CT
Connecticut Senate Bill SB00448

Connecticut 2022 Regular Session

Connecticut Senate Bill SB00448 Compare Versions

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7+General Assembly Substitute Bill No. 448
8+February Session, 2022
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4-Substitute Senate Bill No. 448
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6-Public Act No. 22-133
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9-AN ACT REQUIRING THE DEVELOPMENT OF A PLAN
10-CONCERNING THE DELIVERY OF HEALTH CARE AND MENTAL
11-HEALTH CARE SERVICES TO INMATES OF CORRECTIONAL
12-INSTITUTIONS.
14+AN ACT CONCERNING THE DELIVERY OF HEALTH CARE AND
15+MENTAL HEALTH CARE SERVICES TO INMATES OF
16+CORRECTIONAL INSTITUTIONS.
1317 Be it enacted by the Senate and House of Representatives in General
1418 Assembly convened:
1519
16-Section 1. (NEW) (Effective from passage) (a) As used in this section:
17-(1) "Advanced practice registered nurse" means an advanced practice
18-registered nurse licensed under chapter 373 of the general statutes;
19-(2) "Alcohol and drug counselor" means an alcohol and drug
20-counselor licensed or certified under chapter 376b of the general
21-statutes;
22-(3) "Commissioner" means the Commissioner of Correction;
23-(4) "Correctional institution" means a prison or jail under the
24-jurisdiction of the commissioner;
25-(5) "Dental professional" means a (A) dentist, (B) dental hygienist
26-licensed under chapter 379a of the general statutes, or (C) dental
27-assistant, as defined in section 20-112a of the general statutes;
28-(6) "Dentist" means a dentist licensed under chapter 379 of the general Substitute Senate Bill No. 448
20+Section 1. (NEW) (Effective October 1, 2022) (a) The Commissioner of 1
21+Correction shall ensure that a sufficient number of licensed mental 2
22+health care providers, including, but not limited to, at least four licensed 3
23+mental health care providers with experience in substance use disorder 4
24+diagnosis and treatment, who are employed by or contract with the 5
25+Department of Correction are placed at each correctional institution 6
26+under its jurisdiction to provide mental health care services to inmates. 7
27+A mental health care provider placed at a correctional institution shall 8
28+provide mental health care services to any inmate who requests such 9
29+services or has been referred for such services by correctional staff only 10
30+after the provider makes an in-person assessment of the inmate's need 11
31+for such services and determines that the inmate requires such services. 12
32+Each mental health care provider shall deliver such services in concert 13
33+with the security needs of all inmates and correctional staff and the 14
34+overall operation of the correctional institution, as determined by the 15
35+warden of the correctional institution, in consultation with the 16
36+commissioner. 17 Substitute Bill No. 448
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32-statutes;
33-(7) "Department" means the Department of Correction;
34-(8) "Discharge planner" means a (A) registered nurse licensed under
35-chapter 378 of the general statutes, (B) practical nurse licensed under
36-chapter 378 of the general statutes, (C) clinical social worker or master
37-social worker licensed under chapter 383b of the general statutes, or (D)
38-professional counselor licensed under chapter 383c of the general
39-statutes;
40-(9) "HIV test" means a test to determine human immunodeficiency
41-virus infection or antibodies to human immunodeficiency virus;
42-(10) "Inmate" means a person in the custody of the commissioner and
43-confined in a correctional institution;
44-(11) "Medical professional" means (A) a physician, (B) an advanced
45-practice registered nurse, (C) a physician assistant, (D) a registered
46-nurse licensed under chapter 378 of the general statutes, or (E) a
47-practical nurse licensed under chapter 378 of the general statutes;
48-(12) "Mental health care provider" means (A) a physician who
49-specializes in psychiatry, or (B) an advanced practice registered nurse
50-who specializes in mental health;
51-(13) "Mental health therapist" means (A) a physician who specializes
52-in psychiatry, (B) a psychologist licensed under chapter 383 of the
53-general statutes, (C) an advanced practice registered nurse who
54-specializes in mental health, (D) a clinical social worker or master social
55-worker licensed under chapter 383b of the general statutes, or (E) a
56-professional counselor licensed under chapter 383c of the general
57-statutes;
58-(14) "Physician" means a physician licensed under chapter 370 of the Substitute Senate Bill No. 448
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43+(b) No mental health care provider who is providing mental health 18
44+care services pursuant to subsection (a) of this section shall prescribe or 19
45+administer a psychotropic medication to an inmate unless (1) the mental 20
46+health care provider has reviewed the full mental health history and 21
47+medical history of the inmate, including, but not limited to, the list of all 22
48+medications the inmate is taking, (2) the inmate has undergone a 23
49+physical examination by a licensed health care provider not more than 24
50+thirty days prior to the mental health care provider first prescribing or 25
51+administering the psychotropic medication and the mental health care 26
