious, such parent or parents shall
obtain an order of a court of competent jurisdiction declaring the
putative mother to be the child's mother. Upon receipt of a certified copy
of such order, the department shall amend the child's birth certificate to
reflect the mother's true name.
(f) Upon receipt of a certified copy of an order of a court of competent
jurisdiction changing the name of a person born in this state and upon
request of such person or such person's parents, guardian, or legal
representative, the commissioner or the registrar of vital statistics of the
town in which the vital event occurred shall amend the birth certificate
to show the new name by a method prescribed by the department. Substitute House Bill No. 6666
Public Act No. 21-121 97 of 132
(g) When an applicant submits the documentation required by the
regulations to amend a vital record, the commissioner shall hold a
hearing, in accordance with chapter 54, if the commissioner has
reasonable cause to doubt the validity or adequacy of such
documentation.
(h) When an amendment under this section involves the changing of
existing language on a death certificate due to an error pertaining to the
cause of death, the death certificate shall be amended in such a manner
that the original language is still visible. A copy of the death certificate
shall be made. The original death certificate shall be sealed and kept in
a confidential file at the department and only the commissioner may
order it unsealed. The copy shall be amended in such a manner that the
language to be changed is no longer visible. The copy shall be a public
document.
(i) The commissioner shall issue a new birth certificate to reflect a
gender change upon receipt of the following documents submitted in
the form and manner prescribed by the commissioner: (1) A written
request from the applicant, signed under penalty of law, for a
replacement birth certificate to reflect that the applicant's gender differs
from the sex designated on the original birth certificate; (2) a notarized
affidavit by a physician licensed pursuant to chapter 370 or holding a
current license in good standing in another state, a physician assistant
licensed pursuant to chapter 370 or holding a current license in good
standing in another state, an advanced practice registered nurse
licensed pursuant to chapter 378 or holding a current license in good
standing in another state, or a psychologist licensed pursuant to chapter
383 or holding a current license in good standing in another state, stating
that the applicant has undergone surgical, hormonal or other treatment
clinically appropriate for the applicant for the purpose of gender
transition; and (3) if an applicant is also requesting a change of name
listed on the original birth certificate, proof of a legal name change. The Substitute House Bill No. 6666
Public Act No. 21-121 98 of 132
new birth certificate shall reflect the new gender identity by way of a
change in the sex designation on the original birth certificate and, if
applicable, the legal name change.
(j) The commissioner shall issue a new marriage certificate to reflect
a gender change upon receipt of the following documents, submitted in
a form and manner prescribed by the commissioner: (1) A written
request from the applicant, signed under penalty of law, for a
replacement marriage certificate to reflect that the applicant's gender
differs from the sex designated on the original marriage certificate,
along with an affirmation that the marriage is still legally intact; (2) a
notarized statement from the spouse named on the marriage certificate
to be amended, consenting to the amendment; (3) (A) a United States
passport or amended birth certificate or court order reflecting the
applicant's gender as of the date of the request or (B) a notarized
affidavit by a physician licensed pursuant to chapter 370 or holding a
current license in good standing in another state, physician assistant
licensed pursuant to chapter 370 or holding a current license in good
standing in another state, an advanced practice registered nurse
licensed pursuant to chapter 378 or holding a current license in good
standing in another state or a psychologist licensed pursuant to chapter
383 or holding a current license in good standing in another state stating
that the applicant has undergone surgical, hormonal or other treatment
clinically appropriate for the applicant for the purpose of gender
transition; and (4) if an applicant is also requesting a change of name
listed on the original marriage certificate, proof of a legal name change.
The new marriage certificate shall reflect the new gender identity by
way of a change in the sex designation on the original marriage
certificate and, if applicable, the legal name change.
Sec. 78. Section 19a-215 of the general statutes is repealed and the
following is substituted in lieu thereof (Effective October 1, 2021):
(a) For the purposes of this section: Substitute House Bill No. 6666
Public Act No. 21-121 99 of 132
(1) "Clinical laboratory" means any facility or other area used for
microbiological, serological, chemical, hematological,
immunohematological, biophysical, cytological, pathological or other
examinations of human body fluids, secretions, excretions or excised or
exfoliated tissues, for the purpose of providing information for the
diagnosis, prevention or treatment of any human disease or
impairment, for the assessment of human health or for the presence of
drugs, poisons or other toxicological substances.
(2) "Commissioner's list of reportable diseases, emergency illnesses
and health conditions" and "commissioner's list of reportable laboratory
findings" means the lists developed pursuant to section 19a-2a.
(3) "Confidential" means confidentiality of information pursuant to
section 19a-25.
(4) "Health care provider" means a person who has direct or
supervisory responsibility for the delivery of health care or medical
services, including licensed physicians, nurse practitioners, nurse
midwives, physician assistants, nurses, dentists, medical examiners and
administrators, superintendents and managers of health care facilities.
(5) "Reportable diseases, emergency illnesses and health conditions"
means the diseases, illnesses, conditions or syndromes designated by
the Commissioner of Public Health on the list required pursuant to
section 19a-2a.
(b) A health care provider shall report each case occurring in such
provider's practice, of any disease on the commissioner's list of
reportable diseases, emergency illnesses and health conditions to the
director of health of the town, city or borough in which such case resides
and to the Department of Public Health, no later than twelve hours after
such provider's recognition of the disease. Such reports shall be in
writing, by telephone or in an electronic format approved by the Substitute House Bill No. 6666
Public Act No. 21-121 100 of 132
commissioner. [Such reports of disease shall be confidential and not
open to public inspection except as provided for in section 19a-25.]
(c) A clinical laboratory shall report each finding identified by such
laboratory of any disease identified on the commissioner's list of
reportable laboratory findings to the Department of Public Health not
later than forty-eight hours after such laboratory's finding. A clinical
laboratory that reports an average of more than thirty findings per
month shall make such reports electronically in a format approved by
the commissioner. Any clinical laboratory that reports an average of less
than thirty findings per month shall submit such reports, in writing, by
telephone or in an electronic format approved by the commissioner. [All
such reports shall be confidential and not open to public inspection
except as provided for in section 19a-25.] The Department of Public
Health shall provide a copy of all such reports to the director of health
of the town, city or borough in which the affected person resides or, in
the absence of such information, the town where the specimen
originated.
(d) When a local director of health, the local director's authorized
agent or the Department of Public Health receives a report of a disease
or laboratory finding on the commissioner's lists of reportable diseases,
emergency illnesses and health conditions and laboratory findings, the
local director of health, the local director's authorized agent or the
Department of Public Health may contact first the reporting health care
provider and then the person with the reportable finding to obtain such
information as may be necessary to lead to the effective control of
further spread of such disease. In the case of reportable communicable
diseases and laboratory findings, this information may include
obtaining the identification of persons who may be the source or
subsequent contacts of such infection.
