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General Assembly Substitute Bill No. 5500
February Session, 2022
AN ACT CONCERNING THE DEPARTMENT OF PUBLIC HEALTH'S
RECOMMENDATIONS REGARDING VARIOUS REVISIONS TO THE
PUBLIC HEALTH STATUTES.
Be it enacted by the Senate and House of Representatives in General
Assembly convened:
Section 1. Section 19a-490 of the 2022 supplement to the general 1
statutes, as amended by sections 29 and 30 of public act 21-2 of the June 2
special session, is repealed and the following is substituted in lieu 3
thereof (Effective October 1, 2022): 4
As used in this chapter, unless the context otherwise requires: 5
(a) "Institution" means a hospital, short-term hospital special hospice, 6
hospice inpatient facility, residential care home, nursing home facility, 7
home health care agency, home health aide agency, behavioral health 8
facility, assisted living services agency, substance abuse treatment 9
facility, outpatient surgical facility, outpatient clinic, clinical laboratory, 10
an infirmary operated by an educational institution for the care of 11
students enrolled in, and faculty and employees of, such institution; a 12
facility engaged in providing services for the prevention, diagnosis, 13
treatment or care of human health conditions, including facilities 14
operated and maintained by any state agency; and a residential facility 15
for persons with intellectual disability licensed pursuant to section 17a-16
227 and certified to participate in the Title XIX Medicaid program as an 17 Substitute Bill No. 5500
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intermediate care facility for individuals with intellectual disability. 18
"Institution" does not include any facility for the care and treatment of 19
persons with mental illness or substance use disorder operated or 20
maintained by any state agency, except Whiting Forensic Hospital and 21
the hospital and psychiatric residential treatment facility units of the 22
Albert J. Solnit Children's Center; 23
(b) "Hospital" means an establishment for the lodging, care and 24
treatment of persons suffering from disease or other abnormal physical 25
or mental conditions and includes inpatient psychiatric services in 26
general hospitals; 27
(c) "Residential care home" or "rest home" means a community 28
residence that furnishes, in single or multiple facilities, food and shelter 29
to two or more persons unrelated to the proprietor and, in addition, 30
provides services that meet a need beyond the basic provisions of food, 31
shelter and laundry and may qualify as a setting that allows residents to 32
receive home and community-based services funded by state and 33
federal programs; 34
(d) "Home health care agency" means a public or private 35
organization, or a subdivision thereof, engaged in providing 36
professional nursing services and the following services, available 37
twenty-four hours per day, in the patient's home or a substantially 38
equivalent environment: Home health aide services as defined in this 39
section, physical therapy, speech therapy, occupational therapy or 40
medical social services. The agency shall provide professional nursing 41
services and at least one additional service directly and all others 42
directly or through contract. An agency shall be available to enroll new 43
patients seven days a week, twenty-four hours per day; 44
(e) "Home health aide agency" means a public or private 45
organization, except a home health care agency, which provides in the 46
patient's home or a substantially equivalent environment supportive 47
services which may include, but are not limited to, assistance with 48
personal hygiene, dressing, feeding and incidental household tasks 49 Substitute Bill No. 5500
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essential to achieving adequate household and family management. 50
Such supportive services shall be provided under the supervision of a 51
registered nurse and, if such nurse determines appropriate, shall be 52
provided by a social worker, physical therapist, speech therapist or 53
occupational therapist. Such supervision may be provided directly or 54
through contract; 55
(f) "Home health aide services" as defined in this section shall not 56
include services provided to assist individuals with activities of daily 57
living when such individuals have a disease or condition that is chronic 58
and stable as determined by a physician licensed in the state; 59
(g) "Behavioral health facility" means any facility that provides 60
mental health services to persons eighteen years of age or older or 61
substance use disorder services to persons of any age in an outpatient 62
treatment or residential setting to ameliorate mental, emotional, 63
behavioral or substance use disorder issues; 64
(h) ["Alcohol or drug treatment facility" means any facility for the 65
care or treatment of persons suffering from alcoholism or other drug 66
addiction] "Clinical laboratory" means any facility or other area used for 67
microbiological, serological, chemical, hematological, 68
immunohematological, biophysical, cytological, pathological or other 69
examinations of human body fluids, secretions, excretions or excised or 70
exfoliated tissues for the purpose of providing information for the (1) 71
diagnosis, prevention or treatment of any human disease or 72
impairment, (2) assessment of human health, or (3) presence of drugs, 73
poisons or other toxicological substances; 74
(i) "Person" means any individual, firm, partnership, corporation, 75
limited liability company or association; 76
(j) "Commissioner" means the Commissioner of Public Health or the 77
commissioner's designee; 78
(k) "Home health agency" means an agency licensed as a home health 79
care agency or a home health aide agency; 80 Substitute Bill No. 5500
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(l) "Assisted living services agency" means an agency that provides, 81
among other things, nursing services and assistance with activities of 82
daily living to a population that is chronic and stable and may have a 83
dementia special care unit or program as defined in section 19a-562; 84
(m) "Outpatient clinic" means an organization operated by a 85
municipality or a corporation, other than a hospital, that provides (1) 86
ambulatory medical care, including preventive and health promotion 87
services, (2) dental care, or (3) mental health services in conjunction with 88
medical or dental care for the purpose of diagnosing or treating a health 89
condition that does not require the patient's overnight care; 90
(n) "Multicare institution" means a hospital that provides outpatient 91
behavioral health services or other health care services, psychiatric 92
outpatient clinic for adults, free-standing facility for the care or 93
treatment of substance abusive or dependent persons, hospital for 94
psychiatric disabilities, as defined in section 17a-495, or a general acute 95
care hospital that provides outpatient behavioral health services that (1) 96
is licensed in accordance with this chapter, (2) has more than one facility 97
or one or more satellite units owned and operated by a single licensee, 98
and (3) offers complex patient health care services at each facility or 99
satellite unit. For purposes of this subsection, "satellite unit" means a 100
location where a segregated unit of services is provided by the multicare 101
institution; 102
(o) "Nursing home" or "nursing home facility" means (1) any chronic 103
and convalescent nursing home or any rest home with nursing 104
supervision that provides nursing supervision under a medical director 105
twenty-four hours per day, or (2) any chronic and convalescent nursing 106
home that provides skilled nursing care under medical supervision and 107
direction to carry out nonsurgical treatment and dietary procedures for 108
chronic diseases, convalescent stages, acute diseases or injuries; 109
(p) "Outpatient dialysis unit" means (1) an out-of-hospital out-patient 110
dialysis unit that is licensed by the department to provide (A) services 111
on an out-patient basis to persons requiring dialysis on a short-term 112 Substitute Bill No. 5500
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basis or for a chronic condition, or (B) training for home dialysis, or (2) 113
an in-hospital dialysis unit that is a special unit of a licensed hospital 114
designed, equipped and staffed to (A) offer dialysis therapy on an out-115
patient basis, (B) provide training for home dialysis, and (C) perform 116
renal transplantations; [and] 117
(q) "Hospice agency" means a public or private organization that 118
provides home care and hospice services to terminally ill patients; [.] 119
(r) "Psychiatric residential treatment facility" means a nonhospital 120
facility with a provider agreement with the Department of Social 121
Services to provide inpatient services to Medicaid-eligible individuals 122
under the age of twenty-one; [.] and 123
(s) "Chronic disease hospital" means a long-term hospital having 124
facilities, medical staff and all necessary personnel for the diagnosis, 125
care and treatment of chronic diseases. 126
Sec. 2. Subsection (a) of section 19a-491c of the 2022 supplement to 127
the general statutes is repealed and the following is substituted in lieu 128
thereof (Effective October 1, 2022): 129
(a) As used in this section: 130
(1) "Criminal history and patient abuse background search" or 131
"background search" means (A) a review of the registry of nurse's aides 132
maintained by the Department of Public Health pursuant to section 20-133
102bb, (B) checks of state and national criminal history records 134
conducted in accordance with section 29-17a, and (C) a review of any 135
other registry specified by the Department of Public Health which the 136
department deems necessary for the administration of a background 137
search program. 138
(2) "Direct access" means physical access to a patient or resident of a 139
long-term care facility that affords an individual with the opportunity 140
to commit abuse or neglect against or misappropriate the property of a 141
patient or resident. 142 Substitute Bill No. 5500
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(3) "Disqualifying offense" means a conviction of (A) any crime 143
described in 42 USC 1320a-7(a)(1), (2), (3) or (4), (B) a substantiated 144
finding of neglect, abuse or misappropriation of property by a state or 145
federal agency pursuant to an investigation conducted in accordance 146
with 42 USC 1395i-3(g)(1)(C) or 42 USC 1396r(g)(1)(C), or (C) a 147
conviction of any crime described in section 53a-59a, 53a-60b, 53a-60c, 148
53a-61a, 53a-321, 53a-322 or 53a-323. 149
(4) "Long-term care facility" means any facility, agency or provider 150
that is a nursing home, as defined in section 19a-521, a residential care 151
home, as defined in section 19a-521, a home health care agency, hospice 152
agency or home health aide agency, as defined in section 19a-490, as 153
amended by this act, an assisted living services agency, as defined in 154
section 19a-490, as amended by this act, an intermediate care facility for 155
individuals with intellectual disabilities, as defined in 42 USC 1396d(d), 156
except any such facility operated by a Department of Developmental 157
Services' program subject to background checks pursuant to section 17a-158
227a, a chronic disease hospital, as defined in section [19a-550] 19a-490, 159
as amended by this act, or an agency providing hospice care which is 160
licensed to provide such care by the Department of Public Health or 161
certified to provide such care pursuant to 42 USC 1395x. 162
Sec. 3. Section 19a-535b of the general statutes is repealed and the 163