52+provider determines, based on a review of the record of such 27
53+examination, that it is safe to prescribe or administer such medication, 28
54+(3) the mental health care provider has performed a mental health 29
55+assessment of the inmate not more than seven days prior to first 30
56+prescribing or administering such medication, (4) the mental health care 31
57+provider diagnoses the inmate with a mental health disorder or the 32
58+inmate has received a previous diagnosis of a mental health disorder by 33
59+a licensed mental health care provider and such medication is used to 34
60+treat such mental health disorder, (5) the mental health care provider 35
61+approves the use of such medication by the inmate as part of the 36
62+inmate's mental health treatment plan, and (6) the mental health care 37
63+provider keeps a record of each psychotropic medication such provider 38
64+prescribes or administers to the inmate and all other medications the 39
65+inmate is taking. As used in this subsection, "psychotropic medication" 40
66+means a medication that is used to treat a mental health disorder and 41
67+that affects behavior, mood, thoughts or perception. 42
68+Sec. 2. (NEW) (Effective October 1, 2022) (a) As used in this section and 43
69+sections 3 and 4 of this act: 44
70+(1) "Advanced practice registered nurse" means an advanced practice 45
71+registered nurse licensed under chapter 373 of the general statutes who 46
72+is employed by or contracts with the Department of Correction to 47
73+provide health care services at a correctional institution; 48
74+(2) "Commissioner" means the Commissioner of Correction; 49 Substitute Bill No. 448
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62-general statutes;
63-(15) "Physician assistant" means a physician assistant licensed under
64-chapter 370 of the general statutes; and
65-(16) "Psychotropic medication" means a medication that is used to
66-treat a mental health disorder that affects behavior, mood, thoughts or
67-perception.
68-(b) Not later than January 1, 2023, the commissioner shall develop a
69-plan for the provision of health care services, including, but not limited
70-to, mental health care, substance use disorder and dental care services,
71-to inmates of correctional facilities under the jurisdiction of the
72-department. Such plan shall include, but not be limited to, guidelines
73-for implementation of the following requirements:
74-(1) (A) A sufficient number of mental health therapists, as determined
75-by the commissioner, shall be placed at each correctional institution to
76-provide mental health care services to inmates;
77-(B) A mental health therapist placed at a correctional institution shall
78-provide mental health care services to any inmate who requests such
79-services or has been referred for such services by correctional staff only
80-after the therapist makes an assessment of the inmate's need for such
81-services and determines that the inmate requires such services;
82-(C) Each mental health therapist shall deliver such services in concert
83-with the security needs of all inmates and correctional staff and the
84-overall operation of the correctional institution, as determined by the
85-warden of the correctional institution; and
86-(D) No mental health therapist who is providing mental health care
87-services pursuant to this subdivision and licensed to prescribe
88-medication shall prescribe a psychotropic medication to an inmate
89-unless (i) the mental health therapist has reviewed the mental health Substitute Senate Bill No. 448
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93-history and medical history of the inmate, including, but not limited to,
94-the list of all medications the inmate is taking, (ii) the mental health
95-therapist determines, based on a review of such history, that the benefits
96-of prescribing such medication outweigh the risk of prescribing such
97-medication, (iii) the mental health therapist diagnoses the inmate with
98-a mental health disorder, the inmate has received a previous diagnosis
99-of a mental health disorder by a licensed mental health care provider
100-and such medication is used to treat such mental health disorder, or, in
101-an emergency situation, the mental health therapist makes an
102-assessment that the inmate's mental health is substantially impaired and
103-requires psychotropic medication to treat, (iv) the mental health
104-therapist approves the use of such medication by the inmate as part of
105-the inmate's mental health treatment plan, and (v) the mental health
106-therapist keeps a record of each psychotropic medication such provider
107-prescribes to the inmate and all other medications the inmate is taking.
108-(2) Each inmate shall receive an annual physical examination by a
109-physician, physician assistant or advanced practice registered nurse
110-when such examination is clinically indicated. Such examination may
111-include, but not be limited to, a breast and gynecological examination
112-or prostate examination, where appropriate, and the administration of
113-any test the physician, physician assistant or advanced practice
114-registered nurse deems appropriate.
115-(3) Each inmate shall receive an initial health assessment from a
116-medical professional not later than fourteen days after the inmate's
117-initial intake into a correctional institution.
