Substitute House Bill No. 5792
An Act Making Technical And Other Changes To Certain Public Health Statutes.
Be it enacted by the Senate and House of Representatives in General Assembly convened:
Section 1. Subsection (a) of section 17a-210 of the general statutes is repealed and the following is substituted in lieu thereof:
(a) There shall be a Department of Mental Retardation. The Department of Mental Retardation, with the advice of a Council on Mental Retardation, shall be responsible for the planning, development and administration of complete, comprehensive and integrated state-wide services for persons with mental retardation and persons medically diagnosed as having Prader-Willi syndrome. The Department of Mental Retardation shall be under the supervision of a Commissioner of Mental Retardation, who shall be appointed by the Governor in accordance with the provisions of sections 4-5 to 4-8, inclusive. The Council on Mental Retardation may advise the Governor on the appointment. The commissioner shall be a person who has background, training, education or experience in administering programs for the care, training, education, treatment and custody of persons with mental retardation. The commissioner shall be responsible, with the advice of the council, for planning and developing complete, comprehensive and integrated state-wide services for persons with mental retardation; for the implementation and where appropriate the funding of such services; and for the coordination of the efforts of the Department of Mental Retardation with those of other state departments and agencies, municipal governments and private agencies concerned with and providing services for persons with mental retardation. The commissioner shall be responsible for the administration and operation of the state training school, state mental retardation regions and all state-operated community-based residential facilities established for the diagnosis, care and training of persons with mental retardation. The commissioner shall be responsible for establishing standards, providing technical assistance and exercising the requisite supervision of all state-supported residential, day and program support services for persons with mental retardation and work activity programs operated pursuant to section 17a-226. The commissioner shall conduct or monitor investigations into allegations of abuse and neglect and file reports as requested by state agencies having statutory responsibility for the conduct and oversight of such investigations. The commissioner shall stimulate research by public and private agencies, institutions of higher learning and hospitals, in the interest of the elimination and amelioration of retardation and care and training of persons with mental retardation.
Sec. 2. Subsection (b) of section 19a-77 of the general statutes is repealed and the following is substituted in lieu thereof:
(b) For registration and licensing requirement purposes, child day care services shall not include such services which are:
(1) (A) Administered by a public school system, or (B) administered by a municipal agency or department and located in a public school building for students enrolled in that school;
(2) Administered by a private school which is in compliance with section 10-188 and is approved by the State Board of Education or is accredited by an accrediting agency recognized by the State Board of Education;
(3) Recreation operations such as but not limited to creative art studios for children that offer parent-child recreational programs and classes in music, dance, drama and art that are no longer than two hours in length, library programs, boys' and girls' clubs, church-related activities, scouting, camping or community-youth programs;
(4) Informal arrangements among neighbors or relatives in their own homes, provided the relative is limited to any of the following degrees of kinship by blood or marriage to the child being cared for or to the child's parent: Child, grandchild, sibling, niece, nephew, aunt, uncle or child of one's aunt or uncle;
(5) Drop-in supplementary child care operations for educational or recreational purposes and the child receives such care infrequently where the parents are on the premises; or
(6) Drop-in supplementary child care operations in retail establishments where the parents are on the premises for retail shopping, in accordance with section 19a-77a, as amended, provided that the drop-in supplementary child-care operation does not charge a fee and does not refer to itself as a child day care center.
Sec. 3. Section 19a-84 of the general statutes is repealed and the following is substituted in lieu thereof:
(a) When the Commissioner of Public Health has reason to believe any person licensed under sections 19a-77 to 19a-80, inclusive, and 19a-82 to 19a-87, inclusive, has failed substantially to comply with the regulations adopted under said sections, [he] the commissioner may notify [said] the licensee in writing of [his] the commissioner's intention to suspend or revoke the license or to impose a licensure action. Such notice shall be served by certified mail stating the particular reasons for the proposed action. The [license applicant or license holder] licensee may, if aggrieved by such intended action, make application for a hearing in writing over [his] the licensee's signature to the commissioner. The [aggrieved person] licensee shall state in the application in plain language the reasons why [he] the licensee claims to be aggrieved. The application shall be delivered to the [Commissioner of Public Health] commissioner within thirty days of the [aggrieved person's] licensee's receipt of notification of the intended action. The commissioner shall thereupon hold a hearing within sixty days from receipt [thereof] of such application and shall, at least ten days prior to the date of such hearing, mail a notice, giving the time and place [thereof] of the hearing, to [such aggrieved person] the licensee. The hearing may be conducted by the commissioner or by a hearing officer appointed by the commissioner in writing. The [license applicant or] licensee and the commissioner or hearing officer may issue subpoenas requiring the attendance of witnesses. The [license applicant or] licensee shall be entitled to be represented by counsel and a transcript of the hearing shall be made. If the hearing is conducted by a hearing officer, [he] the hearing officer shall state [his] the hearing officer's findings and make a recommendation to the commissioner on the issue of revocation [and] or suspension or the intended [licensure denial or] licensure action. The commissioner, based upon [said] the findings and recommendation of the hearing officer, or after a hearing conducted by [him] the commissioner, shall render [his] the commissioner's decision in writing suspending, revoking or continuing [said] the license or regarding the intended [licensure denial or] licensure action. A copy of the decision shall be sent by certified mail to the [license applicant or] licensee. The decision revoking or suspending the license or a decision imposing a licensure action shall become effective thirty days after it is mailed by registered or certified mail to the licensee. A [license applicant or] licensee aggrieved by the decision of the commissioner may appeal as provided in section 19a-85.
