Substitute Senate Bill No. 448
Public Act No. 22-133
AN ACT REQUIRING THE DEVELOPMENT OF A PLAN
CONCERNING THE DELIVERY OF HEALTH CARE AND MENTAL
HEALTH CARE SERVICES TO INMATES OF CORRECTIONAL
INSTITUTIONS.
Be it enacted by the Senate and House of Representatives in General
Assembly convened:
Section 1. (NEW) (Effective from passage) (a) As used in this section:
(1) "Advanced practice registered nurse" means an advanced practice
registered nurse licensed under chapter 373 of the general statutes;
(2) "Alcohol and drug counselor" means an alcohol and drug
counselor licensed or certified under chapter 376b of the general
statutes;
(3) "Commissioner" means the Commissioner of Correction;
(4) "Correctional institution" means a prison or jail under the
jurisdiction of the commissioner;
(5) "Dental professional" means a (A) dentist, (B) dental hygienist
licensed under chapter 379a of the general statutes, or (C) dental
assistant, as defined in section 20-112a of the general statutes;
(6) "Dentist" means a dentist licensed under chapter 379 of the general Substitute Senate Bill No. 448
Public Act No. 22-133 2 of 8
statutes;
(7) "Department" means the Department of Correction;
(8) "Discharge planner" means a (A) registered nurse licensed under
chapter 378 of the general statutes, (B) practical nurse licensed under
chapter 378 of the general statutes, (C) clinical social worker or master
social worker licensed under chapter 383b of the general statutes, or (D)
professional counselor licensed under chapter 383c of the general
statutes;
(9) "HIV test" means a test to determine human immunodeficiency
virus infection or antibodies to human immunodeficiency virus;
(10) "Inmate" means a person in the custody of the commissioner and
confined in a correctional institution;
(11) "Medical professional" means (A) a physician, (B) an advanced
practice registered nurse, (C) a physician assistant, (D) a registered
nurse licensed under chapter 378 of the general statutes, or (E) a
practical nurse licensed under chapter 378 of the general statutes;
(12) "Mental health care provider" means (A) a physician who
specializes in psychiatry, or (B) an advanced practice registered nurse
who specializes in mental health;
(13) "Mental health therapist" means (A) a physician who specializes
in psychiatry, (B) a psychologist licensed under chapter 383 of the
general statutes, (C) an advanced practice registered nurse who
specializes in mental health, (D) a clinical social worker or master social
worker licensed under chapter 383b of the general statutes, or (E) a
professional counselor licensed under chapter 383c of the general
statutes;
(14) "Physician" means a physician licensed under chapter 370 of the Substitute Senate Bill No. 448
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general statutes;
(15) "Physician assistant" means a physician assistant licensed under
chapter 370 of the general statutes; and
(16) "Psychotropic medication" means a medication that is used to
treat a mental health disorder that affects behavior, mood, thoughts or
perception.
(b) Not later than January 1, 2023, the commissioner shall develop a
plan for the provision of health care services, including, but not limited
to, mental health care, substance use disorder and dental care services,
to inmates of correctional facilities under the jurisdiction of the
department. Such plan shall include, but not be limited to, guidelines
for implementation of the following requirements:
(1) (A) A sufficient number of mental health therapists, as determined
by the commissioner, shall be placed at each correctional institution to
provide mental health care services to inmates;
(B) A mental health therapist placed at a correctional institution shall
provide mental health care services to any inmate who requests such
services or has been referred for such services by correctional staff only
after the therapist makes an assessment of the inmate's need for such
services and determines that the inmate requires such services;
(C) Each mental health therapist shall deliver such services in concert
with the security needs of all inmates and correctional staff and the
overall operation of the correctional institution, as determined by the
warden of the correctional institution; and
(D) No mental health therapist who is providing mental health care
services pursuant to this subdivision and licensed to prescribe
medication shall prescribe a psychotropic medication to an inmate
unless (i) the mental health therapist has reviewed the mental health Substitute Senate Bill No. 448
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history and medical history of the inmate, including, but not limited to,
the list of all medications the inmate is taking, (ii) the mental health
therapist determines, based on a review of such history, that the benefits
of prescribing such medication outweigh the risk of prescribing such
medication, (iii) the mental health therapist diagnoses the inmate with
a mental health disorder, the inmate has received a previous diagnosis
of a mental health disorder by a licensed mental health care provider
and such medication is used to treat such mental health disorder, or, in
an emergency situation, the mental health therapist makes an
assessment that the inmate's mental health is substantially impaired and
requires psychotropic medication to treat, (iv) the mental health
therapist approves the use of such medication by the inmate as part of
the inmate's mental health treatment plan, and (v) the mental health
therapist keeps a record of each psychotropic medication such provider
prescribes to the inmate and all other medications the inmate is taking.
(2) Each inmate shall receive an annual physical examination by a
physician, physician assistant or advanced practice registered nurse
when such examination is clinically indicated. Such examination may
include, but not be limited to, a breast and gynecological examination
or prostate examination, where appropriate, and the administration of
any test the physician, physician assistant or advanced practice
registered nurse deems appropriate.
(3) Each inmate shall receive an initial health assessment from a
medical professional not later than fourteen days after the inmate's
initial intake into a correctional institution.
(4) If a physician, physician assistant or advanced practice registered
nurse recommends, based on the initial health assessment of an inmate
or person, that such inmate or person be placed in a medical or mental
health housing unit, the department shall ensure that such inmate or
person is placed in an appropriate medical or mental health housing
unit unless there are significant safety or security reasons for not making Substitute Senate Bill No. 448
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such placement.
