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General Assembly Substitute Bill No. 5313
February Session, 2022
AN ACT CONCERNING REGISTRATION OF TEMPORARY NURSING
SERVICES AGENCIES AND MAXIMUM RATES FOR TEMPORARY
NURSING SERVICES AT NURSING HOME FACILITIES.
Be it enacted by the Senate and House of Representatives in General
Assembly convened:
Section 1. (NEW) (Effective July 1, 2022) (a) As used in this section and 1
sections 2 and 3 of this act, (1) "health care facility" means a hospital, 2
residential care home or nursing home facility as those terms are defined 3
in section 19a-490 of the general statutes; (2) "fixed-term nursing 4
services" means services provided under contract for not less than 5
ninety consecutive days exclusively to a health care facility by nursing 6
personnel (A) whose permanent residence is at least two hundred miles 7
from the health care facility, and (B) who establish a temporary 8
residence and incur expenses for temporary accommodations paid for 9
by a temporary nursing services agency to provide such services; (3) 10
"nursing personnel" means an advanced practice registered nurse, a 11
licensed practical nurse or a registered nurse licensed or issued a 12
temporary permit to practice pursuant to chapter 378 of the general 13
statutes or a nurse's aide registered pursuant to chapter 378a of the 14
general statutes; (4) "temporary nursing services" means services 15
provided to a health care facility on a per diem or other temporary basis 16
but does not include fixed-term nursing services; and (5) "temporary 17
nursing services agency" means any person, firm, corporation, limited 18 Substitute Bill No. 5313
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liability company, partnership or association that is engaged for hire in 19
the business of procuring or providing temporary nursing services to a 20
health care facility but does not include (A) a health care facility or 21
subsidiary thereof that supplies nursing personnel to its own facility 22
only and does not charge a fee to such facility, or (B) an individual who 23
offers only his or her own temporary nursing services. 24
(b) Not later than October 1, 2022, the Commissioner of Public Health 25
shall develop a system for a temporary nursing services agency that 26
provides services in the state to register annually with the Department 27
of Public Health. The commissioner may assess an annual registration 28
fee of not more than seven hundred fifty dollars. 29
(c) Not later than January 1, 2023, no temporary nursing services 30
agency shall provide temporary nursing services in the state unless it is 31
registered pursuant to subsection (b) of this section. 32
(d) The Commissioner of Public Health shall adopt regulations, in 33
accordance with the provisions of chapter 54 of the general statutes, to 34
establish requirements for a temporary nursing services agency, 35
including, but not limited to: (1) Minimum qualifications for nursing 36
personnel provided by such agency, and (2) an annual cost report for 37
the previous calendar year to be filed by such agency not later than 38
January fifteenth with the commissioner. Such report shall detail (A) 39
revenues and costs in the state, (B) average fees charged by such agency 40
to a health care facility in the state by type of nursing personnel, and (C) 41
the states of the permanent residences of nursing personnel supplied by 42
the agency to health care facilities in the state, aggregated by type of 43
nursing personnel. Each such agency shall make available records, 44
books, reports and other data relating to its operation at the request of 45
the commissioner or the commissioner's designee. 46
Sec. 2. (NEW) (Effective July 1, 2022) (a) A temporary nursing services 47
agency shall enter into a written agreement with each health care facility 48
to which the agency assigns its nursing personnel. The agreement shall 49
contain an assurance that assigned nursing personnel have appropriate 50 Substitute Bill No. 5313
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credentials. The agreement shall be on file at both the temporary nursing 51
services agency and the health care facility not later than fourteen days 52
from the date of assignment. 53
(b) Any health care facility that fails to have the agreement described 54
in subsection (a) of this section on file may be subject to disciplinary 55
action in accordance with the provisions of chapter 368v of the general 56
statutes and any applicable licensing regulations. 57
Sec. 3. (NEW) (Effective July 1, 2022) (a) Any person aggrieved by any 58
action of a temporary nursing services agency may petition the superior 59
court for the judicial district in which the agency's temporary nursing 60
services were rendered for relief, including temporary and permanent 61
injunctions, or may bring a civil action for damages. 62
(b) Any temporary nursing services agency that violates any 63
