Substitute House Bill No. 5278
Public Act No. 22-33
AN ACT REQUIRING EXPRESS WRITTEN CONSENT TO THE
INTIMATE EXAMINATION OF A PATIENT WHO IS UNDER DEEP
SEDATION OR ANESTHESIA OR UNCONSCIOUS.
Be it enacted by the Senate and House of Representatives in General
Assembly convened:
Section 1. Section 19a-490m of the general statutes is repealed and the
following is substituted in lieu thereof (Effective from passage):
(a) Each hospital and outpatient surgical facility shall develop
protocols for accurate identification procedures that shall be used by
such hospital or outpatient surgical facility prior to surgery. Such
protocols shall include, but need not be limited to, (1) procedures to be
followed to identify the (A) patient, (B) surgical procedure to be
performed, and (C) body part on which the surgical procedure is to be
performed, and (2) alternative identification procedures in urgent or
emergency circumstances or where the patient is nonspeaking,
comatose or incompetent or is a child. After January 1, 2006, no hospital
or outpatient surgical facility may anesthetize a patient or perform
surgery unless the protocols have been followed. Each hospital and
outpatient surgical facility shall make a copy of the protocols available
to the Commissioner of Public Health upon request.
(b) Not later than October 1, 2006, the Department of Public Health Substitute House Bill No. 5278
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shall report, in accordance with section 11-4a, to the joint standing
committee of the General Assembly having cognizance of matters
relating to public health describing the protocols developed pursuant to
subsection (a) of this section.
(c) Not later than January 1, 2023, each hospital and outpatient
surgical facility shall develop and implement procedures for securing
on a written or electronic form a patient's express written consent to an
intimate examination. A health care provider at each hospital and
outpatient surgical facility shall obtain such consent in advance of
performing an intimate examination on a patient who will be under
deep sedation or general anesthesia, or is rendered unconscious, unless
the intimate examination is within the scope of a planned procedure,
diagnostic examination or surgical procedure for which the patient has
provided general consent. If a student in a medical school participating
in a course of instruction or person participating in a residency program
or clinical training program performs an intimate examination on a
patient exclusively for training purposes, and not (1) as part of the
patient's clinical care, or (2) when such student or person is part of the
patient's clinical care team, the hospital or outpatient surgical facility
shall obtain a separate written consent from the patient detailing such
student's or person's involvement in the intimate examination. Express
written patient consent shall not be required under this subsection for
intimate examinations performed in an emergency or urgent care
situation for diagnostic or treatment purposes. Each hospital and
outpatient surgical facility shall make a copy of the procedures and
consent forms developed under this subsection available to the
Commissioner of Public Health upon request. As used in this
subsection, (A) "health care provider" means a physician licensed
pursuant to chapter 370, a student in a medical school participating in a
course of instruction, a person participating in a residency program or
clinical training program, a physician assistant licensed pursuant to
chapter 370 or an advanced practice registered nurse licensed pursuant Substitute House Bill No. 5278
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to chapter 378, and (B) "intimate examination" means a pelvic, prostate
or rectal examination.
