CHAPTER 368ll
MISCELLANEOUS PROVISIONS

Table of Contents

Sec. 19a-900. Use of cartridge injector by staff member of before or after school program, day camp or day care facility.
Sec. 19a-901. Obstetrical ultrasound procedure.
Sec. 19a-902. Providers of mental health services and substance abuse services. Implementation of dual licensure program by Department of Public Health. Regulations.
Sec. 19a-903. Prohibited billing practices re hospital-acquired conditions.
Sec. 19a-903a. Circulating nurses in hospitals and outpatient surgical facilities.
Sec. 19a-903b. Hospital designation of health care providers and technicians to perform oxygen-related patient care activities. Training. Competency testing. Exception.
Sec. 19a-904. Emergency service members and exposure to infectious diseases. Definitions. Designated officers. Duties of hospital. Request for notification. Immunity from liability.

      Sec. 19a-900. Use of cartridge injector by staff member of before or after school program, day camp or day care facility. (a) For the purposes of this section:

      (1) "Before or after school program" means any educational or recreational program for children administered in any building or on the grounds of any school by a local or regional board of education or other municipal agency, before or after regular school hours, or both, but does not include a program that is licensed by the Department of Public Health;

      (2) "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;

      (3) "Day camp" means any recreational camp program operated by a municipal agency; and

      (4) "Day care facility" means any child day care center or group day care home, as defined in subdivisions (1) and (2) of subsection (a) of section 19a-77, that is excluded from the licensing requirements of sections 19a-77 to 19a-87, inclusive, by subsection (b) of section 19a-77.

      (b) Upon the request and with the written authorization of the parent or guardian of a child attending any before or after school program, day camp or day care facility, and pursuant to the written order of (1) a physician licensed to practice medicine, (2) a physician assistant licensed to prescribe in accordance with section 20-12d, or (3) an advanced practice registered nurse licensed to prescribe in accordance with sections 20-94a and 20-94b, the owner or operator of such before or after school program, day camp or day care facility shall approve and provide general supervision to an identified staff member trained to administer medication with a cartridge injector to such child if the child has a medically diagnosed allergic condition that may require prompt treatment in order to protect the child against serious harm or death. Such staff member shall be trained in the use of a cartridge injector by a licensed physician, physician assistant, advanced practice registered nurse or registered nurse or shall complete a course in first aid offered by the American Red Cross, the American Heart Association, the National Ski Patrol, the Department of Public Health or any director of health.

      (P.A. 05-144, S. 2; 05-272, S. 35; P.A. 06-196, S. 151.)

      History: P.A. 05-272 amended Subsec. (a)(1) by redefining "Before or after school program" to include programs administered, rather than offered, by a school board or municipality and by removing private providers from the definition, and amended Subsec. (b) by changing "and" to "or" in provision re training and education of staff members; P.A. 06-196 made a technical change in Subsec. (b), effective June 7, 2006.

      See Sec. 52-557b(h) re immunity of staff member from civil liability for rendering emergency assistance by using a cartridge injector.

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      Sec. 19a-901. Obstetrical ultrasound procedure. No person shall perform an obstetrical ultrasound procedure unless such procedure is (1) ordered by a licensed health care provider, acting within the scope of such provider's authority, and (2) for a medical or diagnostic purpose.

      (P.A. 09-125, S. 1.)

      History: P.A. 09-125 effective July 1, 2009.

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      Sec. 19a-902. Providers of mental health services and substance abuse services. Implementation of dual licensure program by Department of Public Health. Regulations. On or before January 1, 2011, the Department of Public Health, in consultation with the Department of Mental Health and Addiction Services, shall amend the department's substance abuse treatment regulations and shall implement a dual licensure program for behavioral health care providers who provide both mental health services and substance abuse services.

      (P.A. 09-149, S. 3.)

      History: P.A. 09-149 effective June 29, 2009.

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      Sec. 19a-903. Prohibited billing practices re hospital-acquired conditions. (a) As used in this section:

      (1) "Hospital" means an acute care hospital that is subject to the federal inpatient prospective payment system described in 42 CFR 412; and

      (2) "Outpatient surgical facility" has the same meaning as provided in section 19a-493b.