(5) A medical professional shall perform health assessments of
inmates in a location at the correctional institution that the warden of
the correctional institution designates as appropriate for performing
such an examination, provided the analysis of any sample collected
from the inmate during a health assessment may be performed at a
laboratory that is located outside of the correctional institution.
(6) A discharge planner shall conduct an exit interview of each inmate
who is being scheduled for discharge from a correctional institution
prior to the date of discharge if such exit interview is clinically indicated,
provided the lack of such exit interview shall not delay the scheduled
discharge of an inmate. Such exit interview shall include a discussion
with the inmate regarding a medical discharge plan for any continued
medical care or treatment that is recommended by the physician,
physician assistant or advanced practice registered nurse for the inmate
when the inmate reenters the community.
(7) A physician shall be on call on weekends, holidays and outside
regular work hours to provide medical care to inmates as necessary.
(8) The commissioner shall ensure that each inmate has access to all
vaccines licensed or authorized under an emergency use authorization
by the federal Food and Drug Administration that are recommended by
the National Centers for Disease Control and Prevention Advisory
Committee on Immunization Practices, subject to availability of such
vaccines, unless there are substantial security concerns with providing
access to such vaccines. Subject to availability, a physician, physician
assistant or advanced practice registered nurse shall prescribe to an
inmate any such vaccine that (A) the inmate requests, and (B) is
recommended for such inmate by said committee, as determined by the
physician, physician assistant or advanced practice registered nurse,
provided the prescribing of such vaccine does not impose significant Substitute Senate Bill No. 448
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safety concerns.
(9) Except in exigent circumstances, a dental professional shall
perform a dental screening of each inmate not later than one year after
the inmate initially enters a correctional institution and at least once
annually thereafter. At the time the dental professional performs the
dental screening of an inmate, the dental professional shall develop a
dental care plan for the inmate. A dental professional shall provide
dental care in accordance with the inmate's dental care plan throughout
the inmate's time at the correctional institution. The commissioner shall
ensure, in consultation with a dentist, that each correctional institution
has a dental examination room that is fully equipped with all of the
dental equipment necessary to perform a dental examination.
(10) A medical professional shall administer an HIV test to each
inmate who requests an HIV test, subject to the availability of such test.
Except in exigent circumstances and subject to availability, a medical
professional shall offer an HIV test to each inmate where it is clinically
indicated (A) at the time such inmate enters a correctional institution, or
(B) during an annual physical assessment.
(11) A medical professional shall interview each inmate regarding the
inmate's drug and alcohol use history at the time the inmate initially
enters a correctional institution. If an inmate is exhibiting symptoms of
withdrawal from a drug or alcohol at such time, a medical professional
shall perform a physical assessment of the inmate and communicate the
results of such assessment to a physician, physician assistant or
advanced practice registered nurse. Except in exigent circumstances, a
drug and alcohol counselor shall perform an evaluation of the inmate
not later than five days after the inmate initially enters the correctional
institution. The correctional institution shall immediately transfer each
inmate who is determined by a physician, physician assistant or
advanced practice registered nurse to be experiencing withdrawal from
a drug or alcohol to an appropriate area at such correctional institution Substitute Senate Bill No. 448
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for medical treatment of such withdrawal. A physician, a physician
assistant or an advanced practice registered nurse shall periodically
evaluate each inmate who exhibits signs of or discloses an addiction to
a drug or alcohol or who experiences withdrawal from a drug or
alcohol, at a frequency deemed appropriate by the physician, physician
assistant or advanced practice registered nurse.
(12) A physician, a physician assistant or an advanced practice
registered nurse with experience in substance use disorder diagnosis
and treatment shall oversee the medical treatment of an inmate
experiencing withdrawal from a drug or alcohol at each correctional
institution. A medical professional shall be present in the medical unit
at each correctional facility at all times during the provision of medical
treatment to such inmate.
(13) A drug and alcohol counselor shall offer appropriate substance
use disorder counseling services, including, but not limited to,
individual counseling sessions and group counseling sessions, to an
inmate who exhibits signs of or discloses an addiction to a drug or
alcohol and encourage such inmate to participate in at least one
counselling session. At the time of an inmate's discharge from the
correctional institution, a discharge planner may refer an inmate who
has exhibited signs of or disclosed an addiction to a drug or alcohol
while an inmate at such correctional institution to a substance use
disorder treatment program in the community that is deemed
appropriate for the inmate by such discharge planner.
(14) The York Correctional Institution shall provide each inmate who
is pregnant and drug or alcohol-dependent, with information regarding
the dangers of undergoing withdrawal from the drug or alcohol without
medical treatment, the importance of receiving medical treatment
during the second trimester of pregnancy for withdrawal from the drug
or alcohol and the effects of neonatal abstinence syndrome on a
newborn. Substitute Senate Bill No. 448
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(15) The York Correctional Institution shall provide each inmate who
is pregnant prenatal visits at a frequency determined by an obstetrician
to be consistent with community standards for prenatal visits.
(16) The department shall issue a request for information to which a
school of medicine may apply for purposes of providing practical
training at correctional institutions as part of a medical residency
program, through which residents participating in such program may
provide health care services to inmates.
(c) Not later than February 1, 2023, the commissioner shall report, in
accordance with the provisions of section 11-4a of the general statutes,
to the joint standing committees of the General Assembly having
cognizance of matters relating to public health and the judiciary
regarding the plan developed pursuant to subsection (b) of this section,
recommendations for any legislation necessary to implement such plan
and the department's timeline for implementation of such plan.