Connecticut Seal

Substitute Senate Bill No. 569

Public Act No. 04-221

AN ACT CONCERNING REVISIONS TO THE PUBLIC HEALTH STATUTES.

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

Section 1. Subsection (b) of section 20-12b of the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2004):

(b) The department may, upon receipt of a fee of seventy-five dollars, issue a temporary permit to an applicant who (1) is a graduate of an accredited physician assistant program; (2) has completed not less than sixty hours of didactic instruction in pharmacology for physician assistant practice approved by the department; and (3) if applying for such permit on and after September 30, 1991, holds a baccalaureate or higher degree in any field from a regionally accredited institution of higher education. Such temporary permit shall authorize the holder to practice as a physician assistant only in those settings where the supervising physician is physically present on the premises and is immediately available to the physician assistant when needed, but shall not authorize the holder to prescribe or dispense drugs. Such temporary permit shall be valid [from the date of issuance of same until the date of issuance of the results of the first certification examination scheduled by the national commission following the applicant's graduation from an accredited physician assistant program] for a period not to exceed one hundred twenty calendar days after the date of graduation and shall not be renewable. Such permit shall become void and shall not be reissued in the event that the applicant fails to pass [such examination] a certification examination scheduled by the national commission following the applicant's graduation from an accredited physician assistant program. Violation of the restrictions on practice set forth in this subsection may constitute a basis for denial of licensure as a physician assistant.

Sec. 2. Subsection (b) of section 20-70 of the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2004):

(b) Any person who is a graduate of an approved United States physical therapy school and who has filed an application with the department may [, between the dates of filing and the publication of the results of the next succeeding examination,] practice as a physical therapist under the direct and immediate supervision of a licensed physical therapist in this state for a period not to exceed one hundred twenty calendar days after the date of application. If the person practicing pursuant to this section fails to pass the licensure examination, all privileges under this section shall automatically cease.

Sec. 3. Subsection (b) of section 20-70 of the general statutes, as amended by section 13 of public act 00-226, is repealed and the following is substituted in lieu thereof (Effective on and after the later of the effective date of this act, or the date notice is published by the Commissioner of Public Health in the Connecticut Law Journal indicating that the licensing of athletic trainers and physical therapist assistants is being implemented by the commissioner):

(b) (1) Any person who is a graduate of an approved United States physical therapy school and who has filed an application with the department may [, between the dates of filing and the publication of the results of the next succeeding examination,] practice as a physical therapist under the direct and immediate supervision of a licensed physical therapist in this state for a period not to exceed one hundred twenty calendar days after the date of application. If the person practicing pursuant to this subdivision fails to pass the licensure examination, all privileges under this subdivision shall automatically cease.

(2) Any person who is a graduate of an approved United States physical therapist assistant school or an approved physical therapy school and who has filed an application with the department may [, between the dates of filing and the publication of the results of the next succeeding examination,] practice as a physical therapist assistant under the direct and immediate supervision of a licensed physical therapist in this state for a period not to exceed one hundred twenty calendar days after the date of application. If the person practicing pursuant to this subdivision fails to pass the licensure examination, all privileges under this subdivision shall automatically cease.

Sec. 4. Section 20-70a of the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2004):

Any applicant for examination for licensure as a physical therapist whose application is based on a diploma issued to [him] the applicant by a foreign physical therapy school shall furnish documentary evidence, satisfactory to the department that the requirements for graduation are similar to or higher than those required of graduates of approved United States schools of therapy. Any applicant under this section whose application has been filed and approved by said department may [, between the dates of filing and the publication of the results of the next succeeding examination,] practice as a physical therapist under the continuous direction and immediate supervision of a physical therapist licensed to practice in this state, in a licensed health care facility, for a period not to exceed one hundred twenty calendar days after the date of application, provided this privilege shall automatically cease on failure of an applicant to pass the examination.

Sec. 5. Section 20-74d of the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2004):

[Permits limited as to eligibility, practice and duration, shall be issued by the commissioner to any eligible applicant] The department may issue a temporary permit to an applicant who is a graduate of an educational program in occupational therapy who meets the educational and field experience requirements of section 20-74b and has not yet taken the licensure examination. [, except that such permit shall only be effective until the results of the examination next following the issuance of such permit are announced. A permittee shall be authorized to practice occupational therapy only under the direct supervision of a licensed occupational therapist and shall practice only in a public, voluntary or proprietary facility] Such temporary permit shall authorize the holder to practice occupational therapy only under the direct supervision of a licensed occupational therapist and in a public, voluntary or proprietary facility. Such temporary permit shall be valid for a period not to exceed one hundred twenty calendar days after the date of application and shall not be renewable. Such permit shall become void and shall not be reissued in the event that the applicant fails to pass such examination. The fee for a limited permit shall be twenty-five dollars.

Sec. 6. Subsection (f) of section 20-74bb of the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2004):

(f) Notwithstanding the provisions of subsection (a) of this section, a graduate of a course of study approved pursuant to subdivision (1) of said subsection may operate a medical x-ray system [pending the results of the first examination for licensure scheduled following his or her] for a period not to exceed one hundred twenty calendar days after the date of graduation, provided such graduate is working in a hospital or similar organization where adequate supervision is provided. If the person practicing pursuant to this subsection fails to pass the licensure examination, all privileges under this subsection shall cease.

Sec. 7. Section 20-94 of the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2004):

(a) (1) Any [licensed nurse registered in another state or territory] registered nurse who is licensed at the time of application in another state of the United States, the District of Columbia or a commonwealth or territory subject to the laws of the United States, which has licensure requirements that are substantially similar to or higher than those of this state shall be eligible for licensure in this state and entitled to a license without examination upon payment of a fee of ninety dollars. No license shall be issued under this section to any applicant against whom professional disciplinary action is pending or who is the subject of an unresolved complaint. The department shall inform the board annually of the number of applications it receives for licenses under this section.

(2) For the period from the effective date of this section to one year after said date, any advanced practice registered nurse licensed pursuant to section 20-94a, as amended by this act, whose license as a registered nurse pursuant to section 20-93 has become void pursuant to section 19a-88, shall be eligible for licensure and entitled to a license without examination upon receipt of a completed application form and payment of a fee of ninety dollars.

(b) The Department of Public Health may issue a temporary permit to an applicant for licensure without examination or to an applicant previously licensed in Connecticut whose license has become void pursuant to section 19a-88, upon receipt of a completed application form, accompanied by the fee for licensure without examination, a copy of a current license from another state [or territory which has licensure requirements that are substantially similar to or higher than those of this state] of the United States, the District of Columbia or a commonwealth or territory subject to the laws of the United States, and a notarized affidavit attesting that said license is valid and belongs to the person requesting notarization. Such temporary permit shall be valid for a period not to exceed one hundred twenty calendar days and shall not be renewable. No temporary permit shall be issued under this section to any applicant against whom professional disciplinary action is pending or who is the subject of an unresolved complaint.

Sec. 8. Subsection (a) of section 20-94a of the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2004):

(a) The Department of Public Health may issue an advanced practice registered nurse license to a person seeking to perform the activities described in subsection (b) of section 20-87a, as amended, upon receipt of a fee of one hundred dollars, to an applicant who: (1) [Is eligible for] Maintains a license as a registered nurse in this state, as provided by section 20-93 or 20-94, as amended by this act; (2) holds and maintains current certification as a nurse practitioner, a clinical nurse specialist or a nurse anesthetist from one of the following national certifying bodies that certify nurses in advanced practice: The American Nurses' Association, the Nurses' Association of the American College of Obstetricians and Gynecologists Certification Corporation, the National Board of Pediatric Nurse Practitioners and Associates or the American Association of Nurse Anesthetists, their successors or other appropriate national certifying bodies approved by the Board of Examiners for Nursing; (3) has completed thirty hours of education in pharmacology for advanced nursing practice; and (4) if first certified by one of the foregoing certifying bodies after December 31, 1994, holds a master's degree in nursing or in a related field recognized for certification as either a nurse practitioner, a clinical nurse specialist, or a nurse anesthetist by one of the foregoing certifying bodies. No license shall be issued under this section to any applicant against whom professional disciplinary action is pending or who is the subject of an unresolved complaint.

