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OLR Bill Analysis
sHB 5278 (as amended by House "A")*
AN ACT PROHIBITING AN UNAUTHORIZED INTIMATE
EXAMINATION ON A PATIENT WHO IS UNDER DEEP SEDATION
OR ANESTHESIA OR UNCONSCIOUS.
SUMMARY
This bill makes various unrelated changes affecting health care
professions and institutions. Principally, it does the following:
1. requires hospitals and outpatient surgical facilities, by January 1,
2023, to develop and implement procedures to obtain, on a
written or electronic form, a patient’s express written consent to
an “intimate examination” (i.e., pelvic, prostate, or rectal
examination) (§ 1);
2. generally, requires hospitals and outpatient surgical facilities to
obtain a patient’s separate written consent if a medical student,
resident, or fellow performs an intimate examination exclusively
for training purposes and not as part of the patient’s clinical care
or clinical care team (§ 1);
3. allows physicians’ continuing education in (a) risk management
to address screening for endometriosis and (b) cultural
competency to address the effects of systemic racism, explicit and
implicit bias, racial disparities, and the experiences of
transgender and gender diverse people on patient diagnosis,
care, and treatment (§ 2);
4. requires UConn Health Center, in consultation with a research
laboratory, to develop a plan to establish an endometriosis data
and biorepository program and report to the Public Health
Committee by January 1, 2023 , on the plan and its
implementation timeline (§ 3); and 2022HB-05278-R010587-BA.DOCX
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5. modifies the Department of Public Health (DPH) breast and
cervical cancer early detection and treatment referral program
by, among other things, requiring breast cancer screening to
include tomosynthesis, where possible, and adding human
papillomavirus (HPV) tests to the program’s services (§ 4).
*House Amendment “A” replaces the original bill (File 231) with
similar provisions on patient consent for intimate examinations. It
removes the provisions in the underlying bill (1) specifying required
information on patient consent forms and (2) requiring DPH to
investigate alleged violations of written consent requirements. It also
adds the provisions on (1) physicians’ continuing medical education, (2)
the endometriosis data and biorepository program, and (3) DPH breast
and cervical cancer early detection and treatment referral program.
EFFECTIVE DATE: October 1, 2022, except that the provisions on (1)
patient consent for intimate examinations take effect upon passage and
(2) the endometriosis data and biorepository program take effect July 1,
2022.
§ 1 — PATIENT CONSENT FOR INTIMATE EXAMINATIONS
The bill requires hospitals and outpatient surgical facilities, by
January 1, 2023, to develop and implement procedures to obtain, on a
written or electronic form, a patient’s express written consent to an
intimate examination. They must make copies of these procedures and
consent forms available to the DPH commissioner upon request.
It also requires health care providers at hospitals and outpatient
surgical facilities to obtain this written consent before performing an
intimate examination on a patient who will be unconscious or under
deep sedation or general anesthesia. This consent is not required if the
examination is within the scope of the patient’s planned procedure,
surgical procedure, or diagnostic examination for which he or she
provided general consent.
Under the bill, if a medical student, resident, or fellow performs an
intimate examination on a patient exclusively for training purposes and 2022HB-05278-R010587-BA.DOCX
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not as part of the patient’s clinical care or clinical care team, the hospital
or outpatient surgical facility must obtain the patient’s separate written
consent. This consent must detail the medical student’s, resident’s, or
fellow’s involvement in the intimate examination.
The bill exempts from the above written patient consent
requirements intimate examinations performed in an emergency or
urgent care situation for diagnostic or treatment purposes.
Under the bill, “health care providers” are physicians; medical
students, residents, and fellows; physician assistants; and advanced
practice registered nurses.
§ 2 — PHYSICIAN CONTINUING EDUCATION
The bill allows physicians’ continuing education in (1) risk
management to address screening for endometriosis and (2) cultural
competency to address the effects of systemic racism, explicit and
implicit bias, racial disparities, and the experiences of transgender and
gender diverse people on patient diagnosis, care and treatment. It
applies to license registration periods on or after October 1, 2022.
