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Substitute Senate Bill No. 971

Public Act No. 03-146

AN ACT IMPLEMENTING THE RECOMMENDATIONS OF THE LEGISLATIVE PROGRAM REVIEW AND INVESTIGATIONS COMMITTEE CONCERNING DEPARTMENT OF MENTAL RETARDATION CLIENT HEALTH AND SAFETY.

Be it enacted by the Senate and House of Representatives in General Assembly convened:

Section 1. Subsection (a) of section 17a-210 of the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2003):

(a) There shall be a Department of Mental Retardation. The Department of Mental Retardation, with the advice of a Council on Mental Retardation, shall be responsible for the planning, development and administration of complete, comprehensive and integrated state-wide services for persons with mental retardation and persons medically diagnosed as having Prader-Willi syndrome. The Department of Mental Retardation shall be under the supervision of a Commissioner of Mental Retardation, who shall be appointed by the Governor in accordance with the provisions of sections 4-5 to 4-8, inclusive. The Council on Mental Retardation may advise the Governor on the appointment. The commissioner shall be a person who has background, training, education or experience in administering programs for the care, training, education, treatment and custody of persons with mental retardation. The commissioner shall be responsible, with the advice of the council, for: (1) Planning and developing complete, comprehensive and integrated state-wide services for persons with mental retardation; (2) the implementation and where appropriate the funding of such services; and (3) the coordination of the efforts of the Department of Mental Retardation with those of other state departments and agencies, municipal governments and private agencies concerned with and providing services for persons with mental retardation. The commissioner shall be responsible for the administration and operation of the state training school, state mental retardation regions and all state-operated community-based residential facilities established for the diagnosis, care and training of persons with mental retardation. The commissioner shall be responsible for establishing standards, providing technical assistance and exercising the requisite supervision of all state-supported residential, day and program support services for persons with mental retardation and work activity programs operated pursuant to section 17a-226. The commissioner shall conduct or monitor investigations into allegations of abuse and neglect and file reports as requested by state agencies having statutory responsibility for the conduct and oversight of such investigations. In the event of the death of a person with mental retardation for whom the department has direct or oversight responsibility for medical care, the commissioner shall ensure that a comprehensive and timely review of the events, overall care, quality of life issues and medical care preceding such death is conducted by the department and shall, as requested, provide information and assistance to the Independent Mortality Review Board established by Executive Order No. 25 of Governor John G. Rowland. The commissioner shall report to the board and the board shall review any death: (A) Involving an allegation of abuse or neglect; (B) for which the Office of Chief Medical Examiner or local medical examiner has accepted jurisdiction; (C) in which an autopsy was performed; (D) which was sudden and unexpected; or (E) in which the commissioner's review raises questions about the appropriateness of care. The commissioner shall stimulate research by public and private agencies, institutions of higher learning and hospitals, in the interest of the elimination and amelioration of retardation and care and training of persons with mental retardation.

Sec. 2. Section 17a-227 of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2004):

(a) No person, firm or corporation shall conduct or maintain within this state a residential facility which it owns, leases or rents for the lodging, care or treatment of persons with mental retardation or autistic persons unless such person, firm or corporation, upon written application, verified by oath, has obtained a license issued by the Department of Mental Retardation.

(b) The commissioner shall adopt regulations, in accordance with the provisions of chapter 54, to insure the comfort, safety, adequate medical care and treatment of such persons at such residential facilities. Such regulations shall include requirements that: (1) All residential facility staff be certified in cardiopulmonary resuscitation in a manner and timeframe prescribed by the commissioner; (2) records of staffing schedules and actual staff hours worked, by residential facility, be available for inspection by the department upon advance notice; (3) each residential facility develop and implement emergency plans and staff training to address emergencies that may pose a threat to the health and safety of the residents of the facility; (4) department inspectors verify during licensing inspections, that (A) staff is adequately trained to respond in an emergency, and (B) a summary of information on each resident is available to emergency medical personnel for use in an emergency; and (5) at least half of the inspections conducted by the department after initial licensure are unannounced.