Sec. 9. Section 20-97 of the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2004):

(a) Any person [certified] who is licensed at the time of application as a licensed practical nurse, or as a person entitled to perform similar services under a different designation, in another state of the United States, the District of Columbia or a commonwealth or territory subject to the laws of the United States whose requirements for [certification] licensure in such capacity are substantially similar to or higher than those of this state, shall be eligible for licensure in this state and entitled to a license without examination upon payment of a fee of seventy-five dollars. No license shall be issued under this section to any applicant against whom professional disciplinary action is pending or who is the subject of an unresolved complaint. The department shall inform the board annually of the number of applications it receives for licenses under this section.

(b) The Department of Public Health may issue a temporary permit to an applicant for licensure without examination or to an applicant previously licensed in Connecticut whose license has become void pursuant to section 19a-88, upon receipt of a completed application form, accompanied by the appropriate fee for licensure without examination, a copy of a current license from another state [or territory which has licensure requirements that are substantially similar to or higher than those of this state] of the United States, the District of Columbia or a commonwealth or territory subject to the laws of the United States and a notarized affidavit attesting that the license is valid and belongs to the person requesting notarization. Such temporary permit shall be valid for a period not to exceed one hundred twenty calendar days and shall not be renewable. No temporary permit shall be issued under this section to any applicant against whom professional disciplinary action is pending or who is the subject of an unresolved complaint.

Sec. 10. Section 20-101 of the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2004):

No provision of this chapter shall confer any authority to practice medicine or surgery nor shall this chapter prohibit any person from the domestic administration of family remedies or the furnishing of assistance in the case of an emergency; nor shall it be construed as prohibiting persons employed in state hospitals and state sanatoriums and subsidiary workers in general hospitals from assisting in the nursing care of patients if adequate medical and nursing supervision is provided; nor shall it be construed as prohibiting students who are enrolled in schools of nursing approved pursuant to section 20-90, as amended, and students who are enrolled in schools for licensed practical nurses approved pursuant to section 20-90, as amended, from performing such work as is incidental to their respective courses of study; nor shall it prohibit graduates of schools of nursing or schools for licensed practical nurses approved pursuant to section 20-90, as amended, from nursing the sick [pending the results of the first examination for licensure scheduled following their] for a period not to exceed ninety calendar days after the date of graduation, provided such graduate nurses are working in hospitals or organizations where adequate supervision is provided, [; nor shall it prohibit graduates of schools for licensed practical nurses approved pursuant to section 20-90 from caring for the sick pending the results of the first examination for licensure scheduled following their graduation, provided such licensed practical nurses are working in hospitals or nursing homes where adequate supervision is provided; nor shall it prohibit any licensed nurse who is registered in another state or territory and who] and such hospital or other organization has verified that the graduate nurse has successfully completed a nursing program. Upon notification that the graduate nurse has failed the licensure examination, all privileges under this section shall automatically cease. No provision of this chapter shall prohibit any registered nurse who has been issued a temporary permit by the department, pursuant to subsection (b) of section 20-94, as amended by this act, from caring for the sick pending the issuance of a license without examination; nor shall it prohibit any licensed practical nurse who [is licensed in another state or territory and who] has been issued a temporary permit by the department, pursuant to subsection (b) of section 20-97, as amended by this act, from caring for the sick pending the issuance of a license without examination; nor shall it prohibit any qualified registered nurse or any qualified licensed practical nurse of another state from caring for a patient temporarily in this state, provided such nurse has been granted a temporary permit from said department and provided such nurse shall not represent or hold himself or herself out as a nurse licensed to practice in this state; nor shall it prohibit registered nurses or licensed practical nurses from other states from doing such nursing as is incident to their course of study when taking postgraduate courses in this state; nor shall it prohibit nursing or care of the sick, with or without compensation or personal profit, in connection with the practice of the religious tenets of any church by adherents thereof, provided such persons shall not otherwise engage in the practice of nursing within the meaning of this chapter. This chapter shall not prohibit the care of persons in their homes by domestic servants, housekeepers, nursemaids, companions, attendants or household aides of any type, whether employed regularly or because of an emergency of illness, if such persons are not initially employed in a nursing capacity.

Sec. 11. Subsection (a) of section 20-195 of the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2004):

(a) Nothing in this chapter shall be construed to limit the activities and services of a graduate student, intern or resident in psychology, pursuing a course of study in an educational institution registered under the provisions of section 20-189, if such activities constitute a part of a supervised course of study. No license as a psychologist shall be required of a person holding a doctoral degree based on a program of studies whose content was primarily psychological from an educational institution approved under the provisions of section 20-189, provided such activities and services are necessary to satisfy the postdoctoral work experience as required by section 20-188. The provisions of this chapter shall not apply to any person in the salaried employ of any person, firm, corporation, educational institution or governmental agency when acting within the person's own organization. Nothing in this chapter shall be construed to prevent the giving of accurate information concerning education and experience by any person in any application for employment. Nothing in this chapter shall be construed to prevent physicians, optometrists, chiropractors, members of the clergy, attorneys-at-law or social workers from doing work of a psychological nature consistent with accepted standards in their respective professions.

Sec. 12. Section 20-206e of the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2004):

The department may, upon receipt of an application for massage therapist licensure, accompanied by the licensure application fee of three hundred dollars, issue a temporary permit to a person who has met the requirements of subsection (a) of section 20-206b, as amended, except that the applicant has not yet sat for or received the results of the examination required under said subsection (a). Such temporary permit shall authorize the permittee to practice as a massage therapist under the supervision of a person licensed pursuant to section 20-206b, as amended. Such practice shall be limited to those settings where the licensed supervisor is physically present on the premises and is immediately available to render assistance and supervision, as needed, to the permittee. Such temporary permit shall be valid [from the date of issuance until the date of the results of the first licensure examination scheduled following the permittee's] for a period not to exceed one hundred twenty calendar days after the date of completion of the required course of study in massage therapy and shall not be renewable. Such permit shall become void and shall not be reissued in the event that the permittee fails to pass [such] the examination for licensure. No permit shall be issued to any person who has previously failed the examination for licensure prescribed pursuant to section 20-206b, as amended, or who is the subject of an unresolved complaint or pending professional disciplinary action. Violation of the restrictions on practice set forth in this section may constitute a basis for denial of licensure as a massage therapist.