following is substituted in lieu thereof (Effective October 1, 2022): 164
[(a) As used in this section, a "facility" means a chronic disease 165
hospital which is a long-term hospital having facilities, medical staff and 166
all necessary personnel for the diagnosis, care and treatment of chronic 167
diseases.] 168
[(b)] A [facility] chronic disease hospital shall not transfer or 169
discharge a patient from [the facility] such hospital except for medical 170
reasons, or for the patient's welfare or the welfare of other patients, as 171
documented in the patient's medical record; or, in the case of a self pay 172
patient, for nonpayment or arrearage of more than fifteen days of the 173
per diem chronic disease hospital room rates for the patient's stay, 174 Substitute Bill No. 5500
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except as prohibited by the Social Security Act. In the case of an 175
involuntary transfer or discharge, the patient and, if known, the 176
patient's legally liable relative, guardian or conservator and the patient's 177
personal physician, if the discharge plan is prepared by the medical 178
director of the chronic disease hospital, shall be given at least thirty 179
days' written notice of the proposed action to ensure orderly transfer or 180
discharge. 181
Sec. 4. Subsection (a) of section 19a-537 of the general statutes is 182
repealed and the following is substituted in lieu thereof (Effective October 183
1, 2022): 184
(a) As used in this section and section 19a-537a: 185
(1) "Vacancy" means a bed that is available for an admission; 186
(2) "Nursing home" means any chronic and convalescent facility or 187
any rest home with nursing supervision, as defined in section 19a-521; 188
(3) "Hospital" means a general short-term hospital licensed by the 189
Department of Public Health or a hospital for mental illness, as defined 190
in section 17a-495, or a chronic disease hospital. [, as defined in section 191
19-13-D1(a) of the Public Health Code.] 192
Sec. 5. Subsection (a) of section 19a-550 of the 2022 supplement to the 193
general statutes is repealed and the following is substituted in lieu 194
thereof (Effective October 1, 2022): 195
(a) (1) As used in this section, (A) "nursing home facility" has the same 196
meaning as provided in section 19a-521, and (B) "residential care home" 197
has the same meaning as provided in section 19a-521; [, and (C) "chronic 198
disease hospital" means a long-term hospital having facilities, medical 199
staff and all necessary personnel for the diagnosis, care and treatment 200
of chronic diseases;] and (2) for the purposes of subsections (c) and (d) 201
of this section, and subsection (b) of section 19a-537, "medically 202
contraindicated" means a comprehensive evaluation of the impact of a 203
potential room transfer on the patient's physical, mental and 204 Substitute Bill No. 5500
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psychosocial well-being, which determines that the transfer would 205
cause new symptoms or exacerbate present symptoms beyond a 206
reasonable adjustment period resulting in a prolonged or significant 207
negative outcome that could not be ameliorated through care plan 208
intervention, as documented by a physician, physician assistant or an 209
advanced practice registered nurse in a patient's medical record. 210
Sec. 6. Subsections (a) to (e), inclusive, of section 20-185r of the general 211
statutes are repealed and the following is substituted in lieu thereof 212
(Effective October 1, 2022): 213
(a) As used in this section: 214
(1) "Central service technician" means a person who decontaminates, 215
inspects, assembles, packages and sterilizes reusable medical 216
instruments or devices [in] for a health care facility, whether such 217
person is employed by the health care facility or provides services 218
pursuant to a contract with the health care facility; 219
(2) "Health care facility" means an outpatient surgical facility, as 220
defined in section 19a-493b, or a hospital, as defined in section 19a-490, 221
as amended by this act, but does not include a chronic disease hospital, 222
as defined in section [19a-550] 19a-490, as amended by this act; 223
(3) "Health care provider" means a person or organization that 224
provides health care services and is licensed in accordance with this title; 225
and 226
(4) "Central service department" means a department within a health 227
care facility that processes, issues and controls medical supplies, devices 228
and equipment, both sterile and nonsterile, for patient care areas of a 229
health care facility. 230
(b) Unless otherwise permitted pursuant to this section, no person 231
shall practice as a central service technician unless such person (1) (A) 232
has successfully passed a nationally accredited central service exam for 233
central service technicians and holds and maintains one of the following 234 Substitute Bill No. 5500
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credentials: (i) A certified registered central service technician credential 235
administered by the International Association of Healthcare Central 236
Service Materiel Management, or its successor organization, or (ii) a 237
certified sterile processing and distribution technician credential 238
administered by the Certification Board for Sterile Processing and 239
Distribution, Inc., or (B) was employed or otherwise contracted for 240
services as a central service technician [in] by a health care facility before 241
January 1, 2016, or (2) obtains a certified registered central service 242
technician credential administered by the International Association of 243
Healthcare Central Service Materiel Management, or its successor 244
organization, or a certified sterile processing and distribution technician 245
credential administered by the Certification Board for Sterile Processing 246
and Distribution, Inc., not later than two years after such person's date 247
of hire or contracting for services with the health care facility. 248
(c) A central service technician shall complete a minimum of ten 249
hours of continuing education annually. The continuing education shall 250
be in areas related to the functions of a central service technician. 251
(d) A health care facility shall, upon the written request of a central 252
service technician, verify, in writing, the central service technician's 253
dates of employment or the contract period during which the central 254
service technician provided services to the health care facility. 255
(e) Nothing in this section shall prohibit the following persons from 256
performing the tasks or functions of a central service technician: (1) A 257
health care provider; (2) a student or intern performing the functions of 258
a central service technician under the direct supervision of a health care 259
provider as part of the student's or intern's training or internship; or (3) 260
a person who does not work in a central service department in a health 261
care facility, but who has been specially trained and determined 262
competent, based on standards set by a health care facility's infection 263
prevention or control committee, acting in consultation with a central 264
service technician certified in accordance with subsection (b) of this 265
section, to decontaminate or sterilize reusable medical equipment, 266
instruments or devices, in a manner that meets applicable 267 Substitute Bill No. 5500
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manufacturer's instructions and standards. 268
Sec. 7. Subsection (a) of section 12-20a of the general statutes is 269
repealed and the following is substituted in lieu thereof (Effective October 270
1, 2022): 271
(a) Until the fiscal year commencing July 1, 2016, on or before January 272
first, annually, the Secretary of the Office of Policy and Management 273
shall determine the amount due to each municipality in the state, in 274
accordance with this section, as a state grant in lieu of taxes with respect 275
to real property owned by any private nonprofit institution of higher 276
learning or any nonprofit general hospital facility or freestanding 277
chronic disease hospital or an urgent care facility that operates for at 278
least twelve hours a day and that had been the location of a nonprofit 279
general hospital for at least a portion of calendar year 1996 to receive 280
payments in lieu of taxes for such property, exclusive of any such facility 281
operated by the federal government, except a campus of the United 282
States Department of Veterans Affairs Connecticut Healthcare Systems, 283
or the state of Connecticut or any subdivision thereof. As used in this 284
section, "private nonprofit institution of higher learning" means any 285
such institution, as defined in subsection (a) of section 10a-34, or any 286
independent institution of higher education, as defined in subsection (a) 287
of section 10a-173, that is engaged primarily in education beyond the 288
high school level, and offers courses of instruction for which college or 289
university-level credit may be given or may be received by transfer, the 290
property of which is exempt from property tax under any of the 291
subdivisions of section 12-81, as amended by this act; "nonprofit general 292
hospital facility" means any such facility that is used primarily for the 293
purpose of general medical care and treatment, exclusive of any hospital 294
facility used primarily for the care and treatment of special types of 295
disease or physical or mental conditions; and "freestanding chronic 296
disease hospital" [means a facility that provides for the care and 297
treatment of chronic diseases] has the same meaning as "chronic disease 298
hospital" as defined in section 19a-490, as amended by this act, 299
excluding any such facility having an ownership affiliation with and 300 Substitute Bill No. 5500
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operated in the same location as a chronic and convalescent nursing 301
home. 302
Sec. 8. Section 17b-368 of the general statutes is repealed and the 303
following is substituted in lieu thereof (Effective October 1, 2022): 304
On or before July 1, 2004, the Department of Social Services shall, 305
within the limits of available Medicaid funding, implement a pilot 306
project in Greater Hartford with a chronic disease hospital colocated 307
with a skilled nursing facility and with the facilities, medical staff and 308
all necessary personnel for the diagnosis, care and treatment of chronic 309
or geriatric mental conditions that require prolonged hospital or 310
restorative care. For purposes of this section, "chronic disease hospital" 311
[means a long-term hospital with facilities, medical staff and all 312
necessary personnel for the diagnosis, care and treatment of chronic 313
physical and geriatric mental health conditions that require prolonged 314
hospital or restorative care] has the same meaning as provided in section 315
19a-490, as amended by this act. 316
Sec. 9. Subsection (a) of section 19a-491 of the 2022 supplement to the 317
general statutes is repealed and the following is substituted in lieu 318
thereof (Effective from passage): 319
(a) No person acting individually or jointly with any other person 320
shall establish, conduct, operate or maintain an institution in this state 321
without a license as required by this chapter, except for persons issued 322
a license by the Commissioner of Children and Families pursuant to 323
section 17a-145 for the operation of (1) a substance abuse treatment 324
facility, or (2) a facility for the purpose of caring for women during 325
pregnancies and for women and their infants following such 326