(b) The provisions of this section shall not apply to the denial of an initial application for a license under sections 19a-77 to 19a-80, inclusive, and 19a-82 to 19a-87, inclusive, provided the commissioner shall notify the applicant of any such denial and the reasons for such denial by mailing written notice to the applicant at the applicant's address shown on the license application.
Sec. 4. Section 19a-87e of the general statutes is repealed and the following is substituted in lieu thereof:
(a) The Commissioner of Public Health [shall have the discretion to] may refuse to license under section 19a-87b, as amended, a person to own, conduct, operate or maintain a family day care home, as defined in section 19a-77, or to suspend or revoke the license or take any other action that may be set forth in regulation that may be adopted pursuant to section 19a-79 if the person who owns, conducts, maintains or operates the family day care home, or a person employed [therein] in such family day care home in a position connected with the provision of care to a child receiving child day care services, has been convicted, in this state or any other state of a felony, as defined in section 53a-25, involving the use, attempted use or threatened use of physical force against another person, or has a criminal record in this state or any other state that the commissioner reasonably believes renders the person unsuitable to own, conduct, operate or maintain or be employed by a family day care home, or if such persons or a person residing in the household has been convicted in this state or any other state of cruelty to persons under section 53-20, injury or risk of injury to or impairing morals of children under section 53-21, abandonment of children under the age of six years under section 53-23, or any felony where the victim of the felony is a child under eighteen years of age, a violation of section 53a-70, as amended, 53a-70a, as amended, 53a-70b, 53a-71, 53a-72a, 53a-72b, as amended, or 53a-73a, illegal manufacture, distribution, sale, prescription, dispensing or administration under section 21a-277 or 21a-278, or illegal possession under section 21a-279, or if such person, or a person employed [therein] in such family day care home in a position connected with the provision of care to a child receiving child day care services, either fails to substantially comply with the regulations adopted pursuant to section 19a-87b, as amended, or conducts, operates or maintains the home in a manner which endangers the health, safety and welfare of the children receiving child day care services. [However, no] Any refusal of a license pursuant to this section shall be rendered [except] in accordance with the provisions of sections 46a-79 to 46a-81, inclusive. Any person whose license has been revoked pursuant to this section shall be ineligible to apply for a license for a period of one year from the effective date of revocation.
(b) When the [Commissioner of Public Health] commissioner intends to [refuse a license or to] suspend or revoke a license or take any other action against a license set forth in regulation adopted pursuant to section 19a-79, [he] the commissioner shall notify the [license applicant or license holder] licensee in writing of [his] the commissioner's intended action. The [license applicant or license holder] licensee may, if aggrieved by such intended action, make application for a hearing in writing over [his] the licensee's signature to the commissioner. The [aggrieved person] licensee shall state in the application in plain language the reasons why [he] the licensee claims to be aggrieved. The application shall be delivered to the [Commissioner of Public Health] commissioner within thirty days of the [aggrieved person's] licensee's receipt of notification of the intended action. The commissioner shall thereupon hold a hearing within sixty days from receipt [thereof] of such application and shall, at least ten days prior to the date of such hearing, mail a notice, giving the time and place [thereof] of the hearing, to [such aggrieved person] the licensee. The provisions of this subsection shall not apply to the denial of an initial application for a license under section 19a-87b, as amended, provided the commissioner shall notify the applicant of any such denial and the reasons for such denial by mailing written notice to the applicant at the applicant's address shown on the license application.
(c) Any person who is licensed to conduct, operate or maintain a family day care home shall notify the commissioner of any conviction of the owner, conductor, operator or maintainer of the family day care home or of any person residing in the household or any person employed [therein] in such family day care home in a position connected with the provision of care to a child receiving child day care services, of a crime which affects the commissioner's discretion under subsection (a) of this section, immediately upon obtaining knowledge of such conviction. Failure to comply with the notification requirement of this subsection may result in the suspension or revocation of the license or [take] the taking of any other action against a license set forth in regulation adopted pursuant to section 19a-79 and shall subject the licensee to a civil penalty of not more than one hundred dollars per day for each day after the person obtained knowledge of the conviction.
(d) It shall be a class A misdemeanor for any person seeking employment in a position connected with the provision of care to a child receiving family day care home services to make a false written statement regarding prior criminal convictions pursuant to a form bearing notice to the effect that such false statements are punishable, which statement [he] such person does not believe to be true and is intended to mislead the prospective employer.