Sec. 13. Subsection (a) of section 20-236 of the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2004):

[(a) The Department of Public Health shall hold at least four examinations each year, at such times as it may determine and in such locations as may be convenient, notice of each examination to be given at least ten days before such examination to individual applicants. Any person desiring to obtain a license shall make application to said department therefor, shall pay to the department an examination fee of fifty dollars and shall present himself at the next regular examination. Thereupon, the Department of Public Health shall examine such person, and, being satisfied that he possesses a diploma, certificate or other evidence satisfactory to said department, showing graduation from the eighth grade of grammar school, or possesses an equivalent education to be determined on examination, is free from any communicable disease, has successfully completed a course of not less than fifteen hundred hours of study, both of theory and practice, at any Connecticut barber school or barber college, or any barber school or barber college whose requirements are equivalent to those of a Connecticut barber school or barber college, and are approved by the board with the consent of the Commissioner of Public Health, or is a currently practicing, competent barber who holds a license to practice the occupation of barber in any other state having equivalent or higher entry standards, has the requisite skill in said trade to perform all the duties thereof, including the preparation of the tools, shaving, haircutting and all services incident thereto, and has sufficient knowledge concerning the common diseases of the face and skin to avoid the aggravation and spreading of such diseases in the practice of said trade, shall thereupon issue to such person a license entitling him to practice the occupation of master barber in this state for one year. Said department may declare forfeited the application fee of any applicant who has failed to appear at three successive examinations. No license shall be issued without examination under this section to any applicant against whom professional disciplinary action is pending or who is the subject of an unresolved complaint. The department shall inform the board annually of the number of applications it receives for licensure without examination under this section. Examinations required for licensure under this chapter shall be prescribed by the department with the advice and assistance of the board. The department shall establish a passing score for examinations required under this chapter with the advice and assistance of the board. Any person who holds a license to practice the occupation of barbering in any other state or territory having licensure standards similar to or higher than those of this state or any person who holds a license to practice the occupation of barbering in any other state or territory for a period of not less than forty years shall be eligible for licensure without examination. ]

(a) (1) Any person desiring to obtain a license as a barber shall apply in writing on forms furnished by the Department of Public Health and shall pay to the department a fee of fifty dollars. The department shall not issue a license until the applicant has made written application to the department, setting forth by affidavit that the applicant has (A) successfully completed the eighth grade or has passed an equivalency examination evidencing such education, prepared by the Commissioner of Education, (B) completed a course of not less than fifteen hundred hours of study in a school approved in accordance with the provisions of this chapter, or, if trained outside of Connecticut, in a barber school or college whose requirements are equivalent to those of a Connecticut barber school or college, and (C) passed a written examination satisfactory to the department. Examinations required for licensure under this chapter shall be prescribed by the department with the advice and assistance of the board. The department shall establish a passing score for examinations required under this chapter with the advice and assistance of the board.

(2) Any person who (A) holds a license at the time of application to practice the occupation of barbering in any other state, the District of Columbia or in a commonwealth or territory of the United States, (B) has completed not less than fifteen hundred hours of formal education and training in barbering, and (C) was issued such license on the basis of successful completion of an examination, shall be eligible for licensing in this state and entitled to a license without examination upon payment of a fee of fifty dollars. Applicants who trained in another state, district, commonwealth or territory which required less than fifteen hundred hours of formal education and training, may substitute no more than five hundred hours of licensed work experience in such other state, district, commonwealth or territory toward meeting the training requirement. If the examination was taken in a language other than English, the applicant shall demonstrate successful completion of an English proficiency examination as prescribed by the department.

(3) Any person who holds a license to practice the occupation of barbering in any other state, the District of Columbia, or in a commonwealth or territory of the United States, and has held such license for a period of not less than forty years, shall be eligible for licensure without examination. No license shall be issued under this section to any applicant against whom professional disciplinary action is pending or who is the subject of an unresolved complaint.

Sec. 14. Section 20-250 of the general statutes is repealed and the following is substituted in lieu thereof (Effective from passage):

As used in this chapter, unless the context otherwise requires:

(1) "Board" means the Connecticut Examining Board for Barbers, Hairdressers and Cosmeticians established under section 20-235a;

(2) "Commissioner" means the Commissioner of Public Health;

(3) "Department" means the Department of Public Health;

(4) "Hairdressing and cosmetology" means the art of dressing, arranging, curling, waving, weaving, cutting, singeing, bleaching and coloring the hair and treating the scalp of any person, and massaging, cleansing, stimulating, manipulating, exercising or beautifying with the use of the hands, appliances, cosmetic preparations, antiseptics, tonics, lotions, creams, powders, oils or clays and doing similar work on the face, neck and arms, and manicuring the fingernails [and, for cosmetic purposes only, trimming, filing and painting the healthy toenails, excluding cutting nail beds, corns and calluses or other medical treatment involving the foot or ankle,] of any person for compensation, provided nothing in this subdivision shall prohibit an unlicensed person from performing facials, eyebrow arching, shampooing, manicuring of the fingernails or, for cosmetic purposes only, trimming, filing and painting the healthy toenails, excluding cutting nail beds, corns and calluses or other medical treatment involving the foot or ankle, or braiding hair;

(5) "Registered hairdresser and cosmetician" means any person who (A) has successfully completed the ninth grade or has passed an equivalency examination, evidencing such education, prepared by the Commissioner of Education and conducted by the Department of Public Health, and (B) holds a license to practice as a registered hairdresser and cosmetician; and

(6) "Student" means any person who is engaged in learning or acquiring a knowledge of hairdressing and cosmetology at a school approved in accordance with the provisions of this chapter who has successfully completed ninth grade or its equivalent. The provisions of this subdivision shall not apply to schools conducted by the State Board of Education.

Sec. 15. Section 20-252 of the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2004):

No person shall engage in the occupation of registered hairdresser and cosmetician without having obtained a license from the department. Persons desiring such licenses shall apply in writing on forms furnished by the department. No license shall be issued, except a renewal of a license, to a registered hairdresser and cosmetician unless the applicant has shown to the satisfaction of the department that the applicant has complied with the laws and the regulations administered or adopted by the department. No applicant shall be licensed as a registered hairdresser and cosmetician, except by renewal of a license, until the applicant has made written application to the department, setting forth by affidavit that the applicant has successfully completed the eighth grade or has passed an equivalency examination, evidencing such education, prepared by the Commissioner of Education and [conducted by the Department of Public Health and] that the applicant has completed a course of not less than fifteen hundred hours of study in a school approved in accordance with the provisions of this chapter, [or] in a school teaching hairdressing and cosmetology under the supervision of the State Board of Education, or, if trained outside of Connecticut, in a school teaching hairdressing and cosmetology whose requirements are equivalent to those of a Connecticut school and until the applicant has passed a written examination satisfactory to the department. Examinations required for licensure under this chapter shall be prescribed by the department with the advice and assistance of the board. [and shall be administered by the department under the supervision of the board] The department shall establish a passing score for examinations with the advice and assistance of the board which shall be the same as the passing score established in section 20-236, as amended by this act.

Sec. 16. Section 20-254 of the general statutes, as amended by section 1 of public act 03-32, is repealed and the following is substituted in lieu thereof (Effective October 1, 2004):

Any person [licensed] who holds a license at the time of application as a registered hairdresser and cosmetician, or as a person entitled to perform similar services under different designations in any other state, in the District of Columbia, or in a commonwealth or territory of the United States, [whose requirements for licensing in such capacities are equivalent to or higher than those of this state, upon furnishing satisfactory evidence to the department that such person was licensed in such other state, district, commonwealth or territory, and is a currently practicing, competent practitioner] and who (1) has completed not less than fifteen hundred hours of formal education and training in hairdressing and cosmetology, and (2) was issued such license on the basis of successful completion of an examination shall be eligible for licensing in this state and entitled to a license without examination upon payment of a fee of fifty dollars. [; provided such state, district, commonwealth or territory shall accord a like privilege to holders of licenses issued by this state. ] Applicants who trained in another state, district, commonwealth or territory which required less than fifteen hundred hours of formal education and training may substitute no more than five hundred hours of licensed work experience in such other state, district, commonwealth or territory toward meeting the training requirement. If the examination was taken in a language other than English, the applicant shall demonstrate successful completion of an English proficiency examination as prescribed by the department. No license shall be issued under this section to any applicant against whom professional disciplinary action is pending or who is the subject of an unresolved complaint. The department shall inform the board annually of the number of applications it receives for licensure without examination under this section.