      (b) No hospital or outpatient surgical facility shall seek payment for any increased costs that are incurred as the direct result of a hospital-acquired condition, identified as nonpayable by Medicare pursuant to Section 5001(c) of the Deficit Reduction Act of 2005. Except as otherwise provided by federal law or section 17b-278e, the provisions of this section shall apply irrespective of the patient's insurance status or source of payment, including self-pay status.

      (P.A. 09-206, S. 2.)

      History: P.A. 09-206 effective January 1, 2010.

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      Sec. 19a-903a. Circulating nurses in hospitals and outpatient surgical facilities. (a) As used in this section:

      (1) "Circulating nurse" means a registered nurse licensed under chapter 378 who is educated, trained or experienced in perioperative nursing and who is responsible for coordinating the nursing care and safety needs of a patient in an operating room;

      (2) "Outpatient surgical facility" has the same meaning as provided in subsection (a) of section 19a-493b; and

      (3) "Perioperative nursing" means nursing services that are provided to patients during the preoperative, intraoperative and immediate postoperative periods of a surgical procedure.

      (b) Any hospital or outpatient surgical facility shall ensure that a circulating nurse is assigned to, and present for the duration of, each surgical procedure performed in an operating room of such hospital or outpatient surgical facility. While assigned to a surgical procedure, no hospital or outpatient surgical facility shall assign a circulating nurse to another procedure that is scheduled to occur concurrently or that may overlap in time with the originally assigned surgical procedure. A circulating nurse assigned to a surgical procedure shall be present for the duration of the procedure unless it becomes necessary for the nurse to leave the operating room as part of the procedure or the nurse is relieved by another circulating nurse.

      (P.A. 10-117, S. 73.)

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      Sec. 19a-903b. Hospital designation of health care providers and technicians to perform oxygen-related patient care activities. Training. Competency testing. Exception. A hospital, as defined in section 19a-490b, may designate any licensed health care provider and any certified ultrasound or nuclear medicine technician to perform the following oxygen-related patient care activities in a hospital: (1) Connecting or disconnecting oxygen supply; (2) transporting a portable oxygen source; (3) connecting, disconnecting or adjusting the mask, tubes and other patient oxygen delivery apparatus; and (4) adjusting the rate or flow of oxygen consistent with a medical order. Such provider or technician may perform such activities only to the extent permitted by hospital policies and procedures, including bylaws, rules and regulations applicable to the medical staff. A hospital shall document that each person designated to perform oxygen-related patient care activities has been properly trained, either through such person's professional education or through training provided by the hospital. In addition, a hospital shall require that such person satisfy annual competency testing. The provisions of this section shall not apply to any type of ventilator, continuous positive airway pressure or bi-level positive airway pressure units or any other noninvasive positive pressure ventilation.

      (P.A. 10-117, S. 80.)

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      Sec. 19a-904. Emergency service members and exposure to infectious diseases. Definitions. Designated officers. Duties of hospital. Request for notification. Immunity from liability. (a) As used in this section:

      (1) "Infectious disease" includes (A) infectious pulmonary tuberculosis, (B) hepatitis A, (C) hepatitis B, (D) hepatitis C, (E) human immunodeficiency virus (HIV), including acquired immunodeficiency syndrome (AIDS), (F) diphtheria, (G) novel influenza A virus infections with pandemic potential, as defined by the National Centers for Disease Control and Prevention, (H) methicillin-resistant staphylococcus aureus (MRSA), (I) hemorrhagic fevers, (J) meningococcal disease, (K) plague, and (L) rabies;

      (2) "Exposure" means a percutaneous or mucous membrane exposure of an individual to the blood, semen, vaginal secretions, or spinal, synovial, pleural, peritoneal, pericardial or amniotic fluid of another person;

      (3) "Patient" means a person, whether alive or dead, who has been attended, treated, assisted, handled or transported for medical care by an emergency services member as a result of an emergency;

      (4) "Emergency services member" means any police officer as defined in section 7-294a, member of a paid or volunteer fire department, emergency medical technician, ambulance driver, or paramedic as defined in section 19a-175, when acting in an official capacity;

      (5) "Emergency medical technician" means any class of emergency medical technician certified under regulations adopted pursuant to section 19a-179, including, but not limited to, any advanced emergency medical technician or emergency medical responder;

      (6) "Emergency services organization" means the Division of State Police within the Department of Public Safety, an organized local police department, municipal constabulary, paid or volunteer fire department, ambulance company or any organization whether public, private or voluntary that offers transportation or treatment services to patients under emergency conditions;

      (7) "Hospital" has the same meaning as in section 19a-490; and

      (8) "Designated officer" means the employee or volunteer of an emergency services organization designated in accordance with subsection (b) of this section.

