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General Assembly Bill No. 477
February Session, 2022
LCO No. 3789
Referred to Committee on PUBLIC HEALTH
Introduced by:
(PH)
AN ACT CONCERNING THE PUBLIC HEALTH OF RESIDENTS OF
THE STATE.
Be it enacted by the Senate and House of Representatives in General
Assembly convened:
Section 1. Section 19a-562 of the 2022 supplement to the general 1
statutes is repealed and the following is substituted in lieu thereof 2
(Effective October 1, 2022): 3
(a) As used in this section and section 19a-562a, "dementia special 4
care unit or program" means any nursing facility, residential care home, 5
assisted living facility, adult congregate living facility, adult day care 6
center, hospice or adult foster home that locks, secures, segregates or 7
provides a special program or unit for residents with a diagnosis of 8
probable Alzheimer's disease, dementia or other similar disorder, in 9
order to prevent or limit access by a resident outside the designated or 10
separated area, or that advertises or markets the facility as providing 11
specialized care or services for persons suffering from Alzheimer's 12
disease or dementia. 13
(b) [On and after January 1, 2007, each] Each dementia special care 14
unit or program shall provide written disclosure to any person who will 15 Raised Bill No. 477
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be placed in such a unit or program or to that person's legal 16
representative or other responsible party. Such disclosure shall be 17
signed by the patient or responsible party and shall explain what 18
additional care and treatment or specialized program will be provided 19
in the dementia special care unit or program that is distinct from the 20
care and treatment required by applicable licensing rules and 21
regulations, including, but not limited to: 22
(1) Philosophy. A written statement of the overall philosophy and 23
mission of the dementia special care unit or program that reflects the 24
needs of residents with Alzheimer's disease, dementia or other similar 25
disorders. 26
(2) Preadmission, admission and discharge. The process and criteria 27
for placement within or transfer or discharge from the dementia special 28
care unit or program. 29
(3) Assessment, care planning and implementation. The process used 30
for assessing and establishing and implementing the plan of care, 31
including the method by which the plan of care is modified in response 32
to changes in condition. 33
(4) Staffing patterns and training ratios. The nature and extent of staff 34
coverage, including staff to patient ratios and staff training and 35
continuing education. 36
(5) Physical environment. The physical environment and design 37
features appropriate to support the functioning of cognitively impaired 38
adult residents. 39
(6) Residents' activities. The frequency and types of resident activities 40
and the ratio of residents to recreation staff. 41
(7) Family role in care. The involvement of families and family 42
support programs. 43
(8) Program costs. The cost of care and any additional fees. 44 Raised Bill No. 477
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(c) Each dementia special care unit or program shall develop a 45
standard disclosure form for compliance with subsection (b) of this 46
section and shall annually review and verify the accuracy of the 47
information provided by dementia special care units or programs. Each 48
dementia special care unit or program shall provide a written update to 49
the patient, legal representative or responsible party of any significant 50
change to the information reported pursuant to subsection (b) of this 51
section not later than thirty days after such change. Each dementia 52
special care unit or program shall make the standard disclosure form 53
available to the Department of Public Health for inspection upon 54
request. 55
Sec. 2. Section 19a-564 of the 2022 supplement to the general statutes 56
is repealed and the following is substituted in lieu thereof (Effective 57
October 1, 2022): 58
(a) The Commissioner of Public Health shall license assisted living 59
services agencies, as defined in section 19a-490. A managed residential 60
community wishing to provide assisted living services shall become 61
licensed as an assisted living services agency or shall arrange for 62
assisted living services to be provided by another entity that is licensed 63
as an assisted living services agency. 64
(b) A managed residential care community that intends to arrange for 65
assisted living services shall only do so with a currently licensed assisted 66
living services agency. Such managed residential community shall 67
submit an application to arrange for the assisted living services to the 68
Department of Public Health in a form and manner prescribed by the 69
commissioner. 70