pregnancies, provided such exception shall not apply to the hospital and 327
psychiatric residential treatment facility units of the Albert J. Solnit 328
Children's Center. Application for such license shall (A) be made to the 329
Department of Public Health upon forms provided by it, (B) be 330
accompanied by the fee required under subsection (c), (d) or (e) of this 331
section, (C) contain such information as the department requires, which 332 Substitute Bill No. 5500
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may include affirmative evidence of ability to comply with reasonable 333
standards and regulations prescribed under the provisions of this 334
chapter, and (D) not be required to be notarized. The commissioner may 335
require as a condition of licensure that an applicant sign a consent order 336
providing reasonable assurances of compliance with the Public Health 337
Code. The commissioner may issue more than one chronic disease 338
hospital license to a single institution until such time as the state offers 339
a rehabilitation hospital license. 340
Sec. 10. Subsection (a) of section 19a-497 of the general statutes is 341
repealed and the following is substituted in lieu thereof (Effective October 342
1, 2022): 343
(a) Each institution shall, upon receipt of a notice of intention to strike 344
by a labor organization representing the employees of such institution, 345
in accordance with the provisions of the National Labor Relations Act, 346
29 USC 158, file a strike contingency plan with the commissioner not 347
later than five days before the date indicated for the strike. Such strike 348
contingency plan shall include the institution's staffing plan for at least 349
the first three days of such strike. The strike contingency plan shall 350
include, but need not be limited to, the names and titles of the 351
individuals who will be providing services at the institution. 352
Sec. 11. Subsections (a) and (b) of section 19a-515 of the general 353
statutes are repealed and the following is substituted in lieu thereof 354
(Effective from passage): 355
(a) Each nursing home administrator's license issued pursuant to the 356
provisions of sections 19a-511 to 19a-520, inclusive, shall be renewed 357
once every two years, in accordance with section 19a-88, except for 358
cause, by the Department of Public Health, upon forms to be furnished 359
by said department and upon the payment to said department, by each 360
applicant for license renewal, of the sum of two hundred five dollars. 361
Each such fee shall be remitted to the Department of Public Health on 362
or before the date prescribed under section 19a-88. Such renewals shall 363
be granted unless said department finds the applicant has acted or failed 364 Substitute Bill No. 5500
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to act in such a manner or under such circumstances as would constitute 365
grounds for suspension or revocation of such license. 366
(b) Each licensee shall complete a minimum of forty hours of 367
continuing education every two years, including, but not limited to, 368
training in (1) Alzheimer's disease and dementia symptoms and care, 369
and (2) infection prevention and control. Such two-year period shall 370
commence on the first date of renewal of the licensee's license after 371
January 1, 2004. The continuing education shall be in areas related to the 372
licensee's practice. Qualifying continuing education activities are 373
courses offered or approved by the Connecticut Association of 374
Healthcare Facilities, LeadingAge Connecticut, Inc., the Connecticut 375
Assisted Living Association, the Connecticut Alliance for Subacute 376
Care, Inc., the Connecticut Chapter of the American College of Health 377
Care Administrators, the Association For Long Term Care Financial 378
Managers, the Alzheimer's Association or any accredited college or 379
university, or programs presented or approved by the National 380
Continuing Education Review Service of the National Association of 381
Boards of Examiners of Long Term Care Administrators, the 382
Association for Professionals in Infection Control and Epidemiology or 383
by federal or state departments or agencies. 384
Sec. 12. Subsection (a) of section 19a-492e of the 2022 supplement to 385
the general statutes is repealed and the following is substituted in lieu 386
thereof (Effective October 1, 2022): 387
(a) For purposes of this section "home health care agency" and 388
"hospice agency" have the same meanings as provided in section 19a-389
490, as amended by this act. Notwithstanding the provisions of chapter 390
378, a registered nurse may delegate the administration of medications 391
that are not administered by injection to home health aides and hospice 392
aides who have obtained (1) certification and recertification every three 393
years thereafter for medication administration in accordance with 394
regulations adopted pursuant to subsection (b) of this section, or (2) a 395
current certification from the Department of Children and Families or 396
the Department of Developmental Services in accordance with section 397 Substitute Bill No. 5500
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19a-495a, as amended by this act, unless the prescribing practitioner 398
specifies that a medication shall only be administered by a licensed 399
nurse. [Any home health aide or hospice aide who obtained certification 400
in the administration of medications on or before June 30, 2015, shall 401
obtain recertification on or before July 1, 2018.] 402
Sec. 13. Subsections (a) and (b) of section 19a-495a of the general 403
statutes are repealed and the following is substituted in lieu thereof 404
(Effective October 1, 2022): 405
(a) (1) The Commissioner of Public Health may adopt regulations, as 406
provided in subsection (d) of this section, to require each residential care 407
home [, as defined in section 19a-490,] that admits residents requiring 408
assistance with medication administration, to (A) designate unlicensed 409
personnel to obtain certification for the administration of medication 410
from the Department of Public Health, Department of Children and 411
Families or Department of Developmental Services, and (B) ensure that 412
such unlicensed personnel receive such certification and recertification 413
every three years thereafter from the Department of Public Health, 414
Department of Children and Families or Department of Developmental 415
Services. 416
(2) Any regulations adopted pursuant to this subsection shall 417
establish criteria to be used by such homes in determining (A) the 418
appropriate number of unlicensed personnel who shall obtain such 419
certification and recertification, and (B) training requirements, 420
including ongoing training requirements for such certification and 421
recertification. 422
(3) Training requirements for initial certification and recertification 423
shall include, but shall not be limited to: Initial orientation, resident 424
rights, identification of the types of medication that may be 425
administered by unlicensed personnel, behavioral management, 426
personal care, nutrition and food safety, and health and safety in 427
general. 428 Substitute Bill No. 5500
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(b) Each residential care home [, as defined in section 19a-490,] shall 429
ensure that an appropriate number of unlicensed personnel, as 430
determined by the residential care home, obtain certification and 431
recertification for the administration of medication from the 432
Department of Public Health, Department of Children and Families or 433
Department of Developmental Services. Certification and recertification 434
of such personnel shall be in accordance with any regulations adopted 435
pursuant to this section. [, except any personnel who obtained 436
certification in the administration of medication on or before June 30, 437
2015, shall obtain recertification on or before July 1, 2018.] Unlicensed 438
personnel obtaining such certification and recertification may 439
administer medications that are not administered by injection to 440
residents of such homes, unless a resident's physician specifies that a 441
medication only be administered by licensed personnel. 442
Sec. 14. (Effective from passage) The Commissioner of Public Health 443
shall conduct a scope of practice review pursuant to sections 19a-16d to 444
19a-16f, inclusive, of the general statutes, as amended by this act, to 445
determine whether the Department of Public Health should regulate 446
midwives who are not eligible for licensure as nurse-midwives, licensed 447
pursuant to chapter 377 of the general statutes. The commissioner shall 448
report, in accordance with the provisions of section 11-4a of the general 449
statutes, the findings of such review and any recommendations to the 450
joint standing committee of the General Assembly having cognizance of 451
matters relating to public health on or before February 1, 2023. 452
Sec. 15. Section 20-90 of the general statutes is repealed and the 453
following is substituted in lieu thereof (Effective from passage): 454
(a) [Said board may adopt a seal. The Commissioner of Public Health, 455
with advice and assistance from the board, and in consultation with the 456
State Board of Education, shall adopt regulations, in accordance with 457
the provisions of chapter 54, permitting and setting standards for 458
courses for the training of practical nurses to be offered in high schools 459
or by the Technical Education and Career System for students who have 460
not yet acquired a high school diploma. Students who satisfactorily 461 Substitute Bill No. 5500
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complete courses approved by said Board of Examiners for Nursing, 462
with the consent of the Commissioner of Public Health, as meeting such 463
standards shall be given credit for each such course toward the 464
requirements for a practical nurse's license. All schools of nursing in this 465
state, except such schools accredited by the National League for Nursing 466
or other professional accrediting association approved by the United 467
States Department of Education and recognized by the Commissioner 468
of Public Health, and all schools for training licensed practical nurses 469
and all hospitals connected to such schools] The Connecticut State Board 470
of Examiners for Nursing shall have the following duties: (1) Hear and 471
decide matters concerning suspension or revocation of licensure; (2) 472
adjudicate complaints filed against practitioners licensed under this 473
chapter and impose sanctions where appropriate; (3) approve schools of 474
nursing in the state that prepare persons for examination under the 475
provisions of this chapter; and (4) consult, where possible, with national 476
recognized accrediting agencies when approving schools pursuant to 477
subdivision (3) of this subsection. The board may adopt a seal. 478
(b) All schools of nursing in the state that prepare persons for 479
examination under the provisions of this chapter, shall be (1) visited 480
periodically by a representative of the Department of Public Health who 481
shall be a registered nurse or a person experienced in the field of nursing 482
education, and (2) approved by the Connecticut State Board of 483
Examiners for Nursing pursuant to subdivisions (3) and (4) of 484
subsection (a) of this section. 485
(c) The [board shall keep] Department of Public Health shall post a 486
list of all nursing programs and all programs for training licensed 487
practical nurses that are approved by [it, with the consent of the 488
