O F F I C E O F L E G I S L A T I V E R E S E A R C H
P U B L I C A C T S U M M A R Y
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PA 22-33—sHB 5278
Public Health Committee
AN ACT REQUIRING EXPRESS WRITTEN CONSENT TO THE
INTIMATE EXAMINATION OF A PATIENT WHO IS UNDER DEEP
SEDATION OR ANESTHESIA OR UNCONSCIOUS
SUMMARY: This act 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 a patient’s express written
consent to an “intimate examination” (i.e., pelvic, prostate, or rectal
examination) (§ 1);
2. 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 risk management to address
endometriosis screening and requires the continuing education in 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 (a) develop a plan for an endometriosis data and biorepository program
and (b) report to the Public Health Committee by January 1, 2023, on the
plan and its implementation timeline (§ 3); and
5. expands 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).
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 act 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. Copies of the
procedures and consent forms must be available to the DPH commissioner upon
request.
The act also generally requires health care providers (i.e., physicians; medical O L R P U B L I C A C T S U M M A R Y
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students, residents, and fellows; physician assistants; and advanced practice
registered nurses) 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
needed if the examination is within the scope of the patient’s planned procedure,
surgical procedure, or diagnostic examination for which he or she gave general
consent.
Under the act, if a medical student, resident, or fellow performs an intimate
examination on a patient exclusively for training purposes and not as part of the
patient’s clinical care or clinical care team, the hospital or outpatient surgical
facility must first obtain a separate written consent from the patient that details the
student’s, resident’s, or fellow’s involvement in the intimate examination.
The act exempts from these consent requirements intimate examinations
performed in an emergency or urgent care situation for diagnostic or treatment
purposes.
§ 2 — PHYSICIAN CONTINUING EDUCATION
Beginning with license registration periods on or after October 1, 2022, the act
allows physicians’ continuing education in risk management to address screening
for endometriosis. It also requires the continuing education in 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.
As part of existing law’s continuing education requirements, physicians must
complete at least one contact hour each of risk management and cultural
competency training or education (1) during their first license renewal period in
which continuing education is required 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 act 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 better manage the condition, and (3) early
access to the latest therapeutic options for patients.
Program Duties
Under the act, 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 with it; O L R P U B L I C A C T S U M M A R Y
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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 the condition,
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.
Report
Under the act, 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 act 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 act requires the program’s
mammography services to include, where possible, tomosynthesis, which is a
digital x-ray mammogram that creates two- and three-dimensional images. The act
also 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. The program also
includes pap tests every six months for HIV-positive women.