(c) An assisted living services agency providing services as a 71
dementia special care unit or program, as defined in section 19a-562, as 72
amended by this act, shall obtain approval for such unit or program 73
from the Department of Public Health. Such assisted living services 74
agencies shall ensure that they have adequate staff to meet the needs of 75
the residents. The Department of Public Health shall require each 76 Raised Bill No. 477
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assisted living facility that provides services as a dementia special care 77
unit or program to employ a minimum number of staff per shift that 78
provide direct patient care to residents of or participants in the dementia 79
special care unit or program, including, but not limited to, advanced 80
practice registered nurses, registered nurses, licensed practical nurses 81
and nurse's aides. Such minimum staffing requirements shall be 82
prescribed by the department in regulations adopted pursuant to this 83
section, and take effect upon adoption of such regulations. Each assisted 84
living services agency that provides services as a dementia special care 85
unit or program, as defined in section 19a-562, as amended by this act, 86
shall submit to the Department of Public Health a list of dementia 87
special care units or locations and their staffing plans for any such units 88
and locations when completing an initial or a renewal licensure 89
application, or upon request from the department. Such staffing plans 90
shall comply with the minimum staffing requirements in regulations 91
prescribed by the department pursuant to this section. 92
(d) Each assisted living services agency that provides services as a 93
dementia special care unit or program shall post the following 94
information on a daily basis at the beginning of each shift, in a legible 95
format and in a conspicuous place readily accessible to and clearly 96
visible to residents, employees and visitors of the dementia special care 97
unit or location of the dementia special care program, including, but not 98
limited to, persons in a wheelchair: 99
(1) Name of the assisted living services agency and location of the 100
dementia special care unit or program; 101
(2) Date; 102
(3) Total number of (A) advanced practice registered nurses, (B) 103
registered nurses, (C) licensed practical nurses, and (D) nurse's aides 104
who will be responsible for direct patient care during the shift; 105
(4) Total number of hours such (A) advanced practice registered 106
nurses, (B) registered nurses, (C) licensed practical nurses, and (D) 107
nurse's aides are scheduled to work during the shift; 108 Raised Bill No. 477
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(5) Total number of dementia special care unit residents or dementia 109
special care program participants; 110
(6) The minimum number of nursing home facility staff per shift that 111
is required by the regulations of Connecticut state agencies to be 112
responsible for providing direct patient care to residents of the dementia 113
special care unit or participants in the dementia special care program; 114
and 115
(7) The telephone number or Internet web site that a resident, 116
employee or visitor of the dementia special care unit or location of the 117
dementia special care program may use to report a suspected violation 118
by the assisted living services agency of a regulatory requirement 119
concerning staffing levels and direct patient or program participant 120
care. 121
(e) Each assisted living services agency providing services as a 122
dementia special care unit or program shall, upon oral or written 123
request, make the daily information posted pursuant to subsection (d) 124
of this section available to the public for review. The assisted living 125
services agency shall retain such information for not less than eighteen 126
months from the date such information was posted. 127
[(d)] (f) An assisted living services agency shall ensure that (1) all 128
services being provided on an individual basis to [clients] residents are 129
fully understood and agreed upon between either the [client] resident 130
or the [client's] resident's legal representative or responsible party, and 131
(2) the [client or the client's] resident or the resident's legal 132
representative or responsible party are made aware of the cost of any 133
such services. 134
(g) Each assisted living services agency providing services as a 135
dementia special care unit or program shall maintain a daily record of 136
the following regarding each resident of the unit or participant in the 137
program and make such record available to the Department of Public 138
Health upon request: 139 Raised Bill No. 477
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(1) Type and number of meals served and the times each meal was 140