(e) Any person having reasonable cause to believe that a family day care home, as defined in section 19a-77, is operating without a current and valid license or in violation of the regulations adopted under section 19a-87b, as amended, or in a manner which may pose a potential danger to the health, welfare and safety of a child receiving child day care services, may report such information to any office of the Department of Public Health. The department shall investigate any report or complaint received pursuant to this subsection. The name of the person making the report or complaint shall not be disclosed unless (1) such person consents to such disclosure, (2) a judicial or administrative proceeding results [therefrom] from such report or complaint, or (3) a license action pursuant to subsection (a) of this section results [therefrom] from such report or complaint. All records obtained by the department in connection with any such investigation shall not be subject to the provisions of section 1-210, as amended, for a period of thirty days from the date of the petition or other event initiating such investigation, or until such time as the investigation is terminated pursuant to a withdrawal or other informal disposition or until a hearing is convened pursuant to chapter 54, whichever is earlier. A formal statement of charges issued by the department shall be subject to the provisions of section 1-210, as amended, from the time that it is served or mailed to the respondent. Records which are otherwise public records shall not be deemed confidential merely because they have been obtained in connection with an investigation under this section.
Sec. 5. Section 19a-122b of the general statutes is repealed and the following is substituted in lieu thereof:
Notwithstanding the provisions of chapters 368v and 368z, an organization licensed as a hospice pursuant to the Public Health Code or certified as a hospice pursuant to 42 USC Section 1395x, shall be authorized, until October 1, [2000] 2001, to operate on a pilot basis a residence for terminally ill persons, for the purpose of providing hospice home care arrangements including, but not limited to, hospice home care services and supplemental services. Such arrangements shall be provided to those patients who would otherwise receive such care from family members. The residence shall provide a homelike atmosphere for such patients for a time period deemed appropriate for home health care services under like circumstances. Any hospice which operates a residence pursuant to the provisions of this section shall cooperate with the Commissioner of Public Health to develop standards for the licensure and operation of such homes.
Sec. 6. Subsection (b) of section 19a-195a of the general statutes is repealed and the following is substituted in lieu thereof:
(b) The commissioner shall adopt regulations, in accordance with the provisions of chapter 54, to (1) provide for state-wide standardization of certification for ["emergency medical technician-intermediate"] each class of (A) emergency medical technicians, including, but not limited to, paramedics, (B) emergency medical services instructors, and (C) medical response technicians, (2) allow course work for such certification to be taken state-wide, and (3) allow persons so certified to perform within their scope of certification state-wide.
Sec. 7. Subsection (a) of section 20-94a of the general statutes, as amended by section 2 of public act 99-168, is repealed and the following is substituted in lieu thereof:
(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: [satisfies the following requirements: (1) Maintains] (1) Is eligible for a license as a registered nurse in this state, as provided by section 20-93 or 20-94; (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. 8. Section 20-195c of the general statutes, as amended by section 53 of public act 99-2 of the June special session, is repealed and the following is substituted in lieu thereof:
(a) Each applicant for licensure as a marital and family therapist shall present to the department satisfactory evidence that [he] such applicant has: (1) Completed a graduate degree program specializing in marital and family therapy from a regionally accredited college or university or an accredited postgraduate clinical training program approved by the Commission on Accreditation for Marriage and Family Therapy Education and recognized by the United States Department of Education; (2) completed a minimum of twelve months of a supervised practicum or internship to be completed within a period not to exceed twenty-four consecutive months with emphasis in marital and family therapy supervised by the program granting the requisite degree or by an accredited postgraduate clinical training program, approved by the commission on accreditation for marriage and family therapy education recognized by the United States Department of Education in which the student received a minimum of five hundred direct clinical hours that included one hundred hours of clinical supervision; (3) completed a minimum of twelve months of relevant postgraduate experience, including at least (A) one thousand hours of direct client contact offering marital and family therapy services subsequent to being awarded a master's degree or doctorate or subsequent to the training year specified in subdivision (2) of this subsection, and (B) one hundred hours of postgraduate clinical supervision provided by a licensed marital and family therapist who is not directly compensated by such applicant for providing such supervision; and (4) passed an examination prescribed by the department. The fee shall be two hundred fifty dollars for each initial application. [Licenses may be renewed annually in accordance with the provisions of section 19a-88. The fee for such renewal shall be two hundred fifty dollars.]
(b) The department may grant licensure without examination, subject to payment of fees with respect to the initial application, to any applicant who is currently licensed or certified in another state as a marital or marriage and family therapist on the basis of standards which, in the opinion of the department, are substantially similar to or higher than those of this state. 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.
(c) Notwithstanding the requirements of this section, the commissioner shall, not later than February 6, 2000, grant a license as a marital and family therapist to any person who applies for licensure prior to January 1, 2000, and submits satisfactory evidence that the applicant has (1) a minimum of ten years of relevant experience as of January 1, 1998, including a minimum of five years work experience under an approved supervisor or approved substitute supervisor of the American Association for Marriage and Family Therapy or supervisor or substitute supervisor certified or licensed under this chapter, or (2) successfully completed, prior to January 1, 1985, either (A) a graduate degree program specializing in marital and family therapy or (B) an accredited postgraduate clinical training program approved by the Commission on Accreditation for Marriage and Family Therapy Education and recognized by the United States Department of Education.
(d) Licenses issued under this section may be renewed annually in accordance with the provisions of section 19a-88, as amended. The fee for such renewal shall be two hundred fifty dollars. Each licensed marital and family therapist applying for license renewal shall furnish evidence satisfactory to the commissioner of having participated in continuing education programs. The commissioner shall adopt regulations, in accordance with chapter 54, to (1) define basic requirements for continuing education programs, (2) delineate qualifying programs, (3) establish a system of control and reporting, and (4) provide for waiver of the continuing education requirement for good cause.
