Researcher: ND Page 1 4/30/22
OLR Bill Analysis
sHB 5500 (as amended by House "A")*
AN ACT CONCERNING THE DEPARTMENT OF PUBLIC HEALTH'S
RECOMMENDATIONS REGARDING VARIOUS REVISIONS TO THE
PUBLIC HEALTH STATUTES.
TABLE OF CONTENTS:
SUMMARY
§§ 1-8 — CHRONIC DISEASE HOSPITALS
Adds a definition for “chronic disease hospital” in the statute on health care institution
licensure and makes related technical and conforming changes to various public health
statutes
§§ 1, 23-30 & 39 — CLINICAL LABORATORIES
Adds clinical laboratories to the statutory definition of “health care institution” to reflect
current practice and allows the DPH commissioner to waive regulations for these
laboratories under limited conditions
§§ 1 & 42-45 — ALCOHOL OR DRUG TREATMENT FACILITIES
Replaces the term “alcohol or drug treatment facility” with “behavioral health facility” in
several statutes to reflect current practice
§ 6 — CENTRAL SERVICE TECHNICIANS
Allows central service technicians to obtain certification as a registered CST from a
successor organization to the International Association of Healthcare Central Service
Material Management
§ 9 — ALBERT J. SOLNIT CHILDREN’S CENTER
Makes a technical change to specify that Albert J. Solnit Children’s Center and its
psychiatric residential treatment facility units are not exempt from DPH licensure
§ 10 — STRIKE CONTINGENCY PLANS
Requires health care institutions, when notified that their employees intend to strike, to
include a staffing plan as part of the strike contingency plan they must file with DPH;
requires ICF-IIDs, when submitting strike contingency plans, to submit the same
information as nursing homes
§ 11 — NURSING HOME ADMINISTRATOR C ONTINUING
EDUCATION
Adds infection prevention and control to the mandatory topics for nursing home
administrators’ continuing education
§§ 12 & 13 — MEDICATION ADMINISTRATION BY UNLICENSED
PERSONNEL 2022HB-05500-R01-BA.DOCX
Researcher: ND Page 2 4/30/22
Allows a registered nurse to delegate certain medication administration to home health
aides and hospice aides who obtain certification from DCF or DDS, in addition to those
certified by DPH, as under current law and requires more frequent certification for home
health and hospice aides
§§ 14, 16, 17 & 55 — SCOPE OF PRACTICE REVIEW
Reduces, by two weeks, the timeframe of certain steps of DPH’s scope of practice review
process for health care professions; requires DPH to establish a scope of practice review
committee to determine whether it should regulate midwives who are ineligible for nurse-
midwife licensure and report its findings to the Public Health Committee
§ 15 — STATE BOARD OF EXAMINERS FOR NU RSING
Expands the duties of the State Board of Examiners for Nursing; requires DPH, instead of
the board, to post a list of all approved nursing education programs for registered nurses
and licensed practical nurses; and eliminates a requirement that DPH adopt regulations
on adult education practical nursing training programs offered in high schools
§ 18 — CONTINUING EDUCATION (CE) FOR OPTOMETRISTS
Explicitly allows online CE classes; increases, from six to 10, the number of CE credit
hours that can be earned without attending in-person
§§ 19 & 20 — MINOR AND TECHNICAL CHANGES
Makes technical changes to statutory provisions on (1) outpatient mental health treatment
provided to minors without parental consent and (2) physician assistant licensure
§ 21 — EMERGENCY MEDICAL SERVICES ADVISORY BOARD
REPORT
Changes, from December 31 to June 1, the date by which the DPH commissioner must
annually report to the Emergency Medical Services (EMS) Advisory Board on specified
information on EMS calls; delays the date the next report is due until June 1, 2023
§ 22 — AUTHORIZED EMERGENCY VEHICLES
Expands the statutory definition of “authorized emergency vehicle” to include all
authorized EMS vehicles, instead of only ambulances as under current law
§§ 31-32 — ONLINE PAYMENTS FOR VITAL RECORDS
Specifies DPH must approve any locally allowed online payment methods
§ 33 — STATE FOOD CODE
Generally exempts certain owner-occupied bed and breakfast establishments and
noncommercial functions from the state's model food code requirements
§ 34 — TECHNICAL CHANGE
Corrects a reference to statutes on the Clean Water Fund
§ 35 — CONTINUING EDUCATION FOR PSYCHOLOGISTS
Establishes minimum and maximum amounts of CE earned online
§ 36 — SOCIAL WORKER MINIMUM STAFFING REQUIREMENTS IN
NURSING HOMES
Specifies that existing law’s minimum social worker staffing requirement in nursing
homes of one social worker per 60 residents is a number of hours that must vary
proportionally, based on the number of residents in the home; allows the DPH 2022HB-05500-R01-BA.DOCX
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commissioner to implement policies and procedures while adopting minimum staffing
requirements in regulation
§§ 37-38 — STATEWIDE HEALTH INFORMATION EXCHANGE
Allows the Office of Health Strategy executive director to implement policies and
procedures while adopting regulations to (1) administer the Statewide Health Information
Exchange and (2) require certain health care institutions and providers to connect to and
participate in the exchange
§ 40 — DOULA ADVISORY COMMITTEE
Requires DPH, within available resources, to establish an 18-member Doula Advisory
Committee to develop recommendations on (1) doula certification requirements and (2)
standards for recognizing training programs that meet the certification requirements
§ 41 — SAFE HARBOR LEGISLATION
Requires the DPH commissioner to (1) study whether the state should adopt “safe harbor”
legislation allowing certain unlicensed practitioners to provide alternative health care
services and (2) report to the Public Health Committee by January 1, 2023
§ 46 — INVOLUNTARY TRANSFERS OF RESIDENTIAL CARE HOME
RESIDENTS
Modifies requirements for the involuntary discharge of residential care home (RCH)
residents to allow RCHs to qualify as Medicaid home- and community-based settings
§§ 47 & 78 — MEDICAL ASSISTANTS ADMINISTERING VACCINES
Allows clinical medical assistants meeting specified certification, education, and training
requirements to administer vaccines in any setting other than a hospital if acting under
the supervision, control, and responsibility of a physician, PA, or APRN
§ 48 — RARE DISEASE COUNCIL
Establishes a 13-member Connecticut Rare Disease Advisory Council to advise and make
recommendations to DPH and other state agencies on the needs of residents living with
rare diseases and their caregivers
§ 49 — CHRONIC KIDNEY DISEASE ADVISORY COMMITTEE
Removes the Public Health Committee chairpersons and ranking members, and four
members they appoint, from the advisory committee; extends by one year, until January 1,
2024, the date by which the advisory committee must begin annually reporting to the
Public Health Committee
§ 50 — HOSPITAL COMMUNITY BENEFIT PROGRAMS
Makes various changes to the law on hospital community benefit programs, such as
requiring them to submit various documents to OHS on a specified schedule and
requiring OHS to make the state’s all-payer claims database available to hospitals to help
in this process
§ 51 — NON-DISCRIMINATION FOR TRANSPL ANTS BASED ON
DISABILITY
Generally prohibits deeming someone ineligible to receive an anatomical gift, or organ
from a living donor, for transplantation solely because of the person’s physical, mental, or
intellectual disability
§ 52 — INFECTION PREVENTION AND CONTROL SPECIALISTS 2022HB-05500-R01-BA.DOCX
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Makes various changes in requirements for infection prevention and control specialists at
nursing homes and dementia special care units, such as (1) limiting the current
requirement that they employ a full-time specialist to only those facilities with more than
60 residents and (2) allowing these specialists to provide services at both a nursing home
and dementia special care unit or at two nursing homes in some circumstances, with DPH
approval
§§ 53 & 54 — ELDERLY HOUSING COMPLEXES AND ASSISTED
LIVING
Allows elderly housing complexes funded and assisted through HUD’s Assisted Living
Conversion Program, and that intend to arrange for assisted living services, to do so with
a currently licensed assisted living services agency, exempting them from having to
register as a managed residential community
§§ 56-58 — DISPOSITION OF UNCLAIMED BODIES
Allows the Office of the Chief Medical Examiner to take custody and coordinate the
disposition of an unclaimed body and requires the funeral director who handles the
disposition to contact the social services commissioner for reimbursement of related
expenses
§ 59 — COMMISSION ON MEDICOLEGAL INVESTIGATIONS
Removes the requirement that the governor appoint the law and pathology professor
members of the Commission on Medicolegal Investigations from a panel recommended by
a committee of the state’s medical and law school deans
§ 60 — PRIVATE AND SEMIPUBLIC WELLS
Starting October 1, 2022, requires property owners to test the water quality of their newly
constructed private or semipublic wells; requires clinical laboratories to report water
quality test results conducted on wells to DPH and local health departments; requires
prospective homebuyers and renters to be given educational materials on well testing; and
expands the list of contaminants local health departments can test wells for when they
suspect groundwater contamination
§ 61 — EMS ORGANIZATIONS ADDING NEW VEHICLES
Allows commercial EMS organizations, not just other EMS organizations, who are
primary service area responders to add one vehicle to their fleet every three years without
necessarily completing the standard hearing process
§ 62 — LEGIONELLA WORKING GROUP
Requires the DPH commissioner to convene a working group on legionella prevention and
mitigation in hospitals, nursing homes, and other health care facilities and report to the
Public Health Committee by December 31, 2022, on the working group’s findings and
recommendations
§ 63 — POLYSOMNOGRAPHIC TECHNOLOGISTS
Authorizes polysomnographic (sleep) technologists to perform certain oxygen-related
patient care activities in hospitals in the same way that existing law allows for designated
licensed health care providers and certified ultrasound or nuclear medicine technologists
§§ 64-66 — SUICIDE ADVISORY BOARD
Renames and expands the scope of DCF’s Youth Suicide Advisory Board, revises its
membership and procedures, and specifically allows physicians’ continuing medical
education in behavioral health to include suicide prevention training 2022HB-05500-R01-BA.DOCX
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§ 67 — SURGICAL SMOKE EVACUATION POLICIES
Requires each licensed hospital and outpatient surgical facility to develop and implement a
policy for using a surgical smoke evacuation system to prevent exposure to surgical smoke
§§ 68 & 69 — HIV TESTING
Generally requires primary care providers and hospital emergency departments to offer
HIV testing to patients age 13 or older; requires hospitals to adopt related protocols
§ 70 — PLASMAPHERESIS, CLINICAL LABORATORIES, AND BLOOD
DONATION CENTERS
Requires the DPH commissioner to review statutes and regulations on, or otherwise
impacting, the practice of plasmapheresis, clinical laboratories, and blood donation centers
in the state and report her findings and recommendations to the legislature by January 1,
2023
§§ 71 & 72 — MANDATED ELDER ABUSE REPORTER TRAINING
Modifies provisions in HB 5313, as amended by House “A,” extending by six months
until June 30, 2023, the date by which mandated elder abuse reporters must generally
complete the DSS elder abuse training program or another DSS-approved program
§ 73 — TECHNICAL STANDARDS FOR MEDICAL DIAGNOSTIC
EQUIPMENT
Starting January 1, 2023, requires health care facilities to consider certain federal
technical standards for accessibility of medical diagnostic equipment when purchasing this
equipment
§ 74 — ASSISTED LIVING SERVICES AGENCIES TASK FORCE
Establishes a task force to study the regulation and staffing levels of assisted living
services agencies (ALSAs) that provide services as dementia special care units or
programs; requires it to report its findings and recommendations to the Public Health
Committee by January 1, 2023
§ 75 — MATERNAL MORTALITY REVIEW COMMITTEE
EDUCATIONAL MATERIALS
Requires DPH’s Maternal Mortality Review Committee to develop educational materials
on intimate partner violence and pregnant and postpartum persons with mental health
disorders, which DPH must distribute to specified hospitals and health care providers
§ 76 — BIRTHING HOSPITALS PATIENT EDUCATIONAL MATERIALS
Requires birthing hospitals (1) starting October 1, 2022, to provide caesarean section
patients with written information on the importance of mobility following the procedure
and (2) starting January 1, 2023, to provide postpartum patients certain educational
materials and establish a patient portal for them to virtually access any educational
materials and information provided to the patients during their stay or discharge
§ 77 — DESIGNATING MATERNAL MENTAL HEALTH MONTH AND
MATERNAL HEALTH DAY
Designates the month of May as “Maternal Mental Health Month” and each May 5 as
“Maternal Health Day”
2022HB-05500-R01-BA.DOCX
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SUMMARY
This bill makes various substantive, minor, and technical changes in
Department of Public Health (DPH)-related statutes and programs.