offered to the resident. The assisted living services agency shall ensure 141
that the maximum time span between a resident's or participant's 142
evening meal and breakfast does not exceed sixteen hours unless a 143
substantial bedtime nourishment is verbally offered by the assisted 144
living services agency, provided the assisted living services agency shall 145
not be required to serve such nourishment to patients or participants 146
who decline such nourishment; 147
(2) The time a resident or participant bathed or was offered a bath or 148
was bathed by a staff member of the assisted living services agency; 149
(3) The medications taken by the patient or participant and times such 150
medications were taken; and 151
(4) A description of the overall health of the patient or participant. 152
[(e)] (h) The Department of Public Health [may] shall adopt 153
regulations, in accordance with the provisions of chapter 54, to carry out 154
the purposes of this section. 155
Sec. 3. Section 19a-563f of the 2022 supplement to the general statutes 156
is repealed and the following is substituted in lieu thereof (Effective July 157
1, 2022): 158
On or before January 1, 2022, the administrative head of each nursing 159
home and dementia special care unit and, on or before January 1, 2023, 160
the administrative head of each assisted living facility shall encourage 161
the establishment of a family council and assist in any such 162
establishment. The family council shall facilitate and support open 163
communication between the nursing home, [or] dementia special care 164
unit or assisted living facility and each resident's family members and 165
friends. As used in this section, "family council" means an independent, 166
self-determining group of the family members and friends of the 167
residents of a nursing home, [or] dementia special care unit or assisted 168
living facility that is geared to meeting the needs and interests of the 169
residents and their family members and friends. 170 Raised Bill No. 477
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Sec. 4. Section 19a-59i of the 2022 supplement to the general statutes 171
is amended by adding subsection (g) as follows (Effective from passage): 172
(NEW) (g) Not later than January 1, 2023, the maternal mortality 173
review committee shall develop educational materials regarding: 174
(1) The health and safety of pregnant and postpartum persons with 175
mental health disorders, including, but not limited to, perinatal mood 176
and anxiety disorders, for distribution by the Department of Public 177
Health to each birthing hospital in the state. As used in this subsection, 178
"birthing hospital" means a health care facility, as defined in section 19a-179
630, operated and maintained in whole or in part for the purpose of 180
caring for patients during delivery of a child and for a postpartum 181
person and such person's newborn following birth; 182
(2) Evidence-based screening tools for screening patients for intimate 183
partner violence, peripartum mood disorders and substance use 184
disorder for distribution by the Department of Public Health to 185
obstetricians and other health care providers who practice obstetrics; 186
and 187
(3) Indicators of intimate partner violence for distribution by the 188
Department of Public Health to (A) hospitals for use by health care 189
providers in the emergency department and hospital social workers, 190
and (B) obstetricians and other health care providers who practice 191
obstetrics. 192
Sec. 5. (NEW) (Effective July 1, 2022) (a) As used in this section, 193
"birthing hospital" means a health care facility, as defined in section 19a-194
630, operated and maintained in whole or in part for the purpose of 195
caring for a person during delivery of a child and for a postpartum 196
person and such person's newborn following birth. 197
(b) On and after October 1, 2022, each birthing hospital shall provide 198
to each patient who has undergone a caesarean section written 199
information regarding the importance of mobility following a caesarean 200
section and the risks associated with immobility following a caesarean 201 Raised Bill No. 477
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section. 202
(c) Not later than January 1, 2023, each birthing hospital shall 203
establish a patient portal through which a postpartum patient can 204
virtually access, through an Internet web site or application, any 205
educational materials and other information that the birthing hospital 206
provided to the patient during the patient's stay at the birthing hospital 207
and at the time of the patient's discharge from the birthing hospital. 208
(d) On and after January 1, 2023, each birthing hospital shall provide 209
to each postpartum patient the educational materials regarding the 210
health and safety of pregnant and postpartum persons with mental 211