(c) After receiving an application and making such investigation as is deemed necessary and after finding the specified requirements to have been fulfilled, the department shall grant a license to such applicant to conduct a facility of the character described in such application, which license shall specify the name of the person to have charge and the location of such facility. Any person, firm or corporation aggrieved by any requirement of the regulations or by the refusal to grant any license may within twenty days of any order directing the enforcement of any provision of such regulations or the refusal of such license, appeal therefrom in accordance with the provisions of section 4-183, except venue for such appeal shall be in the judicial district in which such facility is located. If the licensee of any such facility desires to place in charge thereof a person other than the one specified in the license, application shall be made to the Department of Mental Retardation, in the same manner as provided for the original application, for permission to make such change. Such application shall be acted upon within ten days from the date of the filing of same. Each such license shall be renewed annually upon such terms as may be established by regulations and may be revoked by the department upon proof that the facility for which such license was issued is being improperly conducted, or for the violation of any of the provisions of this section or of the regulations adopted pursuant to this subsection, provided the licensee shall first be given a reasonable opportunity to be heard in reference to such proposed revocation. Any person, firm or corporation aggrieved by such revocation may appeal in the same manner as hereinbefore provided. Each person, firm or corporation, upon filing an application under the provisions of this section for a license for a facility providing residential services for five or more persons, shall pay to the State Treasurer the sum of fifty dollars.

[(c)] (d) Notwithstanding any regulation to the contrary, subject to the provisions of this section, the Department of Mental Retardation may contract, within available appropriations, with any organization for the operation of a community-based residential facility, provided such facility is licensed by the [Department of Mental Retardation] department. The department shall include in all contracts with such organizations, provisions requiring the department to (1) conduct periodic reviews of contract performance, and (2) take progressive enforcement actions if the department finds poor performance or noncompliance with the contract, as follows: (A) The organization may be placed on a strict schedule of monitoring and oversight by the department; (B) the organization may be placed on a partial-year contract; and (C) payments due under the contract may be reduced by specific amounts on a monthly basis until the organization complies with the contract. If compliance cannot be achieved, the department shall terminate the contract.

[(d)] (e) The department may contract with any person, firm or corporation to provide residential support services for persons with mental retardation who reside in settings which are not licensed by the department. The commissioner shall adopt regulations, in accordance with the provisions of chapter 54, to ensure the safety, adequate supervision and support of persons receiving residential support services.

[(e)] (f) Any person, firm or corporation who conducts any facility contrary to the provisions of this section shall be fined not more than one thousand dollars or imprisoned not more than six months or both. Any person, firm or corporation who conducts any facility contrary to the regulations adopted pursuant to subsection (b) of this section shall be fined not more than one thousand dollars.

Sec. 3. Subsection (a) of section 46a-11c of the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2003):

(a) The director, upon receiving a report that a person with mental retardation allegedly is being or has been abused or neglected, shall make an initial determination whether such person has mental retardation, shall determine if the report warrants investigation and shall cause, in cases that so warrant, a prompt, thorough evaluation to be made to determine whether the person has mental retardation and has been abused or neglected. In cases where there is a death of a person with mental retardation for whom the Department of Mental Retardation has direct or oversight responsibility for medical care, and there are allegations that such death may be due to abuse or neglect, the director shall conduct an investigation to determine whether abuse or neglect occurred, except as may be otherwise required by court order. The director, in consultation with the Commissioner of Mental Retardation, shall establish protocols for conducting such investigations. For the purposes of sections 46a-11a to 46a-11g, inclusive, the determination of mental retardation may be made by means of a review of records and shall not require the director to conduct a full psychological examination of the person. Any delay in making such determination of mental retardation shall not delay the investigation of abuse or neglect or recommendation of provision of protective services. The evaluation shall include a visit to the named person with mental retardation and consultation with those individuals having knowledge of the facts of the particular case. All state, local and private agencies shall have a duty to cooperate with any investigation conducted by the Office of Protection and Advocacy for Persons with Disabilities under this section, including the release of complete client records for review, inspection and copying, except where the person with mental retardation refuses to permit his or her record to be released. The director shall have subpoena powers to compel any information related to [his] such investigation. All client records shall be kept confidential by said office. Upon completion of the evaluation of each case, written findings shall be prepared which shall include a determination of whether abuse or neglect has occurred and recommendations as to whether protective services are needed. The director, except in cases where the parent or guardian is the alleged perpetrator of abuse or is residing with the alleged perpetrator, shall notify the parents or guardian, if any, of the person with mental retardation if a report of abuse or neglect is made which the director determines warrants investigation. The director shall provide the parents or guardians who [he] the director determines are entitled to such information with further information upon request. The person filing the report of abuse or neglect shall be notified of the findings upon request.

Sec. 4. (Effective October 1, 2003) The Department of Mental Retardation shall transfer to the Office of Protection and Advocacy one investigator position to enable the office to investigate deaths of persons with mental retardation for whom the Department of Mental Retardation has direct or oversight responsibility for medical care where allegations of abuse or neglect are present, as provided in section 46a-11c of the general statutes, as amended by this act.

Approved June 26, 2003