*House Amendment “A” replaces the original bill (File 528) with
similar provisions. It also adds sections 46-78.
EFFECTIVE DATE: Various, see below.
§§ 1-8 — CHRONIC DISEASE HOSPITALS
Adds a definition for “chronic disease hospital” in the statute on health care institution
licensure and makes related technical and conforming changes to various public health
statutes
The bill adds a statutory definition for “chronic disease hospital” in
the statute on health care institution licensure. Under the bill, as under
current law, these hospitals are long-term hospitals that have facilities,
medical staff, and all personnel necessary to diagnose, treat, and care for
chronic diseases.
The bill also makes related technical and conforming changes in
various public health statutes.
EFFECTIVE DATE: October 1, 2022
§§ 1, 23-30 & 39 — CLINICAL LABORATORIES
Adds clinical laboratories to the statutory definition of “health care institution” to reflect
current practice and allows the DPH commissioner to waive regulations for these
laboratories under limited conditions
Definition
The bill adds clinical laboratories to the statutory definition of “health
care institution.” In doing so, it extends to these laboratories statutory
requirements for health care institutions about, among other things,
DPH licensure, inspection, and complaint investigation requirements.
(In practice, clinical laboratories are already subject to state and federal
regulation.)
As under current law, the bill defines a “clinical laboratory” as a
facility or other area used for microbiological, serological, chemical,
hematological, immuno-hematological, biophysical, cytological, 2022HB-05500-R01-BA.DOCX
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pathological, or other examinations of human bodily fluids, secretions,
excretions, or excised or exfoliated tissues. The examinations must be
used to provide information for (1) diagnosing, preventing, or treating
a human disease or impairment; (2) assessing human health; or (3)
assessing the presence of drugs, poisons, or other toxicological
substances.
The bill also makes related technical and conforming changes in
various public health statutes.
Waivers
Additionally, the bill allows the DPH commissioner to do the
following:
1. waive regulations affecting clinical laboratories if she determines
that doing so would not endanger a patient’s health, safety, or
welfare;
2. impose waiver conditions assuring patients’ health, safety, and
welfare; and
3. revoke the waiver if she finds that someone’s health, safety, or
welfare has been jeopardized.
Existing law already allows the commissioner to grant waivers for
other health care institutions under these same conditions. Under
existing law and the bill, she cannot grant a waiver that would result in
a violation of the state fire safety or building code.
EFFECTIVE DATE: October 1, 2022, except provisions on waivers are
effective upon passage.
§§ 1 & 42-45 — ALCOHOL OR DRUG TREATMENT FACILITIES
Replaces the term “alcohol or drug treatment facility” with “behavioral health facility” in
several statutes to reflect current practice
The bill removes the statutory definition for “alcohol or drug
treatment facility” and replaces this term with “behavioral health
facility” in several statutes. (Under current practice, these facilities are
licensed and regulated as behavioral health facilities.) 2022HB-05500-R01-BA.DOCX
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EFFECTIVE DATE: October 1, 2022
§ 6 — CENTRAL SERVICE TECHNICIANS
Allows central service technicians to obtain certification as a registered CST from a
successor organization to the International Association of Healthcare Central Service
Material Management
Existing law generally requires anyone who practices as a central
service technician (CST) to, among other things, be certified as either a
(1) sterile processing and distribution technician by the Certification
Board for Sterile Processing and Distribution, Inc. or (2) registered CST
by the International Association of Healthcare Central Service Material
Management (IAHCSMM).
For the latter, the bill allows CSTs to also obtain certification from a
successor organization to IAHCSMM (the organization is currently
changing its name).
By law, CSTs decontaminate, prepare, package, sterilize, store, and
distribute reusable medical instruments or devices in a hospital or
outpatient surgical facility, either as an employee or under contract.
EFFECTIVE DATE: October 1, 2022
§ 9 — ALBERT J. SOLNIT CHILDREN’S CENTER
Makes a technical change to specify that Albert J. Solnit Children’s Center and its
psychiatric residential treatment facility units are not exempt from DPH licensure
Existing law exempts from DPH licensure Department of Children
and Families (DCF)-licensed (1) substance abuse treatment facilities and
(2) maternity homes that offer care to pregnant women, new mothers,
and their newborns.
The bill specifies that this exemption does not apply to Albert J. Solnit
Children’s Center and its psychiatric residential treatment facility units
(“South Campus”). (Existing law requires that DPH license these
facilities.)
EFFECTIVE DATE: Upon passage
2022HB-05500-R01-BA.DOCX
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§ 10 — STRIKE CONTINGENCY PLANS
Requires health care institutions, when notified that their employees intend to strike, to
include a staffing plan as part of the strike contingency plan they must file with DPH;
requires ICF-IIDs, when submitting strike contingency plans, to submit the same
information as nursing homes
By law, a licensed health care institution must file a strike
contingency plan with the DPH commissioner if the institution is
notified by a labor organization representing its employees of its
intention to strike.
The bill requires each institution, as part of the strike contingency
plan, to include its staffing plan for at least the first three days of the
strike. This must include the names and titles of the people who will
provide services during this period. Existing regulations already require
similar information for certain types of institutions, such as nursing
homes and residential care homes (Conn. Agencies Reg., § 19a-497-1).
Under existing law, these institutions must submit their strike
contingency plans no later than five days before the date indicated for
the strike.
The bill also requires licensed, Medicaid-certified intermediate care
facilities for individuals with intellectual disabilities (ICF-IIDs), when
submitting strike contingency plans, to submit the same information as
required of nursing homes.
EFFECTIVE DATE: July 1, 2022
§ 11 — NURSING HOME ADMINISTRATOR CONTINUING
EDUCATION
Adds infection prevention and control to the mandatory topics for nursing home
administrators’ continuing education
The bill adds infection prevention and control to the mandatory
topics for nursing home administrators’ continuing education. It makes
a corresponding change adding courses offered or approved by the
Association for Professionals in Infection Control and Epidemiology to
those that meet continuing education requirements for nursing home
administrators. 2022HB-05500-R01-BA.DOCX
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By law, nursing home administrators must complete at least 40 hours
of continuing education every two years, starting with their first license
renewal. Existing law requires that the education include training in
Alzheimer’s disease and dementia symptoms and care.
EFFECTIVE DATE: Upon passage
§§ 12 & 13 — MEDICATION ADMINISTRATION BY UNLICENSED
PERSONNEL
Allows a registered nurse to delegate certain medication administration to home health
aides and hospice aides who obtain certification from DCF or DDS, in addition to those
certified by DPH, as under current law and requires more frequent certification for home
health and hospice aides
The bill allows a registered nurse (RN) to delegate the administration
of non-injected medications to home health aides and hospice aides who
are currently certified by the departments of Children and Families
(DCF) or Developmental Services (DDS), in addition to those certified
by DPH as under current law.
The bill also requires these unlicensed personnel to renew their
certifications every two years instead of every three years, as under
current law.
Under current law, unchanged by the bill, RNs cannot delegate
medication administration to these unlicensed personnel if a prescribing
practitioner requires a medication to be administered only by a licensed
nurse. Also, residential care homes that admit residents requiring
medication administration assistance must employ enough unlicensed
personnel certified by DPH, DCF, or DDS to perform this function.
The bill also makes related technical and conforming changes to
provisions requiring DPH to adopt regulations to carry out the
medication administration delegation provisions.
EFFECTIVE DATE: October 1, 2022
§§ 14, 16, 17 & 55 — SCOPE OF PRACTICE REVIEW
Reduces, by two weeks, the timeframe of certain steps of DPH’s scope of practice review
process for health care professions; requires DPH to establish a scope of practice review 2022HB-05500-R01-BA.DOCX
Researcher: ND Page 11 4/30/22
committee to determine whether it should regulate midwives who are ineligible for nurse-
midwife licensure and report its findings to the Public Health Committee
Existing law establishes a process to review requests from
representatives of health care professions seeking to establish or revise
a scope of practice before consideration by the legislature. Within
available appropriations, DPH appoints members to scope of practice
review committees (see Background, below).
The bill moves up deadlines for certain steps in this process as shown
in Table 1 below.
Table 1: Scope of Practice Review Step Deadlines
Scope of Practice Review Step Deadline Under
Current Law
Deadline Under
the Bill
DPH must notify the Public Health Committee and
post on its website any scope of practice request it
receives
September 15 September 1
Representatives of health care professions directly
impacted by a submitted scope of practice request
may submit an impact statement to DPH and
provide a copy to the requestor
October 1 September 15
Requestor must submit a written response to an
impact statement to DPH and the entity that
provided the statement
October 15 October 1
DPH commissioner must establish and appoint
members to a scope of practice review committee
November 1 October 15
Under current law, the DPH commissioner must establish and
appoint members to scope of practice review committees for each timely
request the department receives. The bill instead requires the
commissioner, by October 15
th
each year, to select requests the
department will act on from among the timely requests received and
establish the review committee only for those requests.
Additionally, the bill requires, rather than allows, any person or
entity acting on behalf of a health care profession seeking a new or
amended scope of practice to submit a written scope of practice request
to DPH by August 15
th
of the year preceding the start of the next
legislative session. 2022HB-05500-R01-BA.DOCX
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The bill also makes related conforming changes.
Midwife Scope of Practice Review
Additionally, the bill requires the DPH commissioner to conduct a
scope of practice review, under the existing process for scope of practice
review committees, to determine whether DPH should regulate
midwives who are ineligible for nurse-midwife licensure. The
commissioner must report the committee’s findings and
recommendations to the Public Health Committee by February 1, 2023.
EFFECTIVE DATE: Upon passage
Background — Scope of Practice Review Committees
By law, DPH must appoint members to scope of practice review
committees to evaluate scope of practice requests from representatives
of health care professions. The committees consist of (1) the DPH
commissioner or her designee (who serves as the committee chairperson
and in a non-voting capacity), (2) two members representing the
profession making the request, and (3) two members recommended by
each person or entity that submitted a written impact statement to
represent the professions directly impacted by the request. DPH may
also appoint additional members representing health care professions
with a close relationship to the underlying scope of practice request
(CGS § 19a-16e).