Sec. 9. Section 20-275 of the general statutes is repealed and the following is substituted in lieu thereof:
(a) Each person licensed under the provisions of this chapter shall register annually with the department in accordance with the provisions of section 19a-88, as amended, on forms provided by the department, such registration to be accompanied by a fee of fifty dollars.
(b) Each licensed hypertrichologist applying for license renewal shall furnish evidence satisfactory to the Commissioner of Public Health of having participated in continuing education programs. The commissioner shall adopt regulations, in accordance with chapter 54, to (1) define basic requirements for continuing education programs, (2) delineate qualifying programs, (3) establish a system of control and reporting, and (4) provide for waiver of the continuing education requirement for good cause.
Sec. 10. Section 38a-488a of the general statutes, as amended by section 27 of public act 99-284, is repealed and the following is substituted in lieu thereof:
(a) Each individual health insurance policy providing coverage of the type specified in subdivisions (1), (2), (4), (11) and (12) of section 38a-469 delivered, issued for delivery, renewed, amended or continued in this state on or after January 1, 2000, shall provide benefits for the diagnosis and treatment of mental or nervous conditions. For the purposes of this section, "mental or nervous conditions" means mental disorders, as defined in the most recent edition of the American Psychiatric Association's "Diagnostic and Statistical Manual of Mental Disorders". "Mental or nervous conditions" does not include (1) mental retardation, (2) learning disorders, (3) motor skills [disorder] disorders, (4) communication disorders, (5) caffeine-related disorders, (6) relational problems, and (7) additional conditions that may be a focus of clinical attention, that are not otherwise defined as mental disorders in the most recent edition of the American Psychiatric Association's "Diagnostic and Statistical Manual of Mental Disorders".
(b) No such policy shall establish any terms, conditions or benefits that place a greater financial burden on an insured for access to diagnosis or treatment of mental or nervous conditions than for diagnosis or treatment of medical, surgical or other physical health conditions.
(c) In the case of benefits payable for the services of a licensed physician, such benefits shall be payable for the same services when such services are lawfully rendered by a psychologist licensed under the provisions of chapter 383 or by such a licensed psychologist in a licensed hospital or clinic.
(d) [(1)] In the case of benefits payable for the services of a licensed physician or psychologist, such benefits shall be payable for the same services when such services are rendered by:
(1) [a] A clinical social worker who is licensed under the provisions of chapter 383b and who has passed the clinical examination of the American Association of State Social Work Boards and has completed at least two thousand hours of the post-master's social work experience in a nonprofit agency qualifying as a tax-exempt organization under Section 501(c) of the Internal Revenue Code of 1986 or any subsequent corresponding internal revenue code of the United States, as from time to time amended, in a municipal, state or federal agency or in an institution licensed by the Department of Public Health under section 19a-490; [. (2) In the case of benefits payable for the services of a licensed physician or psychologist, such benefits shall be payable for the same services when such services are rendered by]
(2) [a] A social worker who was certified as an independent social worker under the provisions of chapter 383b prior to October 1, 1990; [. (3) In the case of benefits payable for the services of a licensed physician or psychologist, such benefits shall be payable for the same services when such services are rendered by]
(3) [a] A licensed marital and family therapist who has completed at least two thousand hours of the post-master's marriage and family therapy work experience in a nonprofit agency qualifying as a tax-exempt organization under Section 501(c) of the Internal Revenue Code of 1986 or any subsequent corresponding internal revenue code of the United States, as from time to time amended, in a municipal, state or federal agency or in an institution licensed by the Department of Public Health under section 19a-490; [. (4) In the case of benefits payable for the services of a licensed physician or psychologist, such benefits shall be payable for the same services when such services are rendered by]
(4) [a] A marital and family therapist who was certified under the provisions of chapter 383a prior to October 1, 1992; [. (5) In the case of benefits payable for the services of a licensed physician or psychologist, such benefits shall be payable for the same services when such services are rendered by]
(5) [a] A licensed alcohol and drug counselor, as defined in section 20-74s, as amended, or a certified alcohol and drug counselor, as defined in section 20-74s, as amended; or
(6) A licensed professional counselor.
(e) For purposes of this section, the term "covered expenses" means the usual, customary and reasonable charges for treatment deemed necessary under generally accepted medical standards, except that in the case of a managed care plan, as defined in section 38a-478, "covered expenses" means the payments agreed upon in the contract between a managed care organization, as defined in section 38a-478, and a provider, as defined in section 38a-478.
(f) (1) In the case of benefits payable for the services of a licensed physician, such benefits shall be payable for (A) services rendered in a child guidance clinic or residential treatment facility by a person with a master's degree in social work or by a person with a master's degree in marriage and family therapy under the supervision of a psychiatrist, physician, licensed marital and family therapist, or licensed clinical social worker who is eligible for reimbursement under subdivisions (1) to (4), inclusive, of subsection (d) of this section; (B) services rendered in a residential treatment facility by a licensed or certified alcohol and drug counselor who is eligible for reimbursement under subdivision (5) of subsection (d) of this section; or (C) services rendered in a residential treatment facility by a licensed professional counselor who is eligible for reimbursement under subdivision (6) of subsection (d) of this section.