Commissioner of Public Health, as maintaining] the Connecticut State 489
Board of Examiners for Nursing and maintain the standard for the 490
education of nurses and the training of licensed practical nurses as 491
established by the [commissioner. The board shall consult, where 492
possible, with nationally recognized accrediting agencies when 493
approving schools] Commissioner of Public Health on the department's 494 Substitute Bill No. 5500
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Internet web site. 495
[(b) Said board shall (1) hear and decide matters concerning 496
suspension or revocation of licensure, (2) adjudicate complaints filed 497
against practitioners licensed under this chapter and impose sanctions 498
where appropriate.] 499
Sec. 16. Subsections (c) and (d) of section 19a-16d of the general 500
statutes are repealed and the following is substituted in lieu thereof 501
(Effective from passage): 502
(c) In any year in which a scope of practice request is received 503
pursuant to this section, not later than September [fifteenth] first of the 504
year preceding the commencement of the next regular session of the 505
General Assembly, the Department of Public Health, within available 506
appropriations, shall: (1) Provide written notification to the joint 507
standing committee of the General Assembly having cognizance of 508
matters relating to public health of any health care profession that has 509
submitted a scope of practice request, including any request for 510
exemption, to the department pursuant to this section; and (2) post any 511
such request, including any request for exemption, and the name and 512
address of the requestor on the department's Internet web site. 513
(d) Any person or entity, acting on behalf of a health care profession 514
that may be directly impacted by a scope of practice request submitted 515
pursuant to this section, may submit to the department a written 516
statement identifying the nature of the impact not later than [October 517
first] September fifteenth of the year preceding the next regular session 518
of the General Assembly. Any such person or entity directly impacted 519
by a scope of practice request shall indicate the nature of the impact 520
taking into consideration the criteria set forth in subsection (b) of this 521
section and shall provide a copy of the written impact statement to the 522
requestor. Not later than October [fifteenth] first of such year, the 523
requestor shall submit a written response to the department and any 524
person or entity that has provided a written impact statement. The 525
requestor's written response shall include, but not be limited to, a 526 Substitute Bill No. 5500
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description of areas of agreement and disagreement between the 527
respective health care professions. 528
Sec. 17. Subsection (a) of section 19a-16e of the general statutes is 529
repealed and the following is substituted in lieu thereof (Effective from 530
passage): 531
(a) On or before [November first] October fifteenth of the year 532
preceding the commencement of the next regular session of the General 533
Assembly, the Commissioner of Public Health shall, within available 534
appropriations allocated to the department, establish and appoint 535
members to a scope of practice review committee for each timely scope 536
of practice request submitted to the department pursuant to section 19a-537
16d, as amended by this act. Committees established pursuant to this 538
section shall consist of the following members: (1) Two members 539
recommended by the requestor to represent the health care profession 540
making the scope of practice request; (2) two members recommended 541
by each person or entity that has submitted a written impact statement 542
pursuant to subsection (d) of section 19a-16d, as amended by this act, to 543
represent the health care professions directly impacted by the scope of 544
practice request; and (3) the Commissioner of Public Health or the 545
commissioner's designee, who shall serve as an ex-officio, nonvoting 546
member of the committee. The Commissioner of Public Health or the 547
commissioner's designee shall serve as the chairperson of any such 548
committee. The Commissioner of Public Health may appoint additional 549
members to any committee established pursuant to this section to 550
include representatives from health care professions having a proximate 551
relationship to the underlying request if the commissioner or the 552
commissioner's designee determines that such expansion would be 553
beneficial to a resolution of the issues presented. Any member of such 554
committee shall serve without compensation. 555
Sec. 18. Subsection (c) of section 20-132a of the 2022 supplement to 556
the general statutes is repealed and the following is substituted in lieu 557
thereof (Effective from passage): 558 Substitute Bill No. 5500
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(c) (1) Except as provided in this section, a licensee who is actively 559
engaged in the practice of optometry shall earn a minimum of twenty 560
hours of continuing education each registration period. The subject 561
matter for continuing education shall reflect the professional needs of 562
the licensee in order to meet the health care needs of the public, and shall 563
include [(1)] (A) not less than six hours in any of the following areas: 564
Pathology, detection of diabetes and ocular treatment; and [(2)] (B) not 565
less than six hours in treatment as it applies to the use of ocular agents-566
T. 567
(2) Coursework shall be provided in the following manner: (A) Not 568
less than ten hours shall be earned through direct, live instruction that 569
the licensee physically attends; [either individually or as part of a group 570
of participants or through a formal home study or distance learning 571
program. Not] (B) not more than ten hours shall be earned through 572
synchronous online education with opportunities for live interaction; 573
(C) not more than [six] five hours shall be earned through [a home study 574
or other distance learning program] asynchronous online education, 575
distance learning or home study; and (D) not more than six hours shall 576
be in practice management. For the purposes of this subdivision, 577
"synchronous online education" means live online classes that are 578
conducted in real time and "asynchronous online education" means a 579
program where the instructor, learner and other participants are not 580
engaged in the learning process at the same time, there is no real-time 581
interaction between participants and instructors and the educational 582
content is created and made available for later consumption. 583
(3) Qualifying continuing education activities include, but are not 584
limited to, courses offered or approved by the Council on Optometric 585
Practitioner Education of the Association of Regulatory Boards of 586
Optometry, the American Optometric Association or state or local 587
optometry associations and societies that are affiliated with the 588
American Optometric Association, a hospital or other health care 589
institution, a school or college of optometry or other institution of higher 590
education accredited or recognized by the Council on Optometric 591 Substitute Bill No. 5500
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Practitioner Education or the American Optometric Association, a state 592
or local health department, or a national, state or local medical 593
association. 594
Sec. 19. Subsection (b) of section 19a-14c of the 2022 supplement to 595
the general statutes is repealed and the following is substituted in lieu 596
thereof (Effective from passage): 597
(b) A psychiatrist licensed pursuant to chapter 370, a psychologist 598
licensed pursuant to chapter 383, [an independent] a clinical social 599
worker [certified] licensed pursuant to chapter 383b or a marital and 600
family therapist licensed pursuant to chapter 383a may provide 601
outpatient mental health treatment to a minor without the consent or 602
notification of a parent or guardian at the request of the minor if (1) 603
requiring the consent or notification of a parent or guardian would 604
cause the minor to reject such treatment; (2) the provision of such 605
treatment is clinically indicated; (3) the failure to provide such treatment 606
would be seriously detrimental to the minor's well-being; (4) the minor 607
has knowingly and voluntarily sought such treatment; and (5) in the 608
opinion of the provider of treatment, the minor is mature enough to 609
participate in treatment productively. The provider of such treatment 610
shall document the reasons for any determination made to treat a minor 611
without the consent or notification of a parent or guardian and shall 612
include such documentation in the minor's clinical record, along with a 613
written statement signed by the minor stating that (A) the minor is 614
voluntarily seeking such treatment; (B) the minor has discussed with the 615
provider the possibility of involving his or her parent or guardian in the 616
decision to pursue such treatment; (C) the minor has determined it is 617
not in his or her best interest to involve his or her parent or guardian in 618
such decision; and (D) the minor has been given adequate opportunity 619
to ask the provider questions about the course of his or her treatment. 620
Sec. 20. Subsection (b) of section 20-12j of the 2022 supplement to the 621
general statutes is repealed and the following is substituted in lieu 622
thereof (Effective from passage): 623 Substitute Bill No. 5500
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(b) Each person holding a license as a physician assistant shall, 624
annually, during the month of such person's birth, [register] renew such 625
license with the Department of Public Health, upon payment of a fee of 626
one hundred fifty-five dollars, on [blanks] a form to be [furnished] 627
provided by the department for such purpose, giving such person's 628
name in full, such person's residence and business address and such 629
other information as the department requests. No such license shall be 630
renewed unless the department is satisfied that the practitioner (1) has 631
met the mandatory continuing medical education requirements of the 632
National Commission on Certification of Physician Assistants or a 633
successor organization for the certification or recertification of physician 634
assistants that may be approved by the department; (2) has passed any 635
examination or continued competency assessment the passage of which 636
may be required by said commission for maintenance of current 637
certification by said commission; (3) has completed not less than one 638
contact hour of training or education in prescribing controlled 639
substances and pain management in the preceding two-year period; and 640
(4) for registration periods beginning on [or before] and after January 1, 641
2022, during the first renewal period and not less than once every six 642
years thereafter, earn not less than two contact hours of training or 643
education screening for post-traumatic stress disorder, risk of suicide, 644
depression and grief and suicide prevention training administered by 645
the American [Association] Academy of Physician Assistants, or the 646
American Academy of Physician Assistants' successor organization, a 647
hospital or other licensed health care institution or a regionally 648
accredited institution of higher education. 649
Sec. 21. Subparagraph (B) of subdivision (8) of section 19a-177 of the 650
2022 supplement to the general statutes is repealed and the following is 651