health disorders, including, but not limited to, perinatal mood and 212
anxiety disorders, developed by the maternal mortality review 213
committee pursuant to subsection (g) of section 19a-51i, as amended by 214
this act. 215
Sec. 6. Subsection (a) of section 10-29a of the 2022 supplement to the 216
general statutes is amended by adding subdivisions (104) and (105) as 217
follows (Effective from passage): 218
(NEW) (104) Maternal Mental Health Month. The Governor shall 219
proclaim the month of May of each year to be Maternal Mental Health 220
Month, to raise awareness of issues surrounding maternal mental 221
health. Suitable exercises may be held in the State Capitol and elsewhere 222
as the Governor designates for the observance of the month. 223
(NEW) (105) Maternal Mental Health Day. The Governor shall 224
proclaim May fifth of each year to be Maternal Mental Health Day, to 225
raise awareness of issues surrounding maternal mental health. Suitable 226
exercises may be held in the State Capitol and elsewhere as the 227
Governor designates for the observance of the day. 228
Sec. 7. (NEW) (Effective from passage) (a) There is established a 229
Commission on Gun Violence Intervention and Prevention to 230
coordinate the funding and implementation of evidence-based, 231
evidenced-informed, community-centric gun programs and strategies 232 Raised Bill No. 477
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to reduce community gun violence in the state. The commission shall be 233
part of the Legislative Department. 234
(b) The commission shall be composed of the following members: 235
(1) Two appointed by the speaker of the House of Representatives, 236
one of whom shall be a representative of the Connecticut Hospital 237
Association and one of whom shall be a representative of Compass 238
Youth Collaborative; 239
(2) Two appointed by the president pro tempore of the Senate, one of 240
whom shall be a representative of the Connecticut Violence Intervention 241
Program and one of whom shall be a representative of Regional Youth 242
Adult Social Action Partnership; 243
(3) Two appointed by the majority leader of the House of 244
Representatives, one of whom shall be a representative of Hartford 245
Communities That Care, Inc. and one of whom shall be a representative 246
of CT Against Gun Violence; 247
(4) Two appointed by the majority leader of the Senate, one of whom 248
shall be a representative of Project Longevity and one of whom shall be 249
a representative of Saint Francis Hospital and Medical Center; 250
(5) Two appointed by the minority leader of the House of 251
Representatives, one of whom shall be a representative of Yale New 252
Haven Hospital and one of whom shall be a representative of Greater 253
Bridgeport Adolescence Program; 254
(6) Two appointed by the minority leader of the Senate, one of whom 255
shall be a representative of Hartford Hospital and one of whom shall be 256
a youth representative of the Connecticut Justice Alliance; 257
(7) Two appointed by the House chairperson of the joint standing 258
committee of the General Assembly having cognizance of matters 259
relating to public health, one of whom shall be a representative of the 260
Greater Bridgeport Area Prevention Program and one of whom shall be 261
a parent member of the Two Generation Initiative; 262 Raised Bill No. 477
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(8) Two appointed by the Senate chairperson of the joint standing 263
committee of the General Assembly having cognizance of matters 264
relating to public health, one of whom shall be a representative of 265
Mothers United Against Violence and one of whom shall be a 266
representative of Violent Crime Survivors; 267
(9) One appointed by the executive director of the Commission on 268
Women, Children, Seniors, Equity and Opportunity, who shall be a 269
representative of the Health Alliance for Violence Intervention; 270
(10) Two appointed by the Commissioner of Public Health, who shall 271
be representatives of the Department of Public Health's Injury and 272
Violence Surveillance Unit; 273
(11) The Commissioner of Education, or the commissioner's designee; 274
and 275
(12) The executive director of the Commission on Women, Children, 276
Seniors, Equity and Opportunity, or the executive director's designee. 277
(c) Any member of the commission appointed under subdivision (1), 278
(2), (3), (4), (5), (6), (7) or (8) of subsection (b) of this section may be a 279
member of the General Assembly. All initial appointments to the 280
commission shall be made not later than sixty days after the effective 281
date of this section. Appointed members shall serve a term that is 282
coterminous with the appointing official and may serve more than one 283
term. 284
(d) The executive director of the Commission on Women, Children, 285