(2) In the case of benefits payable for the services of a licensed psychologist under subsection (d) of this section, such benefits shall be payable for (A) services rendered in a child guidance clinic or residential treatment facility by a person with a master's degree in social work or by a person with a master's degree in marriage and family therapy under the supervision of such licensed psychologist, licensed marital and family therapist, or licensed clinical social worker who is eligible for reimbursement under subdivisions (1) to (4), inclusive, of subsection (d) of this section; [. (3) In the case of benefits payable for the services of a licensed physician, such benefits shall be payable for services rendered in a residential treatment facility by a licensed or certified alcohol and drug counselor who is eligible for reimbursement under subdivision (5) of subsection (d) of this section. (4) In the case of benefits payable for the services of a licensed psychologist under subsection (d) of this section, such benefits shall be payable for] (B) services rendered in a residential treatment facility by a licensed or certified alcohol and drug counselor who is eligible for reimbursement under subdivision (5) of subsection (d) of this section; or (C) services rendered in a residential treatment facility by a licensed professional counselor who is eligible for reimbursement under subdivision (6) of subsection (d) of this section.
(g) In the case of benefits payable for the service of a licensed physician practicing as a psychiatrist or a licensed psychologist, under subsection (d) of this section, such benefits shall be payable for outpatient services rendered (1) in a nonprofit community mental health center, as defined by the Department of Mental Health and Addiction Services, in a nonprofit licensed adult psychiatric clinic operated by an accredited hospital or in a residential treatment facility; (2) under the supervision of a licensed physician practicing as a psychiatrist, a licensed psychologist, a licensed marital and family therapist, a licensed clinical social worker, [or] a licensed or certified alcohol and drug counselor or a licensed professional counselor who is eligible for reimbursement under subdivisions (1) to [(5)] (6), inclusive, of subsection (d) of this section; and (3) within the scope of the license issued to the center or clinic by the Department of Public Health or to the residential treatment facility by the Department of Children and Families.
(h) Except in the case of emergency services or in the case of services for which an individual has been referred by a physician affiliated with a health care center, nothing in this section shall be construed to require a health care center to provide benefits under this section through facilities that are not affiliated with the health care center.
(i) In the case of any person admitted to a state institution or facility administered by the Department of Mental Health and Addiction Services, Department of Public Health, Department of Children and Families or the Department of Mental Retardation, the state shall have a lien upon the proceeds of any coverage available to such person or a legally liable relative of such person under the terms of this section, to the extent of the per capita cost of such person's care. Except in the case of emergency services, the provisions of this subsection shall not apply to coverage provided under a managed care plan, as defined in section 38a-478.
Sec. 11. Section 38a-514 of the general statutes, as amended by section 28 of public act 99-284, is repealed and the following is substituted in lieu thereof:
(a) Except as provided in subsection (j) of this section, each group health insurance policy, providing coverage of the type specified in subdivisions (1), (2), (4), (11) and (12) of section 38a-469, delivered, issued for delivery, renewed, amended or continued in this state on or after January 1, 2000, shall provide benefits for the diagnosis and treatment of mental or nervous conditions. For the purposes of this section, "mental or nervous conditions" means mental disorders, as defined in the most recent edition of the American Psychiatric Association's "Diagnostic and Statistical Manual of Mental Disorders". "Mental or nervous conditions" does not include (1) mental retardation, (2) learning disorders, (3) motor skills [disorder] disorders, (4) communication disorders, (5) caffeine-related disorders, (6) relational problems, and (7) additional conditions that may be a focus of clinical attention, that are not otherwise defined as mental disorders in the most recent edition of the American Psychiatric Association's "Diagnostic and Statistical Manual of Mental Disorders".
(b) No such group policy shall establish any terms, conditions or benefits that place a greater financial burden on an insured for access to diagnosis or treatment of mental or nervous conditions than for diagnosis or treatment of medical, surgical or other physical health conditions.
(c) In the case of benefits payable for the services of a licensed physician, such benefits shall be payable for the same services when such services are lawfully rendered by a psychologist licensed under the provisions of chapter 383 or by such a licensed psychologist in a licensed hospital or clinic.
(d) [(1)] In the case of benefits payable for the services of a licensed physician or psychologist, such benefits shall be payable for the same services when such services are rendered by:
(1) [a] A clinical social worker who is licensed under the provisions of chapter 383b and who has passed the clinical examination of the American Association of State Social Work Boards and has completed at least two thousand hours of the post-master's social work experience in a nonprofit agency qualifying as a tax-exempt organization under Section 501(c) of the Internal Revenue Code of 1986 or any subsequent corresponding internal revenue code of the United States, as from time to time amended, in a municipal, state or federal agency or in an institution licensed by the Department of Public Health under section 19a-490; [. (2) In the case of benefits payable for the services of a licensed physician or psychologist, such benefits shall be payable for the same services when such services are rendered by]
(2) [a] A social worker who was certified as an independent social worker under the provisions of chapter 383b prior to October 1, 1990; [. (3) In the case of benefits payable for the services of a licensed physician or psychologist, such benefits shall be payable for the same services when such services are rendered by]
(3) [a] A licensed marital and family therapist who has completed at least two thousand hours of the post-master's marriage and family therapy work experience in a nonprofit agency qualifying as a tax-exempt organization under Section 501(c) of the Internal Revenue Code of 1986 or any subsequent corresponding internal revenue code of the United States, as from time to time amended, in a municipal, state or federal agency or in an institution licensed by the Department of Public Health under section 19a-490; [. (4) In the case of benefits payable for the services of a licensed physician or psychologist, such benefits shall be payable for the same services when such services are rendered by]
(4) [a] A marital and family therapist who was certified under the provisions of chapter 383a prior to October 1, 1992; [. (5) In the case of benefits payable for the services of a licensed physician or psychologist, such benefits shall be payable for the same services when such services are rendered by]
(5) [a] A licensed alcohol and drug counselor, as defined in section 20-74s, as amended, or a certified alcohol and drug counselor, as defined in section 20-74s, as amended; or
(6) A licensed professional counselor.