118-(4) If a physician, physician assistant or advanced practice registered
119-nurse recommends, based on the initial health assessment of an inmate
120-or person, that such inmate or person be placed in a medical or mental
121-health housing unit, the department shall ensure that such inmate or
122-person is placed in an appropriate medical or mental health housing
123-unit unless there are significant safety or security reasons for not making Substitute Senate Bill No. 448
81+(3) "Correctional institution" means a correctional institution under 50
82+the jurisdiction of the Department of Correction; 51
83+(4) "Dentist" means a dentist licensed under chapter 379 of the general 52
84+statutes who is employed by or contracts with the Department of 53
85+Correction to provide health care services at a correctional institution; 54
86+(5) "Inmate" means an inmate of a correctional institution; 55
87+(6) "Physician" means a physician licensed under chapter 370 of the 56
88+general statutes who is employed by or contracts with the Department 57
89+of Correction to provide health care services at a correctional institution; 58
90+(7) "Physician assistant" means a physician assistant licensed under 59
91+chapter 370 of the general statutes who is employed by or contracts with 60
92+the Department of Correction to provide health care services at a 61
93+correctional institution; and 62
94+(8) "Registered nurse" means a registered nurse licensed under 63
95+chapter 378 of the general statutes who is employed by or contracts with 64
96+the Department of Correction to provide health care services at a 65
97+correctional institution. 66
98+(b) Each inmate shall receive an annual physical examination by a 67
99+physician, physician assistant or advanced practice registered nurse. 68
100+Such examination may include, but not be limited to, a breast and 69
101+gynecological examination and the administration of any test the 70
102+physician, physician assistant or advanced practice registered nurse 71
103+deems appropriate. 72
104+(c) Each inmate shall receive a routine physical examination by a 73
105+physician, physician assistant or advanced practice registered nurse not 74
106+later than forty-eight hours after entering a correction institution to 75
107+serve a sentence. Each person who is detained at a correctional 76
108+institution shall receive a routine physical examination by a physician, 77
109+physician assistant or advanced practice registered nurse not later than 78
110+ninety-six hours after entering the correctional institution. No inmate or 79 Substitute Bill No. 448
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127-such placement.
128-(5) A medical professional shall perform health assessments of
129-inmates in a location at the correctional institution that the warden of
130-the correctional institution designates as appropriate for performing
131-such an examination, provided the analysis of any sample collected
132-from the inmate during a health assessment may be performed at a
133-laboratory that is located outside of the correctional institution.
134-(6) A discharge planner shall conduct an exit interview of each inmate
135-who is being scheduled for discharge from a correctional institution
136-prior to the date of discharge if such exit interview is clinically indicated,
137-provided the lack of such exit interview shall not delay the scheduled
138-discharge of an inmate. Such exit interview shall include a discussion
139-with the inmate regarding a medical discharge plan for any continued
140-medical care or treatment that is recommended by the physician,
141-physician assistant or advanced practice registered nurse for the inmate
142-when the inmate reenters the community.
143-(7) A physician shall be on call on weekends, holidays and outside
144-regular work hours to provide medical care to inmates as necessary.
145-(8) The commissioner shall ensure that each inmate has access to all
146-vaccines licensed or authorized under an emergency use authorization
147-by the federal Food and Drug Administration that are recommended by
148-the National Centers for Disease Control and Prevention Advisory
149-Committee on Immunization Practices, subject to availability of such
150-vaccines, unless there are substantial security concerns with providing
151-access to such vaccines. Subject to availability, a physician, physician
152-assistant or advanced practice registered nurse shall prescribe to an
153-inmate any such vaccine that (A) the inmate requests, and (B) is
154-recommended for such inmate by said committee, as determined by the
155-physician, physician assistant or advanced practice registered nurse,
156-provided the prescribing of such vaccine does not impose significant Substitute Senate Bill No. 448
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117+person described in this subsection shall be placed in a housing unit at 80
118+the correctional institution until the physician, physician assistant or 81
119+advanced practice registered nurse completes the physical examination 82
120+required under this subsection and approves the placement of such 83
121+inmate or person in a housing unit. If the physician, physician assistant 84
122+or advanced practice registered nurse recommends, based on the 85
123+physical examination of such inmate or person, that such inmate or 86
124+person be placed in a medical or mental health housing unit, the warden 87
125+of the correctional institution shall ensure that such inmate or person is 88
126+placed in a medical or mental health housing unit at the correctional 89
127+institution. 90
128+(d) The physician, physician assistant or advanced practice registered 91
129+nurse shall perform the examinations required under subsections (b) 92
130+and (c) of this section in a location at the correctional institution that the 93
131+physician, physician assistant or advanced practice registered nurse 94
132+deems appropriate for performing such an examination, provided the 95
133+analysis of any sample collected from the inmate during such 96
134+examination may be performed at a laboratory that is located outside of 97
135+the correctional institution. Any x-ray of an inmate ordered by a 98
136+physician, physician assistant or advanced practice registered nurse 99
137+shall be performed at the correctional institution if the correctional 100
138+institution has the equipment necessary to perform an x-ray. 101
139+(e) A physician, physician assistant or advanced practice registered 102
140+nurse shall conduct an exit interview of each inmate who is being 103
141+discharged from a correctional institution not later than seven days 104
142+prior to the date of discharge. Such exit interview shall include a 105
143+discussion with the inmate regarding any continued medical care or 106
144+treatment that is recommended by the physician, physician assistant or 107
145+advanced practice registered nurse for the inmate when the inmate 108
146+reenters the community. 109
147+(f) A physician shall be on call twenty-four hours a day, seven days a 110
148+week at each correctional institution to provide medical care to inmates 111
149+as necessary. 112 Substitute Bill No. 448
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160-safety concerns.