substituted in lieu thereof (Effective from passage): 652
(B) On or before [December 31, 2018] April 1, 2023, and annually 653
thereafter, the commissioner shall prepare a report to the Emergency 654
Medical Services Advisory Board, established pursuant to section 19a-655
178a, that shall include, but not be limited to, the following data: (i) The 656 Substitute Bill No. 5500
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total number of calls for emergency medical services received during 657
the reporting year by each licensed ambulance service, certified 658
ambulance service or paramedic intercept service; (ii) the level of 659
emergency medical services required for each such call; (iii) the name of 660
the emergency medical service organization that provided each such 661
level of emergency medical services furnished during the reporting 662
year; (iv) the response time, by time ranges or fractile response times, 663
for each licensed ambulance service, certified ambulance service or 664
paramedic intercept service, using a common definition of response 665
time, as provided in regulations adopted pursuant to section 19a-179; 666
and (v) the number of passed calls, cancelled calls and mutual aid calls 667
during the reporting year. The commissioner shall prepare such report 668
in a format that categorizes such data for each municipality in which the 669
emergency medical services were provided, with each such 670
municipality grouped according to urban, suburban and rural 671
classifications. 672
Sec. 22. Subdivision (5) of section 14-1 of the 2022 supplement to the 673
general statutes is repealed and the following is substituted in lieu 674
thereof (Effective from passage): 675
(5) "Authorized emergency vehicle" means (A) a fire department 676
vehicle, (B) a police vehicle, or (C) an [ambulance] authorized 677
emergency medical services vehicle, as defined in section 19a-175; 678
Sec. 23. Subsection (a) of section 19a-30 of the 2022 supplement to the 679
general statutes is repealed and the following is substituted in lieu 680
thereof (Effective October 1, 2022): 681
(a) As used in this section, "clinical laboratory" [means any facility or 682
other area used for microbiological, serological, chemical, 683
hematological, immunohematological, biophysical, cytological, 684
pathological or other examinations of human body fluids, secretions, 685
excretions or excised or exfoliated tissues, for the purpose of providing 686
information for the diagnosis, prevention or treatment of any human 687
disease or impairment, for the assessment of human health or for the 688 Substitute Bill No. 5500
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presence of drugs, poisons or other toxicological substances] has the 689
same meaning as provided in section 19a-490, as amended by this act. 690
Sec. 24. Section 19a-31b of the general statutes is repealed and the 691
following is substituted in lieu thereof (Effective October 1, 2022): 692
No clinical laboratory, as defined in section [19a-30] 19a-490, as 693
amended by this act, that offers hair follicle drug testing as part of its 694
array of diagnostic testing services shall refuse to administer a hair 695
follicle drug test that has been ordered by a physician or physician 696
assistant, licensed under chapter 370, or an advanced practice registered 697
nurse, licensed under chapter 378. 698
Sec. 25. Subdivisions (1) and (2) of subsection (a) of section 19a-72 of 699
the 2022 supplement to the general statutes are repealed and the 700
following is substituted in lieu thereof (Effective October 1, 2022): 701
(1) "Clinical laboratory" [means any facility or other area used for 702
microbiological, serological, chemical, hematological, 703
immunohematological, biophysical, cytological, pathological or other 704
examinations of human body fluids, secretions, excretions or excised or 705
exfoliated tissues, for the purpose of providing information for the 706
diagnosis, prevention or treatment of any human disease or 707
impairment, for the assessment of human health or for the presence of 708
drugs, poisons or other toxicological substances] has the same meaning 709
as provided in section 19a-490, as amended by this act; 710
(2) "Hospital" [means an establishment for the lodging, care and 711
treatment of persons suffering from disease or other abnormal physical 712
or mental conditions and includes inpatient psychiatric services in 713
general hospitals] has the same meaning as provided in section 19a-490, 714
as amended by this act; 715
Sec. 26. Subdivision (1) of subsection (a) of section 19a-215 of the 2022 716
supplement to the general statutes is repealed and the following is 717
substituted in lieu thereof (Effective October 1, 2022): 718 Substitute Bill No. 5500
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(1) "Clinical laboratory" [means any facility or other area used for 719
microbiological, serological, chemical, hematological, 720
immunohematological, biophysical, cytological, pathological or other 721
examinations of human body fluids, secretions, excretions or excised or 722
exfoliated tissues, for the purpose of providing information for the 723
diagnosis, prevention or treatment of any human disease or 724
impairment, for the assessment of human health or for the presence of 725
drugs, poisons or other toxicological substances] has the same meaning 726
as provided in section 19a-490, as amended by this act. 727
Sec. 27. Subsection (a) of section 19a-269b of the general statutes is 728
repealed and the following is substituted in lieu thereof (Effective October 729
1, 2022): 730
(a) As used in this section, "clinical laboratory" has the same meaning 731
as provided in section [19a-30] 19a-490, as amended by this act. 732
Sec. 28. Subsection (d) of section 20-7a of the general statutes is 733
repealed and the following is substituted in lieu thereof (Effective October 734
1, 2022): 735
(d) No person or entity, other than a physician licensed under chapter 736
370, a clinical laboratory, as defined in section [19a-30] 19a-490, as 737
amended by this act, or a referring clinical laboratory, shall directly or 738
indirectly charge, bill or otherwise solicit payment for the provision of 739
anatomic pathology services, unless such services were personally 740
rendered by or under the direct supervision of such physician, clinical 741
laboratory or referring laboratory in accordance with section 353 of the 742
Public Health Service Act, (42 USC 263a). A clinical laboratory or 743
referring laboratory may only solicit payment for anatomic pathology 744
services from the patient, a hospital, the responsible insurer of a third 745
party payor, or a governmental agency or such agency's public or 746
private agent that is acting on behalf of the recipient of such services. 747
Nothing in this subsection shall be construed to prohibit a clinical 748
laboratory from billing a referring clinical laboratory when specimens 749
are transferred between such laboratories for histologic or cytologic 750 Substitute Bill No. 5500
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processing or consultation. No patient or other third party payor, as 751
described in this subsection, shall be required to reimburse any provider 752
for charges or claims submitted in violation of this section. For purposes 753
of this subsection, (1) "referring clinical laboratory" means a clinical 754
laboratory that refers a patient specimen for consultation or anatomic 755
pathology services, excluding the laboratory of a physician's office or 756
group practice that takes a patient specimen and does not perform the 757
professional diagnostic component of the anatomic pathology services 758
involved, and (2) "anatomic pathology services" means the gross and 759
microscopic examination and histologic or cytologic processing of 760
human specimens, including histopathology or surgical pathology, 761
cytopathology, hematology, subcellular pathology or molecular 762
pathology or blood banking service performed by a pathologist. 763
Sec. 29. Subsection (a) of section 20-7c of the general statutes is 764
repealed and the following is substituted in lieu thereof (Effective October 765
1, 2022): 766
(a) For purposes of this section, "clinical laboratory" has the same 767
meaning as provided in section [19a-30] 19a-490, as amended by this act. 768
"Clinical laboratory" does not include any state laboratory established 769
by the Department of Public Health pursuant to section 19a-26 or 19a-770
29. 771
Sec. 30. Subparagraph (A) of subdivision (6) of subsection (a) of 772
section 38a-477aa of the general statutes is repealed and the following is 773
substituted in lieu thereof (Effective October 1, 2022): 774
(6) (A) "Surprise bill" means a bill for health care services, other than 775
emergency services, received by an insured for services rendered by an 776
out-of-network health care provider, where such services were rendered 777
by (i) such out-of-network provider at an in-network facility, during a 778
service or procedure performed by an in-network provider or during a 779
service or procedure previously approved or authorized by the health 780
carrier and the insured did not knowingly elect to obtain such services 781
from such out-of-network provider, or (ii) a clinical laboratory, as 782 Substitute Bill No. 5500
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defined in section [19a-30] 19a-490, as amended by this act, that is an 783
out-of-network provider, upon the referral of an in-network provider. 784
Sec. 31. Section 7-51a of the 2022 supplement to the general statutes 785
is repealed and the following is substituted in lieu thereof (Effective from 786
passage): 787
(a) Any person eighteen years of age or older may purchase certified 788
copies of marriage and death records, and certified copies of records of 789
births or fetal deaths which are at least one hundred years old, in the 790
custody of any registrar of vital statistics. The department may issue 791
uncertified copies of death certificates for deaths occurring less than one 792
hundred years ago, and uncertified copies of birth, marriage, death and 793
fetal death certificates for births, marriages, deaths and fetal deaths that 794
occurred at least one hundred years ago, to researchers approved by the 795
department pursuant to section 19a-25, and to state and federal agencies 796
approved by the department. During all normal business hours, 797
members of genealogical societies incorporated or authorized by the 798
Secretary of the State to do business or conduct affairs in this state shall 799
(1) have full access to all vital records in the custody of any registrar of 800
vital statistics, including certificates, ledgers, record books, card files, 801
indexes and database printouts, except for those records containing 802
Social Security numbers protected pursuant to 42 USC 405 (c)(2)(C), and 803
confidential files on adoptions, gender change, surrogacy agreements, 804
and parentage, (2) be permitted to make notes from such records, (3) be 805
permitted to purchase certified copies of such records, and (4) be 806
permitted to incorporate statistics derived from such records in the 807
publications of such genealogical societies. For all vital records 808
containing Social Security numbers that are protected from disclosure 809
pursuant to federal law, the Social Security numbers contained on such 810
records shall be redacted from any certified copy of such records issued 811
to a genealogist by a registrar of vital statistics. 812
(b) For marriage and civil union licenses, the Social Security numbers 813
of the parties to the marriage or civil union shall be recorded in the 814