(e) For purposes of this section, the term "covered expenses" means the usual, customary and reasonable charges for treatment deemed necessary under generally accepted medical standards, except that in the case of a managed care plan, as defined in section 38a-478, "covered expenses" means the payments agreed upon in the contract between a managed care organization, as defined in section 38a-478, and a provider, as defined in section 38a-478.
(f) (1) In the case of benefits payable for the services of a licensed physician, such benefits shall be payable for (A) services rendered in a child guidance clinic or residential treatment facility by a person with a master's degree in social work or by a person with a master's degree in marriage and family therapy under the supervision of a psychiatrist, physician, licensed marital and family therapist or licensed clinical social worker who is eligible for reimbursement under subdivisions (1) to (4), inclusive, of subsection (d) of this section; (B) services rendered in a residential treatment facility by a licensed or certified alcohol and drug counselor who is eligible for reimbursement under subdivision (5) of subsection (d) of this section; or (C) services rendered in a residential treatment facility by a licensed professional counselor who is eligible for reimbursement under subdivision (6) of subsection (d) of this section.
(2) In the case of benefits payable for the services of a licensed psychologist under subsection (d) of this section, such benefits shall be payable for (A) services rendered in a child guidance clinic or residential treatment facility by a person with a master's degree in social work or by a person with a master's degree in marriage and family therapy under the supervision of such licensed psychologist, licensed marital and family therapist or licensed clinical social worker who is eligible for reimbursement under subdivisions (1) to (4), inclusive, of subsection (d) of this section; [. (3) In the case of benefits payable for the services of a licensed physician, such benefits shall be payable for services rendered in a residential treatment facility by a licensed or certified alcohol and drug counselor who is eligible for reimbursement under subdivision (5) of subsection (d) of this section. (4) In the case of benefits payable for the services of a licensed psychologist under subsection (d) of this section, such benefits shall be payable for] (B) services rendered in a residential treatment facility by a licensed or certified alcohol and drug counselor who is eligible for reimbursement under subdivision (5) of subsection (d) of this section; or (C) services rendered in a residential treatment facility by a licensed professional counselor who is eligible for reimbursement under subdivision (6) of subsection (d) of this section.
(g) In the case of benefits payable for the service of a licensed physician practicing as a psychiatrist or a licensed psychologist, under subsection (d) of this section, such benefits shall be payable for outpatient services rendered (1) in a nonprofit community mental health center, as defined by the Department of Mental Health and Addiction Services, in a nonprofit licensed adult psychiatric clinic operated by an accredited hospital or in a residential treatment facility; (2) under the supervision of a licensed physician practicing as a psychiatrist, a licensed psychologist, a licensed marital and family therapist, a licensed clinical social worker, [or] a licensed or certified alcohol and drug counselor, or a licensed professional counselor who is eligible for reimbursement under subdivisions (1) to [(5)] (6), inclusive, of subsection (d) of this section; and (3) within the scope of the license issued to the center or clinic by the Department of Public Health or to the residential treatment facility by the Department of Children and Families.
(h) Except in the case of emergency services or in the case of services for which an individual has been referred by a physician affiliated with a health care center, nothing in this section shall be construed to require a health care center to provide benefits under this section through facilities that are not affiliated with the health care center.
(i) In the case of any person admitted to a state institution or facility administered by the Department of Mental Health and Addiction Services, Department of Public Health, Department of Children and Families or the Department of Mental Retardation, the state shall have a lien upon the proceeds of any coverage available to such person or a legally liable relative of such person under the terms of this section, to the extent of the per capita cost of such person's care. Except in the case of emergency services the provisions of this subsection shall not apply to coverage provided under a managed care plan, as defined in section 38a-478.
(j) A group health insurance policy may exclude the benefits required by this section if such benefits are included in a separate policy issued to the same group by an insurance company, health care center, hospital service corporation, medical service corporation or fraternal benefit society. Such separate policy, which shall include the benefits required by this section and the benefits required by section 38a-533, as amended, shall not be required to include any other benefits mandated by this title.
(k) In the case of benefits based upon confinement in a residential treatment facility, such benefits shall be payable only in situations in which (A) the insured has a serious mental illness which substantially impairs the person's thought, perception of reality, emotional process, or judgment or grossly impairs behavior as manifested by recent disturbed behavior, (B) the insured has been confined in a hospital for such illness for a period of at least three days immediately preceding such confinement in a residential treatment facility, and (C) such illness would otherwise necessitate continued confinement in a hospital if such care and treatment were not available through a residential treatment center for children and adolescents.