§ 15 — STATE BOARD OF EXAMINERS FOR NURSING
Expands the duties of the State Board of Examiners for Nursing; requires DPH, instead of
the board, to post a list of all approved nursing education programs for registered nurses
and licensed practical nurses; and eliminates a requirement that DPH adopt regulations
on adult education practical nursing training programs offered in high schools
The bill codifies current practice by expanding the duties of the State
Board of Examiners for Nursing to explicitly include (1) approving
nursing schools in the state that prepare individuals for state licensure
and (2) where possible, consulting with nationally recognized
accrediting agencies when doing so.
The bill also requires DPH, instead of the board, to post on the
department’s website a list of all approved nursing education programs 2022HB-05500-R01-BA.DOCX
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for registered nurses and licensed practical nurses.
Additionally, the bill eliminates the requirement that DPH adopt
regulations on adult education practical nursing training programs
offered in high schools or through the Technical Education and Career
System (i.e., technical high schools) for students without a high school
diploma. (In practice, these programs have all closed.)
EFFECTIVE DATE: Upon passage
§ 18 — CONTINUING EDUCATION (CE) FOR OPTOMETRISTS
Explicitly allows online CE classes; increases, from six to 10, the number of CE credit
hours that can be earned without attending in-person
Currently, optometrists must earn at least 20 hours of CE during each
annual registration period, of which up to six can be earned through a
home study or distance learning program. The bill specifies that online
education is an acceptable way to earn CE credit.
The bill increases to 10 hours the amount of CE credit that
optometrists may earn through courses that are not in-person. But it
limits to (1) five hours the amount of CE credit that may be earned
through asynchronous online education, distance learning, or home
study programs and (2) ten hours the amount of CE credit that may be
earned though synchronous online education that includes
opportunities for live instruction.
Under the bill, “synchronous online education” is a live, online class
conducted in real time. “Asynchronous online education” is a program
in which (1) the instructor, learner, and other participants are not
engaged in the learning process at the same time; (2) there is no real-
time interaction between participants and instructors; and (3) the
educational content is created and made available for later
consumption.
EFFECTIVE DATE: Upon passage
§§ 19 & 20 — MINOR AND TECHNICAL CHANGES
Makes technical changes to statutory provisions on (1) outpatient mental health treatment
provided to minors without parental consent and (2) physician assistant licensure 2022HB-05500-R01-BA.DOCX
Researcher: ND Page 14 4/30/22
Current law requires physician assistants to receive at least two hours
of training every six years in post-traumatic stress disorder, suicide risk,
depression, grief, and suicide prevention administered by the American
Association of Physician Assistants. The bill makes a minor change to
instead reference the American Academy of Physician Associates and
allows trainings administered by any successor organization to the
academy.
The bill also makes technical changes to statutory provisions on (1)
providing outpatient mental health treatment to minors without
parental consent and (2) other physician assistant licensure
requirements.
EFFECTIVE DATE: Upon passage
§ 21 — EMERGENCY MEDICAL SERVICES ADVISORY BOARD
REPORT
Changes, from December 31 to June 1, the date by which the DPH commissioner must
annually report to the Emergency Medical Services (EMS) Advisory Board on specified
information on EMS calls; delays the date the next report is due until June 1, 2023
The bill changes, from December 31 to June 1, the date by which the
DPH commissioner must annually report to the Emergency Medical
Services Advisory Board. It also delays the date the next report is due
until June 1, 2023.
By law, the report must include the number of emergency medical
services (EMS) calls received during the year; response times; level of
EMS required; names of EMS providers responding; and the number of
passed, cancelled, and mutual aid calls.
EFFECTIVE DATE: Upon passage
§ 22 — AUTHORIZED EMERGENCY VEHICLES
Expands the statutory definition of “authorized emergency vehicle” to include all
authorized EMS vehicles, instead of only ambulances as under current law
The bill broadens the statutory definition of “authorized emergency
vehicle” as used in the laws establishing those vehicles’ rights and
motorists’ responsibilities with respect to them (e.g., generally, these
vehicle drivers may exceed posted speed limits, and motorist must pull 2022HB-05500-R01-BA.DOCX
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to the right when the vehicle is using its sirens or lights).
The bill expands the definition to include all authorized emergency
medical services vehicles, instead of only ambulances as under current
law. In doing so, it includes invalid coaches, advanced emergency
technician-staffed intercept vehicles, and paramedic-staffed intercept
vehicles licensed or certified by DPH to provide emergency medical
care.
Under existing law, unchanged by the bill, authorized emergency
vehicles also include fire and police department vehicles.
EFFECTIVE DATE: Upon passage
§§ 31-32 — ONLINE PAYMENTS FOR VITAL RECORDS
Specifies DPH must approve any locally allowed online payment methods
The bill specifies that if a registrar of vital statistics allows online
payments for vital records (e.g., a birth certificate), the DPH
commissioner or her designee must approve any associated
requirements. Under the bill, this applies to payments for short- and
long-form birth certificates, marriage certificates, death certificates, and
original birth certificates.
EFFECTIVE DATE: Upon passage
§ 33 — STATE FOOD CODE
Generally exempts certain owner-occupied bed and breakfast establishments and
noncommercial functions from the state's model food code requirements
Existing law requires DPH, by January 1, 2023, to adopt the federal
Food and Drug Administration’s Food Code as the state’s food code
regulating food establishments. The bill exempts the following
establishments and functions from the food code’s requirements:
1. owner-occupied bed-and-breakfast establishments (a) with no
more than 16 occupants, (b) with no provisions for cooking or
warming food in guest rooms, (c) where breakfast is the only
meal offered, and (d) that notify guests that food is prepared in
a kitchen unregulated by the local health department and 2022HB-05500-R01-BA.DOCX
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2. noncommercial functions, including bake sales or potluck
suppers at educational, religious, political, or charitable
organizations.
Under current law, these entities must comply with the food code
but are exempt from having to employ a certified food protection
manger and any related reporting requirements.
Existing law, unchanged by the bill, requires that sellers at
noncommercial functions maintain the food under the temperature, pH
level, and water acidity level conditions that inhibit the growth of
infectious or toxic microorganisms (CGS § 21a-115).
EFFECTIVE DATE: Upon passage
§ 34 — TECHNICAL CHANGE
Corrects a reference to statutes on the Clean Water Fund
The bill corrects a reference to statutes governing the Clean Water
Fund in a provision limiting the types of funds the Green Bank’s
Environmental Infrastructure Fund may receive.
§ 35 — CONTINUING EDUCATION FOR PSYCHOLOGISTS
Establishes minimum and maximum amounts of CE earned online
Existing law allows licensed psychologists to earn up to five of their
10 annually required CE credits through online classes, distance
learning, or home study. The bill specifies that the five-hour cap applies
to asynchronous online classes, distance learning, and home study.
The bill additionally requires psychologists to earn at least five hours
of CE credit through synchronous online education. (In doing so, it only
allows licensees to complete up to five of their required 10 CE credits in
person.)
Under the bill, “synchronous online education” is a live, online class
conducted in real time. “Asynchronous online education” is a program
in which (1) the instructor, learner, and other participants are not
engaged in the learning process at the same time; (2) there is no real-
time interaction between participants and instructors; and (3) the 2022HB-05500-R01-BA.DOCX
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educational content is created and made available for later
consumption.
EFFECTIVE DATE: July 1, 2022
§ 36 — SOCIAL WORKER MINIMUM STAFFING REQUI REMENTS IN
NURSING HOMES
Specifies that existing law’s minimum social worker staffing requirement in nursing
homes of one social worker per 60 residents is a number of hours that must vary
proportionally, based on the number of residents in the home; allows the DPH
commissioner to implement policies and procedures while adopting minimum staffing
requirements in regulation
Current law requires DPH to establish minimum staffing level
requirements for social workers in nursing homes of one full-time social
worker per 60 residents. The bill specifies that this requirement is a
number of hours based on this ratio that must vary proportionally,
based on the number of residents in the home (e.g., a home with 90
residents would require 1.5 full-time social workers instead of two).
Existing law, unchanged by the bill, also requires DPH to modify
minimum nursing home staffing requirements to include (1) at least
three hours of direct care per resident per day and (2) recreational staff
at levels the commissioner deems appropriate. She must also adopt
regulations to implement these requirements.
The bill allows the DPH commissioner to implement policies and
procedures while in the process of adopting the new staffing
requirements in regulation. She must publish notice of intent to adopt
the regulation in the eRegulations system within 20 days after
implementing them. Under the bill, the policies and procedures are
valid until the final regulations are adopted.
EFFECTIVE DATE: Upon passage
§§ 37-38 — STATEWIDE HEALTH INF ORMATION EXCHANGE
Allows the Office of Health Strategy executive director to implement policies and
procedures while adopting regulations to (1) administer the Statewide Health Information
Exchange and (2) require certain health care institutions and providers to connect to and
participate in the exchange
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director to adopt regulations to (1) administer the Statewide Health
Information Exchange and (2) require certain health care institutions
and providers to connect to and participate in the exchange. Under the
bill, the executive director may implement policies and procedures
while in the process of adopting the regulations, so long as she (1) holds
a public hearing at least 30 days before implementing them and (2)
publishes notice of the intent to adopt the regulations within 20 days
after implementing them. The policies and procedures are valid until
final regulations take effect.
By law, OHS has administrative authority over the Statewide Health
Information Exchange, which among other things must allow real-time,
secure access to patient health information across all provider settings.
Under existing law, providers must begin the process of connecting
to and participating in the exchange (1) for hospitals, within one year
after the exchange began (it became operational May 3, 2021) and (2) for
health care providers with compatible electronic health records systems,
two years after the exchange began.
EFFECTIVE DATE: Upon passage
§ 40 — DOULA ADVISORY COMMITTEE
Requires DPH, within available resources, to establish an 18-member Doula Advisory
Committee to develop recommendations on (1) doula certification requirements and (2)
standards for recognizing training programs that meet the certification requirements
The bill requires the DPH commissioner, within available resources,
to establish an 18-member Doula Advisory Committee within the
department to develop recommendations on (1) requirements for initial
and renewal doula certification, including training, experience, and
continuing education requirements, and (2) standards for recognizing
doula training program curricula sufficient to satisfy the certification
requirements. Under the bill, a doula is a trained, nonmedical
professional who provides physical, emotional, and informational
support, virtually or in person, to a pregnant person before, during, and
after birth.
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Membership
Under the bill, the DPH commissioner or her designee is the advisory
committee's chairperson. Additional members include (1) the
commissioners of social services, mental health and addiction services,
and early childhood, or their designees and (2) 14 members appointed
by the DPH commissioner, or her designee, as follows:
1. seven actively practicing doulas in the state;
2. one licensed nurse-midwife who has experience working as a
doula;
3. one representative of an acute care hospital, appointed in
consultation with the Connecticut Hospital Association;
4. one representative of an association representing hospitals and
health-related organizations in the state;
5. one licensed health care provider who specializes in obstetrics
and has experience working with a doula;
6. one representative of a community-based doula training
organization;
7. one representative of a community-based maternal and child
health organization; and
8. one member with expertise in health equity.
Review Committee
The bill requires the advisory committee, by January 15, 2023, to
establish a Doula Training Program Review Committee to (1) conduct a
continuous review of doula training programs and (2) provide a list of
approved doula training programs in Connecticut that meet the
advisory committee’s certification requirements.