161-(9) Except in exigent circumstances, a dental professional shall
162-perform a dental screening of each inmate not later than one year after
163-the inmate initially enters a correctional institution and at least once
164-annually thereafter. At the time the dental professional performs the
165-dental screening of an inmate, the dental professional shall develop a
166-dental care plan for the inmate. A dental professional shall provide
167-dental care in accordance with the inmate's dental care plan throughout
168-the inmate's time at the correctional institution. The commissioner shall
169-ensure, in consultation with a dentist, that each correctional institution
170-has a dental examination room that is fully equipped with all of the
171-dental equipment necessary to perform a dental examination.
172-(10) A medical professional shall administer an HIV test to each
173-inmate who requests an HIV test, subject to the availability of such test.
174-Except in exigent circumstances and subject to availability, a medical
175-professional shall offer an HIV test to each inmate where it is clinically
176-indicated (A) at the time such inmate enters a correctional institution, or
177-(B) during an annual physical assessment.
178-(11) A medical professional shall interview each inmate regarding the
179-inmate's drug and alcohol use history at the time the inmate initially
180-enters a correctional institution. If an inmate is exhibiting symptoms of
181-withdrawal from a drug or alcohol at such time, a medical professional
182-shall perform a physical assessment of the inmate and communicate the
183-results of such assessment to a physician, physician assistant or
184-advanced practice registered nurse. Except in exigent circumstances, a
185-drug and alcohol counselor shall perform an evaluation of the inmate
186-not later than five days after the inmate initially enters the correctional
187-institution. The correctional institution shall immediately transfer each
188-inmate who is determined by a physician, physician assistant or
189-advanced practice registered nurse to be experiencing withdrawal from
190-a drug or alcohol to an appropriate area at such correctional institution Substitute Senate Bill No. 448
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194-for medical treatment of such withdrawal. A physician, a physician
195-assistant or an advanced practice registered nurse shall periodically
196-evaluate each inmate who exhibits signs of or discloses an addiction to
197-a drug or alcohol or who experiences withdrawal from a drug or
198-alcohol, at a frequency deemed appropriate by the physician, physician
199-assistant or advanced practice registered nurse.
200-(12) A physician, a physician assistant or an advanced practice
201-registered nurse with experience in substance use disorder diagnosis
202-and treatment shall oversee the medical treatment of an inmate
203-experiencing withdrawal from a drug or alcohol at each correctional
204-institution. A medical professional shall be present in the medical unit
205-at each correctional facility at all times during the provision of medical
206-treatment to such inmate.
207-(13) A drug and alcohol counselor shall offer appropriate substance
208-use disorder counseling services, including, but not limited to,
209-individual counseling sessions and group counseling sessions, to an
210-inmate who exhibits signs of or discloses an addiction to a drug or
211-alcohol and encourage such inmate to participate in at least one
212-counselling session. At the time of an inmate's discharge from the
213-correctional institution, a discharge planner may refer an inmate who
214-has exhibited signs of or disclosed an addiction to a drug or alcohol
215-while an inmate at such correctional institution to a substance use
216-disorder treatment program in the community that is deemed
217-appropriate for the inmate by such discharge planner.