(e) A hospital, as defined in section 19a-490 and licensed pursuant to
chapter 368v, shall provide the Department of Public Health with access, Substitute House Bill No. 6666
Public Act No. 21-121 101 of 132
including remote access, in a manner approved by the Commissioner of
Public Health, to the entirety of each electronic medical record that
concerns a reportable disease, emergency illness or health condition
listed by the commissioner pursuant to subdivision (9) of section 19a-2a
that occurs at such hospital. Such remote access shall take place on or
before October 1, 2022, if technically feasible.
[(e)] (f) All personal information obtained from disease prevention
and control investigations [as performed in subsections (c) and (d) of]
pursuant to this section including the health care provider's name and
the identity of the reported case of disease and suspected source persons
and contacts shall not be divulged to anyone and shall be held strictly
confidential pursuant to section 19a-25, by the local director of health
and the director's authorized agent and by the Department of Public
Health.
[(f)] (g) Any person who violates any reporting or confidentiality
provision of this section shall be fined not more than five hundred
dollars. No provision of this section shall be deemed to supersede
section 19a-584.
Sec. 79. Subsection (c) of section 19a-72 of the general statutes is
repealed and the following is substituted in lieu thereof (Effective October
1, 2021):
(c) [The] (1) A health care provider shall provide the Department of
Public Health, [shall be provided such] at the request of the department,
access to the clinical records of any [health care provider] patient, as the
department deems necessary, to perform case finding or other quality
improvement audits to ensure completeness of reporting and data
accuracy consistent with the purposes of this section.
(2) A hospital shall provide the Department of Public Health with
access, including remote access, to the entirety of a patient's medical Substitute House Bill No. 6666
Public Act No. 21-121 102 of 132
record, as the department deems necessary, to perform case finding or
other quality improvement audits to ensure completeness of reporting
and data accuracy consistent with the purposes of this section. Such
remote access shall be provided on or before October 1, 2022, if
technically feasible. The department shall not divulge any personal
information obtained from the medical record to anyone and shall hold
any such personal information strictly confidential pursuant to section
19a-25.
Sec. 80. (NEW) (Effective October 1, 2021) A hospital shall provide the
Department of Public Health with access, including remote access, to
the entirety of a patient's medical record, as the department deems
necessary, to perform quality improvement audits to ensure
completeness of reporting and data accuracy of birth, fetal death and
death occurrences. Such remote access shall take place on or before
October 1, 2022, if technically feasible. No personal information
obtained from the medical record shall be divulged to anyone and shall
be held strictly confidential pursuant to section 19a-25 of the general
statutes by the Department of Public Health.
Sec. 81. Section 19a-59h of the general statutes is repealed and the
following is substituted in lieu thereof (Effective October 1, 2021):
(a) As used in this section and section 19a-59i, "maternal death"
means the death of a woman while pregnant or not later than one year
after the date on which the woman ceases to be pregnant, regardless of
whether the woman's death is related to her pregnancy, and
"department" means the Department of Public Health.
(b) There is established, within the department, a maternal mortality
review program. The program shall be responsible for identifying
maternal death cases in Connecticut and reviewing medical records and
other relevant data related to each maternal death case, including, but
not limited to, information collected from death and birth records, files Substitute House Bill No. 6666
Public Act No. 21-121 103 of 132
from the Office of the Chief Medical Examiner, and physician office and
hospital records.
(c) Licensed health care providers, health care facilities and
pharmacies shall provide the maternal mortality review program,
established under this section with reasonable access to all relevant
medical records associated with a maternal death case under review by
the program.
(d) A hospital shall provide the department with access, including
remote access, to the entirety of a patient's medical record, as the
department deems necessary, to review case information related to a
maternal death case under review by the program. Such remote access
shall be provided on or before October 1, 2022, if technically feasible. All
personal information obtained from the medical record shall not be
divulged to anyone and shall be held strictly confidential pursuant to
section 19a-25 by the department.
[(d)] (e) All information obtained by the department for the maternal
mortality review program shall be confidential pursuant to section 19a-
25.
[(e)] (f) Notwithstanding subsection [(d)] (e) of this section, the
department may provide the maternal mortality review committee,
established pursuant to section 19a-59i, with information as is necessary,
in the department's discretion, for the committee to make
recommendations regarding the prevention of maternal death.
Sec. 82. (NEW) (Effective October 1, 2021) (a) As used in this section:
(1) "Bottled water" has the same meaning as defined in section 21a-
150 of the general statutes;
(2) "Commissioner" means the Commissioner of Public Health, or his
or her designee; Substitute House Bill No. 6666
Public Act No. 21-121 104 of 132
(3) "Department" means the Department of Public Health;
(4) "Fill station" means a location at which customers of a water
company may obtain potable water;
(5) "Small community water system" has the same meaning as
provided in section 19a-37e of the general statutes; and
(6) "Water company" has the same meaning as provided in section 25-
32a of the general statutes.
(b) A water company shall update its emergency contingency plan
prepared pursuant to section 25-32d of the general statutes and section
25-32d-3 of the regulations of Connecticut state agencies, to include
information regarding the provision of alternative sources of potable
water for human consumption that can be utilized as a temporary
measure when there is a water supply emergency. Such plan shall
identify alternative sources of potable water for possible use at various
stages of an emergency, including, but not limited to, bulk water
provided by a bulk water hauler licensed pursuant to section 20-278h of
the general statutes, bottled water, a fill station, interconnection or
agreement with a nearby public water system for supplemental water
supplies in the event of an emergency, other approved public water
supply source or mechanism for providing water identified in the
emergency contingency plan, or as otherwise approved by the
commissioner. The commissioner, in consultation with water
companies, shall prepare materials and provide guidance to such water
companies to implement the provisions of this subsection. Nothing in
this section shall prevent a water company from providing an
alternative source of potable water for an event lasting less than twelve
hours that may adversely impact the quality or quantity of potable
water supplies. As used in this subsection, "water supply emergency"
means any event lasting more than twelve consecutive hours that results
in the water supplied from the water company to residents that is not in Substitute House Bill No. 6666
Public Act No. 21-121 105 of 132
compliance with the regulations of Connecticut state agencies
concerning the purity and adequacy of drinking water.
(c) A small community water system shall update its emergency
response plan required pursuant to section 19-13-B102 of the regulations
of Connecticut state agencies to include information regarding the
provision of alternative sources of potable water for human
consumption that can be utilized as a temporary measure when there is
a water supply emergency. Such plan shall identify alternative sources
of potable water for possible use at various stages of an emergency,
including, but not limited to, bulk water provided by a bulk water
hauler licensed pursuant to section 20-278h of the general statutes,
bottled water, a fill station, interconnection or agreement with a nearby
public water system for supplemental water supplies in the event of an
emergency, or other approved public water supply source or
mechanism for providing water identified in the emergency
contingency plan. The commissioner, in consultation with small
community water systems, shall prepare materials and provide
guidance to such water systems to implement the provisions of this
section. Nothing in this section shall prevent a small community water
system from providing an alternative source of potable water for an
event lasting less than twelve hours that may adversely impact the
quality or quantity of potable water supplies. As used in this subsection,
"water supply emergency" means any event lasting more than twelve
consecutive hours that results in the water supplied from the small
community water system to residents that is not in compliance with the
regulations of Connecticut state agencies concerning the purity and
adequacy of drinking water.