EFFECTIVE DATE: Upon passage
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§ 41 — SAFE HARBOR LEGISLATION
Requires the DPH commissioner to (1) study whether the state should adopt “safe harbor”
legislation allowing certain unlicensed practitioners to provide alternative health care
services and (2) report to the Public Health Committee by January 1, 2023
The bill requires the DPH commissioner to study whether the state
should adopt “safe harbor” legislation and report to the Public Health
Committee by January 1, 2023.
Under the bill, this legislation would allow alternative health
practitioners who are not licensed, certified, or registered to provide
traditional health care services in the state to provide alternative health
care services without violating state laws on unlicensed medical
practice. These services include, at a minimum, aromatherapy, energetic
healing, healing touch, herbology or herbalism, meditation and mind-
body practices, polarity therapy, reflexology, and Reiki.
EFFECTIVE DATE: Upon passage
§ 46 — INVOLUNTARY TRANSFERS OF RESIDENTIAL CARE
HOME RESIDENTS
Modifies requirements for the involuntary discharge of residential care home (RCH)
residents to allow RCHs to qualify as Medicaid home- and community-based settings
The bill modifies requirements for the involuntary discharge of RCH
residents to allow RCHs to qualify as Medicaid home- and community-
based settings. Specifically, it does the following:
1. requires the written discharge notice to include contact
information for (a) the long-term care ombudsman for RCH
residents and their legally liable residents and (b) Disability
Rights Connecticut, Inc. for residents with mental illness or
intellectual disability;
2. requires RCHs to provide residents with a discharge plan for
alternate residency within seven days after issuing the discharge
notice and, in the case of an appeal, submit it to the Department
of Public Health (DPH) on or before the required hearing date;
3. requires DPH to make a determination on an RCH’s request for
an immediate, emergency transfer within 20 days after the 2022HB-05500-R01-BA.DOCX
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required hearing (current law does not specify a deadline);
4. requires DPH to send a copy of the emergency discharge
determination to the resident, the resident’s legally liable
representative, and the long-term care ombudsman;
5. requires DPH, if it determines an emergency discharge is not
warranted, to proceed with a hearing under the regular
involuntary discharge process; and
6. allows an RCH or a resident aggrieved by a DPH decision to
appeal to the Superior Court, and requires the court to consider
the appeal a privileged case.
The bill defines “emergency” as a situation in which a resident
presents an imminent danger to the health and safety of him- or herself,
another resident, or an owner or employee of the facility.
Written Discharge Notice
By law, RCHs must provide a written discharge notice to residents
and their legally liable representatives at least 30 days prior to the date
of an involuntary transfer. The notice must include the reason for the
transfer and the resident’s right to appeal the discharge.
The bill also requires the notice to include the (1) resident’s right to
represent him- or herself or be represented by legal counsel in an appeal
and (2) contact information for the long-term care ombudsman and, for
residents with mental illness or intellectual disability, also include the
contact information for Disability Rights Connecticut. The notice must
be sent electronically or by fax to the ombudsman on the same day it is
given to the resident and be in a form and manner the DPH
commissioner determines.
Superior Court Appeals
The bill allows an RCH or a resident who is aggrieved by the DPH
commissioner’s final decision to appeal to the Superior Court in
accordance with the Uniform Administrative Procedure Act. Under the
bill, filing an appeal with the court does not in itself stay the DPH 2022HB-05500-R01-BA.DOCX
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decision. The court must consider these appeals as privileged cases to
dispose of them with the least possible delay.
EFFECTIVE DATE: October 1, 2022
Background — Related Bill
sSB 453 (File 453), favorably reported by the Public Health
Committee, contains the same provisions modifying requirements for
the involuntary discharge of RCH residents to allow these homes to
qualify as Medicaid home- and community-based settings.
§§ 47 & 78 — MEDICAL ASSISTANTS ADMINISTERING VACCINES
Allows clinical medical assistants meeting specified certification, education, and training
requirements to administer vaccines in any setting other than a hospital if acting under
the supervision, control, and responsibility of a physician, PA, or APRN
The bill allows clinical medical assistants to administer vaccines
under certain conditions in any setting other than a hospital. They may
do so only if they (1) meet certain certification, education, and training
requirements and (2) act under the supervision, control, and
responsibility of a licensed physician, physician assistant (PA), or
advanced practice registered nurse (APRN). The bill specifies that it
does not authorize employers to require physicians, PAs, or APRNs,
without their consent, to oversee clinical medical assistants
administering vaccines.
The bill also makes a corresponding change by adding to the list of
organizations from whom DPH must obtain a list of state residents
certified as medical assistants.
EFFECTIVE DATE: October 1, 2022
Required Certification, Education, and Training
To be eligible to administer vaccines under the bill, a clinical medical
assistant generally must be certified by the American Association of
Medical Assistants, the National Healthcareer Association, the National
Center for Competency Testing, or the American Medical Technologists.
The clinical medical assistant also generally must have graduated
from a postsecondary medical assisting program that meets either of the 2022HB-05500-R01-BA.DOCX
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following criteria:
1. starting January 1, 2024, is accredited by the Commission on
Accreditation of Allied Health Education Programs, the
Accrediting Bureau of Health Education Schools, or another
accrediting organization recognized by the U.S. Department of
Education or
2. is offered by a higher education institution accredited by an
accrediting organization recognized by the U.S. Department of
Education and includes 720 total hours, of which 160 hours are
clinical practice skills, including administering injections.
The bill’s authorization also applies to clinical medical assistants who
do not meet the above certification and education requirements but who
completed relevant medical assistant training provided by any branch
of the U.S. armed forces.
The bill requires any clinical medical assistant, before administering
vaccines, to complete at least 24 hours of classroom training and eight
hours of clinical training on vaccine administration.
List of Certified Medical Assistants
Under current law, the DPH commissioner must annually obtain
from the American Association of Medical Assistants and the National
Healthcareer Association a list of all state residents on each
organization’s registry of certified medical assistants. The bill extends
this requirement to also include comparable lists from the National
Center for Competency Testing and the American Medical
Technologists. As under existing law, DPH must make these lists
available for public inspection.
Background — Related Bill
sSB 213 (File 217), reported favorably by the Public Health
Committee, contains similar provisions on medical assistants.
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§ 48 — RARE DISEASE COUNCIL
Establishes a 13-member Connecticut Rare Disease Advisory Council to advise and make
recommendations to DPH and other state agencies on the needs of residents living with
rare diseases and their caregivers
Starting July 1, 2023, the bill establishes a 13-member Connecticut
Rare Disease Advisory Council to advise and make recommendations
to DPH and other state agencies on the needs of residents living with
rare diseases and their caregivers. The council is within DPH for
administrative purposes only.
Functions
Under the bill, the advisory council may do the following:
1. hold public hearings and otherwise solicit public comments and
information to assist with studying or surveying residents with
rare diseases and their caregivers and health care providers;
2. consult with rare disease experts to develop policy
recommendations for improving patient access to quality
medical care in the state, affordable and comprehensive
insurance coverage, medications, medically necessary
diagnostics, timely treatment, and other necessary services and
therapies;
3. research and make recommendations to DPH, other state
agencies, and health carriers (i.e., insurers and HMOs) that
provide services to those with rare diseases on the adverse
impact that changes to health insurance coverage, drug
formularies, and utilization review may have on providing
treatment or care to these patients;
4. research and identify priorities related to rare disease treatments
and services and develop policy recommendations on (a)
safeguards and legal protections against discrimination and
other practices that limit access to appropriate health care,
services, or therapies and (b) planning for natural disasters and
other public health emergencies; 2022HB-05500-R01-BA.DOCX
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5. research and make recommendations on improving the quality
and continuity of care for those living with rare diseases who are
transitioning from pediatric to adult health care services;
6. research and make recommendations on developing rare disease
educational materials, including online materials and a list of
reliable resources for DPH, other state agencies, the public,
individuals living with a rare disease and their families and
caregivers, medical students, and health care providers; and
7. research and make recommendations on support and training
resources for caregivers and health care providers of individuals
living with a rare disease.
Membership
Under the bill, the 13-member advisory council includes the
insurance, public health, and social services commissioners or their
designees (which, for the insurance commissioner’s designee, may be a
health care representative) and the 10 appointed members listed in
Table 2 below.
Table 2: Advisory Council Appointed Members
Appointing Authority Qualifications
Governor One licensed physician with expertise in medical genetics
One hospital association representative or hospital
administrator who provides health care to patients with
rare diseases
Public Health Committee
Senate chairperson
One representative of a patient advocacy group in the
state for all rare diseases
One family member or caregiver of a pediatric patient
living with a rare disease
Public Health Committee
House chairperson
One representative of the biopharmaceutical industry who
is involved in rare disease research
One adult living with a rare disease
Public Health Committee
Senate ranking member
One member of the scientific community in the state who
does rare disease research
One caregiver of a person living with a rare disease 2022HB-05500-R01-BA.DOCX
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Appointing Authority Qualifications
Public Health Committee
House ranking member
One licensed physician who treats patients living with a
rare disease
One representative, family member, or caregiver of a
person living with a rare disease
The bill requires appointing authorities to make initial appointments
by October 31, 2023, and fill any vacancies.
Under the bill, five of the first-appointed members serve two-year
terms, five members serve three-year terms, and all members serve two-
year terms thereafter. The DPH commissioner determines which of the
first-appointed members serve two-year or three-year terms.
Members are not compensated for their services but may be
reimbursed for necessary expenses.
Council Meetings and Leadership
Under the bill, the DPH commissioner selects the acting chairperson
from among the council members to organize the first meeting, which
must be held by November 30, 2023. The council members must then
appoint a permanent chairperson and vice-chairperson by majority vote
during the council’s first meeting.
The bill also specifies that the chairperson, vice-chairperson, or any
member may be reappointed to his or her position on the council.
The bill requires the council to meet in person or remotely at least six
times between November 30, 2023, and October 31, 2024, and quarterly
thereafter, as the chairperson determines.
During meetings, the bill requires the council to provide
opportunities for the public to make comments, hear council updates,
and provide input on council activities. The council must also create a
website where it may post meeting minutes and notices, as well as
feedback.
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Report
The bill requires the council to report to the Public Health Committee
within one year of its first meeting and annually thereafter on its
findings and recommendations, including (1) the council’s activities,
research findings, and recommended legislative changes and (2) any
potential funding sources for its activities, including grants, donations
sponsorships, or in-kind donations.
EFFECTIVE DATE: July 1, 2022
Background — Related Bill
sHB 5260 (File 72), reported favorably by the Public Health
Committee, contains similar provisions establishing a 13-member
Connecticut Rare Disease Advisory Council.
§ 49 — CHRONIC KIDNEY DISEASE ADVISORY COMMITTEE
Removes the Public Health Committee chairpersons and ranking members, and four
members they appoint, from the advisory committee; extends by one year, until January 1,
2024, the date by which the advisory committee must begin annually reporting to the
Public Health Committee
Membership
The bill removes from the state’s Chronic Kidney Disease Advisory
Committee the following members: the Public Health Committee
chairpersons and ranking members and the four members they appoint
that have cognizance in public health. In doing so, it reduces the
committee’s required membership from 21 to 13.
