LCO \\PRDFS1\SCOUSERS\FORZANOF\WS\2021SB-00922-R01- SB.docx 1 of 5 General Assembly Substitute Bill No. 922 January Session, 2021 AN ACT CONCERNING RE VISIONS TO THE STATUTES PERTAINING TO DISCHARGES IN A RESIDENTIAL CARE HOME . Be it enacted by the Senate and House of Representatives in General Assembly convened: Section 1. Section 19a-535a of the general statutes is repealed and the 1 following is substituted in lieu thereof (Effective October 1, 2021): 2 (a) As used in this section: [, a "facility"] 3 (1) "Facility" means a residential care home, as defined in section 19a-4 490; 5 (2) "Emergency" means a situation in which a resident of a facility 6 presents an imminent danger to his or her own health or safety, the 7 health or safety of another resident or the health or safety of an 8 employee or the owner of the facility; 9 (3) "Department" means the Department of Public Health; and 10 (4) "Commissioner" means the Commissioner of Public Health, or the 11 commissioner's designee. 12 (b) A facility shall not transfer or discharge a resident from the facility 13 unless (1) the transfer or discharge is necessary to meet the resident's 14 welfare and the resident's welfare cannot be met in the facility, (2) the 15 transfer or discharge is appropriate because the resident's health has 16 Substitute Bill No. 922 LCO {\\PRDFS1\SCOUSERS\FORZANOF\WS\2021SB-00922- R01-SB.docx } 2 of 5 improved sufficiently so the resident no longer needs the services 17 provided by the facility, (3) the health or safety of individuals in the 18 facility is endangered, (4) the resident has failed, after reasonable and 19 appropriate notice, to pay for a stay or a requested service [,] at the 20 facility, or (5) the facility ceases to operate. In the case of an involuntary 21 transfer or discharge, the facility shall provide written notice to the 22 resident and, if known, [his] the resident's legally liable relative, 23 guardian or conservator [shall be given a thirty-day written notification 24 which includes] not less than thirty days prior to the proposed transfer 25 or discharge date, except when the facility has requested an immediate 26 transfer or discharge in accordance with subsection (e) of this section. 27 Such notice shall include the reason for the transfer or discharge, [and 28 notice of] the effective date of the transfer or discharge, the right of the 29 resident to appeal a transfer or discharge by the facility pursuant to 30 subsection (d) of this section and the resident's right to represent himself 31 or herself or be represented by legal counsel. Such notice shall be in a 32 form and manner prescribed by the commissioner, as modified from 33 time to time, and shall include the name, mailing address and telephone 34 number of the State Long-Term Care Ombudsman and be sent by 35 facsimile or electronic communication to the Office of the Long-Term 36 Care Ombudsman on the same day as the notice is given to the resident. 37 If the facility knows the resident has, or the facility alleges that the 38 resident has, a mental illness or an intellectual disability, the notice shall 39 also include the name, mailing address and telephone number of the 40 entity designated by the Governor in accordance with section 46a-10b to 41 serve as the Connecticut protection and advocacy system. No resident 42 shall be involuntarily transferred or discharged from a facility if such 43 transfer or discharge presents imminent danger of death to the resident. 44 (c) The facility shall be responsible for assisting the resident in finding 45 [appropriate placement] an alternative residence. A discharge plan, 46 prepared by the facility, [which indicates] in a form and manner 47 prescribed by the commissioner, as modified from time to time, shall 48 include the resident's individual needs and shall [accompany the 49 patient] be submitted to the resident not later than seven days after the 50 Substitute Bill No. 922 LCO {\\PRDFS1\SCOUSERS\FORZANOF\WS\2021SB-00922- R01-SB.docx } 3 of 5 notice of transfer or discharge is issued to the resident. The facility shall 51 submit the discharge plan to the commissioner at or before the hearing 52 held pursuant to subsection (d) of this section. 53 (d) (1) [For transfers or discharges effected on or after October 1, 1989, 54 a] A resident or [his] the resident's legally liable relative, guardian or 55 conservator who has been notified by a facility, pursuant to subsection 56 (b) of this section, that [he] the resident will be transferred or discharged 57 from the facility may appeal such transfer or discharge to the 58 Commissioner of Public Health by filing a request for a hearing with the 59 commissioner [within] not later than ten days [of] after the receipt of 60 such notice. Upon receipt of any such request, the commissioner [or his 61 designee] shall hold a hearing to determine whether the transfer or 62 discharge is being effected in accordance with this section. Such a 63 hearing shall be held [within] not later than seven business days [of] 64 after the receipt of such request. [and a determination made by the] The 65 commissioner [or his designee within] shall issue a decision not later 66 than twenty days [of the termination of] after the closing of the hearing 67 record. The hearing shall be conducted in accordance with chapter 54. 