Sec. 17. Section 19a-420 of the general statutes is repealed and the following is substituted in lieu thereof (Effective from passage):

As used in this chapter:

(1) "Youth camp" means any regularly scheduled program or organized group activity advertised as a camp or operated by a person, partnership, corporation, association, the state or a municipal agency for recreational or educational purposes and accommodating for profit or under philanthropic or charitable auspices five or more children, under eighteen years of age, who are (A) not bona fide personal guests in the private home of an individual, and (B) living apart from their relatives, parents or legal guardian, for a period of three days or more per week or portions of three or more days per week, provided any such relative, parent or guardian who is an employee of such camp shall not be considered to be in the position of loco parentis to such employee's child for the purposes of this chapter, but does not include (i) classroom-based summer instructional programs operated by any person, provided no activities that may pose a health risk or hazard to participating children are conducted at such programs, (ii) schools which operate a summer educational program, or (iii) licensed day care centers;

(2) "Resident camp" means any youth camp which is established, conducted or maintained on any parcel or parcels of land on which there are located dwelling units or buildings intended to accommodate five or more children under sixteen years of age for at least seventy-two consecutive hours and in which the campers attending such camps eat and sleep;

(3) "Day camp" means any youth camp which is established, conducted or maintained on any parcel or parcels of land on which there are located dwelling units or buildings intended to accommodate five or more children under sixteen years of age during daylight hours for at least three days a week with the campers eating and sleeping at home, except for one meal per day, but does not include programs operated by a municipal agency;

(4) "Person" means any individual, partnership, association, organization, limited liability company or corporation;

(5) "Commissioner" means the Commissioner of Public Health; and

(6) "Department" means the Department of Public Health.

Sec. 18. Section 19a-515 of the general statutes, as amended by section 4 of public act 03-118 and section 20 of public act 03-3 of the June 30 special session, is repealed and the following is substituted in lieu thereof (Effective from passage):

(a) Each nursing home administrator's license issued pursuant to the provisions of sections 19a-511 to 19a-520, inclusive, shall be renewed once every two years, in accordance with section 19a-88, as amended, except for cause, by the Department of Public Health, upon forms to be furnished by said department and upon the payment to said department, by each applicant for license renewal, of the sum of one hundred dollars. Each such fee shall be remitted to the Department of Public Health on or before the date prescribed under section 19a-88, as amended. Such renewals shall be granted unless said department finds the applicant has acted or failed to act in such a manner or under such circumstances as would constitute grounds for suspension or revocation of such license.

(b) Each licensee shall complete a minimum of forty hours of continuing education every two years. Such two-year period shall commence on the first date of renewal of the licensee's license after [October 1, 2004] January 1, 2004. The continuing education shall be in areas related to the licensee's practice. Qualifying continuing education activities are courses offered or approved by the Connecticut Association of Healthcare Facilities, the Connecticut Association of Not-For-Profit Providers For the Aging, the Connecticut Chapter of the American College of Health Care Administrators, any accredited college or university, or programs presented or approved by the National Continuing Education Review Service of the National Association of Boards of Examiners of Long Term Care Administrators, or by federal or state departments or agencies.

(c) Each licensee shall obtain a certificate of completion from the provider of the continuing education for all continuing education hours that are successfully completed and shall retain such certificate for a minimum of three years. Upon request by the department, the licensee shall submit the certificate to the department. A licensee who fails to comply with the continuing education requirements shall be subject to disciplinary action pursuant to section 19a-517.

(d) The continuing education requirements shall be waived for licensees applying for licensure renewal for the first time. The department may, for a licensee who has a medical disability or illness, grant a waiver of the continuing education requirements for a specific period of time or may grant the licensee an extension of time in which to fulfill the requirements.

Sec. 19. Section 20-195n of the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2004):

(a) No person shall practice clinical social work unless [he] such person has obtained a license pursuant to this section. Applicants for licensure as a clinical social worker shall: (1) Hold a doctorate or master's degree from a social work program accredited by the Council on Social Work Education or, if educated outside the United States or its territories, have completed an educational program deemed equivalent by said council; (2) have three thousand hours [postmaster's] post-master's social work experience which shall include not less than one hundred hours of work under professional supervision by a licensed clinical or certified independent social worker; and (3) pass the clinical level examination of the American Association of State Social Work Boards or any other examination prescribed by the commissioner. On and after October 1, 1995, any person certified as an independent social worker prior to October 1, 1995, shall be deemed licensed as a clinical social worker pursuant to this section, except a person certified as an independent social worker on and after October 1, 1990, shall not be deemed licensed as a clinical social worker pursuant to this chapter unless such person has satisfied the requirements of subdivision (3) of this section.

(b) Notwithstanding the provisions of subsection (a) of this section, the commissioner may grant a license by endorsement to an applicant who presents evidence satisfactory to the commissioner that the applicant (1) is licensed or certified as a clinical social worker in good standing in another state or jurisdiction whose requirements for practicing in such capacity are substantially similar to or higher than those of this state, and (2) has successfully completed the clinical level examination of the Association of Social Work Boards, or its successor organization. No license shall be issued under this subsection to any applicant against whom professional disciplinary action is pending or who is the subject of an unresolved complaint.

Sec. 20. (NEW) (Effective October 1, 2004) For the school year commencing in 2005, and each school year thereafter, each public or independent institution of higher education shall provide (1) information about hepatitis B and the risks of contracting hepatitis B by college-age individuals, to all matriculated students, and (2) notice of the availability and benefits of a hepatitis B vaccine.

Sec. 21. Subsection (a) of section 20-12d of the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2004):

(a) A physician assistant who has complied with the provisions of sections 20-12b and 20-12c may perform medical functions delegated by a supervising physician when: (1) The supervising physician is satisfied as to the ability and competency of the physician assistant; (2) such delegation is consistent with the health and welfare of the patient and in keeping with sound medical practice; and (3) when such functions are performed under the oversight, control and direction of the supervising physician. The functions that may be performed under such delegation are those that are within the scope of the supervising physician's license, within the scope of such physician's competence as evidenced by such physician's postgraduate education, training and experience and within the normal scope of such physician's actual practice. Delegated functions shall be implemented in accordance with written protocols established by the supervising physician. All orders written by physician assistants shall be followed by the signature of the physician assistant and the printed name of the supervising physician. A physician assistant may, as delegated by the supervising physician within the scope of such physician's license, (A) prescribe and administer drugs, including controlled substances in schedule IV or V in all settings, (B) renew prescriptions for controlled substances in schedule II or III in outpatient settings, and (C) prescribe and administer controlled substances in schedule II or III to an inpatient in a short-term hospital, chronic disease hospital, emergency room satellite of a general hospital, or, after an admission evaluation by a physician, in a chronic and convalescent nursing home, as defined in the regulations of Connecticut state agencies and licensed pursuant to subsection (a) of section 19a-491, as amended, provided in all cases where the physician assistant prescribes a controlled substance in schedule II or III, the physician under whose supervision the physician assistant is prescribing shall cosign the order not later than twenty-four hours thereafter. The physician assistant may, as delegated by the supervising physician within the scope of such physician's license, request, sign for, receive and dispense drugs to patients, in the form of professional samples as defined in section 20-14c or when dispensing in an outpatient clinic as defined in the regulations of Connecticut state agencies and licensed pursuant to subsection (a) of section 19a-491, as amended, that operates on a not-for-profit basis, or when dispensing in a clinic operated by a state agency or municipality. Nothing in this subsection shall be construed to allow the physician assistant to request, sign for, receive or dispense any drug the physician assistant is not authorized under this subsection to prescribe.