provision of section 1 or 2 of this act may be assessed a civil penalty by 64
the court not to exceed three hundred dollars for each offense. Each 65
violation shall be a separate and distinct offense and, in the case of a 66
continuing violation, each day of continuance thereof shall be deemed 67
to be a separate and distinct offense. The Commissioner of Public Health 68
may request the Attorney General to bring a civil action in the superior 69
court for the judicial district of Hartford for injunctive relief to restrain 70
any further violation of section 1 or 2 of this act. The Superior Court shall 71
grant such relief upon notice and hearing. 72
Sec. 4. (NEW) (Effective July 1, 2022) (a) As used in this section, 73
"temporary nursing services agency", "fixed-term nursing services" and 74
"nursing personnel" have the same meaning as provided in section 1 of 75
this act and "nursing home facility" has the same meaning as provided 76
in section 19a-490 of the general statutes. Not later than January 1, 2023, 77
the Commissioner of Social Services, in consultation with the 78
Commissioner of Public Health, shall establish maximum rates a 79
temporary nursing services agency may charge a nursing home facility 80
in the state by type of nursing personnel provided by such agency. The 81
rates shall include an allowance for wages, payroll taxes, workers' 82 Substitute Bill No. 5313
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compensation insurance, training and fringe benefits, which shall be 83
based upon median wages, payroll taxes and fringe benefits paid to 84
permanent staff nursing personnel of the same type at nursing home 85
facilities in the same geographic region. 86
(b) The Commissioner of Social Services shall include in the rates an 87
allowance for reasonable administrative expenses and a reasonable 88
profit factor for a temporary nursing services agency, as determined by 89
the commissioner, but in no event shall the profit factor exceed fifteen 90
per cent. The commissioner may set higher rates for certain fixed-term 91
nursing services personnel who work exclusively at a nursing home 92
facility under a contract with such facility for a period of not less than 93
ninety days. 94
(c) The Commissioner of Social Services may adopt regulations in 95
accordance with the provisions of chapter 54 of the general statutes to 96
implement the provisions of this section. Beginning January 15, 2024, 97
temporary nursing services agencies shall submit to the commissioner 98
annual cost reports, which may be subject to audit, that include data on 99
average fees charged by such agencies to nursing home facilities in the 100
state by type of nursing personnel such agencies supply to such facilities 101
and wages paid and benefits provided to such nursing personnel. The 102
commissioner shall consider such reports and annual nursing home 103
facility cost reports, provided by such facilities to the commissioner 104
pursuant to section 17b-340 of the general statutes, as amended by this 105
act, when adjusting maximum rates temporary nursing services 106
agencies may charge such facilities for nursing personnel. 107
Sec. 5. Subsection (a) of section 17b-340 of the 2022 supplement to the 108
general statutes is repealed and the following is substituted in lieu 109
thereof (Effective July 1, 2022): 110
(a) For purposes of this subsection, (1) a "related party" includes, but 111
is not limited to, any company related to a chronic and convalescent 112
nursing home through family association, common ownership, control 113
or business association with any of the owners, operators or officials of 114 Substitute Bill No. 5313
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such nursing home; (2) "company" means any person, partnership, 115
association, holding company, limited liability company or corporation; 116
(3) "family association" means a relationship by birth, marriage or 117
domestic partnership; and (4) "profit and loss statement" means the 118
most recent annual statement on profits and losses finalized by a related 119
party before the annual report mandated under this subsection. The 120
rates to be paid by or for persons aided or cared for by the state or any 121
town in this state to licensed chronic and convalescent nursing homes, 122
to chronic disease hospitals associated with chronic and convalescent 123
nursing homes, to rest homes with nursing supervision, to licensed 124
residential care homes, as defined by section 19a-490, and to residential 125
facilities for persons with intellectual disability that are licensed 126
pursuant to section 17a-227 and certified to participate in the Title XIX 127
Medicaid program as intermediate care facilities for individuals with 128
intellectual disabilities, for room, board and services specified in 129
licensing regulations issued by the licensing agency shall be determined 130