218-(14) The York Correctional Institution shall provide each inmate who
219-is pregnant and drug or alcohol-dependent, with information regarding
220-the dangers of undergoing withdrawal from the drug or alcohol without
221-medical treatment, the importance of receiving medical treatment
222-during the second trimester of pregnancy for withdrawal from the drug
223-or alcohol and the effects of neonatal abstinence syndrome on a
224-newborn. Substitute Senate Bill No. 448
156+(g) Only a physician, physician assistant or advanced practice 113
157+registered nurse may administer medication to an inmate. A physician 114
158+assistant or advanced practice registered nurse may administer a 115
159+medication to an inmate only if a physician has ordered, in writing, the 116
160+administration of such medication to the inmate. 117
161+(h) The commissioner shall ensure that each inmate has access to all 118
162+vaccines licensed or authorized under an emergency use authorization 119
163+by the federal Food and Drug Administration that are recommended by 120
164+the National Centers for Disease Control and Prevention Advisory 121
165+Committee on Immunization Practices. A physician, physician assistant 122
166+or advanced practice registered nurse shall administer to an inmate any 123
167+such vaccine that (1) the inmate requests, and (2) is recommended for 124
168+such inmate by said committee, as determined by the physician, 125
169+physician assistant or advanced practice registered nurse. 126
170+(i) A dentist shall perform a dental examination of each inmate not 127
171+later than ten weeks after the inmate enters a correctional institution. At 128
172+the time the dentist performs the dental examination of an inmate, the 129
173+dentist shall develop a dental care plan for the inmate. A dentist shall 130
174+provide dental care to an inmate in accordance with the inmate's dental 131
175+care plan throughout the inmate's sentence at the correctional 132
176+institution. The commissioner shall ensure, in consultation with a 133
177+dentist, that each correctional institution has a dental examination room 134
178+that is fully equipped with all of the dental equipment necessary to 135
179+perform a dental examination. 136
180+Sec. 3. (NEW) (Effective October 1, 2022) A physician, physician 137
181+assistant or advanced practice registered nurse shall administer an HIV 138
182+test to each inmate who requests an HIV test. A physician, physician 139
183+assistant or advanced practice registered nurse shall offer an HIV test to 140
184+each inmate identified as having a high risk of being infected with the 141
185+human immunodeficiency virus (1) at the time such inmate enters a 142
186+correctional institution, or (2) during the annual physical examination 143
187+of the inmate required under subsection (b) of section 2 of this act. As 144
188+used in this subsection, "HIV test" means a test to determine human 145 Substitute Bill No. 448
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228-(15) The York Correctional Institution shall provide each inmate who
229-is pregnant prenatal visits at a frequency determined by an obstetrician
230-to be consistent with community standards for prenatal visits.
231-(16) The department shall issue a request for information to which a
232-school of medicine may apply for purposes of providing practical
233-training at correctional institutions as part of a medical residency
234-program, through which residents participating in such program may
235-provide health care services to inmates.
236-(c) Not later than February 1, 2023, the commissioner shall report, in
237-accordance with the provisions of section 11-4a of the general statutes,
238-to the joint standing committees of the General Assembly having
239-cognizance of matters relating to public health and the judiciary
240-regarding the plan developed pursuant to subsection (b) of this section,
241-recommendations for any legislation necessary to implement such plan
242-and the department's timeline for implementation of such plan.
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195+immunodeficiency virus infection or antibodies to human 146
196+immunodeficiency virus. 147
197+Sec. 4. (NEW) (Effective October 1, 2022) (a) A licensed mental health 148
198+care provider at each correctional institution shall interview each inmate 149
199+regarding the inmate's drug and alcohol use history at the time the 150
200+inmate enters the correctional institution. If an inmate is exhibiting 151
201+symptoms of withdrawal from a drug or alcohol at such time, a 152
202+physician, physician assistant or advanced practice registered nurse 153
203+shall perform a physical examination of the inmate not later than 154
204+twenty-four hours after the inmate enters the correctional institution 155
205+and a licensed mental health care provider shall perform a mental health 156
206+evaluation of the inmate not later than five days after the inmate enters 157
207+the correctional institution. The correctional institution shall 158
208+immediately transfer each inmate who is determined by a physician, 159
209+physician assistant or advanced practice registered nurse to be 160
210+experiencing withdrawal from a drug or alcohol and each inmate who 161
211+requests medical treatment for withdrawal from a drug or alcohol to a 162
212+medical unit at such correctional institution for medical treatment of 163
213+such withdrawal, provided (1) if the inmate is pregnant, the inmate 164
214+provides informed consent to such medical treatment, and (2) if the 165
215+medical treatment to be provided includes the administration of 166