Sec. 22. Section 20-65j of the general statutes is repealed and the following is substituted in lieu thereof (Effective the later of October 1, 2000, or the date notice is published by the Commissioner of Public Health in the Connecticut Law Journal indicating that the licensing of athletic trainers and physical therapist assistants is being implemented by the commissioner):

(a) Except as provided in subsections (b) and (c) of this section, an applicant for a license to practice athletic training shall have: (1) A baccalaureate degree from a regionally accredited institution of higher education, or from an institution of higher learning located outside of the United States that is legally chartered to grant postsecondary degrees in the country in which such institution is located; [(2) successfully completed (A) a course of study in athletic training in a program that, at the time of the applicant's completion, is accredited by the National Athletic Trainers' Association, the Committee on Allied Health Education and Accreditation, or the Commission on Accreditation of Allied Health Education Programs, or (B) a program of study in athletic training during a period of at least two calendar years, a minimum of one thousand five hundred hours of athletic training experience under the supervision of an athletic trainer certified by the National Athletic Trainers' Association Board of Certification, Inc. , or its successor organization, of which a minimum of one thousand hours shall be attained at the interscholastic, intercollegiate or professional sports level, and a minimum of three semester credits of formal education in each of the following areas: (i) Health, (ii) nutrition, (iii) psychology, (iv) human anatomy, (v) kinesiology or biomechanics, (vi) human physiology, (vii) physiology of exercise, (viii) basic athletic training, and (ix) advanced athletic training or therapeutic modalities and rehabilitative exercise; and (3) passed the national certification examination sponsored by the National Athletic Trainers' Association or the National Athletic Trainers' Association Board of Certification, Inc. , or their successor organizations] and (2) current certification as an athletic trainer by the National Athletic Trainers' Association Board of Certification, Inc., or its successor organization.

(b) An applicant for licensure to practice athletic training by endorsement shall present evidence satisfactory to the commissioner (1) of licensure or certification as an athletic trainer, or as a person entitled to perform similar services under a different designation, in another state having requirements for practicing in such capacity that are substantially similar to or higher than the requirements in force in this state, and (2) that there is no disciplinary action or unresolved complaint pending against such applicant.

(c) [Before January 1, 2001, an applicant for a license to practice athletic training may, in lieu of the requirements set forth in subsection (a) of this section, present] For the period from the effective date of this section to one year from said date, the commissioner shall grant a license as an athletic trainer to any applicant who presents evidence satisfactory to the commissioner of (1) the continuous providing of services as an athletic trainer since October 1, 1979, or (2) certification as an athletic trainer by the National Athletic Trainers' Association Board of Certification, Inc.

Sec. 23. Subsection (b) of section 20-65k of the general statutes is repealed and the following is substituted in lieu thereof (Effective the later of October 1, 2000, or the date notice is published by the Commissioner of Public Health in the Connecticut Law Journal indicating that the licensing of athletic trainers and physical therapist assistants is being implemented by the commissioner):

(b) A license to practice athletic training may be renewed in accordance with the provisions of section 19a-88, as amended, providing any licensee applying for license renewal shall maintain certification as an athletic trainer by the National Athletic Trainers' Association Board of Certification, Inc., or its successor organization. The fee for such renewal shall be one hundred dollars.

Sec. 24. Subsection (a) of section 19a-79 of the general statutes is repealed and the following is substituted in lieu thereof (Effective from passage):

(a) The Commissioner of Public Health shall adopt regulations, in accordance with the provisions of chapter 54, to carry out the purposes of sections 19a-77 to 19a-80, inclusive, as amended, and 19a-82 to 19a-87, inclusive, and to assure that child day care centers and group day care homes shall meet the health, educational and social needs of children utilizing such child day care centers and group day care homes. Such regulations shall (1) specify that before being permitted to attend any child day care center or group day care home, each child shall be protected as age-appropriate by adequate immunization against diphtheria, pertussis, tetanus, poliomyelitis, measles, mumps, rubella, hemophilus influenzae type B and any other vaccine required by the schedule of active immunization adopted pursuant to section 19a-7f, including appropriate exemptions for children for whom such immunization is medically contraindicated and for children whose parents object to such immunization on religious grounds, (2) specify conditions under which child day care center directors and teachers and group day care home providers may administer tests to monitor glucose levels in a child with diagnosed diabetes mellitus, and administer medicinal preparations, including controlled drugs specified in the regulations by the commissioner, to a child receiving child day care services at such child day care center or group day care home pursuant to the written order of a physician licensed to practice medicine or a dentist licensed to practice dental medicine in this or another state, or an advanced practice registered nurse licensed to prescribe in accordance with section 20-94a, or a physician assistant licensed to prescribe in accordance with section 20-12d, and the written authorization of a parent or guardian of such child, (3) specify that an operator of a child day care center or group day care home, licensed before January 1, 1986, or an operator who receives a license after January 1, 1986, for a facility licensed prior to January 1, 1986, shall provide a minimum of thirty square feet per child of total indoor usable space, free of furniture except that needed for the children's purposes, exclusive of toilet rooms, bathrooms, coatrooms, kitchens, halls, isolation room or other rooms used for purposes other than the activities of the children, (4) specify that a child day care center or group day care home licensed after January 1, 1986, shall provide thirty-five square feet per child of total indoor usable space, (5) establish appropriate child day care center staffing requirements for employees certified in cardiopulmonary resuscitation by the American Red Cross, [or] the American Heart Association, the National Safety Council, American Safety and Health Institute or Medic First Aid International, Inc., (6) specify that on and after January 1, 2003, a child day care center or group day care home (A) shall not deny services to a child on the basis of a child's known or suspected allergy or because a child has a prescription for an automatic prefilled cartridge injector or similar automatic injectable equipment used to treat an allergic reaction, (B) shall, within three weeks of such child's enrollment in such a center or home, have staff trained in the use of such equipment on-site during all hours when such a child is on-site, (C) shall require such child's parent or guardian to provide the injector or injectable equipment and a copy of the prescription for such medication and injector or injectable equipment upon enrollment of such child, and (D) shall require a parent or guardian enrolling such a child to replace such medication and equipment prior to its expiration date.

Sec. 25. Subsection (d) of section 3 of public act 03-118 is repealed and the following is substituted in lieu thereof (Effective from passage):

(d) This section shall not apply to licensees who have been continuously licensed since [October 1, 1993] February 1, 1994. The continuing education requirements shall be waived for licensees applying for licensure renewal for the first time. The department may, for a licensee who has a medical disability or illness, grant a waiver of the continuing education requirements for a specific period of time or may grant the licensee an extension of time in which to fulfill the requirements.

Sec. 26. Subsection (d) of section 20-206bb of the general statutes is repealed and the following is substituted in lieu thereof (Effective from passage):

(d) Notwithstanding the provisions of subsection (b) of this section, the department shall, [(1)] prior to September 1, [1999] 2005, issue a license to any applicant who presents to the department satisfactory evidence that the applicant has [(A) passed the National Commission for the Certification of Acupuncturists written examination by test or by credentials review, (B) successfully completed the practical examination of point location skills offered by the National Commission for the Certification of Acupuncturists, and (C) successfully completed a course in clean needle technique prescribed by the department pursuant to subsection (b) of this section, and (2) prior to September 1, 1999, issue a license to any applicant who presents to the department satisfactory evidence that the applicant (A) is a member of or has been certified by the National Commission for the Certification of Acupuncturists, and (B) has at least ten years' experience in the practice of acupuncture] (1) earned, or successfully completed requirements for, a master's degree in acupuncture from a program that includes a minimum of one thousand three hundred fifty hours of didactic and clinical training, five hundred of which are clinical, from an institution of higher education accredited by the Department of Higher Education at the time of the applicant's graduation, (2) passed all portions of the National Certification Commission for Acupuncture and Oriental Medicine acupuncture examination, including the Acupuncture Portion of the comprehensive Written Examination in Acupuncture, the Clean Needle Technique Portion of the Comprehensive Written Examination in Acupuncture and the Practical Examination of Point Location Skills, and (3) successfully completed a course in clean needle technique offered by the Council of Colleges of Acupuncture and Oriental Medicine.