annually, except as otherwise provided in this subsection by the 131
Commissioner of Social Services, to be effective July first of each year 132
except as otherwise provided in this subsection. Such rates shall be 133
determined on a basis of a reasonable payment for such necessary 134
services, which basis shall take into account as a factor the costs of such 135
services. Cost of such services shall include reasonable costs mandated 136
by collective bargaining agreements with certified collective bargaining 137
agents or other agreements between the employer and employees, 138
provided "employees" shall not include persons employed as managers 139
or chief administrators or required to be licensed as nursing home 140
administrators, and compensation for services rendered by proprietors 141
at prevailing wage rates, as determined by application of principles of 142
accounting as prescribed by said commissioner. Cost of such services 143
shall not include amounts paid by the facilities to employees as salary, 144
or to attorneys or consultants as fees, where the responsibility of the 145
employees, attorneys, or consultants is to persuade or seek to persuade 146
the other employees of the facility to support or oppose unionization. 147
Nothing in this subsection shall prohibit inclusion of amounts paid for 148
legal counsel related to the negotiation of collective bargaining 149 Substitute Bill No. 5313
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agreements, the settlement of grievances or normal administration of 150
labor relations. The commissioner may, in the commissioner's 151
discretion, allow the inclusion of extraordinary and unanticipated costs 152
of providing services that were incurred to avoid an immediate negative 153
impact on the health and safety of patients. The commissioner may, in 154
the commissioner's discretion, based upon review of a facility's costs, 155
direct care staff to patient ratio and any other related information, revise 156
a facility's rate for any increases or decreases to total licensed capacity 157
of more than ten beds or changes to its number of licensed rest home 158
with nursing supervision beds and chronic and convalescent nursing 159
home beds. The commissioner may, in the commissioner's discretion, 160
revise the rate of a facility that is closing. An interim rate issued for the 161
period during which a facility is closing shall be based on a review of 162
facility costs, the expected duration of the close-down period, the 163
anticipated impact on Medicaid costs, available appropriations and the 164
relationship of the rate requested by the facility to the average Medicaid 165
rate for a close-down period. The commissioner may so revise a facility's 166
rate established for the fiscal year ending June 30, 1993, and thereafter 167
for any bed increases, decreases or changes in licensure effective after 168
October 1, 1989. Effective July 1, 1991, in facilities that have both a 169
chronic and convalescent nursing home and a rest home with nursing 170
supervision, the rate for the rest home with nursing supervision shall 171
not exceed such facility's rate for its chronic and convalescent nursing 172
home. All such facilities for which rates are determined under this 173
subsection shall report on a fiscal year basis ending on September 174
thirtieth. Such report shall be submitted to the commissioner by 175
February fifteenth. Each for-profit chronic and convalescent nursing 176
home that receives state funding pursuant to this section shall include 177
in such annual report a profit and loss statement from each related party 178
that receives from such chronic and convalescent nursing home fifty 179
thousand dollars or more per year for goods, fees and services. No cause 180
of action or liability shall arise against the state, the Department of Social 181
Services, any state official or agent for failure to take action based on the 182
information required to be reported under this subsection. The 183
commissioner may reduce the rate in effect for a facility that fails to 184 Substitute Bill No. 5313
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submit a complete and accurate report on or before February fifteenth 185
by an amount not to exceed ten per cent of such rate. If a licensed 186
residential care home fails to submit a complete and accurate report, the 187
department shall notify such home of the failure and the home shall 188
have thirty days from the date the notice was issued to submit a 189
complete and accurate report. If a licensed residential care home fails to 190
submit a complete and accurate report not later than thirty days after 191
the date of notice, such home may not receive a retroactive rate increase, 192
in the commissioner's discretion. The commissioner shall, annually, on 193
or before April first, report the data contained in the reports of such 194