Sec. 2. Subsection (b) of section 20-10b of the general statutes is
repealed and the following is substituted in lieu thereof (Effective October
1, 2022):
(b) Except as otherwise provided in subsections (d), (e) and (f) of this
section, a licensee applying for license renewal shall earn a minimum of
fifty contact hours of continuing medical education within the
preceding twenty-four-month period. Such continuing medical
education shall (1) be in an area of the physician's practice; (2) reflect the
professional needs of the licensee in order to meet the health care needs
of the public; and (3) during the first renewal period in which continuing
medical education is required and not less than once every six years
thereafter, include at least one contact hour of training or education in
each of the following topics: (A) Infectious diseases, including, but not
limited to, acquired immune deficiency syndrome and human
immunodeficiency virus, (B) risk management, including, but not
limited to, prescribing controlled substances and pain management, and
[, for registration periods beginning on or after October 1, 2019, such risk
management continuing medical education may also include] screening
for inflammatory breast cancer and gastrointestinal cancers, including
colon, gastric, pancreatic and neuroendocrine cancers and other rare
gastrointestinal tumors, and, for registration periods beginning on or
after October 1, 2022, such risk management continuing medical
education may also include screening for endometriosis, (C) sexual
assault, (D) domestic violence, (E) cultural competency, including, but
not limited to, the effects of systemic racism, explicit and implicit bias,
racial disparities, and the experiences of transgender and gender diverse
persons on patient diagnosis, care and treatment, and (F) behavioral
health, provided further that [on and after January 1, 2016,] such
behavioral health continuing medical education may include, but not be Substitute House Bill No. 5278
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limited to, at least 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 diagnosing and treating (i)
cognitive conditions, including, but not limited to, Alzheimer's disease,
dementia, delirium, related cognitive impairments and geriatric
depression, or (ii) mental health conditions, including, but not limited
to, mental health conditions common to veterans and family members
of veterans. Training for mental health conditions common to veterans
and family members of veterans shall include best practices for (I)
determining whether a patient is a veteran or family member of a
veteran, (II) screening for conditions such as post-traumatic stress
disorder, risk of suicide, depression and grief, and (III) suicide
prevention training. For purposes of this section, qualifying continuing
medical education activities include, but are not limited to, courses
offered or approved by the American Medical Association, American
Osteopathic Association, Connecticut Hospital Association,
Connecticut State Medical Society, Connecticut Osteopathic Medical
Society, county medical societies or equivalent organizations in another
jurisdiction, educational offerings sponsored by a hospital or other
health care institution or courses offered by a regionally accredited
academic institution or a state or local health department. The
commissioner, or the commissioner's designee, may grant a waiver for
not more than ten contact hours of continuing medical education for a
physician who: (I) Engages in activities related to the physician's service
as a member of the Connecticut Medical Examining Board, established
pursuant to section 20-8a; (II) engages in activities related to the
physician's service as a member of a medical hearing panel, pursuant to
section 20-8a; or (III) assists the department with its duties to boards and
commissions as described in section 19a-14.
Sec. 3. (Effective July 1, 2022) (a) As used in this section:
(1) "Biorepository" means a facility that collects, catalogs and stores Substitute House Bill No. 5278
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samples of biological material, including, but not limited to, urine,
blood, tissue, cells, DNA, RNA and protein, from humans for laboratory
research; and
(2) "Phenotypic data" means clinical information regarding a person's
disease symptoms and relevant demographic data regarding the
person, including, but not limited to, the person's age, sex, race and
ethnicity.
(b) The University of Connecticut Health Center, in consultation with
a research laboratory, shall develop a plan to establish an endometriosis
data and biorepository program in the state to promote (1) early
detection of endometriosis in adolescents and adults, (2) new
therapeutic strategies for treatment and better overall management of
endometriosis, and (3) early access to the latest therapeutic options for
persons diagnosed with endometriosis.
(c) In developing the plan pursuant to subsection (b) of this section,
The University of Connecticut Health Center shall require the
endometriosis data and biorepository program to have the following
functions:
(1) Collecting standardized phenotypic data along with the collection
of biological samples of a person's endometriosis and control samples to
improve the characterization of endometriosis and of the person with
endometriosis;
(2) Developing standard operating procedures for retention and
storage of biological samples of endometriosis and control samples,
including, but not limited to, collection, transportation, processing and
long-term storage of such samples;
(3) Curating biological samples of endometriosis from a diverse
cross-section of communities to ensure representation of all groups
affected by endometriosis, including, but not limited to, black persons, Substitute House Bill No. 5278
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Latino persons, other persons of color, transgender and gender diverse
persons and persons with disabilities;
(4) Researching the pathogenesis, pathophysiology, progression and
prognosis of endometriosis and the development of noninvasive
diagnostic biomarkers, novel targeted therapeutics, curative therapies
and preventive interventions with regard to endometriosis, including
medical and surgical interventions;
(5) Serving as a centralized resource for endometriosis information;
(6) Facilitating collaboration among researchers and health care
professionals, educators and students regarding best practices for the
diagnosis, care and treatment of endometriosis; and
(7) Researching the impact of endometriosis on residents of the state,
including, but not limited to, its impact on health and comorbidity,
health care costs and overall quality of life.