As part of existing law’s continuing education requirements,
physicians must complete one contact hour each of risk management
and cultural competency training or education (1) during their first
license renewal period and (2) at least once every six years after that.
By law, physicians generally must complete 50 contact hours of
continuing education every two years, starting with their second license
renewal.
§ 3 — ENDOMETRIOSIS DATA AND BIOREPOSITORY PROGRAM
The bill requires UConn Health Center, in consultation with a
research laboratory, to develop a plan to establish an endometriosis data
and biorepository program to promote (1) early detection of
endometriosis in adolescents and adults, (2) new therapeutic strategies
to treat and manage the condition, and (3) early access to the latest
therapeutic options for patients. 2022HB-05278-R010587-BA.DOCX
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Duties
Under the bill, in developing its plan, UConn Health Center must
require that the endometriosis data and biorepository program do the
following:
1. collect standardized phenotypic data along with biological
samples of a person’s endometriosis and control samples to
improve the characterization of the condition and the person who
has it;
2. develop standard operating procedures for retaining and storing
biological endometriosis samples and control samples, including
for their collection, transportation, processing, and long-term
storage;
3. curate biological endometriosis samples from a diverse cross-
section of communities to ensure they represent all groups
affected by endometriosis, including black and Latino persons,
other persons of color, transgender and gender diverse persons,
and persons with disabilities;
4. research the pathogenesis, pathophysiology, progression, and
prognosis of endometriosis and the development of noninvasive
diagnostic biomarkers, novel targeted therapeutics, curative
therapies, and preventive interventions for the condition,
including medical and surgical interventions;
5. serve as a centralized resource for endometriosis information;
6. facilitate collaboration among researchers and health care
professionals, educators, and students on best practices for the
diagnosis, care, and treatment of endometriosis; and
7. research the impact of endometriosis on Connecticut residents,
including its impact on health and comorbidity, health care costs,
and overall quality of life.
2022HB-05278-R010587-BA.DOCX
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Report
Under the bill, the UConn Health Center board of director’s
chairperson must report to the Public Health Committee, by January 1,
2023, on the plan and the timeline for establishing the program.
§ 4 — DPH BREAST AND CERVICAL CANCER EARLY DETECTION
AND TREATMENT REFERRAL PROGRAM
By law, DPH’s breast and cervical cancer early detection and
treatment referral program provides services, within existing
appropriations and through contracts with health care providers, to
women who (1) have incomes at or below 250% of the federal poverty
level, (2) are 21 to 64 years old, and (3) lack health insurance coverage
for breast cancer screening mammography or cervical cancer screening
services. The bill requires the program to give priority consideration to
women in minority communities with higher rates of breast cancer and
cervical cancer than the general population.
Under existing law, the program’s services include clinical breast
exams, screening mammograms, and pap tests. The bill requires the
program’s mammography services to include, where possible,
tomosynthesis, which it defines as a digital x-ray mammogram that
creates two- and three-dimensional images of the breasts. The bill
additionally requires the program to include HPV tests. As under
existing law, these services must be provided as recommended by the
U.S. Preventive Services Task Force guidelines for the woman’s age and
medical history. By law, the program also includes pap tests every six
months for women who are HIV positive.
BACKGROUND
Related Bills
HB 5303 (File 201), favorably reported by the Public Health
Committee, contains the same provisions on physician continuing
medical education and establishing an endometriosis data and
biorepository program.
SB 249 (File 96), favorably reported by the Public Health Committee,
contains the same provisions on the DPH Breast and Cervical Cancer 2022HB-05278-R010587-BA.DOCX
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Early Detection and Treatment Referral Program.
COMMITTEE ACTION
Public Health Committee
Joint Favorable
Yea 31 Nay 0 (03/18/2022)