Sec. 83. (NEW) (Effective October 1, 2021) A water company shall
provide tier 1 notices to its consumers in the languages predominantly
spoken by the consumers in the water company's service area. A water
company shall update its emergency response plan prepared pursuant Substitute House Bill No. 6666
Public Act No. 21-121 106 of 132
to section 25-32d of the general statutes or pursuant to section 19-13-
B102 of the regulations of Connecticut state agencies to include
information regarding the provision of such multilingual
communications. As used in this section, "water company" has the same
meaning as provided in section 25-32a of the general statutes and "tier 1
notices" has the same meaning as provided in section 19-13-B102 of the
regulations of Connecticut state agencies.
Sec. 84. (NEW) (Effective October 1, 2021) In the event that the
Governor declares a state of civil preparedness emergency pursuant to
section 28-9 of the general statutes, or a public health emergency,
pursuant to section 19a-131 of the general statutes, each community
water system shall report the community water system's operational
status to WebEOC as soon as practicable, but not later than eight hours
after the time reporting on WebEOC is made available regarding such
declaration, and at any time thereafter that the status of such system
significantly changes. As used in this section, "community water
system" means a public water system that serves at least twenty-five
residents, and "WebEOC" means a web-based emergency management
information system used by the state to document routine and
emergency events or incidents and provide a real-time common
operating picture and resource request management tool for emergency
managers at the local and state levels during exercises, drills, local or
regional emergencies or state-wide emergencies.
Sec. 85. (NEW) (Effective October 1, 2021) (a) As used in this section:
(1) "Consumer" has the same meaning as provided in section 25-32a
of the general statutes;
(2) "Owner" means the person or entity that owns or controls the
small community water system; and
(3) "Small community water system" has the same meaning as Substitute House Bill No. 6666
Public Act No. 21-121 107 of 132
provided in section 19a-37e of the general statutes.
(b) Not later than January 1, 2025, each owner of a small community
water system shall complete a small community water system capacity
implementation plan on a form prescribed by the Department of Public
Health demonstrating that such owner has the managerial, technical
and financial capacity to continue to own and operate such system and
shall implement such plan. Following the completion of the initial small
community water system capacity implementation plan, each small
community water system shall update such small community water
system capacity implementation plan annually and make such small
community water system capacity implementation plan available to the
department upon request. Such plan shall include:
(1) A description of the small community water system, including the
number of consumers and persons served and sources of drinking
water;
(2) Ownership and management information, including the type of
ownership structure and the current names, addresses and telephone
numbers of the owners, certified operators and emergency contact
persons for the small community water system;
(3) Service area maps;
(4) Facilities maps, including the location of and specific information
regarding sources, storage facilities, treatment facilities, pressure zones,
booster pumps, hydrants, distribution lines, valves and sampling
points;
(5) A description of such system's cross-connection control program;
(6) A description of such system's source water protection program;
(7) A copy of such system's emergency response plan required Substitute House Bill No. 6666
Public Act No. 21-121 108 of 132
pursuant to section 19-13-B102 of the regulations of Connecticut state
agencies;
(8) A capital improvement program, including the schedule that
identifies all capital improvements scheduled for a five-year planning
period and capital improvements or major projects scheduled for a
twenty-year planning period;
(9) Water production and consumption information;
(10) Information regarding public water systems that are nearby,
including the distance from the small community water system and type
of public water system, if any. Such information shall be based on the
coordinated water system plan approved by the Commissioner of
Public Health pursuant to section 25-33h of the general statutes for the
water utility coordinating committee in which such small community
water system is located; and
(11) Financial capacity information, including:
(A) An evaluation of the small community water system's fiscal and
assessment management plan prepared pursuant to section 19a-37e of
the general statutes;
(B) A summary of the income and expenses for the five years
preceding the date of submission of the plan;
(C) A five-year balanced operation budget;
(D) Water rate structure and fees charged, including information
regarding how such rates and fees are updated and whether such rates
and fees are sufficient to maintain cash flow stability and to fund the
capital improvement program, as well as any emergency
improvements; and
(E) An evaluation that has considered the affordability of water rates. Substitute House Bill No. 6666
Public Act No. 21-121 109 of 132
(c) On or before July 1, 2025, and annually thereafter, the small
community water system shall provide a summary of its small
community water system capacity plan in the small community water
system's consumer confidence report required by section 19-13-B102 of
the regulations of Connecticut state agencies.
(d) The provisions of this section shall not apply to a small
community water system that is (1) regulated by the Public Utilities
Regulatory Authority, (2) subject to the requirements set forth in section
25-32d of the general statutes, or (3) a state agency.
(e) The provisions of this section shall be deemed to relate to the
purity and adequacy of water supplies for the purposes of the
imposition of a penalty under section 25-32e of the general statutes.
(f) The commissioner may adopt regulations, in accordance with the
provisions of chapter 54 of the general statutes, to carry out the
provisions of this section.
Sec. 86. Section 21a-150b of the general statutes is repealed and the
following is substituted in lieu thereof (Effective October 1, 2021):
(a) Qualified employees of a bottler shall collect samples of water
from each approved source used by such bottler not less than once
annually to test for contaminants for which allowable levels have been
established in accordance with 21 CFR 165.110 and regulations adopted
pursuant to sections 21a-150 to 21a-150j, inclusive, and not less than
once every three years to test for contaminants for which monitoring is
required pursuant to sections 21a-150 to 21a-150j, inclusive, but for
which no allowable level has been established. Qualified employees of
an approved laboratory shall analyze such samples to determine
whether such source complies with the provisions of sections 21a-150 to
21a-150j, inclusive, any regulation adopted pursuant to said sections
and any allowable contaminant level set forth in 21 CFR 165.110. Substitute House Bill No. 6666
Public Act No. 21-121 110 of 132
Microbiological analysis shall be conducted not less than once each
calendar quarter if the source of such water is other than a public water
supply and shall be in addition to any sampling and analysis conducted
by any government agency or laboratory.
(b) Qualified employees of a bottler shall collect samples of water
from any source used by such bottler when such bottler knows or has
reason to believe that water obtained from such source contains an
unregulated contaminant in an amount which may adversely affect the
health or welfare of the public. Qualified employees of an approved
laboratory shall analyze such samples periodically to determine
whether water obtained from any such source is safe for public
consumption or use.