216+methadone, the inmate provides informed consent to the use of 167
217+methadone. A physician, physician assistant or advanced practice 168
218+registered nurse shall periodically evaluate each inmate who exhibits 169
219+signs of or discloses an addiction to a drug or alcohol or who 170
220+experiences withdrawal from a drug or alcohol, at a frequency deemed 171
221+appropriate by the physician, physician assistant or advanced practice 172
222+registered nurse. 173
223+(b) A physician with experience in substance use disorder diagnosis 174
224+and treatment shall oversee the medical treatment of an inmate 175
225+experiencing withdrawal from a drug or alcohol at each correctional 176
226+institution. A physician, physician assistant, advanced practice 177
227+registered nurse or registered nurse with experience in substance use 178 Substitute Bill No. 448
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234+disorder diagnosis and treatment shall provide such medical treatment 179
235+in a medical unit at each correctional institution. An advanced practice 180
236+registered nurse or registered nurse with experience in substance use 181
237+disorder diagnosis and treatment shall be present in the medical unit at 182
238+each correctional facility all times during the provision of medical 183
239+treatment to an inmate. If a medical unit does not contain enough beds 184
240+to accommodate all inmates who require medical treatment under this 185
241+subsection, the correctional institution shall add additional beds to the 186
242+unit or to another medical unit at such correctional institution to ensure 187
243+that each inmate who requires such medical treatment receives such 188
244+medical treatment. A licensed mental health care provider with 189
245+experience in substance use disorder diagnosis and treatment shall 190
246+monitor each inmate who is experiencing withdrawal from cocaine or 191
247+an amphetamine on a daily basis for not less than five days after the 192
248+inmate first exhibits withdrawal symptoms to attempt to mitigate the 193
249+risk of such inmate attempting suicide. A second physician shall be on 194
250+call twenty-four hours a day, seven days a week at each correctional 195
251+institution to oversee medical treatment under this section if the 196
252+physician assigned to oversee such medical treatment at a correctional 197
253+institution becomes unavailable to oversee such medical treatment. 198
254+(c) A licensed mental health care provider shall (1) offer mental health 199
255+counseling services, including, but not limited to, individual counseling 200
256+sessions and group counseling sessions, to an inmate who exhibits signs 201
257+of or discloses an addiction to a drug or alcohol and encourage such 202
258+inmate to participate in at least one counselling session, and (2) at the 203
259+time of an inmate's discharge from the correctional institution, refer an 204
260+inmate who has exhibited signs of or disclosed an addiction to a drug or 205
261+alcohol while an inmate at such correctional institution to a substance 206
262+use disorder treatment program in the community that is deemed 207
263+appropriate for the inmate by such provider. 208
264+Sec. 5. Section 18-69c of the general statutes is repealed and the 209
265+following is substituted in lieu thereof (Effective October 1, 2022): 210
266+(a) The Commissioner of Correction shall ensure that at least one 211 Substitute Bill No. 448
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273+[departmental or contracted,] licensed health care provider who is 212
274+employed by or contracts with the Department of Correction to provide 213
275+health care services at the York Correctional Institution (1) has been 214
276+trained in prenatal and postpartum medical care, and (2) has knowledge 215
277+of and the ability to educate any inmate who is pregnant concerning 216
278+prenatal nutrition, high-risk pregnancy and addiction and substance 217
279+abuse during pregnancy and childbirth. 218
280+(b) Upon admission to the York Correctional Institution, each inmate 219
281+shall be assessed for pregnancy by a licensed health care provider. The 220
282+licensed health care provider shall inform the inmate of any necessary 221
283+medical tests associated with the pregnancy assessment prior to the 222
284+administration of such tests. 223
285+(c) The York Correctional Institution shall provide each inmate who 224
286+is pregnant with: (1) Counseling and written material, in a form that 225
287+may be reasonably understood, concerning (A) the inmate's options 226
288+with regard to her pregnancy, (B) prenatal nutrition, (C) maintaining a 227
289+healthy pregnancy, (D) for any inmate who is drug or alcohol-228
290+dependent, the dangers of undergoing withdrawal from the drug or 229
291+alcohol without medical treatment, the importance of receiving medical 230
292+treatment during the second trimester of pregnancy for withdrawal 231
293+from the drug or alcohol and the effects of neonatal abstinence 232
294+syndrome on a newborn, (E) labor and delivery, [(E)] (F) the postpartum 233
295+period, [(F)] (G) the institution's policies and practices regarding the 234
296+care of an inmate during pregnancy, [labor and delivery and the 235
297+postpartum period,] and [(G)] (H) restrictions on the use of restraints on 236
298+pregnant inmates, (2) medical care at the correctional institution, which 237
299+shall include, but not be limited to: (A) Periodic health monitoring and 238
300+evaluation during pregnancy, and (B) prenatal vitamins or 239
301+supplements, as deemed necessary by a licensed health care provider, 240