"administrative purposes" section of the marriage or civil union license 815 Substitute Bill No. 5500
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and the application for such license. All persons specified on the license, 816
including the parties to the marriage or civil union, officiator and local 817
registrar shall have access to the Social Security numbers specified on 818
the marriage or civil union license and the application for such license 819
for the purpose of processing the license. Only the parties to a marriage 820
or civil union, or entities authorized by state or federal law, may receive 821
a certified copy of a marriage or civil union license with the Social 822
Security numbers included on the license. Any other individual, 823
researcher or state or federal agency requesting a certified or uncertified 824
copy of any marriage or civil union license in accordance with the 825
provisions of this section shall be provided such copy with such Social 826
Security numbers removed or redacted, or with the "administrative 827
purposes" section omitted. 828
(c) For deaths occurring on or after July 1, 1997, the Social Security 829
number of the deceased person shall be recorded in the "administrative 830
purposes" section of the death certificate. Such administrative purposes 831
section, and the Social Security number contained therein, shall be 832
restricted and disclosed only to the following eligible parties: (1) All 833
parties specified on the death certificate, including the informant, 834
licensed funeral director, licensed embalmer, conservator, surviving 835
spouse, physician or advanced practice registered nurse and town clerk, 836
for the purpose of processing the certificate, (2) the surviving spouse, (3) 837
the next of kin, or (4) any state and federal agencies authorized by 838
federal law. The department shall provide any other individual, 839
researcher or state or federal agency requesting a certified or uncertified 840
death certificate, or the information contained within such certificate, 841
for a death occurring on or after July 1, 1997, such certificate or 842
information. The decedent's Social Security number shall be removed or 843
redacted from such certificate or information or the administrative 844
purposes section shall be omitted from such certificate. 845
(d) The registrar of vital statistics of any town or city in this state that 846
has access to an electronic vital records system, as authorized by the 847
department, may use such system to issue certified copies of birth, 848 Substitute Bill No. 5500
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death, fetal death or marriage certificates that are electronically filed in 849
such system. 850
[(e) Any registrar of vital statistics who receives payment pursuant to 851
this section may permit such payment to be made on an Internet web 852
site designated by the registrar, in a manner prescribed by the registrar.] 853
Sec. 32. Section 7-74 of the general statutes is repealed and the 854
following is substituted in lieu thereof (Effective from passage): 855
(a) The fee for a certification of birth registration, short form, shall be 856
fifteen dollars. The fee for a certified copy of a certificate of birth, long 857
form, shall be twenty dollars, except that the fee for such certifications 858
and copies when issued by the department shall be thirty dollars. 859
(b) (1) The fee for a certified copy of a certificate of marriage or death 860
shall be twenty dollars. Such fees shall not be required of the 861
department. 862
(2) Any fee received by the Department of Public Health for a 863
certificate of death shall be deposited in the neglected cemetery account, 864
established in accordance with section 19a-308b. 865
(c) The fee for one certified copy of a certificate of death for any 866
deceased person who was a veteran, as defined in subsection (a) of 867
section 27-103, shall be waived when such copy is requested by a 868
spouse, child or parent of such deceased veteran. 869
(d) The fee for an uncertified copy of an original certificate of birth 870
issued pursuant to section 7-53 shall be sixty-five dollars. 871
(e) Any registrar of vital statistics who receives payment pursuant to 872
this section may permit such payment to be made on an Internet web 873
site designated by the registrar, in a manner prescribed by the registrar, 874
as approved by the Commissioner of Public Health, or the 875
commissioner's designee. 876 Substitute Bill No. 5500
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Sec. 33. Subsections (c) and (d) of section 19a-36m of the general 877
statutes are repealed and the following is substituted in lieu thereof 878
(Effective from passage): 879
(c) The provisions of the food code that concern the employment of a 880
certified food protection manager and any reporting requirements 881
relative to such certified food protection manager [(1)] shall not apply 882
to [(A)] (1) an owner or operator of a soup kitchen that relies exclusively 883
on services provided by volunteers, [(B)] (2) any volunteer who serves 884
meals from a nonprofit organization, including a temporary food 885
service establishment and a special event sponsored by a nonprofit civic 886
organization, including, but not limited to, school sporting events, little 887
league food booths, church suppers and fairs, or [(C)] (3) any person 888
who serves meals to individuals at a registered congregate meal site 889
funded under Title III of the Older Americans Act of 1965, as amended 890
from time to time, that were prepared under the supervision of a 891
certified food protection manager. [, and (2) shall not prohibit the sale 892
or distribution of food at (A) a bed and breakfast establishment that 893
prepares and offers food to guests, provided the operation is owner-894
occupied and the total building occupant load is not more than sixteen 895
persons, including the owner and occupants, has no provisions for 896
cooking or warming food in the guest rooms, breakfast is the only meal 897
offered and the consumer of such operation is informed by statements 898
contained in published advertisements, mailed brochures and placards 899
posted in the registration area that the food is prepared in a kitchen that 900
is not regulated and inspected by the local health director, and (B) a 901
noncommercial function, including, but not limited to, an educational, 902
religious, political or charitable organization's bake sale or potluck 903
supper, provided the seller or person distributing the food maintains 904
the food at the temperature, pH level and water activity level conditions 905
that will inhibit the growth of infectious or toxigenic microorganisms. 906
For the purposes of this subsection, "noncommercial function" means a 907
function where food is sold or distributed by a person not regularly 908
engaged in the business of selling such food for profit.] 909 Substitute Bill No. 5500
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(d) The provisions of the food code shall not (1) apply to a residential 910
care home with thirty beds or less that is licensed pursuant to chapter 911
368v, provided the administrator of the residential care home or the 912
administrator's designee has satisfactorily passed a test as part of a food 913
protection manager certification program that is evaluated and 914
approved by an accrediting agency recognized by the Conference for 915
Food Protection as conforming to its standard for accreditation of food 916
protection manager certification programs, unless such residential care 917
home enters into a service contract with a food establishment or lends, 918
rents or leases any area of its facility to any person or entity for the 919
purpose of preparing or selling food, at which time the provisions of the 920
food code shall apply to such residential care home, and (2) shall not 921
prohibit the sale or distribution of food at (A) a bed and breakfast 922
establishment that prepares and offers food to guests, provided the 923
operation is owner-occupied and the total building occupant load is not 924
more than sixteen persons, including the owner and occupants, has no 925
provisions for cooking or warming food in the guest rooms, breakfast is 926
the only meal offered and the consumer of such operation is informed 927
by statements contained in published advertisements, mailed brochures 928
and placards posted in the registration area that the food is prepared in 929
a kitchen that is not regulated and inspected by the local health director, 930
and (B) a noncommercial function, including, but not limited to, an 931
educational, religious, political or charitable organization's bake sale or 932
potluck supper, provided the seller or person distributing the food 933
maintains the food at the temperature, pH level and water activity level 934
conditions that will inhibit the growth of infectious or toxigenic 935
microorganisms. For the purposes of this subsection, "noncommercial 936
function" means a function where food is sold or distributed by a person 937
not regularly engaged in the business of selling such food for profit. 938
Sec. 34. Subparagraph (A) of subdivision (2) of subsection (c) of 939
section 16-245n of the 2022 supplement to the general statutes is 940
repealed and the following is substituted in lieu thereof (Effective from 941
passage): 942 Substitute Bill No. 5500
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(2) (A) There is hereby created an Environmental Infrastructure Fund 943
which shall be within the Connecticut Green Bank. The fund may 944
receive any amount required by law to be deposited into the fund and 945
may receive any federal funds as may become available to the state for 946
environmental infrastructure investments, except that the fund shall not 947
receive: (i) Ratepayer or Regional Greenhouse Gas Initiative funds, (ii) 948
funds that have been deposited in, or are required to be deposited in, an 949
account of the Clean Water Fund pursuant to sections 22a-475 to [22a-950
438f] 22a-483f, inclusive, or (iii) funds collected from a water company, 951
as defined in section 25-32a. 952
Sec. 35. Subsection (b) of section 20-191c of the 2022 supplement to 953
the general statutes is repealed and the following is substituted in lieu 954
thereof (Effective July 1, 2022): 955
(b) Qualifying continuing education activities shall be related to the 956
practice of psychology and shall include courses, seminars, workshops, 957
conferences and postdoctoral institutes offered or approved by: (1) The 958
American Psychological Association; (2) a regionally accredited 959
institution of higher education graduate program; (3) a nationally 960
recognized provider of continuing education seminars; (4) the 961
Department of Mental Health and Addiction Services; or (5) a 962
behavioral science organization that is professionally or scientifically 963
recognized. Not more than five continuing education units during each 964
registration period shall be completed via [the Internet] asynchronous 965
online education, distance learning or home study. Not less than five 966
continuing education units shall be earned through synchronous online 967
education. On and after January 1, 2016, qualifying continuing 968
education activities shall include not less than two contact hours of 969
training or education during the first renewal period in which 970
continuing education is required and not less than once every six years 971
thereafter on the topic of mental health conditions common to veterans 972
and family members of veterans, including (A) determining whether a 973
patient is a veteran or family member of a veteran, (B) screening for 974