(c) On or before January 1, 2022, and annually thereafter, qualified
employees of a bottler shall (1) collect samples of water from each
approved source that is located in the state, that has been inspected and
approved by the Department of Public Health pursuant to subdivision
(2) of subsection (a) of section 21a-150a and is used by such bottler, prior
to any treatment, to test for perfluoroalkyl substances and other
unregulated contaminants, and (2) have such samples analyzed by an
environmental laboratory registered by the Department of Public
Health pursuant to section 19a-29a that has the Environmental
Protection Agency approved certification to conduct such analysis. As
used in this subsection, "unregulated contaminant" means a
contaminant for which the Commissioner of Public Health, pursuant to
section 22a-471, has set a level at which such contaminant creates or can
reasonably be expected to create an unacceptable risk of injury to the
health or safety of persons drinking such source of water.
Sec. 87. Section 21a-150d of the general statutes is repealed and the
following is substituted in lieu thereof (Effective October 1, 2021):
(a) A laboratory which analyzes any water sample in accordance with Substitute House Bill No. 6666
Public Act No. 21-121 111 of 132
any provision of sections 21a-150 to 21a-150j, inclusive, shall report the
results of such analysis to the bottler of such water.
(b) Such results shall be available for inspection by the Department
of Consumer Protection.
(c) A bottler shall report any result which indicates that a water
sample contains contaminants in an amount exceeding any applicable
standard to the Department of Consumer Protection not later than
twenty-four hours after learning of such result.
(d) A bottler shall report the results of the analysis conducted
pursuant to subsection (c) of section 21a-150b, as amended by this act,
to the Department of Public Health and the Department of Consumer
Protection not later than nine calendar days after receipt of the results
from the environmental laboratory. If such results exceed the level set
by the Commissioner of Public Health pursuant to section 22a-471 for
such perfluoroalkyl substances and other unregulated contaminants,
the Department of Public Health may require such bottler to discontinue
use of its approved source until such source no longer creates an
unacceptable risk of injury to the health or safety of persons drinking
the bottled water that comes from such source. The Department of
Public Health shall notify the Department of Consumer Protection of
any source for which the Department of Public Health has discontinued
use until such source no longer creates an unacceptable risk of injury to
the health or safety of the persons drinking the bottled water that comes
from such source. As used in this subsection, "unregulated
contaminant" means a contaminant for which the Commissioner of
Public Health, pursuant to section 22a-471, has set a level at which such
contaminant creates or can reasonably be expected to create an
unacceptable risk of injury to the health or safety of the persons drinking
such source of water.
[(d)] (e) All records of any sampling or analysis conducted in Substitute House Bill No. 6666
Public Act No. 21-121 112 of 132
accordance with the provisions of sections 21a-150 to 21a-150j, inclusive,
shall be maintained on the premises of the bottler for not less than five
years.
Sec. 88. Section 25-40a of the general statutes is repealed and the
following is substituted in lieu thereof (Effective October 1, 2021):
(a) Not later than twenty-four hours after obtaining a public water
system test result that shows a contaminant at a level that is in violation
of the federal Environmental Protection Agency national primary
drinking water standards for a public water system that does not submit
a water supply plan pursuant to section 25-32d of the general statutes,
the environmental laboratory that performed the test shall notify any
persons who requested such test or such person's designee, in a form
and manner prescribed by the Commissioner of Public Health, of such
test result. Such person shall notify the Department of Public Health in
a form and manner prescribed by the Commissioner of Public Health
not later than twenty-four hours after obtaining such notification. As
used in this subsection, "contaminant" means e. coli, lead, nitrate and
nitrite.
(b) Not later than five business days after receiving notice that a
public water system is in violation of the federal Environmental
Protection Agency national primary drinking water standards, the
Commissioner of Public Health, or the commissioner's designee, shall
give written or electronic notification of such violation to the chief
elected official of the municipality where such public water system is
located and of any municipality that is served by such public water
system.
Sec. 89. (NEW) (Effective October 1, 2021) Each health care institution,
as defined in section 19a-490 of the general statutes, required to obtain
potable water as a temporary measure to alleviate a water supply
shortage shall obtain such potable water from (1) a bulk water hauler, Substitute House Bill No. 6666
Public Act No. 21-121 113 of 132
licensed pursuant to section 20-278h of the general statutes, or (2) a
bottler, as defined in section 21a-150 of the general statutes.
Sec. 90. Section 19a-175 of the general statutes is repealed and the
following is substituted in lieu thereof (Effective from passage):
As used in this chapter and section 19a-906, unless the context
otherwise requires:
(1) "Emergency medical service system" means a system which
provides for (A) the arrangement of personnel, facilities and equipment
for the efficient, effective and coordinated delivery of health care
services under emergency conditions, and (B) mobile integrated health
care;
(2) "Patient" means an injured or ill person or a person with a physical
disability requiring assistance and transportation;
(3) "Ambulance" means a motor vehicle specifically designed to carry
patients;
(4) "Ambulance service" means an organization which transports
patients;
(5) "Emergency medical technician" means a person who is certified
pursuant to chapter 384d;
[(6) "Ambulance driver" means a person whose primary function is
driving an ambulance;]
[(7)] (6) "Emergency medical services instructor" means a person who
is certified pursuant to chapter 384d;
[(8)] (7) "Communications facility" means any facility housing the
personnel and equipment for handling the emergency communications
needs of a particular geographic area; Substitute House Bill No. 6666
Public Act No. 21-121 114 of 132
[(9)] (8) "Life saving equipment" means equipment used by
emergency medical personnel for the stabilization and treatment of
patients;
[(10)] (9) "Emergency medical service organization" means any
corporation or organization whether public, private or voluntary that
(A) is licensed or certified by the Department of Public Health's Office
of Emergency Medical Services, and (B) offers ambulance transportation
or treatment services to patients primarily under emergency conditions
or a mobile integrated health care program;
[(11)] (10) "Invalid coach" means a vehicle used exclusively for the
transportation of nonambulatory patients, who are not confined to
stretchers, to or from either a medical facility or the patient's home in
nonemergency situations or utilized in emergency situations as a
backup vehicle when insufficient emergency vehicles exist;
[(12)] (11) "Rescue service" means any organization, whether for-
profit or nonprofit, whose primary purpose is to search for persons who
have become lost or to render emergency service to persons who are in
dangerous or perilous circumstances;
[(13)] (12) "Commissioner" means the Commissioner of Public
Health;
[(14)] (13) "Paramedic" means a person licensed pursuant to chapter
384d;
[(15)] (14) "Commercial ambulance service" means an ambulance
service which primarily operates for profit;
[(16)] (15) "Licensed ambulance service" means a commercial
ambulance service or a volunteer or municipal ambulance service issued
a license by the commissioner; Substitute House Bill No. 6666
Public Act No. 21-121 115 of 132
[(17)] (16) "Certified ambulance service" means a municipal,
volunteer or nonprofit ambulance service issued a certificate by the
commissioner;
[(18)] (17) "Automatic external defibrillator" means a device that: (A)