302+(3) a diet containing the nutrients necessary to maintain a healthy 241
303+pregnancy, as determined by a licensed health care provider trained in 242
304+prenatal care, (4) the clothing, undergarments and sanitary materials 243
305+deemed appropriate by a licensed health care provider who has been 244 Substitute Bill No. 448
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312+trained in prenatal and postpartum medical care, (5) the opportunity for 245
313+a minimum of one hour of ambulatory movement every day, and (6) 246
314+access to treatment for postpartum depression by a qualified mental 247
315+health professional, provided such treatment is deemed necessary by a 248
316+licensed health care provider who has been trained in postpartum 249
317+medical care. If a [departmental or contracted] licensed health care 250
318+provider trained in prenatal and postnatal medical care, or any other 251
319+health care professional who evaluates or treats an inmate who is 252
320+pregnant, determines that the inmate's pregnancy is high risk or 253
321+involves any other medical complication for either the inmate or the 254
322+baby, [such inmate shall be immediately transferred] the York 255
323+Correctional Institution shall immediately transfer such inmate to the 256
324+medical infirmary setting or any hospital deemed appropriate, as 257
325+determined by such health care provider or professional. The York 258
326+Correctional Institution shall immediately transfer any inmate who is 259
327+pregnant and decides to terminate the pregnancy prior to the viability 260
328+of the fetus, in consultation with a physician pursuant to section 19a-261
329+602, to a hospital or outpatient clinic regulated by the Department of 262
330+Public Health pursuant to section 19a-116 where the inmate may receive 263
331+an abortion. The written material provided to an inmate pursuant to 264
332+subdivision (1) of this subsection shall be known as the "Pregnant 265
333+Woman's Guide". 266
334+(d) Except as provided in this subsection, correctional staff of the 267
335+York Correctional Institution shall not use any leg or waist restraint on 268
336+any inmate of the institution who is known to be pregnant or in the 269
337+postpartum period. An inmate known to be pregnant may only be 270
338+restrained using handcuffs that are placed on the wrists held in front of 271
339+the inmate's body, except an inmate may be placed in wrist, leg or waist 272
340+restraints if (1) there are compelling grounds to believe that an inmate 273
341+presents (A) an immediate and serious threat of harm to herself, staff 274
342+and others, or (B) a substantial flight risk and cannot be reasonably 275
343+contained by other means, and (2) use of such restraints is approved by 276
344+the unit administrator of the institution, or his or her designee, except 277
345+under exigent circumstances. Such restraints shall be the least restrictive 278 Substitute Bill No. 448
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352+kind of restraints considering the circumstances. Correctional staff shall 279
353+document, in writing, the reasons for such determination, the kind of 280
354+restraints used and the reasons staff considered such restraints to be the 281
355+least restrictive kind available and the most reasonable means of 282
356+preventing harm or escape. The correctional staff of the York 283
357+Correctional Institution shall ensure that any inmate, who is determined 284
358+to be in the second or third trimester of a pregnancy by a licensed health 285
359+care provider, is transported to and from visits to health care providers 286
360+and court proceedings in a vehicle with seatbelts. If an attending 287
361+physician or advanced practice registered nurse requests that the 288
362+inmate's restraints be removed for medical reasons, correctional staff 289
363+shall immediately remove the restraints. Nothing in this subsection shall 290
364+prohibit the use of medical restraints by a licensed health care provider 291
365+to ensure the medical safety of the inmate. As used in this subsection 292
366+and subsection (e) of this section, "restraints" means metal handcuffs, 293
367+metal leg restraints and waist and tether chains. 294
368+(e) Each pregnant inmate of the York Correctional Institution shall 295
369+receive labor and delivery services in a hospital deemed appropriate by 296
370+a [departmental or contracted,] licensed health care provider who is 297
371+employed by or contracts with the Department of Correction to provide 298
372+health care services at said institution. Notwithstanding the provisions 299
373+of subsection (d) of this section, an inmate who is in any stage of labor 300
374+or delivery, as determined by a licensed health care provider, shall not 301
375+be placed in restraints at any time, including, but not limited to, during 302
376+transportation to the hospital. If a correction officer is present with the 303
377+inmate during any stage of labor or delivery, such correction officer 304
378+shall be female, if possible. Such correction officer shall be positioned in 305
379+a location that ensures the inmate's privacy, to the extent possible. 306
380+(f) Any inmate in the postpartum period shall be assessed by a 307
381+licensed health care provider upon return to the correctional institution. 308
382+Each inmate in the postpartum period shall be housed in a medical or 309
383+mental health housing unit at the correctional institution until 310
384+discharged by a licensed health care provider. 311 Substitute Bill No. 448