      (b) Each emergency services organization shall designate one employee or volunteer to act as the designated officer to receive notification of cases of possible exposure to infectious disease, investigate cases of possible exposure, maintain hospital contact information, request further information from hospitals and maintain any records required under this section. The designated officer may designate another employee or volunteer to serve as his or her designee in the event that the designated officer is unavailable.

      (c) (1) Any hospital that diagnoses a patient as having infectious pulmonary tuberculosis shall verbally notify the designated officer of the emergency services organization that attended, treated, assisted, handled or transported such patient no later than forty-eight hours after making such a diagnosis, and shall make such notification in writing not later than seventy-two hours after such diagnosis. Such notification shall include, but not be limited to, the diagnosis and the date on which the patient was attended, treated, assisted, handled or transported as a result of an emergency to such hospital, provided the identity of the patient shall not be disclosed in any such notification.

      (2) Any hospital that determines that a patient, who died at or before reaching such hospital and who was attended, treated, assisted, handled or transported by an emergency services member, had infectious pulmonary tuberculosis shall notify the designated officer of such determination no later than forty-eight hours after making such determination.

      (d) (1) Any member of an emergency service organization who believes that he or she may have been exposed to an infectious disease through the member's contact with a patient who was attended, treated, assisted, handled or transported by the member shall report such possible exposure to the designated officer. The designated officer shall immediately collect the facts surrounding such incident of possible exposure and evaluate such facts to make a determination of whether it would be reasonable to believe that the member may have been exposed to an infectious disease. If the designated officer determines that there may have been exposure to an infectious disease, the designated officer shall submit a written request to the hospital that received the patient requesting to be notified of the results of any test performed on the patient to determine the presence of an infectious disease. The request shall include:

      (A) The name, address and telephone number of the designated officer submitting the request;

      (B) The name of the designated officer's employer or, in the case of a volunteer emergency services member, the entity for which the designated officer volunteers, and the name and contact information of the emergency services member who may have been exposed to the infectious disease; and

      (C) The date, time, location and manner of the possible exposure.

      (2) Such request shall be valid for ten days after it is made. If at the end of such ten-day period no test has been performed to determine the presence of an infectious disease, no diagnosis has been made or the result of the test is negative, the hospital shall so notify the designated officer who made the request. The notification shall not include the name of the patient.

      (3) Any hospital that receives a written request for notification shall give an oral notification of the presence of an infectious disease or of a confirmed positive test result, if known, to the designated officer no later than forty-eight hours after receiving such request, and shall send a written notification no later than three days after receiving such request. If an infectious disease is present or the test results are confirmed positive, both the oral and written notification shall include the name of the infectious disease and the date on which the patient was attended, treated, assisted, handled or transported by the emergency services organization. Such notification shall not disclose the name of the patient.

      (4) If a designated officer makes a request pursuant to this subsection and the patient has died at, or before reaching, the hospital receiving such request, the hospital shall provide a copy of the request to the medical facility ascertaining the cause of death if such facility is not the hospital that received the original request.

      (e) No cause of action for damages shall arise, or any civil penalty be imposed, against any hospital or any designated officer for failure to comply with the duties established by this section.

      (P.A. 09-76, S. 1; 09-232, S. 43; P.A. 10-18, S. 18; 10-117, S. 22.)

      History: P.A. 09-232 redefined "infectious disease" in Subsec. (a)(1); P.A. 10-18 amended Subsec. (a)(5) by replacing "emergency medical technician-intermediate" with "advanced emergency medical technician" and by replacing "medical response technician" with "emergency medical responder"; P.A. 10-117 made technical changes in Subsec. (a)(5), effective June 8, 2010.

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