As under current law, the remaining committee members include the
public health commissioner, or her designee, and the following:
1. one member each appointed by the six top legislative leaders,
governor, and the chief executive officers of the National Kidney
Foundation and the American Kidney Fund;
2. one representative each from the kidney physician community, a
nonprofit organ procurement organization, and kidney patient
community, appointed by the Public Health Committee
chairpersons; and 2022HB-05500-R01-BA.DOCX
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3. any other members the Public Health Committee chairpersons
appoint that they deem necessary to represent public health
clinics, community health centers, minority health organizations,
and health insurers.
The bill extends, from July 12, 2021, to 30 days after the bill’s passage,
the date by which appointing authorities must make their initial
appointments. The bill also extends, from July 12, 2021, to 60 days after
the bill’s passage, the date by which the chairpersons must schedule the
committee’s first meeting.
By law, the Chronic Kidney Disease Advisory Committee works with
policymakers, public health organizations, and educational institutions
to increase awareness of chronic kidney disease and develop related
educational programs.
Report
The bill extends by one year, until January 1, 2024, the date by which
the advisory committee must begin annually reporting its findings and
recommendations to the Public Health Committee.
EFFECTIVE DATE: Upon passage
Background — Related Bill
HB 5485 (File 423), contains similar provisions removing the Public
Health Committee chairpersons and ranking members, and four
members they appoint, from the state’s Chronic Kidney Disease
Advisory Committee.
§ 50 — HOSPITAL COMMUNITY BENEFIT PROGRAMS
Makes various changes to the law on hospital community benefit programs, such as
requiring them to submit various documents to OHS on a specified schedule and
requiring OHS to make the state’s all-payer claims database available to hospitals to help
in this process
The bill makes various changes to the law on hospital community
benefit programs. Principally, it:
1. conforms to existing practice by shifting oversight of this law
from the Office of the Healthcare Advocate (OHA) to the Office 2022HB-05500-R01-BA.DOCX
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of Health Strategy (OHS);
2. requires hospitals to submit, on a specified schedule, their
community health needs assessments, related implementation
strategies, and community benefit status reports, and specifies
several matters that hospitals must include in this reporting;
3. requires for-profit acute care hospitals to submit community
benefit program reporting consistent with the bill’s reporting
schedules and reasonably similar to what they would report to
the IRS, where applicable;
4. requires OHS to make data from the state’s all-payer claims
database available to hospitals to fulfill these requirements; and
5. requires OHS to annually summarize and analyze community
benefit program reporting data and solicit stakeholder input
through a public comment period.
The bill also removes managed care organizations (MCOs) from this
law and makes several minor, technical, and conforming changes.
To maintain tax-exempt status under federal law, a nonprofit hospital
must, among other things, (1) conduct a community health needs
assessment at least once every three years and (2) adopt an
implementation strategy to meet the needs identified in the assessment.
Federal regulations set various steps that hospitals must take in
completing these requirements (26 C.F.R. § 1.501(r)-3).
EFFECTIVE DATE: January 1, 2023
Program Applicability (§ 50(a), (i))
Current law’s community benefit provisions apply to hospitals and
MCOs. The bill removes MCOs from this law and instead applies the
law to (1) nonprofit hospitals that must annually file IRS form 990 (see
Background) and (2) for-profit acute care general hospitals.
The bill requires these for-profit hospitals to submit community
benefit program reporting consistent with the bill’s requirements (see 2022HB-05500-R01-BA.DOCX
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below), and reasonably similar to what the hospital would include in its
federal tax filing, where applicable.
Program Scope
Under current law, a “community benefits program” is a voluntary
program to promote preventive care and improve the health status of
working families and at-risk populations in the communities within a
hospital’s or MCO’s geographic service area.
The bill adds to the program purposes (1) protecting health and
safety, (2) improving health equity (see below), (3) reducing health
disparities, and (4) reducing the cost and burden of poor health. It
broadens the scope of these programs to address all populations within
the hospital’s geographic service area, not just working families and at-
risk populations as under current law. It removes references to MCOs.
Under the bill, “health equity” means that everyone has a fair and
just opportunity to be as healthy as possible. This includes removing
obstacles to health, such as poverty, racism, and their adverse
consequences, including a lack of equitable opportunities, access to
good jobs with fair pay, quality education and housing, safe
environments, and health care.
“Health disparities” are health differences that are closely linked with
social or economic disadvantages that adversely affect groups who have
experienced greater systemic social or economic obstacles to health or a
safe environment based on race or ethnicity; religion; socioeconomic
status; gender; age; mental health; cognitive, sensory, or physical
disability; sexual orientation; gender identity; geographic location; or
other characteristics historically linked to discrimination or exclusion.
Community Benefit Program Reporting
Under current law, each hospital and MCO must submit a biennial
report on whether it has a community benefits program. If the entity has
that program, the report must describe its status and discuss certain
parts of it. Current law also allows hospitals or MCOs to develop
community benefit guidelines focused on specified principles. 2022HB-05500-R01-BA.DOCX
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The bill replaces these provisions, instead requiring hospitals,
starting January 1, 2023, to submit community benefit program
reporting to OHS or a designee selected by the OHS executive director.
This reporting includes three components: the hospital’s community
health needs assessment (CHNA), implementation strategy, and annual
status report on its community benefit program.
The bill outlines the required matters to be included with these
submissions (see below). In certain respects, the required topics are
similar to topics under current law’s provisions for community benefit
programs and related guidelines. For example, similar to the current
guidelines, the bill requires a hospital’s community benefit reporting to
address meaningful participation from the community, as described
below.
Under the bill, a hospital generally must submit these documents on
the following schedule:
1. CHNA: within 30 days after the hospital makes it available to the
public as required by federal regulations;
2. implementation strategy: within 30 days after the hospital adopts
it as required by federal regulations; and
3. status report: annually, starting by October 1, 2023.
In each case, the OHS executive director, or her designee, may grant
an extension.
Current law allows OHA, after notice and the opportunity for a
hearing, to assess civil penalties (up to $50 a day) on hospitals or MCOs
that fail to submit community benefit reports as required. The bill
repeals these provisions and does not transfer similar authority to OHS.
Community Health Needs Assessment (§ 50(c))
The bill requires a hospital’s CHNA submission to include the
following information, consistent with requirements in federal
regulations and as included in the hospital’s federal tax filing: 2022HB-05500-R01-BA.DOCX
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1. a definition of the community the hospital serves and a
description of how the hospital determined that community;
2. a description of how the hospital conducted the CHNA;
3. a description of how the hospital solicited and took into account
input from people representing the community’s broad interests;
4. a prioritized description of the community’s significant health
needs identified through the CHNA, and a description of the
process and criteria used in identifying and prioritizing certain
needs as significant;
5. a description of the resources potentially available to address
these significant health needs; and
6. an evaluation of the impact of any of the hospital’s actions to
address the significant health needs identified in its prior CHNA.
The bill also requires hospitals, as part of the CHNA, to submit the
following information:
1. the names of the people responsible for developing the CHNA;
2. the population demographics for the hospital’s geographic
service area and, to the extent feasible, a detailed description of
the health disparities, health risks, insurance status, service
utilization patterns, and health care costs in this area;
3. a description of the health status and health disparities affecting
this service area’s population, including those affecting a
representative range of age, racial, and ethnic groups; incomes;
and medically underserved populations;
4. a description of meaningful participation for community benefit
partners (see below) and diverse community members in
assessing community health needs, priorities, and target
populations;
5. a description of the barriers to achieving or maintaining health 2022HB-05500-R01-BA.DOCX
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and accessing health care, including social, economic, and
environmental barriers; lack of access to, or availability of,
sources of health care coverage and services; and a lack of access
to, and availability of, prevention and health promotion services
and support;
6. recommendations on what role the state and other community
benefit partners could play in removing these barriers and
enabling effective solutions; and
7. any more information, data, or disclosures that the hospital
voluntarily includes that may be relevant to its community
benefit program.
Under the bill, “community benefit partners” are entities that, in
partnership with hospitals, play an essential role in the policy, system,
program, and financing solutions needed to achieve community benefit
program goals. These partners include federal, state, and municipal
government entities and private sector entities, such as faith-based
organizations; businesses; educational and academic organizations;
health care organizations or health departments; philanthropic
organizations; housing justice or planning and land use organizations;
public safety or transportation organizations; and tribal organizations.
“Meaningful participation” means that (1) residents of a hospital’s
community, including those experiencing the greatest health disparities,
have an appropriate opportunity to participate in the hospital’s
planning and decisions; (2) this participation influences a hospital’s
planning; and (3) the hospital gives participants information
summarizing how the hospital did or did not use their input.
Implementation Strategy (§ 50(d))
The bill requires the hospital’s implementation strategy submission,
consistent with requirements in federal regulations and as included in
the hospital’s federal tax filing, to address each significant need
identified through the CHNA.
For those needs the hospital intends to address, the submission must 2022HB-05500-R01-BA.DOCX
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(1) describe how the hospital plans to do so, including the hospital’s
intended actions and their anticipated impact; (2) list the resources the
hospital plans to commit to address the need; and (3) describe any
planned collaboration with other entities in this process. The submission
must also explain why the hospital does not plan to address any
identified significant need.
Under the bill, a hospital’s implementation strategy submission must
also include the following information:
1. the names of the people responsible for developing the strategy;
2. a description of meaningful participation for community benefit
partners and diverse community members;
3. a description of the community health needs and health
disparities that were prioritized in developing the strategy,
considering DPH’s most recent state health plan;
4. if available, evidence (with references) showing how the strategy
intends to address the corresponding need or disparity;
5. planned methods and measures for the ongoing evaluation of the
proposed actions’ progress or impact;
6. a description of how the hospital solicited community
commentary on the strategy and revisions based on that
commentary; and
7. any other information that the hospital voluntarily includes as
may be relevant, including data, disclosures, expected or planned
resource allocation, investments, or commitments, including
staff, financial, or in-kind commitments.
Status Report (§ 50(e))
The bill requires hospital status reports on their community benefit
programs to describe the following:
1. any major updates on community health needs, priorities, and 2022HB-05500-R01-BA.DOCX
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target populations;
2. progress in the hospital’s actions supporting its implementation
strategy;
3. any major changes to the proposed implementation strategy and
associated hospital actions; and
4. financial and other resources allocated or spent to support the
implementation strategy and related actions.
All-Payer Claims Database (APCD) (§ 50(f), (g))
The bill requires OHS to make data in the state’s APCD available to
hospitals for specified purposes (see below) related to their community
benefit programs and activities. OHS must do so (1) regardless of
existing state law on using APCD data and (2) to the full extent
permitted by specified regulations under the federal Health Insurance
Portability and Accountability Act (HIPAA). Generally, those
regulations allow covered entities, under specified conditions, to use or
disclose a limited data set (i.e., protected health information that
excludes various personal identifiers) for research, public health, or
health care operations. The covered entity must enter into a data use
agreement with the recipient (45 C.F.R. § 164.514(e)).
Under the bill, OHS must make APCD data available to hospitals
solely for (1) preparing their CHNAs, (2) preparing and executing their
implementation strategies, and (3) meeting the bill’s community benefit
program reporting requirements. Any OHS disclosures of non-health
information must be done in a way to protect its confidentiality as may
be required by state or federal law.
The bill excuses hospitals from limitations in meeting their
community benefit program reporting requirements if they are not
provided the APCD data as required.