Is used to administer an electric shock through the chest wall to the
heart; (B) contains internal decision -making electronics,
microcomputers or special software that allows it to interpret
physiologic signals, make medical diagnosis and, if necessary, apply
therapy; (C) guides the user through the process of using the device by
audible or visual prompts; and (D) does not require the user to employ
any discretion or judgment in its use;
[(19)] (18) "Mutual aid call" means a call for emergency medical
services that, pursuant to the terms of a written agreement, is responded
to by a secondary or alternate emergency medical service organization
if the primary or designated emergency medical service organization is
unable to respond because such primary or designated emergency
medical service organization is responding to another call for
emergency medical services or the ambulance or nontransport
emergency vehicle operated by such primary or designated emergency
medical service organization is out of service. For purposes of this
subdivision, "nontransport emergency vehicle" means a vehicle used by
emergency medical technicians or paramedics in responding to
emergency calls that is not used to carry patients;
[(20)] (19) "Municipality" means the legislative body of a municipality
or the board of selectmen in the case of a municipality in which the
legislative body is a town meeting;
[(21)] (20) "Primary service area" means a specific geographic area to
which one designated emergency medical service organization is
assigned for each category of emergency medical response services; Substitute House Bill No. 6666
Public Act No. 21-121 116 of 132
[(22)] (21) "Primary service area responder" means an emergency
medical service organization who is designated to respond to a victim
of sudden illness or injury in a primary service area;
[(23)] (22) "Interfacility critical care transport" means the interfacility
transport of a patient between licensed health care institutions;
[(24)] (23) "Advanced emergency medical technician" means an
individual who is certified as an advanced emergency medical
technician pursuant to chapter 384d;
[(25)] (24) "Emergency medical responder" means an individual who
is certified pursuant to chapter 384d;
[(26)] (25) "Medical oversight" means the active surveillance by
physicians of the provision of emergency medical services sufficient for
the assessment of overall emergency medical service practice levels, as
defined by state-wide protocols;
[(27)] (26) "Office of Emergency Medical Services" means the office
established within the Department of Public Health pursuant to section
19a-178;
[(28)] (27) "Sponsor hospital" means a hospital that has agreed to
maintain staff for the provision of medical oversight, supervision and
direction to an emergency medical service organization and its
personnel and has been approved for such activity by the Department
of Public Health;
[(29)] (28) "Paramedic intercept service" means paramedic treatment
services provided by an entity that does not provide the ground
ambulance transport;
[(30)] (29) "Authorized emergency medical services vehicle" means an
ambulance, invalid coach or advanced emergency technician-staffed Substitute House Bill No. 6666
Public Act No. 21-121 117 of 132
intercept vehicle or a paramedic-staffed intercept vehicle licensed or
certified by the Department of Public Health for purposes of providing
emergency medical care to patients; [and]
[(31)] (30) "Emergency medical services personnel" means an
individual certified to practice as an emergency medical responder,
emergency medical technician, advanced emergency medical
technician, emergency medical services instructor or an individual
licensed as a paramedic; [.]
[(32)] (31) "Mobile integrated health care program" means a program
approved by the commissioner in which a licensed or certified
ambulance service or paramedic intercept service provides services,
including clinically appropriate medical evaluations, treatment,
transport or referrals to other health care providers under
nonemergency conditions by a paramedic acting within the scope of his
or her practice as part of an emergency medical services organization
within the emergency medical services system; and
[(33)] (32) "Alternate destination" means a destination other than an
emergency department that is a medically appropriate facility.
Sec. 91. Section 19a-562 of the general statutes is repealed and the
following is substituted in lieu thereof (Effective from passage):
(a) As used in this section and section 19a-562a, as amended by this
act, ["Alzheimer's special care unit or program"] "dementia special care
unit or program" means any nursing facility, residential care home,
assisted living facility, adult congregate living facility, adult day care
center, hospice or adult foster home that locks, secures, segregates or
provides a special program or unit for residents with a diagnosis of
probable Alzheimer's disease, dementia or other similar disorder, in
order to prevent or limit access by a resident outside the designated or
separated area, or that advertises or markets the facility as providing Substitute House Bill No. 6666
Public Act No. 21-121 118 of 132
specialized care or services for persons suffering from Alzheimer's
disease or dementia.
(b) On and after January 1, 2007, each [Alzheimer's] dementia special
care unit or program shall provide written disclosure to any person who
will be placed in such a unit or program or to that person's legal
representative or other responsible party. Such disclosure shall be
signed by the patient or responsible party and shall explain what
additional care and treatment or specialized program will be provided
in the [Alzheimer's] dementia special care unit or program that is
distinct from the care and treatment required by applicable licensing
rules and regulations, including, but not limited to:
(1) Philosophy. A written statement of the overall philosophy and
mission of the [Alzheimer's] dementia special care unit or program that
reflects the needs of residents with Alzheimer's disease, dementia or
other similar disorders.
(2) Preadmission, admission and discharge. The process and criteria
for placement within or transfer or discharge from the [Alzheimer's]
dementia special care unit or program.
(3) Assessment, care planning and implementation. The process used
for assessing and establishing and implementing the plan of care,
including the method by which the plan of care is modified in response
to changes in condition.
(4) Staffing patterns and training ratios. The nature and extent of staff
coverage, including staff to patient ratios and staff training and
continuing education.
(5) Physical environment. The physical environment and design
features appropriate to support the functioning of cognitively impaired
adult residents. Substitute House Bill No. 6666
Public Act No. 21-121 119 of 132
(6) Residents' activities. The frequency and types of resident activities
and the ratio of residents to recreation staff.
(7) Family role in care. The involvement of families and family
support programs.
(8) Program costs. The cost of care and any additional fees.
(c) Each [Alzheimer's] dementia special care unit or program shall
develop a standard disclosure form for compliance with subsection (b)
of this section and shall annually review and verify the accuracy of the
information provided by [Alzheimer's] dementia special care units or
programs. Each [Alzheimer's] dementia special care unit or program
shall update any significant change to the information reported
pursuant to subsection (b) of this section not later than thirty days after
such change.
Sec. 92. Section 19a-562a of the general statutes is repealed and the
following is substituted in lieu thereof (Effective from passage):
(a) Each nursing home facility that is not a residential care home or
an [Alzheimer's] dementia special care unit or program shall (1)
annually provide a minimum of two hours of training in pain
recognition and administration of pain management techniques, and (2)
provide a minimum of one hour of training in oral health and oral
hygiene techniques not later than one year after the date of hire and
subsequent training in said techniques annually thereafter, to all
licensed and registered direct care staff and nurse's aides who provide
direct patient care to residents.