facilities on the department's Internet web site. For the cost reporting 195
year commencing October 1, 1985, and for subsequent cost reporting 196
years, facilities shall report the cost of using the services of any [nursing 197
pool employee] nursing personnel supplied by a temporary nursing 198
services agency by separating said cost into two categories, the portion 199
of the cost equal to the salary of the employee for whom the [nursing 200
pool employee] nursing personnel supplied by a temporary nursing 201
services agency is substituting shall be considered a nursing cost and 202
any cost in excess of such salary shall be further divided so that seventy-203
five per cent of the excess cost shall be considered an administrative or 204
general cost and twenty-five per cent of the excess cost shall be 205
considered a nursing cost, provided if the total [nursing pool] costs of a 206
facility for nursing personnel supplied by a temporary nursing services 207
agency in any cost year are equal to or exceed fifteen per cent of the total 208
nursing expenditures of the facility for such cost year, no portion of 209
[nursing pool] such costs in excess of fifteen per cent shall be classified 210
as administrative or general costs. The commissioner, in determining 211
such rates, shall also take into account the classification of patients or 212
boarders according to special care requirements or classification of the 213
facility according to such factors as facilities and services and such other 214
factors as the commissioner deems reasonable, including anticipated 215
fluctuations in the cost of providing such services. The commissioner 216
may establish a separate rate for a facility or a portion of a facility for 217
traumatic brain injury patients who require extensive care but not acute 218
general hospital care. Such separate rate shall reflect the special care 219 Substitute Bill No. 5313
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requirements of such patients. If changes in federal or state laws, 220
regulations or standards adopted subsequent to June 30, 1985, result in 221
increased costs or expenditures in an amount exceeding one-half of one 222
per cent of allowable costs for the most recent cost reporting year, the 223
commissioner shall adjust rates and provide payment for any such 224
increased reasonable costs or expenditures within a reasonable period 225
of time retroactive to the date of enforcement. Nothing in this section 226
shall be construed to require the Department of Social Services to adjust 227
rates and provide payment for any increases in costs resulting from an 228
inspection of a facility by the Department of Public Health. Such 229
assistance as the commissioner requires from other state agencies or 230
departments in determining rates shall be made available to the 231
commissioner at the commissioner's request. Payment of the rates 232
established pursuant to this section shall be conditioned on the 233
establishment by such facilities of admissions procedures that conform 234
with this section, section 19a-533 and all other applicable provisions of 235
the law and the provision of equality of treatment to all persons in such 236
facilities. The established rates shall be the maximum amount 237
chargeable by such facilities for care of such beneficiaries, and the 238
acceptance by or on behalf of any such facility of any additional 239
compensation for care of any such beneficiary from any other person or 240
source shall constitute the offense of aiding a beneficiary to obtain aid 241
to which the beneficiary is not entitled and shall be punishable in the 242
same manner as is provided in subsection (b) of section 17b-97. 243
Notwithstanding any provision of this section, the Commissioner of 244
Social Services may, within available appropriations, provide an interim 245
rate increase for a licensed chronic and convalescent nursing home or a 246
rest home with nursing supervision for rate periods no earlier than April 247
1, 2004, only if the commissioner determines that the increase is 248
necessary to avoid the filing of a petition for relief under Title 11 of the 249
United States Code; imposition of receivership pursuant to sections 19a-250
542 and 19a-543; or substantial deterioration of the facility's financial 251
condition that may be expected to adversely affect resident care and the 252
continued operation of the facility, and the commissioner determines 253
that the continued operation of the facility is in the best interest of the 254 Substitute Bill No. 5313
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state. The commissioner shall consider any requests for interim rate 255
increases on file with the department from March 30, 2004, and those 256
submitted subsequently for rate periods no earlier than April 1, 2004. 257
When reviewing an interim rate increase request the commissioner 258
shall, at a minimum, consider: (A) Existing chronic and convalescent 259