OHS Reporting and Solicitation of Stakeholder Input (§ 50(h))
The bill (1) transfers from OHA to OHS the duty to summarize and
analyze submitted community benefit program reports and (2) removes 2022HB-05500-R01-BA.DOCX
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the current condition that this must occur only within available
appropriations. It requires OHS to do so annually, starting by April 1,
2024, and post the summary and analysis online. Under current law,
OHA must biennially make the summary and analysis available to the
public.
The bill also requires OHS to annually solicit stakeholder input
through a public comment period. OHS must use the reporting and
stakeholder input to do the following:
1. identify more stakeholders to help address identified community
health needs, including (a) federal, state, and municipal entities;
(b) non-hospital private sector health care providers; and (c)
private sector entities other than health care providers, including
community-based organizations, insurers, and charities;
2. determine how these stakeholders could help address identified
community health needs or supplement solutions or approaches
reported in implementation strategies;
3. determine whether to make recommendations to DPH in its
development of the state health plan; and
4. inform OHS’s statewide health care facilities and services plan.
Background — IRS Form 990
A nonprofit hospital must include certain information related to the
CHNA process in its IRS Form 990 filing (the tax return for
organizations exempt from the income tax). Along with the standard
form, there is a specific attachment (Schedule H) that these hospitals
must complete which addresses, among other things, the hospital’s
community benefits, community building activities, and financial
assistance policy.
Background — Related Bill
sSB 476 (File 534), reported favorably by the Public Health
Committee, contains identical provisions on hospital community
benefit programs. 2022HB-05500-R01-BA.DOCX
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§ 51 — NON-DISCRIMINATION FOR TRANSPLANTS BASED ON
DISABILITY
Generally prohibits deeming someone ineligible to receive an anatomical gift, or organ
from a living donor, for transplantation solely because of the person’s physical, mental, or
intellectual disability
The bill generally prohibits deeming someone ineligible to receive an
anatomical gift, or organ from a living donor, for transplantation solely
because of his or her physical, mental, or intellectual disability. The bill
provides an exception if a physician determines, after evaluating the
person, that his or her disability medically contraindicates the
acceptance of the anatomical gift or organ.
Under the bill, if a person has the necessary support to help him or
her comply with post-transplant medical requirements, then the
person’s inability to comply without assistance cannot be determined
“medically significant” to make the person ineligible for a transplant.
The bill specifies that (1) the above provisions apply to each part of
the transplant process and (2) it does not require a physician to make a
referral or recommendation for, or perform a medically inappropriate
transplant of, an anatomical gift or organ.
Under the bill, an “anatomical gift” is the donation of all or part of a
human body to take effect after the donor’s death for transplantation
purposes. An “organ” is all or part of the human liver, pancreas, kidney,
intestine, or lung.
EFFECTIVE DATE: Upon passage
Background — Related Bill
sSB 330 (File 184), reported favorably by the Public Health
Committee, contains identical provisions on anatomical gifts and organ
donation.
§ 52 — INFECTION PREVENTION AND CONTROL SPEC IALISTS
Makes various changes in requirements for infection prevention and control specialists at
nursing homes and dementia special care units, such as (1) limiting the current
requirement that they employ a full-time specialist to only those facilities with more than
60 residents and (2) allowing these specialists to provide services at both a nursing home
and dementia special care unit or at two nursing homes in some circumstances, with DPH
approval 2022HB-05500-R01-BA.DOCX
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The bill makes various changes in current law’s requirements for
infection prevention and control specialists at nursing homes and
dementia special care units (i.e., “facilities”).
The bill limits the current requirement that these facilities employ a
full-time specialist to only those facilities with more than 60 residents,
and instead it requires smaller facilities to employ a part-time specialist.
It also removes a provision from current law requiring each facility
to require its specialist to work on a rotating schedule that ensures he or
she covers each eight-hour shift at least once monthly to ensure
compliance with relevant standards. Under the bill, facilities instead
must require the specialists to implement procedures to monitor the
infection prevention and control practices of each daily shift to ensure
compliance.
The bill allows infection prevention and control specialists to provide
services at both a nursing home and dementia special care unit or at two
nursing homes that are (1) next to each other or on the same campus and
(2) commonly owned or operated. Before this may occur, the owner or
operator must submit a written request to the commissioner, or her
designee, and receive notification that the request is approved.
It allows the DPH commissioner to waive the law’s infection
prevention and control specialist requirements if she determines that
doing so would not endanger the life, safety, or health of the facilities’
residents or employees. If the commissioner waives a requirement, she
may (1) impose conditions assuring residents’ and employees’ health,
safety, and welfare and (2) terminate the waiver if she finds that they
have been jeopardized.
EFFECTIVE DATE: July 1, 2022
Background — Related Bill
sSB 371 (File 318), reported favorably by the Public Health
Committee, contains similar provisions on infection prevention and
control specialists. 2022HB-05500-R01-BA.DOCX
Researcher: ND Page 39 4/30/22
§§ 53 & 54 — ELDERLY HOUSING COMPLEXES AND ASSISTED
LIVING
Allows elderly housing complexes funded and assisted through HUD’s Assisted Living
Conversion Program, and that intend to arrange for assisted living services, to do so with
a currently licensed assisted living services agency, exempting them from having to
register as a managed residential community
The bill allows certain elderly housing complexes that intend to
arrange for assisted living services to do so with a currently licensed
assisted living services agency, exempting them from having to register
as a managed residential community. This applies to elderly housing
complexes funded and assisted through the federal Department of
Housing and Urban Development’s Assisted Living Conversion
Program. Upon DPH’s request, such a housing complex must inform
DPH of its arrangement with a licensed agency, in a form and manner
the commissioner prescribes.
EFFECTIVE DATE: July 1, 2022
Background — Related Bill
sSB 371 (File 318), reported favorably by the Public Health
Committee, contains identical provisions on elderly housing complexes.
§§ 56-58 — DISPOSITION OF UNCLAIMED BODIES
Allows the Office of the Chief Medical Examiner to take custody and coordinate the
disposition of an unclaimed body and requires the funeral director who handles the
disposition to contact the social services commissioner for reimbursement of related
expenses
By law, the Office of the Chief Medical Examiner (OCME) must
investigate deaths that (1) involve certain conditions, such as violence
or suspicious circumstances or (2) are sudden or unexpected and not
caused by an easily recognizable disease. Once it completes the
investigation, the office must deliver the body to the person legally
entitled to receive it. For an unclaimed body, the office must return it to
the authorities in the town where the death occurred. The town is
responsible for final disposition of the body and must pay the associated
costs if the deceased person has not left property sufficient to cover the
cost.
The bill allows OCME to take custody and coordinate the disposition 2022HB-05500-R01-BA.DOCX
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(e.g., cremation or burial) of an unclaimed body. Before doing so, the
bill requires the office to wait 21 days after the death is pronounced and
make a reasonable effort to locate and contact any of the decedent’s
relatives. This includes using law enforcement agency services in the
town where the decedent died or resided.
Under the bill, a funeral director who handles the decedent’s
disposition must notify the Department of Social Services (DSS)
commissioner to seek reimbursement for these expenses. (By law, when
an individual dies in Connecticut and does not leave a sufficient estate
or have a legally liable relative able to cover funeral and burial or
cremation costs, DSS must provide a payment toward them.)
The bill correspondingly requires DSS, when it receives a proper bill,
to pay $1,350 to a funeral director, cemetery, or crematory. The
department must pay this amount only if the Chief Medical Examiner,
or his designee, certifies that OCME, after its investigation, was unable
to locate any of the decedent’s friends or family members willing to take
possession of the decedent’s remains and that they were then
transferred to a funeral director, cemetery, or crematory for disposition.
The bill also waives the $150 cremation certificate fee required under
existing law for these dispositions.
EFFECTIVE DATE: October 1, 2022
§ 59 — COMMISSION ON MEDICOLEGAL INVESTIGATIONS
Removes the requirement that the governor appoint the law and pathology professor
members of the Commission on Medicolegal Investigations from a panel recommended by
a committee of the state’s medical and law school deans
By law, the Commission on Medicolegal Investigations oversees
OCME and consists of the DPH commissioner and eight members
appointed by the governor, including two law professors and two
pathology professors. The bill removes the requirement that the
governor appoint the law and pathology professor members from a
panel of at least four professors in each field recommended by a
committee of the state’s medical and law school deans. Under existing
law, unchanged by the bill, commission members serve six-year 2022HB-05500-R01-BA.DOCX
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appointments and are eligible for reappointment.
The bill also makes technical changes, such as removing references to
obsolete language regarding initial appointments to the commission.
EFFECTIVE DATE: October 1, 2022
§ 60 — PRIVATE AND SEMIPUBLIC WELLS
Starting October 1, 2022, requires property owners to test the water quality of their newly
constructed private or semipublic wells; requires clinical laboratories to report water
quality test results conducted on wells to DPH and local health departments; requires
prospective homebuyers and renters to be given educational materials on well testing; and
expands the list of contaminants local health departments can test wells for when they
suspect groundwater contamination
The bill makes various changes affecting water quality testing for
private and semipublic wells.
Laboratory Reporting of Test Results
The bill requires an environmental laboratory that conducts a water
quality test on a private or semipublic well to report the results to DPH
and the local health department of the municipality where the property
is located, within 30 days after completing the test. Current law requires
this only if the testing is related to a real estate transaction (e.g., property
purchase or sale).
Under the bill, test results submitted to DPH or local health
departments, information obtained from any related investigation, and
any morbidity and mortality study related to the results (1) are
confidential and not subject to disclosure, (2) are not admissible as
evidence in any court or agency proceeding, and (3) must be used solely
for medical or scientific research or disease control and prevention
purposes.
Testing Newly Constructed Wells
Starting October 1, 2022, the bill requires property owners to test the
water quality of a newly constructed private or semipublic wells
(current regulation already requires this). At a minimum, the testing
must screen for the following contaminants: coliform, nitrate, nitrite,
sodium, chloride, iron, manganese, hardness, turbidity, pH, sulfate, 2022HB-05500-R01-BA.DOCX
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apparent color, odor, lead, arsenic, and uranium. The owner must
submit the test results to DPH, in a form and manner the commissioner
prescribes.
Educational Materials for Real Estate Agents
By law, homeowners must notify a purchaser or renter that
educational materials about private and semipublic well testing is
available on the DPH website.
The bill additionally requires an electronic or hard copy of the
information to be provided to a prospective buyers or renters by (1) a
licensed realtor, if the prospective buyer or tenant hired the realtor to
facilitate the property transaction, or (2) the property owner, landlord,
or closing attorney, if the prospective buyer or tenant did not hire a
realtor.
Under the bill, the educational materials provided to prospective
buyers and tenants must include information on testing for the
contaminants described above and any other related recommendations
the department deems necessary.
EFFECTIVE DATE: October 1, 2022
Background — Current Testing Requirements
Local health districts and departments oversee private and
semipublic residential wells, and well owners are responsible for
maintaining the well and testing the quality of their own drinking water.
State regulation requires water quality tests for newly constructed
private residential wells, but neither state law nor regulation requires
testing after the wells are first built.
Therefore, existing private wells are not tested unless the (1)
homeowner arranges for the test or (2) local health department or the
Department of Energy and Environmental Protection tests as part of an
investigation (Conn. Agencies Regs. §§ 19-13-B101 and 19-13-B102).