(d) Not later than January 1, 2023, the chairman of the board of
directors of The University of Connecticut Health Center shall report, in
accordance with the provisions of section 11-4a of the general statutes,
regarding the plan developed pursuant to subsections (b) and (c) of this
section and the anticipated timeline for establishing the endometriosis
data and biorepository program to the joint standing committee of the
General Assembly having cognizance of matters relating to public
health.
Sec. 4. Section 19a-266 of the general statutes is repealed and the
following is substituted in lieu thereof (Effective October 1, 2022):
(a) For purposes of this section:
(1) "Breast cancer screening and referral services" means necessary
breast cancer screening services and referral services for a procedure Substitute House Bill No. 5278
Public Act No. 22-33 7 of 9
intended to treat cancer of the human breast, including, but not limited
to, surgery, radiation therapy, chemotherapy, hormonal therapy and
related medical follow-up services.
(2) "Cervical cancer screening and referral services" means necessary
cervical cancer screening services and referral services for a procedure
intended to treat cancer of the human cervix, including, but not limited
to, surgery, radiation therapy, cryotherapy, electrocoagulation and
related medical follow-up services.
(3) "Tomosynthesis" means a digital x-ray mammogram that creates
two-dimensional and three-dimensional images of the breasts.
[(3)] (4) "Unserved or underserved populations" means women who
are: (A) At or below two hundred fifty per cent of the federal poverty
level for individuals; (B) without health insurance that covers breast
cancer screening mammography or cervical cancer screening services;
and (C) twenty-one to sixty-four years of age.
(b) There is established, within existing appropriations, a breast and
cervical cancer early detection and treatment referral program, within
the Department of Public Health, to (1) promote screening, detection
and treatment of breast cancer and cervical cancer among unserved or
underserved populations, while giving priority consideration to women
in minority communities who exhibit higher rates of breast cancer and
cervical cancer than the general population, (2) educate the public
regarding breast cancer and cervical cancer and the benefits of early
detection, and (3) provide counseling and referral services for treatment.
(c) The program shall include, but not be limited to:
(1) Establishment of a public education and outreach initiative to
publicize breast cancer and cervical cancer early detection services and
the extent of coverage for such services by health insurance; the benefits
of early detection of breast cancer and the recommended frequency of Substitute House Bill No. 5278
Public Act No. 22-33 8 of 9
screening services, including clinical breast examinations and
mammography, which shall include, where possible, tomosynthesis;
and the medical assistance program and other public and private
programs and the benefits of early detection of cervical cancer and the
recommended frequency of pap tests and tests for human
papillomavirus;
(2) Development of professional education programs, including the
benefits of early detection of breast cancer and the recommended
frequency of mammography and the benefits of early detection of
cervical cancer and the recommended frequency of pap tests and tests
for human papillomavirus;
(3) Establishment of a system to track and follow up on all women
screened for breast cancer and cervical cancer in the program. The
system shall include, but not be limited to, follow-up of abnormal
screening tests and referral to treatment when needed and tracking
women to be screened at recommended screening intervals;
(4) Assurance that all participating providers of breast cancer and
cervical cancer screening are in compliance with national and state
quality assurance legislative mandates.
(d) The Department of Public Health shall provide unserved or
underserved populations, while giving priority consideration to women
in minority communities who exhibit higher rates of breast cancer and
cervical cancer than the general population, within existing
appropriations and through contracts with health care providers: (1) (A)
Clinical breast examinations, (B) screening mammograms, [and] which
shall include, where possible, tomosynthesis, (C) pap tests, and (D) tests
for human papillomavirus, as recommended in the most current breast
and cervical cancer screening guidelines established by the United
States Preventive Services Task Force, for the woman's age and medical
history; and (2) a pap test every six months for women who have tested Substitute House Bill No. 5278
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HIV positive.