68 [(2) In an emergency the facility may request that the commissioner 69 make a determination as to the need for an immediate transfer or 70 discharge of a resident. Before making such a determination, the 71 commissioner shall notify the resident and, if known, his legally liable 72 relative, guardian or conservator. The commissioner shall issue such a 73 determination no later than seven days after receipt of the request for 74 such determination. If, as a result of such a request, the commissioner or 75 his designee determines that a failure to effect an immediate transfer or 76 discharge would endanger the health, safety or welfare of the resident 77 or other residents, the commissioner or his designee shall order the 78 immediate transfer or discharge of the resident from the facility. A 79 hearing shall be held in accordance with the requirements of 80 subdivision (1) of this subsection within seven business days of the 81 issuance of any determination issued pursuant to this subdivision. 82 (3) Any involuntary transfer or discharge shall be stayed pending a 83 Substitute Bill No. 922 LCO {\\PRDFS1\SCOUSERS\FORZANOF\WS\2021SB-00922- R01-SB.docx } 4 of 5 determination by the commissioner or his designee. Notwithstanding 84 any provision of the general statutes, the determination of the 85 commissioner or his designee after a hearing shall be final and binding 86 upon all parties and not subject to any further appeal.] 87 (2) Any involuntary transfer or discharge that is appealed under this 88 subsection shall be stayed pending a final determination by the 89 commissioner. 90 (3) The commissioner shall send a copy of his or her decision 91 regarding a transfer or discharge to the facility, the resident and the 92 resident's legal guardian, conservator or other authorized 93 representative, if known, or the resident's legally liable relative or other 94 responsible party, and the State Long-Term Care Ombudsman. 95 (e) (1) In the case of an emergency, the facility may request that the 96 commissioner make a determination as to the need for an immediate 97 transfer or discharge of a resident by submitting a sworn affidavit 98 attesting to the basis for the emergency transfer or discharge. The facility 99 shall provide a copy of the request for an immediate transfer or 100 discharge to the resident and the notice described in subsection (b) of 101 this section. After receipt of such request, the commissioner may issue 102 an order for the immediate temporary transfer or discharge of the 103 resident from the facility. The temporary order shall remain in place 104 until a final decision is issued by the commissioner, unless earlier 105 rescinded. The commissioner shall issue the determination as to the 106 need for an immediate transfer or discharge of a resident not later than 107 seven days after receipt of the request from the facility. A hearing shall 108 be held not later than seven business days after the determination issued 109 pursuant to this section. The commissioner shall issue a decision not 110 later than twenty days after the closing of the hearing record. The 111 hearing shall be conducted in accordance with the provisions of chapter 112 54. 113 (2) The commissioner shall send a copy of his or her decision 114 regarding an emergency transfer or discharge to the facility, the resident 115 Substitute Bill No. 922 LCO {\\PRDFS1\SCOUSERS\FORZANOF\WS\2021SB-00922- R01-SB.docx } 5 of 5 and the resident's legal guardian, conservator or other authorized 116 representative, if known, or the resident's legally liable relative or other 117 responsible party and the State Long-Term Care Ombudsman. 118 (3) If the commissioner determines, based upon the request, that an 119 emergency does not exist, the commissioner shall proceed with a 120 hearing in accordance with the provisions of subsection (d) of this 121 section. 122 (f) A facility or resident who is aggrieved by a final decision of the 123 commissioner may appeal to the Superior Court in accordance with the 124 provisions of chapter 54. Pursuant to subsection (f) of section 4-183, the 125 filing of an appeal to the Superior Court shall not, of itself, stay 126 enforcement of an agency decision. The Superior Court shall consider 127 an appeal from a decision of the commissioner pursuant to this section 128 as a privileged case in order to dispose of the case with the least possible 129 delay. 130 This act shall take effect as follows and shall amend the following sections: Section 1 October 1, 2021 19a-535a Statement of Legislative Commissioners: In Sections 1(b) and 1(c), references to "discharge" were changed to "transfer or discharge" for consistency. PH Joint Favorable Subst. -LCO