conditions such as post-traumatic stress disorder, risk of suicide, 975 Substitute Bill No. 5500
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depression and grief, and (C) suicide prevention training. Qualifying 976
continuing education activities may include a licensee's research-based 977
presentation at a professional conference, provided not more than five 978
continuing education units during each registration period shall be 979
completed by such activities. A licensee who has earned a diploma from 980
the American Board of Professional Psychology during the registration 981
period may substitute the diploma for continuing education 982
requirements for such registration period. For purposes of this section, 983
"continuing education unit" means fifty to sixty minutes of participation 984
in accredited continuing professional education. For the purposes of this 985
subsection, "synchronous online education" means live online classes 986
that are conducted in real time and "asynchronous online education" 987
means a program where the instructor, learner and other participants 988
are not engaged in the learning process at the same time, there is no real-989
time interaction between participants and instructors and the 990
educational content is created and made available for later 991
consumption. 992
Sec. 36. Section 19a-563h of the 2022 supplement to the general 993
statutes is repealed and the following is substituted in lieu thereof 994
(Effective from passage): 995
(a) On or before January 1, 2022, the Department of Public Health 996
shall (1) establish minimum staffing level requirements for nursing 997
homes of three hours of direct care per resident per day, and (2) modify 998
staffing level requirements for social work and recreational staff of 999
nursing homes such that the requirements (A) for social work, [are] a 1000
number of hours that is based on one full-time social worker per sixty 1001
residents and that shall vary proportionally based on the number of 1002
residents in the nursing home, and (B) for recreational staff are lower 1003
than the current requirements, as deemed appropriate by the 1004
Commissioner of Public Health. 1005
(b) The commissioner shall adopt regulations in accordance with the 1006
provisions of chapter 54 that set forth nursing home staffing level 1007
requirements to implement the provisions of this section. The 1008 Substitute Bill No. 5500
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Commissioner of Public Health may implement policies and procedures 1009
necessary to administer the provisions of this section while in the 1010
process of adopting such policies and procedures as regulations, 1011
provided notice of intent to adopt regulations is published on the 1012
eRegulations System not later than twenty days after the date of 1013
implementation. Policies and procedures implemented pursuant to this 1014
section shall be valid until the time final regulations are adopted. 1015
Sec. 37. Section 17b-59d of the general statutes is repealed and the 1016
following is substituted in lieu thereof (Effective from passage): 1017
(a) There shall be established a State-wide Health Information 1018
Exchange to empower consumers to make effective health care 1019
decisions, promote patient-centered care, improve the quality, safety 1020
and value of health care, reduce waste and duplication of services, 1021
support clinical decision-making, keep confidential health information 1022
secure and make progress toward the state's public health goals. 1023
(b) It shall be the goal of the State-wide Health Information Exchange 1024
to: (1) Allow real-time, secure access to patient health information and 1025
complete medical records across all health care provider settings; (2) 1026
provide patients with secure electronic access to their health 1027
information; (3) allow voluntary participation by patients to access their 1028
health information at no cost; (4) support care coordination through 1029
real-time alerts and timely access to clinical information; (5) reduce costs 1030
associated with preventable readmissions, duplicative testing and 1031
medical errors; (6) promote the highest level of interoperability; (7) meet 1032
all state and federal privacy and security requirements; (8) support 1033
public health reporting, quality improvement, academic research and 1034
health care delivery and payment reform through data aggregation and 1035
analytics; (9) support population health analytics; (10) be standards-1036
based; and (11) provide for broad local governance that (A) includes 1037
stakeholders, including, but not limited to, representatives of the 1038
Department of Social Services, hospitals, physicians, behavioral health 1039
care providers, long-term care providers, health insurers, employers, 1040
patients and academic or medical research institutions, and (B) is 1041 Substitute Bill No. 5500
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committed to the successful development and implementation of the 1042
State-wide Health Information Exchange. 1043
(c) All contracts or agreements entered into by or on behalf of the state 1044
relating to health information technology or the exchange of health 1045
information shall be consistent with the goals articulated in subsection 1046
(b) of this section and shall utilize contractors, vendors and other 1047
partners with a demonstrated commitment to such goals. 1048
(d) (1) The executive director of the Office of Health Strategy, in 1049
consultation with the Secretary of the Office of Policy and Management 1050
and the State Health Information Technology Advisory Council, 1051
established pursuant to section 17b-59f, shall, upon the approval by the 1052
State Bond Commission of bond funds authorized by the General 1053
Assembly for the purposes of establishing a State-wide Health 1054
Information Exchange, develop and issue a request for proposals for the 1055
development, management and operation of the State-wide Health 1056
Information Exchange. Such request shall promote the reuse of any and 1057
all enterprise health information technology assets, such as the existing 1058
Provider Directory, Enterprise Master Person Index, Direct Secure 1059
Messaging Health Information Service provider infrastructure, analytic 1060
capabilities and tools that exist in the state or are in the process of being 1061
deployed. Any enterprise health information exchange technology 1062
assets purchased after June 2, 2016, and prior to the implementation of 1063
the State-wide Health Information Exchange shall be capable of 1064
interoperability with a State-wide Health Information Exchange. 1065
(2) Such request for proposals may require an eligible organization 1066
responding to the request to: (A) Have not less than three years of 1067
experience operating either a state-wide health information exchange in 1068
any state or a regional exchange serving a population of not less than 1069
one million that (i) enables the exchange of patient health information 1070
among health care providers, patients and other authorized users 1071
without regard to location, source of payment or technology, (ii) 1072
includes, with proper consent, behavioral health and substance abuse 1073
treatment information, (iii) supports transitions of care and care 1074 Substitute Bill No. 5500
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coordination through real-time health care provider alerts and access to 1075
clinical information, (iv) allows health information to follow each 1076
patient, (v) allows patients to access and manage their health data, and 1077
(vi) has demonstrated success in reducing costs associated with 1078
preventable readmissions, duplicative testing or medical errors; (B) be 1079
committed to, and demonstrate, a high level of transparency in its 1080
governance, decision-making and operations; (C) be capable of 1081
providing consulting to ensure effective governance; (D) be regulated or 1082
administratively overseen by a state government agency; and (E) have 1083
sufficient staff and appropriate expertise and experience to carry out the 1084
administrative, operational and financial responsibilities of the State-1085
wide Health Information Exchange. 1086
(e) Notwithstanding the provisions of subsection (d) of this section, 1087
if, on or before January 1, 2016, the Commissioner of Social Services, in 1088
consultation with the State Health Information Technology Advisory 1089
Council, established pursuant to section 17b-59f, submits a plan to the 1090
Secretary of the Office of Policy and Management for the establishment 1091
of a State-wide Health Information Exchange consistent with 1092
subsections (a), (b) and (c) of this section, and such plan is approved by 1093
the secretary, the commissioner may implement such plan and enter 1094
into any contracts or agreements to implement such plan. 1095
(f) The executive director of the Office of Health Strategy shall have 1096
administrative authority over the State-wide Health Information 1097
Exchange. The executive director shall be responsible for designating, 1098
and posting on its Internet web site, the list of systems, technologies, 1099
entities and programs that shall constitute the State-wide Health 1100
Information Exchange. Systems, technologies, entities, and programs 1101
that have not been so designated shall not be considered part of said 1102
exchange. 1103
(g) The executive director of the Office of Health Strategy may 1104
implement policies and procedures necessary to administer the 1105
provisions of this section while in the process of adopting such policies 1106
and procedures in regulation form, provided the executive director 1107 Substitute Bill No. 5500
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publishes notice of intention to adopt the regulations on the Office of 1108
Health Strategy's Internet web site and the eRegulations System not 1109
later than twenty days after implementing such policies and procedures. 1110
Policies and procedures implemented pursuant to this subsection shall 1111
be valid until the time such regulations are effective. 1112
Sec. 38. Section 17b-59e of the general statutes is repealed and the 1113
following is substituted in lieu thereof (Effective from passage): 1114
(a) For purposes of this section: 1115
(1) "Health care provider" means any individual, corporation, facility 1116
or institution licensed by the state to provide health care services; and 1117
(2) "Electronic health record system" means a computer-based 1118
information system that is used to create, collect, store, manipulate, 1119
share, exchange or make available electronic health records for the 1120
purposes of the delivery of patient care. 1121
(b) Not later than one year after commencement of the operation of 1122
the State-wide Health Information Exchange, each hospital licensed 1123
under chapter 368v and clinical laboratory licensed under section 19a-1124
30, as amended by this act, shall maintain an electronic health record 1125
system capable of connecting to and participating in the State-wide 1126
Health Information Exchange and shall apply to begin the process of 1127
connecting to, and participating in, the State-wide Health Information 1128
Exchange. 1129
(c) Not later than two years after commencement of the operation of 1130
the State-wide Health Information Exchange, (1) each health care 1131
provider with an electronic health record system capable of connecting 1132
to, and participating in, the State-wide Health Information Exchange 1133
shall apply to begin the process of connecting to, and participating in, 1134