(b) Each [Alzheimer's] dementia special care unit or program shall
annually provide Alzheimer's and dementia specific training to all
licensed and registered direct care staff and nurse's aides who provide
direct patient care to residents enrolled in the [Alzheimer's] dementia
special care unit or program. Such requirements shall include, but not Substitute House Bill No. 6666
Public Act No. 21-121 120 of 132
be limited to, (1) not less than eight hours of dementia-specific training,
which shall be completed not later than six months after the date of
employment or, if the date of employment is on or after October 1, 2014,
not later than one hundred twenty days after the date of employment
and not less than eight hours of such training annually thereafter, and
(2) annual training of not less than two hours in pain recognition and
administration of pain management techniques for direct care staff.
(c) Each [Alzheimer's] dementia special care unit or program shall
annually provide a minimum of one hour of Alzheimer's and dementia
specific training to all unlicensed and unregistered staff, except nurse's
aides, who provide services and care to residents enrolled in the
[Alzheimer's] dementia special care unit or program. For such staff
hired on or after October 1, 2007, such training shall be completed not
later than six months after the date of employment and, for such staff
hired on or after October 1, 2014, not later than one hundred twenty
days after the date of employment.
Sec. 93. Section 2 of substitute senate bill 2 of public act 21-46 is
repealed and the following is substituted in lieu thereof (Effective July 1,
2021):
(a) As used in this section:
(1) "Contact hour" means a minimum of fifty minutes of continuing
education and activities; and
(2) "Registration period" means the one-year period for which a
license has been renewed in accordance with section 19a-88 of the
general statutes, as amended by this act, and is current and valid.
(b) [For registration periods beginning on and after January 1, 2022, a
physician assistant licensed pursuant to chapter 370 of the general
statutes applying for license renewal shall, during the first renewal
period and not less than once every six years thereafter, earn not less Substitute House Bill No. 6666
Public Act No. 21-121 121 of 132
than two contact hours of training or education administered by the
American Association of Physician Assistants, a hospital or other
licensed health care institution or a regionally accredited institution of
higher education, on (1) screening for post-traumatic stress disorder,
risk of suicide, depression and grief, and (2) suicide prevention
training.] Each person holding a license as a physician assistant shall,
annually, during the month of such person's birth, register with the
Department of Public Health, upon payment of a fee of one hundred
fifty dollars, on blanks to be furnished by the department for such
purpose, giving such person's name in full, such person's residence and
business address and such other information as the department
requests. No such license shall be renewed unless the department is
satisfied that the practitioner (1) has met the mandatory continuing
medical education requirements of the National Commission on
Certification of Physician Assistants or a successor organization for the
certification or recertification of physician assistants that may be
approved by the department; (2) has passed any examination or
continued competency assessment the passage of which may be
required by said commission for maintenance of current certification by
said commission; (3) has completed not less than one contact hour of
training or education in prescribing controlled substances and pain
management in the preceding two-year period; and (4) for registration
periods beginning on or before January 1, 2022, during the first renewal
period and not less than once every six years thereafter, earn not less
than two contact hours of training or education screening for post-
traumatic stress disorder, risk of suicide, depression and grief and
suicide prevention training administered by the American Association
of Physician Assistants, a hospital or other licensed health care
institution or a regionally accredited institution of higher education.
(c) Each physician assistant applying for license renewal pursuant to
section 19a-88 of the general statutes, as amended by this act, shall sign
a statement attesting that he or she has satisfied the continuing Substitute House Bill No. 6666
Public Act No. 21-121 122 of 132
education requirements of subsection (b) of this section on a form
prescribed by the Department of Health. Each licensee shall retain
records of attendance or certificates of completion that demonstrate
compliance with the continuing education requirements of subsection
(b) of this section for a minimum of three years following the year in
which the continuing education was completed and shall submit such
records or certificates to the department for inspection not later than
forty-five days after a request by the department for such records or
certificates.
Sec. 94. Subsection (c) of section 19a-88 of the general statutes is
repealed and the following is substituted in lieu thereof (Effective July 1,
2021):
(c) (1) Each person holding a license to practice as a registered nurse,
shall, annually, during the month of such person's birth, register with
the Department of Public Health, upon payment of one hundred ten
dollars, on blanks to be furnished by the department for such purpose,
giving such person's name in full, such person's residence and business
address and such other information as the department requests. Each
person holding a license to practice as a registered nurse who has retired
from the profession may renew such license, but the fee shall be ten per
cent of the professional services fee for class B, as defined in section 33-
182l, plus five dollars. Any license provided by the department at a
reduced fee shall indicate that the registered nurse is retired.
(2) Each person holding a license as an advanced practice registered
nurse shall, annually, during the month of such person's birth, register
with the Department of Public Health, upon payment of one hundred
thirty dollars, on blanks to be furnished by the department for such
purpose, giving such person's name in full, such person's residence and
business address and such other information as the department
requests. No such license shall be renewed unless the department is
satisfied that the person maintains current certification as either a nurse Substitute House Bill No. 6666
Public Act No. 21-121 123 of 132
practitioner, a clinical nurse specialist or a nurse anesthetist from one of
the following national certifying bodies which certify nurses in
advanced practice: The American Nurses' Association, the Nurses'
Association of the American College of Obstetricians and Gynecologists
Certification Corporation, the National Board of Pediatric Nurse
Practitioners and Associates or the American Association of Nurse
Anesthetists. Each person holding a license to practice as an advanced
practice registered nurse who has retired from the profession may
renew such license, but the fee shall be ten per cent of the professional
services fee for class C, as defined in section 33-182l, plus five dollars.
Any license provided by the department at a reduced fee shall indicate
that the advanced practice registered nurse is retired.
(3) Each person holding a license as a licensed practical nurse shall,
annually, during the month of such person's birth, register with the
Department of Public Health, upon payment of seventy dollars, on
blanks to be furnished by the department for such purpose, giving such
person's name in full, such person's residence and business address and
such other information as the department requests. Each person holding
a license to practice as a licensed practical nurse who has retired from
the profession may renew such license, but the fee shall be ten per cent
of the professional services fee for class A, as defined in section 33-182l,
plus five dollars. Any license provided by the department at a reduced
fee shall indicate that the licensed practical nurse is retired.
(4) Each person holding a license as a nurse-midwife shall, annually,
during the month of such person's birth, register with the Department
of Public Health, upon payment of one hundred thirty dollars, on blanks
to be furnished by the department for such purpose, giving such
person's name in full, such person's residence and business address and
such other information as the department requests. No such license shall
be renewed unless the department is satisfied that the person maintains
current certification from the Accreditation Midwifery Certification Substitute House Bill No. 6666
Public Act No. 21-121 124 of 132
Board.