Additionally, neither state law nor regulation currently requires an
existing well to be tested as a condition of selling a home (Conn. 2022HB-05500-R01-BA.DOCX
Researcher: ND Page 43 4/30/22
Agencies Regs. § 19-13-B101). Instead, current law requires a
homeowner to notify the purchaser that information about well testing
is available on the DPH website.
Background — Related Bill
HB 5484 (File 375), favorably reported by the Public Health
Committee, requires property owners to test the water quality of their
private or semipublic wells when the well is newly constructed or as
part of a real estate transaction.
§ 61 — EMS ORGANIZATIONS ADDING NEW VEHICLES
Allows commercial EMS organizations, not just other EMS organizations, who are
primary service area responders to add one vehicle to their fleet every three years without
necessarily completing the standard hearing process
Existing law allows certain emergency medical services (EMS)
organizations to apply to DPH, on a short form application, to add one
vehicle to their existing fleet every three years, without necessarily
going through the standard hearing process.
Under current law, this applies to licensed or certified volunteer,
hospital-based, or municipal ambulance services, or ambulance or
paramedic intercept services operated by state agencies, that are
primary service area responders (PSARs). The bill instead applies this
provision to any licensed or certified EMS organizations that are PSARs,
thus broadening its applicability to include commercial EMS
organizations.
As under existing law:
1. the applicant must notify, in writing, all other PSARs in any
municipality or abutting municipality in which the applicant
proposes to add a vehicle;
2. the application is deemed approved 30 days after the filing,
unless one of the notified PSARs objects within 15 days after the
notice; and
3. if the objecting PSAR requests a hearing, the applicant must
demonstrate need for the new vehicle through the standard 2022HB-05500-R01-BA.DOCX
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hearing process.
EFFECTIVE DATE: October 1, 2022
§ 62 — LEGIONELLA WORKING GROUP
Requires the DPH commissioner to convene a working group on legionella prevention and
mitigation in hospitals, nursing homes, and other health care facilities and report to the
Public Health Committee by December 31, 2022, on the working group’s findings and
recommendations
The bill requires the DPH commissioner, by July 1, 2022, to convene
a working group on legionella prevention and mitigation in hospitals,
nursing homes, and other health care facilities.
Under the bill, the working group consists of representatives of
hospitals, nursing homes, and water companies who must identify
issues, evaluate data, determine appropriate action timelines, and
develop solutions on preventing and mitigating legionella in the above-
described facilities.
The bill requires the DPH commissioner to report the Public Health
Committee by December 31, 2022, on the working group’s efforts and
recommendations for legislative, regulatory, or other changes on
preventing and mitigating legionella in these facilities. The working
group terminates on the earlier of the date it submits the report or
December 31, 2022.
EFFECTIVE DATE: Upon passage
§ 63 — POLYSOMNOGRAPHIC TECHNOLOGISTS
Authorizes polysomnographic (sleep) technologists to perform certain oxygen-related
patient care activities in hospitals in the same way that existing law allows for designated
licensed health care providers and certified ultrasound or nuclear medicine technologists
The bill allows polysomnographic technologists (“sleep
technologists”) to perform the following oxygen-related patient care
activities in hospitals: (1) connecting or disconnecting oxygen
supply; (2) transporting a portable oxygen source; (3) connecting,
disconnecting, or adjusting the mask, tubes, and other patient oxygen
delivery apparatus; and (4) adjusting the oxygen rate or flow consistent
with a medical order. Existing law already allows designated licensed 2022HB-05500-R01-BA.DOCX
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health care providers and certified ultrasound or nuclear medicine
technologists to do this.
As under existing law, this authorization does not apply to any type
of (1) ventilator, (2) continuous positive airway pressure or bi-level
positive airway pressure unit, or (2) any other noninvasive positive
pressure ventilation.
The state does not regulate polysomnographic technologists. Because
oxygen is considered a prescription drug and can only be administered
by licensed health professionals within their scope of practice,
polysomnographic technologists are currently prohibited from
administering oxygen.
EFFECTIVE DATE: October 1, 2022
§§ 64-66 — SUICIDE ADVISORY BOARD
Renames and expands the scope of DCF’s Youth Suicide Advisory Board, revises its
membership and procedures, and specifically allows physicians’ continuing medical
education in behavioral health to include suicide prevention training
The bill codifies existing practice by expanding the scope of the
Department of Children and Families’ (DCF) Youth Suicide Advisory
Board to address suicide prevention across a person’s lifespan. It
correspondingly renames the board as the Connecticut Suicide
Advisory Board, reflecting existing practice.
It makes conforming changes to the board’s responsibilities to reflect
its broader scope, such as requiring the board to develop a statewide
strategic suicide prevention plan, not just one focused on youth. The bill
specifically adds behavioral health care providers and higher education
faculty members to the list of people to whom the board must
periodically offer training, within available appropriations. It requires
the board’s recommendations to address suicide intervention and
response, not just prevention, procedures for schools, communities, and
interagency service coordination.
The bill also makes several changes to the board’s membership and
procedures. Instead of requiring 20 members as under current law, it 2022HB-05500-R01-BA.DOCX
Researcher: ND Page 46 4/30/22
adds to the types of organizations that can be represented on the board
and makes certain current appointments optional. Among other things,
it (1) adds an additional co-chair to the board and allows for the co-
chairs to appoint a third co-chair and (2) allows the board to adopt
bylaws.
Lastly, the bill specifically allows physicians’ continuing medical
education in behavioral health to include training on suicide prevention.
By law, physicians generally must complete at least one contact hour of
behavioral health continuing education every six years, and a total of 50
contact hours of continuing education every two years, starting with
their second license renewal.
EFFECTIVE DATE: July 1, 2022
Board Membership
Under current law, the board consists of the following members:
1. eight appointed by the DCF commissioner, including a state-
licensed psychiatrist and psychologist, local or regional school
board representative, high school teacher and student, college or
university faculty member and student, and parent;
2. additional DCF commissioner appointees with expertise in
children’s mental health or mental health issues with a focus on
suicide prevention;
3. one representative each from DPH, the State Department of
Education, (SDE), and the Board of Regents for Higher Education
(BOR), appointed by the applicable department commissioner or
Connecticut State Colleges and Universities (CSCU) president;
and
4. the DCF commissioner, who serves in a non-voting, ex-officio
capacity.
The bill makes several changes to the board’s membership, as
reflected in Table 3 below. 2022HB-05500-R01-BA.DOCX
Researcher: ND Page 47 4/30/22
Table 3: Connecticut Suicide Advisory Board Membership Under the Bill
Permissible Appointments (Appointed
by the DCF commissioner)
Required Members
Representatives from suicide prevention
foundations, youth-serving organizations,
law enforcement agencies, religious or
fraternal organizations, civic or volunteer
groups, state and local government
agencies, tribal governments or
organizations, health care providers, or
local organizations with expertise in the
mental health of children or adults or mental
health issues with a focus on suicide
prevention
A state-licensed psychiatrist, state-licensed
psychologist, local or regional school board
representative, high school teacher, high
school student, college or university faculty
member, college or university student,
parent, or person who has experienced
suicide ideation or loss
One representative each from DPH, SDE,
and BOR, appointed by the applicable
commissioner or CSCU president
DCF commissioner or designee (who now
serves as a voting member)
DMHAS commissioner or designee
Board Chairpersons
Under current law, the board elects a chairperson, as well as a vice-
chairperson to act in the chairperson’s absence.
The bill instead reflects current practice by requiring the DCF and
DMHAS commissioners, or their designees, to serve as co-chairpersons
of the board. It also allows them to appoint a third co-chairperson, who
must represent a (1) local organization with mental health expertise or
(2) suicide prevention foundation.
Changes to Board Procedures
The bill allows the board to adopt bylaws to govern itself and its
meetings. It also eliminates provisions in current law providing that
board members (1) serve two-year terms without compensation and (2)
are deemed to have resigned from the board if they miss three meetings
in a row or half of all meetings in a calendar year.
Background — Related Bill
sSB 368 (File 189), reported favorably by the Public Health 2022HB-05500-R01-BA.DOCX
Researcher: ND Page 48 4/30/22
Committee, contains identical provisions on the Suicide Advisory Board
and physicians’ continuing education.
§ 67 — SURGICAL SMOKE EVACUATION POL ICIES
Requires each licensed hospital and outpatient surgical facility to develop and implement a
policy for using a surgical smoke evacuation system to prevent exposure to surgical smoke
The bill requires each licensed hospital and outpatient surgical
facility, by January 1, 2024, to develop a policy for using a surgical
smoke evacuation system to prevent exposure to surgical smoke. Also
by this date, these facilities must implement the policy and, upon
request, provide a copy to DPH.
Under the bill, “surgical smoke” is the by-product of using an energy-
generating device during surgery, such as surgical or smoke plume,
bioaerosols, laser-generated airborne contaminants, or lung-damaging
dust. But the term excludes by -products produced during
gastroenterological or ophthalmic procedures which are not emitted
into the operating room during surgery.
A “surgical smoke evacuation system” is a system, such as a smoke
or laser plume evacuator or local exhaust ventilator, that captures and
neutralizes surgical smoke (1) at the smoke’s site of origin and (2) before
the smoke contacts the eyes or respiratory tract of anyone in an
operating room during surgery.
EFFECTIVE DATE: July 1, 2022
Background — Related Bill
sSB 89 (File 84), reported favorably by the Public Health Committee,
contains similar provisions on surgical smoke evaluation policies.
§§ 68 & 69 — HIV TESTING
Generally requires primary care providers and hospital emergency departments to offer
HIV testing to patients age 13 or older; requires hospitals to adopt related protocols
Starting January 1, 2023, the bill generally requires primary care
physicians, APRNs, and PAs (“primary care providers”) to offer HIV
testing to patients age 13 or older. Specifically, unless one of the bill’s
exceptions applies, the provider or a designee must offer to provide, 2022HB-05500-R01-BA.DOCX
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order, or arrange to order the test.
Starting January 1, 2024, the bill generally requires hospital
employees or staff members treating a patient age 13 or older in the
emergency department to offer the patient an HIV test. By this same
date, it requires hospitals to develop protocols, with specified
components, for implementing this requirement.
For both primary care providers and hospitals, the bill provides
various exceptions to the requirement to offer HIV testing, such as when
the patient is treated for a life-threatening emergency. Also, the bill
requires primary care providers or their designees, and hospital
employees or staff members, to comply with all requirements under
existing law on HIV testing and related information (see
BACKGROUND) .
Under the bill, “primary care” is family medicine, general pediatrics,
primary care, internal medicine, primary care obstetrics, or primary care
gynecology, without regard to board certification.
EFFECTIVE DATE: October 1, 2022
Exceptions to Required Offer of HIV Test
For primary care providers or their designees, the bill’s requirement
does not apply if the provider reasonably believes that the patient (1) is
being treated for a life-threatening emergency, (2) has previously been
offered or received an HIV test, or (3) lacks the capacity to consent.
For hospital employees or staff members, the bill’s requirement does
not apply if they document that the patient (1) is being treated for a life-
threatening emergency, (2) received an HIV test in the prior year, (3)
lacks the capacity to provide general consent to the test, or (4) declines
the test.