the State-wide Health Information Exchange, and (2) each health care 1135
provider without an electronic health record system capable of 1136
connecting to, and participating in, the State-wide Health Information 1137
Exchange shall be capable of sending and receiving secure messages 1138 Substitute Bill No. 5500
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that comply with the Direct Project specifications published by the 1139
federal Office of the National Coordinator for Health Information 1140
Technology. 1141
(d) The executive director of the Office of Health Strategy may 1142
implement policies and procedures necessary to administer the 1143
provisions of this section while in the process of adopting such policies 1144
and procedures in regulation form, provided the executive director 1145
publishes notice of intention to adopt the regulations on the Office of 1146
Health Strategy's Internet web site and the eRegulations System not 1147
later than twenty days after implementing such policies and procedures. 1148
Policies and procedures implemented pursuant to this subsection shall 1149
be valid until the time such regulations are effective. 1150
Sec. 39. Subsection (c) of section 19a-495 of the general statutes is 1151
repealed and the following is substituted in lieu thereof (Effective from 1152
passage): 1153
(c) The commissioner may waive any provisions of the regulations 1154
affecting an institution [, as defined in section 19a-490] or a clinical 1155
laboratory, licensed pursuant to section 19a-30, as amended by this act, 1156
if the commissioner determines that such waiver would not endanger 1157
the health, safety or welfare of any patient or resident. The 1158
commissioner may impose conditions, upon granting the waiver, that 1159
assure the health, safety and welfare of patients or residents, and may 1160
revoke the waiver upon a finding that the health, safety or welfare of 1161
any patient or resident has been jeopardized. The commissioner shall 1162
not grant a waiver that would result in a violation of the Fire Safety 1163
Code or State Building Code. The commissioner may adopt regulations, 1164
in accordance with chapter 54, establishing procedures for an 1165
application for a waiver pursuant to this subsection. 1166
Sec. 40. (Effective from passage) (a) As used in this section: 1167
(1) "Certified doula" means a doula that is certified by the Department 1168
of Public Health; and 1169 Substitute Bill No. 5500
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(2) "Doula" means a trained, nonmedical professional who provides 1170
physical, emotional and informational support, virtually or in person, 1171
to a pregnant person before, during and after birth. 1172
(b) The Commissioner of Public Health shall, within available 1173
resources, establish a Doula Advisory Committee within the 1174
Department of Public Health. The Doula Advisory Committee shall 1175
develop recommendations for (1) requirements for certification and 1176
certification renewal of doulas, including, but not limited to, training, 1177
experience or continuing education requirements; and (2) standards for 1178
recognizing doula training program curricula that are sufficient to 1179
satisfy the requirements for doula certification. 1180
(c) The Commissioner of Public Health, or the commissioner's 1181
designee, shall be the chairperson of the Doula Advisory Committee. 1182
(d) The Doula Advisory Committee shall consist of the following 1183
members: 1184
(1) Seven appointed by the Commissioner of Public Health, or the 1185
commissioner's designee, who are actively practicing as doulas in the 1186
state; 1187
(2) One appointed by the Commissioner of Public Health, or the 1188
commissioner's designee, who is a nurse-midwife, licensed pursuant to 1189
chapter 377 of the general statutes, who has experience working with a 1190
doula; 1191
(3) One appointed by the Commissioner of Public Health, or the 1192
commissioner's designee, in consultation with the Connecticut Hospital 1193
Association, who shall represent an acute care hospital; 1194
(4) One appointed by the Commissioner of Public Health, or the 1195
commissioner's designee, who shall represent an association that 1196
represents hospitals and health-related organizations in the state; 1197
(5) One appointed by the Commissioner of Public Health, or the 1198 Substitute Bill No. 5500
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commissioner's designee, who shall be a licensed health care provider 1199
who specializes in obstetrics and has experience working with a doula; 1200
(6) One appointed by the Commissioner of Public Health, or the 1201
commissioner's designee, who shall represent a community-based 1202
doula training organization; 1203
(7) One appointed by the Commissioner of Public Health, or the 1204
commissioner's designee, who shall represent a community-based 1205
maternal and child health organization; 1206
(8) One appointed by the Commissioner of Public Health, or the 1207
commissioner's designee, who shall have expertise in health equity; 1208
(9) The Commissioner of Social Services, or the commissioner's 1209
designee; 1210
(10) The Commissioner of Mental Health and Addiction Services, or 1211
the commissioner's designee; and 1212
(11) The Commissioner of Early Childhood, or the commissioner's 1213
designee. 1214
(e) Not later than January 15, 2023, the Doula Advisory Committee 1215
shall establish a Doula Training Program Review Committee. Such 1216
committee shall (1) conduct a continuous review of doula training 1217
programs; and (2) provide a list of approved doula training programs 1218
in the state that meet the requirements established by the Doula 1219
Advisory Committee. 1220
Sec. 41. (Effective from passage) The Commissioner of Public Health 1221
shall study whether the state should adopt safe harbor legislation that 1222
permits alternative health care practitioners who are not licensed, 1223
certified or registered in the state to provide traditional health care 1224
services, to provide certain alternative health care services, including, 1225
but not limited to, aromatherapy, energetic healing, healing touch, 1226
herbology or herbalism, meditation and mind body practices, polarity 1227 Substitute Bill No. 5500
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therapy, reflexology and Reiki, without violating any provision of the 1228
general statutes relating to the unlicensed practice of medicine. Not later 1229
than January 1, 2023, the commissioner shall report, in accordance with 1230
the provisions of section 11-4a of the general statutes, regarding such 1231
study to the joint standing committee of the General Assembly having 1232
cognizance of matters relating to public health. 1233
Sec. 42. Subsection (c) of section 19a-498 of the general statutes is 1234
repealed and the following is substituted in lieu thereof (Effective October 1235
1, 2022): 1236
(c) The Department of Mental Health and Addiction Services, with 1237
respect to any behavioral health facility, [or alcohol or drug treatment 1238
facility,] shall be authorized, either upon the request of the 1239
Commissioner of Public Health or at such other times as they deem 1240
necessary, to enter such facility for the purpose of inspecting programs 1241
conducted at such facility. A written report of the findings of any such 1242
inspection shall be forwarded to the Commissioner of Public Health and 1243
a copy shall be maintained in such facility's licensure file. 1244
Sec. 43. Section 19a-509g of the general statutes is repealed and the 1245
following is substituted in lieu thereof (Effective October 1, 2022): 1246
[An alcohol or drug treatment facility, as defined in section 19a-490,] 1247
A behavioral health facility shall use the criteria for admission 1248
developed by the American Society of Addiction Medicine for purposes 1249
of assessing a person for admission to such facility in consideration of 1250
(1) the services for which the facility is licensed, and (2) the appropriate 1251
services required for treatment of such person. 1252
Sec. 44. Subdivision (1) of subsection (b) of section 38a-493 of the 2022 1253
supplement to the general statutes is repealed and the following is 1254
substituted in lieu thereof (Effective October 1, 2022): 1255
(1) "Hospital" means an institution that is primarily engaged in 1256
providing, by or under the supervision of physicians, to inpatients (A) 1257
diagnostic, surgical and therapeutic services for medical diagnosis, 1258 Substitute Bill No. 5500
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treatment and care of persons who have an injury, sickness or disability, 1259
or (B) medical rehabilitation services for the rehabilitation of persons 1260
who have an injury, sickness or disability. "Hospital" does not include a 1261
residential care home, nursing home, rest home or [alcohol or drug 1262
treatment facility] behavioral health facility, as defined in section 19a-1263
490, as amended by this act; 1264
Sec. 45. Subdivision (1) of subsection (b) of section 38a-520 of the 2022 1265
supplement to the general statutes is repealed and the following is 1266
substituted in lieu thereof (Effective October 1, 2022): 1267
(1) "Hospital" means an institution that is primarily engaged in 1268
providing, by or under the supervision of physicians, to inpatients (A) 1269
diagnostic, surgical and therapeutic services for medical diagnosis, 1270
treatment and care of persons who have an injury, sickness or disability, 1271
or (B) medical rehabilitation services for the rehabilitation of persons 1272
who have an injury, sickness or disability. "Hospital" does not include a 1273
residential care home, nursing home, rest home or [alcohol or drug 1274
treatment facility] behavioral health facility, as defined in section 19a-1275
490, as amended by this act;1276
This act shall take effect as follows and shall amend the following
sections:
Section 1 October 1, 2022 19a-490
Sec. 2 October 1, 2022 19a-491c(a)
Sec. 3 October 1, 2022 19a-535b
Sec. 4 October 1, 2022 19a-537(a)
Sec. 5 October 1, 2022 19a-550(a)
Sec. 6 October 1, 2022 20-185r(a) to (e)
Sec. 7 October 1, 2022 12-20a(a)
Sec. 8 October 1, 2022 17b-368
Sec. 9 from passage 19a-491(a)
Sec. 10 October 1, 2022 19a-497(a)
Sec. 11 from passage 19a-515(a) and (b)
Sec. 12 October 1, 2022 19a-492e(a)
Sec. 13 October 1, 2022 19a-495a(a) and (b)
Sec. 14 from passage New section Substitute Bill No. 5500
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Sec. 15 from passage 20-90
Sec. 16 from passage 19a-16d(c) and (d)
Sec. 17 from passage 19a-16e(a)
Sec. 18 from passage 20-132a(c)
Sec. 19 from passage 19a-14c(b)
Sec. 20 from passage 20-12j(b)
Sec. 21 from passage 19a-177(8)(B)
Sec. 22 from passage 14-1(5)
Sec. 23 October 1, 2022 19a-30(a)
Sec. 24 October 1, 2022 19a-31b
Sec. 25 October 1, 2022 19a-72(a)(1) and (2)
Sec. 26 October 1, 2022 19a-215(a)(1)
Sec. 27 October 1, 2022 19a-269b(a)
Sec. 28 October 1, 2022 20-7a(d)
Sec. 29 October 1, 2022 20-7c(a)
Sec. 30 October 1, 2022 38a-477aa(a)(6)(A)
Sec. 31 from passage 7-51a
Sec. 32 from passage 7-74
Sec. 33 from passage 19a-36m(c) and (d)
Sec. 34 from passage 16-245n(c)(2)(A)
Sec. 35 July 1, 2022 20-191c(b)
Sec. 36 from passage 19a-563h
Sec. 37 from passage 17b-59d
Sec. 38 from passage 17b-59e
Sec. 39 from passage 19a-495(c)
Sec. 40 from passage New section
Sec. 41 from passage New section
Sec. 42 October 1, 2022 19a-498(c)
Sec. 43 October 1, 2022 19a-509g
Sec. 44 October 1, 2022 38a-493(b)(1)
Sec. 45 October 1, 2022 38a-520(b)(1)
Statement of Legislative Commissioners:
In Section 15, former Subsec. (b), which had been redesignated as
Subsec. (d), has been bracketed to avoid repetition.
PH Joint Favorable Subst.