(5) (A) Each person holding a license to practice physical therapy
shall, annually, during the month of such person's birth, register with
the Department of Public Health, upon payment of the professional
services fee for class B, as defined in section 33-182l, plus five dollars, on
blanks to be furnished by the department for such purpose, giving such
person's name in full, such person's residence and business address and
such other information as the department requests.
(B) Each person holding a physical therapist assistant license shall,
annually, during the month of such person's birth, register with the
Department of Public Health, upon payment of the professional services
fee for class A, as defined in section 33-182l, plus five dollars, on blanks
to be furnished by the department for such purpose, giving such
person's name in full, such person's residence and business address and
such other information as the department requests.
[(6) Each person holding a license as a physician assistant shall,
annually, during the month of such person's birth, register with the
Department of Public Health, upon payment of a fee of one hundred
fifty-five dollars, on blanks to be furnished by the department for such
purpose, giving such person's name in full, such person's residence and
business address and such other information as the department
requests. No such license shall be renewed unless the department is
satisfied that the practitioner (A) has met the mandatory continuing
medical education requirements of the National Commission on
Certification of Physician Assistants or a successor organization for the
certification or recertification of physician assistants that may be
approved by the department, (B) has passed any examination or
continued competency assessment the passage of which may be
required by said commission for maintenance of current certification by
said commission, and (C) has completed not less than one contact hour
of training or education in prescribing controlled substances and pain Substitute House Bill No. 6666
Public Act No. 21-121 125 of 132
management in the preceding two-year period.]
Sec. 95. Section 20-206mm of the general statutes, as amended by
section 9 of substitute senate bill 2 of public act 21-46, is repealed and
the following is substituted in lieu thereof (Effective July 1, 2021):
(a) Except as provided in subsections (b) and (c) of this section, an
applicant for a license as a paramedic shall submit evidence satisfactory
to the Commissioner of Public Health that the applicant has successfully
(1) completed a paramedic training program approved by the
commissioner, (2) for applicants applying on and after January 1, 2020,
completed mental health first aid training as part of a program provided
by an instructor certified by the National Council for Behavioral Health,
and (3) passed an examination prescribed by the commissioner.
(b) An applicant for licensure by endorsement shall present evidence
satisfactory to the commissioner that the applicant (1) is licensed or
certified as a paramedic in another state or jurisdiction whose
requirements for practicing in such capacity are substantially similar to
or higher than those of this state and that the applicant has no pending
disciplinary action or unresolved complaint against him or her, or (2)
(A) is currently licensed or certified as a paramedic in good standing in
any New England state, New York or New Jersey, (B) has completed an
initial training program consistent with the National Emergency
Medical Services Education Standards, as promulgated by the National
Highway Traffic Safety Administration for the paramedic scope of
practice model conducted by an organization offering a program that is
recognized by the national emergency medical services program
accrediting organization, (C) for applicants applying on or after January
1, 2020, has completed mental health first aid training as part of a
program provided by an instructor certified by the National Council for
Behavioral Health, and (D) has no pending disciplinary action or
unresolved complaint against him or her. Substitute House Bill No. 6666
Public Act No. 21-121 126 of 132
(c) Any person who is certified as an emergency medical technician-
paramedic by the Department of Public Health on October 1, 1997, shall
be deemed a licensed paramedic. Any person so deemed shall renew his
license pursuant to section 19a-88, as amended by this act, for a fee of
one hundred fifty-five dollars.
(d) On or after January 1, 2020, each person seeking certification as an
emergency medical responder, emergency medical technician or
advanced emergency medical technician shall apply to the department
on forms prescribed by the commissioner. Applicants for certification
shall comply with the following requirements: (1) For initial
certification, an applicant shall present evidence satisfactory to the
commissioner that the applicant (A) has completed an initial training
program consistent with the National Emergency Medical Services
Education Standards, as promulgated by the National Highway Traffic
Safety Administration for the emergency medical responder, emergency
medical technician or advanced emergency medical technician
curriculum, (B) has passed the examination administered by the
national organization for emergency medical certification for an
emergency medical responder, emergency medical technician or
advanced emergency medical technician as necessary for the type of
certification sought by the applicant or an examination approved by the
department, and (C) has no pending disciplinary action or unresolved
complaints against such applicant, (2) a certificate issued under this
subsection shall be renewed once every two years in accordance with
the provisions of section 19a-88, as amended by this act, upon
presentation of evidence satisfactory to the commissioner that the
applicant (A) has successfully completed continuing education for an
emergency medical responder, emergency medical technician or
advanced emergency medical technician as required by the national
organization for emergency medical certification or as approved by the
department, or (B) presents a current certification as an emergency
medical responder, emergency medical technician or advanced Substitute House Bill No. 6666
Public Act No. 21-121 127 of 132
emergency medical technician from the national organization for
emergency medical certification, or (3) for certification by endorsement
from another state, an applicant shall present evidence satisfactory to
the commissioner that the applicant (A) is currently certified as an
emergency medical responder, emergency medical technician or
advanced emergency medical technician in good standing by a state that
maintains certification or licensing requirements that the commissioner
determines are equal to or greater than those in this state, or (B) holds a
current certification as an emergency medical responder, emergency
medical technician or advanced emergency medical technician from the
national organization for emergency medical certification.
(e) On or after January 1, 2022, each person seeking renewal of a
certification as an emergency medical responder, [or] emergency
medical technician or advanced emergency medical technician under
subdivision (2) of subsection (d) of this section, shall present evidence
satisfactory to the commissioner that such person has, in the previous
six year period, completed (1) the evidence-based youth suicide
prevention training program administered pursuant to section 1 of
substitute senate bill 2 of public act 21-46, or (2) not less than two hours
of training or education, approved by the Commissioner of Public
Health, on (A) screening for post-traumatic stress disorder, risk of
suicide, depression and grief, and (B) suicide prevention.
(f) On or after January 1, 2020, each person seeking certification as an
emergency medical services instructor shall apply to the department on
forms prescribed by the commissioner. Applicants for certification shall
comply with the following requirements: (1) For initial certification, an
applicant shall present evidence satisfactory to the commissioner that
the applicant (A) is currently certified by the department as an
emergency medical technician or advanced emergency medical
technician or licensed by the department as a paramedic, (B) has
completed a program of training as an emergency medical instructor Substitute House Bill No. 6666
Public Act No. 21-121 128 of 132
based on current national education standards within the prior two
years, (C) has completed twenty-five hours of teaching activity under
the supervision of a currently certified emergency medical services
instructor, (D) has completed written and practical examinations as
prescribed by the commissioner, (E) has no pending disciplinary action
or unresolved complaints against the applicant, and (F) effective on a
date prescribed by the commissioner, presents documentation
satisfactory to the commissioner that the applicant is currently certified
as an emergency medical technician, advanced emergency medical
technician or paramedic by the national organization for emergency
medical certification, or (2) for renewal certification, an applicant shall
present evidence satisfactory to the commissioner that the applicant (A)
has successfully completed continuing education and teaching activity
as required by the department, [which, on and after January 1, 2022,
shall include not less than two hours of training or education, approved
by the Commissioner of Public Health, on (i) screening for post-
traumatic stress disorder, risk of suicide, depression and grief, and (ii)
suicide prevention training, during the first renewal period and not less
than once every six years thereafter,] (B) maintains current certification
by the department as an emergency medical technician, advanced
emergency medical technician or licensure by the department as a
paramedic, and (C) effective on a date as prescribed by the
commissioner, presents documentation satisfactory to the
commissioner that the applicant is currently certified as an emergency
medical technician, advanced emergency medical technician or
paramedic by the national organization for emergency medical
certification.