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391+(g) The York Correctional Institution shall provide a pregnant inmate, 312
392+prior to the inmate's release, with counseling and discharge planning to 313
393+ensure, to the extent feasible, the continuity of prenatal and pregnancy-314
394+related care, including substance abuse programs and treatment 315
395+referrals when deemed appropriate. 316
396+Sec. 6. (NEW) (Effective from passage) (a) There is established an 317
397+advisory committee for the purpose of (1) advising the Commissioner 318
398+of Correction regarding the provision of health care services at 319
399+correctional institutions under the jurisdiction of the Department of 320
400+Correction pursuant to the provisions of sections 1 to 4, inclusive, of this 321
401+act and section 18-69c of the general statutes, as amended by this act, 322
402+and (2) evaluating whether the Department of Public Health should 323
403+have oversight over the provision of such services or license the facilities 324
404+located in such correctional institutions where inmates receive health 325
405+care services. 326
406+(b) The committee shall be composed of the following members: 327
407+(1) Two appointed by the speaker of the House of Representatives, 328
408+one of whom shall be a primary care physician, and one of whom shall 329
409+be a formerly incarcerated female; 330
410+(2) Two appointed by the president pro tempore of the Senate, one of 331
411+whom shall be a physician with expertise in infectious disease 332
412+prevention and control, and one of whom shall be a formerly 333
413+incarcerated male; 334
414+(3) One appointed by the majority leader of the House of 335
415+Representatives, who shall be a health care provider with expertise in 336
416+reproductive health care; 337
417+(4) One appointed by the majority leader of the Senate, who shall be 338
418+a representative of an advocacy organization who has knowledge and 339
419+an understanding of issues concerning gender-affirming care; 340
420+(5) One appointed by the minority leader of the House of 341 Substitute Bill No. 448
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427+Representatives, who shall be a current or former employee of a 342
428+correctional institution; 343
429+(6) One appointed by the minority leader of the Senate, who shall be 344
430+a mental health care provider; 345
431+(7) Two appointed by the Governor, one of whom shall be a health 346
432+care provider with expertise in substance use disorder treatment, and 347
433+one of whom shall be an advocate of racial justice; 348
434+(8) One appointed by the Commissioner of Developmental Services, 349
435+who shall be a professional with experience in communicating the needs 350
436+of persons with a disability, including, but not limited to, an intellectual 351
437+disability; 352
438+(9) The Commissioner of Correction, or the commissioner's designee; 353
439+(10) The Commissioner of Public Health, or the commissioner's 354
440+designee; 355
441+(11) The Commissioner of Mental Health and Addiction Services, or 356
442+the commissioner's designee; and 357
443+(12) The executive director of the Office of Health Strategy, or the 358
444+executive director's designee. 359
445+(c) Any appointment that is vacant for one year or more shall be made 360
446+by the Commissioner of Public Health. The Commissioner of Public 361
447+Health shall notify the appointing authority of the commissioner's 362
448+choice of member for appointment not less than thirty days before 363
449+making such appointment. 364
450+(d) The committee shall meet not less than quarterly. On or before 365
451+January 1, 2023, and once every six months thereafter, the committee 366
452+shall report on its recommendations regarding the provision of health 367
453+care services at correctional institutions under the jurisdiction of the 368
454+Department of Correction pursuant to the provisions of sections 1 to 4, 369 Substitute Bill No. 448
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461+inclusive, of this act and section 18-69c of the general statutes, as 370
462+amended by this act, to the department. On or before January 1, 2023, 371
463+and annually thereafter, the committee shall report, in accordance with 372
464+the provisions of section 11-4a of the general statutes, on such 373
465+recommendations, to the joint standing committees of the General 374
466+Assembly having cognizance of matters relating to public health and 375
467+education. On or before January 1, 2023, the committee shall report, in 376
468+accordance with the provisions of said section, on its evaluation of the 377
469+need for oversight by the Department of Public Health to such joint 378
470+standing committees. 379
471+(e) Administrative support for the activities of the advisory 380
472+committee may be provided by the Department of Public Health. 381
473+This act shall take effect as follows and shall amend the following
474+sections:
475+
476+Section 1 October 1, 2022 New section
477+Sec. 2 October 1, 2022 New section
478+Sec. 3 October 1, 2022 New section
479+Sec. 4 October 1, 2022 New section
480+Sec. 5 October 1, 2022 18-69c
481+Sec. 6 from passage New section
482+
483+Statement of Legislative Commissioners:
484+In Section 2(c), the first two sentences were reworded for clarity; in
485+Section 5(c), "(H)" was deleted, "labor and delivery and the postpartum
486+period" was bracketed and "(I)" was changed to "(H)" for consistency;
487+and in Section 6(d) "to the department" was inserted after "section 18-
488+69c of the general statutes, as amended by this act" for clarity.
489+
490+PH Joint Favorable Subst.
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