Seniors, Equity and Opportunity shall schedule the first meeting of the 286
commission, which shall be held not later than sixty days after the 287
effective date of this section. At such meeting, the chairperson of the 288
commission shall be elected from among the members of the 289
commission. 290
(e) If an appointment under subsection (b) of this section is not made 291
within the sixty-day period required under subsection (c) of this section, 292 Raised Bill No. 477
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the chairperson may designate an individual with the required 293
qualifications stated for the applicable appointment to serve on the 294
commission until an appointment is made pursuant to subsection (b) of 295
this section. 296
(f) A majority of the membership of the commission shall constitute 297
a quorum for the transaction of any business and any decision shall be 298
by a majority vote of those present at a meeting, except the commission 299
may establish such subcommissions, advisory groups or other entities 300
as it deems necessary to further the purposes of the commission. The 301
commission shall adopt rules of procedure. 302
(g) The members of the commission shall serve without 303
compensation, but shall, within the limits of available funds, be 304
reimbursed for expenses necessarily incurred in the performance of 305
their duties. 306
(h) The commission, by majority vote, shall hire an executive director, 307
who shall serve at the pleasure of the commission to carry out the duties 308
and serve as administrative staff of the commission. The commission 309
may request the assistance of the Joint Commission on Legislative 310
Management in hiring the executive director. The executive director 311
may hire not more than two executive assistants to assist in carrying out 312
the duties and serving as administrative staff of the commission. The 313
administrative staff of the Commission on Women, Children, Seniors, 314
Equity and Opportunity shall serve as administrative staff of the 315
commission until such time as such executive director is hired. 316
(i) The commission shall have the following powers and duties: (1) 317
Coordinate the funding and implementation of evidence-based, 318
evidenced-informed, community-centric programs and strategies to 319
reduce community gun violence in the state; (2) secure state, federal and 320
other funds for the purposes of reducing community gun violence; (3) 321
determine community-level needs by engaging with communities 322
impacted by gun violence; (4) (A) establish and implement a grant 323
program, and (B) award grants and offer guidance to organizations or 324 Raised Bill No. 477
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other entities working toward reducing community gun violence in the 325
state; (5) obtain from any legislative or executive department, board, 326
commission or other agency of the state or any organization or other 327
entity such assistance as necessary and available to carry out the 328
purposes of this section; (6) accept any gift, donation or bequest for the 329
purpose of performing the duties described in this subsection; (7) 330
establish bylaws to govern its procedures; and (8) perform such other 331
acts as may be necessary and appropriate to carry out the duties 332
described in this subsection. 333
(j) Not later than January 1, 2023, and annually thereafter, the 334
commission shall submit a report to the joint standing committee of the 335
General Assembly having cognizance of matters relating to public 336
health, in accordance with the provisions of section 11-4a of the general 337
statutes, concerning the activities of the commission during the prior 338
twelve-month period. 339
Sec. 8. (Effective July 1, 2022) The sum of two hundred fifty thousand 340
dollars is appropriated to the Department of Public Health Fund, for the 341
fiscal year ending June 30, 2023, for promotion of the National Centers 342
for Disease Control and Prevention's "Hear Her" campaign to prevent 343
pregnancy-related deaths to obstetricians, other health care providers 344
who practice obstetrics, birthing hospitals and emergency departments. 345
This act shall take effect as follows and shall amend the following
sections:
Section 1 October 1, 2022 19a-562
Sec. 2 October 1, 2022 19a-564
Sec. 3 July 1, 2022 19a-563f
Sec. 4 from passage 19a-59i
Sec. 5 July 1, 2022 New section
Sec. 6 from passage 10-29a(a)
Sec. 7 from passage New section
Sec. 8 July 1, 2022 New section
Statement of Purpose:
To address the public health needs of residents of the state. Raised Bill No. 477
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[Proposed deletions are enclosed in brackets. Proposed additions are indicated by underline, except
that when the entire text of a bill or resolution or a section of a bill or resolution is new, it is not
underlined.]