(l) The services rendered for which benefits are to be paid for confinement in a residential treatment facility must be based on an individual treatment plan. For purposes of this section, the term "individual treatment plan" means a treatment plan prescribed by a physician with specific attainable goals and objectives appropriate to both the patient and the treatment modality of the program.
Sec. 12. Subsection (a) of section 6 of public act 99-168 is repealed and the following is substituted in lieu thereof:
(a) Each person licensed as an advanced practice registered nurse under the provisions of section 20-94a, as amended, who provides direct patient care services shall maintain professional liability insurance or other indemnity against liability for professional malpractice. The amount of insurance that 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. The provisions of this subsection shall not apply to any advanced practice registered nurse licensed pursuant to section 20-94a, as amended, and maintaining current certification from the American Association of Nurse Anesthetists who provides such services under the direction of a licensed physician.
Sec. 13. Section 40 of public act 99-284 is repealed and the following is substituted in lieu thereof:
Each individual health insurance policy providing coverage of the type specified in subdivisions (1), (2), (4), (11) and (12) of section 38a-469 delivered, issued for delivery, renewed or continued in this state on or after January 1, 2000, shall provide coverage for general anesthesia, nursing and related hospital services provided in conjunction with in-patient, outpatient or one day dental services if the following conditions are met:
(1) The anesthesia, nursing and related hospital services are deemed medically necessary by the treating dentist or oral surgeon and the patient's primary care physician in accordance with the health insurance policy's requirements for prior authorization of services; and
(2) The patient is either (A) a child under the age of four who is determined by a licensed dentist, in conjunction with a licensed physician who specializes in primary care, to have a dental condition of significant dental complexity that it requires certain dental procedures to be performed in a hospital, or (B) a person who has a developmental disability, as determined by a licensed physician who specializes in primary care, that places the person at serious risk. The expense of such anesthesia, nursing and related hospital services shall be deemed a medical expense under such health insurance policy and shall not be subject to any limits on dental benefits under such policy.
Sec. 14. Section 41 of public act 99-284 is repealed and the following is substituted in lieu thereof:
Each group health insurance policy providing coverage of the type specified in subdivisions (1), (2), (4), (11) and (12) of section 38a-469 delivered, issued for delivery, renewed or continued in this state on or after January 1, 2000, shall provide coverage for general anesthesia, nursing and related hospital services provided in conjunction with in-patient, outpatient or one day dental services if the following conditions are met:
(1) The anesthesia, nursing and related hospital services are deemed medically necessary by the treating dentist or oral surgeon and the patient's primary care physician in accordance with the health insurance policy's requirements for prior authorization of services; and
(2) The patient is either (A) a child under the age of four who is determined by a licensed dentist, in conjunction with a licensed physician who specializes in primary care, to have a dental condition of significant dental complexity that it requires certain dental procedures to be performed in a hospital, or (B) a person who has a developmental disability, as determined by a licensed physician who specializes in primary care, that places the person at serious risk. The expense of such anesthesia, nursing and related hospital services shall be deemed a medical expense under such health insurance policy and shall not be subject to any limits on dental benefits under such policy.
Sec. 15. (NEW) (a) As used in this section, "department" means the Department of Mental Retardation, the Department of Mental Health and Addiction Services, the Department of Public Health or the Office of Health Care Access, and "provider" means any independent contractor or private agency under contract with the department to provide services.
(b) Notwithstanding any provision of part II of chapter 10 of the general statutes or any regulation adopted or advisory opinion issued under said part, the department may invite a provider to participate in any informal policy-making committee, task force, work group or other ad hoc committee established by the department, and such participation shall not be deemed to be lobbying for purposes of said part.
Sec. 16. (NEW) (a) As used in this section, "emergency medical technician" means (1) any class of emergency medical technician certified under regulations adopted pursuant to section 19a-179 of the general statutes, including, but not limited to, any emergency medical technician-intermediate, and (2) any paramedic licensed pursuant to section 20-206ll of the general statutes.
(b) Any emergency medical technician who has been trained, in accordance with national standards recognized by the Commissioner of Public Health, in the administration of epinephrine using automatic prefilled cartridge injectors or similar automatic injectable equipment and who functions in accordance with written protocols and the standing orders of a licensed physician serving as an emergency department director may administer epinephrine using such injectors or equipment. All emergency medical technicians shall receive such training. All licensed or certified ambulances shall be equipped with epinephrine in such injectors or equipment which may be administered in accordance with written protocols and standing orders of a licensed physician serving as an emergency department director.
Sec. 17. Subsection (a) of section 12 of substitute house bill 5287 of the current session is repealed and the following is substituted in lieu thereof:
(a) Not later than February 1, 2001, the Commissioner of Public Health shall submit to the joint standing committee of the General Assembly having cognizance of matters relating to public health a plan of action for the implementation of a pilot program, in not more than two municipalities that consent to participate in such pilot program, to assess the effect of assigning a primary service area to a selected provider of emergency medical services based on the issuance of requests for proposals with a right of first refusal granted to the provider that holds the primary service area at the time of such issuance. The plan of action shall identify the elements of and the means of implementing the pilot program, including, but not limited to: (1) The procedure for selection of the participating municipalities; (2) the design and measurement of standards for the pilot program; (3) the identification of emergency service factors to be assessed; (4) the identification of the evaluating entity; and (5) the estimated time period for the implementation and completion of the pilot program. The commissioner shall hold a public hearing on the plan of action prior to such submission. The joint standing committee of the General Assembly having cognizance of matters relating to public health shall meet to consider the plan of action not later than sixty days after the date of its submission. If the plan of action is rejected by the committee, the commissioner shall submit a revised plan of action not later than ninety days after the date of such rejection. The committee shall approve a plan of action or amend and approve a plan of action not later than February 1, 2002.