Sec. 27. Subsection (e) of section 52-557b, as amended by section 10 of public act 03-211 of the general statutes, is repealed and the following is substituted in lieu thereof (Effective October 1, 2004):

(e) (1) For purposes of this subsection, "cartridge injector" means an automatic prefilled cartridge injector or similar automatic injectable equipment used to deliver epinephrine in a standard dose for emergency first aid response to allergic reactions.

(2) Any volunteer worker associated with, or any person employed to work for, a program offered to children sixteen years of age or younger by a corporation, other than a licensed health care provider, that is exempt from federal income taxation under Section 501 of the Internal Revenue Code of 1986, or any subsequent corresponding internal revenue code of the United States, as from time to time amended, who (A) has been trained in the use of a cartridge injector by a licensed physician, physician's assistant, advanced practice registered nurse or registered nurse, (B) has obtained the consent of a parent or legal guardian to use a cartridge injector on his or her child, and (C) uses a cartridge injector on such child in apparent need thereof participating in such program, shall not be liable to such child assisted or to such child's parent or guardian for civil damages for any personal injury or death which results from acts or omissions by such worker in using a cartridge injector which may constitute ordinary negligence. The immunity provided in this subsection does not apply to acts or omissions constituting gross, wilful or wanton negligence.

(3) A corporation, other than a licensed health care provider, that is exempt from federal income taxation under Section 501 of the Internal Revenue Code of 1986, or any subsequent corresponding internal revenue code of the United States, as from time to time amended, which provides training in the use of cartridge injectors to any volunteer worker granted immunity pursuant to subdivision (2) of this subsection shall not be liable for civil damages for any injury sustained by, or for the death of, a child sixteen years of age or younger who is participating in a program offered by such corporation, which injury or death results from acts or omissions by such worker in using a cartridge injector, which may constitute ordinary negligence. The immunity provided in this subsection does not apply to acts or omissions constituting gross, wilful or wanton negligence.

Sec. 28. Section 20-86b of the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2004):

A clinical practice relationship shall exist between each nurse-midwife and an obstetrician-gynecologist and shall be based upon mutually agreed upon medical guidelines and protocols. Such protocols shall contain a list of medications, devices and laboratory tests which may be prescribed, dispensed or administered by the nurse-midwife. Such protocols shall be filed with the Department of Public Health. The term "directed" does not necessarily imply the physical presence of an obstetrician-gynecologist while care is being given by a nurse-midwife. Each nurse-midwife shall sign the birth certificate of each infant delivered by the nurse-midwife. A nurse-midwife may make the actual determination and pronouncement of death of an infant delivered by the nurse-midwife provided: (1) The death is an anticipated death; (2) the nurse-midwife attests to such pronouncement on the certificate of death; and (3) the nurse-midwife or a physician licensed pursuant to chapter 370 certifies the certificate of death not later than twenty-four hours after such pronouncement.

Sec. 29. Subsection (c) of section 7-62b of the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2004):

(c) The medical certification portion of the death certificate shall be completed, signed and returned to the licensed funeral director or licensed embalmer [within] no later than twenty-four hours after death by the physician or advanced practice registered nurse in charge of the patient's care for the illness or condition which resulted in death, or upon the death of an infant delivered by a nurse-midwife, by such nurse-midwife, as provided in section 20-86b, as amended by this act. In the absence of such physician or advanced practice registered nurse, or with [his] the physician's or advanced practice registered nurse's approval, the medical certification may be completed and signed by [a designated] an associate physician, an advanced practice registered nurse, a physician assistant as provided in subsection (d) of section 20-12d, as amended by this act, a registered nurse as provided in section 20-101a, as amended by this act, the chief medical officer of the institution in which death occurred, or by the pathologist who performed an autopsy upon the decedent. No physician, advanced practice registered nurse, physician assistant, registered nurse, nurse-midwife, chief medical officer or pathologist shall sign and return the medical certification unless [he] such physician, advanced practice registered nurse, physician assistant, registered nurse, nurse-midwife, chief medical officer or pathologist has personally viewed and examined the body of the person to whom the medical certification relates and [has satisfied himself] is satisfied that at the time of the examination such person was in fact dead, except that in the event a medical certification is completed by a physician, advanced practice registered nurse, physician assistant, registered nurse, nurse-midwife, chief medical officer or pathologist other than the one who made the determination and pronouncement of death, [has been made by a registered nurse pursuant to section 20-101a, such] an additional viewing and examination of the body shall not be required. If a physician, advanced practice registered nurse, physician assistant, registered nurse, nurse-midwife, chief medical officer or pathologist refuses or otherwise fails to complete, sign and return the medical portion of the death certificate to the licensed funeral director or licensed embalmer within twenty-four hours after death, such licensed funeral director or embalmer may notify the Commissioner of Public Health of such refusal. The commissioner may, upon receipt of notification and investigation, assess a civil penalty against such physician, advanced practice registered nurse, physician assistant, registered nurse, chief medical officer or pathologist not to exceed two hundred fifty dollars. The medical certification shall state the cause of death, defined so that such death may be classified under the international list of causes of death, the duration of disease if known and such additional information as the Department of Public Health requires. The department shall give due consideration to national uniformity in vital statistics in prescribing the form and content of such information.

Sec. 30. Section 20-11b of the general statutes is repealed and the following is substituted in lieu thereof (Effective from passage):

(a) [Each] Except as provided in subsection (c) of this section, each person licensed to practice medicine and surgery under the provisions of section 20-13 who provides direct patient care services shall maintain professional liability insurance or other indemnity against liability for professional malpractice. The amount of insurance which each such person shall carry as insurance or indemnity against claims for injury or death for professional malpractice shall not be less than five hundred thousand dollars for one person, per occurrence, with an aggregate of not less than one million five hundred thousand dollars.

(b) Each insurance company which issues professional liability insurance, as defined in subdivisions (1), (6), (7), (8) and (9) of subsection (b) of section 38a-393, shall on and after January 1, 1995, render to the Commissioner of Public Health a true record of the names and addresses, according to classification, of cancellations of and refusals to renew professional liability insurance policies and the reasons for such cancellation or refusal to renew said policies for the year ending on the thirty-first day of December next preceding.

(c) A person subject to the provisions of subsection (a) of this section shall be deemed in compliance with such subsection when providing primary health care services at a clinic licensed by the Department of Public Health that is recognized as tax exempt pursuant to Section 501(c)(3) of the Internal Revenue Code of 1986 or any successor internal revenue code, as may be amended from time to time, provided: (1) Such person is not compensated for such services; (2) the clinic does not charge patients for such services; (3) the clinic maintains professional liability insurance coverage in the amounts required by subsection (a) of this section for each aggregated forty hours of service or fraction thereof for such persons; (4) The clinic carries additional appropriate professional liability coverage on behalf of the clinic and its employees in the amounts of five hundred thousand dollars per occurrence, with an aggregate of not less than one million five hundred thousand dollars; and (5) the clinic maintains total professional liability coverage of not less than one million dollars per occurrence with an annual aggregate of not less than three million dollars. Such person shall be subject to the provisions of subsection (a) of this section when providing direct patient care services in any setting other than such clinic. Nothing in this subsection shall be construed to relieve the clinic from any insurance requirements otherwise required by law.

(d) No person insured pursuant to the requirements of subsection (a) of this section with a claims-made medical malpractice insurance policy shall lose the right to unlimited additional extended reporting period coverage upon such person's permanent retirement from practice if such person solely provides professional services without charge at a clinic recognized as tax exempt under section 501(c)(3) of said internal revenue code.