nursing home or rest home with nursing supervision utilization in the 260
area and projected bed need; (B) physical plant long-term viability and 261
the ability of the owner or purchaser to implement any necessary 262
property improvements; (C) licensure and certification compliance 263
history; (D) reasonableness of actual and projected expenses; and (E) the 264
ability of the facility to meet wage and benefit costs. No interim rate 265
shall be increased pursuant to this subsection in excess of one hundred 266
fifteen per cent of the median rate for the facility's peer grouping, 267
established pursuant to subdivision (2) of subsection (f) of this section, 268
unless recommended by the commissioner and approved by the 269
Secretary of the Office of Policy and Management after consultation 270
with the commissioner. Such median rates shall be published by the 271
Department of Social Services not later than April first of each year. In 272
the event that a facility granted an interim rate increase pursuant to this 273
section is sold or otherwise conveyed for value to an unrelated entity 274
less than five years after the effective date of such rate increase, the rate 275
increase shall be deemed rescinded and the department shall recover an 276
amount equal to the difference between payments made for all affected 277
rate periods and payments that would have been made if the interim 278
rate increase was not granted. The commissioner may seek recovery of 279
such payments from any facility with common ownership. With the 280
approval of the Secretary of the Office of Policy and Management, the 281
commissioner may waive recovery and rescission of the interim rate for 282
good cause shown that is not inconsistent with this section, including, 283
but not limited to, transfers to family members that were made for no 284
value. The commissioner shall provide written quarterly reports to the 285
joint standing committees of the General Assembly having cognizance 286
of matters relating to aging, human services and appropriations and the 287
budgets of state agencies, that identify each facility requesting an 288
interim rate increase, the amount of the requested rate increase for each 289 Substitute Bill No. 5313
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facility, the action taken by the commissioner and the secretary pursuant 290
to this subsection, and estimates of the additional cost to the state for 291
each approved interim rate increase. Nothing in this subsection shall 292
prohibit the commissioner from increasing the rate of a licensed chronic 293
and convalescent nursing home or a rest home with nursing supervision 294
for allowable costs associated with facility capital improvements or 295
increasing the rate in case of a sale of a licensed chronic and convalescent 296
nursing home or a rest home with nursing supervision if receivership 297
has been imposed on such home. For purposes of this section, 298
"temporary nursing services agency" and "nursing personnel" have the 299
same meaning as provided in section 1 of this act. 300
Sec. 6. Subdivision (1) of subsection (f) of section 17b-340 of the 2022 301
supplement to the general statutes is repealed and the following is 302
substituted in lieu thereof (Effective July 1, 2022): 303
(1) Allowable costs shall be divided into the following five cost 304
components: (A) Direct costs, which shall include salaries for nursing 305
personnel, related fringe benefits and [nursing pool] costs for nursing 306
personnel supplied by a temporary nursing services agency; (B) indirect 307
costs, which shall include professional fees, dietary expenses, 308
housekeeping expenses, laundry expenses, supplies related to patient 309
care, salaries for indirect care personnel and related fringe benefits; (C) 310
fair rent, which shall be defined in accordance with subsection (f) of 311
section 17-311-52 of the regulations of Connecticut state agencies; (D) 312
capital-related costs, which shall include property taxes, insurance 313
expenses, equipment leases and equipment depreciation; and (E) 314
administrative and general costs, which shall include (i) maintenance 315
and operation of plant expenses, (ii) salaries for administrative and 316
maintenance personnel, and (iii) related fringe benefits. The 317
commissioner may provide a rate adjustment for nonemergency 318
transportation services required by nursing facility residents. Such 319
adjustment shall be a fixed amount determined annually by the 320
commissioner based upon a review of costs and other associated 321
information. Allowable costs shall not include costs for ancillary 322 Substitute Bill No. 5313
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services payable under Part B of the Medicare program. 323
Sec. 7. Subdivision (4) of subsection (a) of section 17b-340d of the 2022 324
supplement to the general statutes is repealed and the following is 325