Hospital Protocols
The bill’s required hospital protocols must comply with existing
law’s provisions on general consent requirements for HIV testing,
counseling and referral as needed, and related exceptions. 2022HB-05500-R01-BA.DOCX
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Additionally, the protocols must at least include:
1. offering and providing this testing to patients and notifying them
of the results;
2. tracking and documenting the number of tests performed and
declined and the test results;
3. reporting positive test results to DPH, as required under existing
law; and
4. referring patients who test positive to an appropriate health care
provider for treatment.
The bill allows a hospital, in developing and implementing the
protocols, to collaborate with a municipal or district health department,
regional mental health board, emergency medical services council, or
community organization.
Background — HIV Testing and Information
By law, a person who gives general consent for medical procedures
and tests is generally not required to also sign or be given a specific
informed consent form on HIV testing. General consent includes
instruction to the patient that (1) the patient may be tested for HIV as
part of the medical procedures or tests and (2) this testing is voluntary.
Among other things, the law provides that a parent’s or guardian’s
consent is not required for a minor to get tested.
By law, the person ordering an HIV test, when communicating its
result, must give the test subject or his or her authorized representative
counseling information or referrals as needed, addressing certain
matters. These include, among other things, (1) information about
available treatments and support services and (2) the need to notify
partners.
The law establishes exceptions to these consent and counseling
provisions in 10 situations, such as those involving significant
occupational exposure (CGS § 19a-582). 2022HB-05500-R01-BA.DOCX
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The law establishes various other requirements related to HIV testing
and information. For example, subject to certain exceptions, the law
prohibits anyone who obtains confidential HIV-related information
from disclosing it or being compelled to disclose it (CGS § 19a-583).
Background — Related Bill
HB 5190 (File 196), reported favorably by the Public Health
Committee, generally requires physicians, PAs, and APRNs, when
treating a patient age 13 or older in a hospital emergency department or
primary care setting, to offer the patient an HIV test at least annually,
where practicable.
§ 70 — PLASMAPHERESIS, CLINICAL LABORATORIES, AND
BLOOD DONATION CENTERS
Requires the DPH commissioner to review statutes and regulations on, or otherwise
impacting, the practice of plasmapheresis, clinical laboratories, and blood donation centers
in the state and report her findings and recommendations to the legislature by January 1,
2023
The bill requires the DPH commissioner to review statutes and
regulations on, or otherwise impacting, the practice of plasmapheresis,
clinical laboratories, and blood donation centers in the state.
In conducting the review, the bill requires the commissioner to (1)
consult clinical laboratories, businesses, and nonprofit organizations
with expertise in blood collection, plasmapheresis, and clinical
laboratory operations and facilities and (2) review federal regulations
on the practice of plasmapheresis and blood collection.
The bill requires the commissioner, by January 1, 2023, to report to
the legislature on the review and her recommendations on how the state
can better align with related federal regulations while maintaining a
high level of blood donor safety.
EFFECTIVE DATE: Upon passage
§§ 71 & 72 — MANDATED ELDER ABUSE REPORTER TRA INING
Modifies provisions in HB 5313, as amended by House “A,” extending by six months
until June 30, 2023, the date by which mandated elder abuse reporters must generally
complete the DSS elder abuse training program or another DSS-approved program 2022HB-05500-R01-BA.DOCX
Researcher: ND Page 52 4/30/22
The bill modifies provisions in HB 5313, as amended by House “A,”
extending by six months until June 30, 2023, the date by which
mandated elder abuse reporters must generally complete the DSS elder
abuse training program, or another DSS-approved program. Under the
bill, the training must be completed by this date, or within 90 days after
becoming a mandated elder abuse reporter.
The requirement does not apply to any reporter who has already
received the training from an entity that must provide the training to its
employees. By law, any institution, organization, agency, or facility that
employs people to care for seniors age 60 and older must (1) provide
mandatory training on detecting potential elder abuse and (2) inform
employees of their obligation to report such incidences.
By law, the DSS commissioner must develop a training program on
identifying and reporting elder abuse, neglect, exploitation, and
abandonment and make the program available on the department’s
website and in-person or otherwise throughout the state.
Background — Mandated Elder Abuse Reporters
Existing law requires doctors, nurses, long-term care (LTC) facility
administrators and staff, other health care personnel, and certain other
professionals to report suspected abuse, neglect, abandonment, or
exploitation of the elderly and LTC facility residents to DSS within 72
hours of suspecting the abuse or face penalties. They must also report to
the department if they suspect an elderly person needs protective
services (CGS §§ 17a-412 & 17b-451).
EFFECTIVE DATE: Upon passage
§ 73 — TECHNICAL STANDARDS FOR MEDICAL DIAGNOSTIC
EQUIPMENT
Starting January 1, 2023, requires health care facilities to consider certain federal
technical standards for accessibility of medical diagnostic equipment when purchasing this
equipment
Starting January 1, 2023, the bill requires health care facilities to take
into consideration certain federal technical standards for accessibility of
medical diagnostic equipment when purchasing this equipment. 2022HB-05500-R01-BA.DOCX
Researcher: ND Page 53 4/30/22
Specifically, facilities must consider the technical standards developed
by the federal Architectural and Transportation Barriers Compliance
Board (ATBCB) in accordance with the federal Patient Protection and
Affordable Care Act.
Starting by December 1, 2022, the commissioner must annually notify
each health care facility and licensed physician, physician assistant, and
advanced practice registered nurse about information on providing
health care to individuals with accessibility needs, including the ATBCB
technical standards. DPH must also post the information on its website.
Under the bill, a “health care facility” is a hospital, outpatient clinic,
and long-term care or hospice facility. “Medical diagnostic equipment”
includes an examination table or chair; weight scale; mammography
equipment; and x-ray, imaging, and other radiological diagnostic
equipment.
EFFECTIVE DATE: Upon passage
Background — Architectural and Transportation Barriers
Compliance Board
The board is an independent federal agency that provides
information, technical assistance, and training on accessibility design for
people with disabilities. Among other things, it provides design criteria
for transit vehicles, telecommunications equipment, and electronic
information technology.
Background — Related Bill
HB 5277 (File 112), favorably reported by the Public Health
Committee, requires DPH to adopt regulations that require health care
facilities to meet or exceed federal ATBCB technical standards starting
January 1, 2023.
§ 74 — ASSISTED LIVING SERVICES AGENCIES TASK FORCE
Establishes a task force to study the regulation and staffing levels of assisted living
services agencies (ALSAs) that provide services as dementia special care units or
programs; requires it to report its findings and recommendations to the Public Health
Committee by January 1, 2023
The bill establishes a nine-member task force to study ALSAs that 2022HB-05500-R01-BA.DOCX
Researcher: ND Page 54 4/30/22
provide services as a dementia special care units or programs. The study
must examine (1) DPH regulation of these agencies and whether
additional department oversight is required; (2) whether minimum
staffing levels should be required; and (3) agencies’ maintenance of
records on meals served to, bathing of, medication administration to,
and overall health of residents.
Membership
Under the bill, the task force consists of the following nine members:
1. two each appointed by the Senate president pro tempore and
House speaker;
2. one each appointed by the Senate and House majority and
minority leaders; and
3. the DPH commissioner or her designee.
Under the bill, appointing authorities must make their initial
appointments within 30 days after the bill’s passage and fill any
vacancies. Appointed members may be legislators.
The bill requires the Senate president pro tempore and House
speaker to select the task force chairpersons from among its members.
The chairpersons must schedule and hold the first meeting within 60
days after the bill’s passage.
Under the bill, the Public Health Committee’s administrative staff
serve as the task force’s administrative staff.
Report
The bill requires the task force, by January 1, 2023, to report its
findings and recommendations to the Public Health Committee. The
task force terminates when it submits the report or January 1, 2023,
whichever is later.
EFFECTIVE DATE: Upon passage
2022HB-05500-R01-BA.DOCX
Researcher: ND Page 55 4/30/22
Background — Related Bill
sSB 477 (File 535), favorably reported by the Public Health
Committee, contains the same ALSA task force provisions.
§ 75 — MATERNAL MORTALITY REVIEW COMMITTEE
EDUCATIONAL MATERIALS
Requires DPH’s Maternal Mortality Review Committee to develop educational materials
on intimate partner violence and pregnant and postpartum persons with mental health
disorders, which DPH must distribute to specified hospitals and health care providers
By law, a Maternal Mortality Review Committee within DPH
conducts multidisciplinary reviews of maternal deaths to identify
associated factors and make recommendations to reduce these deaths.
The bill requires the committee, by January 1, 2023, to develop
educational materials on the following topics:
1. the health and safety of pregnant and postpartum persons with
mental health disorders, including perinatal mood and anxiety
disorders, for DPH to distribute to each birthing hospital in the
state;
2. evidence-based screening tools for screening patients for intimate
partner violence, peripartum mood disorders, and substance use
disorder, for DPH to distribute to obstetricians and other health
care providers who practice obstetrics; and
3. indicators of intimate partner violence for DPH to distribute to
(a) hospitals for emergency department health care providers to
use and (b) obstetricians and other health care providers who
practice obstetrics.
EFFECTIVE DATE: Upon passage
Background — Related Bill
sSB 477 (File 535), favorably reported by the Public Health
Committee, contains the same provisions requiring the Maternal
Mortality Review Committee to develop educational materials. 2022HB-05500-R01-BA.DOCX
Researcher: ND Page 56 4/30/22
§ 76 — BIRTHING HOSPITALS PATIENT EDUCATIONAL
MATERIALS
Requires birthing hospitals (1) starting October 1, 2022, to provide caesarean section
patients with written information on the importance of mobility following the procedure
and (2) starting January 1, 2023, to provide postpartum patients certain educational
materials and establish a patient portal for them to virtually access any educational
materials and information provided to the patients during their stay or discharge
The bill requires birthing hospitals, starting October 1, 2022, to give
each patient who has undergone a caesarean section written
information on the importance of mobility and the associated risks of
immobility following the procedure.
By January 1, 2023, the bill requires birthing hospitals to establish a
patient portal where a postpartum patient can virtually access, through
the internet or an application, any educational materials and
information that the hospital gave the patient during his or her hospital
stay and discharge.
Also starting by this date, the bill requires birth hospitals to give each
postpartum patient the Maternal Mortality Review Committee’s
educational materials on the health and safety of pregnant and
postpartum persons with mental health disorders, as described above
(see § 75).
EFFECTIVE DATE: July 1, 2022
Background — Related Bill
sSB 477 (File 535), favorably reported by the Public Health
Committee, contains the same provisions requiring birthing hospitals to
provide these written materials and establish a patient portal.
§ 77 — DESIGNATING MATERNAL MENTAL HEALTH MONTH AND
MATERNAL HEALTH DAY
Designates the month of May as “Maternal Mental Health Month” and each May 5 as
“Maternal Health Day”
The bill designates the month of May as “Maternal Mental Health
Month” and each May 5 as “Maternal Health Day,” and allows suitable
exercises to be held at the Capitol and other locations the governor
designates. 2022HB-05500-R01-BA.DOCX
Researcher: ND Page 57 4/30/22
EFFECTIVE DATE: Upon passage
Background — Related Bill
sSB 477 (File 535), favorably reported by the Public Health
Committee, contains the same provisions designating the month of May
as “Maternal Mental Health Month” and each May 5 as “Maternal
Health Day.”
COMMITTEE ACTION
Public Health Committee
Joint Favorable Substitute
Yea 30 Nay 0 (03/30/2022)