Sec. 31. (NEW) (Effective from passage) Notwithstanding the provisions of section 4a-57a of the general statutes, the Commissioner of Administrative Services shall donate up to five vans to municipalities or organizations that operate needle exchange programs established pursuant to section 19a-124 of the general statutes. After the donation takes place, the Department of Administrative Services shall be relieved of any liability regarding the performance or maintenance of the donated vans. The municipality or organization that accepts the donation of the van shall be solely liable for any damage to, or any damage or injury resulting from use of, such van and shall indemnify the state against all claims arising out of the use of such property.

Sec. 32. Subsection (a) of section 19a-79 of the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2004):

(a) The Commissioner of Public Health shall adopt regulations, in accordance with the provisions of chapter 54, to carry out the purposes of sections 19a-77 to 19a-80, inclusive, as amended, and 19a-82 to 19a-87, inclusive, and to assure that child day care centers and group day care homes shall meet the health, educational and social needs of children utilizing such child day care centers and group day care homes. Such regulations shall (1) specify that before being permitted to attend any child day care center or group day care home, each child shall be protected as age-appropriate by adequate immunization against diphtheria, pertussis, tetanus, poliomyelitis, measles, mumps, rubella, hemophilus influenzae type B and any other vaccine required by the schedule of active immunization adopted pursuant to section 19a-7f, including appropriate exemptions for children for whom such immunization is medically contraindicated and for children whose parents object to such immunization on religious grounds, (2) specify conditions under which child day care center directors and teachers and group day care home providers may administer tests to monitor glucose levels in a child with diagnosed diabetes mellitus, and administer medicinal preparations, including controlled drugs specified in the regulations by the commissioner, to a child receiving child day care services at such child day care center or group day care home pursuant to the written order of a physician licensed to practice medicine or a dentist licensed to practice dental medicine in this or another state, or an advanced practice registered nurse licensed to prescribe in accordance with section 20-94a, or a physician assistant licensed to prescribe in accordance with section 20-12d, and the written authorization of a parent or guardian of such child, (3) specify that an operator of a child day care center or group day care home, licensed before January 1, 1986, or an operator who receives a license after January 1, 1986, for a facility licensed prior to January 1, 1986, shall provide a minimum of thirty square feet per child of total indoor usable space, free of furniture except that needed for the children's purposes, exclusive of toilet rooms, bathrooms, coatrooms, kitchens, halls, isolation room or other rooms used for purposes other than the activities of the children, (4) specify that a child day care center or group day care home licensed after January 1, 1986, shall provide thirty-five square feet per child of total indoor usable space, (5) establish appropriate child day care center staffing requirements for employees certified in cardiopulmonary resuscitation by the American Red Cross or the American Heart Association, (6) specify that on and after January 1, 2003, a child day care center or group day care home (A) shall not deny services to a child on the basis of a child's known or suspected allergy or because a child has a prescription for an automatic prefilled cartridge injector or similar automatic injectable equipment used to treat an allergic reaction, or for injectable equipment used to administer glucagon, (B) shall, [within] not later than three weeks [of] after such child's enrollment in such a center or home, have staff trained in the use of such equipment on-site during all hours when such a child is on-site, (C) shall require such child's parent or guardian to provide the injector or injectable equipment and a copy of the prescription for such medication and injector or injectable equipment upon enrollment of such child, and (D) shall require a parent or guardian enrolling such a child to replace such medication and equipment prior to its expiration date, and (7) specify that on and after January 1, 2005, a child day care center or group day care home (A) shall not deny services to a child on the basis of a child's diagnosis of asthma or because a child has a prescription for an inhalant medication to treat asthma, and (B) shall, not later than three weeks after such child's enrollment in such a center or home, have staff trained in the administration of such medication on-site during all hours when such a child is on-site.

Sec. 33. Subsection (c) of section 19a-491a of the general statutes is repealed and the following is substituted in lieu thereof (Effective from passage):

(c) A person seeking to renew a nursing home license shall furnish the department with any information required under subsection (a) of this section that was not previously submitted and with satisfactory written proof that the owner of the nursing home consents to such renewal, if the owner is different than the person seeking renewal, and shall provide data on any change in the information submitted. The commissioner [may] shall refuse to issue or renew a nursing home license if the person seeking renewal fails to provide the information required under this section. Upon such refusal, the commissioner shall grant such license to the holder of the certificate of need, provided such holder meets all requirements for such licensure. If such holder does not meet such requirements, the commissioner shall proceed in accordance with sections 19a-541 to 19a-549, inclusive, as amended. If the commissioner is considering a license renewal application pursuant to an order of the commissioner, the procedures in this subsection shall apply to such consideration.

Sec. 34. Subsection (b) of section 20-87a of the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2004):

(b) Advanced nursing practice is defined as the performance of advanced level nursing practice activities that, by virtue of postbasic specialized education and experience, are appropriate to and may be performed by an advanced practice registered nurse. The advanced practice registered nurse performs acts of diagnosis and treatment of alterations in health status, as described in subsection (a) of this section, and shall collaborate with a physician licensed to practice medicine in this state. If practicing in (1) an institution licensed pursuant to subsection (a) of section 19a-491, as amended, as a hospital, residential care home, health care facility for the handicapped, nursing home, rest home, mental health facility, substance abuse treatment facility, infirmary operated by an educational institution for the care of students enrolled in, and faculty and staff of, such institution, or facility operated and maintained by any state agency and providing services for the prevention, diagnosis and treatment or care of human health conditions, or (2) an industrial health facility licensed pursuant to subsection (h) of section 31-374 which serves at least two thousand employees, or (3) a clinic operated by a state agency, municipality, or private nonprofit corporation, or (4) a clinic operated by any educational institution prescribed by regulations adopted pursuant to section 20-99a, the advanced practice registered nurse may, in collaboration with a physician licensed to practice medicine in this state, prescribe, dispense, and administer medical therapeutics and corrective measures. In all other settings, the advanced practice registered nurse may, in collaboration with a physician licensed to practice medicine in the state, prescribe and administer medical therapeutics and corrective measures and may request, sign for, receive and dispense drugs in the form of professional samples in accordance with sections 20-14c to 20-14e, inclusive, except that an advanced practice registered nurse licensed pursuant to section 20-94a and maintaining current certification from the American Association of Nurse Anesthetists who is prescribing and administrating medical therapeutics during surgery may only do so if the physician who is medically directing the prescriptive activity is physically present in the institution, clinic or other setting where the surgery is being performed. For purposes of this subsection, "collaboration" means a mutually agreed upon relationship between an advanced practice registered nurse and a physician who is educated, trained or has relevant experience that is related to the work of such advanced practice registered nurse. The collaboration shall address a reasonable and appropriate level of consultation and referral, coverage for the patient in the absence of the advanced practice registered nurse, a method to review patient outcomes and a method of disclosure of the relationship to the patient. Relative to the exercise of prescriptive authority, the collaboration between an advanced practice registered nurse and a physician shall be in writing and shall address the level of schedule II and III controlled substances that the advanced practice registered nurse may prescribe and provide a method to review patient outcomes, including, but not limited to, the review of medical therapeutics, corrective measures, laboratory tests and other diagnostic procedures that the advanced practice registered nurse may prescribe, dispense and administer.

Sec. 35. Subsection (c) of section 20-206b of the general statutes is repealed and the following is substituted in lieu thereof (Effective from passage):

(c) (1) Notwithstanding the provisions of subsection (a) of this section, the department may issue a license to an applicant whose school of massage therapy does not satisfy the requirement of subparagraph (A) or (B) of subdivision (1) of said subsection (a), provided the school held, at the time of the applicant's graduation, a certificate issued by the Commissioner of Education pursuant to section 10-7b and provided the applicant graduated within thirty-three months of the date said school first offered the curriculum completed by the applicant. No license shall be issued under this subsection to a graduate of a school that fails to apply for and obtain accreditation by (1) an accrediting agency recognized by the United States Department of Education, or (2) the Commission on Massage Therapy Accreditation within thirty-three months of the date said school first offered the curriculum.