substituted in lieu thereof (Effective July 1, 2022): 326
(4) Allowable costs shall be divided into the following five cost 327
components: (A) Direct costs, which shall include salaries for nursing 328
personnel, related fringe benefits and [nursing pool] costs for nursing 329
personnel supplied by a temporary nursing services agency; (B) indirect 330
costs, which shall include professional fees, dietary expenses, 331
housekeeping expenses, laundry expenses, supplies related to patient 332
care, salaries for indirect care personnel and related fringe benefits; (C) 333
fair rent, which shall be defined in regulations adopted in accordance 334
with subsection (b) of this section; (D) capital-related costs, which shall 335
include property taxes, insurance expenses, equipment leases and 336
equipment depreciation; and (E) administrative and general costs, 337
which shall include maintenance and operation of plant expenses, 338
salaries for administrative and maintenance personnel and related 339
fringe benefits. For (i) direct costs, the maximum cost shall be equal to 340
one hundred thirty-five per cent of the median allowable cost of that 341
peer grouping; (ii) indirect costs, the maximum cost shall be equal to one 342
hundred fifteen per cent of the state-wide median allowable cost; (iii) 343
fair rent, the amount shall be calculated utilizing the amount approved 344
pursuant to section 17b-353; (iv) capital-related costs, there shall be no 345
maximum; and (v) administrative and general costs, the maximum shall 346
be equal to the state-wide median allowable cost. For purposes of this 347
subdivision, "temporary nursing services agency" and "nursing 348
personnel" have the same meaning as provided in section 1 of this act. 349
Sec. 8. Subsection (a) of section 51-344a of the 2022 supplement to the 350
general statutes is repealed and the following is substituted in lieu 351
thereof (Effective July 1, 2022): 352
(a) Whenever the term "judicial district of Hartford-New Britain" or 353
"judicial district of Hartford-New Britain at Hartford" is used or referred 354 Substitute Bill No. 5313
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to in the following sections of the general statutes, it shall be deemed to 355
mean or refer to the judicial district of Hartford on and after September 356
1, 1998: Sections 1-205, 1-206, 2-48, 3-21a, 3-62d, 3-70a, 3-71a, 4-61, 4-160, 357
4-164, 4-177b, 4-180, 4-183, 4-197, 5-202, 5-276a, 8-30g, 9-7a, 9-7b, 9-369b, 358
10-153e, 12-208, 12-237, 12-268l, 12-312, 12-330m, 12-405k, 12-422, 12-448, 359
12-454, 12-456, 12-463, 12-489, 12-522, 12-554, 12-565, 12-572, 12-586f, 12-360
597, 12-730, 13b-34, 13b-235, 13b-315, 13b-375, 14-57, 14-66, 14-67u, 14-361
110, 14-195, 14-311, 14-311c, 14-324, 14-331, 15-125, 15-126, 16-41, 16a-5, 362
17b-60, 17b-100, 17b-238, 17b-531, 19a-85, 19a-86, [19a-123d,] 19a-425, 363
19a-498, 19a-517, 19a-526, 19a-633, 20-12f, 20-13e, 20-29, 20-40, 20-45, 20-364
59, 20-73a, 20-86f, 20-99, 20-114, 20-133, 20-154, 20-156, 20-162p, 20-192, 365
20-195p, 20-202, 20-206c, 20-227, 20-238, 20-247, 20-263, 20-271, 20-307, 366
20-341f, 20-363, 20-373, 20-404, 20-414, 21a-55, 21a-190i, 22-7, 22-228, 22-367
248, 22-254, 22-320d, 22-326a, 22-344b, 22-386, 22a-6b, 22a-7, 22a-16, 22a-368
30, 22a-34, 22a-53, 22a-60, 22a-62, 22a-63, 22a-66h, 22a-106a, 22a-119, 369
22a-180, 22a-182a, 22a-184, 22a-220a, 22a-220d, 22a-225, 22a-226, 22a-370
226c, 22a-227, 22a-250, 22a-255l, 22a-276, 22a-310, 22a-342a, 22a-344, 22a-371
361a, 22a-374, 22a-376, 22a-408, 22a-430, 22a-432, 22a-438, 22a-449f, 22a-372
449g, 22a-459, 23-5e, 23-65m, 25-32e, 25-36, 28-5, 29-143j, 29-158, 29-161z, 373
29-323, 30-8, 31-109, 31-249b, 31-266, 31-266a, 31-270, 31-273, 31-284, 31-374
285, 31-339, 31-355a, 31-379, 35-3c, 35-42, 36a-186, 36a-187, 36a-471a, 36a-375
494, 36a-587, 36a-647, 36a-684, 36a-718, 36a-807, 36b-26, 36b-27, 36b-30, 376
36b-50, 36b-71, 36b-72, 36b-74, 36b-76, 38a-41, 38a-52, 38a-134, 38a-139, 377
38a-140, 38a-147, 38a-150, 38a-185, 38a-209, 38a-225, 38a-226b, 38a-241, 378
38a-337, 38a-470, 38a-620, 38a-657, 38a-687, 38a-774, 38a-776, 38a-817, 379
38a-843, 38a-868, 38a-906, 38a-994, 42-103c, 42-110d, 42-110k, 42-110p, 380
42-182, 46a-56, 46a-100, 47a-21, 49-73, 51-44a, 51-81b, 51-194, 52-146j, 53-381
392d and 54-211a. 382
Sec. 9. Sections 19a-123, 19a-123b and 19a-123d of the general statutes 383
are repealed. (Effective July 1, 2022) 384
This act shall take effect as follows and shall amend the following
sections:
Section 1 July 1, 2022 New section Substitute Bill No. 5313
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Sec. 2 July 1, 2022 New section
Sec. 3 July 1, 2022 New section
Sec. 4 July 1, 2022 New section
Sec. 5 July 1, 2022 17b-340(a)
Sec. 6 July 1, 2022 17b-340(f)(1)
Sec. 7 July 1, 2022 17b-340d(a)(4)
Sec. 8 July 1, 2022 51-344a(a)
Sec. 9 July 1, 2022 Repealer section
AGE Joint Favorable Subst.
PH Joint Favorable