Sec. 18. Notwithstanding the provisions of sections 19a-14 and 19a-88 of the general statutes, as amended, and sections 19a-14-1 to 19a-14-3, inclusive, of the Regulations of Connecticut State Agencies, any person previously licensed to practice as a registered nurse under chapter 378 of the general statutes whose license became void pursuant to section 19a-88 of the general statutes, as amended, solely for the failure to register and pay the annual professional services fee for 1998 or 1999, or both years, may apply to the Commissioner of Public Health for reinstatement of such license, and the commissioner shall reinstate such license without imposing any requirements or conditions other than the filing of such registration and the payment of such fee or fees.
Sec. 19. (NEW) (a) There is established an Advisory Commission on Services and Supports for Persons With Developmental Disabilities. The commission shall consist of: (1) One member appointed by the speaker of the House of Representatives and one member appointed by the president pro tempore of the Senate, who shall be members of the General Assembly; (2) one member appointed by the minority leader of the House of Representatives and one member appointed by the minority leader of the Senate, who shall be members of the General Assembly; (3) a representative of the Governor; (4) the Secretary of the Office of Policy and Management, or the secretary's designee; (5) the Commissioner of Mental Retardation, or the commissioner's designee; (6) the Commissioner of Mental Health and Addiction Services, or the commissioner's designee; (7) the Commissioner of Children and Families, or the commissioner's designee; (8) the Commissioner of Social Services, or the commissioner's designee; (9) the Commissioner of Education, or the commissioner's designee; and (10) sixteen persons who shall be individuals with developmental disabilities who do not have a condition defined as mental retardation pursuant to section 1-1g of the general statutes, as amended, representatives of providers of services to such individuals, or members of the families of or advocates for such individuals, three of whom shall be appointed by the speaker of the House of Representatives, three of whom shall be appointed by the president pro tempore of the Senate, three of whom shall be appointed by the minority leader of the House of Representatives, three of whom shall be appointed by the minority leader of the Senate, and four of whom shall be appointed by the Governor.
(b) The advisory commission shall advise the Commissioner of Mental Retardation concerning the need for services and supports for individuals with developmental disabilities who do not have a condition defined as mental retardation pursuant to section 1-1g of the general statutes, as amended. Such advice shall include, but not be limited to, (1) defining the population to be served, (2) identifying the types of services and supports needed, (3) identifying how such services and supports can best be delivered, and (4) identifying the costs of such services and supports.
(c) The Department of Mental Retardation shall, within available appropriations, provide such staff as is necessary for the performance of the functions and duties of the advisory commission.
Sec. 20. Section 17b-338 of the general statutes is repealed and the following is substituted in lieu thereof:
(a) There is established a Long-Term Care Advisory Council which shall consist of the following: (1) The executive director of the Commission on Aging, or [his] the executive director's designee; (2) the State Nursing Home Ombudsman, or [his] the ombudsman's designee; (3) the president of the Coalition of Presidents of Resident Councils, or [his] the president's designee; (4) the executive director of the Legal Assistance Resource Center of Connecticut, or [his] the executive director's designee; (5) one representative of the Connecticut Chapter of the American Association of Retired Persons, appointed by the president of [said] the chapter; (6) one representative of a bargaining unit for health care employees, appointed by the president of [such] the bargaining unit; (7) the president of the Connecticut Association of Not-For-Profit Providers for the Aging, or [his] the president's designee; (8) the president of the Connecticut Association of Health Care Facilities, or [his] the president's designee; [and] (9) the president of the Connecticut Association of Licensed Homes for the Aged, or [his] the president's designee; (10) the president of the Connecticut Hospital Association or the president's designee; (11) the executive director of the Connecticut Assisted Living Association or the executive director's designee; (12) the executive director of the Connecticut Homecare Association or the executive director's designee; (13) the president of Connecticut Community Care, Inc. or the president's designee; (14) one member of the Connecticut Association of Area Agencies on Aging appointed by the agency; (15) the executive director of the Connecticut Alzheimer's Association or the executive director's designee; (16) one member of the Adult Day Care Association appointed by the association; (17) the president of the Connecticut Chapter of the American College of Health Care Administrators, or the president's designee; (18) the president of the Connecticut Council for Persons with Disabilities, or the president's designee; and (19) the president of the Connecticut Association of Community Action Agencies, or the president's designee.
(b) The council shall advise and make recommendations to the Long-Term Care Planning Committee established under section 17b-337, as amended.
Sec. 21. This act shall take effect from its passage, except that section 17 shall take effect July 1, 2000, section 19 shall take effect October 1, 2000, and section 16 shall take effect January 1, 2001.
Approved May 26, 2000