(2) Notwithstanding the provisions of subsection (a) of this section and subdivision (1) of this subsection, the department may issue a license to an applicant who submits evidence satisfactory to the commissioner that the applicant (A) was enrolled, on or before July 1, 2005, in a school of massage therapy that was approved or accredited by a state board of postsecondary technical trade and business schools or a state agency recognized as such state's board of postsecondary technical trade and business schools, (B) graduated from a school of massage therapy with a course of study of not less than five hundred classroom hours, with the instructor present, that at the time of the applicant's graduation was approved or accredited by a state board of postsecondary technical trade and business schools or a state agency recognized as such state's board of postsecondary technical trade and business schools, and (C) has passed the National Certification Examination for Therapeutic Massage and Bodywork. Passing scores on the examination shall be prescribed by the department.

Sec. 36. Subsection (d) of section 10-206 of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2004):

(d) The results of each assessment done pursuant to this section and the results of screenings done pursuant to section 10-214 shall be recorded on forms supplied by the State Board of Education. Such information shall be included in the cumulative health record of each pupil and shall be kept on file in the school such pupil attends. If a pupil permanently leaves the jurisdiction of the board of education, the pupil's original cumulative health record shall be sent to the chief administrative officer of the school district to which such student moves. The board of education transmitting such health record shall retain a true copy. Each physician, advanced practice registered nurse, registered nurse, or physician assistant performing health assessments and screenings pursuant to this section and section 10-214 shall completely fill out and sign each form and any recommendations concerning the pupil shall be in writing.

Sec. 37. Section 20-206mm of the general statutes is repealed and the following is substituted in lieu thereof (Effective from passage):

(a) Except as provided in subsections (b) and (c) of this section, an applicant for a license as a paramedic shall submit evidence satisfactory to the commissioner, as defined in section 19a-175, that the applicant has successfully (1) completed a mobile intensive care training program approved by the commissioner, and (2) passed an examination prescribed by the commissioner.

(b) An applicant for licensure by endorsement shall present evidence satisfactory to the commissioner that the applicant (1) is licensed or certified as a paramedic in another state or jurisdiction whose requirements for practicing in such capacity are substantially similar to or higher than those of this state and that [he] the applicant has no pending disciplinary action or unresolved complaint against him or her, or (2) (A) is currently licensed or certified as a paramedic in good standing in any New England state, New York or New Jersey, (B) has completed an initial training program consistent with the United States Department of Transportation, National Highway Traffic Safety Administration paramedic curriculum, and (C) has no pending disciplinary action or unresolved complaint against him or her.

(c) Any person who is certified as an emergency medical technician-paramedic by the Department of Public Health on October 1, 1997, shall be deemed a licensed paramedic. Any person so deemed shall renew his license pursuant to section 19a-88, as amended, for a fee of seventy-five dollars.

Sec. 38. Section 19a-179 of the general statutes is repealed and the following is substituted in lieu thereof (Effective from passage):

(a) The commissioner shall adopt regulations, in accordance with chapter 54, concerning (1) the methods and conditions for the issuance, renewal and reinstatement of licensure and certification or recertification of emergency medical service personnel, (2) the methods and conditions for licensure and certification of the operations, facilities and equipment enumerated in section 19a-177, as amended, and (3) complaint procedures for the public and any emergency medical service organization. Such regulations shall be in conformity with the policies and standards established by the commissioner. Such regulations shall require that, as an express condition of the purchase of any business holding a primary service area, the purchaser shall agree to abide by any performance standards to which the purchased business was obligated pursuant to its agreement with the municipality.

(b) The commissioner may issue an emergency medical technician certificate to an applicant who presents evidence satisfactory to the commissioner that the applicant (1) is currently certified as an emergency medical technician in good standing in any New England state, New York or New Jersey, (2) has completed an initial training program consistent with the United States Department of Transportation, National Highway Traffic Safety Administration paramedic curriculum, and (3) has no pending disciplinary action or unresolved complaint against him or her.

Sec. 39. Subdivision (8) of section 19a-177 of the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2004):

(8) (A) Not later than October 1, 2001, develop or cause to be developed a data collection system that will follow a patient from initial entry into the emergency medical service system through arrival at the emergency room and, within available appropriations, may expand the data collection system to include clinical treatment and patient outcome data. The commissioner shall, on a quarterly basis, collect the following information from each licensed ambulance service or certified ambulance service that provides emergency medical services: (i) The total number of calls for emergency medical services received by such licensed ambulance service or certified ambulance service through the 9-1-1 system during the reporting period; (ii) each level of emergency medical services, as defined in regulations adopted pursuant to section 19a-179, required for each such call; (iii) the response time for each licensed ambulance service or certified ambulance service during the reporting period; (iv) the number of passed calls, cancelled calls and mutual aid calls during the reporting period; and (v) for the reporting period, the prehospital data for the nonscheduled transport of patients required by regulations adopted pursuant to subdivision (6) of this section. The information required under this subdivision may be submitted in any written or electronic form selected by such licensed ambulance service or certified ambulance service and approved by the commissioner, provided the commissioner shall take into consideration the needs of such licensed ambulance service or certified ambulance service in approving such written or electronic form. The commissioner may conduct an audit of any such licensed ambulance service or certified ambulance service as the commissioner deems necessary in order to verify the accuracy of such reported information.

(B) The commissioner shall prepare a report that shall include, but not be limited to, the following information: (i) The total number of calls for emergency medical services received during the reporting year by each licensed ambulance service or certified ambulance service; (ii) the level of emergency medical services required for each such call; (iii) the name of the provider of each such level of emergency medical services furnished during the reporting year; (iv) the response time, by time ranges or fractile response times, for each licensed ambulance service or certified ambulance service, using a common definition of response time, as provided in regulations adopted pursuant to section 19a-179; and (v) the number of passed calls, cancelled calls and mutual aid calls during the reporting year. The commissioner shall prepare such report in a format that categorizes such information for each municipality in which the emergency medical services were provided, with each such municipality grouped according to urban, suburban and rural classifications. Not later than March 31, 2002, and annually thereafter, the commissioner shall submit such report to the joint standing committee of the General Assembly having cognizance of matters relating to public health, shall make such report available to the public and shall post such report on the Department of Public Health web site on the Internet.

(C) If any licensed ambulance service or certified ambulance service does not submit the information required under subparagraph (A) of this subdivision for a period of six consecutive months, or if the commissioner believes that such licensed ambulance service or certified ambulance service knowingly or intentionally submitted incomplete or false information, the commissioner shall issue a written order directing such licensed ambulance service or certified ambulance service to comply with the provisions of subparagraph (A) of this subdivision and submit all missing information or such corrected information as the commissioner may require. If such licensed ambulance service or certified ambulance service fails to fully comply with such order not later than three months from the date such order is issued, the commissioner (i) shall conduct a hearing, in accordance with chapter 54, at which such licensed ambulance service or certified ambulance service shall be required to show cause why the primary service area assignment of such licensed ambulance service or certified ambulance service should not be revoked, and (ii) may take such disciplinary action under section 19a-17 as the commissioner deems appropriate.

(D) On and after October 1, 2006, the commissioner shall collect the information required by subparagraph (A) of this subdivision, in the manner provided in said subparagraph, from each person or emergency medical service organization licensed or certified under section 19a-180 that provides emergency medical services. On and after October 1, 2006, such information shall be included in the annual report prepared by the commissioner in accordance with subparagraph (B) of this subdivision and such person or emergency medical service organization shall be subject to the provisions of subparagraph (C) of this subdivision.

Sec. 40. (Effective October 1, 2004) Section 20-252a of the general statutes is repealed.

Approved on June 8, 2004