(g) A certified emergency medical responder, emergency medical
technician, advanced emergency medical technician or emergency
medical services instructor shall document the completion of his or her
continuing educational requirements [through the continuing education
platform Internet web site] in a form and manner prescribed by the Substitute House Bill No. 6666
Public Act No. 21-121 129 of 132
commissioner. A certified emergency medical responder, emergency
medical technician, advanced emergency medical technician or
emergency medical services instructor who is not engaged in active
professional practice in any form during a certification period shall be
exempt from the continuing education requirements of this section,
provided the emergency medical responder, emergency m edical
technician, advanced emergency medical technician or emergency
medical services instructor submits to the department, prior to the
expiration of the certification period, an application for inactive status
on a form prescribed by the department and such other documentation
as may be required by the department. The application for inactive
status pursuant to this subsection shall contain a statement that the
emergency medical responder, emergency medical technician,
advanced emergency medical technician or emergency medical services
instructor may not engage in professional practice until the continuing
education requirements of this section have been met.
(h) The commissioner may issue a temporary emergency medical
technician certificate to an applicant who presents evidence satisfactory
to the commissioner that (1) the applicant was certified by the
department as an emergency medical technician prior to becoming
licensed as a paramedic pursuant to section 20-206ll, or (2) the
applicant's certification as an emergency medical technician has expired
and the applicant's license as a paramedic has become void pursuant to
section 19a-88, as amended by this act. Such temporary certificate shall
be valid for a period not to exceed one year and shall not be renewable.
(i) An applicant who is issued a temporary emergency medical
technician certificate pursuant to subsection (h) of this section may,
prior to the expiration of such temporary certificate, apply to the
department for: (1) Renewal of such person's paramedic license, giving
such person's name in full, such person's residence and business address
and such other information as the department requests, provided the Substitute House Bill No. 6666
Public Act No. 21-121 130 of 132
application for license renewal is accompanied by evidence satisfactory
to the commissioner that the applicant was under the medical oversight
of a sponsor hospital, as those terms are defined in section 19a-175, as
amended by this act, on the date the applicant's paramedic license
became void for nonrenewal; or (2) recertification as an emergency
medical technician, provided the application for recertification is
accompanied by evidence satisfactory to the commissioner that the
applicant completed emergency medical technician refresher training
approved by the commissioner not later than one year after issuance of
the temporary emergency medical technician certificate. The
department shall recertify such person as an emergency medical
technician without the examination required for initial certification
specified in regulations adopted by the commissioner pursuant to
section 20-206oo.
(j) Any person certified as an emergency medical responder,
emergency medical technician, advanced emergency medical technician
or emergency medical services instructor pursuant to this chapter and
the regulations adopted pursuant to section 20-206oo whose
certification has expired may apply to the Department of Public Health
for reinstatement of such certification, provided such person completes
the requirements for renewal certification specified in this section. Any
certificate issued pursuant to this section shall remain valid for ninety
days after the expiration date of such certificate and become void upon
the expiration of such ninety-day period.
(k) The Commissioner of Public Health shall issue an emergency
medical technician certification to an applicant who is a member of the
armed forces or the National Guard or a veteran and who (1) presents
evidence satisfactory to the commissioner that such applicant holds a
current certification as a person entitled to perform similar services
under a different designation by the National Registry of Emergency
Medical Technicians, or (2) satisfies the regulations promulgated Substitute House Bill No. 6666
Public Act No. 21-121 131 of 132
pursuant to subdivision (3) of subsection (a) of section 19a-179. Such
applicant shall be exempt from any written or practical examination
requirement for certification.
(l) For the purposes of this section, "veteran" means any person who
was discharged or released under conditions other than dishonorable
from active service in the armed forces and "armed forces" has the same
meaning as provided in section 27-103.
Sec. 96. Subdivision (2) of subsection (e) of section 14-100a of the
general statutes is repealed and the following is substituted in lieu
thereof (Effective from passage):
(2) The following motor vehicles registered in this state for the first
time on or after October 1, 2007, that transport individuals who remain
in wheelchairs while being transported, shall, in addition to the
requirements of subdivision (1) of this subsection, install or provide and
require the use of a device that secures the wheelchair to the motor
vehicle's mechanical lift or otherwise prevents or seeks to prevent an
individual in a wheelchair from falling from such mechanical lift or
motor vehicle: (A) Motor vehicles in livery service, as defined in section
13b-101, (B) service buses, as defined in section 14-1, (C) invalid coaches,
as defined in [subdivision (11) of] section 19a-175, as amended by this
act, (D) vanpool vehicles, as defined in section 14-1, (E) school buses, as
defined in section 14-1, (F) motor buses, as defined in section 14-1, (G)
student transportation vehicles, as defined in section 14-212, and (H)
camp vehicles, as defined in section 14-1. The provisions of this
subsection shall also apply to all motor vehicles used by municipal,
volunteer and commercial ambulance services and rescue services, as
defined in section 19a-175, as amended by this act.
Sec. 97. Subdivision (14) of subsection (b) of section 20-9 of the general
statutes is repealed and the following is substituted in lieu thereof
(Effective from passage): Substitute House Bill No. 6666
Public Act No. 21-121 132 of 132
(14) Any person rendering service as a physician assistant licensed
pursuant to section 20-12b, a registered nurse, a licensed practical nurse
or a paramedic, as defined in [subdivision (14) of] section 19a-175, as
amended by this act, acting within the scope of regulations adopted
pursuant to section 19a-179, if such service is rendered under the
supervision, control and responsibility of a licensed physician;
Sec. 98. Section 20-195ff of the general statutes is repealed and the
following is substituted in lieu thereof (Effective from passage):
The Commissioner of Public Health may adopt regulations, in
accordance with the provisions of chapter 54, to further the purposes of
subdivision (18) of subsection (c) of section 19a-14, subsection (e) of
section 19a-88, subdivision [(14)] (13) of section 19a-175, as amended by
this act, subsection (b) of section 20-9, as amended by this act, sections
20-195aa to 20-195ee, inclusive, and section 20-195gg.
Sec. 99. Section 20-226 of the general statutes is repealed. (Effective
from passage)